scholarly journals Systematic review of evidence underpinning non-pharmacological therapies in dementia

2018 ◽  
Vol 42 (4) ◽  
pp. 361 ◽  
Author(s):  
Richard Olley ◽  
Andrea Morales
Keyword(s):  
Systematic Review ◽  
Sleep Disturbances ◽  
Research Effort ◽  
Evidence Base ◽  
Pharmacological Therapy ◽  
Sufficient Evidence ◽  
Behavioural Treatment ◽  
Significant Research ◽  
Research Gap ◽  
Meta Analyses

Objective Dementia is one of the most common illnesses worldwide, and is one of the most important causes of disability in older people. Currently, dementia affects over 35 million people around the globe. It is expected that this number will increase to 65.7 million by 2030. Early detection, diagnosis and treatment to control the principal behaviour symptoms may help reduce these numbers and delay the progression to more advanced and dangerous stages of this disorder with resultant increase quality of life for those affected. The main goal of the present systematic literature review was to examine contemporary evidence relating to non-pharmacological therapy in the treatment of dementia. Methods To achieve the study goal, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used. Results This study identified the five most common behaviours in patients with dementia as aggression, wandering, agitation, apathy and sleep disturbances. Two non-pharmacological therapies were the most studied treatment: music therapy and aromatherapy. Ten other non-pharmacological therapies were also identified, but these lack a sufficient evidence-base. Conclusion Although all the therapies identified could be used as part of the treatment of behavioural symptoms, there is insufficient evidence relating to the indications, appropriate use and effectiveness of these therapies to apply in each behavioural treatment. Thus, the present study has demonstrated a significant research gap. What is known about the topic? Despite the widespread use of many different types of therapies, there is limited evidence regarding the efficacy of non-pharmaceutical therapies deployed in the management of behaviours of concern manifested by some people who suffer with dementia in all its forms. What does this paper add? This systematic review examines contemporary evidence from the literature to determine whether there is an evidence base available that would underpin the use of these therapies. This report on a PRISMA systematic review of the available literature demonstrates that only two therapies have some evidence to underpin the use of these non-pharmaceutical therapies and that a significant research gap is exists. What are the implications for practitioners? The implications for practitioners is that significant research effort is required to determine the efficacy of many of the therapies that are currently deployed, and thus many of the therapies used lack an evidence base at this time.

A Systematic Review of Meta-Analyses in Special Education: Exploring the Evidence Base for High-Leverage Practices

2021 ◽  
pp. 074193252110634
Author(s):  
Gena Nelson ◽  
Sara Cothren Cook ◽  
Kary Zarate ◽  
Sarah R. Powell ◽  
Daniel M. Maggin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Special Education ◽  
Students With Disabilities ◽  
Special Education Teachers ◽  
Evidence Base ◽  
Future Research ◽  
Evidence Based Practices ◽  
Intensive Instruction ◽  
Disability Categories ◽  
Meta Analyses

It is crucial that special education teachers are equipped with the knowledge and skills necessary to improve outcomes for students with disabilities. Despite federal legislation and efforts of the field to identify and disseminate evidence-based practices for students with disabilities, it is uncertain whether all special education teachers provide instruction based on the best available research. To better prepare special education teachers, McLeskey et al. proposed 22 high-leverage practices (HLPs). We conducted this systematic review of meta-analyses to provide an initial investigation of the experimental evidence reporting on the effectiveness of the HLPs for students with, or at risk for, a disability. Results indicated the largest amount of evidence from meta-analyses related to intensive instruction, explicit instruction, and social skills, with few meta-analyses reporting on collaboration and assessment. The results highlighted disproportional evidence according to disability categories. Implications for future research, practice, and teacher education are discussed.

scholarly journals Efficacy of Non-Halofuginone-Based Strategies to Prevent or Treat Cryptosporidiosis in Bovine Calves: A Systematic Review

2020 ◽  
Author(s):  
Julii Brainard ◽  
Charlotte C. Hammer ◽  
Kevin Tyler ◽  
Paul R. Hunter
Keyword(s):  
Systematic Review ◽  
Weight Gain ◽  
Kinase Inhibitors ◽  
Management Strategies ◽  
Evidence Base ◽  
High Morbidity ◽  
Case Control Studies ◽  
Nutritional Strategy ◽  
Before And After ◽  
Meta Analyses

