scholarly journals Needling Interventions for Sciatica: Choosing Methods Based on Neuropathic Pain Mechanisms—A Scoping Review

2021 ◽  
Vol 10 (10) ◽  
pp. 2189
Author(s):  
Thomas Perreault ◽  
César Fernández-de-las-Peñas ◽  
Mike Cummings ◽  
Barry C. Gendron
Keyword(s):  
Neuropathic Pain ◽  
Effective Treatment ◽  
Scoping Review ◽  
Reference Lists ◽  
Current Evidence ◽  
Review Of The Literature ◽  
Dry Needling ◽  
Pain Mechanisms ◽  
Literature Searches ◽  
Cochrane Database

Sciatica is a condition often accompanied by neuropathic pain (NP). Acupuncture and dry needling are common treatments for pain, and the current literature supports acupuncture as an effective treatment for sciatica. However, it is unknown if the mechanisms of NP are considered in the delivery of needling interventions for sciatica. Our objective was to assess the efficacy and the effectiveness of needling therapies, to identify common needling practices and to investigate if NP mechanisms are considered in the treatment of sciatica. A scoping review of the literature on needling interventions for sciatica and a review of the literature on mechanisms related to NP and needling interventions were performed. Electronic literature searches were conducted on PubMed, MEDLINE, CINAHL and Cochrane Database of Systematic Reviews from inception to August, 2020 to identify relevant papers. Reference lists of included papers were also manually screened and a related-articles search through PubMed was performed on all included articles. Mapping of the results included description of included studies, summary of results, and identification of gaps in the existing literature. Ten articles were included. All studies used acupuncture for the treatment of sciatica, no studies on dry needling were identified. Current evidence supports the efficacy and effectiveness of acupuncture for sciatica, however, no studies considered underlying NP mechanisms in the acupuncture approach for sciatica and the rationale for using acupuncture was inconsistent among trials. This review reveals that neuropathic pain mechanisms are not routinely considered in needling approaches for patients with sciatica. Studies showed acupuncture to be an effective treatment for sciatic pain, however, further research is warranted to explore if needling interventions for sciatica and NP would be more effective if NP mechanisms are considered.

scholarly journals Determining if Telehealth Can Reduce Health System Costs: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Centaine L Snoswell ◽  
Monica L Taylor ◽  
Tracy A Comans ◽  
Anthony C Smith ◽  
Leonard C Gray ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Focus Group ◽  
Health System ◽  
Scoping Review ◽  
Secondary Care ◽  
Cost Savings ◽  
Current Evidence ◽  
Literature Searches ◽  
The Cost ◽  
Productivity Gains

BACKGROUND Telehealth represents an opportunity for Australia to harness the power of technology to redesign the way health care is delivered. The potential benefits of telehealth include increased accessibility to care, productivity gains for health providers and patients through reduced travel, potential for cost savings, and an opportunity to develop culturally appropriate services that are more sensitive to the needs of special populations. The uptake of telehealth has been hindered at times by clinician reluctance and policies that preclude metropolitan populations from accessing telehealth services. OBJECTIVE This study aims to investigate if telehealth reduces health system costs compared with traditional service models and to identify the scenarios in which cost savings can be realized. METHODS A scoping review was undertaken to meet the study aims. Initially, literature searches were conducted using broad terms for telehealth and economics to identify economic evaluation literature in telehealth. The investigators then conducted an expert focus group to identify domains where telehealth could reduce health system costs, followed by targeted literature searches for corresponding evidence. RESULTS The cost analyses reviewed provided evidence that telehealth reduced costs when health system–funded travel was prevented and when telehealth mitigated the need for expensive procedural or specialist follow-up by providing competent care in a more efficient way. The expert focus group identified 4 areas of potential savings from telehealth: productivity gains, reductions in secondary care, alternate funding models, and telementoring. Telehealth demonstrated great potential for productivity gains arising from health system redesign; however, under the Australian activity-based funding, it is unlikely that these gains will result in cost savings. Secondary care use mitigation is an area of promise for telehealth; however, many studies have not demonstrated overall cost savings due to the cost of administering and monitoring telehealth systems. Alternate funding models from telehealth systems have the potential to save the health system money in situations where the consumers pay out of pocket to receive services. Telementoring has had minimal economic evaluation; however, in the long term it is likely to result in inadvertent cost savings through the upskilling of generalist and allied health clinicians. CONCLUSIONS Health services considering implementing telehealth should be motivated by benefits other than cost reduction. The available evidence has indicated that although telehealth provides overwhelmingly positive patient benefits and increases productivity for many services, current evidence suggests that it does not routinely reduce the cost of care delivery for the health system.

