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Objective: To evaluate harms reporting in systematic reviews (SRs) of microvascular free flap (MFF) in head and neck reconstruction. Data Sources: This cross‐sectional analysis included searches from the following major databases from 2012 to June 1, 2022: MEDLINE (Pubmed and Ovid), Embase, Epistemonikos, and the Cochrane Database of Systematic Reviews. Review Methods: In a masked duplicate manner, screening was performed using Rayyan, and data were extracted using a pilot‐tested Google form. A MeaSurement Tool to Assess systematic Reviews‐2 (AMSTAR‐2) was used to appraise the methodological quality of reviews and the corrected covered area was calculated to detect primary study overlap across all reviews. Reviews were then grouped in pairs of 2, called dyads, and the corrected covered area was calculated again for each individual dyad. Dyads with high overlap (≥50%) were further investigated for the accuracy of harms reporting. Results: Our initial search yielded 268 records, with 50 SRs meeting the inclusion criteria. A total of 46 (92%) of the included reviews demonstrated 50% or more adherence to the items assessed in our harms checklist. Our corrected covered area tool revealed 0.6% primary study overlap across all reviews, and 1 dyad with high overlap (≥50%). No statistically significant relationship was observed between the completeness of harms reporting and reviews listing harms as a primary outcome, reviews reporting adherence to Preferred Reporting Items of Systematic Reviews and Meta‐Analyses, or a review's AMSTAR rating. Conclusion: This study identifies how harms reporting in SRs of MFF reconstruction of the head and neck can be improved and provides suggestions with the potential to mitigate the paucity in current literature. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of "hospital in the home" (HITH) services that significantly substitute for inhospital time on mortality, readmission rates, patient and carer satisfaction, and costs.Data Sources: MEDLINE, Embase, Social Sciences Citation Index, CINAHL, EconLit, PsycINFO and the Cochrane Database of Systematic Reviews, from the earliest date in each database to 1 February 2012.Study Selection: Randomised controlled trials (RCTs) comparing HITH care with inhospital treatment for patients aged > 16 years.Data Extraction: Potentially relevant studies were reviewed independently by two assessors, and data were extracted using a collection template and checklist.Data Synthesis: 61 RCTs met the inclusion criteria. HITH care led to reduced mortality (odds ratio [OR], 0.81; 95% CI, 0.69 to 0.95; P = 0.008; 42 RCTs with 6992 patients), readmission rates (OR, 0.75; 95% CI, 0.59 to 0.95; P = 0.02; 41 RCTs with 5372 patients) and cost (mean difference, -1567.11; 95% CI, -2069.53 to -1064.69; P < 0.001; 11 RCTs with 1215 patients). The number needed to treat at home to prevent one death was 50. No heterogeneity was observed for mortality data, but heterogeneity was observed for data relating to readmission rates and cost. Patient satisfaction was higher in HITH in 21 of 22 studies, and carer satisfaction was higher in and six of eight studies; carer burden was lower in eight of 11 studies, although not significantly (mean difference, 0.00; 95% CI, -0.19 to 0.19).Conclusion: HITH is associated with reductions in mortality, readmission rates and cost, and increases in patient and carer satisfaction, but no change in carer burden. [ABSTRACT FROM AUTHOR]

Aim This study investigated the nature of coordination and control problems in children with developmental coordination disorder (DCD). Method Seven adults (two males, five females, age range 20–28y; mean 23y, SD 2y 8mo) and eight children with DCD (six males, two females, age range 7–9y; mean 8y, SD 8mo), and 10 without DCD (seven males, three females, age range 7–9y; mean 8y, SD 7mo) sat in a swivel chair and looked at or pointed to targets. Optoelectronic apparatus recorded head, torso, and hand movements, and the spatial and temporal characteristics of the movements were computed. Results Head movement times were longer ( p<0.05) in children with DCD than in the comparison group, even in the looking task, suggesting that these children experience problems at the lowest level of coordination (the coupling of synergistic muscle groups within a single degree of freedom). Increasing the task demands with the pointing condition affected the performance of children with DCD to a much greater extent than the other groups, most noticeably in key feedforward kinematic landmarks. Temporal coordination data indicated that all three groups attempted to produce similar movement patterns to each other, but that the children with DCD were much less successful than age-matched children in the comparison group. Interpretation Children with DCD have difficulty coordinating and controlling single degree-of-freedom movements; this problem makes more complex tasks disproportionately difficult for them. Quantitative analysis of kinematics provides key insights into the nature of the problems faced by children with DCD. [ABSTRACT FROM AUTHOR]

To the Editor: Diabetic retinopathy is the leading cause of visual loss in working age adults in the United Kingdom (Evans et al. 1996) and yet, for the vast majority of patients with proliferative retinopathy, early laser treatment will stop the loss of vision, and treatment has also been shown to be beneficial for many patients with maculopathy (The Diabetic Retinopathy Research Group 1978; Early Treatment Diabetic Retinopathy Study Research Group 1991). Unfortunately sight-threatening retinopathy is asymptomatic in its early stages when it is most amenable to treatment and it is only detectable by careful examination of the fundus. This combination of features makes diabetic retinopathy an ideal candidate for screening (Wilson & Jungner 1968) and several economic analysis have established its benefits (Foulds et al. 1983; Javitt et al. 1989; Rohan et al. 1989; Javitt et al. 1994). Guidelines for the screening of diabetic retinopathy recommend checks at least once per year, although it is less clear what method of testing should be used or who should carry out the screen (American Academy of Ophthalmology Quality of Care Committee 1993; Retinopathy Working Party 1991). In Britain many local schemes have been developed through the individual initiatives of ophthalmologists, diabetologists, optometrists or general practitioners. Some schemes use ophthalmoscopy to examine the fundus while others rely on photography. Research suggests that both ophthalmoscopy by an experienced user and photography through a dilated pupil give acceptable sensitivity, that a non-mydriatic camera is less sensitive and that in the hands of a less experienced screener, such as a general practitioner without special training, the quality of ophthalmoscopy will be noticeably worse (Taylor et al. 1990; Buxton et al. 1991; Patel et al. 1992). The World Health Organisation and the International Diabetes Federation were concerned at the failure of health services to prevent blindness from... [ABSTRACT FROM AUTHOR]

The article presents information on a study which investigates the developmental coordination disorder (DCD) in children. It suggests that children having a DCD problem are found worse at force control and motor performance when measured for control and fingertip force production. It reflects on the perception-action mechanisms which is associated with performance and learning.