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BMJ Open ; 11(3): e045598, 2021 03 02.
Artículo en Inglés | MEDLINE | ID: mdl-33653763


INTRODUCTION: Many healthcare facilities in low-income and middle-income countries are inadequately resourced and may lack optimal organisation and governance, especially concerning surgical health systems. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers (HCWs) from viral exposure and ensure the continuity of specialised care for patients. The objective of this broad evidence synthesis is to identify and summarise the available literature regarding the efficacy of different personal protective equipment (PPE) in reducing the risk of COVID-19 infection in health personnel caring for patients undergoing trauma surgery in low-resource environments. METHODS: We will conduct several searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials and over 30 other sources. The search results will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. This review will preferentially consider systematic reviews of experimental and quasi-experimental studies, as well as individual studies of such designs, evaluating the effect of different PPE on the risk of COVID-19 infection in HCWs involved in emergency trauma surgery. Critical appraisal of eligible studies for methodological quality will be conducted. Data will be extracted using the standardised data extraction tool in Covidence. Studies will, when possible, be pooled in a statistical meta-analysis using JBI SUMARI. The Grading of Recommendations, Assessment, Development and Evaluation approach for grading the certainty of evidence will be followed and a summary of findings will be created. ETHICS AND DISSEMINATION: Ethical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders. PROSPERO REGISTRATION NUMBER: CRD42020198267.

/prevención & control , Tratamiento de Urgencia , Personal de Salud , Equipo de Protección Personal , Literatura de Revisión como Asunto , Heridas y Traumatismos/cirugía , Ensayos Clínicos Controlados como Asunto , Humanos , Metaanálisis como Asunto , Pandemias , Servicio de Cirugía en Hospital , Revisiones Sistemáticas como Asunto
Gesundheitswesen ; 83(3): 173-179, 2021 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-33634462


AIMS: During the COVID-19 pandemic, many health-related questions require rapid answers. In the Competence Network Public Health COVID-19, founded by representatives of several scientific societies in March 2020, rapid reviews are often conducted to generate evidence-based answers that are useful for policy makers. The aim of this paper is to reflect on the practical experience with rapid reviews in the context of the Competence Network Public Health. Methods for high-quality and practicable implementation of rapid reviews were developed, which are particularly helpful for rapid evidence generation based on observational studies. METHODS: Using the 8-step approach proposed by Tricco et al. [1], we describe the acute challenges that have arisen in the Public Health Competence Network COVID-19 while conducting rapid reviews on public health-related issues related to the COVID-19-pandemic. The 8 steps are: 1. conceptualization of the research question, 2. literature search, 3. title/abstract and full text screening, 4. data extraction, 5. risk of bias assessment, 6. evidence synthesis, 7. dissemination, 8. update. We develop a methodological approach for conducting rapid reviews by expert consensus of the members (n=42 as of 01/28/2021) of the Rapid Reviews Working Group in the Competence Network Public Health COVID-19. RESULTS: A standardized approach is presented that closely follows the approach of the Cochrane Rapid Reviews Methods Group and takes into account the special requirements of etiological - but often also ecological - observational studies on COVID-19. CONCLUSIONS: The proposed approach for conducting rapid reviews can form an important basis for evidence-based policy advice - certainly beyond questions related to COVID-19. Flexible and rapid funding concepts should be made available for the short-term realization of methodologically high-quality rapid reviews on emerging questions. Scientific cooperation in conducting rapid reviews needs to be expanded, and more methodologically high-quality approaches such as prospective meta-analyses should be used.

Salud Pública , Literatura de Revisión como Asunto , Alemania , Humanos , Pandemias , Estudios Prospectivos
Am J Public Health ; 111(3): 465-470, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33476230


For systematic reviews to have an impact on public health, they must report outcomes that are important for decision-making. Systematic reviews of public health interventions, however, have a range of potential end users, and identifying and prioritizing the most important and relevant outcomes represents a considerable challenge.In this commentary, we describe potentially useful approaches that systematic review teams can use to identify review outcomes to best inform public health decision-making. Specifically, we discuss the importance of stakeholder engagement, the use of logic models, consideration of core outcome sets, reviews of the literature on end users' needs and preferences, and the use of decision-making frameworks in the selection and prioritization of outcomes included in reviews.The selection of review outcomes is a critical step in the production of public health reviews that are relevant to those who use them. Utilizing the suggested strategies may help the review teams better achieve this.