scholarly journals Determining if Telehealth Can Reduce Health System Costs: Scoping Review

10.2196/17298 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e17298
Author(s):  
Centaine L Snoswell ◽  
Monica L Taylor ◽  
Tracy A Comans ◽  
Anthony C Smith ◽  
Leonard C Gray ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Focus Group ◽  
Health System ◽  
Scoping Review ◽  
Secondary Care ◽  
Cost Savings ◽  
Current Evidence ◽  
Literature Searches ◽  
The Cost ◽  
Productivity Gains

Background Telehealth represents an opportunity for Australia to harness the power of technology to redesign the way health care is delivered. The potential benefits of telehealth include increased accessibility to care, productivity gains for health providers and patients through reduced travel, potential for cost savings, and an opportunity to develop culturally appropriate services that are more sensitive to the needs of special populations. The uptake of telehealth has been hindered at times by clinician reluctance and policies that preclude metropolitan populations from accessing telehealth services. Objective This study aims to investigate if telehealth reduces health system costs compared with traditional service models and to identify the scenarios in which cost savings can be realized. Methods A scoping review was undertaken to meet the study aims. Initially, literature searches were conducted using broad terms for telehealth and economics to identify economic evaluation literature in telehealth. The investigators then conducted an expert focus group to identify domains where telehealth could reduce health system costs, followed by targeted literature searches for corresponding evidence. Results The cost analyses reviewed provided evidence that telehealth reduced costs when health system–funded travel was prevented and when telehealth mitigated the need for expensive procedural or specialist follow-up by providing competent care in a more efficient way. The expert focus group identified 4 areas of potential savings from telehealth: productivity gains, reductions in secondary care, alternate funding models, and telementoring. Telehealth demonstrated great potential for productivity gains arising from health system redesign; however, under the Australian activity-based funding, it is unlikely that these gains will result in cost savings. Secondary care use mitigation is an area of promise for telehealth; however, many studies have not demonstrated overall cost savings due to the cost of administering and monitoring telehealth systems. Alternate funding models from telehealth systems have the potential to save the health system money in situations where the consumers pay out of pocket to receive services. Telementoring has had minimal economic evaluation; however, in the long term it is likely to result in inadvertent cost savings through the upskilling of generalist and allied health clinicians. Conclusions Health services considering implementing telehealth should be motivated by benefits other than cost reduction. The available evidence has indicated that although telehealth provides overwhelmingly positive patient benefits and increases productivity for many services, current evidence suggests that it does not routinely reduce the cost of care delivery for the health system.

scholarly journals Rationalisations for women-only randomised controlled trials in conditions that affect both sexes: a scoping review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043370
Author(s):  
Ainsley Matthewson ◽  
Olena Bereznyakova ◽  
Brian Dewar ◽  
Alexandra Davis ◽  
Mark Fedyk ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Scoping Review ◽  
Randomised Controlled Trials ◽  
Standard Of Care ◽  
Standards Of Care ◽  
Controlled Trials ◽  
Theory Approach ◽  
Reference Centre ◽  
Cochrane Database ◽  
Randomised Controlled

