clinical assessment tools

  • 文章类型: Journal Article
    护理学生在临床环境中的护理技能实践促进了理论知识和实践能力的整合。受体的关键作用是评估护生在参与临床实践时必须达到的学习目标。因此,这项研究的目的是探索与能力评估和评估方法有关的当前证据,以及导师在临床环境中评估护理专业学生能力的意愿。范围审查使用了由Arksey和O\'Malley开发的五阶段方法框架,以及系统审查的首选报告项目和范围审查的荟萃分析扩展。通过在以下数据库中应用截至2024年4月的综合文献检索策略来检索相关研究:CINAHL,OVIDMEDLINE,EMBASE,和pubmed。2000年至2024年4月期间共发表了11,297项研究,38人符合入选条件,研究小组将其分为三个主要主题:能力的定义,评估能力的工具以及与护理专业学生能力评估相关的导师和导师观点。这篇综述表明,有许多定量工具可用于评估临床能力;然而,各国和高等教育机构之间的评估工具和方法缺乏一致性是普遍存在的。现有的研究证据表明,受体在临床上进行了评估过程,他们发现了记录评估的困难。护理专业学生的能力评估和评估的复杂性是全世界教育工作者和导师关注的问题。主要关注的问题集中在诸如能力的解释和复杂的测量工具。
    Nursing students\' integration of theoretical knowledge and practical abilities is facilitated by their practice of nursing skills in a clinical environment. A key role of preceptors is to assess the learning goals that nursing students must meet while participating in clinical practice. Consequently, the purpose of this study was to explore the current evidence in relation to competency assessment and assessment approaches, and the willingness of preceptors for assessing nursing students\' competency in a clinical setting. The scoping review used the five-stage methodological framework that was developed by Arksey and O\'Malley, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Relevant studies were searched by applying a comprehensive literature search strategy up to April 2024 across the following databases: CINAHL, OVID MEDLINE, EMBASE, and PUBMED. A total of 11,297 studies published between 2000 and April 2024 were revealed, and 38 were eligible for inclusion, which the research team categorised into three main themes: definitions of competence, tools for assessing competence and preceptors\' and mentors\' viewpoints in relation to the assessment of nursing students\' competence. This review established that there are a multitude of quantitative instruments available to assess clinical competence; however, a lack of consistency among assessment instruments and approaches between countries and higher education institutions is prevalent. Existing research evidence suggests that the preceptors carried out the assessment process clinically and they found difficulties in documenting assessment. The assessing of nursing students\' competency and the complexity of assessment is a concern for educators and mentors worldwide. The main concern centers around issues such as the interpretation of competence and complex measurement tools.
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  • 文章类型: Journal Article
    SARS-CoV-2引起了迅速发展的COVID-19的大流行。截至2023年12月6日,共有765152854例COVID-19康复病例。在一部分康复患者中,被称为“长期COVID”和“COVID-19后病症”(PCCs)或“急性COVID-19后综合征”的长期后果报告更频繁。系统性,神经精神病学,心肺,和胃肠道症状是最普遍的。由于缺乏官方指南和疾病的复杂性,PCC的管理带来了独特的挑战。本摘要强调了从最近的评论和专家建议中得出的关键原则,为医疗保健专业人员提供了一种全面的方法来管理COVID-19后患者。预防医学在管理PCC中起着至关重要的作用。虽然没有特定的药物可用于治疗,预防措施,如COVID-19疫苗接种,坚持预防措施,定期咨询医疗专业人员,监测症状和进展,寻求有关症状管理的信息对于帮助患者康复和提高生活质量至关重要。医疗管理需要透明的目标设定和基于患者症状的协作决策,合并症,和治疗目标。COVID-19后患者的治疗计划应侧重于患者教育,使用注册表和日历来跟踪症状和触发因素,提供支持和保证,并通过同伴网络和支持性心理治疗技术提供整体支持。症状和康复护理,包括完善的症状管理技术,身体康复计划,解决心理健康和福祉问题,是新冠肺炎后管理的重要组成部分。生活方式因素,如减压,营养,应将睡眠纳入COVID-19后患者的基本医疗状况管理中。建议定期随访和转诊给专家,以监测患者的进展,并解决特定的器官系统受累或额外的护理需求。总之,为了有效管理PCC,整体方法应包括预防措施,患者教育,支持性心理治疗,症状和康复护理,医疗管理,关于生活方式元素的咨询,和适当的后续计划。然而,至关重要的是,要及时了解医疗保健当局不断演变的指南和建议,为COVID-19后患者提供最有效和循证的护理。