Medicina Basada en la Evidencia/estadística & datos numéricos , Práctica de Salud Pública/estadística & datos numéricos , Salud Pública , Literatura de Revisión como Asunto , Humanos , Metaanálisis como Asunto , Guías de Práctica Clínica como Asunto
BMJ Open ; 11(1): e044190, 2021 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-33509851


INTRODUCTION: In current medical practice of curative treatment for non-metastatic oesophageal cancer, surgery on principle is carried out by oesophagectomy after neoadjuvant treatment. However, oesophagectomy is often associated with postoperative morbidity and mortality. Taking into account that modern neoadjuvant therapy is effective and many of patients show no vital tumour cells in the operative specimens, we aim to perform a scoping review as part of the development phase for a prospectively planned multicentre randomised controlled trial investigating 'surgery as needed vs surgery on principle in patients with postneoadjuvant complete response of oesophageal cancer' (Prospective trial registration number DRKS00022801). This scoping approach will allow us to finally define and/or adapt the research question including the design and methodology of the randomised controlled trial taking into account the findings for example, research gaps and/or pitfalls in the currently available study pool addressing this or very similar questions. METHODS AND ANALYSIS: To identify relevant research, we will conduct searches in the electronic databases Medline, Web of Science Core Collection, Cochrane Library and Science Direct. We will also check references of relevant studies and perform a cited reference research (forward citation tracking). Titles and abstracts of the records identified by the searches will be screened and full texts of all potentially relevant articles will be obtained. We will consider randomised trials and non-randomised controlled studies. Data extraction tables will be set up, including study and patients' characteristics, aim of study and reported outcomes. We will summarise the data using tables and figures (eg, bubble plots) to present the research landscape and to describe potential clusters and/or gaps to support the planning of a randomised trial in this patient population. ETHICS AND DISSEMINATION: Ethical approval is not required for this scoping review. Study findings will be shared by publication in a peer-reviewed journal and by presentation to key stakeholders on scientific meetings.

Neoplasias Esofágicas/terapia , Esofagectomía/métodos , Estudios Multicéntricos como Asunto/métodos , Terapia Neoadyuvante , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Neoplasias Esofágicas/diagnóstico por imagen , Neoplasias Esofágicas/cirugía , Femenino , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud/métodos , Literatura de Revisión como Asunto
Int Angiol ; 40(2): 170-175, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33463975


BACKGROUND: Seventy percent of patients affected by SARS-COV-2 disease are asymptomatic or with symptoms that not required Hospitalization. A prodromal period lasting about 5 days can be identified. In this phase a patient with a positive swab for viral RNA may or may not evolve towards the phase of symptomatic disease. METHODS: In this paper we reviewed the literature related to COVID-19 therapy we propose a reasoned treatment protocols in outpatients according to the age and the comorbidity. RESULTS: The aim of this study was to reduce the impact of the virus by reducing its ability to attack cells and the inflammatory burden and the prothrombotic effects proposing two therapeutic schemes of proven efficacy according to the age of the patients and the comorbidities. CONCLUSIONS: We aimed to reduce worsening of clinical status and hospitalization while protecting patients at home.

/tratamiento farmacológico , Protocolos Clínicos , Pacientes Ambulatorios , Factores de Edad , Comorbilidad , Femenino , Hospitalización/tendencias , Humanos , Italia , Masculino , Literatura de Revisión como Asunto , Conducta de Reducción del Riesgo , /aislamiento & purificación
Lancet Gastroenterol Hepatol ; 6(3): 169-184, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33515496


BACKGROUND: Treatment for infection with hepatitis C virus (HCV) during pregnancy has not yet been approved; however, interventions specifically targeting women, especially those of childbearing age (15-49 years), could prevent vertical transmission and community spread. To assess the impact of such interventions, improved prevalence estimates in this group are needed. We aimed to estimate the global prevalence of viraemic HCV in 2019 among women of childbearing age. METHODS: In this modelling study, we used previously developed models for 110 countries inputted with country-specific demographic and HCV epidemiology data. We did a literature review, searching PubMed, Embase, and grey literature for studies published between Jan 1, 2000, and June 30, 2018, reporting HCV antibody or viraemic prevalence in women of childbearing age. Studies from the literature review and studies in models were compared by use of a data quality scoring system and models were updated, as appropriate, when a better study was identified. We used these HCV disease burden models to calculate the 2019 prevalence of viraemic HCV in women of childbearing age. In countries without a model, prevalence was extrapolated by Global Burden of Disease (GBD) region. FINDINGS: An estimated 14 860 000 (95% uncertainty interval [UI] 9 667 000-18 282 000) women aged 15-49 years had HCV infection worldwide in 2019, corresponding to a viraemic prevalence of 0·78% (95% UI 0·62-0·86). Globally, HCV prevalence increased with age, rising from 0·25% (95% UI 0·20-0·27) in women aged 15-19 years to 1·21% (0·97-1·34) in women aged 45-49 years. China (16% of total infections) and Pakistan (15%) had the greatest numbers of viraemic infections, but viraemic prevalence was highest in Mongolia (5·14%, 95% CI 3·46-6·28) and Burundi (4·91%, 3·80-18·75). Of the countries with 500 cases or more, viraemic prevalence was lowest in Chile (0·07%, 95% UI 0·04-0·12). Among the GBD regions, eastern Europe had the highest viraemic prevalence (3·39%, 95% UI 1·88-3·54). By WHO region, the Eastern Mediterranean region had the highest viraemic prevalence (1·75%, 95% UI 1·26- 1·90). INTERPRETATION: Most research on HCV disease burden among women aged 15-49 years focuses on pregnant women. Using modelling, this analysis provides global and national estimates of HCV prevalence in all women of childbearing age. These data can inform preconception test-and-treat strategies to reduce vertical transmission and total disease burden. FUNDING: Gilead Sciences, John C Martin Foundation, private donors.

