JBI library of systematic reviews最新文献

{"title":"A systematic review on the role of extremity skin temperature as a non-invasive marker for hypoperfusion in critically ill adults in the intensive care setting.","authors":"Woo Fong Yeong Brigitte, C. Childs","doi":"10.11124/JBISRIR-2012-47","DOIUrl":"https://doi.org/10.11124/JBISRIR-2012-47","url":null,"abstract":"BACKGROUND\u0000Haemodynamic monitoring is the cornerstone of critical care management. The adequacy of peripheral perfusion has been used as a determinant of cardiovascular system status. Poor cardiac function leads to increased vascular resistance, contributing to reduced tissue perfusion, and it is said to cause a large temperature gradient between the core and the skin. Consequently, skin temperature at the extremities has been proposed as a \"proxy\" to assess peripheral perfusion. However, this has not been investigated in a systematic way, hence the need for a systematic review of the literature.\u0000\u0000\u0000OBJECTIVES\u0000The objective of this review is to present the best available evidence on extremity skin temperature as a non-invasive marker of hypoperfusion in critically ill adult patients.\u0000\u0000\u0000SEARCH STRATEGY\u0000A comprehensive search of major databases was performed to ensure all studies meeting the inclusion criteria were retrieved. The search strategy aimed to find both published and unpublished studies, published in English language, from 1969 to 2010.\u0000\u0000\u0000SELECTION CRITERIA\u0000Randomised controlled trials, quasi-experimental studies, non-randomised controlled trials, and before and after studies that investigate the role of skin temperature as a marker of hypoperfusion were included. Observational, correlational studies were included due to the lack of studies with high level of evidence.Male and female critically ill adult patients (aged 18 years and above) admitted to the intensive care setting.The review considered studies that evaluate the role of extremity skin temperature monitoring in the diagnosis of hypoperfusion. Skin temperature monitored subjectively via touch or palpation and objectively via skin temperature monitoring devices.Measures of skin temperature (e.g. toe temperature, core-peripheral temperature, etc.) and markers of perfusion (e.g. cardiac output, mean arterial pressure, heart rate, central venous pressure, etc.).\u0000\u0000\u0000CRITICAL APPRAISAL, DATA COLLECTION & DATA SYNTHESIS\u0000Eligibility of papers were assessed independently by the two reviewers. Ten studies were assessed for methodological quality with a modified Critical Appraisal Checklist. After this process, five were selected. A newly-developed data extraction tool was used to gather specific information from the selected studies. Due to the heterogeneity of the studies' methodology, the results of this systematic review were presented in a narrative summary.\u0000\u0000\u0000RESULTS\u0000There were three studies which support the use of extremity skin temperature as a marker of hypoperfusion and two studies which do not support the use. These results reveal the apparent lack of consensus in the studies as to whether or not extremity skin temperature is an accurate and reliable marker of hypoperfusion.\u0000\u0000\u0000CONCLUSIONS\u0000The use of extremity skin temperature as a \"proxy\" for hypoperfusion cannot be validated or recommended due to the paucity of definitive evidence.The review is unable to provide a definitive re","PeriodicalId":91723,"journal":{"name":"JBI library of systematic reviews","volume":"10 26 1","pages":"1504-1548"},"PeriodicalIF":0.0,"publicationDate":"2012-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11124/JBISRIR-2012-47","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63416668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of interventions for the assessment and prevention of falls in adult psychiatric patients: A systematic review.","authors":"Changqing Xu, Tan Xiang, Ning Audrey, S. Loh, Wan Ting Shanel, J. Tan, R. Parasuram","doi":"10.11124/01938924-201210090-00001","DOIUrl":"https://doi.org/10.11124/01938924-201210090-00001","url":null,"abstract":"Review Questions/Objectives The objective of this review is to identify the best available evidence for the effectiveness of risk assessment tools designed to assess fall risk and reduce the incidence of falls in adult psychiatric patients. Specifically, the review seeks to answer the following:  How effective are the risk assessment tools for falls in reducing fall rates in adult psychiatric patients?  How effective are the interventions undertaken in reducing the incidence of falls among adult psychiatric patients?  