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1.
Rev Panam Salud Publica ; 43, August 2019
Artigo em Espanhol | PAHO-IRIS | ID: phr-51435

RESUMO

[RESUMEN]. Objetivos. Sintetizar la información disponible sobre el efecto del etiquetado nutricional frontal en la elección, compra y consumo de alimentos y bebidas, y el estado nutricional de los consumidores, e identificar los factores que influyen en su efectividad. Métodos. Se realizó una sinopsis de revisiones sistemáticas (RS) conforme a las recomendaciones PRISMA. La búsqueda bibliográfica se realizó en Medline (Pubmed), The Cochrane Library, LILACS, EBSCOhost y Scopus, limitada a estudios publicados en español o inglés sin restricción por fecha de publicación. La calidad metodológica se evaluó utilizando la herramienta AMSTAR 2. Resultados. Se incluyeron siete RS. El etiquetado frontal facilitó la elección de alimentos saludables y tuvo un efecto variable sobre las dimensiones de consumo y compra. Ninguna RS evaluó el efecto sobre el estado nutricional. El costo y sabor, los hábitos alimentarios, el nivel educativo y los sistemas dominantes de procesamiento de información en el consumidor influyeron en su efectividad. La mayoría de RS mostraron limitaciones metodológicas y un nivel de confianza críticamente bajo. Conclusiones. El etiquetado frontal tuvo efecto positivo en la elección de alimentos saludables, con resultados variables en las dimensiones de compra y consumo. Se necesitan estudios locales con una adecuada calidad metodológica para identificar el formato de etiquetado más efectivo en cada país. Su implementación como política de salud pública debe acompañarse de estrategias para mejorar el acceso a alimentos saludables, promover la actividad física y brindar educación nutricional a los consumidores.


[ABSTRACT]. Objectives. Synthesize available information on the effects of front-of-package nutritional labeling on choice, purchase, and consumption of food and beverages, and nutritional status of consumers, and identify factors that influence its effectiveness. Methods. A synopsis of systematic reviews was carried out following PRISMA recommendations. A literature search was performed in MEDLINE (PubMed), Cochrane Library, LILACS, EBSCOhost, and Scopus, limited to studies published in Spanish or English with no restrictions on date of publication. Methodological quality was evaluated using AMSTAR 2. Results. Seven systematic reviews were included. Front-of-package labeling facilitated healthy food choices and had a variable effect on consumption and purchase dimensions. No systematic review evaluated effects on nutritional status. Cost and flavor, eating habits, educational level, and dominant information processing systems in the consumer influenced labeling effectiveness. Most of the systematic reviews showed methodological limitations and critically low confidence levels. Conclusions. Front-of-package labeling had a positive effect on healthy food choices, with variable results on purchase and consumption dimensions. Local studies with adequate methodological quality are needed to identify the most effective labeling format in each country. Implementation of labeling as public health policy should be accompanied by strategies to improve access to healthy foods, promote physical activity, and provide nutrition education to consumers.


[RESUMO]. Objetivos. Sumarizar os dados disponíveis referentes ao efeito da rotulagem nutricional frontal na escolha, compra e consumo de alimentos e bebidas e no estado nutricional dos consumidores e identificar os fatores que influenciam a efetividade desta medida. Métodos. Foi realizado um sumário de estudos de revisão sistemática segundo as recomendações PRISMA. Foi feita uma busca da literatura nas bases de dados MEDLINE (PubMed), Cochrane Library, LILACS, EBSCOhost e Scopus de estudos publicados em espanhol ou inglês, sem restrição de data de publicação. A qualidade metodológica foi avaliada com o uso da ferramenta AMSTAR 2. Resultados. Sete estudos de revisão sistemática foram selecionados. A rotulagem frontal facilitou a escolha de alimentos saudáveis e teve um efeito variável nas dimensões de consumo e compra. Nenhum estudo avaliou o efeito no estado nutricional. Custo e sabor, hábitos alimentares, nível educacional e sistemas dominantes de processamento de informação do consumidor tiveram influência na efetividade desta medida. Os estudos de revisão apresentaram, na sua maioria, limitações metodológicas e um grau de confiança criticamente baixo. Conclusões. A rotulagem nutricional frontal teve efeito positivo na escolha de alimentos saudáveis, com resultados variáveis nas dimensões de compra e consumo. É preciso realizar estudos locais com qualidade metodológica adequada para identificar o formato de rotulagem mais efetivo em cada país. A implementação desta medida como política de saúde pública deve ser acompanhada por estratégias para melhorar o acesso a alimentos saudáveis, promover a atividade física e proporcionar educação nutricional aos consumidores.


