A Systematic Review of the Efficacy and Safety of Over-the-Counter Medications Used in Older People for the Treatment of Primary insomnia

2021 ◽  
Vol 36 (2) ◽  
pp. 83-91
Author(s):  
Sandrah-Ann M. Almond ◽  
Madelyne J. Warren ◽  
Kayce M. Shealy ◽  
Tiffaney B. Threatt ◽  
Eileen D. Ward
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Older People ◽  
Positive Impact ◽  
Data Extraction ◽  
Sleep Time ◽  
Outpatient Setting ◽  
Primary Insomnia ◽  
Over The Counter ◽  
Safety Issues

OBJECTIVE: The purpose of this systematic review is to evaluate the available evidence for safety and efficacy of over-the-counter (OTC) sleep aids used for the treatment of insomnia in older people.<br/> DATA SOURCES: PubMed, EBSCO, and International Pharmaceutical Abstracts.<br/> STUDY SELECTION: Five studies were included that involved humans 65 years of age and older being evaluated on OTC sleep aids in the outpatient setting.<br/> DATA EXTRACTION: Data extraction from each study included primary and secondary efficacy endpoints, such as differences in the mean total sleep time, sleep latency, sleep efficiency, and number of awakenings, along with safety endpoints, such as psychomotor ability, cognitive ability, and adverse effect profiles. Both subjective and objective measures of changes in sleep and adverse effects were included.<br/> DATA SYNTHESIS: Diphenhydramine had a statistically significant increase in sedation and decrease in number of awakenings but was not shown to be any less or more safe than compared products. Despite lacking safety issues, valerian was found to have no effect on subjective or objective sleep outcomes. Overall, melatonin had the most evidence and was found to have a statistically significant positive impact on sleep measures without safety issues.<br/> CONCLUSION: Diphenhydramine and melatonin appear to be efficacious in improving some sleep measures while causing minimal adverse effects. However, there are very few studies that examine the use of over-the-counter sleep aids in those 65 years of age and older with primary insomnia. Additional studies are needed in this population.

scholarly journals A Systematic Review of the Efficacy and Safety of Over-the-Counter Medications Used in Older People for the Treatment of Primary Insomnia

2021 ◽  
Vol 36 (2) ◽  
pp. 83-92
Author(s):  
Sandrah-Ann M. Almond ◽  
Madelyne J. Warren ◽  
Kayce M. Shealy ◽  
Tiffaney B. Threatt ◽  
Eileen D. Ward
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Older People ◽  
Positive Impact ◽  
Data Extraction ◽  
Sleep Time ◽  
Outpatient Setting ◽  
Primary Insomnia ◽  
Over The Counter ◽  
Safety Issues

Objective The purpose of this systematic review is to evaluate the available evidence for safety and efficacy of over-the-counter (OTC) sleep aids used for the treatment of insomnia in older people. Data Sources PubMed, EBSCO, and International Pharmaceutical Abstracts. Study Selection: Five studies were included that involved humans 65 years of age and older being evaluated on OTC sleep aids in the outpatient setting. Data Extraction Data extraction from each study included primary and secondary efficacy endpoints, such as differences in the mean total sleep time, sleep latency, sleep efficiency, and number of awakenings, along with safety endpoints, such as psychomotor ability, cognitive ability, and adverse effect profiles. Both subjective and objective measures of changes in sleep and adverse effects were included. Data Synthesis Diphenhydramine had a statistically significant increase in sedation and decrease in number of awakenings but was not shown to be any less or more safe than compared products. Despite lacking safety issues, valerian was found to have no effect on subjective or objective sleep outcomes. Overall, melatonin had the most evidence and was found to have a statistically significant positive impact on sleep measures without safety issues. Conclusion Diphenhydramine and melatonin appear to be efficacious in improving some sleep measures while causing minimal adverse effects. However, there are very few studies that examine the use of over-the-counter sleep aids in those 65 years of age and older with primary insomnia. Additional studies are needed in this population.

scholarly journals Non-Immersive Virtual Reality for Rehabilitation of the Older People: A Systematic Review into Efficacy and Effectiveness

