Patients’ experiences of cannulation of arteriovenous access for haemodialysis: A qualitative systematic review

Introduction: Cannulation is an essential part of haemodialysis with arteriovenous access. Patients’ experiences of cannulation for haemodialysis are problematic but poorly understood. This review aims to synthesise findings related to patients’ experiences of cannulation for haemodialysis from qualitative studies, providing a fuller description of this phenomenon. Methods: Eligibility criteria defined the inclusion of studies with a population of patients with end-stage kidney disease on haemodialysis. The phenomena of interest was findings related to patients’ experiences of cannulation for haemodialysis and the context was both in-centre and home haemodialysis. MedLine, CINAHL, EMBASE, EMCARE, BNI, PsycInfo and PubMed were last searched between 20/05/2019 and 23/05/2019. The quality of studies was assessed using the using Joanna Briggs Critical Appraisal Checklist for Qualitative Research. Meta-aggregation was used to synthesise findings and CERQual to assess the strength of accumulated findings. Results: This review included 26 studies. The subject of included studies covered cannulation, pain, experiences of vascular access, experiences of haemodialysis and a research priority setting exercise. From these studies, three themes were meta-aggregated: (1) Cannulation for haemodialysis is an unpleasant, abnormal and unique procedure associated with pain, abnormal appearance, vulnerability and dependency. (2) The necessity of cannulation for haemodialysis emphasises the unpleasantness of the procedure. Success had multiple meanings for patients and patients worry about whether the needle insertion will be successful. (3) Patients survive unpleasant, necessary and repetitive cannulation by learning to tolerate cannulation and exerting control over the procedure. Feeling safe can help them tolerate cannulation better and the cannulator can invoke feeling safe. However, some patients still avoid cannulation, due to its unpleasantness. Conclusions: Cannulation is a pervasive procedure that impacts on patients’ experiences of haemodialysis. This review illuminates further patients’ experiences of cannulation for haemodialysis, indicating how improvements can be made to cannulation. Registration: PROSPERO (CRD42019134583).

A hidden pandemic? An umbrella review of global evidence on mental health in the time of COVID-19

Introduction: Vast available international evidence has investigated the mental health impacts of the COVID-19 pandemic. This review aims to synthesise evidence, identifying populations and characteristics associated with poor mental health.Methods: A meta-review of pooled prevalence of anxiety and depression, with subgroup analyses for the general population, healthcare workers (HCW) and COVID-19 patients; and a meta-synthesis of systematic reviews to collate evidence on associated factors and further mental disorders. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to May 2021. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the pandemic.Results: Eighty-one systematic reviews were included, 51 of which incorporated meta-analysis. Meta-review overall anxiety prevalence was 29% (95%CI: 27–31%, I2: 99.83%), with subgroup prevalence as 35% (95%CI: 23–47%, I2: 97.4%) in COVID-19 patients, 29% in HCW (95%CI: 25– 32, I2: 99.8%) and 28% in the general population (95%CI: 25–31%, I2: 99.9%). Meta-review overall depression prevalence was 28% (95%CI: 26–30%, I2: 99.7), with subgroup prevalence as 30% (95%CI: 7–60%, I2: 99.8%) in COVID-19 patients, 28% (95%CI: 25–31%, I2: 99.7%) in HCW and 27% (95%CI: 25–30, I2: 99.8%) in the general population. Meta-synthesis found many experienced psychological distress and PTSD/PTSS during COVID-19, but pooled prevalence ranged substantially. Fear of, proximity to, or confirmed COVID-19 infection; undergoing quarantine; and COVID-19-related news exposure were associated with adverse mental health outcomes. Amongst other factors, people who are younger, female, LGBTIQ, pregnant, parents or experiencing low social support, financial issues or socio-economic disadvantage, tended to have poorer mental health during the pandemic period.Conclusions: Despite high volumes of reviews, the diversity of findings and dearth of longitudinal studies within reviews means clear links between COVID-19 and mental health are not available, although existing evidence indicates probable associations.

Young adult drug interventions: a social marketing systematic review and research agenda

Purpose This paper aims to report on the first comprehensive, social marketing systematic review of interventions targeting illicit drug use by young adults. Design/methodology/approach A total of 3,169 papers were screened, with 20 relevant empirical studies meeting the eligibility criteria for the systematic review. These were analysed according to Andreasen’s (2002) and NSMC’s (2006) social marketing benchmarks. Findings The findings provide evidence regarding the efficacy of behavioural and clinical interventions targeting individuals and groups, including motivational, life skills training, cognitive behavioural therapy, comprehensive health and social risk assessments and buprenorphine treatment interventions. Further, results evidence that there is yet to be an intervention which has implemented the full marketing mix, and limited studies have used the social marketing benchmarks of exchange and competition. Originality/value To the best of the authors’ knowledge, this study is the first to conduct a comprehensive systematic review and provide key recommendations outlining the potential for social marketing to support the improved uptake and efficacy of interventions. A research agenda is also put forward to direct future social marketing scholarship in the area of young adult drug interventions.

