EBSCO Medline Research Articles

Trends in blood pressure: following subarachnoid haemorrhage and preceding cerebral vasospasm

Background Trends in Blood Pressure (BP) following Subarachnoid Haemorrhage (SAH) have been reported in literature since 1982. Recent studies suggest a correlation to the incidence of Cerebral Vasospasm. This renders BP a candidate for possible early detection of Vasospasm. However, conflicting results regarding the nature and numerical of this correlation exist. Objectives To determine trends in BP following SAH in terms of Systolic (SBP), Diastolic (DBP) and Mean Arterial Pressure (MAP) and collaborate current literature evidence of their association to Cerebral Vasospasm. Methods Two databases (EBSCO Medline and PubMed) systematically reviewed using specified search criteria. Thirteen studies were portrayed, of which ten were accessible. Thorough critical appraisal of each paper was then manually performed using the CASP Cohort study checklist. Results A consistent pattern of change is seen through time in majority of studies with differences in the definite values of the BP variables. Collation of results showed a gradual rise in SBP followed by a plateau of 154.08 (±10.79) mmHg on days 4-8 post-SAH. Variations exist with regards to the association with Cerebral Vasospasm: a third of the studies depicted a significant steeper rise in SBP in Vasospasm patients, another third conversely reported sudden drops in SBP, and one study concluded that MAP has no significant relation to Vasospasm. Conclusion A biphasic trend is expected following SAH with an initial gradual rise followed by a sustained hypertensive plateau. Considerable conflict exists in the nature of association between BP and Vasospasm. Further analysis of such beneficial predictive potential is recommended for advancement in Vasospasm and Neuro-Cardiogenic care.

O-108 Acceptance rates and reasons for social oocyte cryopreservation among women: systematic review and meta-analysis

Abstract Study question What are the acceptance rates and reasons for social oocyte cryopreservation (SOC) in the general population and healthcare professionals/students according to the current literature. Summary answer Acceptance rates for SOC was 54%. Lack of a partner and coverage of the costs contributed the acceptance with no differences in subgroup analysis. What is known already Oocyte cryopreservation is used for different purposes such as fertility preservation, social reasons and assisted reproductive treatments. In the last 15 years, many studies have been published in the literature examining the reasons and thoughts of women about oocyte freezing in different countries and groups. There is no study that evaluates this body of literature with a general view on social cryopreservation specifically and with the subgroups of the general population and healthcare professionals/students. Study design, size, duration A systematic review and meta-analysis were performed following the PRISMA guidelines after a comprehensive literature search using PubMed, EBSCO MEDLINE complete, Web of Science, ScienceDirect, Scopus and CINAHL databases between July and September 2023. Studies reporting findings about our primary outcomes including acceptance rates and reasons for SOC in general population and healthcare professionals/students were eligible without limitation on the publication year. Participants/materials, setting, methods Two reviewers independently reviewed eligibility and assessed for quality using Joanna Briggs Institute checklists. Totally, 23 studies were included. Data were expressed in risk ratio with a 95% CI using a random effect model. Prevalence estimates were calculated using meta-analysis of the proportion of women who viewed SOC acceptable. Heterogeneity was calculated using CochranQ and I2 statistics. The Q statistic was reported as p values, and the I2 statistic was reported in percentages. Main results and the role of chance In the metaanalysis based on the previous research data; the overall acceptance rate of social oocyte cryopreservation was found to be 54% (95% CI = 46%–62%). In subgroup analysis performed for healthcare professional/students, acceptance rates were not significantly different (95% CI = 0.47-0.61; p > 0.05). Heterogeneity was high for the acceptance rates of SOC (I2=98.64%, τ2=0.78, df = 22; p < 0.001). In subgroup analysis, acceptance rates were evaluated according to the most common reasons for acceptance. Acceptance rates when the cost of SOC is covered was 57% (95% CI = 0.40% - 0.71%, I2 = 98.62%, τ2 =0.88, df = 7; p < 0.001) and this rate was 49 % in the absence of a partner (95% CI = %34 - %64). Heterogeneity was high (I2=%98,81, τ2=0,96, df = 10; p < 0,001). Acceptance rates according to the reasons did not differ significantly in the subgroups for general population and healtcare professionals/students (coverage of cost: 95% CI = 0.59-0.45; p > 0.05; absence of a partner: 95% CI = 0,51-0,55; p > 0,05). Limitations, reasons for caution Some of the included studies had sample sizes that were not large enough to provide sufficient power for reporting on the disposition decision question. Wider implications of the findings Metaanalysis revealed that more than half of the women viewed SOC acceptable, acceptance varied within a wide range and increased in the absence of a partner and covering the cost. Findings of this review underline that affordable oocyte cryopreservation will increase the use of SOC among women of reproductive age. Trial registration number Not applicable