Assuntos
Rotulagem Nutricional , Comportamento do Consumidor , Estado Nutricional , Literatura de Revisão como Assunto , Rotulagem Nutricional , Comportamento do Consumidor , Estado Nutricional , Literatura de Revisão como Assunto , Rotulagem Nutricional , Comportamento do Consumidor , Literatura de Revisão como Assunto
2.
Stud Health Technol Inform ; 262: 101-104, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349276

RESUMO

Tuberculosis (TB) represents a global challenge in terms of prevention, care and control. Decision support systems (DSS) can supply the necessary knowledge basis to underpin investigators, policy makers and health personnel actions and to provide crucial elements that can help reducing TB burden. Thus, the objectives of this work are to present the protocol to be followed for carrying out a scoping review to identify topics where DSSs are used, to define appropriate categories and to clarify main outcomes and research gaps. As part of the protocol, five electronic bibliographic databases will be searched for articles from 2006 to 2019 and two investigators will independently screen each work using the study inclusion criteria. Data extraction will be performed, and findings will be reported. The results will be used to provide a broad understanding of how DSSs for TB are being used.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Tuberculose , Assistência à Saúde , Pessoal de Saúde , Humanos , Projetos de Pesquisa , Pesquisadores , Literatura de Revisão como Assunto , Tuberculose/terapia
3.
Medicine (Baltimore) ; 98(30): e16517, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348264

RESUMO

BACKGROUND: Prostate cancer (PCa) is common, with it being the 2nd most prevalent cancer in men worldwide and the 6th leading cause of death in men. Screening for any type of cancer aims to increase the chances of successful treatment through early detection of the disease. There were some systematic reviews (SRs) evaluated the diagnostic value of biomarkers for the diagnosis of PCa and no studies have been conducted to analyze the quality of these SRs. We are not clear which kind of marker is the best choice. Thus, this study aims to assess the methodologic quality of the SRs and reanalyze the published data based on SRs for the biomarkers to find the optimal biomarker for the early diagnosis of PCa. METHODS: We performed a systematic literature search of PubMed, Embase, Web of Science, and Cochrane Library and to identify relevant SRs from inception to April 2019. Diagnostic accuracy studies included any type of single biomarker or combined biomarkers aimed at evaluating the diagnostic value is considered eligible for this overview. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) instrument will be used to evaluate the risk of bias of the included SRs. Standard pairwise meta-analysis and adjusted indirect comparison will be used to compare the diagnostic value of different biomarkers. RESULTS: The results of this study will be submitted to a peer-reviewed journal for publication. CONCLUSION: This study will reanalyze the published data based on SRs. We hope that the results will help find a biomarker with the superior diagnostic performance for the diagnosis of PCa. PROSPERO REGISTRATION NUMBER: CRD42019125880.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias da Próstata/diagnóstico , Biomarcadores Tumorais , Humanos , Masculino , Meta-Análise em Rede , Projetos de Pesquisa , Literatura de Revisão como Assunto , Sensibilidade e Especificidade
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(7): 664-667, 2019 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-31288335

RESUMO

Post-marketing surveillance of vaccine safety is an important measure to detect adverse events following immunization and therefore reduce the harms to public health. The conventional method for safety surveillance is a passive way through spontaneous reporting, which suffer from under-reporting and incomplete. While active surveillance, a newly proposed surveillance method in developed countries, is capable to make up the deficiencies of passive surveillance. The surveillance system of vaccine safety in China is currently using passive surveillance, and facing many problems and challenges. This arouses a need to promote development of an active surveillance system for vaccine safety in China, learning from the experience world-wide. This commentary aims to throw out suggestions for establishing the active surveillance system, according to the specific situation in China and based on a scoping review of literature.