Hepatitis C/tratamiento farmacológico , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Viremia/epidemiología , Adolescente , Adulto , Femenino , Carga Global de Enfermedades , Hepacivirus/efectos de los fármacos , Hepacivirus/aislamiento & purificación , Hepatitis C/complicaciones , Hepatitis C/epidemiología , Hepatitis C/virología , Humanos , Persona de Mediana Edad , Modelos Teóricos , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/virología , Prevalencia , Literatura de Revisión como Asunto , Adulto Joven
Arq. odontol ; 57: 3-7, jan.-dez. 2021. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1150642


Objetivo: Fornecer um guia no formato de checklist para auxiliar pesquisadores na condução de revisões integrativas em Odontologia. Métodos:O guiapara revisões integrativas em Odontologiafoi construído a partir do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (The PRISMA Statement). Resultados:Para o delineamento de revisões integrativas em Odontologia é preciso percorrer etapas distintas: 1. Identificação do tema (elaboração da pergunta de pesquisa); 2. Estabelecimento dos critérios de elegibilidade de estudos; 3. Busca sistematizada em diversas fontes de informação; 4. Coleta de dados; 5. Análise dos dados; 6. Discussão; 7. Apresentação da revisão/síntese do conhecimento. Os erros mais comuns ao realizar uma revisão integrativa estão relacionados à descrição incompleta ou não realização de etapas importantes, tais como: 1. Processo de seleção das evidências; 2. Estratégia de busca reprodutível; 3. Detalhes relacionados à busca, seleção e inclusão de estudos; 4. Aplicação dos critérios de elegibilidade; 5. Processo de extração dos dados (definição clara dos dados a serem extraídos, número de revisores envolvidos); 6. Apresentação do processo de seleção de estudos no formato de fluxograma; 7. Avaliação da qualidade dos estudos; 8. Síntese dos resultados. Conclusão:O guia para revisões integrativas em Odontologia apresenta utilidade na redução de equívocos metodológicos frequentemente observados nesse desenho de estudo, bem como estimula a condução de trabalhos com delineamentos robustos.

Aim: To provide a checklist to assist researchers in conducting integrative reviews in Dentistry. Methods: This guideline for integrative reviews in Dentistry was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (The PRISMA Statement). Results: Planning integrative reviews in Dentistry involves different stages: 1. Identification of the theme (elaboration of the research question); 2. Establishment of eligibility criteria; 3. Systematized search in several databases and other data sources; 4. Data collection; 5. Data analysis; 6. Discussion; 7. Report on the review/summary of findings. The most common errors when conducting an integrative review are related to incomplete description or failure to perform important steps, such as: 1. Evidence synthesis; 2. A reproducible search strategy; 3. Details related to studies' search, screening, selection; 4. Clear state eligibility criteria; 5. Data extraction process (clear definition of the data to be extracted, number of reviewers involved); 6. Presentation studies' screening and selection process in a flowchart format; 7. Evaluation of the quality of the studies; 8. Summary of the findings. Conclusion:A guideline for integrative reviews in Dentistry intends to reduce methodological issues frequently observed in this study design, as well as to encourage researchers to conduct studies with a robust design.

Literatura de Revisión como Asunto , Metodología , Revisiones Sistemáticas como Asunto , Revisión
J Occup Environ Med ; 63(3): 199-220, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33350662


OBJECTIVE: Higher probability of developing severe COVID-19 has been associated with health risk factors and medical conditions which are common among workers globally. For at risk workers, return to work may require additional protective policies and procedures. METHODS: A review of the medical literature was conducted on health risk factors and medical conditions associated with increased COVID-19 morbidity and mortality, standardized measures for community COVID transmission, and occupation-specific risk. RESULTS: The relative risk of acquiring and the severity of COVID-19 for workers is associated with three pillars: individual risk, workplace risk, and community risk. Matrices were developed to determine a worker's individual risk based on these three pillars. CONCLUSIONS: A practical decision tool is proposed for physicians evaluating and managing individual worker COVID-19 risk in the context of returning to work.

