Thymic development of unconventional T cells: how NKT cells, MAIT cells and γδ T cells emerge
- Pellicci, Daniel, Koay, Hui-Fern, Berzins, Stuart
- Authors: Pellicci, Daniel , Koay, Hui-Fern , Berzins, Stuart
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Nature Reviews Immunology Vol. 20, no. 12 (2020), p. 756-770
- Full Text: false
- Reviewed:
- Description: T cell lineages are defined by specialized functions and differential expression of surface antigens, cytokines and transcription factors. Conventional CD4+ and CD8+ T cells are the best studied of the T cell subsets, but ‘unconventional’ T cells have emerged as being more abundant and influential than has previously been appreciated. Key subsets of unconventional T cells include natural killer T (NKT) cells, mucosal-associated invariant T (MAIT) cells and γδ T cells; collectively, these make up ~10% of circulating T cells, and often they are the majority of T cells in tissues such as the liver and gut mucosa. Defects and deficiencies in unconventional T cells are associated with autoimmunity, chronic inflammation and cancer, so it is important to understand how their development is regulated. In this Review, we describe the thymic development of NKT cells, MAIT cells and γδ T cells and highlight some of the key differences between conventional and unconventional T cell development. © 2020, Springer Nature Limited.
- Kidgell, Dianna, Hills, Danny, Griffiths, Debra, Endacott, Ruth
- Authors: Kidgell, Dianna , Hills, Danny , Griffiths, Debra , Endacott, Ruth
- Date: 2020
- Type: Text , Journal article , Review
- Relation: International Journal of Nursing Studies Vol. 109, no. (2020), p. 1-10
- Full Text: false
- Reviewed:
- Description: Background: Trade agreements in the 21st century have evolved to include provisions that affect domestic public policy and public health in signatory countries. There are growing calls for health professionals and public health advocates to pursue an active advisory role in trade negotiations in order to anticipate and prevent negative outcomes for health services and public health. Aim: This scoping review explored current literature to identify existing knowledge of the implications of trade agreements for the nursing workforce, nursing practice and public health using as an example the 2018 'Comprehensive and Progressive Agreement for Trans-Pacific Partnership'. Design: Scoping review Data sources: Emerald Insight, Informit, Ovid MEDLINE, PubMed, ProQuest, Scopus, and a number of specialist Economics, International Trade and Business, and International Relations databases. Grey literature included national and international policy documents. Review method: Literature was selected according to extraction field criteria, supplemented by hand searching of relevant grey literature and snowballing references from the selected literature reference lists. Analysis was undertaken to identify key themes emerging from the literature. Review results: Six key themes relevant to nursing workforce, nursing practice or public health were 1. Lack of consultation with public health and health professionals in trade negotiations; 2. Implications of strengthened intellectual property provisions for equitable access to medicines (including biologics) and medical devices; 3. Threats to government capacity to regulate domestic policy for public health and health services through 'Investor State Dispute Settlement' provisions 4. Threats to government capacity to regulate domestic policy for public health and health services through 'Regulatory Coherence' 5. Potential limited benefits to communities and increased health inequities 6. Potential implications of increased temporary migration. Gaps were identified in the literature for implications for nursing practice and the nursing workforce from regulatory and labour provisions of trade agreements. Conclusions: The analysis of the literature reviewed is of international importance for the nursing workforce, nursing practice and public health. Policymakers must anticipate and respond to how the inclusion of labour or regulatory provisions in trade agreements will affect nursing practice and the nursing workforce, and how this may subsequently impact on the health of communities globally. (C) 2020 Elsevier Ltd. All rights reserved.
Traversing the funambulist's fine line between nursing and male identity : A systematic review of the factors that influence men as they seek to navigate the nursing profession
- Terry, Daniel, Peck, Blake, Carden, Clarissa, Perkins, Alicia, Smith, Andrew
- Authors: Terry, Daniel , Peck, Blake , Carden, Clarissa , Perkins, Alicia , Smith, Andrew
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 3 (2020), p. 691-703
- Full Text:
- Reviewed:
- Description: Nursing has seen a dominance of women within the profession, and today, the presence of men in the role remains less understood and appreciated. Males considering or entering nursing face challenges concerning role misconception, marginalization, and gender bias. With a looming shortage of nurses on the horizon, it is more important now than ever before to find better ways of engaging males into nursing. The aim of the study was to examine the psychological constructs that influence male perceptions of nursing as they seek to navigate the profession, and what aspects influence men to consider nursing as a career. To achieve this, a systematic review and mixed research synthesis (integrated design) was conducted. English language research published between 1999 and 2019 was eligible. The methodological rigor of qualitative articles followed the Critical Appraisal Skills Program, while the Best Evidence Medical Education guided the quantitative review. Among the 24 publications identified, three sub-themes emerged from the overarching theme of the funambulist or tightrope walker. Sub-themes included societal, inner and collective voices that inform men's place in nursing or their decision making about entering the profession. There is a need to re-visit what it means to be a nurse in order to address the gendered stereotypes that impact men entering the nursing profession.
- Authors: Terry, Daniel , Peck, Blake , Carden, Clarissa , Perkins, Alicia , Smith, Andrew
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 3 (2020), p. 691-703
- Full Text:
- Reviewed:
- Description: Nursing has seen a dominance of women within the profession, and today, the presence of men in the role remains less understood and appreciated. Males considering or entering nursing face challenges concerning role misconception, marginalization, and gender bias. With a looming shortage of nurses on the horizon, it is more important now than ever before to find better ways of engaging males into nursing. The aim of the study was to examine the psychological constructs that influence male perceptions of nursing as they seek to navigate the profession, and what aspects influence men to consider nursing as a career. To achieve this, a systematic review and mixed research synthesis (integrated design) was conducted. English language research published between 1999 and 2019 was eligible. The methodological rigor of qualitative articles followed the Critical Appraisal Skills Program, while the Best Evidence Medical Education guided the quantitative review. Among the 24 publications identified, three sub-themes emerged from the overarching theme of the funambulist or tightrope walker. Sub-themes included societal, inner and collective voices that inform men's place in nursing or their decision making about entering the profession. There is a need to re-visit what it means to be a nurse in order to address the gendered stereotypes that impact men entering the nursing profession.
