JBI database of systematic reviews and implementation reports最新文献

Objective: The objective of this scoping review is to examine and map the range of vocational rehabilitation available for emergency services personnel.

Introduction: Employee work absence due to illness and injury is an international burden. The emergency service sector (police officers, firefighters and ambulance/paramedic staff) workforce has been shown to report a higher prevalence of illness/injury and sick leave compared to the general population. Despite the evidence of physical and psychological problems that emergency service sector workers can face, vocational rehabilitation (VR) interventions and the structure and effectiveness of VR for these workers are less well known.

Inclusion criteria: This scoping review considered studies that included adult emergency medical services personnel (e.g. police officers, firefighters and ambulance/paramedic staff), regardless of age, sex or rank. Emergency medical services personnel from any developed nation were included. The interventions included any VR regardless of condition, work status (VR to prevent sick leave or for workers on sick leave) or focus (e.g. mental health issues, neurological problems or musculoskeletal conditions). Vocational rehabilitation interventions can include work conditioning, work hardening, physiotherapy, counseling, functional restoration and occupational rehabilitation.

Methods: Published and unpublished literature in English from 2007 to 2017 was included in this review. A three-step search strategy was followed that included five databases and nine websites. Data extraction was performed by two reviewers using a pre-determined data extraction form developed by the authors.

Results: This review identified 24,271 sources of information, of which 48 were screened at full-text stage, and 22 sources were eligible to be included in the final scoping review. The majority of the sources provided evidence of VR for police officers and firefighters. Vocational rehabilitation is typically provided in residential rehabilitation settings as well as some outpatient, off-site and workplace settings. The main type of VR provided is physical, but there is also evidence of psychological rehabilitation and addiction/substance misuse rehabilitation.

Conclusions: This review demonstrated that there is a lack of information in the public domain on VR for staff working in the emergency service sector, as well as a lack of rigorous evaluation available on the effectiveness of VR within the emergency service sector. There is inconsistent provision of VR internationally for emergency service sector staff.

Objective: The purpose of this review is to investigate the effectiveness of adjusting radiographic technique parameters on image quality of projectional radiographs acquired on a direct digital radiography system.

Introduction: Projectional radiography performed with direct digital detectors is now commonplace in many medical imaging departments across the world. While the acquisition technology has advanced, it appears that many sites have not optimized their radiographic technique factors for this new technology. The aim of this review is to uncover evidence to support the continued use of these traditional technique parameters or to suggest changes in clinical practice that would produce optimized results.

Inclusion criteria: The review will consider studies that include projectional radiographs acquired on a direct digital radiography system of the axial and appendicular skeleton. Only studies that investigate a human subject (living or post-mortem), or an anthropomorphic phantom will be included. Studies that directly investigate the effect of changing a technique parameter on the resultant image quality and the effect on patient dose will be included.

Methods: A comprehensive search of both published and unpublished literature will be performed to uncover studies meeting the inclusion criteria. Studies will be screened for inclusion by two reviewers and disagreements resolved through discussion or with a third reviewer. Studies included in final analysis will be critically appraised for methodological quality. Data will be extracted by a single reviewer and checked by the author team for accuracy. Statistical meta-analysis and subgroup analyses will be performed as appropriate, and a Summary of Findings created.

Systematic review registration number: PROSPERO CRD42019137806.

Objective: The objective of this scoping review is to identify and map existing evidence of antimicrobial resistance (AMR) in water in Latin America and the Caribbean (LAC), while also identifying the gaps in AMR information in the region in eight themes of interest.

Introduction: Antimicrobial resistance is a public health concern that has gained increasing global awareness. Concerns have been raised toward the importance of the environment's role in the dissemination of clinically relevant AMR. Although studies on AMR have been conducted, the reality of the role of the environment in the LAC region has not been studied.

Inclusion criteria: Articles that examine AMR in water in the LAC region will be considered for inclusion. Antimicrobial resistance will be defined as a natural process that arises when the microorganisms that cause infection (e.g. bacteria) survive exposure to a drug that would normally kill them or stop their growth. The search will focus on eight themes of interest, as defined in the protocol, relating to the presence of resistant microorganisms in water sources and reported negative health effects. Qualitative and quantitative studies will be considered for inclusion. Reviews and gray literature will be excluded.

Methods: The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews. A search for published literature will be performed in PubMed, Web of Science and Scopus. Independent screening of articles will be performed by examining the abstracts and then the full texts, utilizing pre-defined inclusion and exclusion criteria. Data for specific variables will be extracted, and descriptive examination will be performed.

Objective: The objective of this review is to synthesize the literature on the experiences of older adults accessing specialized healthcare services while living in remote or rural areas.

