International Systematic Review Research Articles

The economic burden of (obstructive) sleep apnea. Costs and implications for Germany based on the results of an international systematic review

The economic burden of (obstructive) sleep apnea. Costs and implications for Germany based on the results of an international systematic review

Systematic review and network meta‐analysis of mesenchymal stem cells in treating diabetic skin ulcers in animal models

AbstractBackgroundDiabetic cutaneous ulcers often pose considerable challenges in the healing process. These challenges stem from factors including inadequate perfusion of the ulcer's surrounding environment, persistent inflammation, tissue damage and microbial proliferation. The existing standard treatment modalities prove insufficient in fully addressing the complex pathogenesis of these ulcers. As a novel approach, researchers are exploring cellular therapies employing mesenchymal stem cells (MSCs) for the treatment of diabetic skin ulcers. MSCs are readily found in various tissues, including bone marrow, adipose tissue, placenta, amniotic membrane, amniotic fluid and umbilical cord. However, the optimal source of MSCs for effectively treating diabetic skin ulcers remains a topic of ongoing discussion.MethodsWe conducted a comprehensive search of Embase, PubMed and Web of Science databases, spanning from their inception to November 2022. Subsequently, we rigorously screened the literature following predetermined inclusion and exclusion criteria and evaluated the quality of the selected studies using the SYRCLE scale. Finally, the included literature underwent analysis, employing the Bayesian school of thought‐based R language. To ensure transparency and accountability, we registered this study with PROSPERO's International Systematic Review Prospective Registry, with the Registration ID: CRD42023387421.ResultsWe included a total of 11 articles in our analysis, all of which were randomized controlled studies involving 218 animal models. Among these studies, two utilized adipose‐derived MSCs, six employed bone marrow‐derived MSCs, one utilized amniotic membrane‐derived MSCs and three utilized umbilical cord‐derived MSCs. Our network meta‐analysis results revealed that there were no statistically significant differences in the healing rates of diabetic skin ulcers among MSCs derived from amniotic membrane, adipose tissue, umbilical cord and bone marrow on days 7–8, 10–12 and 12–14. Notably, according to the probability ranking table, the most effective treatment for diabetic wounds was found to be amniotic membrane‐derived MSCs.ConclusionThere was no statistically significant difference in the efficacy of MSCs derived from amniotic membrane, adipose, umbilical cord and bone marrow in the treatment of diabetic skin ulcers during the short‐term observation period, and the probability ranking graphs indicate that amniotic membrane‐derived MSCs may be the best choice for the treatment of diabetic skin ulcers.

International Consensus Criteria for Pediatric Sepsis and Septic Shock

Sepsis is a leading cause of death among children worldwide. Current pediatric-specific criteria for sepsis were published in 2005 based on expert opinion. In 2016, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, but it excluded children. To update and evaluate criteria for sepsis and septic shock in children. The Society of Critical Care Medicine (SCCM) convened a task force of 35 pediatric experts in critical care, emergency medicine, infectious diseases, general pediatrics, nursing, public health, and neonatology from 6 continents. Using evidence from an international survey, systematic review and meta-analysis, and a new organ dysfunction score developed based on more than 3 million electronic health record encounters from 10 sites on 4 continents, a modified Delphi consensus process was employed to develop criteria. Based on survey data, most pediatric clinicians used sepsis to refer to infection with life-threatening organ dysfunction, which differed from prior pediatric sepsis criteria that used systemic inflammatory response syndrome (SIRS) criteria, which have poor predictive properties, and included the redundant term, severe sepsis. The SCCM task force recommends that sepsis in children be identified by a Phoenix Sepsis Score of at least 2 points in children with suspected infection, which indicates potentially life-threatening dysfunction of the respiratory, cardiovascular, coagulation, and/or neurological systems. Children with a Phoenix Sepsis Score of at least 2 points had in-hospital mortality of 7.1% in higher-resource settings and 28.5% in lower-resource settings, more than 8 times that of children with suspected infection not meeting these criteria. Mortality was higher in children who had organ dysfunction in at least 1 of 4-respiratory, cardiovascular, coagulation, and/or neurological-organ systems that was not the primary site of infection. Septic shock was defined as children with sepsis who had cardiovascular dysfunction, indicated by at least 1 cardiovascular point in the Phoenix Sepsis Score, which included severe hypotension for age, blood lactate exceeding 5 mmol/L, or need for vasoactive medication. Children with septic shock had an in-hospital mortality rate of 10.8% and 33.5% in higher- and lower-resource settings, respectively. The Phoenix sepsis criteria for sepsis and septic shock in children were derived and validated by the international SCCM Pediatric Sepsis Definition Task Force using a large international database and survey, systematic review and meta-analysis, and modified Delphi consensus approach. A Phoenix Sepsis Score of at least 2 identified potentially life-threatening organ dysfunction in children younger than 18 years with infection, and its use has the potential to improve clinical care, epidemiological assessment, and research in pediatric sepsis and septic shock around the world.

