BackgroundThe growing number of sport-based youth development interventions provide a potential avenue for integrating sport meaningfully into the U.S. public health agenda. However, efficacy and quality must be reliably established prior to widespread implementation.MethodsA comprehensive search of databases, peer-reviewed journals, published reviews, and both published and unpublished documents yielded 10,077 distinct records. Title and abstract screening, followed by full-text screening using 6 criteria, resulted in 56 distinct studies (coalescing into 10 sport-based youth development intervention types) included in the synthesis. These studies were then independently assessed and critically appraised.ResultsLimited efficacy data were identified, with the quality of methods and evidence largely classified as weak. Processes likely to contribute to the outcomes of sport-based youth development interventions were identified (e.g., predictors of ongoing engagement, alignment between target population and intervention, intervention design), although more rigorous research is needed on these and other processes. Physical health outcomes were only studied in 3 of the 10 intervention types.ConclusionsThe evidence base does not yet warrant wide-scale implementation of sport-based youth development interventions for public health goals within the U. S., although there is promising research that identifies areas for further exploration.Electronic supplementary materialThe online version of this article (10.1186/s12889-019-6387-z) contains supplementary material, which is available to authorized users.

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Background: Overuse of head computed tomography (CT) for syncope has been reported. However, there is no literature synthesis on this overuse. We undertook a systematic review to determine the use and yield of head CT and risk factors for serious intracranial conditions among syncope patients. Methods:We searched Embase, Medline, and Cochrane databases from inception until June 2017. Studies including adult syncope patients with part or all of patients undergoing CT head were included. We excluded case reports, reviews, letters, and pediatric studies. Two independent reviewers screened the articles and collected data on CT head use, diagnostic yield (proportion with acute hemorrhage, tumors or infarct), and risk of bias. We report pooled percentages, I 2 , and Cochran's Q-test.Results: Seventeen articles with 3,361 syncope patients were included. In eight ED studies (n = 1,669), 54.4% (95% confidence interval [CI] = 34.9%-73.2%) received head CT with a 3.8% (95% CI = 2.6%-5.1%) diagnostic yield and considerable heterogeneity. In six in-hospital studies (n = 1,289), 44.8% (95% CI = 26.4%-64.1%) received head CT with a 1.2% (95% CI = 0.5%-2.2%) yield and no heterogeneity. In two articles, all patients had CT (yield 2.3%) and the third enrolled patients ≥ 65 years old (yield 7.7%). Abnormal neurologic findings, age ≥ 65 years, trauma, warfarin use, and seizure/stroke history were identified as risk factors. The quality of all articles referenced was strong.Conclusion: More than half of patients with syncope underwent CT head with a diagnostic yield of 1.1% to 3.8%. A future large prospective study is needed to develop a robust risk tool. S yncope is defined as a sudden and brief loss of consciousness (LOC) due to transient global cerebral hypoperfusion, followed by spontaneous and complete recovery. 1 It accounts for 1% to 3% of emergency department (ED) visits. 1-4 Among ED patients with syncope, 7% to 23% will have serious underlying conditions identified either in the ED or within 30 days of their index visit. 5-8 Previous studies have reported 2.3% to 4.4% incidence of serious intracranial conditions (subarachnoid hemorrhage, subdural hematoma, space-occupying lesion, or intraparenchymal infarct or hemorrhage) among

The severity of pain and the desire for improved function are strong drivers for patients deciding to undergo elective amputation of a functionally impaired lower extremity. While patients do not want others' opinions, information regarding life with an amputation helps to set realistic expectations regarding outcome.

Background:As part of a health sciences library’s internal assessment of its research support services, an environmental scan and literature review were conducted to identify research services offered elsewhere in Canada. Through this process, it became clear that a more formal review of the academic literature would help libraries make informed decisions about their services. To address this gap, we conducted a scoping review of research services provided in health sciences libraries contexts.Methods:Searches were conducted in Medline, Embase, ERIC, CINAHL, LISTA, LISS, Scopus, Web of Science, Google Scholar and Google for articles which described the development, implementation, or evaluation of one or more research support initiatives in a health sciences library context. We identified additional articles by searching reference lists of included studies and soliciting medical library listservs.Results:Our database searches retrieved 7134 records, 4026 after duplicates were removed. Title/abstract screening excluded 3751, with 333 records retained for full-text screening. Seventy-five records were included, reporting on 74 different initiatives. Included studies were published between 1990 and 2017, the majority from North American and academic library contexts. Major service areas reported were the creation of new research support positions, and support services for systematic review support, grants, data management, open access and repositories.Conclusion:This scoping review is the first review to our knowledge to map research support services in the health sciences library context. It identified main areas of research service support provided by health sciences libraries that can be used for benchmarking or information gathering purposes.

Introduction: Syncope accounts for 1-3% of Emergency Department (ED) visits. Previous studies have reported overuse of computed tomography (CT) of the head among syncope patients. Professional organizations including Choosing Wisely have recommended against its use in the absence of high-risk features. However, a review of CT head use among syncope patients and its diagnostic yield has not been previously reported. Methods: We conducted a systematic review using EMBASE, Medline, and Cochrane databases from inception to August 2016. We included studies involving adult syncope patients that reported CT head use and its diagnostic yield during acute management by a two-step process: first title/abstract review and then full-text review of selected articles. We excluded case reports, narrative reviews and those involving children. We collected the proportion of patients who had CT head performed, and its diagnostic yield. Outcomes included identification of acute intracranial conditions (hemorrhage, mass or infarct) that require further management. Two reviewers independently abstracted the data and discrepancies were resolved by consensus. We calculated inter-observer reliability for inclusion in the systematic review using kappa values. We performed meta-analysis for diagnostic yield of the CT head. Results: Fifteen studies with 2,802 syncope patients in four sub-groups (proportion of patients among whom CT head was performed and its yield in ED and inpatient settings; studies that reported only the yield among those with CT head performed; and the use and yield among syncope patients ≥65 years old) were included. The inter-observer agreement for inclusion of final articles for meta-analysis was κ=0.925 [95% CI: 0.861-0.990]. Seven ED studies (n=1,261) reported 55.7% patients (95% CI: 32.1-78.0%) had head CT performed with a yield of 4.0% (95% CI: 2.7-5.6%); 5 studies with 1138 hospitalized patients reported that 38.6% (95% CI: 20.4-58.6%) had head CT with a yield of 1.1% (95% CI: 0.4-2.2%). The yield among studies that report only outcomes for CT head was 2.3% and the yield among patients’ ≥65 years was 7.7%. Conclusion: Our review found that a very high proportion of syncope patients had CT head performed during acute management with a very low diagnostic yield. The yield is higher among patients ≥65 years old. A robust tool to identify patients who require a CT head will reduce unnecessary testing.

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