Expanded Academic Index Research Articles

Importance of pelvic floor muscle trainig in preparing for vaginal birth

Background: Pregnancy, type of delivery, pelvic floor conditions and number of births can influence the muscle strength of the pelvic floor, causing morbidities of the genitourinary tract and negative effects related to sexual, physical, psychological and social health in women. However, few studies deal with the training of the pelvic floor muscles (PFM) during pregnancy, or in preparation for vaginal delivery. Aims: to discuss the importance of pelvic floor muscle training in childbirth preparation. Method: systematic review in SCIELO, MEDLINE, BIREME, Cochrane, Expanded Academic Index, Clinical Evidence and Pubmed databases using the keywords pregnancy and pelvic floor exercise, restricted to studies in Portuguese or English about pregnant women. Results: Of the 44 articles included, only eight dealt directly with PFM strengthening during pregnancy. Conclusion: Pelvic floor muscle exercises during pregnancy are safe and have no side effects or potential risks for pregnant women, in addition to promoting effective strengthening and increased tissue elasticity, variables capable of facilitating vaginal delivery and minimizing the risk of injuries locations and consequent impairments of pelvic, urinary, anorectal and/or sexual or pelvic statics.

Effects of curcumin on glycemic control and lipid profile in prediabetes and type 2 diabetes mellitus: A systematic review and meta-analysis.

ScopeStudies have demonstrated inconsistent effects of curcumin on glycemic outcomes and lipid parameters in patients with prediabetes and type 2 diabetes mellitus (T2DM). This study aimed to assess the effect of curcumin on glycemic control and lipid profile in prediabetes and T2DM.Methods and resultsA systematic search of randomized controlled trials (RCTs) was conducted from inception to June 2018 in electronic sources including AMED, ANZCTR, BioMed Central, CENTRAL, CINAHL, ClinicalTrials.gov, Expanded Academic Index, Google Scholar, ISRCTN, LILACS, MEDLINE, NCCIH, Science Direct, Scopus, Web of Science, and WHO ICTRP. Hand search was also performed. Of the total 486 records, four trials (N = 508) and eight trials (N = 646) were eligible for the meta-analysis of individuals with prediabetes and T2DM, respectively. Curcumin significantly reduced glycosylated hemoglobin (HbA1c) in prediabetics (MD: -0.9%, 95% CI: -1.7 to -0.1%, p = 0.03). Furthermore, T2DM subjects gained favorable reduction in both HbA1c (MD: -0.5%, 95% CI: -1.0 to -0.0%, p = 0.04) and fasting plasma glucose (MD: -11.7 mg/dL, 95% CI: -22.1 to -1.3 mg/dL, p = 0.03). Tendency of lipid profile improvement was also observed.ConclusionOur findings may encourage curcumin supplementation based on its meaningful effect on glycemic control and positive trend on lipid outcomes in prediabetes and T2DM.

Effectiveness of psychosocial interventions for cognitive dysfunction in cancer patients who have received chemotherapy: a systematic review

Effectiveness of psychosocial interventions for cognitive dysfunction in cancer patients who have received chemotherapy: a systematic review

Understanding young peoples' experience of chronic illness: a systematic review

Objective It has been reported that the diagnosis of a chronic illness increases a child's susceptibility to future mental health problems. Accordingly, the objective of the current review was to summarise the best available evidence that described a young person's experience of chronic illness and make recommendations towards the promotion of mental health and prevention of future mental health difficulties. Inclusion criteria The review considered qualitative research that used the voices of young people (under 18 years) to describe their experience of chronic illness and the impact it had on their lives. Search strategy The search strategy sought to find both published and unpublished research papers (limited to the English language). An extensive search was performed using the following databases: PubMed, CINAHL, Web of Science, PsycInfo, Aust Health, Dissertation Abstract International, Expanded Academic Index, Health Source Nursing, and Academic Search Elite. In addition, the reference lists of identified papers were hand searched, to capture all pertinent material, as well as relevant worldwide web sites. Methodological quality Each paper was assessed by two reviewers for methodological quality prior to inclusion in the review using the critical appraisal instrument (Qualitative Assessment and Review Instrument (QARI) ) from software developed by the Joanna Briggs Institute (JBI). Results A total of 18 qualitative papers were included in the review (nine grounded theory, six phenomenology, one ethnography, one social ecological, and one multiple case study). Forty-four papers were initially identified but 26 were excluded as they did not meet the inclusion criteria. Findings were extracted and meta-synthesised using JBI-QARI. Five syntheses about a young person's experience of chronic illness were derived: (i) the experience of chronic illness makes young people feel uncomfortable in their body and world; (ii) the experience of chronic illness disrupts 'normal' life; (iii) the experience of chronic illness is not all bad; (iv) ways of getting through the chronic illness experience, 'what others can do'; and (v) ways of getting through the chronic illness experience, 'what I can do'. Conclusion A positive perspective needs to be taken to promote mental health in young people with chronic illness; clinicians, families and interventions need to (i) bolster their sense of self; (ii) normalise the experience; (iii) foster its positive impact; (iv) help them accept the situation; and (v) help to develop the future-orientated coping strategies that will provide them with a sense of hope.