What are the most common characteristics of adult psychiatric patients who fall? Inclusion Criteria Types of Participants This review will consider all studies that include adults (19 to 64 years) diagnosed with mental illness according to any editions of the diagnostic manual of ICD (International Statistical Classification of Diseases and Related Health Problems), or DSM (Diagnostic and Statistical Manual of Mental Disorders). Types of Interventions This review will consider all studies that include interventions that assessed or minimized the risk of falling in adult psychiatric patients. Types of Outcome Measures The outcome measure of interest will be the number of patient falls during hospitalization","PeriodicalId":91723,"journal":{"name":"JBI library of systematic reviews","volume":"9 64 Suppl 1","pages":"1-17"},"PeriodicalIF":0.0,"publicationDate":"2012-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63415362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of knowledge and beliefs on adherence to cardiac rehabilitation programs in patients with heart failure: A systematic review.","authors":"T. Jasmine, Sally Chan Wai‐Chi, D. Hegney","doi":"10.11124/JBISRIR-2012-53","DOIUrl":"https://doi.org/10.11124/JBISRIR-2012-53","url":null,"abstract":"BACKGROUND\u0000Heart failure is a global health problem which affects a large percentage of the older population. Cardiac rehabilitation programs have been implemented to aid patients in successfully managing their heart condition. However, non-adherence to cardiac rehabilitation programs is common in this group of patients. This results in higher morbidity and mortality rates, rehospitalisation and ultimately higher healthcare costs. There is a need to have a better understanding of the impact that knowledge and beliefs have on patients' adherence levels, so that healthcare providers can implement appropriate strategies to promote their adherence.\u0000\u0000\u0000OBJECTIVES\u0000This review aimed to establish the best evidence regarding the impact of knowledge and beliefs on adherence to cardiac rehabilitation programs in patients with heart failure; and to make recommendations for healthcare practice and future research.\u0000\u0000\u0000INCLUSION CRITERIA\u0000Patients above the age of 18, who had been diagnosed with heart failure and had been admitted to a cardiac rehabilitation program in inpatient or outpatient settings.This review considered studies that evaluated the impact of heart failure patients' knowledge and beliefs of their disease, medication, diet, exercise and other lifestyle change recommendations, on their adherence to cardiac rehabilitation programs.Heart failure patients' knowledge, beliefs and adherence toward their medication regime, low-sodium diet, exercise, and other lifestyle change recommendations.Quantitative study designs published in the English language, up to December 2010 were considered for inclusion.\u0000\u0000\u0000SEARCH STRATEGY\u0000Using a three-step search strategy, the following databases were assessed: CINAHL, PubMed, SCOPUS, Web of Science, OvidSP, MDConsult, ScienceDirect, Sociological Abstracts, Mosby's Nursing Consult, Mednar and TRIP.\u0000\u0000\u0000METHODOLOGICAL QUALITY\u0000Two independent reviewers assessed each paper for methodological validity prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute.\u0000\u0000\u0000DATA EXTRACTION\u0000Information was extracted by two independent reviewers, from each paper using the standardised data extraction tool from the Joanna Briggs Institute.\u0000\u0000\u0000DATA SYNTHESIS\u0000The findings are presented in narrative form, as statistical pooling was not possible, due to the different instruments used in measuring the outcomes.\u0000\u0000\u0000RESULTS\u0000Twelve quantitative studies were included in this review (one RCT, one pre-test/post-test single group study, and ten descriptive studies). The present findings suggest that the relationship between knowledge and adherence is unclear. However, patient beliefs on medication, symptom monitoring, illness and control were found to have stronger associations of adherence to cardiac rehabilitation programs.Implications for practice Healthcare institutions need to provide adequate support for patients with heart failure; individualise adherence-enhancing interventions to cater for v","PeriodicalId":91723,"journal":{"name":"JBI library of systematic reviews","volume":"10 7 1","pages":"399-470"},"PeriodicalIF":0.0,"publicationDate":"2012-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11124/JBISRIR-2012-53","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63416679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the effectiveness of patient-centred care on emergency room visits, hospitalizations, unscheduled sick clinic visits, and missed school days for children with asthma.","authors":"C. Barnes, Eugene Cauvin, Meral Duran-Kim, Lisa A Montalbano, M. Londrigan","doi":"10.11124/01938924-201109481-00017","DOIUrl":"https://doi.org/10.11124/01938924-201109481-00017","url":null,"abstract":"BACKGROUND