Impact of atopic dermatitis on quality of life in adults:a systematic review and meta-analysis

Atopic dermatitis (AD) can affect quality of life (QoL) of adult patients in whom the condition can be severe and persistent. There are currently no systematic reviews of the impact of AD on adults. This paper provides the first systematic literature review and meta-analysis of the impact of AD on QoL in adults. A systematic search was conducted using MEDLINE, Scopus, and Web of Science for articles published until October 2018. Inclusion criteria were a clinical diagnosis of AD, adult patients, and QoL as an outcome measure. Interventions were excluded. A total of 32 studies were included. While QoL was assessed using Dermatology Life Quality Index (DLQI) in 25 studies, there was heterogeneity in the tools used to measure disease severity across studies. Meta-analysis of the seven studies that used the SCORAD to measure disease severity showed severity to be significantly related to poorer QoL. The remaining 18 studies also showed increased disease severity significantly related to poorer QoL. When compared to healthy controls, AD patients demonstrated significantly lower QoL, but findings were mixed in studies that compared QoL in AD to other skin conditions. The findings highlight the significant impact that AD has on QoL in adults and the need for validated and relevant QoL measures to be implemented in clinical assessments for AD. Areas that require further research include an exploration of gender differences in QoL and the use of longitudinal study designs to explore factors that may cause differences in QoL ratings

A distribuição eletrônica de evidências em saúde permite a criação de novas medidas de relevância informacional

Na ausência de medidas para avaliar qual informação gerada no contexto acadêmico é útil para a prática clínica, há o risco de se adotar o número de citações recebidas pelo artigo científico. Para avaliar se essa medida é eficaz para identificar a relevância clínica da informação, foi realizado um estudo quantitativo com médicos de família canadenses. Eles avaliaram o uso potencial de informação sumarizada oriunda de artigos científicos por meio do Information Assessment Method, do qual foi derivado uma nova medida associada ao uso da informação na prática clínica, CRII. Resultados demonstram que citações não capturam relevância clínica da informação.Sociedad Argentina de Informática e Investigación Operativ

Protocol for a systematic review and thematic synthesis of patient experiences of central venous access devices in anti-cancer treatment

Background: Three types of central venous access devices (CVADs)—peripherally inserted central catheters (PICCs), skin-tunnelled central catheters (Hickman-type devices), and implantable chest wall Ports (Ports)—are routinely used in the intravenous administration of anti-cancer treatment. These devices avoid the need for peripheral cannulation and allow for home delivery of treatment. Assessments of these devices have tended to focus on medical and economic factors, but there is increased interest in the importance of patient experiences and perspectives in this area. The aim of this systematic review is to synthesise existing research regarding patient experiences of these CVADs to help clinicians guide, prepare, and support patients receiving CVADs for the administration of anti-cancer treatment. Method: A systematic search of MEDLINE, Embase, and CINAHL research databases will be carried out along with a supplementary reference list search. This review will include quantitative, qualitative, and mixed methods studies published in peer-review journals, reporting some aspect(s) of patient experiences or perspectives regarding the use of PICC, Hickman, or Port CVADs for the administration of anti-cancer drugs. The methodological quality and risk of bias of included papers will be assessed using the Mixed Methods Appraisal Tool (MMAT). Relevant outcome data will be extracted from included studies and analysed using a thematic synthesis approach. Discussion: The results section of the review will comprise thematic synthesis of quantitative studies, thematic synthesis of qualitative studies, and the aggregation of the two. Results will aim to offer an account of current understandings of patient experiences and perspective regarding PICC, Hickman-type, and Port devices in the context of anti-cancer treatment. Confidence in cumulative evidence will be assessed using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach

A distribuição eletrônica de evidências em saúde permite a criação de novas medidas de relevância informacional

Na ausência de medidas para avaliar qual informação gerada no contexto acadêmico é útil para a prática clínica, há o risco de se adotar o número de citações recebidas pelo artigo científico. Para avaliar se essa medida é eficaz para identificar a relevância clínica da informação, foi realizado um estudo quantitativo com médicos de família canadenses. Eles avaliaram o uso potencial de informação sumarizada oriunda de artigos científicos por meio do Information Assessment Method, do qual foi derivado uma nova medida associada ao uso da informação na prática clínica, CRII. Resultados demonstram que citações não capturam relevância clínica da informação.Sociedad Argentina de Informática e Investigación Operativ

A distribuição eletrônica de evidências em saúde permite a criação de novas medidas de relevância informacional

Na ausência de medidas para avaliar qual informação gerada no contexto acadêmico é útil para a prática clínica, há o risco de se adotar o número de citações recebidas pelo artigo científico. Para avaliar se essa medida é eficaz para identificar a relevância clínica da informação, foi realizado um estudo quantitativo com médicos de família canadenses. Eles avaliaram o uso potencial de informação sumarizada oriunda de artigos científicos por meio do Information Assessment Method, do qual foi derivado uma nova medida associada ao uso da informação na prática clínica, CRII. Resultados demonstram que citações não capturam relevância clínica da informação.Sociedad Argentina de Informática e Investigación Operativ

Successful Strategies to Engage Research Partners for Translating Evidence into Action in Community Health: A Critical Review