The differences in lymph node metastases patterns among non-pancreatic periampullary cancers and histological subtypes: an international multicenter retrospective cohort study and systematic review

The differences in lymph node metastases patterns among non-pancreatic periampullary cancers and histological subtypes: an international multicenter retrospective cohort study and systematic review

A Systematic Review of International and Internal Climate-Induced Migration in Africa

Academics and policymakers have been paying close attention to the impact of climate change on migration in recent years. This phenomenon piqued interest because the factors driving environmentally induced migration are complex and manifold. Noticeably, there has been considerable scholarship on climate change and migration in Africa. However, there has not been a concerted effort to periodically review the existing literature to systematically document the state of scholarship. Using a standardized systematic review procedures to analyze 22 peer-reviewed studies published between 2000 and 2022, we found that climate change impacts migration in many complex and multilayered forms. Beyond what has already been established in the literature on climate-related migration such as environmental effects on migration; migration as an adaptation strategy; and the influence of environmental and non-environmental factors on migration; we also found that (1) studies on climate-induced migration in Africa intensely focused on SSA, suggesting an uneven study of the region, (2) heavily affected people tend to be immobile, and (3) young people have high migration intentions due to harsh climate insecurities. These findings require urgent government and stakeholder attention. Specifically, there is a need for scholarship to interrogate the climate change–immobility nexus in order to design appropriate in situ or ex situ adaptation strategies to support lives and livelihoods.

Delays in transferring patients from prisons to secure psychiatric hospitals: An international systematic review.

Transfer to a psychiatric hospital of prisoners who need inpatient treatment for a mental disorder is an important part of prison healthcare in the UK. It is an essential factor in ensuring the principle of equivalence in the treatment of prisoners. In England and Wales, delays in transferring unwell prisoners to hospital were identified by the 2009 Bradley Report. There has been no subsequent systematic review of progress in so doing nor a corresponding appraisal of transfer arrangements in other parts of the world. To conduct a systematic review of international literature about transfers of mentally unwell individuals from prison to hospital for the treatment of mental disorder since 2009. Eight databases were searched for data-based publications using terms for prison and transfer to hospital from 1 January 2009 to 4 August 2022. Inclusion criteria limited transfer to arrangements for pre-trial and sentenced prisoners going to a health service hospital, excluding hospital orders made on the conclusion of criminal hearing. In England, four articles were identified, all showing that transfer times remain considerably longer than the national targets of 14days (range, 14days to >9months); one study from Scotland found shorter mean transfer times, but more patients had been transferred to psychiatric intensive care units than to secure forensic hospitals. There were only two studies that investigated prison to hospital transfers for mental disorder from outside the UK and only one reported time-to-transfer data. Findings from this literature review highlight failures to resolve transfer delays in England and provide little evidence about the problem elsewhere. Given the lack of data, it is unclear whether other countries do not have this problem or simply that there has been no research interest in it. A possible confounding factor here is that, in some countries, all treatment for prisoners' mental disorders occurs in prison. However, the principle that prisons are not hospitals seems important when people need inpatient care. Prospective, longitudinal cohort studies are urgently needed to map transfer times and outcomes.

