Research

The National eletronic Library for Health (NeLH) is to write a new knowledge service for patients and clinicians. This article describes the background to NeLH in Information for Health and outlines the aims, benefits and architecture of the proposed service. It identifies the challenge to Health librarians to develop new skills in informatics and critical appraisal.

Presenting Baseline Coagulation of Infra Renal Ruptured Abdominal Aortic Aneurysm: A Systematic Review and Pooled Analysis

Aim:This critical review of the literature seeks to understand the psychological impact that treatment interventions may have on prostate cancer (PC) survivors.Materials and Methods:A literature search was conducted using databases of peer-reviewed literature. The search terms used were devised using the building-blocks technique to divide the query into facets. The articles were manually assessed for relevance and appraised using the relevant Critical Appraisal Skills Programme (CASP) tool. Government guidelines and regulations were also used following a manual search on the National Institute for Health and Care Excellence (NICE) website. This process resulted in a total of 12 sources being included in the critical review.Results:The key themes that arose from the review were masculinity, depression, anxiety and psychological implications related to sexual functioning. Psychological impact varies on an individual basis and is influenced by the quality of a patient’s experience during and after treatment in relation to sufficient information giving and support.Findings:Open communication should be encouraged by healthcare professionals to assess patient mental wellbeing. The extent of psychological impact varies on an individual basis; however, there are predictive factors that can make an individual more at risk of being affected psychologically post-PC treatment.

Aim: This critical review of the literature seeks to understand the psychological impact that treatment interventions may have on prostate cancer (PC) survivors. Materials and Methods: A literature search was conducted using databases of peer-reviewed literature. The search terms used were devised using the building-blocks technique to divide the query into facets. The articles were manually assessed for relevance and appraised using the relevant Critical Appraisal Skills Programme (CASP) tool. Government guidelines and regulations were also used following a manual search on the National Institute for Health and Care Excellence (NICE) website. This process resulted in a total of 12 sources being included in the critical review. Results: The key themes that arose from the review were masculinity, depression, anxiety and psychological implications related to sexual functioning. Psychological impact varies on an individual basis and is influenced by the quality of a patient's experience during and after treatment in relation to sufficient information giving and support. Findings: Open communication should be encouraged by healthcare professionals to assess patient mental wellbeing. The extent of psychological impact varies on an individual basis; however, there are predictive factors that can make an individual more at risk of being affected psychologically post-PC treatment.

Coronary revascularisationSurgery is effective on clinical and economic grounds, but stenting does not seem to be cost effective This week, the BMJ publishes three studies dealing with revascularisation in ischaemic...

The TREAD Evidence-Based Practice Model is a framework for faculty to use in graduate research courses so students can become excellent consumers of the best available evidence to use in their clinical decision making in the practice setting. This model is based on competency in information literacy as the basis for developing evidence-based search strategies to find, appraise, and synthesize Level I evidence, including systematic reviews, meta-analyses, and evidence-based practice guidelines. This model emphasizes the use of standardized critical appraisal tools, such as the Critical Appraisal Skills Programme (CASP) or Appraisal of Guidelines for Research and Evaluation (AGREE), to facilitate user-friendly rapid appraisal of Level I evidence. Faculty are challenged to embrace this paradigm shift, to unlearn how they learned, and to teach their graduate research course focusing on the importance of Level I evidence to enable their graduates to make informed advanced practice decisions and improve patient outcomes.