Childhood asthma is a major clinical concern worldwide, associated with increased levels of morbidity and missed school days, placing a heavy strain on healthcare systems in terms of both financial cost and hospital usage. The utilization of suitable therapy, written treatment plans, and patient education have been the focus of many interventional strategies to improve outcomes. OBJECTIVES The objective of this systematic review was to identify, appraise, and synthesize the best available evidence to determine the effectiveness of patient-centred care on emergency room visits, hospitalizations, unscheduled primary care provider visits, and missed school days in the management of children with asthma. INCLUSION CRITERIA The review considered studies that included children from newborn to seventeen years of age with a clinical diagnosis of asthma who were being treated in an outpatient healthcare setting, regardless of severity, previous treatments, co-morbidities, and ethnic or socioeconomic backgrounds.The review considered studies that evaluated the effects of the patient-centred care model in the management of children with asthma.This review considered studies that included the following outcome measures: emergency room (ER) visit rates, hospital admission rates, unscheduled primary care provider visit rates, and number of missed school days per year associated with asthma symptoms.The review considered any randomized controlled trials (RCTs) and quasi-experimental clinical controlled trials (CCTs). SEARCH STRATEGY The search strategy examined both published and unpublished studies from 1970 to present that were written in the English language. The databases searched included: Medline, CINAHL, The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Academic Search Premier, PsycINFO, Healthsource Nursing/Academic edition, and PubMed. A grey literature search was performed. METHODOLOGICAL QUALITY Papers that met the inclusion criteria were assessed by two independent reviewers for methodological validity prior to inclusion in the review, using the standardized critical appraisal instrument from Joanna Briggs Institute. DATA EXTRACTION Data was extracted using the standardized data extraction tool from the JBI - MAStARI. DATA SYNTHESIS Statistical pooling was not possible due to heterogeneity of the studies; therefore the findings were presented in a narrative form. RESULTS Ten studies (nine RCTs and one quasi-experimental CCT) were included in the review. Nine of the studies looked at the outcome of hospitalizations of which five showed a decline in hospitalizations when a patient-centred care model was used; two were significant with p values of <0.05 and <0.001. Eight studies looked at the outcome of ER visits. Six of these reported a decline in ER visits after the intervention of which three were significant with p values of <0.001, <0.05 and <0.05. Six studies looked at missed school days of which one s","PeriodicalId":91723,"journal":{"name":"JBI library of systematic reviews","volume":"10 14 1","pages":"832-894"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63415253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of differences between brain temperature and core body temperature in adult patients with severe traumatic brain injury.","authors":"Kueh Wern Lunn, C. Childs","doi":"10.11124/01938924-201210240-00001","DOIUrl":"https://doi.org/10.11124/01938924-201210240-00001","url":null,"abstract":"BACKGROUND Studies have shown that temperature at the extremes of the thermoregulatory physiological range, commensurate with a clinical diagnosis of hypothermia (at the lower end) and hyperthermia or fever (at the upper end) increase the risk of a poor neurological outcome and contribute to higher mortality. The tissue most at risk is nervous tissue. That said however, precise measurement of cerebral tissue temperature is seldom made during routine clinical care. More commonly, brain temperature is estimated from measurements of core body temperature. Different measurement sites are frequently used as a proxy or 'surrogate' for brain temperature. Knowing whether the assumption that brain temperature can be reliably represented by core body temperature is important because it will help healthcare professionals to deliver appropriate treatment when a rise (or fall) in brain temperature beyond the 'normal' range is suspected. OBJECTIVES This systematic review focused on whether brain temperature is higher, lower, or the same as core body temperature in patients with severe traumatic brain injury. INCLUSION CRITERIA This review considered studies that include male and female patients, aged 15 years and above, admitted to an adult Intensive Care Unit, with the diagnosis of severe traumatic brain injury, with a Glasgow Coma Scale score of less than eight, and who require brain temperature monitoring.The review considered