Vertigo and Dizziness in Children: An Update

Background: Vertigo and dizziness are relatively infrequent in paediatric patients, but specific data on the prevalence of these disorders are limited and influenced by various factors, including the age of the examined population. These conditions often have a significant impact on patients’ and parents’ quality of life. The aim of this paper is to investigate the prevalence of different aetiologies of vertigo in the paediatric population through a systematic review. Methods: According to PRISMA guidelines, a systematic review of the literature was performed. Medline and Embase were searched from January 2011 through to 10 September 2021. The search yielded 1094 manuscripts, which were reduced to 7 upon the application of inclusion criteria. Results: A total of 2470 paediatric patients were evaluated by the selected papers. Vestibular Migraine was the most frequently diagnosed condition, occurring alone or in association with other diseases. Overall, audio-vestibular disorders represented the second cause of vertigo, and the prevalence appears to increase according to age growth. Over the years, even though we assisted in the amelioration of diagnostic rates, partially related to an improvement in diagnostic tools, the aetiology of vertigo remains still unclear in a variable percentage of patients. Conclusion: Vertigo in children, despite being an uncommon symptom, requires a multidisciplinary approach, often involving Paediatricians, Neurologists and Otorhinolaryngologists. A comprehensive evaluation of children suffering from vertigo is crucial for establishing a successful therapy and reducing parental worries.

Paper 3: Selecting rapid review methods for complex questions related to health policy and system issues

Approaches for rapid reviews that focus on streamlining systematic review methods are not always suitable for exploring complex policy questions, as developing and testing theories to explain these complexities requires configuring diverse qualitative, quantitative, and mixed methods studies. Our objective was therefore to provide a guide to selecting approaches for rapidly (i.e., within days to months) addressing complex questions related to health policy and system issues.We provide a two-stage, transdisciplinary collaborative process to select a rapid review approach to address complex policy questions, which consists of scoping the breadth and depth of the literature and then selecting an optimal approach to synthesis. The first stage (scoping the literature) begins with a discussion with the stakeholders requesting evidence to identify and refine the question for the review, which is then used to conduct preliminary searches and conceptually map the documents identified. In the second stage (selection of an optimal approach), further stakeholder consultation is required to refine and tailor the question and approach to identifying relevant documents to include. The approach to synthesizing the included documents is then guided by the final question, the breadth and depth of the literature, and the time available and can include a static or evolving conceptual framework to code and analyze a range of evidence. For areas already covered extensively by existing systematic reviews, the focus can be on summarizing and integrating the review findings, resynthesizing the primary studies, or updating the search and reanalyzing one or more of the systematic reviews.The choice of approaches for conducting rapid reviews is intertwined with decisions about how to manage projects, the amount of work to be done, and the knowledge already available, and our guide offers support to help make these strategic decisions.

Developing, Implementing, and Applying Novel Techniques During Systematic Reviews of Primary Space Medicine Data

BACKGROUND: The Aerospace Medicine Systematic Review Group was set up in 2016 to facilitate high quality and transparent synthesis of primary data to enable evidence-based practice. The group identified many research methods specific to space medicine that need consideration for systematic review methods. The group has developed space medicine specific methods to address this and trialed usage of these methods across seven published systematic reviews. This paper outlines evolution of space medicine synthesis methods and discussion of their initial application.METHODS: Space medicine systematic review guidance has been developed for protocol planning, quantitative and qualitative synthesis, sourcing gray data, and assessing quality and transferability of space medicine human spaceflight simulation study environments.RESULTS: Decision algorithms for guidance and tool usage were created based on usage. Six reviews used quantitative methods in which no meta-analyses were possible due to lack of controlled trials or reporting issues. All reviews scored the quality and transferability of space simulation environments. One review was qualitative. Several research gaps were identified.CONCLUSION: Successful use of the developed methods demonstrates usability and initial validity. The current space medicine evidence base resulting in no meta-analyses being possible shows the need for standardized guidance on how to synthesize data in this field. It also provides evidence to call for increasing use of controlled trials, standardizing outcome measures, and improving minimum reporting standards. Space medicine is a unique field of medical research that requires specific systematic review methods.Winnard A, Caplan N, Bruce-Martin C, Swain P, Velho R, Meroni R, Wotring V, Damann V, Weber T, Evetts S, Laws J. Developing, implementing, and applying novel techniques during systematic reviews of primary space medicine data. Aerosp Med Hum Perform. 2021; 92(8):681688.

