Telemedicine-Based Management of Oral Anticoagulation Therapy: Systematic Review and Meta-analysis.

BACKGROUND: Oral anticoagulation is the cornerstone treatment of several diseases. Its management is often challenging, and different telemedicine strategies have been implemented to support it. OBJECTIVE: The aim of the study is to systematically review the evidence on the impact of telemedicine-based oral anticoagulation management compared to usual care on thromboembolic and bleeding events. METHODS: Randomized controlled trials were searched in 5 databases from inception to September 2021. Two independent reviewers performed study selection and data extraction. Total thromboembolic events, major bleeding, mortality, and time in therapeutic range were assessed. Results were pooled using random effect models. RESULTS: In total, 25 randomized controlled trials were included (n=25,746 patients) and classified as moderate to high risk of bias by the Cochrane tool. Telemedicine resulted in lower rates of thromboembolic events, though not statistically significant (n=13 studies, relative risk [RR] 0.75, 95% CI 0.53-1.07; I2=42%), comparable rates of major bleeding (n=11 studies, RR 0.94, 95% CI 0.82-1.07; I2=0%) and mortality (n=12 studies, RR 0.96, 95% CI 0.78-1.20; I2=11%), and an improved time in therapeutic range (n=16 studies, mean difference 3.38, 95% CI 1.12-5.65; I2=90%). In the subgroup of the multitasking intervention, telemedicine resulted in an important reduction of thromboembolic events (RR 0.20, 95% CI 0.08-0.48). CONCLUSIONS: Telemedicine-based oral anticoagulation management resulted in similar rates of major bleeding and mortality, a trend for fewer thromboembolic events, and better anticoagulation quality compared to standard care. Given the potential benefits of telemedicine-based care, such as greater access to remote populations or people with ambulatory restrictions, these findings may encourage further implementation of eHealth strategies for anticoagulation management, particularly as part of multifaceted interventions for integrated care of chronic diseases. Meanwhile, researchers should develop higher-quality evidence focusing on hard clinical outcomes, cost-effectiveness, and quality of life. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020159208; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=159208.

Agreement Between Dual-Energy X-ray Absorptiometry and Bioelectric Impedance Analysis for Assessing Body Composition in Athletes: A Systematic Review and Meta-Analysis.

OBJECTIVE: To compare dual-energy x-ray absorptiometry (DXA) and bioelectric impedance analysis (BIA) in the assessment of body composition in athletes. DATA SOURCES: A systematic review and meta-analysis was conducted collating peer-reviewed studies that compared BIA with DXA for the assessment of body composition in athletes that indexed in MEDLINE, CINAHL, EMBASE, and PsycINFO databases. MAIN RESULTS: After duplicate removal, 267 articles remained for full-text screening. Sixty-three studies remained for the final inclusion, with 8 focused on athletes (n = 461). Five studies were included in the meta-analysis and were rated as positive after risk of bias assessment, whereas the remaining were neutral. BIA overestimated fat-free mass (FFM) over DXA 2.78 (1.38-4.18) (mean difference ± 95% CI) with an effect size of 3.9( P < 0.001). CONCLUSIONS: BIA was found to overestimate total FFM when compared with DXA. Correlations are high between BIA and DXA; however, the limits of agreement are wide. Hence, BIA may not be a suitable substitute for DXA body composition scanning of athletes. Because of the low level of ionizing radiation exposure, the use of DXA should always be medically justified, and therefore, it is not recommended for repeat, longitudinal measurements in healthy subjects.We recommend that clinicians do not use BIA interchangeably with DXA in the assessment of body composition in athletes. Considerations should be made over the safety and appropriateness of DXA in young healthy adults. For long-term use, BIA can be warranted for athletes.PROSPERO Registration Number: CRD42020183777.

Exercise-induced hypoalgesic effects of different types of physical exercise in individuals with neck pain: A systematic review and meta-analysis.

