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1.
Psychiatr Danub ; 32(Suppl 3): 337-342, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030448

RESUMO

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.


Assuntos
Maus-Tratos Infantis/psicologia , Criança , Humanos , Metanálise como Assunto , Pais/psicologia , Prevalência , Literatura de Revisão como Assunto , Medição de Risco , Fatores de Risco
2.
BMC Public Health ; 20(1): 1483, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004011

RESUMO

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.


Assuntos
Surtos de Doenças/prevenção & controle , Comportamentos Relacionados com a Saúde , Teoria Psicológica , Humanos , Literatura de Revisão como Assunto
3.
Cochrane Database Syst Rev ; 7: CD013651, 2020 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-32700364

RESUMO

BACKGROUND: Within the context of heavy menstrual bleeding, pandemics impact upon women's assessment and treatment by healthcare providers. OBJECTIVES: To summarise the evidence from Cochrane Reviews evaluating interventions for heavy menstrual bleeding that are commonly available during pandemics. METHODS: We sought published Cochrane Reviews, evaluating interventions that can continue during pandemics for women with heavy menstrual bleeding with no known underlying cause. We identified Cochrane Reviews by searching the Cochrane Database of Systematic Reviews in June 2020. The primary outcome was menstrual bleeding. Secondary outcomes included quality of life, patient satisfaction, side effects, and serious adverse events. We undertook the selection of systematic reviews, data extraction, and quality assessment in duplicate. We resolved any disagreements by discussion. We assessed review quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) 2 tool, and the certainty of the evidence for each outcome using GRADE methods. MAIN RESULTS: We included four Cochrane Reviews, with 11 comparisons, data from 44 randomised controlled trials (RCTs), and 3196 women. We assessed all the reviews to be high quality. Non-steroidal anti-inflammatory drugs (NSAIDs) NSAIDs may be more effective in reducing heavy menstrual bleeding than placebo (mean difference (MD) -124 mL per cycle, 95% confidence interval (CI) -186 to -62 mL per cycle; 1 RCT, 11 women; low-certainty evidence). Mefenamic acid may be similar to naproxen (MD 21 mL per cycle, 95% CI -6 to 48 mL per cycle; 2 RCTs, 61 women; low-certainty evidence), and NSAIDs may be similar to combined hormonal contraceptives for heavy menstrual bleeding (MD 25 mL per cycle, 95% CI -22 to 73 mL per cycle; 1 RCT, 26 women; low-certainty evidence). NSAIDs may be be less effective in reducing menstrual bleeding than antifibrinolytics (relative risk (RR) 0.70, 95% CI 0.58 to 0.85; 2 RCTs, 161 women; low-certainty evidence). We are uncertain whether NSAIDs reduce menstrual blood loss more than short-cycle progestogens (RR 0.80, 95% CI 0.49 to 1.32; 1 RCT 32 women; very low-certainty evidence). Antifibrinolytics Antifibrinolytics appear to be more effective in reducing heavy menstrual bleeding than placebo (MD -53 mL per cycle, 95% CI -63 to -44 mL per cycle; 4 RCTs, 565 women; moderate-certainty evidence). Antifibrinolytics may be similar to placebo on the incidence of side effects (RR 1.05, 95% CI 0.93 to 1.18; 1 RCT, 297 women; low-certainty evidence), and they are probably similar on the incidence of serious adverse events (thrombotic events; RR 0.10, 95% CI 0.00 to 2.46; 2 RCT, 468 women; moderate-certainty evidence). Antifibrinolytics may be more effective in reducing heavy menstrual bleeding than short-cycle progestogen (MD -111 mL per cycle, 95% CI -178 mL to -44 mL per cycle; 1 RCT, 46 women; low-certainty evidence). We are uncertain whether antifibrinolytics are similar to short-cycle progestogens on quality of life (RR 1.67, 95% CI 0.76 to 3.64; 1 RCT, 44 women; very low-certainty evidence), patient satisfaction (RR 0.91, 95% CI 0.59 to 1.39; 1 RCT, 42 women; very low-certainty evidence), or side effects (RR 0.85, 95% CI 0.65 to 1.12; 3 RCTs, 211 women; very low-certainty evidence). We are uncertain whether antifibrinolytics are more effective in reducing heavy menstrual bleeding when compared with long-cycle progestogen (MD -9 points per cycle, 95% CI -30 to 12 points per cycle; 2 RCTs, 184 women; low-certainty evidence). Antifibrinolytics may increase self-reported improvement in menstrual bleeding when compared with long-cycle medroxyprogesterone acetate (RR 1.32, 95% CI 1.08 to 1.61; 1 RCT, 94 women; low-certainty evidence). Antifibrinolytics may be similar to long-cycle progestogens on quality of life (MD 5, 95% CI -2.49 to 12.49; 1 RCT, 90 women; low-certainty evidence). We are uncertain whether antifibrinolytics are similar to long-cycle progestogens on side effects (RR 0.58, 95% CI 0.33 to 1.00; 2 RCTs, 184 women; very low-certainty evidence). There were no trials comparing antifibrinolytics to combined hormonal contraceptives. Combined hormonal contraceptives Combined hormonal contraceptives appear to be more effective for heavy menstrual bleeding than placebo or no treatment (RR 13.25, 95% CI 2.94 to 59.64; 2 RCTs, 363 women; moderate-certainty evidence). Combined hormonal contraceptives are probably similar to placebo on the incidence of side effects (RR 1.53, 95% CI 0.90 to 2.60; 2 RCTs, 411 women; moderate-certainty evidence). Progestogens There were no trials comparing progestogens to placebo. Limitations in the evidence included risk of bias in the primary RCTs, inconsistency between the primary RCTs, and imprecision in effect estimates. AUTHORS' CONCLUSIONS: There is moderate-certainty evidence that antifibrinolytics and combined hormonal contraceptives reduce heavy menstrual bleeding compared with placebo. There is low-certainty evidence that NSAIDs reduce heavy menstrual bleeding compared with placebo. There is low-certainty evidence that antifibrinolytics are more effective in reducing heavy menstrual bleeding when compared with NSAIDs and short-cycle progestogens, but we are unable to draw conclusions about the effects of antifibrinolytics compared to long-cycle progestogens, on low-certainty evidence.