"Injuries in Elite Female Soccer Players: An International Systematic Review"

"Injuries in Elite Female Soccer Players: An International Systematic Review"

Workplace violence and its effect on nursing professionals at the in-hospital level: a national and international systematic review

Psychological harassment in the workplace, or mobbing, is a practice that has become today a health problem that affects not only the victim but also society as a whole; however, nursing professionals, who are both victims and perpetrators, are no exception. The present study allows, within the framework of the research, to gather more sources of information in order to provide the basis for the creation of protocols, public policies and measures to protect and promote a healthy work environment, free of violent practices and based on the ultimate goal of the profession: to take care of oneself in order to take care of others. Objective: To identify the effects of workplace violence on the mental health of nursing professionals within the in-hospital setting at the national and international level. Method: An exhaustive analysis of the world literature on workplace mobbing among nursing professionals from different countries was carried out. For this purpose, databases such as Web of Science, Scielo, ResearchGate, PubMed, Science Direct, Redalyc, Google Scholar and the Repositorio Académico de la Universidad de Chile were used, where a series of key words corresponding to the research topic were used. Results: There are effects on health, interpersonal relationships and job performance in nurses when exposed to workplace bullying. Coping and prevention strategies used by nurses from various countries against mobbing were identified. Conclusions: It was possible to identify the negative effects of workplace mobbing among nursing professionals, as well as their respective coping and prevention strategies. It is recommended to increase research on the subject and implement urgent regulations at the national level.

Does Voluntary Work Contribute to Cognitive Performance? - An International Systematic Review.

There is a need for knowledge on activities that can reduce cognitive decline and dementia risk. Volunteering is a productive activity that entails social, physical, and cognitive functions. Therefore, volunteering could be a protective factor for cognitive loss. Thus, this review aims to examine the associations between volunteering and volunteers' cognition and to identify influencing variables. Six international literature databases were searched for relevant articles published between 2017 and 2021 (ALOIS, CENTRAL, CINAL, Embase, PsycINFO, PubMed). Quantitative studies of all study designs were included. The primary outcome was the volunteers' cognition measured by objective, internationally established psychometric function tests. Two authors independently assessed the eligibility and quality of the studies. A narrative synthesis was performed using all studies included in this review. The methodology was in line with the PRISMA guidelines. Fourteen studies met the inclusion criteria and were included. Seven of the included studies confirmed that volunteering positively affects the volunteers' cognitive function. Two other studies identified an association between volunteer activity and volunteers' cognition using cross-sectional measurements. In particular, women and people with a low level of education benefit from the positive effects and associations. The study quality of the included articles was moderate to weak. Our review suggests that volunteering can improve volunteers' cognition. Unfortunately, little attention is given to specific volunteer activities and the frequency of engagement. Additionally, more attention is needed on various risk factors of cognitive impairment.

The impact of tableside ordering technologies on alcohol sales to the intoxicated.

The impact of tableside ordering technologies on alcohol sales to the intoxicated.

An International Systematic Review Concerning the Effect of Social Media Exposure on Public Compliance with Infection Prevention and Control Measures During the COVID-19 Pandemic.