Unmanned aerial vehicle for internet of everything : opportunities and challenges
- Liu, Yalin, Dai, Hong-Ning, Wang, Qubeijian, Shukla, Mahendra, Imran, Muhammad
- Authors: Liu, Yalin , Dai, Hong-Ning , Wang, Qubeijian , Shukla, Mahendra , Imran, Muhammad
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Computer Communications Vol. 155, no. (2020), p. 66-83
- Full Text:
- Reviewed:
- Description: The recent advances in information and communication technology (ICT) have further extended Internet of Things (IoT) from the sole “things” aspect to the omnipotent role of “intelligent connection of things”. Meanwhile, the concept of internet of everything (IoE) is presented as such an omnipotent extension of IoT. However, the IoE realization meets critical challenges including the restricted network coverage and the limited resource of existing network technologies. Recently, Unmanned Aerial Vehicles (UAVs) have attracted significant attentions attributed to their high mobility, low cost, and flexible deployment. Thus, UAVs may potentially overcome the challenges of IoE. This article presents a comprehensive survey on opportunities and challenges of UAV-enabled IoE. We first present three critical expectations of IoE: (1) scalability requiring a scalable network architecture with ubiquitous coverage, (2) intelligence requiring a global computing plane enabling intelligent things, (3) diversity requiring provisions of diverse applications. Thereafter, we review the enabling technologies to achieve these expectations and discuss four intrinsic constraints of IoE (i.e., coverage constraint, battery constraint, computing constraint, and security issues). We then present an overview of UAVs. We next discuss the opportunities brought by UAV to IoE. Additionally, we introduce a UAV-enabled IoE (Ue-IoE) solution by exploiting UAVs's mobility, in which we show that Ue-IoE can greatly enhance the scalability, intelligence and diversity of IoE. Finally, we outline the future directions in Ue-IoE. © 2020 Elsevier B.V.
- Authors: Liu, Yalin , Dai, Hong-Ning , Wang, Qubeijian , Shukla, Mahendra , Imran, Muhammad
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Computer Communications Vol. 155, no. (2020), p. 66-83
- Full Text:
- Reviewed:
- Description: The recent advances in information and communication technology (ICT) have further extended Internet of Things (IoT) from the sole “things” aspect to the omnipotent role of “intelligent connection of things”. Meanwhile, the concept of internet of everything (IoE) is presented as such an omnipotent extension of IoT. However, the IoE realization meets critical challenges including the restricted network coverage and the limited resource of existing network technologies. Recently, Unmanned Aerial Vehicles (UAVs) have attracted significant attentions attributed to their high mobility, low cost, and flexible deployment. Thus, UAVs may potentially overcome the challenges of IoE. This article presents a comprehensive survey on opportunities and challenges of UAV-enabled IoE. We first present three critical expectations of IoE: (1) scalability requiring a scalable network architecture with ubiquitous coverage, (2) intelligence requiring a global computing plane enabling intelligent things, (3) diversity requiring provisions of diverse applications. Thereafter, we review the enabling technologies to achieve these expectations and discuss four intrinsic constraints of IoE (i.e., coverage constraint, battery constraint, computing constraint, and security issues). We then present an overview of UAVs. We next discuss the opportunities brought by UAV to IoE. Additionally, we introduce a UAV-enabled IoE (Ue-IoE) solution by exploiting UAVs's mobility, in which we show that Ue-IoE can greatly enhance the scalability, intelligence and diversity of IoE. Finally, we outline the future directions in Ue-IoE. © 2020 Elsevier B.V.
Watching the tide roll away-reply to Tibby et al (2020)
- Authors: Gell, Peter
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Pacific Conservation Biology Vol. 26, no. 4 (2020), p. 338-343
- Full Text: false
- Reviewed:
- Description: The published findings on the diatom-inferred condition of a terminal lake in the Murray-Darling Basin were overlooked in favour of a revised unpublished interpretation, without the provision of new evidence or argument, posted on the website of the managing state government. Coauthors of the posted report have responded (Tibby et al. 2020) to the publication (Gell 2020) that outlined the changes made to this interpretation. This reply reaffirms that subtle changes were made to published interpretations and that these were critical in the development of a watering plan for the system. It also illustrates that anecdotal evidence was used selectively but would be a valuable contribution if aligned to known climatic variability. Further, this response corrects the widespread misunderstanding that signatory nations to the Ramsar Convention are obliged to retain listed wetlands in the condition observed at the time of listing. Finally, this response contests the favouring of certain evidence and seeks an approach that reconciles all available evidence, incorporates variability into planning and prepares for future management challenges. © 2020 CSIRO.
A comprehensive review of computational methods for automatic prediction of schizophrenia with insight into indigenous populations
- Ratana, Randall, Sharifzadeh, Hamid, Krishnan, Jamuna, Pang, Shaoning
- Authors: Ratana, Randall , Sharifzadeh, Hamid , Krishnan, Jamuna , Pang, Shaoning
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 10, no. (2019), p.
- Full Text:
- Reviewed:
- Description: Psychiatrists rely on language and speech behavior as one of the main clues in psychiatric diagnosis. Descriptive psychopathology and phenomenology form the basis of a common language used by psychiatrists to describe abnormal mental states. This conventional technique of clinical observation informed early studies on disturbances of thought form, speech, and language observed in psychosis and schizophrenia. These findings resulted in language models that were used as tools in psychosis research that concerned itself with the links between formal thought disorder and language disturbances observed in schizophrenia. The end result was the development of clinical rating scales measuring severity of disturbances in speech, language, and thought form. However, these linguistic measures do not fully capture the richness of human discourse and are time-consuming and subjective when measured against psychometric rating scales. These linguistic measures have not considered the influence of culture on psychopathology. With recent advances in computational sciences, we have seen a re-emergence of novel research using computing methods to analyze free speech for improving prediction and diagnosis of psychosis. Current studies on automated speech analysis examining for semantic incoherence are carried out based on natural language processing and acoustic analysis, which, in some studies, have been combined with machine learning approaches for classification and prediction purposes. © Copyright © 2019 Ratana, Sharifzadeh, Krishnan and Pang.
- Authors: Ratana, Randall , Sharifzadeh, Hamid , Krishnan, Jamuna , Pang, Shaoning
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 10, no. (2019), p.