/epidemiología , Control de Enfermedades Transmisibles/normas , Médicos/normas , Reinserción al Trabajo , /prevención & control , Control de Enfermedades Transmisibles/métodos , Guías como Asunto , Humanos , Salud Laboral , Literatura de Revisión como Asunto , Medición de Riesgo , Factores de Riesgo , Lugar de Trabajo/normas
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 199-207, dic. 2020. ilus, tab
Artículo en Español | LILACS | ID: biblio-1145501


La encefalitis límbica es una enfermedad infrecuente y potencialmente grave, que puede o no ser paraneoplásica y se caracteriza por déficit de la memoria reciente, alteraciones psiquiátricas y convulsiones. De origen autoinmunitario, está asociada a anticuerpos séricos e intratecales contra antígenos neuronales intracelulares y de superficie, con especial afectación de zonas límbicas. En este artículo se revisan aspectos históricos y epidemiológicos, patogenia, síndromes más frecuentes y mejor delimitados, histopatología y estudios complementarios. Se repasan también las dificultades del diagnóstico diferencial y la necesidad de descartar siempre un tumor subyacente. La detección de autoanticuerpos neuronales es importante para el diagnóstico, la planificación terapéutica y el pronóstico. La inmunoterapia y, si corresponde, el tratamiento de la neoplasia son cruciales para lograr una recuperación neurológica sustancial. La encefalitis límbica es una entidad probablemente subdiagnosticada, con un pronóstico más favorable si se trata de forma temprana. El actual conocimiento de su patogenia puede además aportar claridad para la mejor comprensión de otros síndromes neurológicos y psiquiátricos que puedan compartir mecanismos autoinmunitarios, como algunos trastornos psicóticos y epilepsias farmacorresistentes. (AU)

Limbic encephalitis is a rare and potentially serious disease, which may or may not be paraneoplastic and is characterized by recent memory deficits, psychiatric disturbances and seizures. Of autoimmune origin, it is associated with serum and intrathecal antibodies against intracellular and surface neuronal antigens, with special involvement of limbic areas. This article reviews historical and epidemiological aspects, pathogenesis, more frequent and better defined syndromes, histopathology and complementary studies. The difficulties of differential diagnosis and the need to always rule out an underlying tumor are also reviewed. Detection of neuronal autoantibodies is important for diagnosis, therapeutic planning and prognosis. Immunotherapy and, if appropriate, neoplasm treatment, are crucial to achieve substantial neurological recovery. Limbic encephalitis is probably an underdiagnosed entity, with a more favorable prognosis if treated early. The current knowledge of its pathogenesis may also provide clarity for a better understanding of other neurological and psychiatric syndromes that may share autoimmune mechanisms, such as some psychotic disorders and drug-resistant epilepsies. (AU)

Humanos , Autoanticuerpos/metabolismo , Enfermedades Autoinmunes/patología , Síndromes Paraneoplásicos del Sistema Nervioso/patología , Encefalitis Límbica/patología , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/etiología , Enfermedades Autoinmunes/diagnóstico , Enfermedades Autoinmunes/etiología , Enfermedades Autoinmunes/terapia , Literatura de Revisión como Asunto , Síndromes Paraneoplásicos del Sistema Nervioso/diagnóstico , Síndromes Paraneoplásicos del Sistema Nervioso/etiología , Síndromes Paraneoplásicos del Sistema Nervioso/terapia , Encefalitis Límbica/diagnóstico , Encefalitis Límbica/etiología , Encefalitis Límbica/historia , Encefalitis Límbica/terapia , Epilepsia/diagnóstico , Epilepsia/etiología
Rev. cuba. estomatol ; 57(4): e3192, Oct.-Dec. 2020. graf
Artículo en Español | LILACS, CUMED | ID: biblio-1144455


