The purpose of this systematic review is to identify evidence of the appropriate dose of telehealth intervention services provided to community dwelling adults experiencing chronic illness or disability related to eff...The purpose of this systematic review is to identify evidence of the appropriate dose of telehealth intervention services provided to community dwelling adults experiencing chronic illness or disability related to effectiveness, quality, safety, and cost. Academic Search Complete, CINAHL, MEDLINE, Cochrane, and JBI were searched using combinations of “telehealth or telemedicine or telemonitoring or telepractice or telenursing or telecare AND chronic illness or chronic disease”. Of the identified 449 articles, 47 articles met the inclusion criteria. Most study designs were quasi-experimental one group pre-test post-test (N = 16) with few Randomized Controlled Trials (N = 12). Twenty-three published articles studied the effect of telehealth for one chronic condition (49.9%) while 24 (51.1%) examined the effectiveness of telehealth for multiple chronic conditions. Measurement of telehealth outcomes varied and included efficacy, healthcare utilization, quality, adherence, cost, and safety. No standard measure of dose could be extrapolated. Length of intervention was measured and reported differently in each study. The dose of telehealth services that improve care effectiveness, quality, safety, and cost is still unknown for community dwelling adults experiencing chronic illness. The findings from this systematic review do indicate that longer duration of telehealth services (51 weeks), regardless of modality, produced positive outcomes as opposed to those with shorter durations (37 - 38 weeks) that produced neutral or mixed results. Collecting and reporting data related to clinical workflow such as dose of intervention specific to disease and type of modality is recommended. Rigorous study design including standard measurement at the RCT and Comparative Effectiveness level is still needed.展开更多
Polycomb Group Proteins(PcG)are a family of epigenetic regulators responsible for the repression of an array of genes important in development and cell fate specification.PcG proteins complex to form two types of epig...Polycomb Group Proteins(PcG)are a family of epigenetic regulators responsible for the repression of an array of genes important in development and cell fate specification.PcG proteins complex to form two types of epigenetic regulators:Polycomb Repressive Complex 1 and 2(PRC1 and PRC2).Although the mechanisms regulating PRC2 recruitment and activity in mammals remain poorly understood,recent work has identified a non-canonical PRC2 in mouse embryonic stem cells(mESC)with unique activities required for repression of PRC2 target genes and necessary for mESC differentiation and somatic cell reprogramming.Here we review the functions of PRC2 in embryonic stem cells and explore the role of the newly identified mESC specific PRC2 regulatory subunits Jarid2(jumonji,AT rich interactive domain 2),Mtf2(metal response element binding transcription factor 2)and esPRC2p48.展开更多
文摘The purpose of this systematic review is to identify evidence of the appropriate dose of telehealth intervention services provided to community dwelling adults experiencing chronic illness or disability related to effectiveness, quality, safety, and cost. Academic Search Complete, CINAHL, MEDLINE, Cochrane, and JBI were searched using combinations of “telehealth or telemedicine or telemonitoring or telepractice or telenursing or telecare AND chronic illness or chronic disease”. Of the identified 449 articles, 47 articles met the inclusion criteria. Most study designs were quasi-experimental one group pre-test post-test (N = 16) with few Randomized Controlled Trials (N = 12). Twenty-three published articles studied the effect of telehealth for one chronic condition (49.9%) while 24 (51.1%) examined the effectiveness of telehealth for multiple chronic conditions. Measurement of telehealth outcomes varied and included efficacy, healthcare utilization, quality, adherence, cost, and safety. No standard measure of dose could be extrapolated. Length of intervention was measured and reported differently in each study. The dose of telehealth services that improve care effectiveness, quality, safety, and cost is still unknown for community dwelling adults experiencing chronic illness. The findings from this systematic review do indicate that longer duration of telehealth services (51 weeks), regardless of modality, produced positive outcomes as opposed to those with shorter durations (37 - 38 weeks) that produced neutral or mixed results. Collecting and reporting data related to clinical workflow such as dose of intervention specific to disease and type of modality is recommended. Rigorous study design including standard measurement at the RCT and Comparative Effectiveness level is still needed.
基金Hengbin Wang is a Sidney Kimmel Scholar and work in Wang Lab is supported by NIH Grant(GM081489).
文摘Polycomb Group Proteins(PcG)are a family of epigenetic regulators responsible for the repression of an array of genes important in development and cell fate specification.PcG proteins complex to form two types of epigenetic regulators:Polycomb Repressive Complex 1 and 2(PRC1 and PRC2).Although the mechanisms regulating PRC2 recruitment and activity in mammals remain poorly understood,recent work has identified a non-canonical PRC2 in mouse embryonic stem cells(mESC)with unique activities required for repression of PRC2 target genes and necessary for mESC differentiation and somatic cell reprogramming.Here we review the functions of PRC2 in embryonic stem cells and explore the role of the newly identified mESC specific PRC2 regulatory subunits Jarid2(jumonji,AT rich interactive domain 2),Mtf2(metal response element binding transcription factor 2)and esPRC2p48.