- Full Text:
- Reviewed:
- Description: Psychiatrists rely on language and speech behavior as one of the main clues in psychiatric diagnosis. Descriptive psychopathology and phenomenology form the basis of a common language used by psychiatrists to describe abnormal mental states. This conventional technique of clinical observation informed early studies on disturbances of thought form, speech, and language observed in psychosis and schizophrenia. These findings resulted in language models that were used as tools in psychosis research that concerned itself with the links between formal thought disorder and language disturbances observed in schizophrenia. The end result was the development of clinical rating scales measuring severity of disturbances in speech, language, and thought form. However, these linguistic measures do not fully capture the richness of human discourse and are time-consuming and subjective when measured against psychometric rating scales. These linguistic measures have not considered the influence of culture on psychopathology. With recent advances in computational sciences, we have seen a re-emergence of novel research using computing methods to analyze free speech for improving prediction and diagnosis of psychosis. Current studies on automated speech analysis examining for semantic incoherence are carried out based on natural language processing and acoustic analysis, which, in some studies, have been combined with machine learning approaches for classification and prediction purposes. © Copyright © 2019 Ratana, Sharifzadeh, Krishnan and Pang.
A systematic review of Lean in healthcare : a global prospective
- Antony, Jiju, Sunder, Vijaya, Sreedharan, Raja, Chakraborty, Ayon, Gunasekaran, Angappa
- Authors: Antony, Jiju , Sunder, Vijaya , Sreedharan, Raja , Chakraborty, Ayon , Gunasekaran, Angappa
- Date: 2019
- Type: Text , Journal article , Review
- Relation: International Journal of Quality and Reliability Management Vol. 36, no. 8 (2019), p. 1370-1391
- Full Text:
- Reviewed:
- Description: Purpose: Fostered by a rapid spread beyond the manufacturing sector, Lean philosophy for continuous improvement has been widely used in service organizations, primarily in the healthcare sector. However, there is a limited research on the motivating factors, challenges and benefits of implementing Lean in healthcare. Taking this as a valuable opportunity, the purpose of this paper is to present the key motivating factors, limitations or challenges of Lean deployment, benefits of Lean in healthcare and key gaps in the literature as an agenda for future research. Design/methodology/approach: The authors used the secondary data from the literature (peer-reviewed journal articles) published between 2000 and 2016 to understand the state of the art. The systematic review identified 101 articles across 88 journals recognized by the Association of Business Schools ranking guide 2015. Findings: The systematic review helped the authors to identify the evolution, current trends, research gaps and an agenda for future research for Lean in healthcare. A bouquet of motivating factors, challenges/limitations and benefits of Lean in healthcare are presented. Practical implications: The implications of this work include directions for managers and healthcare professionals in healthcare organizations to embark on a focused Lean journey aligned with the strategic objectives. This work could serve as a valuable resource to both practitioners and researchers for learning, investigating and rightly adapting the Lean in the healthcare sector. Originality/value: This study is perhaps one of the comprehensive systematic literature reviews covering an important agenda of Lean in Healthcare. All the text, figures and tables featured here are original work carried by five authors in collaboration (from three countries, namely, India, the USA and the UK). © 2019, Emerald Publishing Limited.
- Authors: Antony, Jiju , Sunder, Vijaya , Sreedharan, Raja , Chakraborty, Ayon , Gunasekaran, Angappa
- Date: 2019
- Type: Text , Journal article , Review
- Relation: International Journal of Quality and Reliability Management Vol. 36, no. 8 (2019), p. 1370-1391
- Full Text:
- Reviewed:
- Description: Purpose: Fostered by a rapid spread beyond the manufacturing sector, Lean philosophy for continuous improvement has been widely used in service organizations, primarily in the healthcare sector. However, there is a limited research on the motivating factors, challenges and benefits of implementing Lean in healthcare. Taking this as a valuable opportunity, the purpose of this paper is to present the key motivating factors, limitations or challenges of Lean deployment, benefits of Lean in healthcare and key gaps in the literature as an agenda for future research. Design/methodology/approach: The authors used the secondary data from the literature (peer-reviewed journal articles) published between 2000 and 2016 to understand the state of the art. The systematic review identified 101 articles across 88 journals recognized by the Association of Business Schools ranking guide 2015. Findings: The systematic review helped the authors to identify the evolution, current trends, research gaps and an agenda for future research for Lean in healthcare. A bouquet of motivating factors, challenges/limitations and benefits of Lean in healthcare are presented. Practical implications: The implications of this work include directions for managers and healthcare professionals in healthcare organizations to embark on a focused Lean journey aligned with the strategic objectives. This work could serve as a valuable resource to both practitioners and researchers for learning, investigating and rightly adapting the Lean in the healthcare sector. Originality/value: This study is perhaps one of the comprehensive systematic literature reviews covering an important agenda of Lean in Healthcare. All the text, figures and tables featured here are original work carried by five authors in collaboration (from three countries, namely, India, the USA and the UK). © 2019, Emerald Publishing Limited.