Systematic review of rural interventions addressing barriers and facilitators in recruitment and adherence of oncology clinical trials.

e13675 Background: Rural patients are significantly underrepresented in cancer clinical trials leading to an inequitable distribution of research funding and excluding rural patients from innovative care. Properly understanding the barriers and facilitators to rural patient participation in cancer clinical trials is essential to lessen this disparity in representation. Methods: EBSCO Medline, Embase, Cinahl, Cochrane and PsycInfo were systematically searched for articles related to the primary research objective. The search strategies focused on a combination of keywords pertaining to “rural populations”, “cancer”, and “clinical trials”. Additional search terms included the presence of “barriers” or “facilitators” within the articles. Articles were removed from the study if they were not written in English, were conducted outside the U.S., focused on pediatric populations, or lacked original data. Results: A systematic review of the literature reveals that barriers and facilitators to cancer clinical trial participation by rural populations are present at the patient, physician, and healthcare system levels. Notable barriers found in this review include the burden of travel, lack of patient knowledge about clinical trial participation, insufficient provider communication and awareness of current trials, and strict eligibility criteria. Promising facilitators include caregiver support, close physician support and contact, and programs to increase patient understanding of clinical trials. Potential future interventions include telemedicine, expanding monetary support for clinical trial transportation, utilizing RUCA codes to document disparities and elucidate further interventions, and cultivating stronger partnerships between industry and rural medical facilities, as well as between the NCI, academic institutions, and rural medical facilities. Conclusions: There is a significant and urgent need to strengthen this body of literature as is underscored by the apparent lack of cancer clinical trials in rural counties, specifically in the state of Texas (CPRIT). It is evident that barriers need to be further elucidated to ascertain why rural patients have less participation in clinical trials, and facilitators need to be further explored in order to sufficiently illustrate and thus effectively harness the power of facilitators in the pursuit of lessening disparities and improving cancer outcomes for rural patients.

Penerapan Intervensi Audiovisual dalam Meningkatkan Kepatuhan Selama Proses Induksi Anestesi pada Anak yang Menjalani Tindakan Operasi

This study aims to evaluate the effectiveness of audiovisual intervention in enhancing compliance during anesthesia induction in children undergoing surgery. The methodology used is a systematic review of several English-language research articles published between 2014 and 2023. Articles were retrieved from five online databases, such as ProQuest, ScienceDirect, Scopus, Ebsco MEDLINE, and Embase. The results of this study demonstrated that the use of audiovisual intervention was effective in enhancing compliance during anesthesia induction in children undergoing surgery. In conclusion, audiovisual intervention can be implemented as part of preoperative preparation programs for children undergoing surgery in order to enhance their levels of compliance during anesthesia induction. Audiovisual interventions can be used to achieve positive postoperative outcomes, either when utilized alone or combined with standard perioperative care practices. Keywords:Audiovisual Intervention, Child, Surgery, Induction Compliance.

