Yes / Purpose: We systematically reviewed the literature to investigate when refraction is stable following routine cataract surgery implanting monofocal intraocular lenses. Current advice recommends obtaining new spectacles 4–6 weeks following surgery. Due to advancements in surgical techniques, we hypothesised that refractive stability would be achieved earlier, which could have major short-term improvements in quality of life for patients. Methods: Medline, CINAHL, AMED, Embase, Web of Science and the Cochrane Library were searched with key words chosen to find articles, which assessed refraction following uncomplicated cataract surgery. Citation chains and the reference lists of all included papers were searched. Unpublished literature was identified using OpenGrey (www.opengrey.eu). The review considered studies that measured refraction at regular intervals following surgery until stability was achieved. Results: The search identified 6,680 papers. Two reviewers independently screened the abstracts and nine papers were found to fit the criteria, of which five were included in the meta-analysis. The quality of the papers was evaluated using the Methodological Index for Non-Randomised Studies (MINORS) instrument. Meta-analysis of 301 patients’ data of spherical, cylindrical and spherical equivalent correction were performed using Review Manager 5 (RevMan 5.3) (https://revman.cochrane.org/). Refraction at 1-week versus the gold standard of 4-weeks showed no significant difference for sphere data (effect size and 95% confidence interval of; ES = 0.00, 95% CI: −0.17, 0.17; p = 1.00), cylindrical data (ES = +0.06; 95% CI: −0.05, 0.17; p = 0.31), and spherical equivalent (ES = −0.01; 95% CI: −0.12, 0.10; p = 0.90). Heterogeneity was non-significant (I2

Yes / Implementation and uptake of novel and cost-effective medicines can improve patient health outcomes and healthcare efficiency. However, the uptake of new medicines into practice faces a wide range of obstacles. Earlier reviews provided insights into determinants for new medicine uptake (such as medicine, prescriber, patient, organization, and external environment factors). However, the methodological approaches used had limitations (e.g., single author, narrative review, narrow search, no quality assessment of reviewed evidence). This systematic review aims to identify barriers and facilitators affecting the uptake of new medicines into clinical practice and identify areas for future research. A systematic search of literature was undertaken within seven databases: Medline, EMBASE, Web of Science, CINAHL, Cochrane Library, SCOPUS, and PsychINFO. Included in the review were qualitative, quantitative, and mixed-methods studies focused on adult participants (18 years and older) requiring or taking new medicine(s) for any condition, in the context of healthcare organizations and which identified factors affecting the uptake of new medicines. The methodological quality was assessed using QATSDD tool. A narrative synthesis of reported factors was conducted using framework analysis and a conceptual framework was utilised to group them. A total of 66 studies were included. Most studies (n = 62) were quantitative and used secondary data (n = 46) from various databases, e.g., insurance databases. The identified factors had a varied impact on the uptake of the different studied new medicines. Differently from earlier reviews, patient factors (patient education, engagement with treatment, therapy preferences), cost of new medicine, reimbursement and formulary conditions, and guidelines were suggested to influence the uptake. Also, the review highlighted that health economics, wider organizational factors, and underlying behaviours of adopters were not or under explored. This systematic review has identified a broad range of factors affecting the uptake of new medicines within healthcare organizations, which were grouped into patient, prescriber, medicine, organizational, and external environment factors. This systematic review also identifies additional factors affecting new medicine use not reported in earlier reviews, which included patient influence and education level, cost of new medicines, formulary and reimbursement restrictions, and guidelines. PROSPERO database (CRD42018108536). / This work presents research funded by the Pharmacy Research UK (grant reference: PRUK-2018-GA-1-KM) and Leeds Teaching Hospitals NHS Trust.

Yes / Falls are the most common safety incident reported by acute hospitals. In England national guidance recommends delivery of a multifactorial falls risk assessment (MFRA) and interventions tailored to address individual falls risk factors. However, there is variation in how these practices are implemented. This study aimed to explore the variation by examining what supports or constrains delivery of MFRAs and tailored interventions in acute hospitals. A realist review of literature was conducted with searches completed in three stages: (1) to construct hypotheses in the form of Context, Mechanism, Outcome configurations (CMOc) about how MFRAs and interventions are delivered, (2) to scope the breadth and depth of evidence available in Embase to test the CMOcs, and (3) following prioritisation of CMOcs, to refine search strategies for use in multiple databases. Citations were managed in EndNote; titles, abstracts, and full texts were screened, with 10% independently screened by two reviewers. Two CMOcs were prioritised for testing labelled: Facilitation via MFRA tools, and Patient Participation in interventions. Analysis indicated that MFRA tools can prompt action, but the number and type of falls risk factors included in tools differ across organisations leading to variation in practice. Furthermore, the extent to which tools work as prompts is influenced by complex ward conditions such as changes in patient condition, bed swaps, and availability of falls prevention interventions. Patient participation in falls prevention interventions is more likely where patient directed messaging takes individual circumstances into account, e.g., not wanting to disturb nurses by using the call bell. However, interactions that elicit individual circumstances can be resource intensive and patients with cognitive impairment may not be able to participate despite appropriately directed messaging. Organisations should consider how tools can be developed in ways that better support consistent and comprehensive identification of patients' individual falls risk factors and the complex ward conditions that can disrupt how tools work as facilitators. Ward staff should be supported to deliver patient directed messaging that is informed by their individual circumstances to encourage participation in falls prevention interventions, where appropriate. PROSPERO: CRD42020184458. / This research is funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research (HSDR) Programme (project number NIHR129488).