Studi Literatur: Hubungan Pengetahuan dengan Stigma pada Penderita HIV/AIDS (ODHA)

HIV/AIDS is a disease that has become a pandemic and worries people all over the world, because until now there has not been found a vaccine or drug for the prevention of HIV/AIDS. HIV positive cases in Indonesia from year to year have increased. The problems faced by people with HIV/AIDS are very complex. Every day the patient's condition will get weaker if he does not take medication regularly because the HIV virus will attack the patient's immune system. In addition, the stigma and discrimination of the surrounding community are also a burden that must be borne by people with HIV AIDS. The stigma makes HIV sufferers worse, with this stigma, HIV sufferers are ashamed to seek treatment at a health service. This writing is to determine the relationship between knowledge and stigma against people living with HIV/AIDS (PLWHA) through a review of various literature with the same theme. The method used in this paper uses rivew literature. This type of research uses systematic review. The study design used retrospective, prospective and systematic review methods. There is a relationship between knowledge and stigma against PLWHA. People with low knowledge tend to stigmatize people with HIV.

What Contributes to the Variation of Dairy Recommendations in Global Food-Based Dietary Guidelines

Objectives Dairy consumption remains controversial due to uncertainty about its health impacts and effects on food sustainability. There are variations in dairy recommendations in global food-based dietary guidelines (FBDGs). Yet, how methods used to develop recommendations contribute to such variation is unknown. In this study, we assessed this dietary context in dairy recommendations. Methods We search the FBDG database at the Food and Agricultural Organization website in 2019 to identify dietary guidelines published since 2009. Eligible guidelines needed to include dietary recommendations and describe the guideline development processes. Protocols for this review were registered (CRD42019125258; CRD42019126452) and published previously. Two reviewers independently reviewed the guidelines and extracted information on dairy recommendations. Systematic review methods, quality of evidence assessment, evidence underpinning the recommendations, and information on health equity were evaluated. We used descriptive statistics to summarize the findings. Results We included 26 eligible FBDGs, including the Dietary Guidelines for Americans 2020–2025. Serving sizes of dairy recommendations varied, ranging from 1 ser/d (11.5%) to 3–5 ser/d (3.9%), with 27% of the guidelines recommending 2 ser/d and another 27% having no or unclear recommendations. The majority of the guidelines (n = 19, 73%) endorsed low-fat or skimmed fat dairy, while 7 (27%) did not emphasize fat contents. All guidelines recommended dairy as a dietary source for calcium (n = 16, 61.5%) and/or vitamin D (n = 10, 38.5%). Only 8 guidelines (31%) recommended dairy alternatives, among which 4 (18%) recommended soy products. Systematic review methods and evidence quality assessment were implemented in 5 guidelines (19%). Only 12 guidelines (46%) considered health equity to address cultural/regional aspects to formulate dietary recommendations. Conclusions Most dietary guidelines recommend reduced-fat dairy consumption, but only 31% recommend plant-based protein as dairy alternatives, despite lactose intolerance and food sustainability as global concerns. Methodological rigor in the evidence base and health equity considerations remain a challenge in dietary guideline development. Funding Sources The Australian National Health and Medical Research Council.