    SARS-CoV-2 caused the pandemic of the rapidly evolving COVID-19. As of December 6, 2023, there were 765,152,854 COVID-19-recovering cases. Long-term consequences known as \"long COVID\" and \"post-COVID-19 conditions\" (PCCs) or \"post-acute COVID-19 syndrome\" are being reported more frequently in a subset of recovering patients. Systemic, neuropsychiatric, cardio-respiratory, and gastrointestinal symptoms are the most prevalent. The management of PCCs poses unique challenges due to the lack of official guidelines and the complex nature of the illness. This abstract highlights key principles derived from recent reviews and expert recommendations to provide healthcare professionals with a comprehensive approach to manage post-COVID-19 patients. Preventive medicine plays a crucial role in managing PCCs. While no specific medications are available for treatment, preventive measures such as COVID-19 vaccination, adherence to precautionary measures, regular consultations with medical professionals, monitoring symptoms and progress, and seeking information on symptom management are essential to assist patients in their recovery and improve their quality of life. Medical management requires transparent goal-setting and collaborative decision-making based on the patient\'s symptoms, comorbidities, and treatment objectives. Treatment plans for post-COVID-19 patients should focus on patient education, using registries and calendars to track symptoms and triggers, providing support and reassurance, and offering holistic support through peer networks and supportive psychotherapy techniques. Symptomatic and rehabilitative care, including well-established symptom management techniques, physical rehabilitation programs, and addressing mental health and well-being, are vital components of post-COVID-19 management. Lifestyle factors such as stress reduction, nutrition, and sleep should be incorporated into managing underlying medical conditions in post-COVID-19 patients. Regular follow-up visits and referrals to specialists are recommended to monitor the patient\'s progress and address specific organ system involvement or additional care needs. In summary, for the effective management of PCCs, a holistic approach should include preventive measures, patient education, supportive psychotherapy, symptomatic and rehabilitative care, medical management, counseling on lifestyle elements, and appropriate follow-up plans. However, it is crucial to stay updated with evolving guidelines and recommendations from healthcare authorities to provide the most effective and evidence-based care to post-COVID-19 patients.
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  • 文章类型: Journal Article
    目的:在本文中,我们回顾了EOS诊断和评估方法的最新进展,手术适应症和选择,早发性脊柱侧凸研究领域的基础科学创新。
    结果:早发性脊柱侧凸(EOS)涵盖了多种,影响10岁以下儿童的脊柱和胸壁畸形的异质性范围。最近的努力试图检查最近开发的分类系统的有效性和可靠性,以更好地标准化EOS的表示。人们还将注意力集中在发展更安全的问题上,翔实,和现成的成像和临床评估工具,从减少的微剂量射线照片中,定量动态MRI,和肺功能检查.EOS的基础科学创新集中在开发能够复制脊柱侧弯畸形的大型动物模型,以更好地评估矫正技术。鉴于近年来管理EOS的方法越来越多,关于EOS病因的手术适应症,几乎没有明确的指南。尽管如此,在过去的二十年里,脊柱植入物领域已经发生了相当大的转变,向有利于增长的仪器转变,特别是MCGR植入物的利用。随着新的生物和基础科学治疗和疗法的出现,延长了与EOS相关的疾病病因的存活率,近年来,EOS的治疗方法稳步发展。随之而来的是EOS的数量和管理选项的变化,以及需要多学科和创造性的方法来治疗这些复杂和异质性疾病的患者。
    OBJECTIVE: In this article, we review the most recent advancements in the approaches to EOS diagnosis and assessment, surgical indications and options, and basic science innovation in the space of early-onset scoliosis research.