Assuntos
Menorragia/tratamento farmacológico , Pandemias , Anti-Inflamatórios não Esteroides/uso terapêutico , Antifibrinolíticos/uso terapêutico , Anticoncepcionais Orais Hormonais/uso terapêutico , Feminino , Humanos , Ácido Mefenâmico/uso terapêutico , Placebos/uso terapêutico , Progestinas/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Literatura de Revisão como Assunto
4.
Public Health ; 185: 167-173, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32634608

RESUMO

OBJECTIVE: With the continuing rise in the global incidence of diabetes, the prevention of diabetes and control of associated medical expenses has become a public health issue worldwide. This study aims to identify the medical expenses of patients with diabetes in different regions of China and examine the differences in inpatient medical expenses and the impacts of them on these patients. STUDY DESIGN: This study is a longitudinal analysis of medical expenses for inpatients with diabetes for different years; horizontal analysis of medical expenses among different regions; and literature review. METHODS: Data were derived from China's Medical Insurance Department database. We selected inpatients with diabetes in the eastern, central, and western regions of China for the period 2013-2015 and randomly selected data through systematic sampling. RESULTS: Among the 4150 patients with diabetes considered in this study, the patients' medical expenses were found to differ significantly across regions, years, ages, medical insurance types, medical institution levels, total medical expenses, medical insurance fund payments, and out-of-pocket (OOP) expenses. In addition, there were significant differences in total medical expenses for male and female patients. Furthermore, medical insurance type, patients' age, medical institution level, and year significantly influenced total medical expenses. CONCLUSIONS: Inpatients with diabetes in different regions exhibited significant differences in total medical expenses, medical insurance fund payments, and OOP expenses. China should invest more in chronic disease treatment in its central and western regions, narrow the regional differences in medical expenses, and endeavor to ensure equity in the availability and cost of medical services. Moreover, patients with diabetes must be encouraged to access primary care to reduce their medical expenses.


