Trajectory

轨迹
  • 文章类型: Journal Article
    这篇综述系统地研究了过去十年中有关为立体定向神经外科应用量身定制的多种路径规划算法的最新研究。我们的全面调查涉及彻底搜索GoogleScholar的学术论文,PubMed,IEEEXplore,还有Scopus,利用严格的纳入和排除标准。筛选和选择过程是由一个由三名医学生组成的多学科小组精心进行的,具有路径规划技术和医疗机器人专业知识的机器人专家,和董事会认证的神经外科医生。对每篇入选的论文进行了详细的回顾,本综述对研究结果进行了综合和报道.本文围绕三种不同类型的干预工具进行组织:直针,可操纵针头,和同心管机器人。我们提供了适用于单目标和多目标场景的各种路径规划算法的深入分析。多目标计划技术仅针对直工具进行讨论,因为尚无有关可操纵针和同心管机器人的多目标计划的公开工作。此外,我们讨论使用的成像模式,路径规划过程中考虑的关键解剖结构,以及将其转化为临床人体研究的研究现状。据我们所知,作为这篇系统综述的结论,这是过去十年中发表的第一篇综述论文,报告了针对不同类型的微创神经外科手术工具的各种路径规划技术。此外,这项审查概述了未来的趋势,并确定了该领域现有的技术差距。通过强调这些方面,我们的目标是提供一个全面的概述,可以指导未来的研究和发展的路径规划的立体定向神经外科,最终有助于推进更安全、更有效的神经外科手术。
    This review systematically examines the recent research from the past decade on diverse path-planning algorithms tailored for stereotactic neurosurgery applications. Our comprehensive investigation involved a thorough search of scholarly papers from Google Scholar, PubMed, IEEE Xplore, and Scopus, utilizing stringent inclusion and exclusion criteria. The screening and selection process was meticulously conducted by a multidisciplinary team comprising three medical students, robotic experts with specialized knowledge in path-planning techniques and medical robotics, and a board-certified neurosurgeon. Each selected paper was reviewed in detail, and the findings were synthesized and reported in this review. The paper is organized around three different types of intervention tools: straight needles, steerable needles, and concentric tube robots. We provide an in-depth analysis of various path-planning algorithms applicable to both single and multi-target scenarios. Multi-target planning techniques are only discussed for straight tools as there is no published work on multi-target planning for steerable needles and concentric tube robots. Additionally, we discuss the imaging modalities employed, the critical anatomical structures considered during path planning, and the current status of research regarding its translation to clinical human studies. To the best of our knowledge and as a conclusion from this systematic review, this is the first review paper published in the last decade that reports various path-planning techniques for different types of tools for minimally invasive neurosurgical applications. Furthermore, this review outlines future trends and identifies existing technology gaps within the field. By highlighting these aspects, we aim to provide a comprehensive overview that can guide future research and development in path planning for stereotactic neurosurgery, ultimately contributing to the advancement of safer and more effective neurosurgical procedures.
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  • 文章类型: Journal Article
    重复经颅磁刺激(rTMS)后的抑郁反应轨迹仍未得到充分研究。我们搜索了盲法随机对照试验(RCT),该试验检查了左背外侧前额叶皮层(DLPFC)上常规rTMS的重度抑郁发作(MDE)。效应大小计算为抑郁症改善的差异,在活跃和假rTMS之间。我们进行了随机效应剂量反应荟萃分析,以模拟从rTMS开始到治疗后随访阶段的反应轨迹。计算第一个8周反应轨迹的曲线下面积(AUC)以比较不同rTMS方案之间的抗抑郁功效。我们纳入了40项随机对照试验(n=2012)。最佳拟合轨迹模型呈现对数曲线(X2=17.7,P<0.001),显示出逐步上升,在3-4周左右逐渐缩小,并保持到16周。在第16周时,最大效应大小为6.1(95CI:1.25-10.96)。亚组分析显示了不同rTMS协议的不同轨迹。此外,AUC的比较表明,具有更多脉冲/会话组或更多总脉冲的常规rTMS方案比具有更少脉冲/会话或更少总脉冲的方案具有更大的疗效。分别。一个疗程的常规左DLPFCrTMS可能导致急性抗抑郁作用和持续的后遗症,在MDE中通过不同的rTMS协议建模。
    The depression response trajectory after a course of repetitive transcranial magnetic stimulation(rTMS) remains understudied. We searched for blinded randomized controlled trials(RCTs) that examined conventional rTMS over left dorsolateral prefrontal cortex(DLPFC) for major depressive episodes(MDE). The effect size was calculated as the difference in depression improvement, between active and sham rTMS. We conducted a random-effects dose-response meta-analysis to model the response trajectory from the beginning of rTMS to the post-treatment follow-up phase. The area under curve (AUC) of the first 8-week response trajectory was calculated to compare antidepressant efficacy between different rTMS protocols. We included 40 RCTs(n = 2012). The best-fitting trajectory model exhibited a logarithmic curve(X2=17.7, P < 0.001), showing a gradual ascent with tapering off around the 3-4th week mark and maintaining until week 16. The maximum effect size was 6.1(95 %CI: 1.25-10.96) at week 16. The subgroup analyses showed distinct trajectories across different rTMS protocols. Besides, the comparisons of AUC showed that conventional rTMS protocols with more pulse/session group or more total pulses were associated with greater efficacy than those with fewer pulse/session or fewer total pulses, respectively. A course of conventional left DLPFC rTMS could lead to both acute antidepressant effects and sustained after-effects, which were modeled by different rTMS protocols in MDE.