    RESULTS: Early-onset scoliosis (EOS) covers a diverse, heterogeneous range of spinal and chest wall deformities that affect children under 10 years old. Recent efforts have sought to examine the validity and reliability of a recently developed classification system to better standardize the presentation of EOS. There has also been focused attention on developing safer, informative, and readily available imaging and clinical assessment tools, from reduced micro-dose radiographs, quantitative dynamic MRIs, and pulmonary function tests. Basic science innovation in EOS has centered on developing large animal models capable of replicating scoliotic deformity to better evaluate corrective technologies. And given the increased variety in approaches to managing EOS in recent years, there exist few clear guidelines around surgical indications across EOS etiologies. Despite this, over the past two decades, there has been a considerable shift in the spinal implant landscape toward growth-friendly instrumentation, particularly the utilization of MCGR implants. With the advent of new biological and basic science treatments and therapies extending survivorship for disease etiologies associated with EOS, the treatment for EOS has steadily evolved in recent years. With this has come a rising volume and variation in management options for EOS, as well as the need for multidisciplinary and creative approaches to treating patients with these complex and heterogeneous disorders.
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  • 文章类型: Review
    目的:牙齿磨损是一种多因素的情况,导致牙齿硬组织的不可逆损失。一个明确的可用性,普遍适用的评估协议仍然缺乏。作者的目标是开发一套用于评估牙齿磨损(DC-TW)的诊断标准。将使用两步方法来实现该目标:1.为了开发DC-TW的初步测试版,基于作者的临床经验和他们共同的专业知识,并得到对现有文献的叙述性回顾的支持,和2。为了开发最终的DC-TW,与使用国际德尔菲过程的更大专家组的意见。本文涉及的第一步。
    方法:作者概述了应纳入DC-TW的组件。进行文献检索以调查他们的概念是否与现有文献一致。从开始到2022年7月11日,进行搜索是为了确定合格的出版物。两位作者独立筛选了所有出版物,通过共识程序解决了判决中的分歧。
    结果:搜索产生了5,362种出版物,最终纳入383。这些出版物分为四个主要主题:1。命名法/分类法;2.自我报告工具;3.临床评估工具;和4.临床决策。
    结论:使用了出版物中的信息,并将其与作者的临床经验和共同的专业知识融合在一起,为DC-TW的初步beta版本的开发做出了贡献。
    BACKGROUND: Tooth wear is a multifactorial condition, leading to the irreversible loss of dental hard tissues. The availability of an unambiguous, universally applicable assessment protocol remains lacking.
    OBJECTIVE: The goal of the authors is to develop a set of diagnostic criteria for the assessment of tooth wear (DC-TW). A two-step approach will be used to achieve this objective: (1) to develop a preliminary beta version of the DC-TW, based on the authors\' clinical experience and their shared expertise and supported by a narrative review of the existing literature, and (2) to develop the final DC-TW, with input from a larger group of experts using an international Delphi process. This paper relates to the first step.
    METHODS: The authors outlined the components that should be incorporated into the DC-TW. The literature search was performed to investigate if their concept was in line with the available literature. The search was conducted to identify eligible publications from inception to July 11, 2022. Two authors independently screened all publications, and differences in judgements were resolved through a consensus procedure.
    RESULTS: The search yielded 5362 publications, resulting in the final inclusion of 383. These publications were divided into four main topics: (1) nomenclature/taxonomies; (2) self-report tools; (3) clinical assessment tools; and (4) clinical decision-making.
    CONCLUSIONS: The information from the publications was used and fused with the clinical experience and shared expertise of the authors to contribute to the development of a preliminary beta version of the DC-TW.