Assuntos
Diabetes Mellitus/economia , Diabetes Mellitus/epidemiologia , Gastos em Saúde , Pacientes Internados , Adulto , Idoso , China/epidemiologia , Diabetes Mellitus/prevenção & controle , Feminino , Humanos , Incidência , Seguro Saúde , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Literatura de Revisão como Assunto , Adulto Jovem
7.
Arq Bras Oftalmol ; 83(3): 250-261, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-528294

RESUMO

To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limited, although this is understandable given the circumstances. Both the possible presence of viral particles in tears and conjunctiva, and the potential for conjunctival transmission remain controversial. Ocular manifestations are not frequent and could resemble viral infection of the ocular surface. Most recommendations are based on the strategies implemented by Asian countries during previous coronavirus outbreaks. There is a need for substantive studies evaluating these strategies in the setting of SARS-CoV-2. In the meantime, plans for applying these measures must be implemented with caution, taking into account the context of each individual country, and undergo regular evaluation.


Assuntos
Infecções por Coronavirus/complicações , Oftalmopatias/complicações , Pneumonia Viral/complicações , Túnica Conjuntiva/virologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Medicina Baseada em Evidências , Humanos , Oftalmologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Literatura de Revisão como Assunto , Lágrimas/virologia
8.
Medicine (Baltimore) ; 99(21): e20377, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481335

RESUMO

BACKGROUND: The tears of rotator cuff is caused by the tears or aseptic inflammation of tendon tissue such as subscapular muscle, supraspinatus muscle, infraspinatus muscle, teres minor muscle, and so on, which make up the rotator cuff. Managements of rotator cuff disease often include acupuncture and manual therapy, usually delivered together. The aim of this review is to assess the effectiveness and safety of such interventions in patients with pain and dysfunction caused by rotator cuff tears. METHODS: We will search the EMBASE, the Cochrane Library, Ovid MEDLINE, PubMed, Web of Science, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Wanfang Database, the Chongqing VIP, the US National Institute of Health, the NIH clinical registry Clinical Trials, the International Clinical Trials Registry Platform, the Australian New Zealand Clinical Trials Registry and the Chinese clinical registry, from their inception to April 1, 2020. Randomized controlled trials that include patients with rotator cuff tears receiving acupuncture and manual therapy versus a control group will be included. The selection of studies, data extraction and risk of bias assessment will be conducted by 2 independent researchers. A third review author will resolve disagreements. The dichotomous data will be presented as risk ratios with 95% CIs and the continuous data will be presented as weighted mean differences or standardized mean differences with 95% CIs. Evidence quality will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation system. DISCUSSION: This systematic review will provide updated evidence of various types of acupuncture and manual therapy specifically focuses on its effectiveness and safety for patients' pain and dysfunction caused by rotator cuff tears. ETHICS AND DISSEMINATION: Ethical approval is not necessary as this review will not require data from individual patients. The results of this will be published through peer-reviewed journal articles or conference presentations. REGISTRATION: Open Science Framework Preregistration. Registration number 10.17605/OSF.IO/M3NKV.


Assuntos
Terapia por Acupuntura/normas , Manipulações Musculoesqueléticas/normas , Lesões do Manguito Rotador/terapia , Terapia por Acupuntura/métodos , China , Protocolos Clínicos , Humanos , Metanálise como Assunto , Manipulações Musculoesqueléticas/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Literatura de Revisão como Assunto
9.
Arq Bras Oftalmol ; 83(3): 250-261, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32490972

RESUMO

To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limited, although this is understandable given the circumstances. Both the possible presence of viral particles in tears and conjunctiva, and the potential for conjunctival transmission remain controversial. Ocular manifestations are not frequent and could resemble viral infection of the ocular surface. Most recommendations are based on the strategies implemented by Asian countries during previous coronavirus outbreaks. There is a need for substantive studies evaluating these strategies in the setting of SARS-CoV-2. In the meantime, plans for applying these measures must be implemented with caution, taking into account the context of each individual country, and undergo regular evaluation.


