The experience of attempting to return to work following spinal cord injury : a systematic review of the qualitative literature
- Authors: Hilton, Gillean , Unsworth, Carolyn , Murphy, Gregory
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Disability and Rehabilitation Vol. 40, no. 15 (2018), p. 1745-1753
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- Description: Purpose: This review sought to answer the question “What are the barriers and facilitators influencing people’s experience of return to work following spinal cord injury?” Methods: Studies that met the selection criteria were identified, presented and critically appraised using National Institute for Health and Care Excellence guidelines. Thematic synthesis was completed with studies possessing strong methodological rigor. Synthesis and interpretation involved three stages; coding of primary data; development of descriptive themes reflective of the primary data; and establishment of analytical themes to answer the review question. Results: Data from nine papers were included in the thematic synthesis. Several descriptive themes and three analytical themes were drawn from the data to answer the research question. Analytical themes included: a matrix of personal and environmental factors exists requiring complex navigation in order to create possibilities and opportunities for postinjury employment; the process of seeking or gaining employment shares a reciprocal relationship with the temporal nature of adjustment to spinal cord injury; and there is an intrinsic need for occupational engagement through paid employment. Conclusions: Returning to or gaining employment after spinal cord injury is a fundamentally difficult experience for people. Multiple strategies are required to support the navigation of the process. There is, however, a need in people with spinal cord injury, to be a worker, and with that comes the inherent benefits of being employed. Implications for rehabilitation Returning to work should be a significant focus of spinal cord injury rehabilitation. Employment is both possible and health promoting following spinal cord injury. Multiple strategies are required to support people to navigate the return to work process. It is important to be cognizant of the individual motivations for being a worker and the complexity of the adjustment process. Spinal cord injury centers can provide a consistent and supportive framework and culture of positivity about employment after spinal cord injury. © 2017 Informa UK Limited, trading as Taylor & Francis Group.
Categorising the broad impacts of continuing professional development : a scoping review
- 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
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- 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
Noncoding genes on sex chromosomes and their function in sex determination, dosage compensation, male traits, and diseases
- Authors: Maier, Michelle , McInerney, Molly-Rose , Graves, Jennifer , Charchar, Fadi
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Sexual Development Vol. 15, no. 5-6 (2021), p. 432-440
- Relation: http://purl.org/au-research/grants/nhmrc/1123472
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- Description: The mammalian Y chromosome has evolved in many species into a specialized chromosome that contributes to sex development among other male phenotypes. This function is well studied in terms of protein-coding genes. Less is known about the noncoding genome on the Y chromosome and its contribution to both sex development and other traits. Once considered junk genetic material, noncoding RNAs are now known to contribute to the regulation of gene expression and to play an important role in refining cellular functions. The prime examples are noncoding genes on the X chromosome, which mitigate the differential dosage of genes on sex chromosomes. Here, we discuss the evolution of noncoding RNAs on the Y chromosome and the emerging evidence of how micro, long, and circular noncoding RNAs transcribed from the Y chromosome contribute to sex differentiation. We briefly touch on emerging evidence that these noncoding RNAs also contribute to some other important clinical phenotypes in humans. © 2021 S. Karger AG. All rights reserved.
The physical hospital environment and its effects on palliative patients and their families : a qualitative meta-synthesis
- Authors: Miller, Elizabeth , Porter, Joanne , Barbagallo, Michael
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Health Environments Research and Design Journal Vol. 15, no. 1 (2022), p. 268-291
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- Description: Aim: To review the latest qualitative literature on how the physical hospital environment affects palliative patients and their families. Background: People with a life-limiting illness may receive palliative care to improve their quality of life in hospital and may have multiple admissions as their illness progresses. Yet, despite a preference for a death at home, more than half of the dying population will receive end-of-life care in hospital. The physical hospital environment consists of ambiance, aesthetics, and architectural factors, and it is well known that the hospital’s acute wards are not a homely environment. Demand is increasing for the physical environment to be improved to better meet the needs and demands of palliative and end-of-life patients and their families. Method: Combining thematic analysis and meta-ethnography methodologies, 12 international qualitative papers were analyzed and synthesized by the three authors. Results: Findings resulted in the development of the SSAFeR Place approach that incorporates the concepts that are important to palliative and end-of-life patients and their families by describing an environment within the acute or palliative care units that feels safe, is private, customizable, and accommodates family; is a space to share with others, is homelike in ambiance and aesthetics, and is conducive for reflection. The concepts of identity, belonging, and safety are connected to the notions of home. Conclusions: To provide person-centered care and to move the focus toward the palliative approach of comfort and quality of life, attention to room size, layout, aesthetics, and ambiance is needed. © The Author(s) 2021.