OBJECTIVE: To evaluate the exercise-induced hypoalgesic (EIH) effects of different types of physical exercise in individuals with neck pain. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: An electronic search of six databases was completed to include studies assessing EIH effects on neck pain. STUDY SELECTION CRITERIA: Randomized controlled trials, controlled trials, and observational studies that assessed before and immediate after-effects of a single session of physical exercise in people with neck pain were included. Two reviewers independently screened records, extracted outcomes, assessed the risk of bias, and rated the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. DATA SYNTHESIS: EIH is characterized by increased pain threshold, pain tolerance, and/or decreased sensitivity to painful stimuli or unpleasantness, which may last up to 30 min after a single bout of exercise. EIH is usually measured with quantitative sensory testing (QST) and is mostly taken as the difference between pre- and postexercise pressure pain threshold (PPT). Data were pooled and analyzed using a fixed-effect meta-analysis. RESULTS: Eleven articles were included in this review; nine with low risk of bias and two with some concerns about the risk of bias. Three studies with chronic whiplash-associated disorders (WAD) were included in the meta-analysis; isometric exercise had a larger EIH effect at the local testing site compared with submaximal aerobic exercises (MD = -0.21, [95% CI = -0.43, 0.00], p = 0.05, I2  = 92%), submaximal aerobic and isometric exercises had equal EIH effects at the remote testing site (MD = 0.01, [95% CI = -0.33, 0.35], p = 0.95, I2  = 0%), and submaximal aerobic exercises exerted comparably larger EIH effect at the remote testing site than local testing site (MD = -0.01, [95% CI = -0.20, 0.18], p = 0.93, I2  = 56%). The certainty of evidence (GRADE) for these analyses was low to very low. According to the descriptive analysis of the studies of chronic nonspecific neck pain, isometric and range of motion (ROM) exercises have shown EIH effects. Active stretching exercises have illustrated contradictory effects. CONCLUSION: Isometric and ROM exercises exerted hypoalgesia at local and remote sites. A larger EIH effect following submaximal aerobic exercises was exerted at the remote testing site compared with the local site.

Impact of the COVID-19 pandemic on suicidal attempts and death rates: a systematic review.

BACKGROUND: The COVID-19 pandemic has exacerbated the risk factors associated with suicidal behavior and thus, prioritizing its prevention is recommended. METHODS: This study systematically reviewed the global evidence on the incidence of suicide/suicidal attempts and the trend in suicidal rates during the COVID-19 pandemic. Cross-sectional and cohort studies investigating the outcomes of suicidal death and suicidal attempts at any setting during the COVID-19 pandemic were searched in Medline, Embase, and PsycINFO databases for papers published from December 2019 to May 2021. RESULTS: Out of 1052 studies18 studies with 12,746 suicidal attempts and 33,345 suicidal deaths were included in the final analysis. The mental health impact of social distancing, COVID-19 quarantine, and financial crises due to loss of employment were associated risk factors with suicide and/or suicidal attempts during the COVID-19 pandemic. Six common thematic recommendations for preventing suicidal deaths and suicidal attempts were identified. CONCLUSIONS: Unexpected behavior changes during the COVID-19 pandemic may have contributed to the increasing trend of suicidal attempts reported. Domestic conflicts and violence, financial loss, anxiety and depression, and pre-existing mental health condition/s should be considered in preventing suicidal attempts and deaths secondary to the COVID 19 pandemic. Early detection and timely intervention for individuals with suicidal behavior is crucial and collated recommendations in the current study can be utilized for those preventive interventions. More systematic suicide risk screening process should be introduced who are at risk, along with an evidence base prevention approach.

Adherence to literature search reporting guidelines in leading rheumatology journals' systematic reviews: umbrella review protocol.

Literature searches are important components of systematic reviews. They are not only informative of the retrieval process, but they also set the data to be analyzed and influence additional components of systematic reviews. Despite the available guidelines, several studies have shown that the quality of reporting in systematic reviews is deficient in several medical fields. Systematic reviews may not comply completely with those guidelines despite explicitly stating they do. This protocol intends to answer to what extent systematic reviews published in rheumatology journals have complied with the PRISMA's search strategy guidelines published in 2009. The objective of the study is to analyze the compliance with the PRISMA (2009) search strategy guidelines among systematic reviews published in leading rheumatology journals. Inclusion criteria for this umbrella review protocol are systematic reviews (with or without meta-analyses) that mention having followed the PRISMA statement (2009) in their methods section, and published in journals listed in the Rheumatology category of the Journal of Citations Report 2020. Exclusion criteria are articles published before 2009; retraction letters, notes, expressions of concern; systematic reviews using PRISMA 2020. Databases to be consulted are Web of Science, PubMed and Scopus, from inception to present. Data summaries will be presented in graphs, figures, tables and network maps. A narrative synthesis will be described. This protocol complies with guidelines such as PRISMA 2020, PRISMA-A, PRISMA-P, PRISMA-S, PRESS, and JBI Manual for evidence synthesis, as long as it is suitable for umbrella review protocols. Articles in any language will be considered.