Introduction: Older persons with chronic illnesses often need specialized healthcare services. Those who live in remote or rural areas may have limited access to these specialized healthcare services, potentially leading to an increase in morbidity and mortality. Little is known about the experience of older adults accessing specialized healthcare services while living in remote or rural areas.

Inclusion criteria: This review will consider studies of persons 65 years and over who have self-identified as living in remote or rural areas. They will have on at least one occasion sought access in person to specialized healthcare services for a chronic condition(s) such as cardiovascular diseases, renal diseases, diabetes, cancers, mental illness or a major health concern beyond the scope of a primary care clinician, such as palliative care.

Methods: The search strategy will aim to find published and unpublished studies in English from 1980. Databases to be searched include: CINAHL, PubMed, PsycINFO, AgeLine, ProQuest Dissertations and Theses, Google Scholar and MedNar. Titles and abstracts will be screened against the inclusion criteria. Papers meeting the inclusion criteria will be appraised by two independent reviewers for methodological quality. Data will be extracted by two independent reviewers using a standardized data extraction tool. Findings will be pooled with the meta-aggregation approach, and a ConQual Summary of Findings will be presented.

Objectives: The objective of the review was to synthesize the evidence on new mothers' and fathers' experiences of postpartum depression (PPD).

Introduction: Postpartum depression is a form of clinical depression that affects women and, less frequently, men, typically during the first months after childbirth. It has been estimated that 10% to 20% of women and 10% of men suffer from PPD and it may have serious consequences for mothers, fathers and their children. Therefore, this review covers the experiences of both mothers and fathers.

Inclusion criteria: This qualitative review considered studies that included new mothers and fathers who had any number of children and who experienced PPD within a one-year postpartum period. The phenomenon of interest was the lived experience of new mothers and fathers with PPD. Qualitative studies including, but not limited to, phenomenology, grounded theory, ethnography, action research and feminist research were considered.

Methods: The review systematically searched the following databases: MEDLINE, CINAHL, PsycINFO, Scopus and the Finnish database MEDIC. In addition, the search for unpublished articles included ProQuest Dissertations and Theses. The methodological quality of the included studies was assessed independently by two reviewers, and qualitative data were extracted from papers by two independent reviewers using a standardized data extraction tool. Qualitative research findings were pooled using the JBI methodology.

Results: Thirteen papers that considered mothers' (n = 199) experiences of PPD were included in the review. A total of 98 findings were extracted and aggregated into 14 categories, and from them, four synthesized findings were developed: i) Depressed mothers feel unable to control their own lives due to low resilience; ii) The ambivalent feelings depressed mothers experience towards their babies, partners and in-laws cause distress and suffering; iii) Depressed mothers experience anger and despair if they perceive imbalances between their support needs and the support they get from healthcare providers and significant others; and iv) Depressed mothers experience hopelessness and helplessness resulting from their new-found motherhood and financial worries. Two papers that considered fathers' (n = 20) experiences of PPD were included in the review. A total of 19 findings were extracted and aggregated into six categories, and from them, two synthesized findings were developed: i) Depressed fathers experience disappointment arising from perceived imbalances between their support needs and the support they get from their partner and significant others; and ii) Depressed fathers are more imbalanced after childbirth than fathers who are not suffering from PPD, so they feel unable to control their own lives due to low resilience.

Conclusions: The qualitative stud

Objective: The objective of this review is to map the evidence on the use of behavioral economic insights to improve medication adherence in adults with chronic conditions.

Introduction: Medication non-adherence is a barrier to effectively managing chronic conditions, leading to poorer patient outcomes and placing an additional financial burden on healthcare systems. As the population ages and the prevalence of chronic disease increases, new ways to influence patient behavior are needed. Approaches that use insights from behavioral economics may help improve medication adherence, thus reducing morbidity, mortality and financial costs of unmanaged chronic diseases.

Inclusion criteria: Eligible studies will include adults taking medication for a chronic condition. All interventions relevant to high-income settings using insights from behavioral economics to improve medication adherence in adults will be considered. Contexts may include, but are not limited to, primary health care, corporate wellness programs and health insurance schemes. Any study design published in English will be considered. Studies in facilities where medication is administered to patients will be excluded.

Methods: PubMed, Embase, Scopus, PsycINFO, EconLit and CINAHL will be searched from database inception to present. Gray literature will be searched using Google Scholar, OpenGrey and the Grey Literature Report. One reviewer will review titles, and then two reviewers will independently review abstracts to identify eligible studies. One reviewer will extract data on study characteristics, study design and study outcomes. A second reviewer will validate 25% of the extracted information. The results of the data extraction will be presented in a table, and a narrative summary will be presented.