Effective health communication is crucial for achieving positive population health outcomes. This is important for infection prevention and control (IPC), which relies on widespread public compliance to be effective. Whilst social media (SM) platforms disseminate health information, there is conflicting evidence to suggest their influence on compliance with public health guidelines. To appraise the available evidence and determine the extent to which social media exposure contributes to public compliance with IPC measures. A systematic protocol based on the MOOSE and PRISMA guidelines was followed. Observational studies were identified through systematic searches of four electronic databases and a hand search. Following data extraction, eligible studies were quality assessed, and the findings were integrated using narrative synthesis. 15 studies were included. The studies located presented heterogeneous designs and findings. A weak positive association was identified, with 60% of the studies observing a positive association between social media and compliance with IPC measures. 26.7% identified a negative correlation, and 13.3% identified no correlation. Several factors were identified to mediate the relationship, including knowledge and conspiracy beliefs. This systematic review identified a weak positive correlation between exposure to social media and public compliance with recommended IPC measures, suggesting that social media should be utilised in future IPC related communication strategies. Social media provides a cost-effective, publicly accessible platform to disseminate accurate information, and neutralise misinformation. Recommendations are made for further research to reduce the uncertainty created by the identification of heterogenous studies.

Outbreaks Following Natural Disasters: A Review of the Literature.

Understanding the relationship between infectious disease outbreaks and natural disasters is important in developing response and disaster risk reduction strategies. The aim of this study was to identify outbreaks associated with natural disasters during the past 20 y, and outline risk factors and mechanisms for postdisaster outbreaks. Review of the international disaster database (EM-DAT) and systematic review of the literature were conducted. The records of disaster events in EM-DAT during the past 20 y were screened. A literature search was carried out in the databases PubMed and Embase. Articles in English language published between 2000 and 2020 were searched. Data were extracted from articles and Narrative synthesis was used to summarize the findings. We found 108 events associated with epidemics, the majority being floods. We found 36 articles, most of them focused on outbreaks after floods. Risk factors and mechanisms that contributed to the outbreaks were mainly related to the consequences of disaster and its impact on the environment and living conditions of population. Infrastructure readiness and postdisaster measures play important roles in controlling the spread of epidemics after natural disasters. More evidence and research are required for better understanding of the association between natural disasters and infectious diseases outbreaks.

“Am I Going to Die?”: Delivering Serious News to Patients With Liver Disease

“Am I Going to Die?”: Delivering Serious News to Patients With Liver Disease

Life-threatening cardiac arrhythmia and sudden death during electronic gaming: An international case series and systematic review.

Electronic gaming has recently been reported as a precipitant of life-threatening cardiac arrhythmia in susceptible individuals. The purpose of this study was to describe the population at risk, the nature of cardiac events, and the type of game linked to cardiac arrhythmia associated with electronic gaming. A multisite international case series of suspected or proven cardiac arrhythmia during electronic gaming in children and a systematic review of the literature were performed. Twenty-two patients (18 in the case series and 4 via systematic review; aged 7-16 years; 19 males [86%]) were identified as having experienced suspected or proven ventricular arrhythmia during electronic gaming; 6 (27%) had experienced cardiac arrest, and 4 (18%) died suddenly. A proarrhythmic cardiac diagnosis was known in 7 (31%) patients before their gaming event and was established afterward in 12 (54%). Ten patients (45%) had catecholaminergic polymorphic ventricular tachycardia, 4 (18%) had long QT syndrome, 2 (9%) were post-congenital cardiac surgery, 2 (9%) had "idiopathic" ventricular fibrillation, and 1 (after Kawasaki disease) had coronary ischemia. In 3 patients (14%), including 2 who died, the diagnosis remains unknown. In 13 (59%) patients for whom the electronic game details were known, 8 (62%) were war games. Electronic gaming can precipitate lethal cardiac arrhythmias in susceptible children. The incidence appears to be low, but syncope in this setting should be investigated thoroughly. In children with proarrhythmic cardiac conditions, electronic war games in particular are a potent arrhythmic trigger.

