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  • Author: Jie Meng x
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Abstract

Background

Early mobilization (EM) is a regimen that was carried out by physiotherapists in a relatively early stage. It has been investigated by an increasing number of researchers. However, there has not been a meta-analysis concerning whether EM could benefit the clinical outcomes of critically ill patients requiring mechanical ventilation (MV). The present systematic review aims to evaluate the effect of EM compared with immobilization for mechanically ventilated patients.

Methods

A computerized literature search was performed in six databases for related articles from inception to June 2017. We included randomized controlled trials and controlled clinical trials and used the Physiotherapy Evidence Database scale to assess the quality of included studies. Primary outcomes were measures of muscle function, duration of MV, and incidence of mortality. Secondary outcomes were adverse effects and length of stay (LOS) in intensive care unit (ICU) and hospital.

Results

Eight trials were included; of those, only one study without standard EM reported that the intervention was invalid to improve the outcomes. The result of meta-analysis indicated that EM shortened the duration of MV; however, it had no positive effect on mortality and LOS in ICU.

Conclusions

This review suggests that EM improves the muscle function and ventilation duration. Further research highlighting standard intervention and specific groups is needed.

Abstract

Objective

To evaluate the effectiveness of integrated nursing interventions for fatigue in patients with advanced cancer.

Methods

Medline, Pubmed, Embase, CINAHL, Web of Science, and the Cochrane Library were searched systematically till June 2017. A systematic review was conducted to collect randomized controlled trials (RCTs) reporting on the effect of nurse-driven interventions to improve fatigue in patients with advanced cancer. Quality assessment was conducted using the Cochrane Collaboration’s risk of bias tool.

Results

Six RCTs involving 736 adult participants were included. The fatigue intensity was improved significantly by nursing interventions. The analyzed results revealed significant improvements in the intervention group: less than 3 months (standard mean difference [SMD] = −0.33, 95% confidence interval [CI] [−0.48, −0.19], P < 0.01) and more than or equal to 3 months (SMD = −0.40, 95% CI [−0.57, −0.24], P < 0.01). Four studies with a moderate risk of bias were judged, and the remaining studies were at high risk of bias.

Conclusions

The results indicate that integrated nursing interventions may relieve fatigue in patients with advanced cancer. However, due to the high risk of bias in most of the included studies and the diversity of interventions, the results and implementation process should be carefully monitored.

Abstract

A home-made electrostatic force microscopy (EFM) system is described which is directed toward assessment of the microscopic geometry of the surface of specimens made of non-conductive material with a large thickness. This system is based on the variation in the electrostatic force between the conductive probe and the non-conductive specimen in order to get its surface morphology. First, based on the principle of dielectric polarization, the variation rules of the electrostatic force between the charged probe and the non-conductive specimen were studied. Later, a special tuning fork resonant probe unit made of quartz crystal was fabricated for measurement of the electrostatic force, and the scanning probe microscopic system in the constant force mode was constructed to characterize the three-dimensional micro-topography of the surface of the specimen. Finally, this system was used to perform scanning measurement experiments on the indented surface of the specimen made of the polyvinyl chloride (PVC) material with thickness 3 mm. In the present experimental system, when the external voltage was 100 V and the distance from the probe tip to the specimen surface approximately 100 nm, the variance in the resonant frequency of the probe unit was around 0.5 Hz. These results indicate that this home-made EFM system can effectively characterize the micro-topography of the non-conductive specimen with very large thickness which is above several millimeters.

Abstract

Objective

The purposes of this study were to analyze the influencing factors of self-directed learning readiness (SDLR) of nursing undergraduates and explore the impacts of learning attitude and self-efficacy on nursing undergraduates.

Methods

A total of 500 nursing undergraduates were investigated in Tianjin, with the Chinese version of SDLR scale, learning attitude questionnaire of nursing college students, academic self-efficacy scale, and the general information questionnaire.

Result

The score of SDLR was 149.99±15.73. Multiple stepwise regressions indicated that academic self-efficacy, learning attitude, attitudes to major of nursing, and level of learning difficulties were major influential factors and explained 48.1% of the variance in SDLR of nursing interns.

Conclusions

The score of SDLR of nursing undergraduates is not promising. It is imperative to correct students’ learning attitude, improve self-efficacy, and adopt appropriate teaching model to improve SDLR.

Abstract

Objective

This meta-analysis aimed to examine the effects of parental involvement in infant care in neonatal intensive care units (NICUs).

Methods

PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database were searched till November 2017. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) examining the effect of parental involvement in the NICU were considered for inclusion.

Results

We included 10 studies (three RCTs, seven CCTs) with a total of 1,851 participants. The meta-analysis demonstrated that there were no statistically significant differences on nosocomial infection between two groups (risk ratio [RR] = 0.90, 95% CI 0.63–1.30, P = 0.58). Compared with no parental involvement groups, parental involvement groups showed more weight gain (mean difference [MD] = 1.47, 95% CI 0.65–2.29, P < 0.05), higher breast-feeding rate (RR = 1.38, 95% C11.25–1.53, P < 0.05), lower readmission rate (RR = 0.35, 95% CI 0.15–0.80, P < 0.05), and higher satisfaction rate (RR = 1.09, 95% CI 1.02–1.16, P< 0.05).