RESUMEN Introducción: La presencia de estructuras dentofaciales atípicas puede ser el primer indicador de otros defectos congénitos relacionados con síndromes también de origen genético. El síndrome Nance-Horan es un trastorno monogénico ligado al cromosoma X, caracterizado fenotípicamente por alteraciones dismorfológicas dentales y craneofaciales distintivas, cataratas congénitas y déficit cognitivo. Objetivo: Describir un caso inusual de anomalías dentarias en el curso del síndrome Nance-Horan. Presentación de caso: Paciente de 13 años de edad, masculino, de piel blanca. Al examen clínico se constató un patrón dismórfico dado por facies alargada y estrecha, orejas prominentes con anteversión de la aurícula, nariz grande con puente nasal alto, diastema generalizado en ambas arcadas, todos los dientes con anomalías de forma y microdónticos. En el estudio radiológico periapical se constataron raíces cortas y cámaras pulpares amplias. Los antecedentes patológicos personales de nuestro paciente, el patrón dismórfico cráneo facial y las radiografías coinciden con características de otros casos de síndrome Nance-Horan reportados en la literatura. La mutación del gen síndrome Nance-Horan se expresa completamente solo en los varones. Como los varones son hemicigóticos para los genes ligados al cromosoma X, basta con una copia del alelo mutado para que aparezca una enfermedad de herencia recesiva ligada al sexo. Conclusiones: Se evidenció que es de crucial importancia realizar un cuidadoso examen, tanto clínico como radiográfico, de los pacientes con anomalías dentales. Se insiste en el trabajo mancomunado entre diferentes disciplinas y especialidades, tanto médicas como estomatológicas(AU)

ABSTRACT Introduction: The presence of atypical dentofacial structures may be the first indicator of other congenital defects related to syndromes of likewise genetic origin. Nance-Horan syndrome is a monogenic X linked disorder phenotypically characterized by distinctive dysmorphic dental and craniofacial alterations, congenital cataracts and cognitive deficit. Objective: Describe an unusual case of dental anomalies in the course of Nance-Horan syndrome. Case presentation: A case is presented of a white male 13-year-old patient. Clinical examination revealed a dysmorphic pattern characterized by long narrow facies, prominent ears with auricular anteversion, a big nose with a high nasal bridge, generalized diastema in both arches, and all the teeth microdontic and abnormally shaped. Periapical radiological examination found short roots and broad pulp chambers. The personal pathological antecedents of the patient, the dysmorphic craniofacial pattern and the radiographs correspond to characteristics of other cases of Nance-Horan syndrome reported in the literature. Mutation of the Nance-Horan syndrome gene is completely expressed only in males. Since males are hemizygous for X linked genes, one copy of the mutated allele is sufficient for the appearance of a sex-linked recessive inheritance disease. Conclusions: Evidence was found of the crucial importance of conducting careful examination, both clinical and radiographic, of patients with dental anomalies. Emphasis is placed on the joint work of various disciplines and specialties, both medical and dental(AU)

Humanos , Masculino , Adolescente , Anomalías Dentarias/diagnóstico por imagen , Anomalías Congénitas/etiología , Catarata/diagnóstico , Literatura de Revisión como Asunto
Rev. cuba. estomatol ; 57(4): e3074, Oct.-Dec. 2020. tab, graf
Artículo en Español | LILACS, CUMED | ID: biblio-1144454


RESUMEN Introducción: La crioanestesia es una forma de anestesia tópica utilizada en procedimientos médicos menores aprovechando el descenso o inhibición del umbral doloroso causado por el estímulo térmico. Es posible emplearla en procedimientos sobre tejidos dentales para complementar la anestesia con fármacos y combatir el fracaso anestésico. Objetivo: Describir los hallazgos sobre el uso y aplicación de la crioanestesia dental en odontología. Métodos: Revisión exploratoria de la literatura científica y gris, donde se evaluó la disminución de la sensación dolorosa empleando frío sin alcanzar congelación del tejido dental. Fueron consultadas las bases de datos Pubmed, Embase, Scopus, SciELO, Elsevier y Science Direct. La búsqueda en Google Académico se realizó eliminando las entradas repetidas y limitada a los 100 primeros resultados. La investigación cubrió el periodo de 1941 hasta diciembre de 2018 y se utilizó la lista de comprobación PRISMA para ejecutar la revisión. Resultados: Cuatro artículos fueron seleccionados. Todos emplearon diferentes dispositivos, refrigerantes y escalas para valoración del dolor; sin embargo, todos reportaron ausencia de dolor en algunas de sus muestras. Conclusión: Se identificó evidencia escasa y antigua con desigualdad en las escalas de valoración, protocolos clínicos, sustancias refrigerantes y dispositivos utilizados(AU)

