The Database of Abstracts of Reviews of Effects (DARE)

Systematic reviews are useful tools for busy decision-makers because they identify, appraise and synthesise the available research evidence on a particular topic. Many thousands of systematic reviews relevant to health care have been published. However, they can be difficult to locate and their quality is variable. DARE (the Database of Abstracts of Reviews of Effects) contains summaries of systematic reviews which have met strict quality criteria. Each summary also provides a critical commentary on the quality of the review. DARE covers a broad range of health care related topics and can be used for answering questions about the effects of health care interventions, as well as for developing clinical guidelines and policy making. DARE is available free of charge on the internet (http://nhscrd.york.ac.uk), and as part of the Cochrane Library. Alternatively, DARE can be searched, on your behalf, by CRD information staff (tel: 01904 433707 or email [email protected])

Evaluating the implementation and delivery of a social prescribing intervention: a research protocol

Background: In response to the increasing numbers of people with (multiple) chronic conditions, the need for integrated care is increasing too. Social prescribing is a new approach that aims to integrate the social and healthcare sector to improve the quality of care and user experience. Understanding main stakeholders’ perceptions and experiences is key to the implementation of social prescription and for informing future initiatives.  Objectives: This paper presents the protocol of a qualitative research study to explore factors that (i) facilitate and hinder the implementation of a social prescribing pilot in the East of England, and (ii) affect the uptake, adherence, and completion rates by service users.  Methods: A qualitative study including semi-structured interviews with managers, health professionals, service providers, navigators, and service users. Iterative thematic analysis will be used to analyse the data.  Conclusion: This study will produce evidence on factors that hinder and facilitate the implementation of a social prescribing programme, as well as factors affecting the engagement, and non-engagement, of service users. Findings can contribute to the development of an evidence base for social prescription programmes in the UK, and inform practice, policy, and future research in the field

Patient Information Leaflets for Lumbar Spine Surgery: A Missed Opportunity

Background: High-quality patient information is recommended to help reduce procedure-related anxiety and encourage patients to become active participants in their recovery. The objective of this study was to analyze the quality of patient information leaflets (PILs) given to National Health Service (NHS) patients ahead of lumbar spine surgery. Methods: The DISCERN tool was used to evaluate the quality of PILs, sourced from NHS websites. Results: Thirty-two PILs on lumbar surgery were included. Two (6%) leaflets were considered poor, 13 (41%) were marked as fair, 14 (44%) were of good quality, and 3 (9%) were scored as excellent. The total mean score was 55 (30-74), which corresponds to good quality. The lowest scoring questions were sources of information (Q4), balanced/unbiased content (Q6), and explanation of no treatment (Q12). Conclusions: There is considerable variation in the quality of PILs provided ahead of lumbar spine surgery. The scope for improvement is clear, and as the move toward patient-centered, evidence-based care continues, it is important that hospital resources provide recommendations based upon evidence of clinical effectiveness

Understanding the palliative care needs and experiences of people with mesothelioma and their family carers : an integrative systematic review

Background: People with mesothelioma and their families have palliative care needs throughout the relatively short trajectory of their illness. Aim: To describe the palliative care needs and experiences of people with mesothelioma and their family carers. Design: Integrative systematic review with narrative synthesis (PROSPERO: CRD42020190115). Data sources: MEDLINE, CINAHL, PsycINFO and the Cochrane Library were searched for articles published between 01 January 2000 and 10 May 2020. Articles were included if they presented empirical studies or comprehensive reviews including information about the palliative care needs and experiences of people with mesothelioma and their family carers. Results: The search yielded 508 articles, 14 were included in the analysis. A cross cutting theme of ‘uncertainty’ was identified encompassing five themes: (1) organisation and co-ordination of services, (2) communication and information needs, (3) management of care needs and high symptom burden, (4) consideration of the impact of seeking compensation and (5) family carer needs. Our findings demonstrate that people with mesothelioma want a co-ordinated, team-based approach to palliative care with a named point of contact. Whilst carers value and benefit from early referral to specialist palliative care, this does not necessarily reflect the outcomes and views of patients. Conclusion: The evidence base around the palliative care needs and experiences of people with mesothelioma and their carers needs to be strengthened. The results of this review support the need to develop a greater understanding about the role non-specialist palliative care clinicians’ play in providing generalist palliative care for people with mesothelioma and their carers

Economic evidence for the prevention and treatment of atopic eczema: a protocol for a systematic review