Use of the supportive and palliative care indicators tool (SPICT™) for end-of-life discussions: a scoping review

BackgroundIn order to mitigate the distress associated with life limiting conditions it is essential for all health professionals not just palliative care specialists to identify people with deteriorating health and unmet palliative care needs and to plan care. The SPICT™ tool was designed to assist with this.AimThe aim was to examine the impact of the SPICT™ on advance care planning conversations and the extent of its use in advance care planning for adults with chronic life-limiting illness.MethodsIn this scoping review records published between 2010 and 2024 reporting the use of the SPICT™, were included unless the study aim was to evaluate the tool for prognostication purposes. Databases searched were EBSCO Medline, PubMed, EBSCO CINAHL, APA Psych Info, ProQuest One Theses and Dissertations Global.ResultsFrom the search results 26 records were reviewed, including two systematic review, two theses and 22 primary research studies. Much of the research was derived from primary care settings. There was evidence that the SPICT™ assists conversations about advance care planning specifically discussion and documentation of advance care directives, resuscitation plans and preferred place of death. The SPICT™ is available in at least eight languages (many versions have been validated) and used in many countries.ConclusionsUse of the SPICT™ appears to assist advance care planning. It has yet to be widely used in acute care settings and has had limited use in countries beyond Europe. There is a need for further research to validate the tool in different languages.

Assesment Fungsi Kognitif pada Anak dengan Penyakit Kronik

This study aims to identify what assessments can be used to screen cognitive function in children with chronic illnesses. The method used is a systematic review using the PRISMA flow diagram. Researchers used PIOs and searched for English language articles published from 2013 to October 2023. The databases used were PubMed, ProQuest, Science Direct, Taylor & Francis, Scopus, and EBSCO Medline. This systematic review showed that the initial total of articles obtained from all databases was 5889. After limiting the articles, 297 articles were obtained, which were then screened according to the inclusion criteria, with the final result being eight articles with a cross-sectional design. In conclusion, four instruments for assessing cognitive function in children with chronic diseases include Ouvrier modified MMSE, EpiTrack Junior (EpitrackJR), pedsFACIT-PCF, and Ped-ANAM. The Ouvrier-modified MMSE is widely used in several kinds of literature and is validated against standard cognitive function examinations by examination. Keywords: Children with Chronic Diseases, Assessment, Cognitive Function

Auditory Processing and Speech-Sound Disorders.

Speech-sound disorders (SSD) have been linked to auditory processing difficulties, and auditory processing disorders (APD) have been related to phonological awareness and literacy development. To this date, there has not been a systematic literature review investigating the results of psychophysiology and language assessments related to SSD and APD in children. The literature search was conducted in PubMed, Medline EBSCO, and Scopus to identify studies with children diagnosed/suspected of having APDs and SSDs. The quality of methodology in the selected articles was evaluated with the Newcastle Ottawa Scale. Seven out of 378 relevant studies met the selection criteria. The findings were summarized for children with SSD and APD based on (a) metalinguistic and literacy skills, (b) cognitive abilities, and (c) temporal processing abilities. Three articles indicated that children with APD and SSD exhibit lower temporal task accuracy and reaction time. In two studies, children with SSD exhibited lower scores in discrimination, sequencing, and recall of brief stimuli in rapid succession. This review revealed associations between SSD severity and APD that may underline low performance in metalinguistic skills. Diagnostic assessments have been proposed based on the review to adequately identify children with SSD and APD and provide useful information for more suitable intervention.

A Systematic Review on Hearing and Balance in Patients with Chronic Kidney Disease with and Without Hemodialysis.

Exploring the auditory and vestibular manifestations associated with chronic kidney disease (CKD) has been growing in recent years. Understanding these complaints in CKD patients is crucial for comprehensive patient care. This review aimed to investigate the audiological findings and profiles across various stages of CKD and guide for informed decision-making in their management. Relevant articles from PubMed, ScienceDirect, EBSCO Medline, SCOPUS, Google Scholar, and Clinical Key were identified for review. The selected articles were published from 2008 to 2023 and written in English language. A total of 41 articles on auditory and vestibular assessments in CKD were eligible for review. Pure tone audiometry (PTA), immittance audiometry (IA) and otoacoustic emissions (OAEs) were the most commonly employed hearing tests respectively, with a higher frequency of utilization in hemodialysis cases compared to non-hemodialysis ones. Also, vestibular evoked myogenic potentials (VEMPs) emerged as the most popular vestibular test among hemodialysis patients while questionnaires were frequently employed in CKD patients. Moreover, our analysis suggests a potential association between the duration of hemodialysis and the development of tinnitus and vertigo. Abnormalities were also observed in auditory brainstem response (ABR), speech audiometry, central auditory processing tests and videonystagmography (VNG) assessment in hemodialysis and non-hemodialysis patients. CKD patients, particularly those undergoing hemodialysis, face a higher risk of hearing loss, tinnitus, and vestibular complaints. Performing otoacoustic emissions and vestibular-evoked myogenic potentials along with PTA on CKD patients, regardless of the disease stage is recommended to more effective management of audiovestibular complaints in these population.

