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1.
J Palliat Care ; 38(1): 78-96, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35996340

RESUMO

Objective: Traditional gender norms and expectations may disproportionately constrain in-home palliative care received by women. This scoping review aims to canvass and evaluate the literature on gender disparities in end of life care and explore relevant themes that could inform future research and practice. Methods: A systematic search of MEDLINE, OVID, COCHRANE, and EMBASE was conducted using MeSH terms palliative care, palliative medicine, terminal care, or hospice care, combined with gender equity, sex factors, sexism, or gender disparities. Articles were limited to those in English (2010 to 2021), focusing on end of life care, gender roles, patients, and caregivers. Results: Of 624 articles identified, 15 met inclusion criteria for critical appraisal using the AMSTAR checklist for systematic reviews and NICE guidelines for quantitative and qualitative studies. Most studies were of poor to moderate quality. Thematic analyses identified 6 major themes related to gender disparities: living situation, symptom experience, care context, care preferences, caregiving, and coping strategies. Conclusion: Larger scale research of better quality is needed to fully characterize gender disparities in end of life care and understand how physicians might mitigate these disparities by building awareness of personal gender biases, providing support to families, educating them, and initiating care discussions that overturn traditional and stereotypic gendered expectations.


Assuntos
Cuidados Paliativos na Terminalidade da Vida , Assistência Terminal , Humanos , Feminino , Revisões Sistemáticas como Assunto , Cuidados Paliativos , Cuidadores
2.
Braz. j. oral sci ; 21: e226351, jan.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1355010

RESUMO

Aim: This study aimed to assess the reporting characteristics of systematic review abstracts published in the proceedings of the Sociedade Brasileira de Pesquisa Odontológica (SBPqO) meeting. Methods: We selected abstracts published in the SBPqO meeting proceedings of 2019 and 2020, mentioning that a systematic review was conducted in the title, objective or methods sections. One researcher performed the screening and the data extraction after a pilot test training. The following data were extracted: affiliation of the primary author, dental specialization, the term "systematic review" mentioned in the title, reporting of the objective, reporting of eligibility criteria, reporting of information sources, reporting of the number of included studies and if a meta-analysis was performed. A descriptive analysis of the data was performed with data summarized as frequencies. Results: We included 235 abstracts. A total of 20 studies were from the Universidade de Uberlândia (8.5%), and the main specialization was Restorative and Esthetic Dentistry, with 47 studies (20%). Most of the studies mentioned the term "systematic review" in the title (n=219; 93.2%) and reported the objective (n=231; 98.3%). A great majority of studies did not report the eligibility criteria (n=97; 41.3%) or it was classified as unclear (n=96; 40.8%). The great majority of studies only reported the databases searched (n=103; 43.8%) or databases and date of search (n=74; 31.5%). Most of the studies reported the number of included studies (n=204; 86.8%). Conclusion: Based on this study, the reporting characteristics of systematic review abstracts published in the proceedings of the SBPqO meeting are satisfactory. However, there is room for improvement


Assuntos
Congressos como Assunto , Pesquisa em Odontologia/estatística & dados numéricos , Indexação e Redação de Resumos , Relatório de Pesquisa , Revisões Sistemáticas como Assunto
3.
Front Public Health ; 10: 981383, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36438301

RESUMO

Objective: Accessibility to quality healthcare, histopathology of tumor, tumor stage and geographical location influence survival rates. Comprehending the bases of these differences in cervical cancer survival rate, as well as the variables linked to poor prognosis, is critical to improving survival. We aimed to perform the first thorough meta-analysis and systematic review of cervical cancer survival times in Africa based on race, histopathology, geographical location and age. Methods and materials: Major electronic databases were searched for articles published about cervical cancer survival rate in Africa. The eligible studies involved studies which reported 1-year, 3-year or 5-year overall survival (OS), disease-free survival (DFS) and/or locoregional recurrence (LRR) rate of cervical cancer patients living in Africa. Two reviewers independently chose the studies and evaluated the quality of the selected publications, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-P). We used random effects analysis to pooled the survival rate across studies and heterogeneity was explored via sub-group and meta-regression analyses. A leave-one-out sensitivity analysis was undertaken, as well as the reporting bias assessment. Our findings were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-P). Results: A total of 16,122 women with cervical cancer were covered in the 45 articles (59 studies), with research sample sizes ranging from 22 to 1,059 (median = 187.5). The five-year overall survival (OS) rate was 40.9% (95% CI: 35.5-46.5%). The five-year OS rate ranged from 3.9% (95% CI: 1.9-8.0%) in Malawi to as high as 76.1% (95% CI: 66.3-83.7%) in Ghana. The five-year disease-free survival rate was 66.2% (95% CI: 44.2-82.8%) while the five-year locoregional rate survival was 57.0% (95% CI: 41.4-88.7%). Conclusion: To enhance cervical cancer survival, geographical and racial group health promotion measures, as well as prospective genetic investigations, are critically required.