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  • 文章类型: Journal Article
    背景:成骨不全症和Ehlers-Danlos综合征患者的临床功能评估对于临床治疗至关重要。然而,没有明确的信息,疾病特异性的临床实践评估工具,从而限制了疾病相关损伤的量化和管理。
    目的:本范围综述旨在研究成骨不全症和Ehlers-Danlos综合征患者最常见的临床功能特征和评估工具,并提供与每种疾病的功能障碍相关的最新国际功能分类(ICF)模型。
    方法:文献修订在PubMed上进行,Scopus和Embase数据库。文章报道了临床功能特征的ICF模型和成骨不全症和Ehlers-Danlos综合征个体的评估工具。
    结果:共纳入27篇文章,7报告ICF模型,和20个报告临床功能评估工具。据报道,成骨不全症和Ehlers-Danlos综合征患者的身体功能和结构均受损,ICF的活动和参与领域。对于这两种疾病,发现了不同数量的评估工具,疼痛,锻炼的耐力,疲劳,平衡和运动协调,和流动性。
    结论:成骨不全和Ehlers-Danlos综合征患者在身体功能和结构方面表现出多种损害和局限性,ICF的活动和参与领域。因此,有必要对疾病相关损伤进行适当和持续的评估,以改善临床实践.尽管在以前的文献中发现了评估工具的异质性,但可以使用几种功能检查和临床量表来评估患者。
    Clinical-functional assessment of patients affected by Osteogenesis Imperfecta and Ehlers-Danlos Syndromes is essential for clinical management. However, there is no clear information on disease-specific tools of assessment for clinical practice, thus limiting quantification and management of the diseases-related impairments.
    The present scoping review was aimed at investigating the most common clinical-functional features and assessment tools in individuals with Osteogenesis Imperfecta and Ehlers-Danlos Syndromes, and to provide an updated International Classification of Functioning (ICF) model related to functional impairments for each disease.
    The literature revision was conducted on PubMed, Scopus and Embase databases. Articles reporting an ICF model of clinical-functional features and assessment tools for Osteogenesis Imperfecta and Ehlers-Danlos Syndromes individuals were included.
    A total of 27 articles were included, 7 reporting an ICF model, and 20 reporting clinical-functional assessment tools. It was reported that patients with Osteogenesis Imperfecta and Ehlers-Danlos Syndromes show impairments in both Body Function and Structure, and Activities and Participation domains of the ICF. A heterogeneous number of assessment tools was found for both diseases regarding proprioception, pain, endurance to exercise, fatigue, balance and motor coordination, and mobility.
    Patients with Osteogenesis Imperfecta and Ehlers-Danlos Syndromes show several impairments and limitations in Body Function and Structure, and Activities and Participation domains of the ICF. Thus, an appropriate and ongoing assessment of the disease-related impairments is necessary to improve clinical practice. Several functional tests and clinical scales can be used to assess the patients despite the heterogeneity of assessment tools found in previous literature.
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  • 文章类型: Journal Article
    这个范围审查描述了使用,有效性,以及预防老年人未来骨质疏松性骨折的临床骨折风险评估工具的成本效益。结果表明,筛查在预防所有骨质疏松症相关骨折方面并不优于常规治疗。然而,它积极影响了参与者对骨质疏松症的看法,可能减少了髋部骨折,而且看起来很划算.
    目的:我们的目的是提供关于使用临床骨折风险评估工具来影响健康结果的证据概要。包括减少未来的骨质疏松性骨折及其成本效益。
    方法:我们遵循了Arksey和O\'Malley的指南及其修改。创建了一个全面的搜索策略来搜索CINAHL,Medline,和Embase数据库,直到2021年6月29日,没有任何限制。我们批判性地评估了所有纳入研究的质量。
    结果:在筛选了2484篇标题和68篇全文文章后,将14项研究纳入综述。四项随机对照试验研究了临床骨折风险评估工具在减少老年女性所有骨折方面的有效性。与常规护理相比,使用这些评估工具并未显示出骨质疏松性骨折风险的统计学显着降低;然而,对其中两项试验的其他分析显示出减少髋部骨折的趋势,结果可能具有临床意义。四项研究测试了筛查计划对其他健康结果的影响,参与者报告了积极的结果。八项模拟研究估计了使用这些工具筛查裂缝的成本效益,大多数显示出巨大的潜在储蓄。
    结论:根据现有证据,在预防所有骨质疏松相关骨折方面,使用临床骨折风险评估筛查工具没有比常规治疗更有效.然而,使用这些筛查工具积极影响女性对骨质疏松症的看法,可能会降低髋部骨折的风险,并且可能具有成本效益。这是一个相对较新的研究领域,需要更多的研究。
    This scoping review described the use, effectiveness, and cost-effectiveness of clinical fracture-risk assessment tools to prevent future osteoporotic fractures among older adults. Results show that the screening was not superior in preventing all osteoporosis-related fractures to usual care. However, it positively influenced participants\' perspectives on osteoporosis, may have reduced hip fractures, and seemed cost-effective.