A systematic review of public transport accessibility for people using mobility devices
- Authors: Unsworth, Carolyn , So, Man , Chua, Julian , Gudimetla, Prasad , Naweed, Anjum
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Disability and Rehabilitation Vol. 43, no. 16 (2021), p. 2253-2267
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- Description: Purpose: Being able to access public transport is vital for mobility device users as this is an affordable way of maintaining community connections and participating in activities that promote quality of life. This systematic review investigated literature on public transport access for people using mobility devices, excluding transit restraint and securement literature. Materials and methods: A systematic review of the peer-reviewed literature in English from 1995 to 2019, with critical appraisal and narrative synthesis. Results: Twenty-six articles were identified, including 14 studies investigating user experiences, seven examining bus formats and floor layouts, and five focusing on bus ramp incidents and optimal design. Studies were generally observational and descriptive, with 12 including analysis of video data. Conclusion: This is the first systematic review of literature related to the accessibility of public transport for people using mobility devices. Topics such as ramp access have been relatively well-researched, as have the experiences of users. However, many gaps remain and there is a need for research to; address the barriers identified through user experiences, discern the best access to stations and stops, as well as floor formats for people to ingress, manoeuvre and egress from a variety of transport modes, and promote universal design principles in the transport sector. Rehabilitation professionals can use the findings of this review to advocate for, and support people using mobility devices to successfully negotiate public transport.Implications for Rehabilitation Accessible public transport is vital to enable people using mobility devices to remain connected in their communities. Despite increased international awareness and adoption of accessibility features by the public transport sector to improve getting to a stop, ingress, manoeuvrability within and egress from conveyances, access for people using wheeled mobility devices cannot be assumed. When prescribing new wheeled mobility devices with clients, rehabilitation professionals and users need to consider public transport access and the suitability of different devices for this purpose. Rehabilitation professionals can undertake skills training with people using wheeled mobility devices to test out access prior to independent travel on public transport and develop strategies to overcome any barriers. © 2019 Informa UK Limited, trading as Taylor & Francis Group.
Equity in healthcare resource allocation decision making : a systematic review
- Authors: Lane, Haylee , Sarkies, Mitchell , Martin, Jennifer , Haines, Terry
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Social Science and Medicine Vol. 175, no. (2017), p. 11-27
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- Description: Objective To identify elements of endorsed definitions of equity in healthcare and classify domains of these definitions so that policy makers, managers, clinicians, and politicians can form an operational definition of equity that reflects the values and preferences of the society they serve. Design Systematic review where verbatim text describing explicit and implicit definitions of equity were extracted and subjected to a thematic analysis. Data sources The full holdings of the AMED, CINAHL plus, OVID Medline, Scopus, PsychInfo and ProQuest (ProQuest Health & Medical Complete, ProQuest Nursing and Allied Health Source, ProQuest Social Science Journals) were individually searched in April 2015. Eligibility criteria for selecting studies Studies were included if they provided an original, explicit or implicit definition of equity in regards to healthcare resource allocation decision making. Papers that only cited earlier definitions of equity and provided no new information or extensions to this definition were excluded. Results The search strategy yielded 74 papers appropriate for this review; 60 of these provided an explicit definition of equity, with a further 14 papers discussing implicit elements of equity that the authors endorsed in regards to healthcare resource allocation decision making. Five key themes emerged i) Equalisation across the health service supply/access/outcome chain, ii) Need or potential to benefit, iii) Groupings of equalisation, iv) Caveats to equalisation, and v) Close enough is good enough. Conclusions There is great inconsistency in definitions of equity endorsed by different authors. Operational definitions of equity need to be more explicit in addressing these five thematic areas before they can be directly applied to healthcare resource allocation decisions. © 2016 Elsevier Ltd
Adult inpatients’ perceptions of their fall risk : a scoping review
- Authors: Dabkowski, Elissa , Cooper, Simon , Duncan, Jhodie , Missen, Karen
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Healthcare (Switzerland) Vol. 10, no. 6 (2022), p.