Cryptosporidiosis is a common illness in young cattle that causes high morbidity and some mortality. A common prophylactic treatment are halofuginone products but it seems likely disease could be reduced by other other pharmacological products or some management strategies. We undertook a systematic review and meta-analyses on key outcomes for treatment of calves before and after 5 days of age with any management strategy, any nutritional strategy or any non-halofuginone product. A systematic literature search was undertaken with data extracted for outcomes = oocyst shedding, diarrhea, mortality and weight gain. Experiments had to describe results for same age animals in contemporary arms. Control animals had to be observed concurrently in planned experiments (pre-post and case-control studies were not eligible). Both randomized and other clinically controlled trials were eligible. Results were subgrouped by study design and outcomes were described in detail where at least two articles described the same treatment strategy. 55 articles were found. Significantly lower incidence of oocyst shedding, diarrhea burden and mortality was reported in many experimental arms, especially when animals started treatment before 5 days old. Weight gain was not mostly affected by treatment, however, by three weeks of age. The evidence base is at least encouraging but insufficient about paromomycin, bumped kinase inhibitors and azithromycin treatment, especially for diarrhea and oocyst shedding, given late or early. Azithromycin is the most promising of these.

scholarly journals Umbrella systematic review of systematic reviews and meta-analyses on comorbid physical conditions in people with autism spectrum disorder

2020 ◽  
Vol 218 (1) ◽  
pp. 10-19 ◽  
Author(s):  
Ewelina Rydzewska ◽  
Kirsty Dunn ◽  
Sally-Ann Cooper
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorder ◽  
Systematic Reviews ◽  
Sleep Problems ◽  
Evidence Base ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Physical Conditions ◽  
Sensory Impairments ◽  
Meta Analyses

BackgroundComorbid physical conditions may be more common in people with autism spectrum disorder (ASD) than other people.AimsTo identify what is and what is not known about comorbid physical conditions in people with ASD.MethodWe undertook an umbrella systematic review of systematic reviews and meta-analyses on comorbid physical conditions in people with ASD. Five databases were searched. There were strict inclusion/exclusion criteria. We undertook double reviewing for eligibility, systematic data extraction and quality assessment. Prospective PROSPERO registration: CRD42015020896.ResultsIn total, 24 of 5552 retrieved articles were included, 15 on children, 1 on adults, and 8 both on children and adults. Although the quality of included reviews was good, most reported several limitations in the studies they included and considerable heterogeneity. Comorbid physical conditions are common, and some are more prevalent than in the general population: sleep problems, epilepsy, sensory impairments, atopy, autoimmune disorders and obesity. Asthma is not. However, there are substantial gaps in the evidence base. Fewer studies have been undertaken on other conditions and some findings are inconsistent.ConclusionsComorbid physical conditions occur more commonly in people with ASD, but the evidence base is slim and more research is needed. Some comorbidities compound care if clinicians are unaware, for example sensory impairments, given the communication needs of people with ASD. Others, such as obesity, can lead to an array of other conditions, disadvantages and early mortality. It is essential that potentially modifiable physical conditions are identified to ensure people with ASD achieve their best outcomes. Heightening clinicians’ awareness is important to aid in assessments and differential diagnoses, and to improve healthcare.

Prevalence and risk factors of sleep disturbances in breast cancersurvivors: systematic review and meta-analyses

2019 ◽  
Vol 27 (12) ◽  
pp. 4401-4433 ◽  
Author(s):  
Laurence Leysen ◽  
Astrid Lahousse ◽  
Jo Nijs ◽  
Nele Adriaenssens ◽  
Olivier Mairesse ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Sleep Disturbances ◽  
Meta Analyses

scholarly journals Considering the methodological limitations in the evidence base of antidepressants for depression: a reanalysis of a network meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e024886 ◽  
Author(s):  
Klaus Munkholm ◽  
Asger Sand Paludan-Müller ◽  
Kim Boesen
Keyword(s):  
Systematic Review ◽  
Clinical Study ◽  
Effect Size ◽  
Meta Analysis ◽  
Evidence Base ◽  
Risk Of Bias ◽  
Depression Symptom ◽  
Meta Analyses ◽  
The Impact ◽  
Clinical Study Reports