Understanding young peoplesʼ experience of chronic illness

Objective It has been reported that the diagnosis of a chronic illness increases a child's susceptibility to future mental health problems. Accordingly, the objective of the current review was to summarise the best available evidence that described a young person's experience of chronic illness and make recommendations towards the promotion of mental health and prevention of future mental health difficulties. Inclusion criteria The review considered qualitative research that used the voices of young people (under 18 years) to describe their experience of chronic illness and the impact it had on their lives. Search strategy The search strategy sought to find both published and unpublished research papers (limited to the English language). An extensive search was performed using the following databases: Pub Med, CINAHL, Web of Science, Psyc Info, Aust Health, Dissertation Abstract International, Expanded Academic Index, Health Source Nursing, and Academic Search Elite. In addition, the reference lists of identified papers were hand searched, to capture all pertinent material, as well as relevant worldwide web sites. Methodological quality Each paper was assessed by two reviewers for methodological quality prior to inclusion in the review using the critical appraisal instrument (Qualitative Assessment and Review Instrument (QARI)) from software developed by the Joanna Briggs Institute (JBI). Results A total of 18 qualitative papers were included in the review (nine grounded theory, six phenomenology, one ethnography, one social ecological, and one multiple case study). Forty-four papers were initially identified but 26 were excluded as they did not meet the inclusion criteria. Findings were extracted and meta-synthesised using JBI-QARI. Five syntheses about a young person's experience of chronic illness were derived: (i) the experience of chronic illness makes young people feel uncomfortable in their body and world; (ii) the experience of chronic illness disrupts ‘normal’ life; (iii) the experience of chronic illness is not all bad; (iv) ways of getting through the chronic illness experience, ‘what others can do’; and (v) ways of getting through the chronic illness experience, ‘what I can do’. Conclusion A positive perspective needs to be taken to promote mental health in young people with chronic illness; clinicians, families and interventions need to (i) bolster their sense of self; (ii) normalise the experience; (iii) foster its positive impact; (iv) help them accept the situation; and (v) help to develop the future-orientated coping strategies that will provide them with a sense of hope.

Understanding young peoples' experience of chronic illness: a systematic review.

It has been reported that the diagnosis of a chronic illness increases a child's susceptibility to future mental health problems. Accordingly, the objective of the current review was to summarise the best available evidence that described a young person's experience of chronic illness and make recommendations towards the promotion of mental health and prevention of future mental health difficulties. The review considered qualitative research that used the voices of young people (under 18 years) to describe their experience of chronic illness and the impact it had on their lives. The search strategy sought to find both published and unpublished research papers (limited to the English language). An extensive search was performed using the following databases: PubMed, CINAHL, Web of Science, PsycInfo, Aust Health, Dissertation Abstract International, Expanded Academic Index, Health Source Nursing, and Academic Search Elite. In addition, the reference lists of identified papers were hand searched, to capture all pertinent material, as well as relevant worldwide web sites. Each paper was assessed by two reviewers for methodological quality prior to inclusion in the review using the critical appraisal instrument (Qualitative Assessment and Review Instrument (QARI)) from software developed by the Joanna Briggs Institute (JBI). A total of 18 qualitative papers were included in the review (nine grounded theory, six phenomenology, one ethnography, one social ecological, and one multiple case study). Forty-four papers were initially identified but 26 were excluded as they did not meet the inclusion criteria. Findings were extracted and meta-synthesised using JBI-QARI. Five syntheses about a young person's experience of chronic illness were derived: (i) the experience of chronic illness makes young people feel uncomfortable in their body and world; (ii) the experience of chronic illness disrupts 'normal' life; (iii) the experience of chronic illness is not all bad; (iv) ways of getting through the chronic illness experience, 'what others can do'; and (v) ways of getting through the chronic illness experience, 'what I can do'. A positive perspective needs to be taken to promote mental health in young people with chronic illness; clinicians, families and interventions need to (i) bolster their sense of self; (ii) normalise the experience; (iii) foster its positive impact; (iv) help them accept the situation; and (v) help to develop the future-orientated coping strategies that will provide them with a sense of hope.