Spider's Silk as a Potential Source of Antibiotics: An Integrative Review.

Spiders produce webs, which are still a largely unexplored source of antibacterial compounds, although the reports of its application in the medical field. Therefore, this study aims to present an integrative review of the antibacterial activity of spider webs. The research was conducted using Google Scholar, Scielo, Web of Science, PubMed, ScienceDirect, Medline EBSCO, LILACS, and Embase. The inclusion criteria were original articles written in English that studied the antibiotic properties of the web or isolated compounds tested. The studies were compared according to the spider species studied, the type of web, treatment of the sample, type of antimicrobial test, and the results obtained. Nine hundred and seventy-three publications were found, and after applying the inclusion and exclusion criteria, sixteen articles were selected. Bacterial inhibition was found in seven studies against various species of bacteria such as Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Salmonella Typhi, Bacillus megaterium, Listeria monocytogenes, Acinetobacter baumannii, Streptococcus pneumoniae, Pasteurella multocida, and Bacillus subtilis. Additionally, there was no apparent relationship between the proximity of the spider species evaluated in the studies and the presence or absence of activity. Methodological problems detected may affected the reproducibility and reliability of the results in some studies, such as the lack of description of the web or microorganism strain, as well as the absence of adequate controls and treatments to sterilize the sample. Spider webs can be a valuable source of antibiotics; however, more studies are needed to confirm the real activity of the web or components involved.

Nursing student volunteers and their level of involvement during the COVID-19 pandemic: a systematic review

Abstract Objective Many strategic efforts were made to address nurses’ shortage in controlling Coronavirus disease 2019 (COVID-19), including recruiting student health volunteers. This review aimed to explore the contribution and involvement of nursing student volunteers during COVID-19. Methods A systematic review was registered in PROSPERO International CRD42021283069. Electronic databases for article search included: SCOPUS, EBSCO MEDLINE, PubMed, ProQuest, Springer, Sage Pub, and hand searching. The critical appraisal study quality using The Joanna Briggs Institutes. Data extraction and synthesis used Population, Intervention, Comparison, Outcome, and Design (PICO and D) framework with thematic analysis. Results Twelve studies were enrolled from 2545 retrieved, with 4 synthesized themes: (1) determinant of the involvement of nursing student volunteers during COVID-19, which includes 3 subthemes: motivations, perception, and barriers, (2) expectations and actual condition of nursing students as volunteers, (3) the need for nursing student volunteers, and (4) the impact and level of student volunteers’ contribution. All student volunteers contribute to providing direct or indirect services to patients. Conclusions This review provides an overview of nursing student volunteers’ needs useful in developing competency frameworks and the role of culturally sensitive volunteers in education and training. In the future, student volunteers could choose the appropriate volunteer program and location according to their competence.

Prioritising patients for semi-urgent surgery: A scoping review.