- Chen, Jiarui, Cross, Wendy, Plummer, Virginia, Lam, Louisa, Tang, Siyuan
- Authors: Chen, Jiarui , Cross, Wendy , Plummer, Virginia , Lam, Louisa , Tang, Siyuan
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Women and Birth Vol. 32, no. 6 (Dec 2019), p. 487-492
- Full Text: false
- Reviewed:
- Description: Background: As the number of immigrants grows, the health of Chinese immigrant women, especially their perinatal health, has gradually attracted public attention. Our review has two main purposes. First, estimate the prevalence of postpartum depressive symptoms in Chinese immigrant women, and then determine risk factors for postpartum depressive symptoms among these women. Methods: The following databases: MEDLINE, Embase, Scopus, Web of Science, PsycINFO and PubMed were used in literature search from their commencements until November 21st 2017. The Joanna Briggs Institute (JBI) Critical Appraisal instruments were used to evaluate the quality of the article. Four studies met the inclusion criteria, contributed to our review and meta-analysis. Result: The prevalence of postpartum depression is high in Chinese immigrant women. Risk factors for postpartum depression in Chinese immigrant women were defined as lack of social support, unstable economic status, and acculturation. Conclusion: There have been few studies on postpartum depression among Chinese immigrant women. Existing studies have shown a high prevalence of postpartum depression in Chinese immigrant women. Moreover, there is an urgent need for studies on postpartum depression among Chinese immigrant women informing better understanding, programs of care and improving the perinatal health status of Chinese immigrant women. (C) 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
A systematic review of the effectiveness of empathy education for undergraduate nursing students
- Levett-Jones, Tracy, Cant, Robyn, Lapkin, Samuel
- Authors: Levett-Jones, Tracy , Cant, Robyn , Lapkin, Samuel
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Nurse Education Today Vol. 75, no. (2019), p. 80-94
- Full Text: false
- Reviewed:
- Description: Objective: The objective of this systematic review was to identify, critically appraise and synthesize evidence for the effectiveness of empathy interventions in undergraduate nursing education. Design: A systematic review of literature. Data Sources: A three-stage systematic search of six electronic databases was conducted. Review Methods: The Preferred Reporting Items for Systematic reviews and Meta-Analyses guided the review. English language articles published between 2000 and 2018 were eligible. Methodological rigour was examined using the Medical Education Research Study Quality Instrument. Changes in empathy were assessed using Cohen's effect size correlation (r) and reported as effective when the variance was >0.2 standard deviations (r
Abrasion injuries on artificial turf : A systematic review
- Twomey, Dara, Petrass, Lauren, Fleming, Paul, Lenehan, Kurt
- Authors: Twomey, Dara , Petrass, Lauren , Fleming, Paul , Lenehan, Kurt
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Journal of Science and Medicine in Sport Vol. 22, no. 5 (2019), p. 550-556
- Full Text:
- Reviewed:
- Description: Objectives: To review the incidence of abrasion injuries sustained on artificial turf playing fields and the level of evidence existing on player perceptions of abrasion injuries on these surfaces. Design: Systematic review. Method: A systematic search was performed using SPORTDiscus, Medline, Web of Science, Scopus and Science Direct databases. Inclusion criteria included: abrasion type injuries measured; conducted on artificial/synthetic turf; type of sport reported; peer-reviewed original research; English language search terms, but no language restrictions. A quality assessment was conducted using the Newcastle-Ottawa quality scale. Results: The search yielded 76 potential articles, with 25 meeting all inclusion criteria. Twenty articles were injury-based and five were perception–based. The differences in injury definition and the lack of details of the playing surfaces produced varying results on the rate of injuries on artificial turf. Regardless of the condition of the surface, the level of play, or the sport, players perceived the fear of abrasion injuries as a major disadvantage of artificial turf surfaces. Conclusions: The review highlighted the current disparity that exists between players’ perceptions of abrasion injuries and the level of evidence of abrasion injury risk on artificial turf playing surfaces. There is a need for the inclusion of greater detail of playing surfaces’ specifications and condition, and an injury definition sufficiently sensitive to better measure abrasion injury incidence and severity. Without this more detailed information, it is likely that the strongly perceived risk of abrasion injuries will continue as a barrier to the adoption of artificial playing surfaces.
- Authors: Twomey, Dara , Petrass, Lauren , Fleming, Paul , Lenehan, Kurt
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Journal of Science and Medicine in Sport Vol. 22, no. 5 (2019), p. 550-556
- Full Text:
- Reviewed:
- Description: Objectives: To review the incidence of abrasion injuries sustained on artificial turf playing fields and the level of evidence existing on player perceptions of abrasion injuries on these surfaces. Design: Systematic review. Method: A systematic search was performed using SPORTDiscus, Medline, Web of Science, Scopus and Science Direct databases. Inclusion criteria included: abrasion type injuries measured; conducted on artificial/synthetic turf; type of sport reported; peer-reviewed original research; English language search terms, but no language restrictions. A quality assessment was conducted using the Newcastle-Ottawa quality scale. Results: The search yielded 76 potential articles, with 25 meeting all inclusion criteria. Twenty articles were injury-based and five were perception–based. The differences in injury definition and the lack of details of the playing surfaces produced varying results on the rate of injuries on artificial turf. Regardless of the condition of the surface, the level of play, or the sport, players perceived the fear of abrasion injuries as a major disadvantage of artificial turf surfaces. Conclusions: The review highlighted the current disparity that exists between players’ perceptions of abrasion injuries and the level of evidence of abrasion injury risk on artificial turf playing surfaces. There is a need for the inclusion of greater detail of playing surfaces’ specifications and condition, and an injury definition sufficiently sensitive to better measure abrasion injury incidence and severity. Without this more detailed information, it is likely that the strongly perceived risk of abrasion injuries will continue as a barrier to the adoption of artificial playing surfaces.
Aerobic training protects cardiac function during advancing age : A meta-analysis of four decades of controlled studies
- Beaumont, Alexander, Grace, Fergal, Richards, Joanna, Campbell, Amy, Sculthorpe, Nicholas
- Authors: Beaumont, Alexander , Grace, Fergal , Richards, Joanna , Campbell, Amy , Sculthorpe, Nicholas
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 49, no. 2 (2019), p. 199-219
- Full Text:
- Reviewed:
- Description: Background: In contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny. Objectives: We conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age. Methods: Electronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95% confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic. Results: Overall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95% CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95% CI 0.85–1.60), posterior wall thickness (1.20 mm, 95% CI 0.83–1.56), LV mass (72 g, 95% CI 46–98), LV mass index (28.17 g·m2, 95% CI 19.84–36.49) and stroke volume (13.59 mL, 95% CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95% CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95% CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95% CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95% CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95% CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age. Conclusions: Athletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing. © 2018, The Author(s).
- Authors: Beaumont, Alexander , Grace, Fergal , Richards, Joanna , Campbell, Amy , Sculthorpe, Nicholas
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 49, no. 2 (2019), p. 199-219
- Full Text:
- Reviewed:
- Description: Background: In contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny. Objectives: We conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age. Methods: Electronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95% confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic. Results: Overall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95% CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95% CI 0.85–1.60), posterior wall thickness (1.20 mm, 95% CI 0.83–1.56), LV mass (72 g, 95% CI 46–98), LV mass index (28.17 g·m2, 95% CI 19.84–36.49) and stroke volume (13.59 mL, 95% CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95% CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95% CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95% CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95% CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95% CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age. Conclusions: Athletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing. © 2018, The Author(s).