Assuntos
Vigilância de Produtos Comercializados/métodos , Vacinas/efeitos adversos , China , Humanos , Literatura de Revisão como Assunto
5.
Rev. chil. nutr ; 46(3): 230-238, jun. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1003699

RESUMO

ABSTRACT This study analyzed the profile of scientific production related to the nutritional aspects of the etiology and/or progress of Multiple Sclerosis (MS). We conducted an integrative review that analyzed 64 works published in English, Spanish or Portuguese between 2012 and 2017 on the relationship between nutrition and MS. There was a predominance of studies in humans (54.0%, n= 34) and randomized clinical trials (38.3%, n= 13). The association between vitamin D and etiology progression and/or development of disabilities resulting from MS was the most studied aspect (30.2%, n= 19), followed by studies that evaluated the importance of fat concentration and/or types for MS risk (22.2%, n= 14), and research that analyzed the role of antioxidant vitamins (19.0%; n= 12) in the disease development and/ or evolution. The study showed that most research involves small samples and that a healthy diet contributes to the prevention and mitigation of disease evolution. However, this affirmation cannot be made with regards to dietary supplements. Further research is necessary, from cross-sectional studies to randomized clinical trials considering the wide knowledge gap on this subject.


RESUMEN El presente estudio buscó plantear el perfil de las producciones científicas que relacionan aspectos nutricionales con la etiología y/o progresión de la Esclerosis Múltiple (EM). Fue una revisión integrativa que analizó 63 trabajos publicados en el idioma inglés, español y portugués, entre 2012 a 2017, sobre la relación entre los aspectos nutricionales y la EM. Predominaron estudios con seres humanos (54,0%, n= 34), del tipo ensayo clínico randomizado (38,3%, n= 13). La asociación de la vitamina D con la etiología, progresión y/o desarrollo de incapacidades consecuentes de la EM fue la más estudiada (30,2%, n= 19), seguida de los estudios que evaluaron la importancia de la concentración y/o de los tipos de gordura para el riesgo o progresión de la EM (22,2%, n= 14), y de estudios que analizaron el papel de las vitaminas antioxidantes (19,0%; n= 12) en el desencadenamiento y/o evolución de la enfermedad. La mayoría de los estudios incluyó muestras pequeñas y una dieta saludable que aporta con la prevención y atenuación de la evolución de la enfermedad. No se pueó hacer esta afirmación para los suplementos dietéticos. Son necesarios más estudios, dada la enorme laguna de conocimiento que envuelve el tema.


Assuntos
Humanos , Alimentação , Alimentos , Progressão da Doença , Esclerose Múltipla/etiologia , Literatura de Revisão como Assunto
6.
Rev. chil. nutr ; 46(3): 343-351, jun. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1003713

RESUMO

ABSTRACT The object of the present study was to carry out a literature review to analyze the influence of physical activity and dietary behavior on body mass index in school-age children and adolescents. A search was carried out using the PubMed and LILACS databases, in which 1,412 articles were found. After application of inclusion and exclusion criteria, 17 studies were selected for qualitative analysis. Overweight and obesity were related with incorrect dietary habits (skipping breakfast, consumption of foods with high fat contents and high-sugar soft drinks), low levels of physical activity and long hours devoted to sedentary activities (playing video games or watching TV) were also related.