ABSTRACT Introduction: Cryoanesthesia is a type of topical anesthesia used in minor medical procedures. It is based on the descent or inhibition of the pain threshold caused by the thermal stimulus. Cryoanesthesia may be used in procedures performed on dental tissues to complement anesthetic drugs and combat anesthetic failure. Objective: Describe the findings about the use and application of cryoanesthesia in dental practice. Methods: An exploratory review was conducted of scientific and grey literature to evaluate pain reduction using cold temperatures without freezing the dental tissue. The databases consulted were Pubmed, Embase, Scopus, SciELO, Elsevier and Science Direct. The search in Google Scholar removed repeated entries and was limited to the first 100 results. The study covered the period extending from 1941 to December 2018, and used the PRISMA checklist to carry out the review. Results: Four papers were selected. All four used different devices, refrigerants and pain assessment scales. However, they all reported an absence of pain in some of their samples. Conclusion: Scant, outdated evidence was identified which contained discrepancies in the assessment scales, clinical protocols, refrigerant substances and devices used(AU)

Humanos , Crioanestesia/métodos , Anestesia Dental/métodos , Literatura de Revisión como Asunto , Bases de Datos Bibliográficas
Afr J AIDS Res ; 19(4): 276-286, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33337981


Domestic stigmatisation serves as an umbrella term for acts of enacted or felt stigma experienced in a person's domestic environment. This article reports on the term which transpired from a narrative inquiry in 2011 with people living with HIV (PLWH) who reported humiliation or segregation, experienced or perceived, within the domestic environment that rendered the individual disabled, diseased, unworthy, unhealthy, or deficient. A literature review about this form of stigma was conducted using the following inclusion criteria: 1) a peer-reviewed source; 2) published between 2011 and 2018; 3) access to full-text articles; 4) accessible in English; 5) reported from any country; and 6) using qualitative or mixed-method approaches. A total of 37 studies were included in the review - documenting 51 specific experiences of domestic stigmatisation (referred to as acts for the purpose of the review) across all studies. A matrix was developed detailing each study's' publication date, geographical context, participant gender (where possible) and the reported acts. A critical analysis is offered on the concept "domestic stigmatisation" and its relevance to domestic or family interventions. Deliberate attention to this concept can potentially refocus HIV stigma-reducing interventions to benefit families and promote coping strategies to reduce stigma-related stress associated with seropositive identities.

Infecciones por VIH/psicología , Estereotipo , Estrés Psicológico/prevención & control , Adaptación Psicológica , Adulto , Femenino , Humanos , Masculino , Literatura de Revisión como Asunto , Estigma Social
Syst Rev ; 9(1): 256, 2020 11 04.
Artículo en Inglés | MEDLINE | ID: mdl-33148320


BACKGROUND: The COVID-19 pandemic has created a sense of urgency in the research community in their bid to contribute to the evidence required for healthcare policy decisions. With such urgency, researchers experience methodological challenges to maintain the rigour and transparency of their work. With this in mind, we offer reflections on our recent experience of undertaking a rapid Cochrane qualitative evidence synthesis (QES). METHODS: This process paper, using a reflexive approach, describes a rapid QES prepared during, and in response to, the COVID-19 pandemic. FINDINGS: This paper reports the methodological decisions we made and the process we undertook. We place our decisions in the context of guidance offered in relation to rapid reviews and previously conducted QESs. We highlight some of the challenges we encountered in finding the balance between the time needed for thoughtfulness and comprehensiveness whilst providing a rapid response to an urgent request for evidence. CONCLUSION: The need for more guidance on rapid QES remains, but such guidance needs to be based on actual worked examples and case studies. This paper and the reflections offered may provide a useful framework for others to use and further develop.

Infecciones por Coronavirus , Toma de Decisiones , Medicina Basada en la Evidencia , Pandemias , Neumonía Viral , Edición , Proyectos de Investigación , Literatura de Revisión como Asunto , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Exactitud de los Datos , Humanos , Neumonía Viral/epidemiología , Neumonía Viral/virología , Investigación Cualitativa
Tog (A Coruña) ; 17(2): 205-213, nov. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-198817


OBJETIVOS: describir la investigación realizada sobre drogodependencia en el campo de la terapia ocupacional a través de la extensión, alcance y características de esta y de la evidencia científica sobre la eficacia de las intervenciones de terapia ocupacional en drogodependencia. MÉTODO: Se utilizó el método de scoping review para reinterpretar de manera analítica la literatura relacionada con la terapia ocupacional en drogodependencia, de forma que pudiera examinar el alcance, rango y naturaleza de esta. La revisiónse realizó en cinco etapas siguiendo las pautas PRISMA. RESULTADOS: Las bases de datos utilizadas fueron PubMed y Web of Science donde se identificaron un total de 48 referencias, pero tras aplicar los criterios de selección, la búsqueda se redujo a 25 referencias. Entre ellas las que destacaban eran del tipo: No experimental transversal, teoría fundamentada y scoping review. CONCLUSIÓN: Esta investigación tuvo una tendencia creciente de estudios. Predominó la investigación cuantitativa, aunque se destacó la escasez de las de carácter experimental, en especial de ECAs haciendo difícil consolidar evidencia científica