Traumatic brain injury (TBI) is the most significant cause of death and severe disability following major trauma within Australia. Populations at risk include young adults aged 15 to 34, older adults, and military personnel. The main form of intervention following traumatic brain injury is rehabilitation, which places a large demand on the healthcare system. Telerehabilitation involves interventions delivered via telecommunication, which can improve accessibility and reduce this burden. There have been no systematic reviews conducted on the effectiveness of telerehabilitation in treating traumatic brain injury. Purpose: To examine the effectiveness of telerehabilitation for adults with traumatic brain injury. Methods: A systematic search of Medline, Embase, the Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, The Cochrane Library, OTSeeker and Google Scholar was conducted. Studies were included with participants aged 18 to 64 with traumatic brain injury and receiving telerehabilitation interventions. Methodological quality was assessed using the critical appraisal tools: Critical Appraisal Skills Programme (CASP) checklist for randomised controlled trials, and McMaster Critical Review for Quantitative Studies for non-randomised studies. Results: Three randomised controlled trials, one pseudo-randomised controlled trial, one case-control trial and one pre-post case series were included in this systematic review. Critical appraisal of the included studies revealed overall methodological quality to be moderate. A range of interventions with differing parameters were used as part of telerehabilitation. Collectively, there is some consistent evidence to indicate that telerehabilitation may be equally effective as other forms of care in the delivery of cognitive and psychological interventions, in addressing memory and depressive symptoms for adults with mild to severe traumatic brain injury. However, it is unclear if it is superior to other forms of care. Conclusions: A small number of studies have investigated the effect of telerehabilitation for adults with traumatic brain injury. The current evidence base is limited due to lack of standardised intervention parameters, outcomes measures and robust sample size. Despite these limitations, telerehabilitation may offer a complementary model of care for adults with traumatic brain injury, especially in instances where traditional models of care may not be readily accessible (such as those in rural and remote areas).

The National electronic Library for Health (NeLH) is now taking shape, as the virtual branch libraries begin to accumulate 'books', among their resources. In the Primary Care branch (http://www.nelh-pc.nhs.uk), one of the first available books was the Statement of Fees and Allowances (otherwise known as the Red Book). While being held up as an example of what the NeLH can offer, this book and the story of its transformation from paper to Internet format is a powerful example of how much further the National Health Service (NHS) must go before it can claim to be fully exploiting the benefits of information technology (IT). This article refers to the author's experience in producing electronic books for primary care using WaX software, and an example of a process change from paper to screen that was managed within a university administrative office. The author suggests that to reap optimal benefits from IT, the NeLH and its collaborators must address the fundamental issues of people and the paper-based processes used by information providers. The NeLH must work with both NHS IT trainers and information providers in a three-way collaboration involving key people and processes, to achieve the efficient production of an updateable and user-friendly library of electronic books.

Using critically appraised topics to inform nursing practice in DVT prevention using graduated compression stockings

The digital age has reached early childhood, and the use of touch screens by young children is common place. Research on the use of touch screen tablets with young children is becoming more prevalent; however, less information is available on the use of touch screen tablets to support young children with disabilities. Touch screen tablets may offer possibilities to preschool children with disabilities to participate in learning in a digital way. The iPad provides easy interaction on the touch screen and access to a multitude of engaging early learning applications. This paper summarizes a pilot study with 8 young children with disabilities included in a preschool classroom, who were given iPads to use in class and at home for a period of 21 weeks. Systematic observations, classroom assessments, and teacher and parent interviews documented the improvements in learning outcomes for each child in many areas including, but not limited to: shape and color recognition, letter recognition, and tracing letters throughout six research cycles.

Touch screens are increasingly prevalent, and anecdotal evidence suggests that young children are very drawn towards them. Yet there is little data regarding how young children use them. A brief online questionnaire queried over 450 French parents of infants between the ages of 5 and 40 months on their young child’s use of touch-screen technology. Parents estimated frequency of use, and further completed several checklists. Results suggest that, among respondent families, the use of touch screens is widespread in early childhood, meaning that most children have some exposure to touch screens. Among child users, certain activities are more frequently reported to be liked than others, findings that we discuss in light of current concern for children’s employment of time and the cognitive effects of passive media exposure. Additionally, these parental reports point to clear developmental trends for certain types of interactive gestures. These results contribute to the investigation of touch screen use on early development and suggest a number of considerations that should help improve the design of applications geared towards toddlers, particularly for scientific purposes.