Assuntos
Infecções por Coronavirus/complicações , Oftalmopatias/complicações , Pneumonia Viral/complicações , Túnica Conjuntiva/virologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Medicina Baseada em Evidências , Humanos , Oftalmologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Literatura de Revisão como Assunto , Lágrimas/virologia
10.
Rev Lat Am Enfermagem ; 28: e3275, 2020.
Artigo em Português, Espanhol, Inglês | MEDLINE | ID: mdl-32491120

RESUMO

OBJECTIVE: to develop a Navigation Program for cancer patients, based on the model proposed by The GW Cancer Institute at George Washington University, adapted to the reality of a Brazilian High Complexity Center in Oncology. METHOD: a convergent care research applied in the development of a patient navigation care process, based on the model proposed by George Washington University, adapted for a High Complexity Center in Oncology in Brazil. Phases of the Convergent Assistance Research: conception, instrumentation, scrutiny, analysis and interpretation. These were correlated with the stages of the Program Development Cycle. Scale designed to categorize patients into navigation levels, validated by the Delphi Technique, with 12 specialists. RESULTS: in the diagnosis, patients with head and neck cancer were defined for inclusion in the Navigation Program. Planning and implementation took place simultaneously, allowing the basic formatting of the program and its processes to be designed. Navigation Needs Assessment Scale designed to select the patient to join the Program and determine the recommended support. The scale validation had a consensus index of 96.42%. Evaluation of the stages of the cycle occurred through the adapted Plan/Do/Check/Act cycle. CONCLUSION: a Navigation Program was developed adapted to the Brazilian reality, and attributions of the navigators were created.


Assuntos
Neoplasias/terapia , Navegação de Pacientes/organização & administração , Idoso , Brasil , Feminino , Acesso aos Serviços de Saúde/organização & administração , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/enfermagem , Papel do Profissional de Enfermagem , Enfermagem Oncológica , Navegação de Pacientes/métodos , Literatura de Revisão como Assunto
13.
Recenti Prog Med ; 111(6): 354-356, 2020 06.
Artigo em Italiano | MEDLINE | ID: mdl-32573550

RESUMO

For over 20 years the Evidence-Based Orthopaedics Working Group (GLOBE) has been promoting evidence-based medicine (EBM) in orthopaedics and traumatology. However, despite a constant and wide-ranging editorial production and fruitful collaborations with colleagues and institutions at national and international level, the orthopaedic scientific community finds it difficult to recognize the EBM model as a solid reference: there are few guidelines available, there is little awareness of their usefulness, and the complexity of the methodology of production and adaptation of documents widens the gap between the orthopaedic real world and that of clinical epidemiology. After a quick analysis of the causes of this contrast, the authors reflect on the possible solutions to the problem, and propose to collaborate for a simplification of the guidelines production methodology, using innovative models of literature review, which have proved to be effective to make the best knowledge available quickly during the CoViD-19 pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Medicina Baseada em Evidências , Guias como Assunto , Ortopedia/normas , Pandemias , Pneumonia Viral , Coleta de Dados , Humanos , Literatura de Revisão como Assunto , Fatores de Tempo
14.
Rev Assoc Med Bras (1992) ; 66(4): 534-540, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32578792

RESUMO

OBJECTIVES: To bring summarized information about what has been published so far regarding Covid-19, facilitating the access to information and a better understanding of this pandemic, and to contribute to the medical community in the decision-making against this virus. METHODS: This review article brings collected information from different articles published since the beginning of the pandemic of the 2019 novel coronavirus. KEY RESULTS: This paper aggregates and consolidates some epidemiological parameters and clinical knowledge about the novel coronavirus and brings what is new in the search for pandemic control. MAJOR CONCLUSIONS: Governments and health authorities are under increased pressure to control the COVID-19 spreading. In this scenario, the scientific community is working hard to produce relevant papers which will help in the next steps against coronavirus. Our review summarized the latest news about SARS-CoV2, evidencing what we know about COVID-19 until now.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Oftalmopatias/complicações , Oftalmopatias/epidemiologia , Humanos , Ensaios Clínicos Controlados não Aleatórios como Assunto , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Literatura de Revisão como Assunto
15.
Chem Biol Interact ; 327: 109177, 2020 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-32533983