IntroductionWomen have historically been under-represented in randomised controlled trials (RCTs), including many landmark RCTs that established standards of care. In light of this fact, some modern researchers are calling for replication of earlier landmark trials with women only. This approach is ethically concerning, in that it would require some enrolled women to be deprived of treatments that are currently considered standard of care.ObjectiveIn an attempt to better understand the justification of a women-only approach to designing clinical trials, this study looks to systematically categorise the number of women-only RCTs for conditions that affect both men and women and the reasons given within the medical and philosophical literatures to perform them.MethodologyThis scoping review of the literature will search, screen and select articles based on predetermined inclusion/exclusion criteria, after which a grounded theory approach will be used to synthesise the data. It is expected that there will be a variety of reasons given for why a women-only trial may be justified. Electronic databases that will be searched include MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Clinical Trials Register, Web of Science Proceedings, ClinicalTrials.gov, Philosopher’s Index, Phil Papers, JSTOR, Periodicals Archive Online, Project MUSE and the National Reference Centre for Bioethics.SignificanceThe scope of this study is to determine published rationales used to justify women-only randomised trials, both in the case of new trials and in the repetition of landmark trials.Ethics and disseminationResearch ethics board approval is not required for this study as there is no participant involvement. Results will be published as a stand-alone manuscript and will inform a larger project related to the ethics of a women-only RCT of carotid intervention for women with symptomatic high-grade carotid stenosis.

scholarly journals Creating Dementia-Friendly Communities for Social Inclusion: A Scoping Review

2021 ◽  
Vol 7 ◽  
pp. 233372142110135
Author(s):  
Lillian Hung ◽  
Allison Hudson ◽  
Mario Gregorio ◽  
Lynn Jackson ◽  
Jim Mann ◽  
...  
Keyword(s):  
Scoping Review ◽  
Social Inclusion ◽  
Search Strategy ◽  
Current Evidence ◽  
Future Research ◽  
Education Practice ◽  
Active Involvement ◽  
People With Dementia ◽  
Index Terms ◽  
Inclusion Methods

Aims: This scoping review explores key strategies of creating inclusive dementia-friendly communities that support people with dementia and their informal caregiver. Background: Social exclusion is commonly reported by people with dementia. Dementia-friendly community has emerged as an idea with potential to contribute to cultivating social inclusion. Methods: This scoping review follows the Joanna Briggs Institute scoping review methodology and took place between April and September 2020. The review included a three-step search strategy: (1) identifying keywords from CINAHL and AgeLine; (2) conducting a second search using all identified keywords and index terms across selected databases (CINAHL, AgeLine, MEDLINE, PsycINFO, Web of Science, ProQuest, and Google); and (3) hand-searching the reference lists of all included articles and reports for additional studies. Results: Twenty-nine papers were included in the review. Content analysis identified strategies for creating dementia-friendly communities: (a) active involvement of people with dementia and caregivers (b) inclusive environmental design; (c) public education to reduce stigma and raise awareness; and (d) customized strategies informed by theory. Conclusion: This scoping review provides an overview of current evidence on strategies supporting dementia-friendly communities for social inclusion. Future efforts should apply implementation science theories to inform strategies for education, practice, policy and future research.

scholarly journals LGBTQ+ Aging Research in Canada: A 30-Year Scoping Review of the Literature

Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 60
Author(s):  
Kimberley Wilson ◽  
Arne Stinchcombe ◽  
Sophie M. Regalado
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Scoping Review ◽  
Lived Experiences ◽  
Systematic Search ◽  
Review Of The Literature ◽  
Aging Research ◽  
Aging Populations ◽  
Diverse Groups

Canada has a unique socio-political history concerning the inclusion of lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people. With aging populations, understanding diverse groups of older adults is paramount. We completed a systematic search and scoping review of research in Canada to quantify and articulate the scale and scope of research on LGBTQ+ aging. Our search identified over 4000 results and, after screening for relevance, our review focused on 70 articles. Five major themes in the literature on LGBTQ+ aging in Canada were identified: (1) risk, (2) HIV, (3) stigma, and discrimination as barriers to care, (4) navigating care and identity, (5) documenting the history and changing policy landscapes. Most of the articles were not focused on the aging, yet the findings are relevant when considering the lived experiences of current older adults within LGBTQ+ communities. Advancing the evidence on LGBTQ+ aging involves improving the quality of life and aging experiences for LGBTQ+ older adults through research.