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  • 文章类型: Systematic Review
    越来越多的证据支持母乳喂养在降低肥胖风险方面的有益作用,但母乳喂养对体重指数(BMI)纵向变化的持久影响(即,BMI轨迹)尚不清楚。本系统综述总结了母乳喂养如何影响生命后期BMI纵向轨迹的证据。文献检索在Medline进行,Embase,WebofScience,和ScienceDirect,以确定评估母乳喂养(相对于其他喂养类型或持续时间)与BMI或BMIz评分的纵向轨迹相关的研究.纳入3项随机对照试验(RCTs)和24项纵向队列研究。三分之二(18/27)的研究被评为可接受或高质量。大多数队列研究(9/11)表明,与配方奶喂养或混合喂养的儿童相比,在3至12个月继续母乳喂养的儿童的BMI轨迹较低或遵循高BMI轨迹的几率较低。母乳喂养和其他喂养组之间的BMI差异从7个月开始就很明显,直到8岁,组间BMI差异的大小随着年龄的增加而增加。对于母乳喂养持续时间,15项队列研究中的12项发现,更长的母乳喂养持续时间与18岁之前的较低BMI轨迹相关。此外,观察到纯母乳喂养和任何母乳喂养与BMI轨迹的有益关联.相比之下,3个RCT报告了混合的结果,这些RCT比较了从出生到12~24个月的BMI轨迹,分别为促进母乳喂养与对照组或母乳喂养与配方喂养组.本综述从队列研究中提供了进一步的纵向证据,表明母乳喂养与配方奶/混合喂养或更长的母乳喂养持续时间与较低的BMI轨迹相关。这种在儿童早期开始的协会随着年龄的增长而变得更加明显,并持续到成年早期。现有证据证实了促进和持续母乳喂养以支持预防肥胖的重要性。
    Mounting evidence supports the beneficial role of breastfeeding in lowering obesity risk, but the enduring impact of breastfeeding on longitudinal changes in body mass index (BMI) (i.e., BMI trajectories) remains unclear. This systematic review summarized evidence on how breastfeeding influenced the longitudinal trajectories of BMI later in life. Literature searches were conducted in Medline, Embase, Web of Science, and ScienceDirect to identify studies that assessed how breastfeeding (versus other feeding types or duration) was associated with longitudinal trajectories of BMI or BMI z-score. Three randomized controlled trials (RCTs) and 24 longitudinal cohort studies were included. Two-thirds (18/27) of studies were rated as acceptable or high quality. Most cohort studies (9/11) showed that children who continued to breastfeed at 3 to 12 mo of age had a lower BMI trajectory or lower odds of following a high BMI trajectory than those who were formula-fed or mixed-fed. The BMI differences between breastfeeding and other feeding groups were evident from age 7 mo and remained up to 8 y, and the magnitude of between-group BMI differences increased with age. For breastfeeding duration, 12 out of 15 cohort studies found that longer breastfeeding duration was associated with lower BMI trajectories up to age 18 y. Moreover, beneficial associations were observed for both exclusive and any breastfeeding with BMI trajectory. In contrast, mixed findings were reported from 3 RCTs that compared BMI trajectories from birth to ages 12 to 24 mo between breastfeeding promotion versus control or breastfeeding versus formula-feeding groups. The current review provides further longitudinal evidence from cohort studies that breastfeeding versus formula/mixed feeding or longer breastfeeding duration was associated with lower BMI trajectories. Such associations initiated in early childhood became more apparent with age and were sustained into early adulthood. The existing evidence substantiates the importance of breastfeeding promotion and continuation to support obesity prevention.