Understanding young peoplesʼ experience of chronic illness: a systematic review

Objective It has been reported that the diagnosis of a chronic illness increases a child's susceptibility to future mental health problems. Accordingly, the objective of the current review was to summarise the best available evidence that described a young person's experience of chronic illness and make recommendations towards the promotion of mental health and prevention of future mental health difficulties. Inclusion criteria The review considered qualitative research that used the voices of young people (under 18 years) to describe their experience of chronic illness and the impact it had on their lives. Search strategy The search strategy sought to find both published and unpublished research papers (limited to the English language). An extensive search was performed using the following databases: PubMed, CINAHL, Web of Science, PsycInfo, Aust Health, Dissertation Abstract International, Expanded Academic Index, Health Source Nursing, and Academic Search Elite. In addition, the reference lists of identified papers were hand searched, to capture all pertinent material, as well as relevant worldwide web sites. Methodological quality Each paper was assessed by two reviewers for methodological quality prior to inclusion in the review using the critical appraisal instrument (Qualitative Assessment and Review Instrument (QARI)) from software developed by the Joanna Briggs Institute (JBI). Results A total of 18 qualitative papers were included in the review (nine grounded theory, six phenomenology, one ethnography, one social ecological, and one multiple case study). Forty-four papers were initially identified but 26 were excluded as they did not meet the inclusion criteria. Findings were extracted and meta-synthesised using JBI-QARI. Five syntheses about a young person's experience of chronic illness were derived: (i) the experience of chronic illness makes young people feel uncomfortable in their body and world; (ii) the experience of chronic illness disrupts ‘normal' life; (iii) the experience of chronic illness is not all bad; (iv) ways of getting through the chronic illness experience, ‘what others can do'; and (v) ways of getting through the chronic illness experience, ‘what I can do'. Conclusion A positive perspective needs to be taken to promote mental health in young people with chronic illness; clinicians, families and interventions need to (i) bolster their sense of self; (ii) normalise the experience; (iii) foster its positive impact; (iv) help them accept the situation; and (v) help to develop the future-orientated coping strategies that will provide them with a sense of hope.

Risk communication in the internet age: The rise of disorganized skepticism

Communicating risks has become a core ingredient in the regulatory functions of government, interest group advocacy, public health, and corporate relations. The channels of risk communication have grown in complexity along with the development and expansion of the Internet and the birth of personalized blogging. This paper discusses three stages in the development of risk communication as an area of study and research. It examines the way risk is framed in three channels of communication, newsprint, the Expanded Academic Index, and Google using the example of the controversial chemical perfluorooctanoic acid (PFOA). The paper concludes that the Internet, as illustrated by the Google search engine, has created more opportunities for citizen learning and expanded the breadth and channels of risk communication, while also providing new opportunities for stakeholders to influence the message. Democritization of information does not necessarily create greater concordance between the cultural and technical assessment of risk.

Further Research is Required to Determine Which Database Products Best Support Research in Public Administration

A review of:
 
 Tucker, James, Corey. “Database Support for Research in Public Administration.” Behavioral & Social Sciences Librarian 24.1 (2005): 47-60.
 
 Objective – To examine the extent to which six commercial database products support student and faculty research in the area of public administration.
 
 Design – Bibliometric study.
 
 Setting – Academic library in the United States.
 
 Subjects – Six commercial business-related database products were examined: Proquest’s ABI/INFORM Global edition (ABI), EBSCO’s Business Source Premier (BSP), Gale’s General BusinessFile ASAP (GBF), EBSCO’s Academic Search Premier (ASP), EBSCO’s Expanded Academic Index (EAI) and Proquest’s International Academic Research Library (ARL). Three of the databases (ABI, BSP, GBF) were chosen because they address the management, human resource, and financing elements of public administration. The other three (ASP, EAI, ARL) were included because of their multidisciplinary coverage.
 
 Methods – A list of journal titles covering public administration was assembled from the Institute of Scientific Information’s Social Sciences Citation Index and previously published lists of recommended journals in the field. The author then compared the compiled list of journal titles against the journal titles indexed by the six database
 products. He further analyzed the results by level of journal coverage (abstract only, full-text, and full-text with embargo) and subject area based on categories described in Ulrich’s Periodicals Directory.
 
 Main Results – The study found that three of the six database products --EAI, BSP, and ARL -- provide indexing for the greatest number of public administration journals contained in the compiled list. EIA and ARL cover the greatest number of those that are full-text journals, while BSP and ASP cover the greatest number of those full-text journals limited by publisher embargoes.
 
 Conclusion – The author concludes that of the six databases examined, EAI, BSP, and ARL are the best for public administration research, based on their strength in the subject areas of public administration and public finance. The author also recommends that librarians in the field of public administration “carefully evaluate each database to see which one best fits the needs of the library and patrons” (56).

Effectiveness of standard short-course chemotherapy for treating tuberculosis and the impact of drug resistance on its outcome