RESUMO

Since its inception in 1969, Chemico-Biological Interactions (CBI) has persistently published high quality research articles. As part of the journal's golden anniversary (50 years), we performed an electronic search on Scopus to get all publications details. Based on citescore, ranking & percentile, CBI holds 21st position in the top 113 relevant journals (in 2018). CBI also completed publications of 8005 manuscripts in March 2020. The highest documents were articles (6972/87.09%) followed by conference papers (588/7.34%) and reviews (252/3.14%). The maximum number of publications (385) was recorded in 2019, followed by 366 (in 2010) and 336 in 2016. Furthermore, details of the top 50 countries, top 50 authors and top 20 institutes with total publications, h-index, total citations and without selfcitations (WSC) are provided. USA (2371), China (786) and United Kingdom (658) are the top three countries, O'Brien, P.J (48), Maser, E. (45) and Lockridge, O. (35) are the top three authors and Karolinska Institutet (144), Stockholm University (102) & Ministry of Education China (94) are the top three institutes involved in research publications. More than eighty-four thousand (84,000) key words were amassed from scopus and after critical analysis we proposed a common sequence and connectivity. The top 200 articles, 200 reviews and 200 conference papers were analyzed by Vosviewer for various parameters. While, the top three (3) research articles and reviews are briefly described. The bibliometric analyses confirm a noteworthy growth of CBI in research publications and scientometric performance.


Assuntos
Bibliometria , Publicações Seriadas/tendências , Toxicologia/tendências , Academias e Institutos/estatística & dados numéricos , Autoria , Pesquisa Biomédica/estatística & dados numéricos , Órgãos Governamentais/estatística & dados numéricos , Humanos , Literatura de Revisão como Assunto , Universidades/estatística & dados numéricos
17.
Medicine (Baltimore) ; 99(20): e20084, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443318

RESUMO

OBJECTIVE: We plan to review all published systematic reviews (SRs) and meta-analyses (MAs) of exercise or sport activities for patients with cancer. The aim of this study is to combine and reanalyze related data and to provide more comprehensive and higher-level evidence. METHODS: We plan to search four English databases and four Chinese databases from inception to June 2019. Patients who were treated by all of exercise or sport activities such as running, gymnastics, taichi, and qigong, will be included. The following information will be extracted from each included SR: first author, year of publication, country of origin, number of primary study; the number of patients enrolled, participant characteristics, duration of cancer diagnosis, cancer types. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and A Measurements Tool to Assess Systematic Reviews 2 (AMSTAR-2) will be used to assess the reporting and methodological quality of SRs/MAs. The characteristics of included SRs/MAs and their quality will be descriptively summarized using systematically structured tables. The network MA approach and narrative synthesis will be used to examine data when applicable. Odds ratio and (standardized) mean difference with their 95% confidence intervals will be used as summary statistics. Stata 13.0 software will be used to analyze and pool data. RESULTS: The results of the overview will be submitted to a peer-reviewed journal for publication. ETHICS AND DISSEMINATION: The study is not a clinical study, and we will search and evaluate existing sources of literature. So, ethical approval is not required.


Assuntos
Terapia por Exercício , Neoplasias/terapia , Literatura de Revisão como Assunto , Humanos , Metanálise como Assunto
18.
Pediatrics ; 145(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32471843

RESUMO

Down syndrome disintegrative disorder (DSDD), a developmental regression in children with Down syndrome (DS), is a clinical entity that is characterized by a loss of previously acquired adaptive, cognitive, and social functioning in persons with DS usually in adolescence to early adulthood. Initially reported in 1946 as "catatonic psychosis," there has been an increasing interest among the DS community, primary care, and subspecialty providers in this clinical area over the past decade. This condition has a subacute onset and can include symptoms of mood lability, decreased participation in activities of daily living, new-onset insomnia, social withdrawal, autistic-like regression, mutism, and catatonia. The acute phase is followed by a chronic phase in which baseline functioning may not return. No strict criteria or definitive testing is currently available to diagnose DSDD, although a comprehensive psychosocial and medical evaluation is warranted for individuals presenting with such symptoms. The etiology of DSDD is unknown, but in several hypotheses for regression in this population, psychological stress, primary psychiatric disease, and autoimmunity are proposed as potential causes of DSDD. Both psychiatric therapy and immunotherapies have been described as DSDD treatments, with both revealing potential benefit in limited cohorts. In this article, we review the current data regarding clinical phenotypes, differential diagnosis, neurodiagnostic workup, and potential therapeutic options for this unique, most disturbing, and infrequently reported disorder.