2019 ◽  
Vol 8 (11) ◽  
pp. 1882 ◽  
Author(s):  
Bevilacqua ◽  
Maranesi ◽  
Riccardi ◽  
Donna ◽  
Pelliccioni ◽  
...  
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Older People ◽  
Randomized Controlled Trials ◽  
Cognitive Abilities ◽  
Positive Impact ◽  
Data Extraction ◽  
Future Research ◽  
Controlled Trials ◽  
Randomized Controlled

: Objective: the objective of this review is to analyze the advances in the field of rehabilitation through virtual reality, while taking into account non-immersive systems, as evidence have them shown to be highly accepted by older people, due to the lowest “cibersikness” symptomatology. Data sources: a systematic review of the literature was conducted in June 2019. The data were collected from Cochrane, Embase, Scopus, and PubMed databases, analyzing manuscripts and articles of the last 10 years. Study selection: we only included randomized controlled trials written in English aimed to study the use of the virtual reality in rehabilitation. We selected 10 studies, which were characterized by clinical heterogeneity. Data extraction: quality evaluation was performed based on the Physioterapy Evidence Database (PEDro) scale, suggested for evidence based review of stroke rehabilitation. Of 10 studies considered, eight were randomized controlled trials and the PEDro score ranged from four to a maximum of nine. Data synthesis: VR (Virtual Reality) creates artificial environments with the possibility of a patient interaction. This kind of experience leads to the development of cognitive and motor abilities, which usually positively affect the emotional state of the patient, increasing collaboration and compliance. Some recent studies have suggested that rehabilitation treatment interventions might be useful and effective in treating motor and cognitive symptoms in different neurological disorders, including traumatic brain injury, multiple sclerosis, and progressive supranuclear palsy. Conclusions: as it is shown by the numerous studies in the field, the application of VR has a positive impact on the rehabilitation of the most predominant geriatric syndromes. The level of realism of the virtual stimuli seems to have a crucial role in the training of cognitive abilities. Future research needs to improve study design by including larger samples, longitudinal designs, long term follow-ups, and different outcome measures, including functional and quality of life indexes, to better evaluate the clinical impact of this promising technology in healthy old subjects and in neurological patients.

scholarly journals The Safety and Efficacy of Phage Therapy for Superficial Bacterial Infections: A Systematic Review

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 754
Author(s):  
Angharad Steele ◽  
Helen J. Stacey ◽  
Steven de Soir ◽  
Joshua D. Jones
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Bacterial Infections ◽  
Chronic Wound ◽  
Phage Therapy ◽  
Data Extraction ◽  
Primary Data ◽  
Burn Wound ◽  
Promising Alternative ◽  
Safety And Efficacy

Superficial bacterial infections, such as dermatological, burn wound and chronic wound/ulcer infections, place great human and financial burdens on health systems globally and are often complicated by antibiotic resistance. Bacteriophage (phage) therapy is a promising alternative antimicrobial strategy with a 100-year history of successful application. Here, we report a systematic review of the safety and efficacy of phage therapy for the treatment of superficial bacterial infections. Three electronic databases were systematically searched for articles that reported primary data about human phage therapy for dermatological, burn wound or chronic wound/ulcer infections secondary to commonly causative bacteria. Two authors independently assessed study eligibility and performed data extraction. Of the 27 eligible reports, eight contained data on burn wound infection (n = 156), 12 on chronic wound/ulcer infection (n = 327) and 10 on dermatological infections (n = 1096). Cautionary pooled efficacy estimates from the studies that clearly reported efficacy data showed clinical resolution or improvement in 77.5% (n = 111) of burn wound infections, 86.1% (n = 310) of chronic wound/ulcer infections and 94.14% (n = 734) of dermatological infections. Over half of the reports that commented on safety (n = 8/15), all published in or after 2002, did not express safety concerns. Seven early reports (1929–1987), described adverse effects consistent with the administration of raw phage lysate and co-administered bacterial debris or broth. This review strongly suggests that the use of purified phage to treat superficial bacterial infections can be highly effective and, by various routes of administration, is safe and without adverse effects.