Feasibility of Using Detuned Laser as a Placebo In Manual Therapy Research: An Analysis of Participant Perceptions.

OBJECTIVE: The purpose of this study was to determine the feasibility of using detuned laser as a placebo intervention in manual therapy research. METHODS: We performed a secondary data analysis of a randomized controlled trial. In our analysis, 30 participants with chronic ankle instability (manual therapy group: n = 13, age = 33.1 ± 8.1 years, female participants = 50%; detuned laser group: n = 17, age = 31.9 ± 11.8 years, female participants = 72%) were asked to indicate which intervention (manual therapy [active] or detuned laser [placebo]), they thought they had received and to give a confidence rating on their response regarding the received intervention at the conclusion of the course of intervention. Independent t tests were used to compare the groups. Participants in both groups were asked the following open-ended question: "What did you think of the intervention?". RESULTS: There were 52.9% participants in the detuned laser group and 53.8% participants in the manual therapy group who perceived that they had received the active intervention. The confidence ratings about their perceptions (6.7 ± 2.0, detuned laser group; 6.3 ± 2.4, manual therapy group) (P = .66) and the self-reported recovery ratings (1.9 ± 1.5 and 1.8 ± 1.2, respectively) (P = .77) were similar. CONCLUSIONS: Participants in this study confidently perceived that detuned laser was an active intervention. They positively rated their recovery following the course of the placebo intervention and perceived that detuned laser was effective in treating their condition. Therefore, it is feasible for detuned laser to be used as a placebo for manual therapy trials.

What do stroke survivors' value about participating in research and what are the most important research problems related to stroke or transient ischemic attack (TIA)? A survey.

BACKGROUND: Recruitment to stroke clinical trials is challenging, but consumer registers can facilitate participation. Researchers need to understand the key factors that facilitate trial involvement and improve consumer partnerships to identify what research topics important to stroke and transient ischemic attack (TIA) survivors and their carers. We aimed to examine i) the experience of being involved in a stroke research register, and ii) the priorities for stroke research from the perspective of stroke survivors. METHODS: Online and paper-based surveys were sent directly to members of a stroke register and disseminated online. Multiple choice questions were reported as counts and percentages and open-ended questions were thematically analysed using Braun and Clarke's 6-stage process. RESULTS: Of 445 survey respondents, 154 (38%) were a member of the Stroke Research Register. The most frequently reported reason for research participation was to help others in the future. Respondents reported they were less likely to take part in research if the research question was not relevant to them, if transport was an issue, or because they lacked time. The most important research problems reported were targeting specific impairments including recovery of movement, fatigue, and aphasia, improvement of mental health services, and increased support for carers. CONCLUSIONS: Recruitment to trials may be improved by research registers if an inclusive research culture is fostered, in which consumers feel valued as members of a community, have direct and timely access to research findings and the opportunity to be meaningfully involved in research around the problems that consumers find most important.

Coronavirus disease (COVID-19) pandemic: an overview of systematic reviews.