Semi-urgent surgery where surgical intervention is required within 48 h of admission and the patient is medically stable is vulnerable to scheduling delays. Given the challenges in accessing health care, there is a need for a detailed understanding of the factors that impact decisions on scheduling semi-urgent surgeries. To identify and describe the organisational, departmental and contextual factors that determine healthcare professionals' prioritising patients for semi-urgent surgeries. We used the Joanna Briggs Institute guidance for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR) checklist. Four online databases were used: EBSCO Academic Search Complete, EBSCO Cumulative Index to Nursing and Allied Health Literature, OVID Embase and EBSCO Medline. Articles were eligible for inclusion if they published in English and focussed on the scheduling of patients for surgery were included. Data were extracted by one author and checked by another and analysed descriptively. Findings were synthesises using the Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework. Twelve articles published between 1999 and 2022 were included. The Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework highlighted themes of emergency surgery scheduling and its impact on operating room utilisation. Gaps in the management of operating room utilisation and the incorporation of semi-urgent surgeries into operating schedules were also identified. Finally, the lack of consensus on the definition of semi-urgent surgery and the parameters used to assign surgical acuity to patients was evident. This scoping review identified patterns in the scheduling methods, and involvement of key decision makers. Yet there is limited evidence about how key decision makers reach consensus on prioritising patients for semi-urgent surgery and its impact on patient experience. No Patient or Public Contribution.

Is there 'trustworthy' evidence for using manual therapy to treat patients with shoulder dysfunction?: A systematic review.

The primary objective of this review was to create a 'trustworthy,' living systematic review and meta-analysis for the application of manual therapy interventions in treating patients with shoulder dysfunction. Included studies were English-language randomized controlled trials published between 1/1/2010 and 8/3/2023, with searches performed in: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), CINHAL, ProQuest Nursing & Allied Health, EBSCO Medline, and PEDro. The population of focus included adults 18 years and older with musculoskeletal impairments related to shoulder dysfunction. Our primary outcomes included pain and region-specific outcome measures. We excluded trials, including participants having shoulder dysfunction resulting from surgery, radicular pain, instability/dislocation, fracture, lymphedema, and radiation. Our screening methodology was based upon a previously published 'trustworthy' systematic review protocol. This included the application of our PICOTS criteria in addition to screening for prospective clinical trial registration and following of prospective intent, as well as assessment of PEDro scores, risk-of-bias ratings, GRADE scoring, and examination of confidence in estimated effects. Twenty-six randomized controlled trials met our PICOTS criteria; however, only 15 of these were registered. Only three were registered prospectively. Two of these did not have discussions and conclusions that aligned with their primary outcome. The remaining single study was found to have a high risk-of-bias, meaning the remainder of the protocol could not be employed and that no randomized controlled trials could undergo further assessment or meta-analysis. The results of this systematic review indicate there are no 'trustworthy' randomized controlled trials examining the effectiveness of manual therapy interventions for the treatment of patients with shoulder dysfunction, as defined by the prospectively established methodology. Therefore, these findings signal that creating a 'trustworthy,' living systematic review on this clinically relevant topic is not yet possible due to a lack of 'trustworthy' randomized controlled trials.

Factors Influencing Nurses Turnover in Saudi Arabia: A Systematic Review

The turnover of nurses has been an ordeal for healthcare institutions not only locally but also globally. It ranges from changing unit or workplace to changing or leaving the nursing profession. High turnover rates affect care provision and organizational cost. Therefore, this review aims to identify the factors that influence nurse turnover in Saudi Arabia. An in‐depth review of quantitative, qualitative, and mixed‐method studies that includes all studies on nurses who intend to leave the job or profession (resigned or terminated) in any institution within Saudi Arabia was conducted. The grey literature and studies conducted outside of Saudi Arabia were excluded. PubMed, ScienceDirect, EBSCO Medline, ProQuest, and Web of Science were searched for relevant literature from inception to publication. MMAT (Mixed‐Methods Appraisal Tool) is used to assess the risk of bias. A narrative synthesis of the findings is conducted and presented in a table. A total of 1286 articles were retrieved from the initial search and managed using Rayyan software. Out of 1102 articles screened, 44 articles were reviewed for eligibility yielding to 21 articles included in this study. Preliminary screening is performed by two authors by independently scrutinizing the title and abstracts followed by full‐text screening. The data are carefully extracted by the author and validated by a second reviewer. The factors identified to influence nurse turnover in Saudi Arabia are classified into themes, namely, individual‐related factors (demographic characteristics and psychological and personal aspects), work environment, and organizational factors. More studies are needed in all regions using more robust designs. The review protocol is registered in Prospero with ID no. CRD42023433406.