Animal movements in fire-prone landscapes
- Nimmo, Dale, Avitabile, Sarah, Banks, Sam, Bird, Rebecca, Callister, Kate, Clarke, Michael, Dickman, Chris, Doherty, Tim, Driscoll, Don, Greenville, Aaron, Haslem, Angie, Kelly, Luke, Kenny, Sally, Lahoz-Monfort, Jose, Lee, Connie, Leonard, Steven, Moore, Harry, Newsome, Thomas, Parr, Catherine, Ritchie, Euan, Schneider, Kathryn, Turner, James, Watson, Simon, Westbrooke, Martin, Wouters, Mike, White, Matthew, Bennett, Andrew
- Authors: Nimmo, Dale , Avitabile, Sarah , Banks, Sam , Bird, Rebecca , Callister, Kate , Clarke, Michael , Dickman, Chris , Doherty, Tim , Driscoll, Don , Greenville, Aaron , Haslem, Angie , Kelly, Luke , Kenny, Sally , Lahoz-Monfort, Jose , Lee, Connie , Leonard, Steven , Moore, Harry , Newsome, Thomas , Parr, Catherine , Ritchie, Euan , Schneider, Kathryn , Turner, James , Watson, Simon , Westbrooke, Martin , Wouters, Mike , White, Matthew , Bennett, Andrew
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Biological Reviews Vol. 94, no. 3 (2019), p. 981-998
- Full Text:
- Reviewed:
- Description: Movement is a trait of fundamental importance in ecosystems subject to frequent disturbances, such as fire-prone ecosystems. Despite this, the role of movement in facilitating responses to fire has received little attention. Herein, we consider how animal movement interacts with fire history to shape species distributions. We consider how fire affects movement between habitat patches of differing fire histories that occur across a range of spatial and temporal scales, from daily foraging bouts to infrequent dispersal events, and annual migrations. We review animal movements in response to the immediate and abrupt impacts of fire, and the longer-term successional changes that fires set in train. We discuss how the novel threats of altered fire regimes, landscape fragmentation, and invasive species result in suboptimal movements that drive populations downwards. We then outline the types of data needed to study animal movements in relation to fire and novel threats, to hasten the integration of movement ecology and fire ecology. We conclude by outlining a research agenda for the integration of movement ecology and fire ecology by identifying key research questions that emerge from our synthesis of animal movements in fire-prone ecosystems.
- Authors: Nimmo, Dale , Avitabile, Sarah , Banks, Sam , Bird, Rebecca , Callister, Kate , Clarke, Michael , Dickman, Chris , Doherty, Tim , Driscoll, Don , Greenville, Aaron , Haslem, Angie , Kelly, Luke , Kenny, Sally , Lahoz-Monfort, Jose , Lee, Connie , Leonard, Steven , Moore, Harry , Newsome, Thomas , Parr, Catherine , Ritchie, Euan , Schneider, Kathryn , Turner, James , Watson, Simon , Westbrooke, Martin , Wouters, Mike , White, Matthew , Bennett, Andrew
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Biological Reviews Vol. 94, no. 3 (2019), p. 981-998
- Full Text:
- Reviewed:
- Description: Movement is a trait of fundamental importance in ecosystems subject to frequent disturbances, such as fire-prone ecosystems. Despite this, the role of movement in facilitating responses to fire has received little attention. Herein, we consider how animal movement interacts with fire history to shape species distributions. We consider how fire affects movement between habitat patches of differing fire histories that occur across a range of spatial and temporal scales, from daily foraging bouts to infrequent dispersal events, and annual migrations. We review animal movements in response to the immediate and abrupt impacts of fire, and the longer-term successional changes that fires set in train. We discuss how the novel threats of altered fire regimes, landscape fragmentation, and invasive species result in suboptimal movements that drive populations downwards. We then outline the types of data needed to study animal movements in relation to fire and novel threats, to hasten the integration of movement ecology and fire ecology. We conclude by outlining a research agenda for the integration of movement ecology and fire ecology by identifying key research questions that emerge from our synthesis of animal movements in fire-prone ecosystems.
Benefits of pilates in Parkinson's Disease : A systematic review and meta-analysis
- Suarez-Iglesias, David, Miller, Kyle, Seijo-Martinez, Manuel, Ayan, Carlos
- Authors: Suarez-Iglesias, David , Miller, Kyle , Seijo-Martinez, Manuel , Ayan, Carlos
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Medicina-Lithuania Vol. 55, no. 8 (2019), p. 1-14
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- Description: Pilates may be a beneficial method of exercise for people with Parkinson's disease (PD). However, no studies have critically reviewed the scientific evidence in this regard. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of Pilates as a rehabilitation strategy for PD. A systematic search of the electronic databases PubMed, PEDro, Scopus, and SPORTDiscus was conducted to identify studies related to the effect of Pilates on PD. The search timeframe ranged from the inception of each database to March 2019. The search resulted in the identification of four randomized controlled trials (RCTs) and four non-RCT studies. The methodological quality of the investigations ranged from poor to fair. The descriptive analysis of the eight investigations showed that Pilates resulted in beneficial effects on fitness, balance and functional autonomy. A subsequent meta-analysis on the four RCTs indicated that Pilates was more effective than traditional training programmes in improving lower limb function. Pilates can be safely prescribed for people with mild-to-moderate PD. Preliminary evidence indicates that its practice could have a positive impact on fitness, balance and physical function. Its benefits on lower-body function appear to be superior to those of other conventional exercises. Future randomized studies with greater samples are needed to confirm these observations.
- Authors: Suarez-Iglesias, David , Miller, Kyle , Seijo-Martinez, Manuel , Ayan, Carlos
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Medicina-Lithuania Vol. 55, no. 8 (2019), p. 1-14
- Full Text:
- Reviewed:
- Description: Pilates may be a beneficial method of exercise for people with Parkinson's disease (PD). However, no studies have critically reviewed the scientific evidence in this regard. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of Pilates as a rehabilitation strategy for PD. A systematic search of the electronic databases PubMed, PEDro, Scopus, and SPORTDiscus was conducted to identify studies related to the effect of Pilates on PD. The search timeframe ranged from the inception of each database to March 2019. The search resulted in the identification of four randomized controlled trials (RCTs) and four non-RCT studies. The methodological quality of the investigations ranged from poor to fair. The descriptive analysis of the eight investigations showed that Pilates resulted in beneficial effects on fitness, balance and functional autonomy. A subsequent meta-analysis on the four RCTs indicated that Pilates was more effective than traditional training programmes in improving lower limb function. Pilates can be safely prescribed for people with mild-to-moderate PD. Preliminary evidence indicates that its practice could have a positive impact on fitness, balance and physical function. Its benefits on lower-body function appear to be superior to those of other conventional exercises. Future randomized studies with greater samples are needed to confirm these observations.