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  • 文章类型: Journal Article
    在2019年冠状病毒病(COVID-19)的背景下,实验室医学在诊断和严重程度评估中起着至关重要的作用.尽管已经广泛报道了基线实验室发现的重要性,关于它们在临床过程中的演变的数据是有限的.本叙述性综述的目的是提供重症COVID-19患者在其危重疾病过程中报告的常规实验室变量的动态变化。在文献中搜索了提供重症COVID-19患者在重症监护病房(ICU)期间常规实验室检查时间过程数据的文章。白细胞,中性粒细胞和淋巴细胞计数,中性粒细胞与淋巴细胞的比率,血小板计数,以及D-二聚体,纤维蛋白原,C反应蛋白,选择乳酸脱氢酶和血清白蛋白水平作为疾病特征和常规实验室指标。总共有25篇研究文章报告了上述实验室参数在重症COVID-19临床过程中的动态趋势。在每个研究提供的随访期间,在幸存者和非幸存者中,大部分实验室值持续异常.此外,在大多数研究中,实验室值的时间趋势在幸存者和非幸存者之间有明显的区别.总之,入住ICU的重度COVID-19的幸存者和非幸存者之间的选定常规实验室参数存在明显的时间趋势,表明它们在临床预后中的重要性。
    In the context of coronavirus disease 2019 (COVID-19), laboratory medicine has played a crucial role in both diagnosis and severity assessment. Although the importance of baseline laboratory findings has been extensively reported, data regarding their evolution over the clinical course are limited. The aim of the present narrative review was to provide the dynamic changes of the routine laboratory variables reported in patients with severe COVID-19 over the course of their critical illness. A search was made of the literature for articles providing data on the time-course of routine laboratory tests in patients with severe COVID-19 during their stay in the intensive care unit (ICU). White blood cell, neutrophil and lymphocyte counts, neutrophil to lymphocyte ratio, platelet counts, as well as D-dimer, fibrinogen, C-reactive protein, lactate dehydrogenase and serum albumin levels were selected as disease characteristics and routine laboratory parameters. A total of 25 research articles reporting dynamic trends in the aforementioned laboratory parameters over the clinical course of severe COVID-19 were identified. During the follow-up period provided by each study, the majority of the laboratory values remained persistently abnormal in both survivors and non-survivors. Furthermore, in the majority of studies, the temporal trends of laboratory values distinctly differentiated patients between survivors and non-survivors. In conclusion, there are distinct temporal trends in selected routine laboratory parameters between survivors and non-survivors with severe COVID-19 admitted to the ICU, indicating their importance in the prognosis of clinical outcome.