Impact of Self-medications and Medications Misuse on Health Outcomes

Introduction: The availability of prescription drugs as OTC medications is also becoming more common. However, self-medication carries risks such as misdiagnosis, use of excessive drug doses, prolonged use, and drug interactions. This review aimed to collect evidence about the impact of self-medications on health outcomes. Methods: The systematic review in this study involved several steps to identify and assess relevant research. The search phase involved finding potentially relevant studies in various databases such as PubMed, PsychInfo, EBSCO Medline, BioMed central, and Science Direct. The screening phase involved applying predetermined inclusion and exclusion criteria to determine which studies were appropriate for the review. To conclude the selection process, the full text of the articles was reviewed to determine whether they met the inclusion criteria. Additionally, the full text of review articles was reviewed to identify any additional articles that might be relevant and included in the review. Results: A total of 17 studies were found that met the inclusion criteria. The majority (11/17) of these studies were cross-sectional and relied on self-report. The combined sample size of the 17 studies was 28,628 (ranging from 5 to 5,426), and the average response rate was 66%. In 76% of the studies, reported self-treatment was 50% (ranging from 12% to 99%). Overall, only one or two respondents were registered with a general practitioner (GP) or primary care physician (mean of 56%, ranging from 21% to 96%). In the 13 studies that provided information on self-prescription, the mean percentage of physicians reporting self-prescription was 61% with a standard deviation of 25% and a range of 9% to 99%. Conclusions: Although many patients view over-the-counter (OTC) medications as completely safe, their use always carries some degree of risk for the consumer. This is especially true for patients who do not follow the instructions on the label or package insert.

The Adverse Outcomes of Chorioamnionitis on the Pregnant Female and Their Fetus

Introduction: Chorioamnionitis is an intra-amniotic infection caused by an ascending polymicrobial bacterial infection. Triple I (intrauterine inflammation or infection or both) is also proposed to replace chorioamnionitis due to its imprecise definition and variable clinical manifestations. Intraamniotic infection is characterized by inflammation of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Maternal fever, uterine tenderness, maternal tachycardia, fetal tachycardia, and purulent fluid coming from the cervical os (the cervical opening can be external, near the vagina, or internal, near the uterus) are the key clinical findings that are crucial for the diagnosis of clinical chorioamnionitis. Clinically, intra-amnionitic infections have been linked to severe morbidity and death in pregnant women, fetuses, and newborns. Method: A systematic search of PubMed, Embase, LitCovid, MedRxiv, BioRxiv, Google Scholar, EBSCO MEDLINE, CINAHL and Scopus electronic database was done using key words like Chorioamnionitis, adverse complication in pregnancy to mother and her fetus associated with intrauterine infection, Intraamniotic inflammation and triple I. Studies have been included from January 2015 to December 2022. Result: Chorioamnionitis is most typically caused by ascending infection and is frequently linked with premature membrane rupture. Chorioamnionitis is typically caused by a polymicrobial infection, with Ureaplasma urealyticum, Mycoplasma hominis, and Gram-negative anaerobes being common pathogens. Antimicrobial drugs, antipyretics, rapid treatment, and supportive care are the mainstays of management. Conclusion: Overall, this review provides a better understanding of Chorioamnionitis and its potential impact on public health. By shedding light on this emerging disease, we hope to contribute to ongoing efforts to prevent and treat of this serious disorder. Keywords: Chorioamnionitis, Intrauterine Infection, Pregnancy, adverse complication, Triple I, Intraamniotic Inflammation

A scoping review on the psychosocial interventions used in day care service for people living with dementia