RESUMEN El objetivo de este estudio fue analizar, mediante una revisión de la literatura, la influencia de la práctica de actividad física y del comportamiento dietético sobre el índice de masa corporal de niños y adolescentes en fase escolar. Se realizó una búsqueda en las bases PubMed y LILACS. Se encontraron 1.412 artículos. Tras la aplicación de los criterios de inclusión y exclusión fueron seleccionados 17 estudios para realizar un análisis cualitativo. El sobrepeso y la obesidad están relacionadas a una alimentación in-adecuada (saltar el desayuno, consumo de alimentos con alto contenido de grasa y de bebidas azucaradas), niveles bajos de actividad física y longas horas realizando actividad sedentaria (jugando video-juegos o visualizando la TV).


Assuntos
Exercício , Índice de Massa Corporal , Criança , Adolescente , Comportamento Alimentar , Literatura de Revisão como Assunto
7.
Medicine (Baltimore) ; 98(23): e15841, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31169687

RESUMO

OBJECTIVE: The aim of the study was to determine whether exclusive breastfeeding or exclusive formula feeding is more cost-effective when a Canadian mother with HIV is adherent to antiretroviral therapy and has full virologic suppression. DESIGN: Current Canadian guidelines recommend that mothers with HIV practice exclusive formula feeding. This contradicts the updated World Health Organization (WHO) guidelines which recommend that mothers with HIV should breastfeed for ≥12 months while receiving support for antiretroviral therapy adherence. Due to the economic and health risks and benefits associated with each modality, there remains expert disagreement on whether the WHO recommendations should be adopted in high-income countries. METHODS: A microsimulation model was developed to estimate lifetime costs and effectiveness (i.e., infant's quality-adjusted life years) of a hypothetical group of 1,000,000 initially healthy, HIV-negative infants, if the mother with HIV was on antiretroviral therapy with full virologic suppression and either exclusive breastfeeding or exclusive formula feeding. The model was developed from the economic perspective of the Ontario Ministry of Health, taking into account direct costs associated with infant feeding modality as well as related indirect costs born out of the child's lifetime health outcomes. Uncertainties related to model parameters were evaluated using one-way and probabilistic sensitivity analyses. RESULTS: In comparison to exclusive formula feeding, exclusive breastfeeding was the dominant feeding modality (i.e., less costly and more effective) yielding cost-savings of $13,812 per additional quality-adjusted life year gained. Neither one-way nor probabilistic sensitivity analyses altered the conclusions. CONCLUSIONS: Despite the risk of HIV transmission, exclusive breastfeeding was more cost-effective than exclusive formula feeding. These findings merit review of current infant feeding guidelines for mothers with HIV living in high-income countries.


Assuntos
Antirretrovirais/uso terapêutico , Aleitamento Materno/economia , Fórmulas Infantis/economia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Mães , Resposta Viral Sustentada , Antirretrovirais/administração & dosagem , Canadá , Simulação por Computador , Análise Custo-Benefício , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Metanálise como Assunto , Modelos Econométricos , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Anos de Vida Ajustados por Qualidade de Vida , Literatura de Revisão como Assunto
8.
Medicine (Baltimore) ; 98(25): e16043, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232938

RESUMO

BACKGROUND: Multiple sclerosis (MS) is a chronic immune mediated disease which affects the central nervous system (CNS), having a substantial financial, functional, and quality of life (QOL) impact on these people. The vitamin A supplementation has been studied as a therapeutic possibility for in MS. Therefore, the objective of this protocol is to build an outline for a future systematic review, which will provide up-to-date available evidence about the clinical impact of nutritional supplementation of vitamin A in the outcomes related to the symptoms in patients with this pathology. METHODS: The search will be performed in the following databases: PubMed, Embase, Scopus, cinahl, Scielo, Web of Science, the Cochrane Library and Science Direct, randomized clinical trials published until May 2019 that evaluate the relationship of the supplementation of vitamin A and health-related outcomes in patients with MS will be included. Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) will be used to outline the protocol, and PRISMA to the systematic review. Undergraduate handbook of quality of evidence and strength of recommendations for decision making in health (GRADE) will be used to assess the quality of evidence and the strength of the recommendation, and the JADAD scale to assess the internal validity of selected studies. For the extraction of all the data found a database in Microsoft Excel will be created. For the summary of the findings the Cochrane Collaboration Handbook recommendations will be used, and for the meta-analysis standard statistical techniques the RevMan software will be used. RESULTS: In this study, we hope to find a considerable number of articles presenting evidence about the effectiveness of vitamin A supplementation in patients with MS. CONCLUSION: Currently, many lines of evidence have been produced when it comes to the use of food supplements. This systematic review proposal might provide recent, important, and trusted information for better treatment of patients. RECORD OF SYSTEMATIC REVIEW: This review was recorded in the International Register of Prospective Systematic Reviews (PROSPERO) on the January 30, 2019 (registration: CRD42019121757). Available at: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019121757.