This study serves to collate and evaluate measures of self-directed learning (SDL), with the goal of guiding the measurement and discussion of SDL. Used in a variety of settings, many applications of SDL have been proposed, but a consistent definition has yet to be formulated. Despite the lack of a cohesive definition, several tools exist to measure SDL. Within this study, which implemented the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) protocols, 157 articles were analyzed for content and themes were identified. An important finding of this study was a definite lack of cohesion in application and understanding of SDL as a framework. While some regard it as a stand-alone learning intervention, others address it as a personality trait. Close examination of the instruments used to measure SDL led to the conclusion that it is both inappropriate and ineffective to continue using, as they broadly lack construct validity and generalizability. Limitations of this study are single subject research, number studies available within databases used, and lack of raw data from studies covered. Future research surrounding the conceptual framework and instrumentation is indicated to further develop the field's understanding of SDL's value and implications.

In the ongoing discussion of treatment efficacy, some researchers have argued for the use of evidence from randomized controlled trials while others have argued the case for the use of non-randomized designs (Ingham 2003) in the study of the treatment of stuttering. Few attempts have been made to integrate findings from the research on stuttering intervention {Andrews, et al.1980; Howard, Nye, & Vanryckegbem, 2005; Herder, Howard, Nye & Vanryckeghem 2006; Thomas and Howell, 2001). Since the usual approach to the study of treatment efficacy uses experimental and quasi-experimental sources, a summary of the data available from single subject design {SSD) studies would seem warranted. The purpose of this project was to conduct a systematic review and meta-analysis of the effectiveness of stuttering treatment for children and adults by summarizing studies and determining an overall effect by calculating the percentage of non-overlapping data points (PND). The resulting review provides a summary of the effects of stuttering treatment, the nature of the treatment program characteristics and their associated effectiveness, and a general mapping of the research landscape in stuttering treatment terms of its' strengths and weaknesses and areas of need for future research.

Multiple sclerosis is a commonly diagnosed neurological disease that currently has no cure. Due to the significant physical and emotional impact that this disease has on the course of life, depressive symptoms frequently occurs among its sufferers. Many interventions have been developed and studied in an effort to reduce the depressive symptoms without the use of traditional antidepressant medications. This integrated literature review examines empirical evidence regarding non-pharmacologic interventions for depression published between 2003 and 2008. Cognitive behavioral therapy, complementary therapy, and support interventions were examined. Although no single intervention was shown to completely alleviate depressive symptoms, most interventions had a favorable impact.

Yes / Background: medication-related problems occur frequently when older patients are discharged from hospital. Interventions to support medication use have been developed; however, their effectiveness in older populations are unknown. This review evaluates interventions that support successful transitions of care through enhanced medication continuity. Methods: a database search for randomised controlled trials was conducted. Selection criteria included mean participant age of 65 years and older, intervention delivered during hospital stay or following recent discharge and including activities that support medication continuity. Primary outcome of interest was hospital readmission. Secondary outcomes related to the safe use of medication and quality of life. Outcomes were pooled by random-effects meta-analysis where possible. Results: twenty-four studies (total participants=17,664) describing activities delivered at multiple time points were included. Interventions that bridged the transition for up to 90 days were more likely to support successful transitions. The meta-analysis, stratified by intervention component, demonstrated that self-management activities (RR 0.81 [0.74, 0.89]), telephone followup (RR 0.84 [0.73, 0.97]) and medication reconciliation (RR 0.88 [0.81, 0.96]) were statistically associated with reduced hospital readmissions. Conclusion: our results suggest that interventions that best support older patients’ medication continuity are those that bridge transitions; these also have the greatest impact on reducing hospital readmission. Interventions that included self management, telephone follow-up and medication reconciliation activities were most likely to be effective; however, further research needs to identify how to meaningfully engage with patients and caregivers to best support post-discharge medication continuity. Limitations included high subjectivity of intervention coding, study heterogeneity and resource restrictions. / National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant PB-PG-0317-20010).

The purpose of the investigation is to examine relevant material on current trends of teaching literature to the adolescent, as revealed in reported practices of classroom teachers throughout the United States. A compilation of these procedures appears to present a picture of what is being done in the field of literature on the upper-elementary-grade level in various sections of the country.

No description available.

published_or_final_version / Education / Master / Master of Education