Assuntos
Atividades Cotidianas/psicologia , Transtorno Autístico/epidemiologia , Transtorno Autístico/psicologia , Síndrome de Down/epidemiologia , Síndrome de Down/psicologia , Adolescente , Transtorno Autístico/diagnóstico , Catatonia/diagnóstico , Catatonia/epidemiologia , Catatonia/psicologia , Criança , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/psicologia , Síndrome de Down/diagnóstico , Feminino , Humanos , Masculino , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Transtornos do Humor/psicologia , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Literatura de Revisão como Assunto
19.
JMIR Public Health Surveill ; 6(2): e18928, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32406853

RESUMO

BACKGROUND: The current coronavirus disease (COVID-19) pandemic is holding the world in its grip. Epidemiologists have shown that the mortality risks are higher when the health care system is subjected to pressure from COVID-19. It is therefore of great importance to maintain the health of health care providers and prevent contamination. An important group who will be required to treat patients with COVID-19 are health care providers during semiacute surgery. There are concerns that laparoscopic surgery increases the risk of contamination more than open surgery; therefore, balancing the safety of health care providers with the benefit of laparoscopic surgery for the patient is vital. OBJECTIVE: We aimed to provide an overview of potential contamination routes and possible risks for health care providers; we also aimed to propose research questions based on current literature and expert opinions about performing laparoscopic surgery on patients with COVID-19. METHODS: We performed a scoping review, adding five additional questions concerning possible contaminating routes. A systematic search was performed on the PubMed, CINAHL, and Embase databases, adding results from gray literature as well. The search not only included COVID-19 but was extended to virus contamination in general. We excluded society and professional association statements about COVID-19 if they did not add new insights to the available literature. RESULTS: The initial search provided 2007 records, after which 267 full-text papers were considered. Finally, we used 84 papers, of which 14 discussed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eight papers discussed the added value of performing intubation in a low-pressure operating room, mainly based on the SARS outbreak experience in 2003. Thirteen papers elaborated on the risks of intubation for health care providers and SARS-CoV-2, and 19 papers discussed this situation with other viruses. They conclude that there is significant evidence that intubation and extubation is a high-risk aerosol-producing procedure. No papers were found on the risk of SARS-CoV-2 and surgical smoke, although 25 papers did provide conflicting evidence on the infection risk of human papillomavirus, hepatitis B, polio, and rabies. No papers were found discussing tissue extraction or the deflation risk of the pneumoperitoneum after laparoscopic surgery. CONCLUSIONS: There seems to be consensus in the literature that intubation and extubation are high-risk procedures for health care providers and that maximum protective equipment is needed. On the other hand, minimal evidence is available of the actual risk of contamination of health care providers during laparoscopy itself, nor of operating room pressure, surgical smoke, tissue extraction, or CO2 deflation. However, new studies are being published daily from current experiences, and society statements are continuously updated. There seems to be no reason to abandon laparoscopic surgery in favor of open surgery. However, the risks should not be underestimated, surgery should be performed on patients with COVID-19 only when necessary, and health care providers should use logic and common sense to protect themselves and others by performing surgery in a safe and protected environment.