scholarly journals Pengaruh Pelatihan Komunikasi Terapeutik terhadap Kepuasan Pasien : A Systematic Review

2020 ◽  
Vol 11 (2) ◽  
pp. 125
Author(s):  
Agostinha Soares ◽  
Kusnanto Kusnanto ◽  
Ninuk Dian Kurniawati
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Positive Impact ◽  
Data Extraction ◽  
Quality Care ◽  
Communication Training ◽  
Therapeutic Communication ◽  
Communication Performance ◽  
Patient’S Satisfaction ◽  
Poor Outcomes

Background: Communication is an important element of quality care that can help build a nurse-patient relationship. Good nurse-patient communication has the potential to increase patient understanding of treatment plans and reduce behaviors that lead to poor outcomes. Not appreciating the importance of people-centered communication and improper communication training can result in unsatisfactory communication performance. Objective: Knowing the effect of therapeutic communication training on patient satisfaction Methods: The database used in this systematic review were taken from Scopus, Science direct, Proquest and Pubmed, journals were limited to the 2013-2019 publication year in the area of nursing medicine journals, as well as English journals. This systematic review used 9 articles that fitted the inclusion criteria. Critical appraisal and data extraction were performed independently by two different authors, there was a difference in results, the consensus was opted to solve the differences. Results: From 9 selected articles found that training varies between 50%-80% there was an influence on patient satisfaction. Therapeutic communication training had a positive impact on hospital services. Conclusion: Therapeutic communication training improves skills, encourages, supports, strengthens therapeutic communication, communication training reduces poor nurse interaction behavior and can increase patient satisfaction. Keywords: training; therapeutic communication; patient's satisfaction ABSTRAK Latar belakang: Komunikasi adalah elemen penting dari perawatan yang berkualitas dapat membantu membangun hubungan perawat-pasien. Komunikasi perawat-pasien yang baik memiliki potensi untuk meningkatkan pemahaman pasien tentang rencana perawatan dan mengurangi perilaku yang mengarah pada hasil yang buruk. Kurang menghargai pentingnya komunikasi yang berpusat pada orang dan pelatihan komunikasi yang tidak tepat dapat mengakibatkan kinerja komunikasi yang tidak memuaskan. Tujuan: Mengetahui pengaruh pelatihan komunikasi terapeutik terhadap kepuasan pasien Metode: Database yang digunakan dalam systematic review ini adalah scopus, science direct, proques dan pubmed, journal dibatasi dengan tahun publikasi 2013-2019 dengan area jurnal nursing medicine, serta jurnal berbahasa Inggris. Systematic review ini menggunakan 9 artikel yang sesuai dengan kriteria inklusi. Telaah artikel dan ekstraksi data dilakukan secara terpisah oleh dua peneliti, jika terdapat perbedaan, maka hasil diambil secara consensus. Hasil Dari 9 artikel terpilih ditemukan bahwa pelatihan bervariasi antara50%-80% ada pengaruh terhadap kepuasan pasien. Pelatihan komunikasi terapeutik memberikan dampak yang positif terhadap pelayanan rumah sakit. Simpulan: pelatihan komunikasi terapeutik meningkatkan keterampilan, mendorong, mendukung, memperkuat komunikasi terapeutik, pelatihan komunikasi mengurangi perilaku interaksi perawat yang buruk dan bisa meningkatkan kepuasan pasien Kata kunci: pelatihan; komunikasi terapeutik; kepuasan pasien

scholarly journals Effects of cosmetic and other camouflage interventions on appearance-related and psychological outcomes among adults with visible differences in appearance: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e046634
Author(s):  
Shadi Gholizadeh ◽  
Danielle B Rice ◽  
Andrea Carboni-Jiménez ◽  
Linda Kwakkenbos ◽  
Jill Boruff ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Adverse Effects ◽  
Data Extraction ◽  
Routine Care ◽  
Psychological Outcomes ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
Randomised Controlled ◽  
Poor Reporting