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  • 文章类型: Journal Article
    了解婴儿和儿童的神经发育轨迹对于早期识别神经发育障碍至关重要,阐明疾病背后的神经机制,并预测发展结果。功能性近红外光谱(fNIRS)是一种婴儿友好的神经成像工具,可以监测新生儿期的脑血流动力学反应。由于其优点,fNIRS是研究神经发育轨迹的有前途的工具。尽管许多研究人员已经使用fNIRS来研究婴儿/儿童的神经发育,并报道了重要的发现,缺乏使用fNIRS追踪婴儿和儿童神经发育轨迹的综合证据.当前的系统综述总结了84项原始fNIRS研究,并显示了与年龄相关的网络整合和隔离增加的总体趋势。半球间的连通性,向左不对称,以及静息状态下相位振荡的差异。此外,通常发育中的婴儿和儿童在处理视觉时表现出更加局部化和分化的激活的发展趋势,听觉,和触觉信息,建议更成熟和专业的感官网络。在以后的生活中,儿童在处理社会听觉和语言信息时,从招募双侧听觉转变为左侧语言回路,并在执行功能任务期间显示出前额叶激活增加。发育障碍儿童的发育轨迹不同,有自闭症谱系障碍风险的婴儿在静息状态下表现出最初的过度连接,然后是连接不足;与整个童年时期通常发展中的同龄人相比,患有注意力缺陷/多动障碍的儿童在执行功能任务期间表现出更低的前额叶皮层激活。当前的系统评价支持使用fNIRS跟踪儿童的神经发育轨迹。需要更多的纵向研究来验证神经发育轨迹,并探索这些神经生物标志物在早期识别发育障碍和追踪干预效果中的应用。
    Understanding the neurodevelopmental trajectories of infants and children is essential for the early identification of neurodevelopmental disorders, elucidating the neural mechanisms underlying the disorders, and predicting developmental outcomes. Functional Near-Infrared Spectroscopy (fNIRS) is an infant-friendly neuroimaging tool that enables the monitoring of cerebral hemodynamic responses from the neonatal period. Due to its advantages, fNIRS is a promising tool for studying neurodevelopmental trajectories. Although many researchers have used fNIRS to study neural development in infants/children and have reported important findings, there is a lack of synthesized evidence for using fNIRS to track neurodevelopmental trajectories in infants and children. The current systematic review summarized 84 original fNIRS studies and showed a general trend of age-related increase in network integration and segregation, interhemispheric connectivity, leftward asymmetry, and differences in phase oscillation during resting-state. Moreover, typically developing infants and children showed a developmental trend of more localized and differentiated activation when processing visual, auditory, and tactile information, suggesting more mature and specialized sensory networks. Later in life, children switched from recruiting bilateral auditory to a left-lateralized language circuit when processing social auditory and language information and showed increased prefrontal activation during executive functioning tasks. The developmental trajectories are different in children with developmental disorders, with infants at risk for autism spectrum disorder showing initial overconnectivity followed by underconnectivity during resting-state; and children with attention-deficit/hyperactivity disorders showing lower prefrontal cortex activation during executive functioning tasks compared to their typically developing peers throughout childhood. The current systematic review supports the use of fNIRS in tracking the neurodevelopmental trajectories in children. More longitudinal studies are needed to validate the neurodevelopmental trajectories and explore the use of these neurobiomarkers for the early identification of developmental disorders and in tracking the effects of interventions.
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  • 文章类型: Systematic Review
    背景:弹性作为动态概念已经通过各种纵向研究进行了描述。为了更好地了解护理人员在提供护理过程中的弹性变化,然而,范围审查可以更清晰地描述他们的复原过程,反过来,可用于改善护理人员的福祉。
    目的:全面概述照顾者在照顾家庭的同时恢复力的动态变化,以增进对未来研究的理解和潜力。
    方法:遵循Arksey和O\'Malley的方法框架,本范围审查使用系统审查的首选报告项目和范围审查的Meta分析扩展(PRISMA-ScR)清单进行.在2012年1月至2022年5月之间,搜索了五个电子数据库以英语发表的研究,然后进行了手动搜索。纵向研究中与韧性和护理人员相关的关键术语被纳入并筛选。使用内容分析对弹性模式的识别轨迹和与弹性过程相关的因素进行了分类。
    结果:总计,24项纵向研究符合资格标准。概念上,我们的研究结果证明了医疗保健挑战后的三种变化模式,每一个都有很大的不同。方法上,研究结果揭示了三个子类别的评估工具,可用于在面对重大医疗保健挑战时影响护理人员的复原力。因此,个人特质和环境资源与韧性过程的相互作用将导致其韧性的各种结果,包括稳定性,增长,或下降。
    结论:这篇综述描述了弹性过程的变化模式,评估工具,及相关因素,为心理弹性的调查和干预提供动态视角。尽管如此,在韧性的可操作动态变化方面,未来的研究仍存在重大差距。
    Resilience as a dynamic concept has already been described through various longitudinal studies. To better understand the changes in the resilience of caregivers over the course of care-providing, however, a scoping review can provide a clearer picture of their resilience process which, in turn, can be used to improve caregivers\' well-being.
    To provide a comprehensive overview of dynamic change in the resilience of caregivers while caring for the family to enhance understanding and potential for future research.