Assuntos
Suplementos Nutricionais/normas , Metanálise como Assunto , Esclerose Múltipla/dietoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Literatura de Revisão como Assunto , Humanos , Terapia Nutricional/métodos , Avaliação de Resultados (Cuidados de Saúde)/métodos , Avaliação de Resultados (Cuidados de Saúde)/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Vitamina A/uso terapêutico , Vitaminas/uso terapêutico
9.
Medicine (Baltimore) ; 98(25): e16044, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232939

RESUMO

BACKGROUND: Artemisinin was discovered to be highly effective antimalarial drugs shortly after the isolation of the parent artemisinin in 1971 in China. It is derived from extracts of sweet wormwood (Artemisia annua) and are well established for the treatment of malaria. Recently, artemisinin has been shown that it might have therapeutic value for several other diseases. The purpose of this review is to assess the efficacy of artemisinin as a treatment for macular edema associated with retinal vein occlusion. METHODS AND ANALYSIS: A systematic literature search will be performed in all available databases to quantitatively review eligible studies and identify all relevant data. We will include randomized controlled trials assessing efficacy of artemisinin as a treatment for macular edema associated with retinal vein occlusion. The methodological qualities, including the risk of bias, will be evaluated using the Cochrane risk of bias assessment tool, while confidence in the cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. ETHICS AND DISSEMINATION: Ethical approval is not required, as this study is based on the review of published research. This review will be published in a peer-reviewed journal and disseminated both electronically and in print. PROSPERO REGISTRATION NUMBER: The protocol for this systematic review has been registered on PROSPERO under the number CRD42019131408.


Assuntos
Artemisininas/uso terapêutico , Edema Macular/etiologia , Metanálise como Assunto , Oclusão da Veia Retiniana/tratamento farmacológico , Literatura de Revisão como Assunto , Humanos , Pesquisa/normas , Oclusão da Veia Retiniana/complicações
10.
Pol J Microbiol ; 68(2): 153-164, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31250588

RESUMO

Microbiological contamination is a big challenge to the food industry, medicine, agriculture, and environmental protection. For this reason, scientists are constantly looking for alternative methods of decontamination, which ensure the effective elimination of unwanted biological agents. Cold plasma is a new technology, which due to its unique physical and chemical properties becomes a point of interest to a growing group of researchers. The previously conducted experiments confirm its effective action, e.g. in the disinfection of skin wounds, air, and sewage treatment, as well as in food preservation and decontamination. The reactive compounds present in the plasma: high-energy electrons, ionized atoms and molecules, and UV photons are the key factors that cause an effective reduction in the number of microorganisms. The mechanism and effectiveness of the cold plasma are complex and depend on the process parameters, environmental factors and the type and properties of the microorganisms that are to be killed. This review describes the current state of knowledge regarding the effectiveness of the cold plasma and characterizes its interaction with various groups of microorganisms based on the available literature data.Microbiological contamination is a big challenge to the food industry, medicine, agriculture, and environmental protection. For this reason, scientists are constantly looking for alternative methods of decontamination, which ensure the effective elimination of unwanted biological agents. Cold plasma is a new technology, which due to its unique physical and chemical properties becomes a point of interest to a growing group of researchers. The previously conducted experiments confirm its effective action, e.g. in the disinfection of skin wounds, air, and sewage treatment, as well as in food preservation and decontamination. The reactive compounds present in the plasma: high-energy electrons, ionized atoms and molecules, and UV photons are the key factors that cause an effective reduction in the number of microorganisms. The mechanism and effectiveness of the cold plasma are complex and depend on the process parameters, environmental factors and the type and properties of the microorganisms that are to be killed. This review describes the current state of knowledge regarding the effectiveness of the cold plasma and characterizes its interaction with various groups of microorganisms based on the available literature data.


