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Retrieved Papers (retrieved + paper)
Selected AbstractsChild sexual abuse in the etiology of depression: A systematic review of reviewsDEPRESSION AND ANXIETY, Issue 7 2010Roberto Maniglio Psy.D. Ph.D. Abstract Background: Despite a large amount of research, there is considerable controversy about the role that child sexual abuse plays in the etiology of depression. To prevent interpretative difficulties, mistaken beliefs, or confusion among professionals who turn to this literature for guidance, this article addresses the best available scientific evidence on the topic, by providing a systematic review of the several reviews that have investigated the literature on the issue. Methods: Seven databases were searched, supplemented with hand search of reference lists from retrieved papers. The author and a psychiatrist independently evaluated the eligibility of all studies identified, abstracted data, and assessed study quality. Disagreements were resolved by consensus. Results: Four reviews, including about 60,000 subjects from 160 studies and having no limitations that could invalidate their results, were analyzed. There is evidence that child sexual abuse is a significant, although general and nonspecific, risk factor for depression. The relationship ranges from small-to-medium in magnitude and is moderated by sample source. Additional variables may either act independently to promote depression in people with a history of sexual abuse or interact with such traumatic experience to increase the likelihood of depression in child abuse survivors. Conclusions: For all victims of abuse, programs should focus not only on treating symptoms, but also on reducing additional risk factors. Depressed adults who seek psychiatric treatment should be enquired about early abuse within admission procedures. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Severe mental illness and criminal victimization: a systematic reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009R. Maniglio Objective:, To estimate the prevalence of criminal victimization among people with severe mental illness and to explore risk factors. Method:, Four databases (MEDLINE, ScienceDirect, ERIC, and AMED) were searched for articles published between January 1966 and August 2007, supplemented with hand-search of reference lists from retrieved papers. The author and a Medical Doctor independently abstracted data and assessed study quality. Disagreements were resolved by consensus after review of the article and the review protocol. Results:, Nine studies, including 5195 patients, were identified. Prevalence estimates of criminal victimization ranged from 4.3% to 35.04%. Rates of victimization among severely mentally ill persons were 2.3,140.4 times higher than those in the general population. Criminal victimization was most frequently associated with alcohol and/or illicit drug use/abuse, homelessness, more severe symptomatology, and engagement in criminal activity. Conclusion:, Prevention and intervention programs should target high-risk groups and improve patients' mental health and quality of life. [source] EVIDENCE SYNTHESIS: Appropriateness of using a symbol to identify dementia and/or deliriumINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 3 2010Sonia Hines RN BN Abstract Aim, The main objective of this systematic review was to evaluate any published and unpublished evidence regarding the appropriateness of developing a symbol for dementia and/or delirium, which could be used in a variety of settings to indicate that a person has dementia and/or delirium. Methods, Using the methods of the Joanna Briggs Institute, we conducted a systematic search of a wide range of databases, Internet resources and unpublished literature. Papers meeting the inclusion criteria were critically appraised by two independent reviewers. Data were extracted, using the standardised tool from the Joanna Briggs Institute, from those papers considered to be of sufficient quality. Because of significant methodological heterogeneity, no meta-analysis was possible and results are presented narratively instead. Results, From a total of 37 retrieved papers, 18 were found to be of sufficient relevance and quality to be included in the review. There was general consensus among the literature that a symbol for dementia is appropriate in the acute care setting. It was also clear from the research that an abstract symbol, as opposed to one that explicitly attempts to depict dementia, was most acceptable to staff, people with dementia and their carers. Conclusions, Both staff and health consumers seem to have largely positive perceptions and attitudes towards the use of a symbol for dementia. Families and carers of people with dementia are frequently concerned about their loved one wandering away and becoming lost and unable to identify themselves, and these concerns seem to outweigh any reservations they hold about the use of a symbol or some other identifier. In healthcare settings the use of symbols to indicate special needs seems well established and widely accepted. However, regarding the use of a symbol for dementia in the broader community, there remain concerns about issues such as stigmatisation and the potential for victimisation of this vulnerable population and so further research is indicated. [source] Effectiveness of general practice nurse interventions in cardiac risk factor reduction among adultsINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 