Although prevalence and incidence figures for pressure ulcers vary widely across health-care settings, common trends can be identified. This review examines data from three countries.
The prevalence of pressure ulcers has remained constant at about 7% over the past 20 years, even though considerable time and money has been invested in various prevention strategies. This literature review explores whether pressure-prevention programmes can reduce the prevalence rate still lower or whether they are working but are limited by an increasingly aged population and rising patient acuity.
In 2015, Aotearoa New Zealand became a signatory to the Sendai Framework for Disaster Risk Reduction 2015-2030, the Paris Climate Change Agreement (Paris Agreement), and the Sustainable Development Goals (SDGs). Since 2017 Aotearoa New Zealand has been undergoing governance reform to realign priorities and to improve the management of natural hazards and climate change. The aim of this article is to provide a review of how Aotearoa New Zealand is taking steps to improve consistency of planning across the legislative environment, thereby implementing its commitments to the Sendai Framework, the SDGs, and the Paris Agreement. It provides an overview of the national governance arrangements, with a focus on the key legislative tools; identifies how key terms are defined nationally; and provides an overview of the governance arrangements that contribute to the country's international obligations. The discussion describes how obligations are applied, and considers two ''disruptive and proactive'' action examples. Four recommended actions are provided to further implement these international aspirations: (1) take into account these international agreements during the development and implementation of all legislation; (2) build awareness, capability, and capacity within central, regional, and local governments to support implementation; (3) actively evaluate the progress of implementing initiatives designed to reduce vulnerability and strengthen resilience; and (4) ensure that more weight and value are given to indigenous planning documents.
Objectives: No guidelines exist in the approach that Evidence Review Groups (ERGs) should take to appraise search methodologies in the manufacturer's submission (MS) in Single Technology Appraisals (STA). As a result, ERGs are left to appraise searches using their own approach. This study investigates the limitations of manufacturers' search methodologies as critiqued by ERGs in published STA reports and to provide a recommended checklist.Methods: Limitations from search critiques in 83 ERG reports published in the NIHR Web site between 2006 and May 2011 were extracted. The limitations were grouped into themes. Comparisons were made between limitations reported in the clinical effectiveness versus cost-effectiveness searches.Results: Twelve themes were identified, six relating to the search strategy, source, limits, filters, translation, reporting, and missing studies. The search strategy theme contained the most limitations. Missing studies were frequently found by the ERG group in the clinical effectiveness searches. The omission of searches by manufacturers for unpublished and ongoing trials was frequently reported by the ERG. By contrast, failure of the manufacturer to report strategies was the most common limitation in the cost-effectiveness searches. Themes with the most frequent limitations in both types of searches are search strategy, reporting and source.Conclusions: It is recommended that a checklist that has reporting, source and search strategy elements be used in the appraisal of manufacturer's searches during the STA process.
BackgroundPeople living with long-term neurological conditions (LTNC) often require palliative care. Rehabilitation medicine specialists often coordinate the long-term care of these patients.ObjectiveThe aim of the present review was to undertake systematic literature searches to identify the evidence on palliative care for people with LTNC to guide rehabilitation medicine specialists caring for these patients in the UK.MethodsWe searched for evidence for (1) discussion of end of life, (2) planning for end-of-life care, (3) brief specialist palliative care interventions, (4) support for family and carers, (5) training of rehabilitation medicine specialists in palliative care, and (6) commissioning of services. The databases searched were MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database and Health Technology Assessment Database. Evidence was assimilated using a simplified version of the Grading of Recommendations Assessment, Development and Evaluation method.ResultsWe identified 2961 records through database searching for neurological conditions and 1261 additional records through database searches for specific symptoms. We removed duplicate records and conference presentations. We screened 3234 titles and identified 330 potentially relevant abstracts. After reading the abstracts we selected 34 studies for inclusion in the evidence synthesis.ConclusionsFrom the evidence reviewed we would like to recommend that we move forward by establishing a closer working relationship with specialists in palliative care and rehabilitation medicine and explore the implications for cross-specialty training.
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