    Following the methodological framework of Arksey and O\'Malley, this scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and the Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Five electronic databases were searched for research published in English between January 2012 and May 2022, after which a manual search was performed. Key terms related to resilience and caregivers in longitudinal studies were included and screened for. Identified trajectories of patterns in resilience and factors associated with resilience process were categorized using content analysis.
    In total, 24 longitudinal studies met the eligibility criteria. Conceptually, our findings demonstrate three modes of change following healthcare challenges, each of which varies substantially. Methodologically, the results reveal three subcategories of assessment tools that can be used to impact caregivers\' resilience when confronted with significant healthcare challenges. Consequentially, personal traits and environmental resources interacting with the resilience process will then lead to various outcomes in their resilience, including stability, growth, or decline.
    This review describes the change patterns of the resilience process, assessment instruments, and associated factors to offer a dynamic perspective for the investigation and intervention of psychological resilience. Major gaps nonetheless remain for future research regarding an operationalizing dynamic change in resilience.
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  • 文章类型: Meta-Analysis
    自闭症儿童和成人表现出可能被描述为具有挑战性的行为的风险增加,然而,人们对这些行为是否或如何随着时间的推移而改变知之甚少。鉴于挑战性行为会对自闭症患者及其支持网络产生深远的影响,重要的是要更好地理解挑战性行为的轨迹。这项系统的综述和荟萃分析确定并综合了自闭症患者挑战性行为的观察性纵向研究。56项研究被纳入系统评价,并通过荟萃分析检查了来自其中34份报告的37个独立样本的效应大小.至关重要的是,在37个样本中,挑战性行为的衡量标准得分减少了一小部分,然而意义重大,随着时间的推移。尽管基线评估时样本的年龄并未减轻影响,基线评估与最终随访之间的时间以及最终随访时的年龄都缓和了影响的大小,在(a)基线和最终随访间隔时间较长的研究和(b)随访时间较长的研究中,挑战性行为评分在更大程度上降低。当前系统综述和荟萃分析的结果对于理解自闭症个体随着时间的推移具有挑战性的行为具有理论和实践意义。还强调了未来研究的途径,这可能有助于更好地理解,因此,支持,挑战自闭症个体的行为。
    Autistic children and adults are at increased risk of showing behaviours that may be described as challenging, however, little is known about whether or how these behaviours may change over time. Given the profound impact that challenging behaviour can have on both the autistic individual and their support network, it is critical that the trajectory of challenging behaviours be better understood. This systematic review and meta-analysis identified and synthesised observational longitudinal studies of challenging behaviour in autistic individuals. Fifty-six studies were included in the systematic review, and the effect sizes of 37 independent samples arising from 34 of these reports were examined through meta-analysis. Crucially, across the 37 samples, scores on the measures of challenging behaviour reduced by a small, yet significant, extent over time. Although age of the sample at baseline assessment did not moderate the effect, the time between the baseline assessment and final follow-up and age at final follow-up both moderated the magnitude of the effect, with challenging behaviour scores reducing to a larger extent in (a) studies with longer intervals between baseline and final follow-up and (b) studies with older samples at follow-up. The results from the current systematic review and meta-analysis have both theoretical and practical implications for understanding challenging behaviour over time in autistic individuals. Avenues for future research are also highlighted that may allow better understanding, and therefore support of, challenging behaviour in autistic individuals.
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  • 文章类型: Journal Article
    The Deese/Roediger-McDermott (DRM) paradigm has been used extensively to examine false memory. During the study session, participants learn lists of semantically related items (e.g., pillow, blanket, tired, bed), referred to as targets. Critical lures are items which are also associated with the lists but are intentionally omitted from study (e.g., sleep). At test, when asked to remember targets, participants often report false memories for critical lures. Findings from experiments using the DRM show the ease with which false memories develop in the absence of suggestion or misinformation. Given this, it is important to examine factors which influence the generalizability of the findings. One important factor is the persistence of false memory, or how long false memories last. Therefore, we conducted a systemic review to answer this research question: What is the persistence of false memory for specific items in the DRM paradigm? To help answer this question our review had two research objectives: (1) to examine the trajectory of target memory and false memory for critical lures and (2) to examine whether memory for targets exceeded false memory for critical lures. We included empirical articles which tested memory for the same DRM lists with at least two testing sessions. We discuss the results with respect to single-session delays, long-term memory recall and recognition, remember and know judgments for memory, and the effect of development, valence, warning, and connectivity on the trajectory of memory. Overall, the trajectory of targets showed a relatively consistent pattern of decrease across delay. The trajectory of critical lures was inconsistent. The proportion of targets versus critical lures across delay was also inconsistent. Despite the inconsistencies, we conclude that targets and critical lures have a dissimilar trajectory across delay and that critical lures are more persistent than targets. The findings with respect to long-term recall and recognition are consistent with both Fuzzy Trace Theory and Associative-Activation Theory of the DRM effect. The generation of false memory with brief delays (3-4 s) is better explained by Associative-Activation Theory. Examining the connectivity between target items, and critical lures, and the effect that has during study and retrieval, can provide insight into the persistence of false memory for critical lures.