OBJECTIVE: To describe the range, scope and characteristics of drug addiction in the field of Occupational Therapy, and the scientific proof to show the efficacy of occupational therapy interventions in drug addictions. METHOD: The method scoping review was used to reinterpret, in an analytical way, the literature related to Occupational Therapy in drug addiction, so that the spreading, range and nature of it can be analysed. The research consisted of five stages following PRISMA rules. RESULTS: Pubmed and Web of Science were the databases used, where the research identified 48 references, but after applying the selection criteria, the search dropped to 25 references. Among them stand out: non-experimental transverse, grounded theory and scoping review. CONCLUSION: This research had a growing trend of studies. Quantitative research predominated, although the scarcity of experimental research was highlighted, especially ECAs, making it difficult to consolidate scientific evidence

Humanos , Masculino , Femenino , Trastornos Relacionados con Sustancias/terapia , Terapia Ocupacional/métodos , Resultado del Tratamiento , Investigación Cualitativa , Alcoholismo/epidemiología , Alcoholismo/terapia , Literatura de Revisión como Asunto
Tog (A Coruña) ; 17(2): 254-266, nov. 2020. graf
Artículo en Español | IBECS | ID: ibc-198819


OBJETIVOS: enumerar y describir las intervenciones llevadas a cabo por terapeutas ocupacionales, realizadas en población infantil que se encuentren ingresados en unidades de cuidados intensivos pediátricos o neonatales, recogidas en la literatura científica. METODOLOGÍA: se realizó una búsqueda bibliográfica en las bases de datos Scopus, Cochrane, Web of Science, OT Seeker, Pubmed, en la que se incluyeron: ensayos clínicos aleatorizados, casos y controles, estudios pretest-postest, diseños transversales, estudios de cohortes y estudios cualitativos, entre otros, durante los últimos 10 años. RESULTADOS: de 448 registros, 65 fueron sometidos a una revisión completa, de ellos, 19 cumplieron los criterios de inclusión y fueron analizados. CONCLUSIONES: la figura del terapeuta ocupacional está presente en las unidades de cuidados intensivos. Las principales intervenciones son: posicionamiento, alimentación, ferulaje, educación a los padres y modificación del entorno. Se necesitarían investigaciones futuras para perfilar debidamente el ámbito de actuación y contribuir a un aumento de la presencia de esta figura profesional

OBJECTIVE: List and describe the interventions performed by occupational therapists, make in children who are admitted to paediatric or neonatal intensive care units, included in the scientific literature. METHODOLOGY: A bibliographic search was performed on the Scopus, Cochrane, Web of Science, OT Seeker, Pubmed databases, which included works with the following designs: randomized clinical trial, cases and controls, pretest-postest studies, cross-sectional designs, cohort studies and qualitative studies, among others, in the last 10 years. RESULTS: 448 records, 66 were subjected to a full review, of which 19 studies met the inclusion criteria and were analysed. CONCLUSION: the occupational therapist figure is present in intensive care units. The main interventions performed by occupational therapists are: Positioning, eating and feeding, parent education and adapting and modifying environment. Finally, future research would be needed to properly outline the scope of action and contribute to an increase in the presence of this professional figure

Humanos , Terapia Ocupacional/métodos , Unidades de Cuidado Intensivo Pediátrico , Unidades de Cuidado Intensivo Neonatal , Terapia Ocupacional/organización & administración , Personal de Salud/estadística & datos numéricos , Literatura de Revisión como Asunto
BMC Public Health ; 20(1): 1483, 2020 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-33004011