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- Description: Patient falls in hospitals continue to be a global concern due to the poor health outcomes and costs that can occur. A large number of falls in hospitals are unwitnessed and mostly occur due to patient behaviours and not seeking assistance. Understanding these patient behaviours may help to direct fall prevention strategies, with evidence suggesting the need to integrate patients’ perspectives into fall management. The aim of this scoping review was to explore the extent of the literature about patients’ perceptions and experiences of their fall risk in hospital and/or of falling in hospital. This review was conducted using a five-stage methodological framework recommended by Arksey and O’Malley. A total of nine databases were searched using key search terms such as “fall*”, “perception” and “hospital.” International peer-reviewed and grey literature were searched between the years 2011 and 2021. A total of 41 articles, ranging in study design, met the inclusion criteria. After reporting on the article demographics and fall perception constructs and measures, the qualitative and quantitative findings were organised into five domains: Fall Risk Perception Measures, Patients’ Perceptions of Fall Risk, Patients’ Perceptions of Falling in Hospital, Patients’ Fear of Falling and Barriers to Fall Prevention in Hospital. Approximately two-thirds of study participants did not accurately identify their fall risk compared to that defined by a health professional. This demonstrates the importance of partnering with patients and obtaining their insights on their perceived fall risk, as this may help to inform fall management and care. This review identified further areas for research that may help to inform fall prevention in a hospital setting, including the need for further research into fall risk perception measures. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Precision medicine : an optimal approach to patient care in renal cell carcinoma
- Authors: Sharma, Revati , Kannourakis, George , Prithviraj, Prashanth , Ahmed, Nuzhat
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Frontiers in Medicine Vol. 9, no. (2022), p.
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- Description: Renal cell cancer (RCC) is a heterogeneous tumor that shows both intra- and inter-heterogeneity. Heterogeneity is displayed not only in different patients but also among RCC cells in the same tumor, which makes treatment difficult because of varying degrees of responses generated in RCC heterogeneous tumor cells even with targeted treatment. In that context, precision medicine (PM), in terms of individualized treatment catered for a specific patient or groups of patients, can shift the paradigm of treatment in the clinical management of RCC. Recent progress in the biochemical, molecular, and histological characteristics of RCC has thrown light on many deregulated pathways involved in the pathogenesis of RCC. As PM-based therapies are rapidly evolving and few are already in current clinical practice in oncology, one can expect that PM will expand its way toward the robust treatment of patients with RCC. This article provides a comprehensive background on recent strategies and breakthroughs of PM in oncology and provides an overview of the potential applicability of PM in RCC. The article also highlights the drawbacks of PM and provides a holistic approach that goes beyond the involvement of clinicians and encompasses appropriate legislative and administrative care imparted by the healthcare system and insurance providers. It is anticipated that combined efforts from all sectors involved will make PM accessible to RCC and other patients with cancer, making a tremendous positive leap on individualized treatment strategies. This will subsequently enhance the quality of life of patients. Copyright © 2022 Sharma, Kannourakis, Prithviraj and Ahmed.
Exercise and the gut microbiome : implications for supportive care in cancer
- Authors: Hart, Nicholas , Wallen, Matthew , Farley, Morgan , Haywood, Darren , Boytar, Alexander , Secombe, Kate , Joseph, Ria , Chan, Raymond , Kenkhuis, Marlou-Floor , Buffart, Laurien , Skinner, Tina , Wardill, Hannah
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Supportive Care in Cancer Vol. 31, no. 12 (2023), p.