    OBJECTIVE: We aim to provide a synopsis of the evidence about the use of clinical fracture-risk assessment tools to influence health outcomes, including reducing future osteoporotic fractures and their cost-effectiveness.
    METHODS: We followed the guidelines of Arksey and O\'Malley and their modifications. A comprehensive search strategy was created to search CINAHL, Medline, and Embase databases until June 29, 2021, with no restrictions. We critically appraised the quality of all included studies.
    RESULTS: Fourteen studies were included in the review after screening 2484 titles and 68 full-text articles. Four randomized controlled trials investigated the effectiveness of clinical fracture-risk assessment tools in reducing all fractures among older women. Using those assessment tools did not show a statistically significant reduction in osteoporotic fracture risk compared to usual care; however, additional analyses of two of these trials showed a trend toward reducing hip fractures, and the results might be clinically significant. Four studies tested the impact of screening programs on other health outcomes, and participants reported positive results. Eight simulation studies estimated the cost-effectiveness of using these tools to screen for fractures, with the majority showing significant potential savings.
    CONCLUSIONS: According to the available evidence to date, using clinical fracture-risk assessment screening tools was not more effective than usual care in preventing all osteoporosis-related fractures. However, using those screening tools positively influenced women\'s perspectives on osteoporosis, may have reduced hip fracture risk, and could potentially be cost-effective. This is a relatively new research area where additional studies are needed.
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  • 文章类型: Journal Article
    本文的目的是考虑,评估,并比较用于评估ChiariI畸形患者的临床结局测量工具。本文重点介绍了儿科和成年ChiariI畸形患者人群中使用的各种一般和疾病特异性结局指标。虽然一般措施可以与临床结果和生活质量相关,这种关联通常不具有统计学意义,他们通常不具备评估和测量直接影响Chiari患者人群的因素的能力。然而,在考虑特定疾病的结果测量时存在局限性,因为这些工具通常没有从初始验证开始进行严格的外部评估,或者已经过外部验证,但结果无法复制。确定成人和患者的结果测量工具将有助于提供者决策和管理的临床工具。
    The purpose of this article was to consider, evaluate, and compare the clinical outcomes measurement tools that are used to assess patients with Chiari I malformation. This article highlights the variety of general and disease-specific outcome measures used in both the pediatric and adult Chiari I malformation patient populations. Although general measures can be associated with clinical outcomes and quality of life, that association is not often found to be statistically significant, and they do not often have the capabilities to assess and measure factors that directly impact the Chiari patient population. However, limitations exist when considering the disease-specific outcome measures, as these tools most often have not been rigorously evaluated externally from the initial validation or have been externally validated but results cannot be replicated. Identifying an outcomes measurement tool for both adults and patients will contribute to the clinical tools available to providers for decision-making and management.
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  • 文章类型: Review
    目的:确定居民急性病情恶化的临床指标以及影响老年护理机构工作人员识别这些指标的因素。
    方法:快速回顾和叙事综合。
    方法:WHO和Cochrane快速审查方法小组的建议指导了审查过程。CINAHL,Medline,PubMed,从2000年到2022年1月,搜索了Cochrane图书馆。使用气道对与恶化的临床指标相关的数据进行分类,呼吸,循环,残疾,暴露评估框架,影响检测的因素分为消费者(居民和家庭),老年护理劳动力,和组织因素。
    结果:包括20篇出版物,其中14项知情的临床指标;影响工作人员识别这些指标的9个突出因素和3个知情因素。包括的物品总体质量低于中等质量。大多数临床指标被归入意识水平改变的“残疾”类别,行为,最常见的疼痛。很少有研究报告在一般人群中使用更传统的恶化指标-生命体征的变化。影响急性恶化检测的最常见因素是组织和劳动力相关的,包括资源,知识,和信心不足。
    结论:研究结果表明居民的健康状况发生了微妙的变化,而不是主要关注急性护理环境预警工具中使用的生理参数,在设计住宅老年护理设施的预警工具时,应得到认可和考虑。
    结论:建议使用对居民独特需求敏感的预警工具和对老年护理机构工作人员的支持,以提高老年护理机构护理人员早期识别和管理急性恶化以避免住院的能力。
    To identify the clinical indicators of acute deterioration in residents and the factors that influence residential aged care facility staff\'s identification of these.