Background: Eczema, synonymous with atopic eczema or atopic dermatitis, is a chronic skin disease that has a similar impact on health-related quality of life as other chronic diseases. The proposed research aims to provide a comprehensive systematic assessment of the economic evidence base available to inform economic modelling and decision making on interventions to prevent and treat eczema at any stage of the life course. Whilst the Global Resource of Eczema Trials (GREAT) database collects together the effectiveness evidence for eczema there is currently no such systematic resource on the economics of eczema. It is important to gain an overview of the current state of the art of economic methods in the field of eczema in order to strengthen the economic evidence base further. Methods/design: The proposed study is a systematic review of the economic evidence surrounding interventions for the prevention and treatment of eczema. Relevant search terms will be used to search MEDLINE, EMBASE, Database of Abstracts of Reviews of Effects, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, Health Technology Assessment, Cumulative Index to Nursing and Allied Health Literature, Econ Lit, Scopus, Cost-Effectiveness Analysis Registry and Web of Science in order to identify relevant evidence. To be eligible for inclusion studies will be primary empirical studies evaluating the cost, utility or full economic evaluation of interventions for preventing or treating eczema. Two reviewers will independently assess studies for eligibility and perform data abstraction. Evidence tables will be produced presenting details of study characteristics, costing methods, outcome methods and quality assessment. The methodological quality of studies will be assessed using accepted checklists. Discussion: The systematic review is being undertaken to identify the type of economic evidence available, summarise the results of the available economic evidence and critically appraise the quality of economic evidence currently available to inform future economic modelling and resource allocation decisions about interventions to prevent or treat eczema. We aim to use the review to offer guidance about how to gather economic evidence in studies of eczema and/or what further research is necessary in order to inform this

The prevalence of domestic violence among pregnant women in Nigeria: a systematic review.

To identify, appraise, and synthesize research evidence on the prevalence of domestic violence (DV) among pregnant women in Nigeria. We conducted a systematic review of all published studies between April 2004 and June 2016. Comprehensive searches were conducted on electronic databases such as PubMed, CINAHL, Global Health, MEDLINE, PsycINFO, Directory of Open Access Journals, Google Scholar, and electronic libraries of the authors' institution. Identified articles were screened in two stages against the inclusion criteria with titles and abstract screened first followed by full-text screening. Selected articles were assessed using the "guidelines for evaluating prevalence studies," and findings were synthesized narratively. Among 19 studies that met the inclusion criteria, two articles were excluded due to low methodological quality and 17 articles were included in the review. The prevalence of DV during pregnancy in Nigeria ranged between 2.3% and 44.6% with lifetime prevalence rates ranging between 33.1% and 63.2%. Physical, sexual, psychological, and verbal abuses were the most frequent types of DV reported in this review. The most common perpetrators were husbands, as reported in 11 of the 17 studies. Pregnant women between the ages of 20 and 30 years were the most common victims of DV. Our review suggests high prevalence of DV in pregnancy among women in Nigeria and higher lifetime prevalence. However, determining an overall, synthesized accurate prevalence rate of DV within this population based on existing evidence presents a challenge. The findings have important implications for stakeholders such as planners, policy makers, maternity care providers, and researchers in public health and social policy at national, regional, and international levels toward combating the issue. OBJECTIVE METHOD RESULTS CONCLUSIO

The effect of maternal position at birth on perineal trauma: A systematic review.

yesPerineal trauma is associated with short- and long-term maternal morbidity. Research has found that maternal position at birth can influence perineal trauma. However, there is a dearth of evidence examining specific maternal positions, including waterbirth, and how these can influence incidence and degree of perineal trauma. Such evidence is important to help reduce trauma rates and improve information for women and midwives. To address this gap in reliable evidence, a systematic review was conducted. Seven studies met the inclusion criteria. Compared to land birth, waterbirth was found to cause an increase in perineal trauma. Kneeling and all-fours positions were most protective of an intact perineum. Allowing for different variables, sitting, squatting and using a birth-stool caused the greatest incidence of trauma. The findings of this review demonstrate that further research is required around perineal guarding in alternative birth positions and how parity affects trauma rates with waterbirth, so that women may be advised appropriately. It also suggests findings that midwives can use when discussing alternative birth positions with women

Long-term psychosocial impact reported by childhood critical illness survivors: a systematic review

Aim: To undertake a qualitative systematic review that explores psychological and social impact, reported directly from children and adolescents at least 6 months after their critical illness. Background: Significant advances in critical care have reduced mortality from childhood critical illness, with the majority of patients being discharged alive. However, it is widely reported that surviving critical illness can be traumatic for both children and their family. Despite a growing body of literature in this field, the psychological and social impact of life threatening critical illness on child and adolescent survivors, more than 6 months post event, remains under-reported. Data sources: Searches of six online databases were conducted up to February 2012. Review methods: Predetermined criteria were used to select studies. Methodological quality was assessed using a standardized checklist. An adapted version of the thematic synthesis approach was applied to extract, code and synthesize data. Findings: Three studies met the inclusion criteria, which were all of moderate methodological quality. Initial coding and synthesis of data resulted in five descriptive themes: confusion and uncertainty, other people’s narratives, focus on former self and normality, social isolation and loss of identity, and transition and transformation. Further synthesis culminated in three analytical themes that conceptualize the childhood survivors’ psychological and social journey following critical illness. Conclusions: Critical illness in childhood can expose survivors to a complex trajectory of recovery, with enduring psychosocial adversity manifesting in the long term. Nurses and other health professionals must be aware and support the potential multifaceted psychosocial needs that may arise. Parents and families are identified as fundamental in shaping psychological and social well-being of survivors. Therefore intensive care nurses must take opportunities to raise parents’ awareness of the journey of survival and provide appropriate support. Further empirical research is warranted to explore the deficits identified with the existing literature