BACKGROUND: Navigating the rapidly growing body of scientific literature on the SARS-CoV-2 pandemic is challenging, and ongoing critical appraisal of this output is essential. We aimed to summarize and critically appraise systematic reviews of coronavirus disease (COVID-19) in humans that were available at the beginning of the pandemic. METHODS: Nine databases (Medline, EMBASE, Cochrane Library, CINAHL, Web of Sciences, PDQ-Evidence, WHO's Global Research, LILACS, and Epistemonikos) were searched from December 1, 2019, to March 24, 2020. Systematic reviews analyzing primary studies of COVID-19 were included. Two authors independently undertook screening, selection, extraction (data on clinical symptoms, prevalence, pharmacological and non-pharmacological interventions, diagnostic test assessment, laboratory, and radiological findings), and quality assessment (AMSTAR 2). A meta-analysis was performed of the prevalence of clinical outcomes. RESULTS: Eighteen systematic reviews were included; one was empty (did not identify any relevant study). Using AMSTAR 2, confidence in the results of all 18 reviews was rated as "critically low". Identified symptoms of COVID-19 were (range values of point estimates): fever (82-95%), cough with or without sputum (58-72%), dyspnea (26-59%), myalgia or muscle fatigue (29-51%), sore throat (10-13%), headache (8-12%) and gastrointestinal complaints (5-9%). Severe symptoms were more common in men. Elevated C-reactive protein and lactate dehydrogenase, and slightly elevated aspartate and alanine aminotransferase, were commonly described. Thrombocytopenia and elevated levels of procalcitonin and cardiac troponin I were associated with severe disease. A frequent finding on chest imaging was uni- or bilateral multilobar ground-glass opacity. A single review investigated the impact of medication (chloroquine) but found no verifiable clinical data. All-cause mortality ranged from 0.3 to 13.9%. CONCLUSIONS: In this overview of systematic reviews, we analyzed evidence from the first 18 systematic reviews that were published after the emergence of COVID-19. However, confidence in the results of all reviews was "critically low". Thus, systematic reviews that were published early on in the pandemic were of questionable usefulness. Even during public health emergencies, studies and systematic reviews should adhere to established methodological standards.

Impact of Big Data Analytics on People's Health: Overview of Systematic Reviews and Recommendations for Future Studies.

BACKGROUND: Although the potential of big data analytics for health care is well recognized, evidence is lacking on its effects on public health. OBJECTIVE: The aim of this study was to assess the impact of the use of big data analytics on people's health based on the health indicators and core priorities in the World Health Organization (WHO) General Programme of Work 2019/2023 and the European Programme of Work (EPW), approved and adopted by its Member States, in addition to SARS-CoV-2-related studies. Furthermore, we sought to identify the most relevant challenges and opportunities of these tools with respect to people's health. METHODS: Six databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews via Cochrane Library, Web of Science, Scopus, and Epistemonikos) were searched from the inception date to September 21, 2020. Systematic reviews assessing the effects of big data analytics on health indicators were included. Two authors independently performed screening, selection, data extraction, and quality assessment using the AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2) checklist. RESULTS: The literature search initially yielded 185 records, 35 of which met the inclusion criteria, involving more than 5,000,000 patients. Most of the included studies used patient data collected from electronic health records, hospital information systems, private patient databases, and imaging datasets, and involved the use of big data analytics for noncommunicable diseases. "Probability of dying from any of cardiovascular, cancer, diabetes or chronic renal disease" and "suicide mortality rate" were the most commonly assessed health indicators and core priorities within the WHO General Programme of Work 2019/2023 and the EPW 2020/2025. Big data analytics have shown moderate to high accuracy for the diagnosis and prediction of complications of diabetes mellitus as well as for the diagnosis and classification of mental disorders; prediction of suicide attempts and behaviors; and the diagnosis, treatment, and prediction of important clinical outcomes of several chronic diseases. Confidence in the results was rated as "critically low" for 25 reviews, as "low" for 7 reviews, and as "moderate" for 3 reviews. The most frequently identified challenges were establishment of a well-designed and structured data source, and a secure, transparent, and standardized database for patient data. CONCLUSIONS: Although the overall quality of included studies was limited, big data analytics has shown moderate to high accuracy for the diagnosis of certain diseases, improvement in managing chronic diseases, and support for prompt and real-time analyses of large sets of varied input data to diagnose and predict disease outcomes. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) CRD42020214048; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214048.

Effects of mobilisation with movement (MWM) on anatomical and clinical characteristics of chronic ankle instability: a randomised controlled trial protocol.