Objectives. To undertake a critical review describing key strategies supporting development of participatory research (PR) teams to engage partners for creation and translation of action-oriented knowledge. Methods. Sources are four leading PR practitioners identified via bibliometric analysis. Authors' publications were identified in January 1995-October 2009 in PubMed, Embase, ISI Web of Science and CAB databases, and books. Works were limited to those with a process description describing a research project and practitioners were first, second, third, or last author. Results. Adapting and applying the "Reliability Tested Guidelines for Assessing Participatory Research Projects" to retained records identified five key strategies: developing advisory committees of researchers and intended research users; developing research agreements; using formal and informal group facilitation techniques; hiring co-researchers/partners from community; and ensuring frequent communication. Other less frequently mentioned strategies were also identified. Conclusion. This review is the first time these guidelines were used to identify key strategies supporting PR projects. They proved effective at identifying and evaluating engagement strategies as reported by completed research projects. Adapting these guidelines identified gaps where the tool was unable to assess fundamental PR elements of power dynamics, equity of resources, and member turnover. Our resulting template serves as a new tool to measure partnerships

Health outcomes of online consumer health information: A systematic mixed studies review with framework synthesis.

The Internet has become the first source of consumer health information. Most theoretical and empirical studies are centered on information needs and seeking, rather than on information outcomes. This review's purpose is to explore and explain health outcomes of Online Consumer Health Information (OCHI) in primary care. A participatory systematic mixed studies review with a framework synthesis was undertaken. Starting from an initial conceptual framework, our specific objectives were to (a) identify types of OCHI outcomes in primary care, (b) identify factors associated with these outcomes, and (c) integrate these factors and outcomes into a comprehensive revised framework combining an information theory and a psychosocial theory of behavior. The results of 65 included studies were synthesized using a qualitative thematic data analysis. The themes derived from the literature underwent a harmonization process that produced a comprehensive typology of OCHI outcomes. The revised conceptual framework specifies four individual and one organizational level of OCHI outcomes, while including factors such as consumers' information needs and four interdependent contextual factors. It contributes to theoretical knowledge about OCHI health outcomes, and informs future research, information assessment methods, and tools to help consumers find and use health information

Barriers and facilitators to adherence to group exercise in institutionalized older people living with dementia: a systematic review

Objectives Research suggests targeted exercise is important for people living with dementia, especially those living in residential care. The aim of this review was to collect and synthesize evidence on the known barriers and facilitators to adherence to group exercise of institutionalized older people living with dementia. Methods We searched all available electronic databases. Additionally, we searched trial registries (clinicaltrial.gov, and WHO ICTRP) for ongoing studies. We searched for and included papers from January 1990 until September 2017 in any language. We included randomized, non-randomized trials. Studies were not eligible if participants were either healthy older people or people suffering from dementia but not living in an institution. Studies were also excluded if they were not focused on barriers and facilitators to adherence to group exercise. Results Using narrative analysis, we identified the following themes for barriers: bio-medical reasons and mental wellbeing and physical ability, relationships dynamics, and socioeconomic reasons. The facilitators were grouped under the following thematic frames: bio-medical benefits and benefits related to physical ability, feelings and emotions and confidence improvements, therapist and group relationships dynamics and activity related reasons. Conclusions We conclude that institutionalized older people living with dementia, even those who are physically frail, incontinent and/or have mild dementia can demonstrate certain level of exercise adherence, and therefore can respond positively to exercise programs. Tailored, individually-adjusted and supported physical activity, led by a knowledgeable, engaging and well communicating therapist/facilitator improves the adherence to group exercise interventions of institutionalized older people living with dementia

Evidence-based medicine among internal medicine residents in a community hospital program using smart phones

BACKGROUND: This study implemented and evaluated a point-of-care, wireless Internet access using smart phones for information retrieval during daily clinical rounds and academic activities of internal medicine residents in a community hospital. We did the project to assess the feasibility of using smart phones as an alternative to reach online medical resources because we were unable to find previous studies of this type. In addition, we wanted to learn what Web-based information resources internal medicine residents were using and whether providing bedside, real-time access to medical information would be perceived useful for patient care and academic activities. METHODS: We equipped the medical teams in the hospital wards with smart phones (mobile phone/PDA hybrid devices) to provide immediate access to evidence-based resources developed at the National Library of Medicine as well as to other medical Websites. The emphasis of this project was to measure the convenience and feasibility of real-time access to current medical literature using smart phones. RESULTS: The smart phones provided real-time mobile access to medical literature during daily rounds and clinical activities in the hospital. Physicians found these devices easy to use. A post-study survey showed that the information retrieved was perceived to be useful for patient care and academic activities. CONCLUSION: In community hospitals and ambulatory clinics without wireless networks where the majority of physicians work, real-time access to current medical literature may be achieved through smart phones. Immediate availability of reliable and updated information obtained from authoritative sources on the Web makes evidence-based practice in a community hospital a reality

Gender perspectives on views and preferences of older people on exercise to prevent falls: a systematic mixed studies review

Background: To offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both womens and mens views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older peoples views or preferences regarding uptake and adherence to exercise to prevent falls. Methods: A review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach. Results: Nine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of mens and womens views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies. Conclusion: Although there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older womens and mens views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise.Funding Agencies|Swedish Research Council [2015-03481]; Strategic Research Programme in Care Sciences, Umea University; Karolinska Institute, Sweden; Umea University</p