Assia Djebri, Zahra Sadaoui, Mohamed Belmedani, Lionel Domergue, Mohamed Trari
Removal efficiency of pharmaceutical drugs (Mebeverine hydrochloride MEB) by an activated carbon prepared from dates stems
Journal of environmental health science & engineering
primary malignant brain tumours unpredictable course highgrade gliomas typically relentlessly progressive disease trajectory cause profound symptom burden affecting physical neurocognitive social functioning early stage illness significantly impact role function experiences needs informal caregivers access specialist palliative supportive care early disease trajectory highgrade tumours particular potential improve patients caregivers quality life however provision palliative supportive care people primary brain tumours informal caregivers historically illdefined ad hoc benefits early palliative interventions confirmed therefore important define role effectiveness early referral specialist palliative care services andor effectiveness interventions focused palliating disease impact people informal caregivers would help guide improvement service provision defining interventions effective across range domains developing evidencebased model integrated supportive palliative care population assess evidence base early palliative care interventions including referral specialist palliative care services compared usual care improving outcomes adults diagnosed primary brain tumour carers conducted searches electronic databases central medline cinahl web science psycinfo last searched 16 november 2021 conducted searches incorporate qualitative quantitative search terms addition searched currently recruiting trials clinicaltrialsgov world health organization international clinical trials registry platform ictrp search portal undertook citation tracking via scopus also handsearched reference lists potentially eligible systematic review articles identify relevant studies contacted experts field searched key authors via web science searched sigle system information grey literature europe included studies looking early referral specialist palliative care services early targeted palliative interventions healthcare professionals improving quality life symptom control psychological outcomes overall survival primary secondary outcome measure studies included randomised controlled trials rcts nonrandomised studies nrs well qualitative mixedmethods studies qualitative quantitative data included participants adults confirmed radiological andor histological diagnosis primary malignant brain tumour andor informal adult carers either individual family level people primary malignant brain tumour followed standard cochrane methodological procedures data extraction management analysis used grade assess certainty evidence symptom control ie cognitive function identified 9748 references searches 8337 remaining duplicates removed fulltext review included one trial studies early specialist palliative care interventions early coordinated generalist palliative care approaches included randomised trial addressed single symptom area focusing early cognitive rehabilitation administered within two weeks surgery mixed brain tumour population approximately half highgrade glioma intervention administered individually therapistled computerised exercises 16 onehour sessions four timesweek four weeks sessions addressed several cognitive domains including time orientation spatial orientation visual attention logical reasoning memory executive function betweengroup differences outcome tests logicalexecutive function differences observed domains visual attention verbal memory risk bias assessed stated high performance bias attrition bias selective reporting unclear whether outcomes reported considered certainty evidence assessed grade low currently lack research focusing introduction early palliative interventions specifically people primary brain tumours either coordinated specialist palliative care approaches interventions focusing specific aspect palliation future research address methodological shortcomings described early palliative intervention studies cancers chronic conditions particular specific population investigation timing setting intervention clearly described standardised palliative carespecific components intervention defined detail