The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.

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Cochrane Handbook for Systematic Reviews of Interventions

/pdf/cochrane-handbook-for-systematic-reviews-of-interventions-1xbdy6uvru.pdf

The present historical moment may seem a particularly inopportune time to review Bowling Alone, Robert Putnam's latest exploration of civic decline in America. After all, the outpouring of volunteerism, solidarity, patriotism, and self-sacrifice displayed by Americans in the wake of the September 11 terrorist attacks appears to fly in the face of Putnam's central argument: that \"social capital\" -defined as \"social networks and the norms of reciprocity and trustworthiness that arise from them\" (p. 19)'has declined to dangerously low levels in America over the last three decades. However, Putnam is not fazed in the least by the recent effusion of solidarity. Quite the contrary, he sees in it the potential to \"reverse what has been a 30to 40-year steady decline in most measures of connectedness or community.\"' As an example of how the current \"war on terrorism\" could generate a durable civic renewal, Putnam points to the burst in civic practices that occurred during and after World War II, which he says \"permanently marked\" the generation that lived through it and had a \"terrific effect on American public life over the last half-century.\" 3 If Americans can follow this example and channel their current civic

Bowling alone: The collapse and revival of American community

Riedel DJ, Gonzalez-Cuyar LF, Zhao XF, Redfi eld RR, Gilliam BL. Plasmablastic lymphoma of the oral cavity: a rapidly progressive lymphoma associated with HIV infection. Lancet Infect Dis 2008; 8: 261–67. In this Grand Round, the references for the sentence “Occasionally, CD138-negative plasmablastic lymphoma cases (such as this case) have been reported” (page 265) should be 32, 34, and 38. Book Systematic reviews: CRD’s guidance for undertaking reviews in health care

/pdf/systematic-reviews-crd-s-guidance-for-undertaking-reviews-in-4hcrkbrbv4.pdf

Systematic reviews: CRD's guidance for undertaking reviews in health care

Inadequate generation of the allocation sequence, allocation concealment, and double blinding lead to exaggerated estimates of intervention benefit and may contribute to discrepancies between the r...

Reported Methodologic Quality and Discrepancies between Large and Small Randomized Trials in Meta-Analyses

This paper summarises the research evidence presented in a recent issue of Effective Health Care on drug treatments for schizophrenia.1

Schizophrenia is an illness or a group of illnesses affecting language, planning, emotion, perceptions, and movement. In the UK, approximately 250 000 people suffer from schizophrenia or a schizophrenia-like illness.2

A quarter of those who have experienced an episode of schizophrenia recover and the illness does not recur. Another 25% experience an unremitting illness. The remaining 50% have a recurrent illness, but with long episodes of considerable recovery from positive symptoms such as delusions, hallucinations, disordered thinking, and catatonic movements.3 Many with recurrent illness have enduring problems from schizophrenia such as persistent psychotic symptoms, but, for most people, the problems consist of negative symptoms such as loss of enthusiasm and emotional responsiveness, apathy, and social withdrawal.3 These negative symptoms, though intrinsic to schizophrenia, are compounded by the adverse effects of drugs, living in impoverished circumstances, and by the social stigma associated with mental illness. Recovery from episodes of schizophrenia for some people is often complicated by episodes of depression, substance abuse, and anxiety. People with schizophrenia have a shortened life expectancy4 due to physical illness, accidents, and other causes of violent death, especially suicide.5

Treatments for schizophrenia are divided into the so-called “physical interventions” of drugs, psychological and social managements and, rarely in the UK, electroconvulsant treatment. This article draws upon evidence from systematic reviews undertaken by the Cochrane Schizophrenia Group, and summarises the evidence on the effectiveness of the main drugs used in the treatment of schizophrenia. More detailed information is available on each treatment within the referenced reviews. These reviews are regularly updated in the Cochrane Library .6

The main class of drugs used to treat or manage schizophrenia is antipsychotics …

https://qualitysafety.bmj.com/content/qhc/9/1/73.full.pdf

Drug treatments for schizophrenia

Peer interventions involving prisoners in delivering peer education and peer support in a prison setting can address health need and add capacity for health services operating in this setting. This paper reports on a qualitative synthesis conducted as part of a systematic review of prison-based peer interventions. One of the review questions aimed to investigate the positive and negative impacts of delivering peer interventions within prison settings. This covered organisational and process issues relating to peer interventions, including prisoner and staff views. A qualitative synthesis of qualitative and mixed method studies was undertaken. The overall study design comprised a systematic review involving searching, study selection, data extraction and validity assessment. Studies reporting interventions with prisoners or ex-prisoners delivering education or support to prisoners resident in any type of prison or young offender institution, all ages, male and female, were included. A thematic synthesis was undertaken with a subset of studies reporting qualitative data (n = 33). This involved free coding of text reporting qualitative findings to develop a set of codes, which were then grouped into thematic categories and mapped back to the review question. Themes on process issues and wider impacts were grouped into four thematic categories: peer recruitment training and support; organisational support; prisoner relationships; prison life. There was consistent qualitative evidence on the need for organisational support within the prison to ensure smooth implementation and on managing security risks when prisoners were involved in service delivery. A suite of factors affecting the delivery of peer interventions and the wider organisation of prison life were identified. Alongside reported benefits of peer delivery, some reasons for non-utilisation of services by other prisoners were found. There was weak qualitative evidence on wider impacts on the prison system, including better communication between staff and prisoners. Gaps in evidence were identified. The quality of included studies limited the strength of the conclusions. The main conclusion is that peer interventions cannot be seen as independent of prison life and health services need to work in partnership with prison services to deliver peer interventions. More research is needed on long-term impacts. PROSPERO ref: CRD42012002349
 .