Assuntos
Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa do Paciente para o Profissional , Laparoscopia/efeitos adversos , Pneumonia Viral/transmissão , Ensaios Clínicos como Assunto , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Literatura de Revisão como Assunto , Medição de Risco
20.
rev. cuid. (Bucaramanga. 2010) ; 11(2): e826, 1 de Mayo de 2020.
Artigo em Espanhol | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1118383

RESUMO

Introducción: La coordinación adecuada para organizar la atención de enfermería a nivel hospitalario es decisiva frente al servicio que se ofrece a los sujetos de cuidado y al mejoramiento permanente de la institución. Objetivo: Describir qué dice la literatura mundial sobre cómo fortalecer el rol de coordinación de enfermería a nivel hospitalario. Materiales y Métodos: Búsqueda integradora de literatura bajo parámetros de Ganong, con publicaciones arbitradas, observación de seis años, sin límites geográficos, en idiomas inglés, español y portugués. Resultados: De acuerdo con la literatura surgen tres categorías que incluyen: características del rol de coordinador de enfermería; impacto de esta coordinación en los resultados frente al sujeto de cuidado; y estrategias para fortalecer el rol de coordinación dentro de la institución. La evidencia que respalda el desarrollo de la coordinación de enfermería en el hospital es débil, con una mayoría de estudios de tipo descriptivo. Discusión: La coordinación de enfermería debe articular la dirección y la operación en el hospital y para ello requiere conocer y acompañar la directriz institucional a mediano y largo plazo y manejar estrategias de motivación y acompañamiento para facilitar su logro. Conclusiones: En una institución hospitalaria, la enfermera coordinadora debe mantener el norte en medio de la cotidianeidad de la asistencia; acompañar y motivar al personal a su cargo mediante competencias de liderazgo, trabajo en equipo y conocimiento clínico e institucional. Requiere para el ejercicio de su rol, proyectar el cambio y mantener un pensamiento integrador.


Introduction: An effective coordination to manage nursing care at the hospital level is essential for the service offered to the subjects of care and for the constant improvement of the institution. Objective: To describe the international literature related to the strengthening of the role of nursing coordination at the hospital level. Materials and Methods: An integrated literature search was carried out under Ganong parameters with arbitrated publications and six-year observations without geographical limits in English, Spanish, and Portuguese. Results: Three categories were identified from the literature search, namely, characteristics of the nurse care coordination role, impact of this coordination on the results for the subject of care, and strategies to enhance the coordination role within the institution. The evidence supporting the development of nurse care coordination at hospitals is poor, most of which are descriptive studies. Discussion: Nurse care coordination must articulate hospital direction and operation, which requires knowing and supporting institutional guidelines over the medium and longer-term and developing motivation and support strategies to facilitate its achievement. Conclusions: The nurse care coordinator in a hospital must keep their focus on the daily care of patients as well as support and encourage their staff through leadership skills, teamwork, and clinical/institutional knowledge. To perform their role, the coordinator must promote change and maintain an integrated approach.


Introdução: A coordenação adequada para organizar a assistência de enfermagem em nível hospitalar é decisiva diante do serviço oferecido aos sujeitos da assistência e a melhoria permanente da instituição. Objetivo: Descrever o que a literatura mundial diz sobre como fortalecer o papel da coordenação de enfermagem no nível hospitalar. Materiais e Métodos: Pesquisa integrativa de literatura sob os parâmetros Ganong, com publicações arbitradas, observação de seis anos, sem limites geográficos, nos idiomas inglês, espanhol e português. Resultados: Segundo a literatura, existem três categorias que incluem: características do papel do coordenador de enfermagem; impacto dessa coordenação nos resultados contra o paciente; e estratégias para fortalecer o papel de coordenação dentro da instituição. As evidências que sustentam o desenvolvimento da coordenação de enfermagem no hospital são fracas, com a maioria dos estudos descritivos. Discussão: A coordenação de enfermagem deve articular a direção e a operação no hospital e, para isso, requer conhecer e acompanhar as diretrizes institucionais a médio e longo prazo e gerenciar estratégias motivacionais e de acompanhamento para facilitar sua realização. Conclusões: Em uma instituição hospitalar, o enfermeiro coordenador deve manter seu foco no meio da assistência diária; acompanhar e motivar a equipe responsável por meio de habilidades de liderança, trabalho em equipe e conhecimento clínico e institucional. Requer para o exercício de seu papel, projetar mudanças e manter um pensamento integrador.


Assuntos
Humanos , Masculino , Feminino , Literatura de Revisão como Assunto , Supervisão de Enfermagem , Cuidados de Enfermagem , Serviço Hospitalar de Enfermagem
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