- Relation: http://purl.org/au-research/grants/nhmrc/1194051
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- Description: Purpose: Growing recognition of the gut microbiome as an influential modulator of cancer treatment efficacy and toxicity has led to the emergence of clinical interventions targeting the microbiome to enhance cancer and health outcomes. The highly modifiable nature of microbiota to endogenous, exogenous, and environmental inputs enables interventions to promote resilience of the gut microbiome that have rapid effects on host health, or response to cancer treatment. While diet, probiotics, and faecal microbiota transplant are primary avenues of therapy focused on restoring or protecting gut function in people undergoing cancer treatment, the role of physical activity and exercise has scarcely been examined in this population. Methods: A narrative review was conducted to explore the nexus between cancer care and the gut microbiome in the context of physical activity and exercise as a widely available and clinically effective supportive care strategy used by cancer survivors. Results: Exercise can facilitate a more diverse gut microbiome and functional metabolome in humans; however, most physical activity and exercise studies have been conducted in healthy or athletic populations, primarily using aerobic exercise modalities. A scarcity of exercise and microbiome studies in cancer exists. Conclusions: Exercise remains an attractive avenue to promote microbiome health in cancer survivors. Future research should elucidate the various influences of exercise modalities, intensities, frequencies, durations, and volumes to explore dose-response relationships between exercise and the gut microbiome among cancer survivors, as well as multifaceted approaches (such as diet and probiotics), and examine the influences of exercise on the gut microbiome and associated symptom burden prior to, during, and following cancer treatment. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Benefits of supportive strategies for carers of people with high-grade glioma : a systematic review : strategies for addressing the needs of high-grade glioma carers
- Authors: Jones, Diana , Pinkham, Mark , Wallen, Matthew , Hart, Nicolas , Joseph, Ria , Strodl, Esben , Ownsworth, Tamara , Beesley, Vanessa , Crichton, Megan , Chan, Raymond
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Supportive Care in Cancer Vol. 30, no. 12 (2022), p. 10359-10378
- Relation: http://purl.org/au-research/grants/nhmrc/1194051
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- Description: Purpose: To systematically review and examine current evidence for the carer-reported benefits of supportive care strategies for carers of adults with high-grade glioma (HGG). Methods: Four databases (CINAHL, EMBASE, PubMed, PsycINFO) were searched for articles published between January 2005 and April 2022 that assessed strategies for addressing the supportive care needs of carers of adults with HGG (WHO grade 3–4). Study selection and critical appraisal were conducted independently by three authors (DJ/MC, 2021; DJ/RJ 2022). Data extraction was conducted by one author (DJ) and checked by a second author (RJ). Results were synthesised narratively. Results: Twenty-one studies involving 1377 caregivers were included, targeting the carer directly (n = 10), the patient-carer dyad (n = 3), or focused on people with HGG + /
Impact of dementia literacy interventions for non-health-professionals: systematic review and meta-analysis
- Authors: Nguyen, Hoang , Phan, Hoang , Terry, Daniel , Doherty, Kathleen , McInerney, Fran
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Aging and Mental Health Vol. 26, no. 3 (2022), p. 442-456
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- Description: Objectives: To assess evidence regarding the effects of interventions aimed at improving dementia literacy for different groups of non-health-professionals. Methods: A systematic search for relevant interventions was conducted using a range of online databases (e.g. CINAHL, Embase, Medline, ProQuest, and PsycINFO) and hand-searching of reference lists. Eligible interventions were identified based on predefined inclusion/exclusion criteria and methodological quality criteria. Meta analyses were performed using a random-effects model. Results: The final review included 14 interventions, which were either randomised controlled trials or non-randomised controlled trials. The interventions had varied contents, approaches, settings, and outcome measures. Evidence of improved dementia literacy in various aspects was found, and the intervention effects were strongest on knowledge of dementia. Discussion: There is evidence for the positive impact of dementia literacy interventions on different groups of non-health-professionals. Best practices in intervention contents, approaches, and outcome measures should be examined to guide future interventions. © 2021 Informa UK Limited, trading as Taylor & Francis Group.