Assuntos
Desinfetantes/farmacologia , Desinfecção/métodos , Viabilidade Microbiana/efeitos dos fármacos , Viabilidade Microbiana/efeitos da radiação , Gases em Plasma/farmacologia , Pesquisa Biomédica/tendências , Literatura de Revisão como Assunto
11.
Hu Li Za Zhi ; 66(3): 106-111, 2019 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-31134606

RESUMO

Medical Device Related Pressure Injury was incorporated into the redefinition of pressure injuries during the National Pressure Ulcer Advisory Panel 2016 Staging Consensus Conference. It is evident that this type of iatrogenic injury is gradually receiving more attention. Unlike pressure injuries over a bony prominence, which may be alleviated by repositioning different body parts, injuries that require non-retractable medical devices to be securely fastened to an injury site carry a higher risk of causing pressure injuries and of requiring subsequent care in a clinical setting. Furthermore, facial skin and mucosal membranes are the most common sites of Medical Device Related Pressure Injuries. Once these injuries occur, they easily result in damage to appearance, loss of function, and even bone exposure and infection, which may lead to medical disputes. Therefore, in recent years, research and exploration in this field has increased in many countries. However, discussions regarding Medical Device Related Pressure Injuries in Taiwan are still lacking. Thus, the aim of this article is to discuss the definition, risk factors, damage classification, and prevention strategies of Medical Device Related Pressure Injuries by combining domestic and international literature reviews and clinical verifications for the purpose of providing knowledge to medical staffs in hopes of reducing the incidence of Medical Device Related Pressure Injuries and degree of damage.


Assuntos
Equipamentos e Provisões/efeitos adversos , Lesão por Pressão/etiologia , Lesão por Pressão/prevenção & controle , Humanos , Literatura de Revisão como Assunto , Fatores de Risco , Taiwan
12.
Medicine (Baltimore) ; 98(10): e14644, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30855451

RESUMO

INTRODUCTION: Twenty years ago, the first study was conducted to access adverse childhood experiences (ACEs) and their relation to outcomes in adulthood. The effects of exposure to childhood trauma can also be transmitted to other generations. There are some studies that suggest the hypothesis that intergenerational transmission may begin during intrauterine life through the change in placental-fetal physiology due to maternal exposure to adverse events in childhood. Those exposures can lead to a variety of conditions such as altered brain architecture, increase in placental corticotrophin hormone (pCRH) at the end of gestation, or emotional and behavioral changes during childhood and adolescence. The systematic review, therefore, is established to determine if there is a reliable association between maternal ACEs in childhood and altered child development. METHOD: We will conduct a systematic review according to the guidelines of the meta-analysis of observational studies in epidemiology (MOOSE) and with the preferred reporting items for systematic review with a focus on health equity (PRISMA-E). A comprehensive search strategy will be conducted in the following databases: MEDLINE, EMBASE, CINAHL, Web of Science, SCOPUS, Lilacs, and SciELO. Following a 2-step screening process, data including the full reference, objectives, target population, description of the exposure (ACEs), outcome measures, study design, length of follow-up period, and the study results will be extracted, synthesized, and reported. Risk of bias and quality of the studies will also be assessed. DISSEMINATION AND ETHICS: The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review has been published, this review does not require ethical approval. DISCUSSION: This systematic review of the last 20 years will summarize and present the evidence for the relationship between maternal ACEs and the development of her child. SYSTEMATIC REVIEW REGISTRATION: PROSPERO #CRD42018111456.