Binge eating in patients with polycystic ovary syndrome : Prevalence, causes, and management strategies
- Krug, Isabel, Giles, Sarah, Paganini, Chiara
- Authors: Krug, Isabel , Giles, Sarah , Paganini, Chiara
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Neuropsychiatric Disease and Treatment Vol. 15, no. (2019), p. 1273-1285
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- Description: Emerging evidence suggests that disordered eating, particularly binge-eating symptomatology, is overrepresented within Polycystic Ovary Syndrome (PCOS) populations. This comorbidity presents a clinical dilemma as current treatment approaches for PCOS emphasize the importance of weight management, diet, exercise, and the potential for harm of such treatment approaches in PCOS patients with comorbid disordered eating. However, limited research has assessed the occurrence of binge eating and disordered eating in PCOS patients. Consequently, little is known about the prevalence of binge eating in PCOS, and the possible etiological processes to explain this comorbidity remain poorly understood. Given the paucity of research on this topic, the aims of this narrative review are fourfold: 1) to outline the main symptoms of PCOS and binge eating; 2) to provide an overview of the prevalence of binge eating in PCOS; 3) to outline possible etiological factors for the comorbidity between PCOS and binge eating; and 4) to provide an overview of management strategies of binge eating in PCOS.
- Authors: Krug, Isabel , Giles, Sarah , Paganini, Chiara
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Neuropsychiatric Disease and Treatment Vol. 15, no. (2019), p. 1273-1285
- Full Text:
- Reviewed:
- Description: Emerging evidence suggests that disordered eating, particularly binge-eating symptomatology, is overrepresented within Polycystic Ovary Syndrome (PCOS) populations. This comorbidity presents a clinical dilemma as current treatment approaches for PCOS emphasize the importance of weight management, diet, exercise, and the potential for harm of such treatment approaches in PCOS patients with comorbid disordered eating. However, limited research has assessed the occurrence of binge eating and disordered eating in PCOS patients. Consequently, little is known about the prevalence of binge eating in PCOS, and the possible etiological processes to explain this comorbidity remain poorly understood. Given the paucity of research on this topic, the aims of this narrative review are fourfold: 1) to outline the main symptoms of PCOS and binge eating; 2) to provide an overview of the prevalence of binge eating in PCOS; 3) to outline possible etiological factors for the comorbidity between PCOS and binge eating; and 4) to provide an overview of management strategies of binge eating in PCOS.
Biochar versus bone char for a sustainable inorganic arsenic mitigation in water : What needs to be done in future research?
- Alkurdi, Susan, Herath, Indika, Bundschuh, Jochen, Al-Juboori, Raed, Vithanage, Meththika, Mohan, Dinesh
- Authors: Alkurdi, Susan , Herath, Indika , Bundschuh, Jochen , Al-Juboori, Raed , Vithanage, Meththika , Mohan, Dinesh
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Environment International Vol. 127, no. (2019), p. 52-69
- Full Text:
- Reviewed:
- Description: Arsenic (As) is an emerging contaminant on a global scale posing threat to environmental and human health. The relatively brief history of the applications of biochar and bone char has mapped the endeavors to remove As from water to a considerable extent. This critical review attempts to provide a comprehensive overview for the first time on the potential of bio- and bone-char in the immobilization of inorganic As in water. It seeks to offer a rational assessment of what is existing and what needs to be done in future research as an implication for As toxicity of human health risks through acute and chronic exposure to As contaminated water. Bio- and bone-char are recognized as promising alternatives to activated carbon due to their lower production and activation cost. The surface modification via chemical methods has been adopted to improve the adsorption capacity for anionic As species. Surface complexation, ion exchange, precipitation and electrostatic interactions are the main mechanisms involved in the adsorption of As onto the char surface. However, arsenic-bio-bone char interactions along with their chemical bonding for the removal of As in aqueous solution is still a subject of debate. Hence, the proposed mechanisms need to be scrutinized further using advanced analytical techniques such as synchrotron-based X-ray. Moving this technology from laboratory phase to field scale applications is an urgent necessity in order to establish a sustainable As mitigation in drinking water on a global scale.
- Authors: Alkurdi, Susan , Herath, Indika , Bundschuh, Jochen , Al-Juboori, Raed , Vithanage, Meththika , Mohan, Dinesh
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Environment International Vol. 127, no. (2019), p. 52-69
- Full Text:
- Reviewed:
- Description: Arsenic (As) is an emerging contaminant on a global scale posing threat to environmental and human health. The relatively brief history of the applications of biochar and bone char has mapped the endeavors to remove As from water to a considerable extent. This critical review attempts to provide a comprehensive overview for the first time on the potential of bio- and bone-char in the immobilization of inorganic As in water. It seeks to offer a rational assessment of what is existing and what needs to be done in future research as an implication for As toxicity of human health risks through acute and chronic exposure to As contaminated water. Bio- and bone-char are recognized as promising alternatives to activated carbon due to their lower production and activation cost. The surface modification via chemical methods has been adopted to improve the adsorption capacity for anionic As species. Surface complexation, ion exchange, precipitation and electrostatic interactions are the main mechanisms involved in the adsorption of As onto the char surface. However, arsenic-bio-bone char interactions along with their chemical bonding for the removal of As in aqueous solution is still a subject of debate. Hence, the proposed mechanisms need to be scrutinized further using advanced analytical techniques such as synchrotron-based X-ray. Moving this technology from laboratory phase to field scale applications is an urgent necessity in order to establish a sustainable As mitigation in drinking water on a global scale.
Bone char as a green sorbent for removing health threatening fluoride from drinking water
- Alkurdi, Susan, Al-Juboori, Raed, Bundschuh, Jochen, Hamawand, Ihsan
- Authors: Alkurdi, Susan , Al-Juboori, Raed , Bundschuh, Jochen , Hamawand, Ihsan
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Environment International Vol. 127, no. (2019), p. 704-719
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- Reviewed:
- Description: Millions of people around the world suffer from or prone to health problems caused by high concentration of fluoride in drinking water sources. One of the environmentally friendly and cost-effective ways for removing fluoride is the use of bone char. In this review, the structural properties and binding affinity of fluoride ions from different water sources was critically discussed. The effect of experimental conditions on enhancing the adsorption capacity of fluoride ions using bone char samples was addressed. It appears that surface properties, and conditions of the bone char production such as temperature and residence time play an important role in designing the optimal fluoride removal process. The optimum temperature for fluoride removal seems to be in the range of 500–700 °C and a residence time of 2 h. Applying various equilibrium adsorption isotherms for understanding fluoride adsorption mechanism was presented. The effect of bone char modification with different elements were discussed and recommendations for a further increase in the removal efficiency was proposed. Cost of bone char production and large-scale treatment systems were also discussed based on information available from scientific and commercial sources. Challenges with existing domestic defluoridation designs were highlighted and suggestions for new conceptual designs were provided.