ObjectivesTo investigate whether the conclusion of a recent systematic review and network meta-analysis (Ciprianiet al) that antidepressants are more efficacious than placebo for adult depression was supported by the evidence.DesignReanalysis of a systematic review, with meta-analyses.Data sources522 trials (116 477 participants) as reported in the systematic review by Ciprianiet aland clinical study reports for 19 of these trials.AnalysisWe used the Cochrane Handbook’s risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate the risk of bias and the certainty of evidence, respectively. The impact of several study characteristics and publication status was estimated using pairwise subgroup meta-analyses.ResultsSeveral methodological limitations in the evidence base of antidepressants were either unrecognised or underestimated in the systematic review by Ciprianiet al. The effect size for antidepressants versus placebo on investigator-rated depression symptom scales was higher in trials with a ‘placebo run-in’ study design compared with trials without a placebo run-in design (p=0.05). The effect size of antidepressants was higher in published trials compared with unpublished trials (p<0.0001). The outcome data reported by Ciprianiet aldiffered from the clinical study reports in 12 (63%) of 19 trials. The certainty of the evidence for the placebo-controlled comparisons should be very low according to GRADE due to a high risk of bias, indirectness of the evidence and publication bias. The mean difference between antidepressants and placebo on the 17-item Hamilton depression rating scale (range 0–52 points) was 1.97 points (95% CI 1.74 to 2.21).ConclusionsThe evidence does not support definitive conclusions regarding the benefits of antidepressants for depression in adults. It is unclear whether antidepressants are more efficacious than placebo.

The experience of conducting a Cochrane systematic review of the impact of clinical pathways on professional practice, patient outcomes, length of stay and hospital costs

2009 ◽  
Vol 13 (2) ◽  
pp. 62-66 ◽  
Author(s):  
Thomas Rotter ◽  
Leigh Kinsman ◽  
Erica James ◽  
Andreas Machotta ◽  
Holger Gothe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Pathways ◽  
Hospital Costs ◽  
Evidence Base ◽  
Care Group ◽  
Level Of Evidence ◽  
Organisation Of Care ◽  
High Level ◽  
Meta Analyses ◽  
The Impact

Despite the high prevalence of clinical pathways (CPWs), the results from published studies are inconsistent and contradictory. The plethora of study designs, settings and lack of an agreed definition of a CPW make the relevance of individual studies difficult to apply to clinical settings. It was timely to catalogue and analyse the existing evidence base for CPWs via a rigorous systematic review. Systematic reviews and meta-analyses provide a high level of evidence for the effectiveness of interventions and are commonly employed reviewing strategies for addressing scientific questions in health-related research. This method is especially useful when research results are known to be inconsistent. Instead of conducting another primary evaluation, a detailed review is needed that reflects a summation of available research. This paper reports and discusses methodological and technical issues of a systematic review of the effectiveness of CPWs in hospitals, based on our experience with the Cochrane Effective Practice and Organisation of Care Group.

Describing the Mental Health Profile of First Responders: A Systematic Review

2017 ◽  
Vol 23 (3) ◽  
pp. 200-214 ◽  
Author(s):  
Sara Jones
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Sleep Disturbances ◽  
First Responders ◽  
Psychiatric Nurses ◽  
Health Profile ◽  
Eligibility Criteria ◽  
Cumulative Impact ◽  
Multiple Services ◽  
Meta Analyses

BACKGROUND: First responders (FRs) are responsible for providing multiple services during various critical events. Considering the frequency, nature, and intensity of duty-related traumatic exposures, the cumulative impact on FRs’ mental health is of paramount importance. OBJECTIVES: The purpose of this systematic review was to describe how duty-related trauma exposure can affect the comprehensive mental health profile of FRs, including firefighters, emergency medical technicians, and paramedics. DESIGN: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was conducted using keywords related to FRs and mental health. RESULTS: Twenty-seven data-based articles met eligibility criteria and were included in this systematic review. Studies explored various mental health concerns, including posttraumatic stress disorder, depression, suicidality, anxiety, alcohol use, and sleep disturbances. CONCLUSIONS: Findings pose significant implications for psychiatric nurses in practice and research, including the need for tailored strategies to meet the mental health needs of this at-risk population.

scholarly journals Double Burden of Malnutrition Among Migrants and Refugees in Developed Countries

2021 ◽  
Vol 4 ◽  
pp. 1-13
Author(s):  
Blessing Akombi-Inyang ◽  
Md. Nazmul Huda ◽  
Judith Byaruhanga ◽  
Andre Renzaho
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Developed Countries ◽  
Evidence Base ◽  
Bibliographic Databases ◽  
Double Burden ◽  
Ovid Medline ◽  
Double Burden Of Malnutrition ◽  
Meta Analyses