studies that measured brain temperature and core body temperature.The agreement of core body temperature as a surrogate measure for brain temperature in adult patients with severe traumatic brain injury.The review considered any randomised controlled trials. In the absence of randomised controlled trials, other research designs such as non-randomised controlled trials, before and after studies, cohort studies, case-control studies and descriptive studies were considered for inclusion. SEARCH STRATEGY Utilising a three-step search strategy, articles published in English from the years 1980 to 2010 from the following databases were searched: CINAHL, PubMed, Scopus, Web of Science, Science Direct, Ovid SP, Mednar and ProQuest Dissertations & Theses Database. METHODOLOGICAL QUALITY Two reviewers independently reviewed studies using the appraisal tool developed by the authors, as the critical appraisal instrument provided by the Joanna Briggs Institute was not suitable for this systematic review. DATA EXTRACTION Data were extracted using the extraction tool developed by the authors, as the data extraction instrument provided by the Joanna Briggs Institute was not suitable for this systematic review. DATA SYNTHESIS A narrative summary of all findings was presented as statistical pooling was not possible. RESULTS Thirty-three studies were identified through the keywords search using the databases listed above. Eight studies were included in this systematic review after the assessment of methodological quality. Eleven temperatur","PeriodicalId":91723,"journal":{"name":"JBI library of systematic reviews","volume":"10 24 1","pages":"1410-1451"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63415408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying and reducing the incidence of post discharge Venous Thromboembolism (VTE) in orthopaedic patients: a systematic review.","authors":"P. McLiesh, R. Wiechula","doi":"10.11124/jbisrir-2012-315","DOIUrl":"https://doi.org/10.11124/jbisrir-2012-315","url":null,"abstract":"BACKGROUND The risk of venous thromboembolism for orthopaedic patients is often high due to the length of surgery, damage from trauma to bone and soft tissues and lengthy periods of immobility or reduced mobility. Although venous thromboembolism occurs mainly in inpatients a significant number of patients develop venous thromboembolism post discharge OBJECTIVES: To synthesise the best available evidence on strategies that effectively reduce post discharge venous thromboembolism in orthopaedic patients. INCLUSION CRITERIA Patients regardless of age, gender or co-morbidities that have been admitted with an acute orthopaedic injury (unplanned) or a planned orthopaedic surgery/procedure and then followed up after discharge. Only papers describing the incidence and prophylaxis treatment used in non-Asian patients were considered for inclusion.Any interventions of combinations of chemoprophylaxis and/or mechanical prophylaxis to prevent venous thromboembolism incidence extending beyond hospital admission.Outcomes included diagnosis of venous thromboembolism following an orthopaedic admission/surgery for up to 6 months post discharge and the incidence of any significant bleeding or death related to venous thromboembolism or haemorrhage.The review considered any randomised controlled trials; in the absence of RCTs other research designs, such as non-randomised controlled trials and before and after studies, were considered SEARCH STRATEGY: Search strategy considered only papers in English from 2000 to March 2012. METHODOLOGICAL QUALITY Papers selected for retrieval were assessed using standardised critical appraisal instruments from the Joanna Briggs Institute. DATA COLLECTION Data was extracted from the studies using the standardised Johanna Briggs Institute data extraction form. DATA SYNTHESIS Of the included studies none matched methodology, treatment or comparator that allowed meta-analysis. The results were therefore presented in a narrative form and were structured using patient population, then intervention and then analysis of results. RESULTS 20 articles were included in the systematic review. The overall incidence of post discharge venous thromboembolism in orthopaedic patients is not possible to determine due to the variability in reporting criteria and poor follow-up. Use of Low Molecular Weight Heparins was generally shown to be effective in preventing venous thromboembolism. The new generation Factor Xa inhibitors were shown to improve venous thromboembolism prevention however had a slightly higher risk of bleeding. There was limited high level research presented to allow effective assessment of aspirin and/or mechanical compression devices. CONCLUSIONS Prevention of post discharge venous thromboembolism is complex due to the number of variables that can influence its occurrence. The risk of post