There is an increasing international interest in patient and public involvement (PPI) in research, yet relatively little robust evidence exists about its impact on health and social care research. To identify the impact of patient and public involvement on health and social care research. A systematic search of electronic databases and health libraries was undertaken from 1995 to 2009. Data were extracted and quality assessed utilizing the guidelines of the NHS Centre for Reviews and Dissemination 2009 and the Critical Appraisal Skills Programme (CASP). Grey literature was assessed using the Dixon-Woods etal. (2005) checklist. All study types that reported the impact PPI had on the health and/or social care research study. A total of 66 studies reporting the impact of PPI on health and social care research were included. The positive impacts identified enhanced the quality and appropriateness of research. Impacts were reported for all stages of research, including the development of user-focused research objectives, development of user-relevant research questions, development of user-friendly information, questionnaires and interview schedules, more appropriate recruitment strategies for studies, consumer-focused interpretation of data and enhanced implementation and dissemination of study results. Some challenging impacts were also identified. This study provides the first international evidence of PPI impact that has emerged at all key stages of the research process. However, much of the evidence base concerning impact remains weak and needs significant enhancement in the next decade.

Background: Caring for a child with long-term functional limitations can have a negative impact on the physical and psychological well-being of the caregiver. Family-centered care (FCC) interventions have the potential to empower caregivers and contribute to their well-being. This systematic review aimed to synthesize existing evidence on the effectiveness of FCC interventions in improving the well-being of caregivers of children with cerebral palsy (CP), and identify the key components of such interventions that are most commonly practiced and deemed effective. Methods: This review systematically searched seven databases for randomized controlled trials that evaluated the effectiveness of any FCC intervention on the well-being of caregivers of children with or at risk of CP. We used the Cochrane RoB 2.0 tool to assess risk of bias and Critical Appraisal Skills Programme (CASP) checklist for critical appraisal. Due to high heterogeneity of studies, narrative synthesis was used to summarize the data. Results: The review consists of 11 studies which were categorized into five sections based on the components of FCC intervention provided in each individual study: 1. Information provision, and Enabling and partnership (n= 5); 2. Information provision, and Respectful and supportive care (n= 1); 3. Enabling and partnership (n= 2); 4. Enabling and partnership, and Respectful and supportive care (n= 2); 5. Information provision, Enabling and partnership and Respectful and supportive care (n= 1). Risk of bias was low in four studies, unclear in two studies, and high in five studies. Conclusion: FCC interventions were found to be effective in improving caregivers’ satisfaction with attainment of child and caregiver goals. Evidence from multiple studies does not strongly support the effectiveness of FCC interventions on caregiver’s mental health, parenting and personal outcomes. Limited evidence precludes a conclusion on the effectiveness of the components of FCC on well-being of caregivers of children with CP.

Summary The growing number of doctoral graduates in nursing management, together with more focus on qualitative studies, has contributed to the development of qualitative studies. This study aimed to provide a critical appraisal of qualitative research papers in the field of nursing management by Iranian authors, published in national and international journals. In a cross-sectional study, international and Persian electronic databases were used for a systematic search of the relevant literature using the keywords: qualitative studies, nursing management, and Iran. Criteria provided by the Critical Appraisal Skills Program (CASP) for the qualitative studies checklist was used for quality appraisal of the included studies. Of the 22 qualitative studies appraised, 48% had used grounded theory and 22% had adopted the research method of content analysis. The mean score for ethical consideration was 1.66 out of 4. The mean scores for rigor and research credibility were 5.123 out of 9 and 1.66 out of 4, respectively. In terms of research purpose and methodology, mean scores were 3.33 out of 4 and 2.22 out of 3, respectively. Quality of research design obtained the mean score of 2.66 out of 6 and the score for method of data collection was 4.44 out of 7. Results showed that quality of the published qualitative studies in the field of nursing management by Iranian authors seemed not appropriate and the most significant weakness was related to the partial compliance with ethical principles.

PurposeFunctional neurological disorders are common, highly stigmatised and associated with significant disability. A systematic review of the experiences of people with functional seizures described negative interactions with healthcare professionals and...