    Rapid review and narrative synthesis.
    The WHO and Cochrane Rapid Review Methods Group recommendations guided the review processes. CINAHL, Medline, PubMed, and the Cochrane Library were searched from 2000 to January 2022. Data related to clinical indicators of deterioration were categorized using the Airway, Breathing, Circulation, Disability, Exposure assessment framework, and factors influencing detection were grouped as consumer (resident and family), aged care workforce, and organization factors.
    Twenty publications were included of which 14 informed clinical indicators; nine highlighted factors that influence staff\'s identification of these and three informed both. Included article were collectively below moderate quality. Most clinical indicators were grouped into the \'Disability\' category with altered level of consciousness, behavior, and pain identified most frequently. Few studies reported more traditional indicators of deterioration used in the general population - changes in vital signs. The most common factors influencing the detection of acute deterioration were organizational and workforce-related including resource, knowledge, and confidence deficits.
    Findings suggest subtle changes in resident\'s health status, rather than focusing primarily on physiologic parameters used in early warning tools for acute care settings, should be recognized and considered in the design of early warning tools for residential aged care facilities.
    Early warning tools sensitive to the unique needs of residents and support for aged care facility staff are recommended to improve the capacity of aged care facility care staff to identify and manage acute deterioration early to avoid hospitalization.
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  • 文章类型: Journal Article
    β-螺旋桨蛋白相关神经变性(BPAN)是一种罕见的神经退行性疾病,其特征是大脑中铁的积累,具有神经发育和运动表型。为了期待未来的临床试验,并为临床护理提供信息,捕获这种罕见疾病的表型多样性并更好地定义疾病亚型的需求尚未满足.
    在我们的自然史研究中,共有27名患有BPAN的个体。从18名受试者中获得了传统的结局指标。人口统计和诊断信息,在获得基本发展技能和总体神经系统严重程度的同时,我们从医疗记录中提取.对于不能亲自旅行的患者,在评估时进行功能结果测量或在最后一次临床检查时进行回顾性应用。根据年龄和功能水平,进行了以下评估:Leiter-3,粗大运动功能测量(GMFM)-66项目集,Vineland-3和Peabody-2.
    总的来说,与粗大运动功能相比,认知功能受损更严重.在生命的前6个月内,BPAN症状的发作与步行增加和口语增加有关(步行:对数秩检验p=0.0015;第一个单词的增加:p=0.0015)。癫痫发作的年龄与最初症状发作的年龄之间没有差异(p=0.8823)。在我们的患者人群中,前瞻性结局指标的收集受到注意力和行为的限制,加强表型评估的复杂性和可用标准化测试的不足。总的来说,与精细运动和非语言认知测试相比,粗大运动和适应性行为评估能够更好地捕获BPAN人群的功能动态范围.对于认知和适应行为测试,在一部分个体的结果测量中注意到地板效应。
    我们的数据表明BPAN的不同表型:严重,早期发作形式和具有较高认知能力的减弱形式。发病年龄早是预测未来神经系统损害的关键因素。
    Beta-propeller protein-associated neurodegeneration (BPAN) is a rare neurodegenerative disorder characterized by iron accumulation in the brain with spectrum of neurodevelopmental and movement phenotypes. In anticipation of future clinical trials and to inform clinical care, there is an unmet need to capture the phenotypic diversity of this rare disorder and better define disease subtypes.
    A total of 27 individuals with BPAN were included in our natural history study, from which traditional outcome measures were obtained in 18 subjects. Demographic and diagnostic information, along with acquisition of basic developmental skills and overall neurologic severity were extracted from the medical records. Functional outcome measures were administered at the time of the evaluation or applied retrospectively at the last clinical encounter for patients who were not able to travel for in person. Based on age and functional level, the following assessments were administered: Leiter-3, Gross Motor Function Measure (GMFM)-66 Item Sets, Vineland-3, and Peabody-2.