discharge venous thromboembolism varies among different patient populations so consideration must be given to matching the risk for ea","PeriodicalId":91723,"journal":{"name":"JBI library of systematic reviews","volume":"10 41 1","pages":"2658-2710"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11124/jbisrir-2012-315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63416618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The psychometric properties, feasibility and utility of behavioural-observation methods in pain assessment of cognitively impaired elderly people in acute and long-term care: A systematic review.","authors":"Siok Qi, J. Diane, D. Kay","doi":"10.11124/jbisrir-2012-62","DOIUrl":"https://doi.org/10.11124/jbisrir-2012-62","url":null,"abstract":"BACKGROUND The key factor to improving pain management for cognitively impaired elderly patients is accurate pain assessment. Behavioural-observation methods are required for individuals who cannot communicate their pain verbally. A thorough understanding of the key components of behavioural pain assessment and the use of valid and reliable behavioural pain assessment tools would enhance the assessment of pain in this vulnerable population. OBJECTIVES To identify the key components involved in behavioural pain assessment in cognitively impaired elderly people and to analyse the reported psychometric properties, feasibility and utility of behavioural pain assessment tools. SELECTION CRITERIA Studies using descriptive, correlation and comparative designs were included.Cognitively impaired elderly people older than 65 years in aged care, acute care or nursing home settings were included.Components measured in behavioural pain assessment; psychometric properties, feasibility and utility of behavioural pain assessment tools used to assess pain in cognitively impaired elderly people in acute or long-term care settings.Identification of behavioural criteria for assessment of pain and investigation of any aspect of the psychometric properties of behavioural pain assessment tools. SEARCH STRATEGY An initial limited search of MEDLINE and CINAHL to find published studies between 1990 to 2010 in the English Language was undertaken, following an analysis of the text words contained in the title and abstract. A second search using all identified keywords and index terms was undertaken and extended to a further seven relevant databases. Thirdly, the reference lists of all identified reports and articles were searched for additional studies. METHODOLOGICAL QUALITY Studies selected for retrieval were assessed for inclusion by two independent reviewers for methodological validity using the Critical Appraisal Tool for Psychometric Studies adapted from Fallon, Westaway, and Moloney1. DATA EXTRACTION Quantitative data were extracted from included studies using the Data Extraction Tool for Psychometric Studies adapted from Fallon, Westaway, and Mahoney1. DATA SYNTHESIS As statistical pooling was not possible, evidence in relation to psychometric properties, was analysed and presented in narrative summary. RESULTS Twenty three studies were included in the review. No tool has been found suitable for use across both acute and long-term care settings. Nevertheless, three tools show the most promising outcomes and potential for use. CONCLUSIONS Although behavioural measures may inform healthcare providers on the presence of pain in an individual, they do not provide information about the aetiology of pain. Hence, pain assessment should not depend solely on behavioural observation conducted using standardised behavioural pain assessment tools, but regarded as an essential component of a multifaceted approach to pain assessment. Clinicians may select tools wh","PeriodicalId":91723,"journal":{"name":"JBI library of systematic reviews","volume":"10 17 1","pages":"977-1085"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11124/jbisrir-2012-62","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63417027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors associated with spinal pain in adolescent computer users: a systematic review.","authors":"Yi-Liang Kuo, Ling-Ling Lee","doi":"10.11124/01938924-201008161-00018","DOIUrl":"https://doi.org/10.11124/01938924-201008161-00018","url":null,"abstract":"BACKGROUND Increased computer use has been suggested as a contributing factor for a rapid increase in the prevalence of neck and back pain in adolescents in the late 1990s and the beginning of 2000. OBJECTIVE The overall objective of this review was to synthesise the best available evidence on the estimates of prevalence of, and risk factors associated with, spinal discomfort in adolescent computer users. INCLUSION CRITERIA This review considered cross-sectional, case-control, or cohort studies. Studies were considered for inclusion if they reported either prevalence or risk factors