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  • 文章类型: Journal Article
    为移动机器人提供自主能力是有利的。它允许人们免除人类操作员的干预,这可能在经济和安全方面被证明是有益的。自主性需要,在大多数情况下,使用路径规划器,使机器人能够考虑如何在一个时刻从其位置移动到另一个位置。根据用户提出的要求寻找最合适的路径规划算法可能具有挑战性,考虑到文献中存在的绝大多数方法。此外,这里分析的过去的回顾作品只涵盖了其中的一些方法,缺少重要的。出于这个原因,我们的论文旨在作为一个起点,对迄今为止的研究进行清晰和全面的概述。它介绍了一种全局分类的路径规划算法,重点关注与自动地面车辆一起使用的方法,但也可以扩展到其他在表面上移动的机器人,如自主船。此外,用于表示环境的模型,以及机器人的移动性和动力学,还从路径规划的角度进行了讨论。分类中提出的每个路径规划类别都被披露和分析,最后增加了对其适用性的讨论。
    Providing mobile robots with autonomous capabilities is advantageous. It allows one to dispense with the intervention of human operators, which may prove beneficial in economic and safety terms. Autonomy requires, in most cases, the use of path planners that enable the robot to deliberate about how to move from its location at one moment to another. Looking for the most appropriate path planning algorithm according to the requirements imposed by users can be challenging, given the overwhelming number of approaches that exist in the literature. Moreover, the past review works analyzed here cover only some of these approaches, missing important ones. For this reason, our paper aims to serve as a starting point for a clear and comprehensive overview of the research to date. It introduces a global classification of path planning algorithms, with a focus on those approaches used along with autonomous ground vehicles, but is also extendable to other robots moving on surfaces, such as autonomous boats. Moreover, the models used to represent the environment, together with the robot mobility and dynamics, are also addressed from the perspective of path planning. Each of the path planning categories presented in the classification is disclosed and analyzed, and a discussion about their applicability is added at the end.
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  • 文章类型: Journal Article
    对于痴呆症患者及其护理伙伴而言,跨护理环境的多次过渡可能会造成破坏性影响。并可能导致零散的护理带来不良后果。进行这项范围审查是为了识别和分类痴呆症患者的多个设置中的护理轨迹。并了解个人和组织层面的多种转变和相关因素的普遍性。搜索三个数据库,限于2007年至2017年发表的同行评审研究,提供了33篇文章供纳入。我们确定了26种不同的护理轨迹。常见的轨迹涉及从医院重新入院或出院到长期护理。与转变相关的因素主要是在人口统计学和医学特征水平上确定的。研究结果表明,有必要投资于更强大的基于社区的护理系统,以减少过渡。建议进行进一步的研究,以解决有关痴呆症患者亚人群所经历的复杂和纵向护理轨迹和轨迹的知识差距。
    Multiple transitions across care settings can be disruptive for older adults with dementia and their care partners, and can lead to fragmented care with adverse outcomes. This scoping review was conducted to identify and classify care trajectories across multiple settings for people with dementia, and to understand the prevalence of multiple transitions and associated factors at the individual and organizational levels. Searches of three databases, limited to peer-reviewed studies published between 2007 and 2017, provided 33 articles for inclusion. We identified 26 distinct care trajectories. Common trajectories involved hospital readmission or discharge from hospital to long-term care. Factors associated with transitions were identified mainly at the level of demographic and medical characteristics. Findings suggest a need for investing in stronger community-based systems of care that may reduce transitions. Further research is recommended to address knowledge gaps about complex and longitudinal care trajectories and trajectories experienced by sub-populations of people living with dementia.
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