Higher Education Stakeholders’ Views on Guiding the Implementation of Learning Analytics for Study Success


 
 
 Learning analytics show promise to support study success in higher education. Hence, they are increasingly adopted in higher education institutions. This study examines higher education stakeholders’ views on learning analytics utilisation to support study success. Our main research question was to investigate how ready higher education institutions are to adopt learning analytics. We derived policy guidelines from an international systematic review of the last five years of learning analytics research. Due to the lack of rigorous learning analytics research and adoption, this study examines how ready university stakeholders are to adopt learning analytics. In order to validate the guidelines, we conducted an interview study with 37 higher education stakeholders. The majority of participants stated that their institutions required further resources in order to adopt learning analytics but were able to identify what these resources were in order for successful implementation. Overall, stakeholders agree that learning analytics show much promise to support study success at higher education institutions.
 
 

An International Systematic Review of Prevalence, Risk, and Protective Factors Associated with Young People's E-Cigarette Use.

While the prevalence of young people’s conventional cigarette use has decreased in many countries, the use of e-cigarettes has risen. To effectively counteract the growing popularity of e-cigarettes among young people internationally, researchers should know the exact prevalence as well as the protective and risk factors associated with vaping. Based on five eligibility criteria, 53 articles were chosen and analyzed by general characteristics, prevalence, sample characteristics, gender difference, protective factors, and risk factors. In this study, the international pooled prevalence of young people’s lifetime e-cigarette use was 15.3%, the current use was 7.7%, and dual use was 4.0%. While the highest lifetime, current, and dual prevalence were found in Sweden, Canada, and the United Kingdom, respectively, the lowest prevalence was found in Germany, followed by South Korea and Sweden. Some protective and risk factors include perceived cost and danger of vaping, parental monitoring, internal developmental assets, cigarette use, family and peer smoking, exposure to online advertisements, and the presence of nearby retail stores. Based on this review, researchers and practitioners can develop different intervention programs and strategies for young smokers.

Social Work and attention to the social dimension of eating disorders: an international systematic review

ABSTRACT Social Work addresses the social dimension of the person, which must be taken into account to promote a comprehensive approach to eating disorders. Under this consideration, we have tried to synthesise and analyze the available evidence of the role of Social Work and social intervention in eating disorders through an international systematic review. The systematic review followed the PRISMA standards, and a narrative synthesis analysis was generated. We searched the databases Web of Science, Scopus, PubMed y Cochchrane. 501 references were found, and a total of 19 articles that met the quality indicators were analyzed, in which the following categories related to eating disorders were found: types of interventions and Social Work in eating disorders, sociodemographic aspects to be considered, clinical particularities to be contemplated, attention to the family system and the support network, ethical aspects, and barriers and needs of the disease to be covered. The need for Social Work to delve into the particularities and consequences of eating disorders to make a social diagnosis and address the social dimension is highlighted. To date, the discipline has little specific literature on the subject, which is a professional challenge to be met.

Guidelines for the management of male urinary tract infections in primary care: a lack of international consensus-a systematic review of the literature.

The management of adult male urinary tract infections (mUTIs) in primary care lacks international consensus. The main objective of this study was to describe the different guidelines for the diagnosis and management of mUTIs in primary care, to assess their methodological quality, and to describe their evidence-based strength of recommendation (SoR). An international systematic literature review of the electronic databases Medline (PubMed) and EMBASE, and gray-literature guideline-focused databases was performed in 2021. The Appraisal of Guidelines for Research and Evaluation (AGREE II) assessment tool was used by 2 independent reviewers to appraise each guideline. From 1,678 records identified, 1,558 were screened, 134 assessed for eligibility, and 29 updated guidelines met the inclusion criteria (13 from Medline, 0 from EMBASE, and 16 from gray literature). Quality assessment revealed 14 (48%) guidelines with high-quality methodology. A grading system methodology was used in 18 (62%) guidelines. Different classifications of mUTIs are described, underlining a lack of international consensus: an anatomic classification (cystitis, prostatitis, pyelonephritis) and a symptomatic classification (approach based on the intensity and tolerance of symptoms). The duration of antibiotic treatment for febrile mUTIs has been gradually reduced over the last 20 years from 28 days to 10-14 days of fluoroquinolones (FQ), which has become the international gold standard. Guidelines from Scandinavian countries propose short courses (3-5 days) of FQ-sparing treatments: pivmecillinam, nitrofurantoin, or trimethoprim. Guidelines from French-speaking countries use a watchful waiting approach and suggest treating mUTIs with FQ, regardless of fever. This lack of scientific evidence leads to consensus and disagreement: 14 days of FQ for febrile mUTIs is accepted despite a high risk of antimicrobial resistance, but FQ-sparing treatment and/or short treatment for afebrile mUTIs is not. The definition of afebrile UTIs/cystitis is debated and influences the type and duration of antibiotic treatment recommended.