Conclusions

Parental involvement in the NICU interventions could not increase the rate of nosocomial infection of neonates, but could improve their weight gain, breast-feeding and parental satisfaction and decrease their readmission. However, since the conclusion of this meta-analysis was drawn based on the limited number of high-quality RCTs, more high-quality studies should be conducted in the future to confirm its positive intervention effects.

Abstract

Objective

This study assessed the methodological quality of systematic reviews/meta-analysis of the effectiveness of probiotics against irritable bowel syndrome (IBS) using the accepted methodological quality assessment scale AMSTAR and explored the factors that influenced the quality of methodology. It was designed to provide a reference for future research and systematic reviews/metaanalysis.

Methods

The methodological quality of existing systematic reviews/meta-analysis was evaluated using the AMSTAR scale. Influencing factors of methodological quality were statistically analyzed using RevMan 5.3 software. The included systematic reviews/metaanalysis must include the following characteristics: (1) methods using systematic evaluation/meta-analysis, (2) probiotic intervention, and (3) language limitation to Chinese and English.

Results

The AMSTAR score was 5–9 (7.42 ± 1.22), and the quality is above average. The factors affecting the methodological quality are the number of authors and whether they cooperate with the institution.

Conclusions

Studies have shown that current systematic reviews/meta-analysis of the effectiveness of probiotics on IBS does not fully comply with methodological quality standards, and therefore the methodological quality of research in this area needs to be strengthened. To better clarify how probiotics affect IBS, future systematic reviews and meta-analyses should not only follow methodological quality standards but also include more effective outcome measures, and they should focus more on the discussion of research results. We look forward to the development of higher-quality randomized controlled trials in the future.

Abstract

Objectives

To examine the best practice evidence of the effectiveness of the flipped classroom (FC) as a burgeoning teaching model on the development of self-directed learning in nursing education.

Data sources

The relevant randomized controlled trial (RCT) and non-RCT comparative studies were searched from multiple electronic databases including PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), Wanfang Data, China National Knowledge Infrastructure (CNKI), and Chinese Science and Technology Periodical Database (VIP) from inception to June 2017.

Review methods

The data were independently assessed and extracted for eligibility by two reviewers. The quality of included studies was assessed by another two reviewers using a standardized form and evaluated by using the Cochrane Collaboration’s risk of bias tool. The self-directed learning scores (continuous outcomes) were analyzed by using the 95% confidence intervals (CIs) with the standard deviation average (SMD) or weighted mean difference (WMD). The heterogeneity was assessed using Cochran’s I statistic.

Results

A total of 12 studies, which encompassed 1440 nursing students (intervention group = 685, control group = 755), were eligible for inclusion in this review. Of 12 included studies, the quality level of one included study was A and of the others was B. The pooled effect size showed that compared with traditional teaching models, the FC could improve nursing students’ self-directed learning skill, as measured by the Self-Directed Learning Readiness Scale (SDLRS), Self-Directed Learning Readiness Scale for Nursing Education (SDLRSNE), Self-Regulated Learning Scale (SRL), Autonomous Learning Competencies scale (ALC), and Competencies of Autonomous Learning of Nursing Students (CALNS). Overall scores and subgroup analyses with the SRL were all in favor of the FC.

Conclusions

The result of this meta-analysis indicated that FCs could improve the effect of self-directed learning in nursing education. Future studies with more RCTs using the same measurement tools are needed to draw more authoritative conclusions.

Abstract

Objective

To summarize and evaluate the evidence of guidelines and systematic reviews (SRs) of nonpharmacological interventions for mild cognitive impairment (MCI) to support the development of future guidelines and clinical decisions for MCI patients.

Methods

Scottish Intercollegiate Guideline Network (SIGN), National Institute for Health and Clinical Excellence (NICE), American Academy of Neurology (AAN), Registered Nurses Association of Ontario (RNAO), Web of Science, PubMed, Cochrane Library, CNAHL, VIP, China National Knowledge Infrastructure (CNKI), and Wanfang Database were searched for relevant publications, including guidelines and SRs, from January 2014 to March 2019. Two authors independently screened articles, extracted data, and assessed the publications for adherence to the inclusion criteria. Appraisal of Guidelines for Research and Evaluation (AGREE II) was used to assess the quality of the guidelines, and Assessment of Multiple Systematic Reviews (AMSTAR 2) was used to assess the quality of SRs. In addition, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of outcomes.

Results

Thirty-two articles were retrieved, including 1 guideline and 31 SRs. Fourteen SRs of physical exercise for MCI, six articles describing cognitive interventions, four articles describing acupuncture, and seven articles assessing dietary interventions (including four articles employing a Mediterranean diet, one article using vitamin B supplementation, and two articles assessing the effects of tea, coffee, and caffeine) were included. The quality of the articles was very low for 4 (13%), low for 10 (32%), and moderate for 17 (55%).

Conclusions

Based on the evidence available to date, nonpharmacological interventions may improve the current cognitive function of persons with MCI. In particular, physical exercise, cognitive interventions, and acupuncture exerted promising effects. However, due to the limited number and quality of the included publications, additional high-quality reviews are needed to further confirm.