A scoping review of the literature on the involvement of service users in personality disorder services

2014 ◽  
Vol 31 (4) ◽  
pp. 233-243
Author(s):  
L. Montgomery ◽  
M. Donnelly
Keyword(s):  
Health Policy ◽  
Personality Disorder ◽  
Scoping Review ◽  
Service User ◽  
Mental Health Policy ◽  
User Involvement ◽  
Service Users ◽  
Service User Involvement ◽  
Review Of The Literature ◽  
Policy Makers

BackgroundService user involvement is receiving increasing support from mental health policy makers, service planners and research commissioners. However, we lack a good understanding of the nature and extent to which service users are involved in personality disorder (PD) services and the effects of involvement in these services.ObjectivesTo review and appraise published sources; increase understanding about service user involvement in PD services; and highlight knowledge gaps and related issues.MethodsA scoping review methodology was adopted. Data were ‘charted’ to illustrate the landscape of writings and views and a qualitative analysis synthesized the results in terms of key emergent themes.ResultsOnly a small amount of published work was identified with significant gaps in the literature. Effects were reported mostly in terms processes and emotional and practical benefits for service users. Emergent themes were wellness and health, recruitment and support for service users.ConclusionsThis scoping review uncovered a lack of published work despite service user involvement being a key strand of health policy. There is a need for outcomes-focused research regarding service user involvement. Successful user involvement in PD services requires attention to be focused on the context, recruitment, support and ‘wellness’ of service users.

Peritoneal Dialysis: A Scoping Review of Strategies to Maximize pd Utilization

2017 ◽  
Vol 37 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Bikaramjit S. Mann ◽  
Braden J. Manns ◽  
Lianne Barnieh ◽  
Matthew J. Oliver ◽  
Daniel Devoe ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Scoping Review ◽  
Controlled Trials ◽  
Effective Strategies ◽  
Online Databases ◽  
Unpublished Studies ◽  
Cochrane Database ◽  
Stage Renal Disease ◽  
End Stage ◽  
Effective Use

The percentage of end-stage renal disease (ESRD) patients treated with peritoneal dialysis (PD) has declined in many countries since the mid-1990s. Barriers to PD have been reviewed extensively in the literature, but evidence about strategies to address these barriers and maximize the safe and effective use of PD is lacking. We therefore decided to conduct a scoping review identifying strategies to maximize PD use in adults with ESRD. Our search strategy included the following online databases: MEDLINE (OVID), EMBASE, PubMed, Cochrane Controlled Trials Register, Current Controlled Trials, and Cochrane Database of Systematic Reviews for articles published from 1974 to November 2013. Experts in the field were contacted for information about other ongoing or unpublished studies. A complementary search was conducted in the gray literature. Websites of national, provincial or regional agencies were searched for documents regarding policies surrounding the use of PD. Individual dialysis centers need to identify barriers to increasing PD in their program and direct targeted strategies to maximize PD utilization. Our review highlights some effective strategies that may be used. Our review also highlights the need for further research into strategies to maximize PD utilization.

Single-sex education in the 21st century: A 20-year scoping review of the literature

2021 ◽  
Vol 106 ◽  
pp. 103462
Author(s):  
Daniel B. Robinson ◽  
Jennifer Mitton ◽  
Greg Hadley ◽  
Meagan Kettley
Keyword(s):  
Sex Education ◽  
21St Century ◽  
Scoping Review ◽  
Review Of The Literature ◽  
Single Sex ◽  
Single Sex Education
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