    Overall, cognitive function was more impaired compared to gross motor function. Onset of symptoms of BPAN within the first 6 months of life was associated with decreased gain of ambulation and gain of spoken language (ambulation: log-rank test p = 0.0015; gain of first word: p = 0.0015). There was no difference in age at seizure onset by age at initial symptom onset (p = 0.8823). Collection of prospective outcome measures was limited by attention and behavior in our patient population, reinforcing the complexity of phenotype assessment and inadequacy of available standardized tests. Overall, gross motor and adaptive behavior assessments were better able to capture the dynamic range of function across the BPAN population than the fine motor and non-verbal cognitive tests. Floor effects were noted across outcome measures in a subset of individuals for cognitive and adaptive behavior tests.
    Our data suggest the distinct phenotypes of BPAN: a severe, early onset form and an attenuated form with higher cognitive capabilities. Early age at onset was a key factor in predicting future neurologic impairment.
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  • 文章类型: Journal Article
    目的:本系统综述更新了口腔健康特征与虚弱状态之间关联的证据,找出转化牙科研究中的差距,并将脆弱评估应用于临床实践。
    背景:临床医生对医学复杂的老年人进行适当阶段的牙科治疗几乎没有指导。口腔健康特征与虚弱状态有关,通过经过验证的评估工具确定,代表一个简明的健康衡量标准。将脆弱评估转化为牙科实践并不是以前评论的重点。
    方法:利用PRISMA框架进行系统评价,全面的数据库搜索确定了描述感兴趣关联的文章。包括横截面或纵向,在英语中,包括50岁或以上的参与者,使用经过验证的虚弱评估并测量了临床相关的口腔健康结局。从835篇筛选的文章中,26篇全文有资格获得质量评估和综合。
    结果:脆弱患病率介于8.5%至66.0%之间。大多数研究都使用了Fried脆弱标准。17项横断面研究和9项纵向研究的定性综合表明,虚弱状态和牙齿数量之间存在显着的协变量调整关联,咀嚼能力,假肢特征,龋齿,牙周炎,牙齿利用率和口腔健康相关的生活质量因素。研究结果的变异性反映了基于研究来源国的研究样本多样性,招募年龄,样本量,脆弱评估类型,临床与自我报告结局指标的使用以及统计学分析的差异.
    结论:尽管有强有力的证据表明与口腔健康特征有关,虚弱评估尚未充分应用于转化牙科研究和临床实践。
    OBJECTIVE: This systematic review updates the evidence for association between oral health characteristics and frailty status, identifying gaps in translational dental research and application of frailty assessment into clinical practice.
    BACKGROUND: Clinicians have little guidance on stage-appropriate dental treatment for medically complex older adults. Oral health characteristics have been associated with frailty status, determined through validated assessment tools representing a concise measure of health. Translation of frailty assessment into dental practice has not been the focus of previous reviews.
    METHODS: Utilising the PRISMA framework for systematic reviews, a comprehensive database search identified articles describing the association of interest. Those included were cross-sectional or longitudinal, in English, included participants aged 50 years or older, used validated frailty assessments and measured clinically relevant oral health outcomes. From 835 screened articles, 26 full-text articles were eligible for quality appraisal and synthesis.
    RESULTS: Frailty prevalence ranged from 8.5% to 66.0%. Most studies utilised the Fried frailty criteria. Qualitative synthesis of 17 cross-sectional and nine longitudinal studies demonstrated significant covariate-adjusted association between frailty status and number of teeth, chewing ability, prosthetic characteristics, dental caries, periodontitis, dental utilisation and oral health-related quality of life factors. Variability in findings reflected study sample diversity based on country of study origin, age at recruitment, sample size, frailty assessment type, use of clinical versus self-reported outcome measures and differences in statistical analysis.
    CONCLUSIONS: Despite robust evidence of association with oral health characteristics, frailty assessment has yet to be sufficiently applied to translational dental research and clinical practice.
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