Background Treating tuberculosis (TB) with short-course chemotherapy is recommended by the World Health Organization tuberculosis program and is one of the five packages of directly observed treatment short-course (DOTS) strategy. Objectives To investigate the effectiveness of short-course chemotherapy for treating new and retreatment TB patients and to assess the impact of drug resistance on its outcomes. Search strategy and selection criteria Published studies from the electronic databases such as Cochrane Library, DARE, Medline, Embase, Current Contents, CINAHL, Expanded Academic Index, PsycInfo, AustHealth and unpublished studies from Dissertation Abstract International, Index to These, Cochrane Reviewer Handbook were searched between 1993-2002. Studies addressing the treatment of patients with short-course regimen and the association between drug resistance and treatment outcomes were included. Two reviewers independently assessed study quality and extracted data. Results and discussion Eleven cohort studies met the inclusion criteria. Treatment with 6-month daily regimens was effective for new TB patients with success rate (percentage of cure cases and treatment completed cases) of over 80%. Implementation of 100% directly observed treatment was necessary to achieve over 80% treatment success in new cases treated with the intermittent regimen. The intermittent regimens did not work effectively for retreatment cases since success rate was only 68.5% even in the setting using 100% directly observed treatment in Peru. Short-course regimens were effective against drug-sensitive TB with the success rate of 87%; ineffective for patients with multi-drug resistance (rate of treatment failure in new cases ranged 22.3%-35.5% and rate of treatment failure in retreatment cases ranged 16.3-37.1%). Drug resistance had a negative impact on the outcome of short-course therapy and multi-drug resistance had a huge negative impact on the effectiveness of chemotherapy for TB. Conclusion The evidence suggests that the World Health Organization-targeted cure rate of 85% in new smear-positive TB cases is not achievable using the intermittent regimen and the target rate should be adjusted. DOTS-plus multi-drug resistant TB program of the world Health Organization should be adopted. However, the evidence is limited and the level of evidence was III-2.

Understanding young peoples' experience of chronic illness: a systematic review.

The objective of the review was to summarise the best available evidence that described a young person's experience of chronic illness and make recommendations towards the promotion of mental health and prevention of future mental health difficulties. The review considered qualitative research that used the voices of young people (under 18 years) to describe their experience of chronic illness and the impact it had on their lives. The search strategy sought to find both published and unpublished research papers (limited to the English language). An extensive search was performed using the following databases: PubMed, CINAHL, Web of Science, PsycInfo, Aust Health, Dissertation Abstract International, Expanded Academic Index, Health Source Nursing, and Academic Search Elite. In addition, the reference lists of identified papers were hand searched, to capture all pertinent material, as well as relevant worldwide websites. Each paper was assessed by two reviewers for methodological quality prior to inclusion in the review using the critical appraisal instrument [Qualitative Assessment and Review Instrument (QARI)] from software developed by the Johanna Briggs Institute (JBI). A total of 18 qualitative papers were included in the review (nine grounded theory, six phenomenology, one ethnography, one social ecological, and one multiple case study). Forty-four papers were initially identified but 26 were excluded as they did not meet the inclusion criteria. Findings were extracted and meta-synthesised using JBI-QARI. Five syntheses about a young person's experience of chronic illness were derived: () the experience of chronic illness makes young people feel uncomfortable in their body and world; () the experience of chronic illness disrupts 'normal' life; () the experience of chronic illness is not all bad; () ways of getting through the chronic illness experience 'what others can do'; and () ways of getting through the chronic illness experience 'what I can do'. A positive perspective needs to be taken to promote mental health in young people with chronic illness; clinicians, families, and interventions need to (a) bolster their sense of self, (b) normalise the experience,

Understanding young peoples’ experience of chronic illness: a systematic review

Objective The objective of the review was to summarise the best available evidence that described a young person's experience of chronic illness and make recommendations towards the promotion of mental health and prevention of future mental health difficulties. Inclusion Criteria The review considered qualitative research that used the voices of young people (under 18 years) to describe their experience of chronic illness and the impact it had on their lives. Search Strategy The search strategy sought to find both published and unpublished research papers (limited to the English language). An extensive search was performed using the following databases: PubMed, CINAHL, Web of Science, PsycInfo, Aust Health, Dissertation Abstract International, Expanded Academic Index, Health Source Nursing, and Academic Search Elite. In addition, the reference lists of identified papers were hand searched, to capture all pertinent material, as well as relevant worldwide websites. Methodological Quality Each paper was assessed by two reviewers for methodological quality prior to inclusion in the review using the critical appraisal instrument [Qualitative Assessment and Review Instrument (QARI)] from software developed by the Johanna Briggs Institute (JBI). Results A total of 18 qualitative papers were included in the review (nine grounded theory, six phenomenology, one ethnography, one social ecological, and one multiple case study). Forty-four papers were initially identified but 26 were excluded as they did not meet the inclusion criteria. Findings were extracted and meta-synthesised using JBI-QARI. Five syntheses about a young person's experience of chronic illness were derived: (1) the experience of chronic illness makes young people feel uncomfortable in their body and world; (2) the experience of chronic illness disrupts ‘normal’ life; (3) the experience of chronic illness is not all bad; (4) ways of getting through the chronic illness experience ‘what others can do’; and (5) ways of getting through the chronic illness experience ‘what I can do’. Conclusion A positive perspective needs to be taken to promote mental health in young people with chronic illness; clinicians, families, and interventions need to (a) bolster their sense of self, (b) normalise the experience, (c) foster its positive impact, (d) help them accept the situation, and (e) help to develop the future orientated coping strategies that will provide them with a sense of hope.

Effectiveness of standard short-course chemotherapy for treating tuberculosis and the impact of drug resistance on its outcome.