- Authors: Alkurdi, Susan , Al-Juboori, Raed , Bundschuh, Jochen , Hamawand, Ihsan
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Environment International Vol. 127, no. (2019), p. 704-719
- Full Text:
- Reviewed:
- Description: Millions of people around the world suffer from or prone to health problems caused by high concentration of fluoride in drinking water sources. One of the environmentally friendly and cost-effective ways for removing fluoride is the use of bone char. In this review, the structural properties and binding affinity of fluoride ions from different water sources was critically discussed. The effect of experimental conditions on enhancing the adsorption capacity of fluoride ions using bone char samples was addressed. It appears that surface properties, and conditions of the bone char production such as temperature and residence time play an important role in designing the optimal fluoride removal process. The optimum temperature for fluoride removal seems to be in the range of 500–700 °C and a residence time of 2 h. Applying various equilibrium adsorption isotherms for understanding fluoride adsorption mechanism was presented. The effect of bone char modification with different elements were discussed and recommendations for a further increase in the removal efficiency was proposed. Cost of bone char production and large-scale treatment systems were also discussed based on information available from scientific and commercial sources. Challenges with existing domestic defluoridation designs were highlighted and suggestions for new conceptual designs were provided.
Categorising the broad impacts of continuing professional development : a scoping review
- Allen, Louise, Palermo, Claire, Armstrong, Elizabeth, Hay, Margaret
- Authors: Allen, Louise , Palermo, Claire , Armstrong, Elizabeth , Hay, Margaret
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Medical Education Vol. 53, no. 11 (2019), p. 1087-1099
- Full Text: false
- Reviewed:
- Description: Context: A number of systematic reviews have evaluated the impacts of continuing professional development (CPD). These reviews, due to their focused nature, may fail to capture the full range of impacts of CPD. This scoping review aims to explore the broader impacts of CPD with the intention of developing a categorisation of the types of impact of CPD. Methods: The authors searched MEDLINE, CINAHL and ERIC databases for studies published between 2007 and 2017 that looked at the impacts of formal CPD programmes for all health professionals. Studies were independently screened for eligibility; one reviewer charted data for all included studies, a sample of 10% was reviewed by a second reviewer. The charted data were analysed using both qualitative and quantitative content analysis. Results: The search returned 2750 manuscripts; 192 manuscripts describing 191 studies were included in this review. Most articles were from the USA (78 studies, 41%) and included medical doctors in the population (105 studies, 55%). Twelve categories of impact were generated through conventional content analysis: knowledge, practice change, skill, confidence, attitudes, career development, networking, user outcomes, intention to change, organisational change, personal change and scholarly accomplishments. Knowledge was most commonly measured (103 studies, 54%), whereas measurement of scholarly accomplishments was the least common (10 studies, 5%). Conclusions: Existing evidence takes a narrow view when assessing the impacts of CPD. Emphasis on measuring impacts as knowledge, behaviour, confidence, skills and attitudes may be due to the widely accepted four levels of evaluation from the Kirkpatrick Model or because the majority of studies used quantitative methods. The categories proposed in this review may be used to capture a broader view of the impacts of CPD programmes, contributing to the evidence base for their value and translating into CPD programmes that truly transform health professionals, their careers and their practice. © 2019 John Wiley & Sons Ltd and The Association for the Study of Medical Education
Choking interventions in sports : A systematic review
- Gröpel, Peter, Mesagno, Christopher
- Authors: Gröpel, Peter , Mesagno, Christopher
- Date: 2019
- Type: Text , Journal article , Review
- Relation: International Review of Sport and Exercise Psychology Vol. 12, no. 1 (2019), p. 176-201
- Full Text:
- Reviewed:
- Description: Choking under pressure describes suboptimal sport performance in stressful situations, which has led to two fundamental ‘choking’ models: distraction and self-focus. The purpose of this review was to provide an overview of empirical studies that have tested interventions used to alleviate choking. The systematic review includes 47 empirical studies published up to April 2017, including experimental, quasi-experimental, and single-case studies with athletes. These studies encompassed a variety of interventions (n = 13) that were either distraction based or self-focus based. In addition, a third group–acclimatisation interventions–was identified. The results indicate that, in general, choking interventions based on both choking models and on acclimatisation provide a benefit to performance under pressure. The most reported effective interventions were pre-performance routines, quiet eye training, left-hand contractions, and acclimatisation training. The use of dual task was beneficial for performance under pressure but harmful when used in training. Mixed evidence was found for analogy learning, and null effects were reported for goal setting, neurofeedback training, and reappraisal cues. These results may help athletes and coaches select and implement effective strategies and methods to improve performance under pressure.
- Authors: Gröpel, Peter , Mesagno, Christopher
- Date: 2019
- Type: Text , Journal article , Review
- Relation: International Review of Sport and Exercise Psychology Vol. 12, no. 1 (2019), p. 176-201
- Full Text:
- Reviewed:
- Description: Choking under pressure describes suboptimal sport performance in stressful situations, which has led to two fundamental ‘choking’ models: distraction and self-focus. The purpose of this review was to provide an overview of empirical studies that have tested interventions used to alleviate choking. The systematic review includes 47 empirical studies published up to April 2017, including experimental, quasi-experimental, and single-case studies with athletes. These studies encompassed a variety of interventions (n = 13) that were either distraction based or self-focus based. In addition, a third group–acclimatisation interventions–was identified. The results indicate that, in general, choking interventions based on both choking models and on acclimatisation provide a benefit to performance under pressure. The most reported effective interventions were pre-performance routines, quiet eye training, left-hand contractions, and acclimatisation training. The use of dual task was beneficial for performance under pressure but harmful when used in training. Mixed evidence was found for analogy learning, and null effects were reported for goal setting, neurofeedback training, and reappraisal cues. These results may help athletes and coaches select and implement effective strategies and methods to improve performance under pressure.