A RESISTÊNCIA ANTIMICROBIANA E CUSTOS DE CUIDADO DE SAÚDE: UMA REVISÃO SISTEMÁTICA

There is a growing concern about the multi-resistant capabilities presented by microorganisms to antimicrobials. Society is harmed by the redirection of financial resources from other areas, also lacking the population, to purchase more potent antimicrobials and in larger quantities. This study describes the consumption of antimicrobial drugs and their impact generated through a systematic review, following the recommendations of the Prisma method. Searches were performed in four databases (Portal BVS, PubMed, Embase and Science Direct). A total of 196 articles were found, 11 of which were selected after applying the eligibility criteria. A prospective study showed that the difference in expenditures can reach $31.17 patients/day between prophylactics and those with nosocomial infections. Studies have shown that the increase in costs is related to the increase in the length of stay. Mortality and admission to the ICU also increased. Further studies with high levels of evidence are recommended.

Lactobacillus Reuteri DSM 17938 in Infantile Colic: A Systematic Review and Meta-Analysis

Background. Infantile colic, defined as paroxysmal, excessive, and consolable crying without an identifiable cause. It is common in the first 3 months of life. There have been many RCT studies conducted. A systematic synthesis is required to summarize the results of these RCTs. This study was aimed to systematically analyze the benefits of Lactobacillus reuteri DSM 17938 for infantile colic. Methods. This systematic review and meta-analysis used keywords: (“infantile colic” OR “abdominal cramps” OR “abdominal cramp” OR “infant colic”) AND “lactobacillus reuteri” AND (placebo OR placebos) AND (“randomized controlled trial” OR RCT). The databases used were: pubmed, science direct, and google scholar. Meta-analysis was conducted to combine the articles. The eligibility criteria were: patient with infantile colic, intervention with L. reuteri DSM 17938, control was placebo, RCT study design, outcome with dichotomous scale, all races, all ethnicities, all countries, all genders, in English, and not limited by year. Results. The search resulted in 800 articles. After reducing duplication, the number of articles was 747. Screening with titles and abstracts resulted in 13 full teks articles. Six articles fitted the eligibility criteria. The results of the meta-analysis were as follows. The forest plot showed that the combined effect of the six articles showed an RR of 0.47 and was statistically significant (p <0.001). Conclusion. Based on the results of this meta-analysis, L. reuteri DSM 17938 is recommended for infants with infantile colic. There were no significant side effects with the use of L. reuteri DSM 17938 on infantile colic.

Lessons learned from terror attacks: thematic priorities and development since 2001—results from a systematic review

Purpose The threat of national and international terrorism remains high. Preparation is the key requirement for the resilience of hospitals and out-of-hospital rescue forces. The scientific evidence for defining medical and tactical strategies often feeds on the analysis of real incidents and the lessons learned derived from them. This systematic review of the literature aims to identify and systematically report lessons learned from terrorist attacks since 2001. Methods PubMed was used as a database using predefined search strategies and eligibility criteria. All countries that are part of the Organization for Economic Cooperation and Development (OECD) were included. The time frame was set between 2001 and 2018. Results Finally 68 articles were included in the review. From these, 616 lessons learned were extracted and summarized into 15 categories. The data shows that despite the difference in attacks, countries, and casualties involved, many of the lessons learned are similar. We also found that the pattern of lessons learned is repeated continuously over the time period studied. Conclusions The lessons from terrorist attacks since 2001 follow a certain pattern and remained constant over time. Therefore, it seems to be more accurate to talk about lessons identified rather than lessons learned. To save as many victims as possible, protect rescue forces from harm, and to prepare hospitals at the best possible level it is important to implement the lessons identified in training and preparation.

Role of clinical pharmacist in the palliative care of adults and elderly patients with cancer: A scoping review

Objective: We conducted this scoping review to map and summarize scientific evidence on the role of clinical pharmacists in the palliative care of adults and elderly patients with cancer. Data Sources: A literature search was performed in MEDLINE, PubMed Central, Embase, Web of Science, Scopus, and BVS/BIREME for studies published until November 22nd, 2020. Studies that reported work experiences adopted by clinical pharmacists in the palliative care of adults and elderly patients with cancer were included. Two independent authors performed study selection and data extraction. Any disagreements were resolved by discussion with the third and fourth authors. The pharmacist interventions identified in the included studies were described based on key domains in the DEPICT v.2. Data Summary: A total of 586 records were identified, of which 14 studies fully met the eligibility criteria. Most of them were conducted in the United States of America (n = 5) and Canada (n = 5) and described the workplace of the pharmacist in clinic/ambulatory (n = 10). Clinical pharmacists performed several activities and provided services, highlighting medication review (n = 12), patient and caregivers education (n = 12), medication histories and-or medication reconciliation (n = 6). The pharmacist interventions were mostly conducted for patients/caregivers (n = 13), by one-on-one contact (n = 14), and by face-to-face (n = 13). Pharmacists were responsible mainly for change or suggestion for change in therapy (n = 12) and patient counselling (n = 12). Pharmacist interventions were well accepted by the clinical team. Overall, studies showed that pharmacists, within an interdisciplinary team, had significant impacts on measured outcomes. Conclusions: In recent years, there have been advances in the role of the pharmacist in palliative care of patients with cancer and there are great opportunities in this field. They play an important role in managing cancer pain and other symptoms, as well as resolving drug related problems. We encourage more research to be carried out to strengthen this field and to benefit patients with advanced cancer with higher quality of life.