Background Adult Day care centres provide an important aspect of care provision through all phases of the dementia illness from diagnosis to the end of life (Dabelko HI 2008) supporting the well-being of both older people living with dementia and their care partners. Services within adult day care settings are designed to provide biopsychosocial health benefits to participants as well as care partner respite. Objective To examine research studies, literature reviews and grey literature and identify and map the literature on psychosocial interventions used in day care services for older people living with dementia and chart their use, evaluation and outcomes. The research review question is “what are the psychosocial interventions used in day care service for older people living with dementia?” Psychosocial interventions are important non-pharmacological interventions which support people’s wellbeing. Methods Inclusion/Exclusion criteria were identified and guided the search strategy. Participants were people aged 60 years and over living with dementia attending day care services. The use of psychosocial interventions for this cohort was the focus of the review. Databases were searched (Cochrane Reviews, CINAHL, Embase, Medline EBSCO, Medline Ovid, Medline PubMed, PsycINFO, Scopus, Open Grey, Lenus and WHO Global Index Medicus databases) using keywords/terms with Boolean operators from 2011 to 2023. Rayyan was used to extract and manage the data. Results The findings present a narrative and charting of the data from the 45 papers that met the review criteria, and this data is mapped onto the five objectives. Within this review, interventions were grouped into five broad types: nature (n = 6 papers), memory/cognitive (n = 11 papers), social (n = 17 papers), animal (n = 4 papers), or physical/sensory (n = 7 papers) based interventions. Conclusions This review has illustrated the wide variety in the types, range and facilitation of psychosocial interventions within adult day care services. This review highlights the potential benefits of these interventions. However, findings must be considered in the context that many were provided as brief intervention studies with little evidence of continuation after the study and further research is required given the complex and diverse range of interventions. Results will be of interest to practitioners planning to implement or evaluate psychosocial interventions used in day care services for older people living with dementia.

Effectiveness of Psychoeducation on Burden among Family Caregivers of Adults with Schizophrenia: A Systematic Review and Meta-Analysis.

Caring for relatives living with schizophrenia could lead to caregivers' burden. It is believed that lack of information and understanding about schizophrenia and lack of skills to cope effectively while caring for their adult relatives largely contribute to the burden they experience. The burden is assessed using assessment scales. This review aims to assess the effectiveness of psychoeducation in alleviating the burden experienced by family caregivers of adults living with schizophrenia and to identify essential factors that facilitate positive outcomes. Five databases (ASSIA, CINAHL, Embase, MEDLINE EBSCO, and PsycINFO) were systematically searched using combinations of the following key terms: "family caregivers," "schizophrenia," "burden," "psychoeducation," and "adults." Meta-analysis of included studies was conducted using RevMan 5.4. Five RCTs with 320 family caregivers were included in the review. Overall, none of the studies showed a low risk of bias. The evidence suggests that face-to-face group psychoeducation reduced family caregivers' burden when measured across different time points: one-week postintervention (mean difference -3.87 and Cl -6.06 to -1.70), six months (MD -8.76 and Cl -12.38 to -5.13), and twelve months (MD -7.38 and Cl -9.85 to -4.91). Measurements immediately after the intervention, one month, and three months postintervention when reported narratively also showed a reduction in family caregivers' burden. Face-to-face group psychoeducation provided for family caregivers effectively alleviates the burden they experience. Factors such as program content and teaching methods facilitated positive outcomes. It is recommended that psychoeducation should be integrated as a routine intervention for family caregivers.

Prophylactic Antibiotics to Prevent Cholangitis in Children with Biliary Atresia After Kasai Portoenterostomy: A Meta-Analysis.

A connection between the bowel and bile ducts after the Kasai hepatoportoenterostomy (HPE) procedure poses a risk of ascending cholangitis. There were only a few evidence-based consensuses on the benefits of prophylactic antibiotics. This study aims to assess the value of prophylactic antibiotics in reducing the risk of cholangitis following the Kasai HPE procedure. Meta-analysis is performed using random-effects model from the search result of 5 online databases (PubMed, Google Scholar, EBSCO MEDLINE, ClinicalTrials.gov , and EuropePMC) from inception to October 27, 2021. The keywords used were "antibiotic," "antimicrobial," "Kasai," "portoenterostomy," "biliary atresia," and "bile duct atresia." Cochrane Risk of Bias tool and Newcastle-Ottawa Scale is used to assess the risk of bias. The outcomes are incidence of cholangitis and native liver survival. Six studies consisting of 4 cohorts and 2 cross-sectional studies were extracted. A total of 714 patients reported different cholangitis incidence after prophylactic antibiotics administration post-Kasai HPE. The incidence of cholangitis following Kasai HPE was not statistically significant among participants. There is conflicting evidence on the efficacy of antibiotics in prolonging native liver survival. The existing evidence does not support the administration of prophylactic antibiotics in preventing cholangitis after Kasai HPE among biliary atresia patients. Additionally, their roles in native liver survival are still inconclusive. The fact that there were heterogeneous method and antibiotic usage between existing studies must also be highlighted for better design in future studies.