Implantable cardioverter defibrillator devices: when, how and who should discuss deactivation with patients: a systematic literature review

BackgroundImplantable cardioverter defibrillators (ICDs) are used to treat life-threatening cardiac arrhythmias and prevent sudden cardiac arrest. As recipients age they may develop greater risk of dying as a result of progressive multimorbidity rather than sudden cardiac death. Defibrillation shocks may prolong an uncomfortable dying process. Deactivation of the defibrillator would prevent this, yet is not always discussed and planned.AimTo systematically review published evidence on ICD deactivation discussions and make recommendations on when, how and who should facilitate effective and patient-centred deactivation discussions.MethodsUsing standard systematic review methods, MEDLINE, EMBASE, CINAHL and PsycInfo were searched for studies published in the English language between 2010 and March 2021. Inclusion criteria were studies of adults (≥18 years) and including discussions on ICD deactivation and/or related communication. Included studies were independently reviewed, data extracted, quality assessed and data synthesised using a deductive approach.ResultsOf the 8893 articles identified, 22 papers met the inclusion criteria. Deductive approach led to identification of five main themes: (1) timing of ICD deactivation discussions, (2) initiation of deactivation discussions, (3) advance directives, (4) barriers to discussions and (5) facilitators of discussions.ConclusionsDespite available guidelines, conversations on device deactivation are not being undertaken consistently. Evidence suggests lack of professional awareness of guidelines and limited training in communication skills. To prevent distress and promote comfortable dying, there needs to be a proactive clinical and policy initiative in the education of both professionals and patients and their relatives about device deactivation.

Research–Practice Partnerships in Education Within The United States

Research–practice partnerships (RPPs) in education are long-term collaborations aimed at educational improvement and transformation through engagement with research, intentionally organized to connect diverse forms of expertise and to ensure that all partners have a say in the joint work. They have the potential to create conditions for research to inform practice more effectively than a one-way model that emphasizes translation of research into practice. After a description of systematic review methods and brief background on RPPs, this article is organzed into five focal RPP outcome areas: building trust and cultivating relationships, conducting rigorous and relevant research, supporting local improvement efforts, producing knowledge for the field more broadly, and building capacity for involved participants and organizations.

Historical Analysis Exposes Catastrophic Seagrass Loss for the United Kingdom

The spatial extent of seagrass is poorly mapped, and knowledge of historical loss is limited. Here, we collated empirical and qualitative data using systematic review methods to provide unique analysis on seagrass occurrence and loss in the United Kingdom. We document 8,493 ha of recently mapped seagrass in the United Kingdom since 1998. This equates to an estimated 0.9 Mt of carbon, which, in the current carbon market represents about £22 million. Using simple models to estimate seagrass declines triangulated against habitat suitability models, we provide evidence of catastrophic seagrass loss; at least 44% of United Kingdom’s seagrasses have been lost since 1936, 39% since the 1980’s. However, losses over longer time spans may be as high as 92%. Based on these estimates, historical seagrass meadows could have stored 11.5 Mt of carbon and supported approximately 400 million fish. Our results demonstrate the vast scale of losses and highlight the opportunities to restore seagrass to support a range of ecosystems services.

How Do People Communicate about Knee Osteoarthritis? A Discourse Analysis

Objective To explore the ways in which people talk about knee osteoarthritis and how this may influence engagement in physical activity and activity-based interventions as recommended by clinical practice guidelines. Design A qualitative synthesis using discourse analysis methods. Methods Systematic review methods were used to identify qualitative studies exploring the perceptions of people with knee osteoarthritis, their carers and/or clinicians. Methodological quality was evaluated using the Critical Appraisal Skills Programme. Raw quotes extracted from each study were analysed using inductive discourse analysis. Results A search of five electronic databases from inception until August 2019 yielded 778 articles. Sixty-two articles from 56 studies were included, reporting data (1673 direct quotes) from people with knee osteoarthritis, carers and clinicians in 16 countries. Two overarching discourses were identified—impairment and participation. The overarching impairment discourse prevailed in all participant groups and study settings. In this discourse, knee osteoarthritis was likened to a machine that inevitably wore-down over time and required a doctor to repair. The overarching participatory discourse almost always co-existed alongside an impairment discourse. According to this discourse, a ′busy body′ was perceived as ′healthy′ and people could remain active despite knee osteoarthritis. Conclusion The prevailing impairment discourse may potentially discourage people from using knees that have passed their ′use-by-date′ and increase reliance on doctors to repair joint damage. Consistent with recommendations in clinical practice guidelines, a participatory discourse may provide an alternative way of communicating, which may encourage people with knee osteoarthritis to continue to engage in physical activity by focusing on what they can do, rather than what they cannot do.