ObjectiveVisible differences in appearance are associated with poor social and psychological outcomes. Effectiveness of non-surgical cosmetic and other camouflage interventions is poorly understood. The objective was to evaluate effects of cosmetic and other camouflage interventions on appearance-related outcomes, general psychological outcomes and adverse effects for adults with visible appearance differences.DesignSystematic review.Data sourcesMEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid) CINAHL and Cochrane Central databases searched from inception to 24 October 2020. Two reviewers independently reviewed titles and abstracts and full texts.Eligibility criteriaRandomised controlled trials in any language on non-surgical cosmetic or other camouflage interventions that reported appearance-related outcomes, general psychological outcomes or adverse effects for adults with visible appearance differences.Data extraction and synthesisTwo reviewers independently extracted data, assessed intervention reporting using the Template for Intervention Description and Replication checklist, and assessed risk of bias using the Cochrane risk of bias tool. Outcomes included appearance-related outcomes, general psychological outcomes (eg, depression, anxiety) and adverse effects.ResultsOne head-to-head trial and five trials with waiting list or routine care comparators were included. All had unclear or high risk of bias in at least five of seven domains. Effect sizes could not be determined for most outcomes due to poor reporting. Between-group statistically significant differences were not reported for any appearance-related outcomes and for only 5 of 25 (20%) other psychological outcomes. Given heterogeneity of populations and interventions, poor reporting and high risk of bias, quantitative synthesis was not possible.ConclusionsConclusions about effectiveness of non-surgical cosmetic or other camouflage interventions could not be drawn. Well-designed and conducted trials are needed. Without such evidence, clinicians or other qualified individuals should engage with patients interested in cosmetic interventions in shared decision making, outlining potential benefits and harms, and the lack of evidence to inform decisions.PROSPERO registration numberCRD42018103421.

scholarly journals Medication Review in Preventing Older Adults’ Fall-Related Injury: a Systematic Review & Meta-Analysis

2021 ◽  
Vol 24 (3) ◽  
pp. 237-250
Author(s):  
Yu Ming ◽  
Aleksandra A. Zecevic ◽  
Susan W. Hunter ◽  
Wenxin Miao ◽  
Rommel G. Tirona
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Medication Review ◽  
Positive Impact ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Difference ◽  
Community Dwelling ◽  
Randomized Controlled Studies ◽  
Community Dwelling Older Adults

Background Medication review is essential in managing adverse drug reactions and improving drug safety in older adults. This systematic review evaluated medication review’s role as a single intervention or combined with other interventions in preventing fall-related injuries in older adults. Methods Electronic databases search was conducted in PubMed, EMBASE, Scopus, and CINAHL. Two reviewers screened titles and abstracts, reviewed full texts, and performed data extraction and risk of bias assessment. Meta-analyses were conducted on studies with similar participants, interventions, outcomes or settings. Results Fourteen randomized, controlled studies were included. The pooled results indicated that medication review as a stand-alone intervention was effective in preventing fall-related injuries in community-dwelling older adults (Risk Difference [RD] = -0.06, 95% CI: [-0.11, -0.00], I2 = 61%, p = .04). Medication review also had a positive impact on decreasing the risk of fall-related fractures (RD = -0.02, 95% CI: [-0.04, -0.01], I2 = 0%, p = .01). Discussion This systematic review and meta-analysis has demonstrated that medication review is effective in preventing fall-related injuries in general, and fractures specifically, in community-dwelling older adults. Future investigations focusing on the process of performing medication review will further inform fall-related injury prevention for older adults.

Relationship between knowledge sharing and job satisfaction: a systematic review

2018 ◽  
Vol 119 (5/6) ◽  
pp. 295-312 ◽  
Author(s):  
Ghulam Murtaza Rafique ◽  
Khalid Mahmood
Keyword(s):  
Systematic Review ◽  
Job Satisfaction ◽  
Knowledge Sharing ◽  
English Language ◽  
Positive Impact ◽  
Data Extraction ◽  
Google Scholar ◽  
Content Type ◽  
Language Studies ◽  
The Relationship