Treating tuberculosis (TB) with short-course chemotherapy is recommended by the World Health Organization tuberculosis program and is one of the five packages of directly observed treatment short-course (DOTS) strategy. To investigate the effectiveness of short-course chemotherapy for treating new and retreatment TB patients and to assess the impact of drug resistance on its outcomes. Published studies from the electronic databases such as Cochrane Library, DARE, Medline, Embase, Current Contents, CINAHL, Expanded Academic Index, PsycInfo, AustHealth and unpublished studies from Dissertation Abstract International, Index to These, Cochrane Reviewer Handbook were searched between 1993-2002. Studies addressing the treatment of patients with short-course regimen and the association between drug resistance and treatment outcomes were included. Two reviewers independently assessed study quality and extracted data. Eleven cohort studies met the inclusion criteria. Treatment with 6-month daily regimens was effective for new TB patients with success rate (percentage of cure cases and treatment completed cases) of over 80%. Implementation of 100% directly observed treatment was necessary to achieve over 80% treatment success in new cases treated with the intermittent regimen. The intermittent regimens did not work effectively for retreatment cases since success rate was only 68.5% even in the setting using 100% directly observed treatment in Peru. Short-course regimens were effective against drug-sensitive TB with the success rate of 87%; ineffective for patients with multi-drug resistance (rate of treatment failure in new cases ranged 22.3%-35.5% and rate of treatment failure in retreatment cases ranged 16.3-37.1%). Drug resistance had a negative impact on the outcome of short-course therapy and multi-drug resistance had a huge negative impact on the effectiveness of chemotherapy for TB. The evidence suggests that the World Health Organization-targeted cure rate of 85% in new smear-positive TB cases is not achievable using the intermittent regimen and the target rate should be adjusted. DOTS-plus multi-drug resistant TB program of the world Health Organization should be adopted. However, the evidence is limited and the level of evidence was III-2.

Database Support for Research in Public Administration

Abstract This study examines the extent to which databases support student and faculty research in the area of public administration. A list of journals in public administration, public policy, political science, public budgeting and finance, and other related areas was compared to the journal content list of six business databases. These databases included ABI/INFORM, Business Source Premier, General Business File, Academic Search Premier, Expanded Academic Index, and International Academic Research Library. The results show that Expanded Academic Index, Business Source Premier, and International Academic Research Library have the most comprehensive holdings of public administration journals.

Management of short‐term indwelling urethral catheters to prevent urinary tract infections

Executive summaryBackground This systematic review updates a previous review published in 2000. The objective of this review was to present the best available evidence relating to the prevention of catheter‐associated urinary tract infections (UTI).Selection criteria This review considered randomised controlled trials (RCTs) of adult patients with short‐term urethral catheters. In the absence of RCTs, other research designs such as non‐randomised controlled trials and before and after studies were considered for inclusion. Interventions of interest were those related to the prevention of catheter‐related UTI and included: sterile versus non‐sterile insertion technique, special coatings to catheters versus standard non‐coated catheters, the use of flush solutions, the use of solutions added to urinary drainage bag, maintenance of a closed urinary drainage circuit, the use of antireflux valves, antibiotic creams applied to the external meatus–catheter interface, meatal care regimens, education programs, and changed care delivery practices. This review was limited to short‐term urethral catheters, and so studies evaluating long‐term or suprapubic catheters were excluded. The primary outcome of interest was the difference in the rates of UTI between experimental intervention and the control.Search strategy The search included both published and unpublished studies with an initial limited search of MEDLINE and CINAHL databases undertaken to identify key words contained in the title or abstract, and index terms used to describe relevant interventions. A second extensive search used all identified key words and index terms. The third step included a search of the reference lists and bibliographies of relevant articles. The databases searched included: CINAHL, MEDLINE, Current Contents, Cochrane Library, Expanded Academic Index, and Embase. The Dissertation Abstracts International database was searched for unpublished studies.Assessment of methodological quality Methodological quality was assessed using a standardised checklist. Critical appraisal and data extraction were conducted by two independent reviewers; discrepancies were addressed through discussion with a third reviewer as required.Results There was no significant difference in infection rate using either sterile surgical or non‐sterile insertion technique. The use of water for cleansing prior to catheter insertion was recommended. There was no additional benefit from specific meatal care other than standard daily personal hygiene and removal of debris. Infection rates were similar for both latex and silicone catheters. Comparisons between silver and Teflon coating clearly favoured the silver alloy coating. The use of a complex closed drainage system in the intensive care environment did not confer any additional benefit. Studies comparing types of junction seals and use of junction seals either prior to or following catheterisation found no clear benefit from using either preconnected sealed systems or sealed systems with the addition of silver releasing devices. Neither the addition of chlorhexidine nor hydrogen peroxide to the drainage bag was found to be effective at reducing UTI rates. The findings indicated there was a higher incidence of bacteriuria associated with Foley catheters compared with intermittent catheterisation (P < 0.025). A single RCT examined the effect on UTI rates of routine bag changes against no routine bag change. Routine bag changes were not advantageous in reducing the risk of infection.Conclusions Current RCT evidence suggests the use of a surgical sterile catheterisation technique is not required, and that tap water is sufficient for cleaning genitalia. Following insertion, daily hygiene around the meatal area is as effective as catheter toilets; and catheters impregnated with silver may reduce the incidence of catheter associated bacteriuria. Sealed (e.g. taped, presealed) drainage systems should not be relied upon as the sole mechanism for prevention of bacteriuria. The addition of antibacterial solutions to drainage bags and the routine change of drainage bags had no effect on catheter associated infection. However, most of the recommendations arising from this review were based on single studies, often with limited numbers of participants. There is an urgent need to replicate these studies in other clinical settings.