BACKGROUND: Up to 40% of individuals who sprain their ankle develop chronic ankle instability (CAI). One treatment option for this debilitating condition is joint mobilisation. There is preliminary evidence that Mulligan's Mobilisation With Movement (MWM) is effective for treating patients with CAI, but the mechanisms by which it works are unclear, with Mulligan suggesting a repositioning of the fibula. This randomised controlled trial aims to determine the effects of MWM on anatomical and clinical characteristics of CAI. METHODS: Participants 18 years or over with CAI will be accepted into the study if they satisfy the inclusion and exclusion criteria endorsed by the International Ankle Consortium. They will be randomised into the experimental group (MWM) or the placebo group (detuned laser) and will receive the assigned intervention over 4 weeks. General joint hypermobility and the presence of mechanical instability of the ankle will be recorded during the first visit. Further, position of the fibula, self-reported function, ankle dorsiflexion range, pressure pain threshold, pain intensity, and static and dynamic balance will be assessed at baseline, and at the conclusion of course of intervention. Follow-up data will be collected at the twelfth week and at the twelfth month following intervention. DISCUSSION: Effectiveness of MWM on clinically relevant outcomes, including long term benefits will be evaluated. The capacity of MWM to reverse any positional fault of the fibula and the association of any positional fault with other clinically important outcomes for CAI will be explored. Proposed biomechanical mechanisms of fibular positional fault and other neurophysiological mechanisms that may explain the treatment effects of MWM will be further explored. The long term effectiveness of MWM in CAI will also be assessed. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry; ACTRN12617001467325 (17/10/2017).

Clinical Benefits of Joint Mobilization on Ankle Sprains: A Systematic Review and Meta-Analysis.

OBJECTIVE: To assess the clinical benefits of joint mobilization for ankle sprains. DATA SOURCES: MEDLINE, MEDLINE In-Process, Embase, AMED, PsycINFO, CINAHL, Cochrane Library, PEDro, Scopus, SPORTDiscus, and Dissertations and Theses were searched from inception to June 2017. STUDY SELECTION: Studies investigating humans with grade I or II lateral or medial sprains of the ankle in any pathologic state from acute to chronic, who had been treated with joint mobilization were considered for inclusion. Any conservative intervention was considered as a comparator. Commonly reported clinical outcomes were considered such as ankle range of movement, pain, and function. After screening of 1530 abstracts, 56 studies were selected for full-text screening, and 23 were eligible for inclusion. Eleven studies on chronic sprains reported sufficient data for meta-analysis. DATA EXTRACTION: Data were extracted using the participants, interventions, comparison, outcomes, and study design approach. Clinically relevant outcomes (dorsiflexion range, proprioception, balance, function, pain threshold, pain intensity) were assessed at immediate, short-term, and long-term follow-up points. DATA SYNTHESIS: Methodological quality was assessed independently by 2 reviewers, and most studies were found to be of moderate quality, with no studies rated as poor. Meta-analysis revealed significant immediate benefits of joint mobilization compared with comparators on improving posteromedial dynamic balance (P=.0004), but not for improving dorsiflexion range (P=.16), static balance (P=.96), or pain intensity (P=.45). Joint mobilization was beneficial in the short-term for improving weight-bearing dorsiflexion range (P=.003) compared with a control. CONCLUSIONS: Joint mobilization appears to be beneficial for improving dynamic balance immediately after application, and dorsiflexion range in the short-term. Long-term benefits have not been adequately investigated.

Chronic musculoskeletal ankle disorders in Sri Lanka.

BACKGROUND: Musculoskeletal disorders of the lower extremities are commonly affected by chronicity and disability. One of the most commonly affected areas is the ankle. Epidemiological information is limited for chronic musculoskeletal ankle disorders in the general community, particularly in the developing world. This study aimed to determine the prevalence and impact of chronic musculoskeletal ankle disorders in the Sri Lankan community. METHODS: A cross-sectional stratified random sample of people (n = 1000) aged 18 to 85 years in Sri Lanka was undertaken by questionnaire in the general community setting. Of those questionnaires, 827 participants provided data. Point prevalence for no history of ankle injury or ankle disorders, history of ankle injuries without chronic ankle disorders, and chronic ankle disorders were obtained. Point prevalence of chronic musculoskeletal disorders and causes for chronicity was evaluated. RESULTS: There were 448 (54.2%) participants with no ankle disorders, 164 (19.8%) with a history of ankle injury but no chronic disorders, and 215 (26.0%) with chronic ankle disorders. The major component of chronic ankle disorders was musculoskeletal disorders (n = 113, 13.7% of the total sample), most of which were due to ankle injury (n = 80, 9.7% of the total). Sprains were responsible for 17.7% of the total ankle injuries. Arthritis was the other main cause for chronicity of ankle disorders with 4% of total participants (n = 33). CONCLUSIONS: Almost 14% of the Sri Lankan community was affected by chronic musculoskeletal ankle disorders. The majority were due to a previous ankle injury, and arthritis. Most people had to limit or change their physical activity because of the chronic ankle disorder. A very low utility of physiotherapy services was observed.