Purpose The purpose of this study was to systematically collect and review the English language studies that provided empirical evidence for the existence of relationship between knowledge sharing (KS) and job satisfaction (JS) and their impact on each other. Design/methodology/approach A systematic review of the literature was conducted searching Google Scholar, LISTA, ISI Web of Knowledge, Scopus and ProQuest Dissertation and Theses. Searches were completed through March 2017. Language limit was applied; and manual searching from review articles and some key studies using backward and forward citation from Google Scholar was also completed. Studies determining the relationship or correlation between KS and JS were included and books were excluded in this review. Data extraction and critical appraisal were performed to determine the risk of bias of each study. Findings The findings clearly reveal that these two variables had a significant relationship with and were influenced by each other. It is concluded that KS had a positive impact on JS and, similarly, JS had strong effect on KS among the individuals working in different organizations. Originality/value This review is first to examine the relationship between KS and JS and their impact on each other by systematically collecting and reviewing the English language studies. This study has theoretical and practical implications for managers and HR departments.

scholarly journals Senna alata (akapulko) Extract versus Topical Antifungals for Treatment of Superficial Fungal Skin Infections: a Systematic Review and Meta-analysis

2020 ◽  
Vol 54 (1) ◽  
Author(s):  
Erin Jane L. Tababa ◽  
Rowena Natividad S. Flores-Genuino ◽  
Charissa Mia D. Salud-Gnilo
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Sodium Thiosulfate ◽  
Skin Infections ◽  
Efficacy And Safety ◽  
Mycologic Cure ◽  
Meta Analyses ◽  
Senna Alata

Objective. The study aimed to assess the efficacy and safety of Senna alata (akapulko) plant extracts compared with topical antifungals in the treatment of superficial fungal skin infections. Methods. A systematic review and meta-analysis of randomized controlled trials that studied patients with diagnosed cutaneous tinea or dermatophytosis (excluding hair and nail), tinea versicolor, or cutaneous candidiasis, via microscopy or culture, and compared the efficacy and safety of S. alata (akapulko) extract versus topical antifungals. Two authors independently screened titles and abstracts of merged search results from electronic databases (The Cochrane Skin Group Specialized Register, CENTRAL, MEDLINE, EMBASE (January 1990 to December 2011), Health Research and Development Information Network (HERDIN), and reference lists of articles), assessed eligibility, assessed the risk of bias using the domains in the Cochrane Risk Bias tool and collected data using a pretested Data extraction form (DEF). Meta-analyses were performed when feasible. Results. We included seven RCTs in the review. There is low certainty of evidence that S. alata 50% lotion is as efficacious as sodium thiosulfate 25% lotion (RR 0.91, 95% CI, 0.79 to 1.04; 4 RCTs, n=216; p=0.15; I2=52%) and high quality evidence that S. alata cream is as efficacious as ketoconazole (RR 0.95, 95% CI, 0.82 to 1.09; 1 RCT, n=40; p=0.44) and terbinafine cream (RR 0.93, 95% CI, 0.86 to 1.01; 1 RCT, n=150; p=0.09) in mycologic cure. For adverse effects, there is very low certainty of evidence of increased harm with S. alata 50% lotion compared to sodium thiosulfate 25% lotion (RR 1.26, 95% CI, 0.46, 3.44; 2 RCTs, n=120; p=0.65; I2=19%). Adverse effects were few and mild. Conclusion. S. Alata 50% lotion may be as efficacious as sodium thiosulfate 25% lotion and is as efficacious as ketoconazole 2% and terbinafine 1% creams. There is insufficient evidence to compare the safety of S. alata 50% lotion with sodium thiosulfate 25% lotion

scholarly journals Opioid-Free Analgesia for Supratentorial Craniotomies: A Systematic Review

2019 ◽  
Vol 46 (04) ◽  
pp. 415-422 ◽  
Author(s):  
Denise Darmawikarta ◽  
Michel Sourour ◽  
Rachel Couban ◽  
Sriganesh Kamath ◽  
Kesava KV Reddy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Relief ◽  
Adverse Effects ◽  
Data Extraction ◽  
Multimodal Analgesia ◽  
Opioid Analgesia ◽  
Rescue Analgesia ◽  
Pain Scores ◽  
Study Selection ◽  
Post Operative Nausea