Child safety on farms: Issues and best practice recommendations

Objective: The main objective of this study was to systematically review the existing evidence for the effectiveness of farm injury prevention interventions.Search Strategy: We used a systematic approach to search the following electronic databases: MEDLINE, EMBASE, ERIC, PsycInfo, Sociofile, NTIS, Agricola, Expanded Academic Index, Dissertation Abstracts, and Occupational Safety and Health (NIOSHTIC). Proceedings and technical papers of the National Institute for Farm Safety were reviewed. We also checked the references of potentially eligible studies and consulted with experts in the field to identify other relevant information sources.Selection Criteria: Papers had to involve a farm safety intervention to be included in the review. To best characterize the current state of farm safety research, all study designs were accepted, including those without comparison groups and those with absent or inadequate evaluation methods.Results: We identified 25 studies for the review. Eleven of the studies involved farm safety education programs, five consisted of multifaceted interventions that included environmental revisions, a farm visit, or both; nine papers described farm safety interventions but did not report results from an evaluation. Farm safety education interventions included safety fairs, day camps; certification programs; workshops; and courses for farm families, youth, and agricultural workers. Multifaceted interventions were targeted to farm operators and generally involved farm safety audits, followed by environmental or equipment changes and/or safety education. Program evaluations assessed changes in safety attitudes, knowledge, and/or behaviors and generally involved pre- and post-test methodology. Only three studies examined changes in the incidence of farm injuries. Of the studies evaluated, most reported positive changes following the interventions. However, limitations in the design of evaluations make the results of many of the studies difficult to interpret.Conclusions: There is a need for more rigorous evaluations of farm safety intervention programs. Suggested study design improvements include randomization of study subjects when appropriate, use of control groups and the objective measurement of outcomes such as behavior change and injury incidence.

Management of short-term indwelling urethral catheters to prevent urinary tract infections

Background This systematic review updates a previous review published in 2000. The objective of this review was to present the best available evidence relating to the prevention of catheter-associated urinary tract infections (UTI). Selection criteria This review considered randomised controlled trials (RCTs) of adult patients with short-term urethral catheters. In the absence of RCTs, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion. Interventions of interest were those related to the prevention of catheter-related UTI and included: sterile versus non-sterile insertion technique, special coatings to catheters versus standard non-coated catheters, the use of flush solutions, the use of solutions added to urinary drainage bag, maintenance of a closed urinary drainage circuit, the use of antireflux valves, antibiotic creams applied to the external meatus–catheter interface, meatal care regimens, education programs, and changed care delivery practices. This review was limited to short-term urethral catheters, and so studies evaluating long-term or suprapubic catheters were excluded. The primary outcome of interest was the difference in the rates of UTI between experimental intervention and the control. Search strategy The search included both published and unpublished studies with an initial limited search of MEDLINE and CINAHL databases undertaken to identify key words contained in the title or abstract, and index terms used to describe relevant interventions. A second extensive search used all identified key words and index terms. The third step included a search of the reference lists and bibliographies of relevant articles. The databases searched included: CINAHL, MEDLINE, Current Contents, Cochrane Library, Expanded Academic Index, and Embase. The Dissertation Abstracts International database was searched for unpublished studies. Assessment of methodological quality Methodological quality was assessed using a standardised checklist. Critical appraisal and data extraction were conducted by two independent reviewers; discrepancies were addressed through discussion with a third reviewer as required. Results There was no significant difference in infection rate using either sterile surgical or non-sterile insertion technique. The use of water for cleansing prior to catheter insertion was recommended. There was no additional benefit from specific meatal care other than standard daily personal hygiene and removal of debris. Infection rates were similar for both latex and silicone catheters. Comparisons between silver and Teflon coating clearly favoured the silver alloy coating. The use of a complex closed drainage system in the intensive care environment did not confer any additional benefit. Studies comparing types of junction seals and use of junction seals either prior to or following catheterisation found no clear benefit from using either preconnected sealed systems or sealed systems with the addition of silver releasing devices. Neither the addition of chlorhexidine nor hydrogen peroxide to the drainage bag was found to be effective at reducing UTI rates. The findings indicated there was a higher incidence of bacteriuria associated with Foley catheters compared with intermittent catheterisation (P < 0.025). A single RCT examined the effect on UTI rates of routine bag changes against no routine bag change. Routine bag changes were not advantageous in reducing the risk of infection. Conclusions Current RCT evidence suggests the use of a surgical sterile catheterisation technique is not required, and that tap water is sufficient for cleaning genitalia. Following insertion, daily hygiene around the meatal area is as effective as catheter toilets; and catheters impregnated with silver may reduce the incidence of catheter associated bacteriuria. Sealed (e.g. taped, presealed) drainage systems should not be relied upon as the sole mechanism for prevention of bacteriuria. The addition of antibacterial solutions to drainage bags and the routine change of drainage bags had no effect on catheter associated infection. However, most of the recommendations arising from this review were based on single studies, often with limited numbers of participants. There is an urgent need to replicate these studies in other clinical settings.