Staff training in physical interventions: a literature review.

Restrictive practices are used frequently by frontline staff in a variety of care contexts, including psychiatric hospitals, children's services, and support services for older adults and individuals with intellectual and developmental disabilities. Physical restraint has been associated with emotional harm, physical injury to staff and consumers, and has even resulted in death of individuals in care environments. Various interventions have been implemented within care settings with the intention of reducing instances of restraint. One of the most common interventions is staff training that includes some physical intervention skills to support staff to manage crisis situations. Despite physical intervention training being used widely in care services, there is little evidence to support the effectiveness and application of physical interventions. This review will examine the literature regarding outcomes of staff training in physical interventions across care sectors. A systematic search was conducted following PRISMA guidelines using Cochrane Database, Medline EBSCO, Medline OVID, PsychINFO, and the Web of Science. Main search keywords were staff training, physical intervention, physical restraint. The MMAT was utilised to provide an analytical framework for the included studies. Seventeen articles have been included in this literature review. The included studies take place in a range of care settings and comprise a wide range of outcomes and designs. The training programmes examined vary widely in their duration, course content, teaching methods, and extent to which physical skills are taught. Studies were of relatively poor quality. Many descriptions of training programmes did not clearly operationalise the knowledge and skills taught to staff. As such, it is difficult to compare course content across the studies. Few papers described physical interventions in sufficient detail. This review demonstrates that, although staff training is a 'first response' to managing health and safety in care settings, there is very little evidence to suggest that staff training in physical intervention skills leads to meaningful outcomes.

A systematic review of randomised-controlled trials on deprescribing outcomes in older adults with polypharmacy.

Mixed findings about deprescribing impact have emerged from varied study designs, interventions, outcome measures and targeting sub-categories of medications or morbidities. This systematic review controls for study design by reviewing randomised-controlled trials (RCTs) of deprescribing interventions using comprehensive medication profiles. The goal is to provide a synthesis of interventions and patient outcomes to inform healthcare providers and policy makers about deprescribing effectiveness. This systematic review aims to (1) review RCT deprescribing studies focusing on complete medication reviews of older adults with polypharmacy across all health settings, (2) map patients' clinical and economic outcomes against intervention and implementation strategies and (3) inform research agendas based on observed benefits and best practices. The PRISMA framework for systematic reviews was followed. Databases used were EBSCO Medline, PubMed, Cochrane Library, Scopus and Web of Science. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomised trials. Fourteen articles were included. Interventions varied in setting, preparation, use of interdisciplinary teams, validated guidelines and tools, patient-centredness and implementation strategy. Thirteen studies (92.9%) found deprescribing interventions reduced the number of drugs and/or doses taken. No studies found threats to patient safety in terms of primary outcomes including morbidity, hospitalisations, emergency room use and falls. Four of five studies identifying health quality of life as a primary outcome found significant effects associated with deprescribing. Both studies with cost as their primary outcome found significant effects as did two with cost as a secondary outcome. Studies did not systematically study how intervention components influenced deprescribing impact. To explore this gap, this review mapped studies' primary outcomes to deprescribing intervention components using the Consolidated Framework for Implementation Research. Five studies had significant, positive primary outcomes related to health-related quality of life (HRQOL), cost and/or hospitalisation, with four reporting patient-centred elements in their intervention. RCT primary outcomes found deprescribing is safe and reduces drug number or dose. Five RCTs found a significant deprescribing impact on HRQOL, cost or hospitalisation. Important future research agendas include analysing (1) understudied outcomes like cost, and (2) intervention and implementation components that enhance effectiveness, such as patient-centred elements.