Frequency of use and adequacy of Cochrane risk of bias tool 2 in non-Cochrane systematic reviews published in 2020: Meta-research study.

Risk of bias (RoB) assessment is essential to the systematic review methodology. The new version of the Cochrane RoB tool for randomized trials (RoB 2) was published in 2019 to address limitations identified since the first version of the tool was published in 2008 and to increase the reliability of assessments. This study analyzed the frequency of usage of the RoB 2 and the adequacy of reporting the RoB 2 assessments in non-Cochrane reviews published in 2020. This meta-research study included non-Cochrane systematic reviews of interventions published in 2020. For the reviews that used the RoB 2 tool, we analyzed the reporting of the RoB 2 assessment. Among 3880 included reviews, the Cochrane RoB 1 tool was the most frequently used (N = 2228; 57.4%), followed by the Cochrane RoB 2 tool (N = 267; 6.9%). From 267 reviews that reported using the RoB 2 tool, 213 (79.8%) actually used it. In 26 (12.2%) reviews, erroneous statements were used to indicate the RoB 2 assessment. Only 20 (9.4%) reviews presented a complete RoB 2 assessment with a detailed table of answers to all signaling questions. The judgment of risk of bias by the RoB 2 tool was not justified by a comment in 158 (74.2%) reviews. Only in 33 (14.5%) of reviews the judgment in all domains was justified in the accompanying comment. In most reviews (81.7%), the RoB was inadequately assessed at the study level. In conclusion, the majority of non-Cochrane reviews published in 2020 still used the Cochrane RoB 1 tool. Many reviews used the RoB 2 tool inadequately. Further studies about the uptake and the use of the RoB 2 tool are needed.

Biomechanical and clinical relationships between lower back pain and knee osteoarthritis: a systematic review.

BACKGROUND: Osteoarthritis (OA) and lower back pain (LBP) are most common health problems which lead to pain and disability. This study aimed to systematically review the evidence to find any relationship between knee osteoarthritis (KOA) and LBP or any potential causation. METHODS: The databases of Scopus, MEDLINE, and Embase were searched from inception to 01 October 2022. Any study published in English assessing live humans over 18 years with KOA and LBP was eligible to be included. Studies were independently screened by two researchers. Data of the included studies were extracted based on the participants, outcomes related to knee and lumbar spine, reported association or causation between LBP and KOA, and study design. Data were narratively analyzed and presented as graphs and table. Methodology quality was assessed. RESULTS: Of 9953 titles and abstracts, duplicates were removed, and 7552 were screened. Altogether, 88 full texts were screened, and 13 were eligible for the final inclusion. There were some biomechanical and clinical causations were observed for the concurrent presence of LBP and KOA. Biomechanically, high pelvic incidence is a risk factor for development of spondylolisthesis and KOA. Clinically, knee pain intensity was higher in KOA when presents with LBP. Less than 20% of studies have justified their sample size during the quality assessment. DISCUSSION: Development and progression of KOA in patients with degenerative spondylolisthesis may be induced by significantly greater mismatches of lumbo-pelvic sagittal alignment. Elderly patients with degenerative lumbar spondylolisthesis and severe KOA reported a different pelvic morphology, increased sagittal malalignment with a lack of lumbar lordosis due to double-level listhesis, and greater knee flexion contracture than in patients with no to mild and moderate KOA. People with concurrent LBP and KOA have reported poor function with more disability. Both LBP and lumbar kyphosis indicate functional disability and knee symptoms in patients with KOA. CONCLUSIONS: Different biomechanical and clinical causations were revealed for the concurrent existence of KOA and LBP. Therefore, careful assessment of both back and knee joints should be considered when treating KOA and vice versa. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022238571.

Investigating the Effects of Intraprofessional Learning in Nursing Education: Protocol for a Longitudinal Study.