Assuntos
Experiências Adversas da Infância , Desenvolvimento Infantil , Mães/psicologia , Projetos de Pesquisa , Feminino , Humanos , Lactente , Relações Mãe-Filho , Literatura de Revisão como Assunto
13.
BMC Health Serv Res ; 19(1): 169, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-30876452

RESUMO

BACKGROUND: Healthcare-associated infections (HAIs) are common and increase morbidity, mortality, and healthcare costs. Their control continues to be an unresolved issue worldwide. HAIs epidemiology shows sex/gender differences. Thus the lack of consideration of sex/gender in Cochrane reviews will limit their applicability and capacity to support informed decisions. This study aims to describe the extent to which Cochrane reviews of interventions for preventing HAIs consider sex and gender. METHODS: Methodology study appraising Cochrane reviews of interventions to prevent HAIs. SEARCH METHODS: Cochrane Database of Systematic Reviews from 1995 (launch of the journal) to 31 December 2016. Two authors independently extracted data with EPPI-Reviewer 4 software, and independently appraised the sex/gender content of the reviews with the Sex and Gender Appraisal Tool for Systematic Reviews (SGAT-SR). RESULTS: This study included 113 reviews assessing the effects of interventions for preventing HAIs. 100 reviews (88%) used at least one sex or gender-related term. The terminology used was heterogeneous, being "sex" the term used in more reviews (51%). No review defined neither sex nor gender. Thus we could not assess the definitions provided. Consideration of sex and gender was practically absent in the included reviews; in fact, no review met all the applicable items of the SGAT-SR, and 51 reviews (50%) fulfilled no item. No review provided a complete description of the sex and the gender of the samples of the included studies. Only ten reviews (10%) planned to perform sex- and gender-based analysis and only three (3%) could complete the analysis. The method chosen was always the subgroup analysis based on sex (one review) or gender (two reviews). Three reviews (3%) considered sex or gender-related findings in the conclusions. CONCLUSION: Consideration of sex and gender in Cochrane reviews of interventions for preventing HAIs was practically absent. This lack of attention to sex and gender reduces the quality of Cochrane reviews, and their applicability for all people: women and men, boys and girls, and people of diverse gender identities. Cochrane should attempt to address the shortfalls detected.


Assuntos
Infecção Hospitalar/prevenção & controle , Literatura de Revisão como Assunto , Sexismo , Feminino , Humanos , Masculino
14.
Z Evid Fortbild Qual Gesundhwes ; 141-142: 62-65, 2019 May.
Artigo em Alemão | MEDLINE | ID: mdl-30846306

RESUMO

Practitioners and providers who want to apply evidence from studies will usually face the following two questions: 1) 'Are the study results valid?', and 2) 'Will these results be the same in my setting?' Major progress has been achieved in regard to the first question. An array of tools to assess the validity has been developed. Much less effort, though, has been put into developing and applying methods to assess the transferability of evidence from one setting to another. Existing concepts to assess transferability aim at identifying similarities and differences between the study context and the context in which the study findings are supposed to be applied. In a second step, the impact of the differences on the outcomes are estimated. Context can be distinguished into 'implementation' (how is an intervention applied?), 'target group' (who will receive the intervention?), and 'setting.' In this article selected tools to identify context variables and to assess transferability are presented.