The effect of orthodontic treatment with fixed appliances on sleep quality in adults and adolescents in Saudi Arabia using Pittsburgh sleep quality index

Objectives: The aim of this study was to investigate the effect of pain caused by orthodontic fixed appliances on sleep quality of participants using the Pittsburgh Sleep Quality Index (PSQI). Materials and Methods: A previously validated Arabic version of PSQI was electronically distributed through different social media platforms and in waiting areas of orthodontic offices. Eligibility criteria included healthy adults and adolescents with orthodontic fixed appliances and with no systemic conditions that may affect sleep. The cut-off point used to determine poor sleep quality was (>5). Results: Three hundred and eighteen participants were included in the final analysis (28.9% males and 71.1% females). Both males and females with orthodontic fixed appliances had poor sleep quality with (Mean = 6.48, SD = 2.85, P = 0.000) for males, and (Mean = 7.18, SD = 2.87, P = 0.000) for females. Comparing males and females, we found that females scored higher than males in both subjective sleep quality and PSQI global score. Conclusion: Individuals undergoing orthodontic treatment with fixed appliances have poor sleep quality. Females undergoing orthodontic treatment tend to have poorer sleep quality compared to males.

DWI-related texture analysis for prostate cancer: differences in correlation with histological aggressiveness and data repeatability between peripheral and transition zones

Background We investigated the correlation between texture features extracted from apparent diffusion coefficient (ADC) maps or diffusion-weighted images (DWIs), and grade group (GG) in the prostate peripheral zone (PZ) and transition zone (TZ), and assessed reliability in repeated examinations. Methods Patients underwent 3-T pelvic magnetic resonance imaging (MRI) before radical prostatectomy with repeated DWI using b-values of 0, 100, 1,000, and 1,500 s/mm2. Region of interest (ROI) for cancer was assigned to the first and second DWI acquisition separately. Texture features of ROIs were extracted from comma-separated values (CSV) data of ADC maps generated from several sets of two b-value combinations and DWIs, and correlation with GG, discrimination ability between GG of 1–2 versus 3–5, and data repeatability were evaluated in PZ and TZ. Results Forty-four patients with 49 prostate cancers met the eligibility criteria. In PZ, ADC 10% and 25% based on ADC map of two b-value combinations of 100 and 1,500 s/mm2 and 10% based on ADC map with b-value of 0 and 1,500 s/mm2 showed significant correlation with GG, acceptable discrimination ability, and good repeatability. In TZ, higher-order texture feature of busyness extracted from ADC map of 100 and 1,500 s/mm2, and high gray-level run emphasis, short-run high gray-level emphasis, and high gray-level zone emphasis from DWI with b-value of 100 s/mm2 demonstrated significant correlation, excellent discrimination ability, but moderate repeatability. Conclusions Some DWI-related features showed significant correlation with GG, acceptable to excellent discrimination ability, and moderate to good data repeatability in prostate cancer, and differed between PZ and TZ.

Eligibility criteria for pediatric patients who may benefit from anti SARS-CoV-2 monoclonal antibody therapy administration: an Italian inter-society consensus statement

The fast diffusion of the SARS-CoV-2 pandemic have called for an equally rapid evolution of the therapeutic options.The Human recombinant monoclonal antibodies (mAbs) have recently been approved by the Food and Drug Administration (FDA) and by the Italian Medicines Agency (AIFA) in subjects aged ≥12 with SARS-CoV-2 infection and specific risk factors.Currently the indications are specific for the use of two different mAbs combination: Bamlanivimab+Etesevimab (produced by Eli Lilly) and Casirivimab+Imdevimab (produced by Regeneron).These drugs have shown favorable effects in adult patients in the initial phase of infection, whereas to date few data are available on their use in children.AIFA criteria derived from the existing literature which reports an increased risk of severe COVID-19 in children with comorbidities. However, the studies analyzing the determinants for progression to severe disease are mainly monocentric, with limited numbers and reporting mostly generic risk categories.Thus, the Italian Society of Pediatrics invited its affiliated Scientific Societies to produce a Consensus document based on the revision of the criteria proposed by AIFA in light of the most recent literature and experts’ agreement.This Consensus tries to detail which patients actually have the risk to develop severe disease, analyzing the most common comorbidities in children, in order to detail the indications for mAbs administration and to guide the clinicians in identifying eligible patients.