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A qualitative synthesis of the positive and negative impacts related to delivery of peer-based health interventions in prison settings

A shared sense of purpose drives successful multisector collaboration – lessons from the COVID-19 pandemic

Objectives To examine four key areas: (1) the effectiveness and cost-effectiveness of spinal fixation surgery, (2) the consequences of immediate versus delayed referral to a spinal injuries unit (SIU), (3) the number of people with a new spinal cord injury (SCI) who are discharged from hospital without ever being transferred to an SIU, and (4) the effectiveness and cost-effectiveness of steroids for people with SCI Data sources Searches were carried out on several databases and also on the Internet Specialist SCI and spinal injury related websites were searched, specifically the Spinal Injuries Association, the British Association of Spinal Cord Injury Specialists and the National Spinal Cord Injury Association Review methods Three separate search strategies were devised to find studies relating to the four key areas Two reviewers independently screened all study citations for inclusion The lists of all retrieved studies were scanned for additional studies Quality of studies was assessed and data were extracted by one reviewer then checked by the second Data from included studies were summarised within each key area For dichotomous data, relative risks were calculated with 95% confidence intervals Pooled relative risks were calculated as appropriate For continuous data, mean differences with 95% confidence intervals were calculated and, if data were pooled, weighted mean differences were calculated Searches were carried out to identify economic evaluations, details of these together with a critical appraisal of quality are presented in structured tables Quality was assessed using a checklist supplemented with additional comments on the adequacy of methodology where appropriate Results For spinal fixation versus no fixation, 68 retrospective observational studies were found that suggested some benefits of fixation surgery Only four studies were found on fixation surgery in SIUs compared with non-SIU hospitals and no significant differences were seen All 28 studies concerning delayed referral to a SIU were retrospective observational studies In most, study details were poorly reported and there was doubt over the comparability of groups at baseline and on confounding factors Times of referral and transfer were not reported separately Evidence suggested an effect in favour of the SIU group for neurological improvement No relevant published studies of any design were found regarding how many people with a new SCI are discharged from hospital without ever being transferred to an SIU Two systematic reviews were found that assessed the effectiveness of steroids No studies were identified that considered both costs and the impact on patient outcomes of a given intervention Conclusions Although there was evidence to suggest some benefits of fixation surgery and also a benefit of immediate referral to SIUs compared with delayed or no referral, owing to the limitations of the data these should be interpreted with caution Not enough data were found to assess whether surgery is more beneficial when carried out in SIUs and further research is required in this area Well-designed prospective observational studies with appropriately matched controls are needed High-dose methylprednisolone steroid therapy may be effective in promoting some degree of neurological recovery if given within 8 hours of injury There is a need for more randomised controlled trials (RCTs) of pharmacological therapy for acute SCI No published studies of any design were found to answer the question of how many people with acute SCI are discharged from hospital without ever being transferred to an SIU Primary research involving audit of selected hospital records should be commissioned and published The search strategy did not identify any full economic evaluations Future research should include full economic evaluations, possibly alongside a large RCT, which fully consider the costs and consequences of implementing interventions

Effectiveness and cost-effectiveness of acute hospital-based spinal cord injuries services: systematic review

ABSTRACT Objectives Depression and cognitive impairment are disabling conditions that commonly occur together in older adults. The interaction is challenging when choosing appropriate measurement scales. This review aimed to summarize the scales to measure depression symptoms in older people with cognitive impairment, investigating how cognitive impairment is related to the choice of measurement, and how the setting may affect the choice of measurement. Methods A scoping review of literature published between 2015 and 2021. Results After screening 1580 articles, 26 were included in the review with 11 different measures of depression symptoms identified. The measures mostly commonly used were the Geriatric Depression Scale (GDS), Cornell Scale for Depression in Dementia (CSDD) and the Neuropsychiatric Inventory (NPI-Q). Most studies did not report on the usability of depression scales used with people with cognitive impairment and only two scales (CSDD and NPI-Q, not GDS) have been validated for use with this population. Conclusions Severe cognitive impairment was under-represented in the identified studies, and no association was detected between study setting, cognitive impairment and type of measure used. Clinical Implications Clinicians and researchers should consider both the cognitive status of participants and the setting they live in when choosing a measure of depression symptoms.

A Scoping Review of the Measurement of Depression in Older Adults with Cognitive Impairment

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