BACKGROUND: Behavioural science can play a critical role in combatting the effects of an infectious disease outbreak or public health emergency, such as the COVID-19 pandemic. The current paper presents a synthesis of review literature discussing the application of behaviour change theories within an infectious disease and emergency response context, with a view to informing infectious disease modelling, research and public health practice. METHODS: A scoping review procedure was adopted for the searches. Searches were run on PubMed, PsychInfo and Medline with search terms covering four major categories: behaviour, emergency response (e.g., infectious disease, preparedness, mass emergency), theoretical models, and reviews. Three further top-up reviews was also conducted using Google Scholar. Papers were included if they presented a review of theoretical models as applied to understanding preventative health behaviours in the context of emergency preparedness and response, and/or infectious disease outbreaks. RESULTS: Thirteen papers were included in the final synthesis. Across the reviews, several theories of behaviour change were identified as more commonly cited within this context, specifically, Health Belief Model, Theory of Planned Behaviour, and Protection Motivation Theory, with support (although not universal) for their effectiveness in this context. Furthermore, the application of these theories in previous primary research within this context was found to be patchy, and so further work is required to systematically incorporate and test behaviour change models within public health emergency research and interventions. CONCLUSION: Overall, this review identifies a range of more commonly applied theories with broad support for their use within an infectious disease and emergency response context. The Discussion section details several key recommendations to help researchers, practitioners, and infectious disease modellers to incorporate these theories into their work. Specifically, researchers and practitioners should base future research and practice on a systematic application of theories, beginning with those reported herein. Furthermore, infectious disease modellers should consult the theories reported herein to ensure that the full range of relevant constructs (cognitive, emotional and social) are incorporated into their models. In all cases, consultation with behavioural scientists throughout these processes is strongly recommended to ensure the appropriate application of theory.

Brotes de Enfermedades/prevención & control , Conductas Relacionadas con la Salud , Teoría Psicológica , Humanos , Literatura de Revisión como Asunto
Psychiatr Danub ; 32(Suppl 3): 337-342, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33030448


INTRODUCTION: Child neglect is one of the most prevalent forms of child abuse. Neglect can be defined as a lack of sufficient attention, responsibility and protection that matches the age and needs of the child. There is no theory that fully explains why neglect of children happens. Three different causal models of neglect are given: parental deficit model, ecological deficit model and ecological-transaction model. Exposure to neglect in childhood may have a negative impact on the development of the child and cause short-term and long-term health, emotional, cognitive, academic and social difficulties. The aim of this paper was to provide a comprehensive theoretical overview of neglect of children causes and consequences. METHODS: In this paper, we used review articles and meta-analyzes about child neglect causes and consequences published on Medline. RESULTS: Child neglect has a relatively high prevalence rate compared to other types of child abuse. Several studies suggest that the impact of neglect on the health and development of the child is just as negative as the impact of other types of abuse. Children who experience neglect in early childhood are more likely to have health, cognitive, emotional and social consequences in later life. A significant number of studies suggest the existence of a link between child neglect and risk factors related to parents, the child and the environment. CONCLUSIONS: Child neglect is determined by multiple risk areas and is considered as the result of a complex interaction of risk factors present in children and in their care environment. Neglect may have long-term consequences for all aspects of the health and functioning of the child.

Maltrato a los Niños/psicología , Niño , Humanos , Metaanálisis como Asunto , Padres/psicología , Prevalencia , Literatura de Revisión como Asunto , Medición de Riesgo , Factores de Riesgo
PLoS One ; 15(9): e0238131, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32936801


BACKGROUND: The recommendations of experts who write review articles are a critical determinant of the adaptation of new treatments by clinicians. Several types of reviews exist (narrative, systematic, meta-analytic), and some of these are more vulnerable to researcher bias than others. Recently, the interest in nutritional interventions in psychiatry has increased and many experts, who are often active researchers on this topic, have come to strong conclusions about the benefits of a healthy diet on depression. In a young and active field of study, we aimed to investigate whether the strength of an author's conclusion is associated with the type of review article they wrote. METHODS: Systematic searches were performed in PubMed, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar for narrative reviews and systematic reviews with and without meta-analyses on the effects of diet on depression (final search date: May 30th, 2020). Conclusions were extracted from the abstract and discussion section and rated as strong, moderate, or weak by independent raters who were blind to study type. A benchmark on legitimate conclusion strength was based on a GRADE assessment of the highest level of evidence. This systematic review was registered with PROSPERO, number CRD42020141372. FINDINGS: 24 narrative reviews, 12 systematic reviews, and 14 meta-analyses were included. In the abstract, 33% of narrative reviews and 8% of systematic reviews came to strong conclusions, whereas no meta-analysis did. Narrative reviews were 8.94 (95% CI: 2.17, 36.84) times more likely to report stronger conclusions in the abstract than systematic reviews with and without meta-analyses. These findings were similar for conclusions in the discussion section. Narrative reviews used 45.6% fewer input studies and were more likely to be written by authors with potential conflicts of interest. A study limitation is the subjective nature of the conclusion classification system despite high inter-rater agreements and its confirmation outside of the review team. CONCLUSIONS: We have shown that narrative reviews come to stronger conclusions about the benefits of a healthy diet on depression despite inconclusive evidence. This finding empirically underscores the importance of a systematic method for summarizing the evidence of a field of study. Journal editors may want to reconsider publishing narrative reviews before meta-analytic reviews are available.

Depresión/dietoterapia , Literatura de Revisión como Asunto , Humanos