Interprofessional learning (IPL), where nursing students learn how to work with multiple health professionals in their future practice to deliver the highest quality of care, has become an essential feature of undergraduate nursing programs. Intraprofessional learning (IaPL) is where individuals of two or more disciplines within the same profession collaborate; however, there is a dearth of literature investigating its effects in nursing education. The aim of this study is to investigate the impact of IaPL on the development of nursing students' knowledge, skills, and attitudes for collaborative practice. The study will utilize a mixed methods approach with surveys conducted at six time points across two years of two nursing programs and focus groups at the end of the program. Participants will be recruited from the Diploma and Bachelor of Nursing programs at an Australian Training and Further Education institute. Four specific IaPL educational experiences incorporating simulation will be developed on aged care, mental health, complex care and acute care. The study will provide nursing students with multiple opportunities to develop the necessary capabilities for collaborative practice. It will longitudinally evaluate nursing students' attitudes towards IaPL and examine whether IaPL motivates Diploma of Nursing students to pathway into a Bachelor of Nursing degree. The study will also investigate awareness amongst nursing students of the scope of practice, roles and responsibilities of the nursing team.

Instruments evaluating the quality of the clinical learning environment in nursing education: An updated systematic review.

OBJECTIVES: The clinical learning environment offers meaningful learning opportunities for nursing students to apply theoretical knowledge to practice on actual or simulated patients. A previous systematic review assessed the quality of several instruments that evaluated the quality of clinical learning environments. This updated systematic review aimed to identify: any additional instruments that have been researched in the last 5 years, ii) the psychometric properties of available instruments and iii) the estimated comparable psychometric properties of the available instruments. DATA SOURCES: Medline, CINAHL and Cochrane databases REVIEW METHODS: Databases were searched from January 2016 to January 2023. Studies were included if they: a) validated instruments evaluating the experience and quality of clinical learning environments; b) assessed the pre-licensure nursing student experience; c) were published in English; and d) were published after April 2016. Two independent reviewers conducted title and abstract screening, full text screening, data extraction and methodological quality assessment. Any disagreements were resolved by consensus. A summary of the findings was tabulated using the same format as the initial review. RESULTS: An additional 18 studies were found, which used seven different clinical learning environment evaluation instruments. Internal consistency and structural validity were the most frequently reported psychometric properties. In almost all studies, methodology for these properties were of sufficient quality according to the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) tool evaluation. Other properties were inconsistently reported, with differing qualities in the methodology. Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) remains the most translated and validated instrument across several countries. CONCLUSIONS: Instruments developed and validated using a systematic, transparent and high-quality methodology assist in accurately assessing the skills, attitudes and decision-making abilities of the preregistration level nursing student. These tools can be used in clinical placement accreditation and quality improvement of nursing education. The methodology for evaluation of the psychometric properties of instruments should be clearly described.

Is Maternal Carbohydrate Intake Having an Impact on Newborn Birth Weight? A Systematic Review.

Glucose is a vital fuel for fetal growth, and carbohydrates are the primary source of glucose in the diet. The effects of carbohydrate intake during pregnancy on neonatal birth weight have not been fully investigated or systematically reviewed. Therefore, this systematic review aimed to collate the available evidence to determine whether carbohydrate intake during pregnancy impacts newborn birth weight. A literature search was performed from inception to March 2022 in Embase, Medline, and PsycInfo. Articles published in English were independently screened for the title and abstracts, and then for full texts. Out of 17 studies included, a significant relationship between the intake of maternal carbohydrate or its subcomponents and neonatal birth weight was reported in six studies. Of them, one study reported that higher carbohydrate intake in early pregnancy was associated with lower birth weight. The two other studies reported a positive correlation between maternal carbohydrate intake and neonatal birth weight regarding first- and second-trimester intake. Maternal carbohydrate intake may have an impact on birth weight, as suggested by the included studies in this systematic review. However, the overall review indicates contradictory findings concerning the relationship between carbohydrate intake and neonatal birth weight. Studies assessing the type of carbohydrate and the amount consumed with improved methodological quality are recommended.

Health screening questionnaires used in the management of mental distress acquired during an injured worker's return to work: A scoping review.