- Al-Moteri, Modi, Plummer, Virginia, Cooper, Simon J., Symmons, Mark
- Authors: Al-Moteri, Modi , Plummer, Virginia , Cooper, Simon J. , Symmons, Mark
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Australian Critical Care Vol. 32, no. 5 (2019), p. 411-420
- Full Text: false
- Reviewed:
- Description: Aim: The aim of this review was to identify and synthesise published accounts of recognising and responding to patient deterioration in the presence of deterioration antecedents. Design: The systematic review canvassed four electronic databases/ search engines for studies of adult ward patients who had altered physiological parameters before developing major adverse events. Synthesis Methods: The findings were synthesised using a narrative approach. Results: Clinical deterioration can be missed by nurses, even with adequate charting. Delays in recognising and responding to patient deterioration remains an international patient safety concern, and strategies to enhance recognition of patient deterioration have not achieved consistent improvements. The lack of significant and sustained improvement through targeted training suggests the problem may be rooted in human behaviour and local ward culture. Nurses play a pivotal role in recognising and responding to patient deterioration; however, patient records do not facilitate tracking of all nurse decisions and actions, and any undocumented care cannot be easily captured by auditing processes. Conclusion: Failure to recognise clinical deterioration was evident even with adequate charting. It is not clear if nurses do not recognise clinical deterioration because they failed to interpret the signs of deterioration or they made a conscious decision not to escalate based on their clinical judgement or they lacked attention at the time of the event. Whatever the reason, focus is warranted for nurses' decisionmaking after the recording of clinical deterioration signs and the role of human factors in delayed recognition, before maximum benefit of any strategy can be achieved.
Communication training and its effects on carer and care-receiver outcomes in dementia settings : A systematic review
- Nguyen, Hoang, Terry, Daniel, Phan, Hoang, Vickers, James, McInerney, Fran
- Authors: Nguyen, Hoang , Terry, Daniel , Phan, Hoang , Vickers, James , McInerney, Fran
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 28, no. 7-8 (2019), p. 1050-1069
- Full Text:
- Reviewed:
- Description: Aims and objectives To review communication interventions that aim to improve regular care interactions between people with dementia and their carers in various settings; and to examine the impact of such interventions on both carer and care-receiver outcomes. Background Effective communication is imperative to ensure quality of care for people living with dementia. Due to neurodegenerative changes, people with dementia encounter ongoing and progressive difficulties in both understanding and expressing themselves. This in turn creates challenges for carers, which highlights the need for equipping them with necessary communication skills to respond to the specific communication needs of people with dementia. Design Systematic review and meta-analysis. Method Medline, Embase, CINAHL, ProQuest and PsycINFO databases were searched for eligible interventions with any date of the publication. Hand searching was also conducted through reviewing the reference lists of relevant articles. The screening and selection of studies were based on the inclusion/exclusion criteria for eligibility and the methodological quality assessment checklist. Random-effects meta-analyses were conducted on comparable quantitative data. The review is reported following the PRISMA reporting guidelines. Results Seventeen studies were included in the final review, including 12 randomised controlled trials (RCTs), three nonrandomised controlled trials (NRCTs) and two controlled before-after interventions. The intervention designs, settings and outcome measures were varied. The findings suggest that the communication training had a positive impact on both carer and care-receiver outcomes, albeit to different degrees. The intervention effects were found to be strongest on carer communication skills and knowledge. Conclusion There is solid evidence for the positive impact of communication training on the skills and knowledge of carers. More research is needed regarding the effects of such educational interventions on carer physio-psychological outcomes and care-receiver neuropsychiatric symptoms. It is important to establish best practices in training design, develop validated outcome measures and adopt consistent reporting approaches. Relevance to clinical practice The increasing global prevalence of people with dementia manifests across clinical and community contexts. The profound impact of dementia on communication and associated care raises the imperative for enhanced health worker and carer communication skills to meet the needs of this particular client group. The findings of this review indicate that educational interventions incorporating face-to-face and diverse instructional delivery methods in dementia communication showed positive outcomes for communication skills in all carer groups and warrant inclusion as strategies in dementia training.
- Authors: Nguyen, Hoang , Terry, Daniel , Phan, Hoang , Vickers, James , McInerney, Fran
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 28, no. 7-8 (2019), p. 1050-1069
- Full Text:
- Reviewed:
- Description: Aims and objectives To review communication interventions that aim to improve regular care interactions between people with dementia and their carers in various settings; and to examine the impact of such interventions on both carer and care-receiver outcomes. Background Effective communication is imperative to ensure quality of care for people living with dementia. Due to neurodegenerative changes, people with dementia encounter ongoing and progressive difficulties in both understanding and expressing themselves. This in turn creates challenges for carers, which highlights the need for equipping them with necessary communication skills to respond to the specific communication needs of people with dementia. Design Systematic review and meta-analysis. Method Medline, Embase, CINAHL, ProQuest and PsycINFO databases were searched for eligible interventions with any date of the publication. Hand searching was also conducted through reviewing the reference lists of relevant articles. The screening and selection of studies were based on the inclusion/exclusion criteria for eligibility and the methodological quality assessment checklist. Random-effects meta-analyses were conducted on comparable quantitative data. The review is reported following the PRISMA reporting guidelines. Results Seventeen studies were included in the final review, including 12 randomised controlled trials (RCTs), three nonrandomised controlled trials (NRCTs) and two controlled before-after interventions. The intervention designs, settings and outcome measures were varied. The findings suggest that the communication training had a positive impact on both carer and care-receiver outcomes, albeit to different degrees. The intervention effects were found to be strongest on carer communication skills and knowledge. Conclusion There is solid evidence for the positive impact of communication training on the skills and knowledge of carers. More research is needed regarding the effects of such educational interventions on carer physio-psychological outcomes and care-receiver neuropsychiatric symptoms. It is important to establish best practices in training design, develop validated outcome measures and adopt consistent reporting approaches. Relevance to clinical practice The increasing global prevalence of people with dementia manifests across clinical and community contexts. The profound impact of dementia on communication and associated care raises the imperative for enhanced health worker and carer communication skills to meet the needs of this particular client group. The findings of this review indicate that educational interventions incorporating face-to-face and diverse instructional delivery methods in dementia communication showed positive outcomes for communication skills in all carer groups and warrant inclusion as strategies in dementia training.