3 2007Elizabeth Halcomb RN BN(Hons) Grad Cert. Abstract Background, Cardiovascular disease is the leading cause of death for adults in Australia. In recent years there has been a shift in health service delivery from institutional to community-based care for chronic conditions, including cardiovascular disease. The general practice setting is seen to offer greater flexibility, higher levels of efficiency and more client focused healthcare delivery than is possible in the acute care sector. It has been suggested that practice nurses represent a useful adjunct to current models of cardiovascular disease management. To date, significant descriptive research has been conducted exploring the demographics, roles, educational needs and issues facing practice nurses. However, there is a need to evaluate the effectiveness of practice nurse interventions in terms of patient outcomes, clinician satisfaction and cost-effectiveness. Objectives, This review seeks to present the best available evidence regarding the efficacy of general practice nurse interventions for cardiac risk factor reduction in healthy adults, as well as those with established cardiovascular disease or known cardiac risk factors. Search Strategy, A systematic literature search was performed using Medline (1966 , 2005), CINAHL (1982 ,2005), Cochrane Controlled Trials Register (Issue 4, 2005) and the Joanna Briggs Institute Evidence Library. In addition, the reference lists of retrieved papers, conference proceedings and the Internet, were scrutinised for additional trials. Selection Criteria, This review considered any English language randomised trials that investigated interventions conducted by the practice nurse for cardiovascular disease management or reduction of cardiac risk factors. Interventions conducted by specialist cardiac nurses in general practice were excluded. Outcomes measured included blood pressure, smoking cessation, total cholesterol, exercise, body weight/body mass index and cost-effectiveness. Results, Eighteen trials, reported in 33 papers, were included in the review. Ten trials investigated multifaceted interventions, while the remaining eight trials reported targeted interventions. Of the trials that reported multifaceted interventions, three trials investigated risk reduction in those with established cardiovascular disease, four trials focused on those with known cardiovascular disease risk factors and three trials included the general community. The eight trials which examined the efficacy of targeted interventions focused upon dietary intake (two trials), smoking cessation (three trials), weight reduction (one trial) and physical activity (two trials). The effect of both the multifaceted and targeted interventions on patient outcomes was variable. However, both the multifaceted and targeted interventions demonstrated similar outcome trends for specific variables. Improvements were demonstrated by most studies in blood pressure, cholesterol level, dietary intake and physical activity. The variation in outcome measures and contradictory findings between some studies makes it difficult to draw definitive conclusions. Conclusions, While interventions to reduce cardiovascular disease risk factors have produced variable results, they offer significant potential to assist patients in modifying their personal risk profile and should be developed. The public health importance of these changes is dependant upon the sustainability of the change and its effect on the health outcomes of these individuals. Further well-designed research is required to establish the effectiveness of practice nurse interventions for cardiovascular disease management and risk factor reduction in terms of patient outcomes and cost-effectiveness. [source] Factors associated with constructive staff,family relationships in the care of older adults in the institutional settingINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 4 2006Emily Haesler BN PGradDipAdvNsg Abstract Background, Modern healthcare philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's well-being. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family involvement in the healthcare of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the healthcare environment to benefit from the involvement of their family members, healthcare professionals need an understanding of the issues surrounding family presence in the healthcare environment and the strategies to best support it. Objectives, The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff,family relationships in the care of older adults in the healthcare setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff,family relationships. Search strategy, A literature search was performed using the following databases for the years 1990,2005: Ageline, APAIS Health, Australian Family and Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage was conducted through review of reference lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language. Selection criteria, The review was limited to studies involving residents and patients within acute, subacute, rehabilitation and residential settings, aged over 65 years, their family and healthcare staff. Papers addressing family members and healthcare staff perceptions of their relationships with each other were considered for this review. Studies in this review also included those relating to interventions to promote constructive staff,family relationships including organisational