ABSTRACT:Background: Post-craniotomy pain can be severe and is often undermanaged. Opioids can interfere with neurological monitoring and are associated with adverse effects. This systematic review aimed to identify measures of opioid-free analgesia and compare their effectiveness with opioid analgesia for post-craniotomy pain in patients with supratentorial tumors. Methods: EMBASE, MEDLINE, and Cochrane databases were searched from their inception to February 14, 2017, for randomized controlled trials (RCTs) evaluating opioid versus non-opioid analgesia post-supratentorial craniotomy. Two reviewers independently carried out study selection and data extraction. Risk of bias assessment was performed using the Cochrane Collaboration’s tool. Outcomes were pain control (changes to pain scores or use of rescue analgesia) and adverse effects. Considering the number of studies and heterogeneity, a narrative synthesis was done without pooling and results were summarized using tables. Non-opioids were assessed for the potential to be equivalent to opioid-based analgesics for pain relief and adverse effects. Results: Of 467 RCTs, 4 met our inclusion criteria (n = 186 patients). Patients with scalp blocks (2 RCTs) had less post-operative nausea and vomiting (PONV), but scalp block was not superior to morphine for analgesia. Acetaminophen (1 RCT) was less likely to induce PONV but provided inadequate pain relief compared to morphine and sufentanil. Dexmedetomidine (1 RCT) was not superior to remifentanil for analgesia although it delayed time to rescue analgesia. Conclusions: Limited evidence suggests that scalp blocks and dexmedetomidine have the potential to eliminate the need for opioid analgesia. Multimodal analgesia should be considered as significant opioid-sparing effects have been shown.

720 Actigraphy to Evaluate Sleep in the Inpatient Setting: A Systematic Review

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A281-A281
Author(s):  
Sarah Sussman ◽  
Elie Fares ◽  
Ashwin Ananth ◽  
Maurits Boon ◽  
Zhanna Fast ◽  
...  
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
English Language ◽  
Meta Analysis ◽  
Hospital Setting ◽  
Sleep Time ◽  
Outpatient Setting ◽  
Outpatient Rehabilitation ◽  
Inpatient Setting ◽  
Language Studies

Abstract Introduction Sleep disruption is common among hospitalized patients due to psychological, physiological, and environmental reasons including illness, pain, anxiety, invasive interventions, frequent monitoring, and stimuli, especially noise and light. The AASM has published guidelines for the use of actigraphy in the outpatient setting, but there is a paucity of literature evaluating the validity of actigraphy in inpatients. We sought to summarize the evidence surrounding the use of actigraphy for inpatient sleep evaluation. Methods Systematic review was conducted according to the Preferred Reporting of Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Databases were queried by two independent reviewers for English-language studies published between 1990 and 2020. The initial search screened for all occurrences of “actigraphy AND sleep AND hospital” then was further refined to include studies of actigraphy used for monitoring in the inpatient hospital setting and exclude studies evaluating actigraphy in outpatient, rehabilitation, immediate postoperative, or intensive care unit settings. Results 1221 were screened from initial search results. 48 articles were identified through screening of abstracts. Full-text review of the articles was then completed. Of the 48 articles, a total of 12 studies examined general medical inpatients, 12 studies examined inpatients with neurologic disorders, 5 studies examined inpatients with cancer, 6 studies examined patients with mental illness, 9 studies examined elderly patients, and 4 studies examined other defined populations (pregnancy, trauma, liver transplantation, and hip arthroplasty). We summarize the qualitative findings of inpatient actigraphy as it relates to each of these populations. Commonly reported outcome measures were total sleep time (TST), number of nighttime awakenings, and concordance with polysomnography (PSG). Conclusion We summarize the existing evidence for the use of actigraphy in the inpatient setting. Actigraphy may provide a simple and effective method for screening of sleep disorders in the inpatient setting. With regard to the published literature, there is support for the use of actigraphy in the inpatient setting in certain patient populations, especially traumatic brain injury. Variation in data output of actigraphy devices and outcome measures presents a barrier to meta-anaylsis of pooled data. Standardization of outcome measures will allow for effective synthesis of future studies. Support (if any):

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