associated with spinal pain in adolescents aged between 13 and 18 years using computer in school or at home. SEARCH STRATEGY The search included The Cochrane Library, JBI Library of Systematic Reviews, PEDro, MEDLINE, CINAHL, Web of Science, ERIC, PsycINFO, EMBASE, and CEPS. The grey literature was also searched. The search was limited to English and Chinese language papers, and spanned from the inception of each database to May 2011. METHODOLOGICAL QUALITY Two review authors independently evaluated the methodological quality of the included studies using the standardised Joanna Briggs Institute instruments. DATA EXTRACTION Data was extracted using the standardised Joanna Briggs Institute data extraction form. DATA SYNTHESIS Meta-analysis was not appropriate because there was considerable heterogeneity between studies. The findings were summarised in tables and in narrative form. RESULTS Seven studies were included in this review: three studies were carried out in Finland, two in the USA, one in Sweden, and one in South Africa. There was marked variability in the period prevalence data across different studies: 15-60% for cervical pain and 12-53% for lumbar pain. None of the reviewed studies reported the confidence intervals for prevalence estimate. Four studies investigated the association between the duration of computer use and cervical pain, two studies for lumbar pain and none for thoracic pain. Positive associations between the duration of computer use and cervical pain were found in three out of four studies, with the odds ratio ranged from 1.3 (95% CI 1.1 to 1.6) to 2.3 (95% CI 1.5 to 3.6). One study found that weekly internet use greater than 42 hours predicted the occurrence of lumbar pain, and the odds ratio was 1.9 with 95% CI of 1.1 to 3.4. The other study reported non-significant association without providing statistical evidence. CONCLUSION This systematic review suggests a relatively high prevalence of spinal pain in adolescents. The cervical spine region appears to be more prone to musculoskeletal pain than the lumbar or thoracic regions. Cervical spine pain was statistically significantly associated with duration of computer use, however the odds ratio may be too small to be considered clinical significant. There is conflicting evidence on the association with duration of computer use and lumbar pain and no evidence for thoracic spine","PeriodicalId":91723,"journal":{"name":"JBI library of systematic reviews","volume":"10 45 1","pages":"2906-2943"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63414932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting trail-blazing: A systematic review of the factors that facilitate or inhibit the implementation of new nursing roles: the experiences of UK consultant nurses.","authors":"Georgina Hourahane, Nicola West, R. Barnes, S. Rees, A. Bowyer, J. Dundon, D. Allen","doi":"10.11124/jbisrir-2009-542","DOIUrl":"https://doi.org/10.11124/jbisrir-2009-542","url":null,"abstract":"BACKGROUND If emerging 'trail-blazers', such as the consultant nurse, are to be successful in developing and sustaining new ways of working then factors that support or inhibit new role developments need identification. There is a growing body of evaluative and anecdotal evidence about the experience of consultant nurses since the introduction of the role in the UK thirteen years ago. OBJECTIVE To synthesise the evidence on the experiences of UK consultant nurses in implementing a new role in order to identify inhibitors and facilitators of role development. INCLUSION CRITERIA This review sought qualitative and mixed methodology studies that yielded qualitative data about the phenomenon of interest, together with narrative opinion papers i.e. consultant nurses' experiences of role development. SEARCH STRATEGY The search in 14 databases considered studies and opinion papers published between January 1999 and April 2010 in English. METHODOLOGICAL QUALITY All retrieved studies and opinion papers were assessed by two independent reviewers using the standardised Joanna Briggs Institute critical appraisal tools. DATA COLLECTION Data were extracted from included papers using the standardised Joanna Briggs Institute data extraction tool. DATA SYNTHESIS Data synthesis used the Joanna Briggs Institute approach for meta-synthesis by meta-aggregation. Findings were synthesised into categories and categories were aggregated into synthesised findings. RESULTS On the basis of critical appraisal, no opinion papers were included in the review. A total of 11 qualitative studies were included, yielding a total of 313 findings. These were synthesised into 64 categories which were further synthesised into 11 synthesised findings about factors that facilitate and inhibit the role's implementation and development. CONCLUSION Drawing directly on consultant nurses' experiences, these findings add evidence