Self-management eHealth solutions for menopause - a systematic scoping review.

OBJECTIVE: The purpose of this scoping review was to highlight the current scientific evidence on eHealth-based information tools for menopause in terms of quality, requirements and previous intervention outcomes. METHODS: We systematically searched electronic databases (Embase, CINAHL, Cochrane Library, Global Health Database [Ovid], Web of Science, ClinicalTrials.gov [NLM], LIVIVO Search Portal [ZB MED] and Google Scholar) from 1974 to March 2022 for relevant records. RESULTS: Our search yielded 1773 records, of which 28 met our inclusion criteria. Thirteen of 28 selected studies were cross-sectional with qualitative content analysis of websites about menopause; 9 studies were cohort studies examining the impact of an eHealth intervention; two studies were randomized controlled trials comparing eHealth tools with conventional ones; and four studies were non-systematic literature reviews. CONCLUSION: This scoping review highlights the potential of eHealth-based information tools for the management of menopause and shows that most eHealth-based information tools are inadequate in terms of readability and the balanced view on information. Providers of eHealth-based information tools should pay attention to a participatory design, readability, balance of content and the use of multimedia tools for information delivery to improve understanding.

Long-term trends in juvenile Mugil liza abundance in relation to selected environmental and fisheries influences in southern Brazil.

Overfishing constitutes a major threat affecting marine fish population worldwide, including mullet species that have been exploited by fisheries during the reproductive migration in temperate and tropical latitudes for millennia. In the present study, we investigated the relationship of fishing intensity of mullet Mugil liza during its reproductive migration and the abundance of their juveniles in an essential nursery ground for the species in the southwest Atlantic Ocean. To carry out this analysis, we used a 23-year standardized long-term time series (1997-2019) of monthly abundance of M. liza juveniles, local/regional (water temperature, salinity, water transparency and river discharge) and global (ENSO) environmental factors, along with compilations of fishing landing data for the species. Generalized Additive Models (GAM) revealed the negative effect of fishing adult populations on the abundance of juveniles when they reach the marine surf-zone and after recruiting into the estuary. Our results reinforce the importance of adequate conservation and fishery regulation policies to prevent the species' stock from collapsing.

Progestogens for endometrial protection in combined menopausal hormone therapy: A systematic review.

Menopausal women with an intact uterus choosing estrogens for menopausal symptom relief require a progestogen for endometrial protection. The aim of this systematic review was to evaluate the risks of endometrial hyperplasia resp. malignancy with different progestogens used in combined MHT. Overall, 84 RCTs were included. We found that 1) most studies were done with NETA, followed by MPA, MP and DYD and LNG, 2) most progestogens were only available as oral formulations, 3) the most frequently studied progestogens (oral MP, DYD, MPA, oral and transdermal NETA, transdermal LNG) were assessed in continuously as well as in sequentially combined MHT regimens, 4) FDA endometrial safety criteria were only fulfilled for some progestogen formulations, 5) most studies demonstrated endometrial protection for the progestogen dose and time period examined. However, 6) study quality varied which should be taken into account, when choosing a combined MHT, especially if off-label-use is chosen.

Hydroclimatic influence on the trophic ecology of Atlantic goliath grouper juveniles (Epinephelus itajara) in a tropical estuary using non-lethal methodologies.

The Atlantic goliath grouper Epinephelus itajara is the largest species of groupers in the Atlantic Ocean, reaching over 2 m total length and 400 kg. It has an ontogenetic migration, with adults using nearshore and offshore marine areas and juveniles inhabiting estuarine/mangrove areas. Despite of its high ecological relevance and classification as a threatened species for several decades in the IUCN red lists, critical phases of its life cycle, like juveniles inhabiting estuaries, are still poorly investigated. In this study, we evaluated if hydroclimatic changes may affect the trophic ecology of juveniles in a tropical estuary. We described their diet composition, isotopic niche area, food assimilation, and trophic position of juveniles across seasons using two non-lethal techniques: stomach content analysis using a stomach flushing procedure and stable isotope analysis using a dermal biopsy. A total of 87 individuals with TL ranging from 38 to 331 mm had their stomachs analyzed, of which 31 had food content. We identified 11 prey items, shrimp being the most abundant prey group (IRI% = 88.4), followed by fish (6.6), blue crab (2.8), and crab (2.2). A total of 93 specimens had their muscle's carbon (δ13C) and nitrogen (δ15N) stable isotope ratios analyzed (38-332 mm TL). Average δ13C values showed statistically significant changes across seasons, but no significant changes were observed for δ15N. As initially predicted, isotopic niche size of juveniles changed consistently along the entire hydroclimatic cycle, reaching its peak at the end of the wet season. We also observed changes in the proportion of prey assimilation by juveniles between seasons. Shrimp (92.1%) was the most assimilated prey group during the late dry season, whereas tidal crabs (36.7%), blue crab (27.8%), and shrimp (25.1%) were the most important in the late wet season. Average trophic position of juveniles remained similar across wet (3.32 ± 0.10) and dry (3.23 ± 0.11) seasons. These findings provide important information to help decision makers to promote more efficient management and conservation legislations to protect early life stages of the Atlantic goliath grouper in tropical estuaries.

Complex interactions of ENSO and local conditions buffer the poleward shift of migratory fish in a subtropical seascape.

Ocean warming is associated with the tropicalization of fish towards higher latitudes. However, the influence of global climatic phenomena like the El Niño Southern Oscillation (ENSO) and its warm (El Niño) and cold (La Niña) phases on tropicalization has been overlooked. Understanding the combined effects of global climatic forces together with local variability on the distribution and abundance of tropical fish is essential for building more accurate predictive models of species on the move. This is particularly important in regions where ENSO-related impacts are known to be major drivers of ecosystem change, and is compounded by predictions that El Niño is becoming more frequent and intense under current ocean warming. In this study, we used long-term time series of monthly standardized sampling (August 1996 to February 2020) to investigate how ocean warming, ENSO and local environmental variability influence the abundance of an estuarine dependent tropical fish species (white mullet Mugil curema) at subtropical latitudes in the southwestern Atlantic Ocean. Our work revealed a significant increasing trend in surface water temperature in shallow waters (<1.5 m) at estuarine and marine sites. However, against our initial expectation, we did not observe an increasing trend in the abundance of this tropical mullet species. Generalized Additive Models revealed complex, non-linear relationships between species abundance and environmental factors operating at large (ENSO's warm and cold phases), regional (freshwater discharge in the coastal lagoon's drainage basin) and local (temperature and salinity) scales across the estuarine marine gradient. These results demonstrate that fish responses to global climate change can be complex and multifaceted. More specifically, our findings suggested that the interaction among global and local driving forces dampen the expected effect of tropicalization for this mullet species in a subtropical seascape.