Radiotherapy and Radiosurgery in the Management of Optic Nerve Sheath Meningiomas: An International Systematic Review and Meta-Analysis of Twenty Studies

Optic nerve sheath meningiomas (ONMs) are often managed with radiotherapy (RT) with the goal of achieving radiographic local control (LC) and preventing deterioration of visual acuity (VA). We aimed to perform a systematic review and meta-analysis of outcomes for patients with ONM treated with RT. The PICOS/PRISMA/MOOSE selection criteria were used to identify studies. Primary outcomes were stable or improved VA and radiographic LC at last follow-up. The secondary outcomes were incidences of radiation-induced retinopathy and xerophthalmia and stable or improved visual fields (VFs). Weighted random-effects meta-analyses using the DerSimonian and Laird methods were conducted to characterize effect sizes. Mixed-effects regression models were used to examine potential correlations between gross tumor volume (GTV) and outcomes. In total, 444 patients with ONM across 20 published studies were included. The estimated LC rate was 99.8% (95% confidence interval [CI], 98.3%-100%), and the estimated proportion of patients with stable or improved VA or VF was 89.7% (95% CI, 86.2%-92.4%) and 93.3% (95% CI, 89.5%-95.8%), respectively. Estimated incidences of radiation-induced retinopathy and xerophthalmia were 7.2% and 10.1%, respectively. GTV was significantly associated with VA (P= 0.014) with estimated VA rates of 96.4%, 91.4%, and 80.5% for GTVs of 2.0, 3.0, and 4.0 cm3, respectively. RT was well tolerated, with excellent LC achieved. Nearly 90% of patients noted either stability or improvement in VA and VF. Larger ONMs were associated with poorer VA.

A review of trial and real-world data applying elements of a realist approach to identify behavioural mechanisms supporting practitioners to taper opioids.

This evidence synthesis applying realist concepts and behavioural science aimed to identify behavioural mechanisms and contexts that facilitate prescribers tapering opioids. We identified relevant opioid‐tapering interventions and services from a 2018 international systematic review and a 2019 England‐wide survey, respectively. Interventions and services were eligible if they provided information about contexts and/or behavioural mechanisms influencing opioid‐tapering success. A stakeholder group (n = 23) generated draft programme theories based around the 14 domains of the Theoretical Domains Framework. We refined these using the trial and service data. From 71 articles and 21 survey responses, 56 and 16 respectively were included, representing primary care, hospital, specialist pain facilities and prison services. We identified 6 programme theories comprising 5 behavioural mechanisms: prescribers' knowledge about how to taper; build prescribers' beliefs about capabilities to initiate tapering discussions and manage psychological consequences of tapering; perceived professional role in tapering; the environmental context enabling referral to specialists; and facilitating positive social influence by aligning patient: prescriber expectations of tapering. No interventions are addressing all 6 mechanisms supportive of tapering. Work is required to operationalise programme theories according to organisational structures and resources. An example operationalisation is combining tapering guidelines with information about local excess opioid problems and endorsing these with organisational branding. Prescribers being given the skills and confidence to initiate tapering discussions by training them in cognitive‐based interventions and incorporating access to psychological and physical support in the patient pathway. Patients being provided with leaflets about the tapering process and informed about the patient pathway.