to what is already known about what does and does not work in developing a consultant role. They indicate that an understanding about the role's core functions is needed, as is a supportive environment in which the consultant can fully operate. IMPLICATIONS FOR PRACTICE The implications for practice are derived from the results of the synthesised findings. An organisation, through its policies, practices, procedures and individuals, must support the consultant's leadership and collaborative goal directed approach to care delivery and service development. This can be achieved by allowing the consultant both autonomy and authority. The synthesised findings reinforce the need to optimise the facilitators and minimise the inhibitors of role development. They can also make a contribution to the conceptual understanding of the consultant role. IMPLICATIONS FOR RESEARCH Further research into the experiences of consultant nurses is necessary - in particular, how nurse consultants interpret their relationships with others, negotiate resources and demonstrate ","PeriodicalId":91723,"journal":{"name":"JBI library of systematic reviews","volume":"44 1","pages":"3146-3294"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11124/jbisrir-2009-542","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63415619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of non‐compliance with Antiretroviral Therapy among adults living with HIV/AIDS: A Systematic Review","authors":"D. Gemeda, L. Gebretsadik, T. Dejene, Mirkuzie Wolde, M. Sudhakar","doi":"10.11124/01938924-201210560-00001","DOIUrl":"https://doi.org/10.11124/01938924-201210560-00001","url":null,"abstract":"Background Non‐compliance with Antiretroviral Therapy is a major public health concern and further challenged by interaction of various social and clinical obstacles. So; near perfect pill taking is desirable in order to maximise its benefits. Objectives To systematically search, appraise and synthesise the best available evidence on determinants of non‐compliance with Antiretroviral Therapy among adults living with HIV/AIDS and provide direction to future how to increase compliance with Antiretroviral Therapy. Inclusion criteria Types of participants The systematic review considered studies with 18 years and above year old adults living with HIV/AIDS. Focus of the review Determinants of non‐compliance with Antiretroviral Therapy among adults living with HIV/AIDS. Types of studies Quantitative study designs were considered for inclusion. Types of outcomes Socio‐economic, Health service, Psychosocial and behavioural and Clinical related outcomes. Search strategy English language articles published between January1997 and December 2011 were sought across major databases. Methodological quality Methodological quality was assessed using Joanna Briggs Institute Meta Analysis of Statistical Assessment and Review Instrument critical appraisal tools. Data collection Data were extracted from papers included in the review by using a standardized data extraction tool. Data synthesis Meta‐ analysis was conducted using fixed and random effects model with mantel Haenszel method using Revman5 software. Heterogeneity between the studies was assessed using &khgr;2 test at a p‐value of <0.05. Summary statistics were expressed as adjusted odds ratio or adjusted risk ratio with 95% confidence intervals at a p‐value of <0.05. Results Nine studies (seven cross‐sectional, one cohort study and one case‐control study) were included in the review. Results from meta analysis showed that white race adults living with HIV/AIDS were 1.38 times more likely to non‐comply with Antiretroviral Therapy when compared with black adults living with HIV/ AIDS (Adjusted Relative Risk=1.38; 95%CI=1.21, 1.58, p value<0.00001). Non‐depressed adults living with HIV/AIDS were 1.77 times more likely to non‐comply with Antiretroviral Therapy when compared with depressed adults living with HIV/AIDS (Adjusted Odds ratio =1.77; 95%CI=1.17, 2.69, p value=0.007). Substance non‐user adults living with HIV/ AIDS were 2.04 times more likely to non‐comply with Antiretroviral Therapy when compared with substance user adults living with HIV/ AIDS (Adjusted Relative Risk =2.04; 95%CI=1.51, 2.74, p value=<0.00001). Adults living with HIV/ AIDS with baseline CD4 count ≥200cells/ml were 1.8 times more likely to non‐comply with Antiretroviral Therapy when compared with adults livings with HIV/ AIDS with baseline CD4 count ≥200cells/ml (Adjusted Odds ratio=1.84; 95%CI=1.08, 3.15, p value=0.03). Conclusion We found the base line CD4 count ≥200cells/ml, not being depressed; not using substances and being white i","PeriodicalId":91723,"journal":{"name":"JBI library of systematic reviews","volume":"10 1","pages":"3596–3648"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63415422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}