strategies, staff,family meetings, case conferencing, environmental approaches, etc. The review considered both quantitative and qualitative research and opinion papers for inclusion. Data collection and analysis, All retrieved papers were critically appraised for eligibility for inclusion and methodological quality independently by two reviewers, and the same reviewers collected details of eligible research. Appraisal forms and data extraction forms designed by the Joanna Briggs Institute as part of the QARI and NOTARI systematic review software packages were used for this review. Findings, Family members' perceptions of their relationships with staff showed that a strong focus was placed on opportunities for the family to be involved in the patient's care. Staff members also expressed a theoretical support for the collaborative process, however, this belief often did not translate to the staff members' clinical practice. In the studies included in the review staff were frequently found to rely on traditional medical models of care in their clinical practice and maintaining control over the environment, rather than fully collaborating with families. Four factors were found to be essential to interventions designed to support a collaborative partnership between family members and healthcare staff: communication, information, education and administrative support. Based on the evidence analysed in this systematic review, staff and family education on relationship development, power and control issues, communication skills and negotiating techniques is essential to promoting constructive staff,family relationships. Managerial support, such as addressing workloads and staffing issues; introducing care models focused on collaboration with families; and providing practical support for staff education, is essential to gaining sustained benefits from interventions designed to promote constructive family,staff relationships. [source] Muscle Weakness and Falls in Older Adults: A Systematic Review and Meta-AnalysisJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2004Julie D. Moreland MSc Objectives: To evaluate and summarize the evidence of muscle weakness as a risk factor for falls in older adults. Design: Random-effects meta-analysis. Setting: English-language studies indexed in MEDLINE and CINAHL (1985,2002) under the key words aged and accidental falls and risk factors; bibliographies of retrieved papers. Participants: Fifty percent or more subjects in a study were aged 65 and older. Studies of institutionalized and community-dwelling subjects were included. Measurements: Prospective cohort studies that included measurement of muscle strength at inception (in isolation or with other factors) with follow-up for occurrence of falls. Methods: Sample size, population, setting, measure of muscle strength, and length of follow-up, raw data if no risk estimate, odds ratios (ORs), rate ratios, or incidence density ratios. Each study was assessed using the validity criteria: adjustment for confounders, objective definition of fall outcome, reliable method of measuring muscle strength, and blinded outcome measurement. Results: Thirty studies met the selection criteria; data were available from 13. For lower extremity weakness, the combined OR was 1.76 (95% confidence interval (CI)=1.31,2.37) for any fall and 3.06 (95% CI=1.86,5.04) for recurrent falls. For upper extremity weakness the combined OR was 1.53 (95% CI=1.01,2.32) for any fall and 1.41 (95% CI=1.25,1.59) for recurrent falls. Conclusion: Muscle strength (especially lower extremity) should be one of the factors that is assessed and treated in older adults at risk for falls. More clinical trials are needed to isolate whether muscle-strengthening exercises are effective in preventing falls. [source] Risk of second malignant neoplasms among childhood cancer survivors treated with radiotherapy: meta-analysis of nine epidemiological studiesPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2009Kazutaka Doi Summary In the light of notable advances made in childhood cancer therapies, an understanding of the late effects of treatment is important for continued medical care. We conducted a meta-analysis of studies on the excess relative risk (ERR) of second malignant neoplasm (SMN) among childhood cancer survivors treated with radiotherapy. Relevant studies were retrieved by searching the PubMed database, supplemented by hand-searching of reference lists of already retrieved papers. Nine studies were identified and overall ERR estimates were calculated using a fixed effects model and a random effects model. The overall ERR per Gy (absorbed dose of ionising radiation) estimates of radiotherapy by a fixed effect model and a random effects model were 0.50 [95% CI 0.20, 1.21] and 0.53 [95% CI 0.22, 1.31] respectively. Heterogeneity among studies was suggested by Cochran's Q statistic (Q = 40.4, d.f. = 8, P < 0.001). The estimate obtained using a random effects model was far smaller than the corresponding estimate of 1.7 [95% CI 1.1, 2.5] from the study on atomic bomb survivors exposed as young children, suggesting underestimation of ERR estimates among the nine studies compared with the estimates from the study of atomic bomb survivors. In view of the heterogeneity and underestimation in ERR estimates, more studies concerning the risk of SMN among childhood cancer survivors are still needed for further understanding of the carcinogenic effects of radiotherapy on children. [source] | ||||||||||