Management of short-term indwelling urethral catheters to prevent urinary tract infections

Background This systematic review updates a previous review published in 2000. The objective of this review was to present the best available evidence relating to the prevention of catheter-associated urinary tract infections (UTI). Selection criteria This review considered randomised controlled trials (RCTs) of adult patients with short-term urethral catheters. In the absence of RCTs, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion. Interventions of interest were those related to the prevention of catheter-related UTI and included: sterile versus non-sterile insertion technique, special coatings to catheters versus standard non-coated catheters, the use of flush solutions, the use of solutions added to urinary drainage bag, maintenance of a closed urinary drainage circuit, the use of antireflux valves, antibiotic creams applied to the external meatus-catheter interface, meatal care regimens, education programs, and changed care delivery practices. This review was limited to short-term urethral catheters, and so studies evaluating long-term or suprapubic catheters were excluded. The primary outcome of interest was the difference in the rates of UTI between experimental intervention and the control. Search strategy The search included both published and unpublished studies with an initial limited search of MEDLINE and CINAHL databases undertaken to identify key words contained in the title or abstract, and index terms used to describe relevant interventions. A second extensive search used all identified key words and index terms. The third step included a search of the reference lists and bibliographies of relevant articles. The databases searched included: CINAHL, MEDLINE, Current Contents, Cochrane Library, Expanded Academic Index, and Embase. The Dissertation Abstracts International database was searched for unpublished studies. Assessment of methodological quality Methodological quality was assessed using a standardised checklist. Critical appraisal and data extraction were conducted by two independent reviewers; discrepancies were addressed through discussion with a third reviewer as required. Results There was no significant difference in infection rate using either sterile surgical or non-sterile insertion technique. The use of water for cleansing prior to catheter insertion was recommended. There was no additional benefit from specific meatal care other than standard daily personal hygiene and removal of debris. Infection rates were similar for both latex and silicone catheters. Comparisons between silver and Teflon coating clearly favoured the silver alloy coating. The use of a complex closed drainage system in the intensive care environment did not confer any additional benefit. Studies comparing types of junction seals and use of junction seals either prior to or following catheterisation found no clear benefit from using either preconnected sealed systems or sealed systems with the addition of silver releasing devices. Neither the addition of chlorhexidine nor hydrogen peroxide to the drainage bag was found to be effective at reducing UTI rates. The findings indicated there was a higher incidence of bacteriuria associated with Foley catheters compared with intermittent catheterisation (P < 0.025). A single RCT examined the effect on UTI rates of routine bag changes against no routine bag change. Routine bag changes were not advantageous in reducing the risk of infection. Conclusions Current RCT evidence suggests the use of a surgical sterile catheterisation technique is not required, and that tap water is sufficient for cleaning genitalia. Following insertion, daily hygiene around the meatal area is as effective as catheter toilets; and catheters impregnated with silver may reduce the incidence of catheter associated bacteriuria. Sealed (e.g. taped, presealed) drainage systems should not be relied upon as the sole mechanism for prevention of bacteriuria. The addition of antibacterial solutions to drainage bags and the routine change of drainage bags had no effect on catheter associated infection. However, most of the recommendations arising from this review were based on single studies, often with limited numbers of participants. There is an urgent need to replicate these studies in other clinical settings.

Management of short-term indwelling urethral catheters to prevent urinary tract infections.