BACKGROUND: Mental distress is often endured by injured workers participating in the rehabilitation or return to work process following a physical injury. Delays in detecting the onset and treating mental distress can lead to a diverse range of cognitive and behavioural changes that may precipitate psychological distress such as anxiety, depression, and posttraumatic stress. OBJECTIVE: The objective of this scoping review was to provide an overview of existing health questionnaires utilised by health care providers and affiliated researchers. It reviewed their effectiveness and suitability to detect mental distress endured by injured workers engaged in the return to work process. METHODS: A scoping review methodology was conducted using the Arksey and O'Malley framework which examined peer-reviewed articles published between 2000 and March 2020 comprising health questionnaires. Database searches included Medline, CINAHL, EMBASE and PsycINFO combining specific MeSH terms and key words. RESULTS: The full search identified 3168 articles. Following full screening a total of 164 articles reviewed the use of health questionnaires and specific criteria to determine their suitability. Most of the health questionnaires reviewed were used as screening measures for identifying both work and non-work-related psychological hazards. However, they were found to be limited in their application when considering all potential predictors of delayed return to work such as poor or stressful interactions with stakeholders, financial stress and the injured workers experience of the RTW process. CONCLUSION: Earlier identification of mental distress using an optimal MHSQ followed by appropriate intervention will reduce the risk of psychological injury becoming cumulative on a physical workplace injury. Without such complications, early return to work can be achieved with significant cost saving to the economy.

Safety and efficacy of therapeutic taping in primary dysmenorrhea: a systematic review and meta-analysis.

Primary dysmenorrhea (PD) is a common gynecological condition among adolescent and adult women. Several pharmacological and alternative therapies (e.g. therapeutic taping) have been used to treat PD, with varying effect. This systematic review and meta-analysis was performed to evaluate the safety and efficacy of therapeutic taping on clinical symptoms of PD, considering pain as the primary outcome. MEDLINE, Cochrane Library, Embase, PEDro, CINAHL and gray literature sources were searched from inception to February 2022 for randomized controlled trials (RCTs) that assessed the effect of therapeutic taping for PD. The language was restricted to English. A total of ten studies were included in the systematic review, involving 685 participants. Eight studies were included in quantitative analysis. The quality of the studies ranged from 4 to 7 with a median of 5 as assessed by PEDro scale. Meta-analyses indicated short-term improvements of pain compared to sham and no interventions. Elastic therapeutic taping (ETT) indicated short term improvements in anxiety associated with PD. Moderate to high quality of evidence suggested that ETT is an effective intervention in improving pain, anxiety, and quality of life of women with PD. A scarcity of evidence on the long-term effects of therapeutic taping in PD is observed.

Adverse Perinatal Outcomes in COVID-19 Infected Pregnant Women: A Systematic Review and Meta-Analysis.

The impact of COVID-19 virus infection during pregnancy is still unclear. This systematic review and meta-analysis aimed to quantitatively pool the evidence on impact of COVID-19 infection on perinatal outcomes. Databases of Medline, Embase, and Cochrane library were searched using the keywords related to COVID-19 and perinatal outcomes from December 2019 to 30 June 2021. Observational studies comparing the perinatal outcomes of COVID-19 infection in pregnancy with a non-infected comparator were included. The screening process and quality assessment of the included studies were performed independently by two reviewers. Meta-analyses were used to pool the comparative dichotomous data on perinatal outcomes. The database search yielded 4049 results, 1254 of which were duplicates. We included a total of 21 observational studies that assessed the adverse perinatal outcomes with COVID-19 infection. The odds of maternal death (pooled OR: 7.05 [2.41-20.65]), preeclampsia (pooled OR: 1.39 [1.29-1.50]), cesarean delivery (pooled OR: 1.67 [1.29-2.15]), fetal distress (pooled OR: 1.66 [1.35-2.05]), preterm birth (pooled OR: 1.86 [1.34-2.58]), low birth weight (pooled OR: 1.69 [1.35-2.11]), stillbirth (pooled OR: 1.46 [1.16-1.85]), 5th minute Apgar score of less than 7 (pooled OR: 1.44 [1.11-1.86]) and admissions to neonatal intensive care unit (pooled OR: 2.12 [1.36-3.32]) were higher among COVID-19 infected pregnant women compared to non-infected pregnant women.