Assuntos
Medicina Baseada em Evidências , Literatura de Revisão como Assunto , Interpretação Estatística de Dados , Alemanha , Humanos
16.
Disasters ; 43 Suppl 2: S132-S150, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30821359

RESUMO

Fragile and conflict-affected states are frequently characterised by their inability to fulfil three core governance functions: provision of security, effective delivery of basic public goods and services, and managing political participation and accountability. This article explores the utility of social accountability interventions in fragile environments. Successful social accountability interventions can lead to joint examinations of public service standards by service-users and providers, resulting in collaborative improvement efforts. The few available studies of such interventions implemented in fragile or conflict-affected states show reasons for optimism as well as challenges. This article advocates the continued use of social accountability methods in fragile settings and provides examples of social accountability interventions in the health sector in Sierra Leone. The study suggests that social accountability can improve interaction between citizens and public service providers. Successful social accountability interventions can also lead to better quality and more accessible public services, which, in turn, can enhance state legitimacy.


Assuntos
Relações Comunidade-Instituição , Setor de Assistência à Saúde , Atenção Primária à Saúde , Responsabilidade Social , Pesquisa Empírica , Humanos , Literatura de Revisão como Assunto , Serra Leoa
18.
Rev. cuba. estomatol ; 56(1): e1360, ene.-mar. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1003870

RESUMO

Introducción: El complejo cigomático maxilar con su convexidad prominente, es muy vulnerable a las lesiones. Objetivo: Abordar elementos actuales sobre el diagnóstico, clasificación, tratamiento y complicaciones de las fracturas del complejo cigomático. Métodos: Se realizó una revisión bibliográfica en septiembre de 2016. Se evaluaron revistas de impacto de Web of Sciencies (29 revistas) y 2 libros. Se consultaron las bases de datos de MEDLINE, PubMed y SciELO con los descriptores: zygomatic fracture, treatment, epidemiology. Se incluyeron artículos en idioma inglés, preferentemente de los últimos 5 años. Se obtuvieron 109 artículos. El estudio se circunscribió a 41. Análisis e integración de la información: El correcto diagnóstico basado en los hallazgos clínicos y medios auxiliares de diagnóstico, permite clasificar la fractura. La clasificación más empleada en nuestro medio es la de las Guías Prácticas de Estomatología. Las modalidades terapéuticas pueden incluir el tratamiento quirúrgico con el uso de métodos de fijación que permiten mayor o menor estabilidad. Las complicaciones pueden aparecer. Conclusiones: La proyección anatómica de los huesos malares justifica la incidencia de estas fracturas. El diagnóstico debe basarse en el interrogatorio, examen físico y los medios auxiliares de diagnóstico imaginológicos. La radiografía Waters es una buena opción de imagen. Al clasificar la fractura se establece un plan de tratamiento basado en la valoración individual de cada caso con el objetivo de evitar complicaciones posteriores(AU)


Introduction: Due to its prominent convexity, the zygomaticomaxillary complex is very vulnerable to injuries. Objective: Address current notions about the diagnosis, classification, treatment and complications of fractures of the zygomatic complex. Methods: A literature review was conducted in September 2016. The evaluation included high impact journals from the Web of Science (29 journals) and 2 books. The databases MEDLINE, PubMed and SciELO were consulted, using the search terms zygomatic fracture, treatment, epidemiology. Papers written in English were included, preferably from the last five years. Of the 109 papers obtained, the study considered 41. Data analysis and integration: Appropriate diagnosis based on clinical findings and the use of diagnostic aids allows classification of the fracture. The classification most commonly used in our environment is that of the Dental Practice Guidelines. Therapy modes may include surgery with fixation methods allowing greater or lesser stability. Complications may appear. Conclusions: The anatomical protrusion of malar bones accounts for the incidence of these fractures. Diagnosis should be based on interrogation, physical examination and the use of auxiliary diagnostic imaging. Waters radiography is a good imaging option. Upon classification of the fracture, a treatment plan is devised based on individual assessment of each case so as to prevent future complications(AU)


Assuntos
Humanos , Literatura de Revisão como Assunto , Guias de Prática Clínica como Assunto/normas , Fixação de Fratura/métodos , Fraturas Maxilomandibulares/complicações , Fraturas Maxilomandibulares/diagnóstico , Bases de Dados Bibliográficas/normas , Fraturas Maxilomandibulares/terapia
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