This systematic review updates a previous review published in 2000. The objective of this review was to present the best available evidence relating to the prevention of catheter-associated urinary tract infections (UTI). This review considered randomised controlled trials (RCTs) of adult patients with short-term urethral catheters. In the absence of RCTs, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion. Interventions of interest were those related to the prevention of catheter-related UTI and included: sterile versus non-sterile insertion technique, special coatings to catheters versus standard non-coated catheters, the use of flush solutions, the use of solutions added to urinary drainage bag, maintenance of a closed urinary drainage circuit, the use of antireflux valves, antibiotic creams applied to the external meatus-catheter interface, meatal care regimens, education programs, and changed care delivery practices. This review was limited to short-term urethral catheters, and so studies evaluating long-term or suprapubic catheters were excluded. The primary outcome of interest was the difference in the rates of UTI between experimental intervention and the control. The search included both published and unpublished studies with an initial limited search of MEDLINE and CINAHL databases undertaken to identify key words contained in the title or abstract, and index terms used to describe relevant interventions. A second extensive search used all identified key words and index terms. The third step included a search of the reference lists and bibliographies of relevant articles. The databases searched included: CINAHL, MEDLINE, Current Contents, Cochrane Library, Expanded Academic Index, and Embase. The Dissertation Abstracts International database was searched for unpublished studies. Methodological quality was assessed using a standardised checklist. Critical appraisal and data extraction were conducted by two independent reviewers; discrepancies were addressed through discussion with a third reviewer as required. There was no significant difference in infection rate using either sterile surgical or non-sterile insertion technique. The use of water for cleansing prior to catheter insertion was recommended. There was no additional benefit from specific meatal care other than standard daily personal hygiene and removal of debris. Infection rates were similar for both latex and silicone catheters. Comparisons between silver and Teflon coating clearly favoured the silver alloy coating. The use of a complex closed drainage system in the intensive care environment did not confer any additional benefit. Studies comparing types of junction seals and use of junction seals either prior to or following catheterisation found no clear benefit from using either preconnected sealed systems or sealed systems with the addition of silver releasing devices. Neither the addition of chlorhexidine nor hydrogen peroxide to the drainage bag was found to be effective at reducing UTI rates. The findings indicated there was a higher incidence of bacteriuria associated with Foley catheters compared with intermittent catheterisation (P < 0.025). A single RCT examined the effect on UTI rates of routine bag changes against no routine bag change. Routine bag changes were not advantageous in reducing the risk of infection. Current RCT evidence suggests the use of a surgical sterile catheterisation technique is not required, and that tap water is sufficient for cleaning genitalia. Following insertion, daily hygiene around the meatal area is as effective as catheter toilets; and catheters impregnated with silver may reduce the incidence of catheter associated bacteriuria. Sealed (e.g. taped, presealed) drainage systems should not be relied upon as the sole mechanism for prevention of bacteriuria. The addition of antibacterial solutions to drainage bags and the routine change of drainage bags had no effect on catheter associated infection. However, most of the recommendations arising from this review were based on single studies, often with limited numbers of participants. There is an urgent need to replicate these studies in other clinical settings.

Prevention and management of shoulder pain in the hemiplegic patient

Executive summaryObjective The objective of this review was to summarise the best available research related to the prevention and management of shoulder pain in the hemiplegic patient.Inclusion criteria This review considered all studies that included hemiplegic patients post‐cerebral vascular accident (CVA). Interventions of interest were any treatments or programs used to manage or prevent shoulder pain secondary to hemiplegia. The primary outcomes of interest were those related to pain. This review considered any randomised controlled trials (RCT) that evaluated the effectiveness of interventions that addressed shoulder pain in hemiplegic patients. In the absence of RCT, other research designs such as non‐randomised controlled trials, time series and case series were also considered for inclusion in a narrative summary.Search strategy The search sought to find both published and unpublished studies. Databases were searched up to February 2002 and included Medline, CINAHL, Current Contents, Cochrane Library, Expanded Academic Index, Electronic Collections Online, Turning Research Into Practice (TRIP), Dissertation Abstracts and Proceedings First. The reference lists of all studies identified were searched for additional studies.Assessment of methodological quality All studies were checked for methodological quality by two reviewers and data was extracted using a data extraction tool.Results Current research evaluating the effectiveness of treatment interventions on hemiplegic shoulder pain is very limited. The studies were very diverse in their nature of research. There has been no replication of studies, with the studies found using different populations, interventions or outcome measures. Not one study could be compared with another. Meta‐analysis was unable to be performed not only because of inadequate reporting of results, but more often due to differences between the studies’ participants and the range of interventions used. The diversity in interval post‐CVA also makes it difficult to make any comparisons between studies. For this reason the review is in narrative form.Conclusions With this limited evidence, no single intervention has been identified that offers a dramatic effect in terms of treating pain in the hemiplegic shoulder. There is potential for some benefits for the patient's functional and comfort status, thereby improving their quality of life and maximising their social participation.Preventive interventions demonstrated that a shoulder positioning policy had no statistically significant effect on pain. Strapping within 48 h significantly delayed the onset of pain and current research evaluating exercise is not limited to just one area of exercise, but a diverse range, making it difficult to make any comparisons. Some studies did suggest evidence of improvement, albeit limited. However, some of the exercise techniques aggravated shoulder pain. Treatment interventions demonstrated that electromyogram biofeedback cannot be evaluated as a stand‐alone therapy as it is used in conjunction with relaxation therapy. Intra‐articular Triamcinolone Acetonide injections in a small RCT have not been proven to be beneficial, and are associated with a high incidence of side‐effects. Different exercise techniques may aggravate shoulder pain more than others (e.g. Bobath technique compared to cryotherapy). The systematic review on the effectiveness of functional electrical stimulation was used for prevention and treatment and concluded that there is currently no evidence for effect.