Background: The double burden of malnutrition (DBM) increases the risk of developing non-communicable diseases among migrant and refugee populations living in developed countries. This systematic review aims to examine the DBM among migrants and refugees in developed countries. It aims to appraise, synthesise, and summarise literature to create an evidence base that looks at multiple faces of DBM. Methods/Design: This protocol is informed by the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A systematic review of peer-reviewed quantitative, qualitative and mixed-methods studies on DBM among migrants and refugees in developed countries will be undertaken. The review will include only studies published in English. Eight bibliographic databases will be searched: Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, ProQuest, Scopus, PubMed, and web of science. Grey literature will also be searched. Studies that meet the inclusion criteria will be imported to Covidence. Screening for eligible studies will be conducted by two independent researchers. The quality of included studies will be appraised for risk of bias using validated tools. A narrative synthesis approach will be undertaken to report retrieved data. Discussion: The protocol provides insight into the scope and parameters of the systematic review to be conducted.

scholarly journals Effect of periodontal therapy on the systemic inflammation and metabolic  markers in patients undergoing hemodialysis or/and peritoneal dialysis: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Hui Yue ◽  
Xinxin Xu ◽  
Qin Liu ◽  
Xiaozhi Li ◽  
Yiting Xiao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peritoneal Dialysis ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Periodontal Treatment ◽  
Sufficient Evidence ◽  
Metabolic Markers ◽  
Significant Difference ◽  
Meta Analyses

Abstract Background: This systematic review aimed to investigate whether periodontal treatment can reduce the systemic inflammatory levels and improve the metabolic levels in patients undergoing hemodialysis (HD) or/and peritoneal dialysis (PD). Methods: Electronic databases (PubMed, EMBASE, CENTRAL, NCKI, and WFPD) were searched up to July 2019. The risk of bias within studies was assessed through the Cochrane Collaboration' s risk assessment tool. The systemic inflammatory and metabolic measures were the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumor necrosis factor-α (TNF-a), the albumin (Alb), and lipid metabolic levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate. Results: Five studies were eligible for this systematic review. The result of four studies revealed a significant difference in the CRP level after periodontal treatment in patients receiving HD or/and PD. Two studies reported the IL-6 and the Alb level after periodontal treatment but revealed no significant difference. No MAs could be performed on the TNF- a level and the lipid metabolic markers. Conclusions: Periodontal treatment may moderately reduce the serum of CRP levels in HD or/and PD patients. For the TNF-a, IL-6, Alb levels and lipid metabolic markers, no sufficient evidence supports the difference after periodontal treatment. Therefore, larger scales and high-quality randomized-controlled trials (RCTs) are required to assess the effect of periodontal treatment on systemic inflammatory and metabolic parameters in HD or/and PD patients.

scholarly journals Tai Chi and other mind–body interventions for cancer-related fatigue: an updated systematic review and network meta-analyses protocol

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e052137
Author(s):  
Hong-Juan Fu ◽  
Hao Zhou ◽  
Yong Tang ◽  
Jie Li ◽  
Da Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Evaluation System ◽  
Tai Chi ◽  
Evidence Base ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
China National Knowledge Infrastructure ◽  
Cancer Related Fatigue ◽  
Meta Analyses

IntroductionFatigue is one of the most common symptoms in patients with cancer and is responsible for a reduced quality of life. There is a strong evidence base for mind–body interventions (MBIs) to manage cancer-related fatigue (CRF). However, the efficacy of Tai Chi and other MBIs in the treatment of CRF remains controversial.Methods and analysisWe will perform a systematic review and network meta-analyses (NMAs) that aim to assess the effects of Tai Chi and other MBIs in patients with CRF. The following databases will be searched from their inception to 1 August 2021: PubMed, EMBASE, Scopus, OVID, Web of Science, Cochrane Central Register of Controlled Trials, the China National Knowledge Infrastructure, China Science and Technology Journal Database, Chinese Biomedical Database and Wan Fang Digital Journals. We will include randomised controlled trials that compare MBIs with no treatment, placebo and usual care in the treatment of CRF. The primary outcome will be changes in the fatigue state as evaluated by validated scales. We will perform a Bayesian NMA to analyse all the evidence for each outcome. The surface under the cumulative ranking curve and the mean ranks will be used to rank the various treatments. We will assess the quality of evidence contributing to network estimates of outcomes using the Grading of Recommendations Assessment, Development and Evaluation system framework.Ethics and disseminationThis NMAs will be disseminated through publication in a peer-reviewed journal. Since no individual patient data will be involved in the review, ethics approval and concerns about privacy are not needed.PROSPERO registration numberCRD42021244999.

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