Assuntos
Neoplasias do Colo do Útero , Humanos , Feminino , Estudos Prospectivos , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Gana
4.
BMJ Open ; 12(11): e062046, 2022 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-36424111

RESUMO

INTRODUCTION: Atherosclerosis is the leading cause of cardiovascular disease (CVD), which is one of the most common causes of morbidity and mortality worldwide. Lipid accumulation and inflammation play a crucial role in the pathogenesis of atherosclerosis. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are an emerging lipid-lowering agent reported as a potential anti-inflammation effect in the prevention of CVD. However, the anti-inflammatory effect is still elusive. Therefore, a systematic review and meta-analysis is needed to analyse the anti-inflammatory effect of PCSK9 inhibitors on atherosclerosis in practice. METHODS AND ANALYSIS: This protocol was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. We will include double-blind, randomised controlled trials that reported changes in the levels of inflammatory markers, with an intervention arm of PCSK9 inhibitors and a treatment duration of more than 2 weeks. The following databases will be mainly searched from 1 January 2003 to the formal search date: PubMed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials. The primary aim is to assess the effect of PCSK9 inhibitors on inflammatory markers, including circulating inflammatory markers such as C-reactive protein, high-sensitivity C-reactive protein, white cell counts, IL-1ß, IL-6 and TNF-α and local inflammatory markers such as the most diseased segment target-to-background ratio of the index vessel in adult patients with atherosclerosis. We will assess the quality of evidence, heterogeneity and report bias following the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. ETHICS AND DISSEMINATION: Due to the systematic review being based on published studies, no ethics approval is required. The study results will be presented at international conferences and published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42022297710.


Assuntos
Aterosclerose , Doenças Cardiovasculares , Adulto , Humanos , Anti-Inflamatórios , Aterosclerose/tratamento farmacológico , Biomarcadores , Proteína C-Reativa , Lipídeos , Metanálise como Assunto , Inibidores de PCSK9 , Pró-Proteína Convertase 9 , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto
5.
Front Immunol ; 13: 1013784, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36426364

RESUMO

Background: Multiple sclerosis (MS) is a debilitating neurodegenerative disorder characterized by axonal damage, demyelination, and perivascular inflammatory lesions in the white matter of the central nervous system (CNS). Kynurenine pathway (KP), which is the major route of tryptophan (TRP) metabolism, generates a variety of neurotoxic as well as neuroprotective compounds, affecting MS pathology and the severity of impairments. Alterations in KP have been described not only in MS, but also in various psychiatric and neurodegenerative diseases. The purpose of this systematic review is to investigate the previously reported dysregulation of KP and differences in its metabolites and enzymes in patients with MS compared to healthy control subjects. Method: Electronic databases of PubMed, Scopus, Cochrane Database of Systematic Reviews, and Web of Science were searched to identify studies measuring concentrations of KP metabolites and enzymes in MS patients and control subjects. The following metabolites and enzymes implicated in the KP were investigated: TRP, kynurenine (KYN), kynurenic acid (KYNA), quinolinic acid (QUIN), picolinic acid (PIC), hydroxyindoleacetic acid (HIAA), indoleamine 2,3-dioxygenase (IDO), kynurenine aminotransferase (KAT), and their related ratios. Result: Ten studies were included in our systematic review. Our review demonstrates that IDO expression is reduced in the peripheral blood mononuclear cells (PBMCs) of MS patients compared to healthy controls. Also, increased levels of QUIN and QUIN/KYNA in the serum and cerebrospinal fluid (CSF) of MS patients is observed. Differences in levels of other metabolites and enzymes of KP are also reported in some of the reviewed studies, however there are discrepancies among the included reports. Conclusion: The results of this investigation suggest a possible connection between alterations in the levels of KP metabolite or enzymes and MS. QUIN levels in CSF were higher in MS patients than in healthy controls, suggesting that QUIN may be involved in the pathogenesis of MS. The data indicate that differences in the serum/blood or CSF levels of certain KP metabolites and enzymes could potentially be used to differentiate between MS patients and control subjects.


Assuntos
Cinurenina , Esclerose Múltipla , Humanos , Cinurenina/metabolismo , Triptofano/metabolismo , Leucócitos Mononucleares/metabolismo , Revisões Sistemáticas como Assunto , Ácido Quinolínico , Ácido Cinurênico/metabolismo
6.
Crit Rev Oncol Hematol ; 180: 103869, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36356701

RESUMO

Telehealth facilitates access to cancer care for patients unable to attend in-person consultations, as in COVID-19. This systematic review used the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to evaluate telehealth implementation and examine enablers and barriers to optimal implementation in oncology. MEDLINE, PubMed, CINAHL, and the Cochrane Database of Systematic Reviews were searched between January 2011-June 2022. Eighty-two articles representing 73 studies were included. One study explicitly used the RE-AIM framework to guide study design, conduct, or reporting. Reach (44%) and implementation (38%) were most commonly reported, maintenance (5%) least commonly. Key telehealth implementation enablers included professional-led delivery, patient-centred approaches, and positive patient perceptions. Key barriers included patient discomfort with technology, limited supporting clinic infrastructure, and poor access to reliable internet connection and videoconferencing. While a patient-centred and professional-supported approach enables telehealth implementation, technology and infrastructure constraints need surmounting for sustained implementation beyond the COVID-19 pandemic.


Assuntos
COVID-19 , Telemedicina , Humanos , Pandemias , COVID-19/epidemiologia , Revisões Sistemáticas como Assunto , Oncologia
7.
Trials ; 23(1): 943, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36397081

RESUMO

BACKGROUND: A Core Outcome Set (COS) is a standardised list of outcomes that should be reported as a minimum in all clinical trials. In epilepsy, the choice of outcomes varies widely among existing studies, particularly in clinical trials. This diminishes opportunities for informed decision-making, contributes to research waste and is a barrier to integrating findings in systematic reviews and meta-analyses. Furthermore, the outcomes currently being measured may not reflect what is important to people with epilepsy. Therefore, we aim to develop a COS specific to clinical effectiveness research for adults with epilepsy using Delphi consensus methodology. METHODS: The EPSET Study will comprise of three phases and follow the core methodological principles as outlined by the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Phase 1 will include two focused literature reviews to identify candidate outcomes from the qualitative literature and current outcome measurement practice in phase III and phase IV clinical trials. Phase 2 aims to achieve international consensus to define which outcomes should be measured as a minimum in future trials, using a Delphi process including an online consensus meeting involving key stakeholders. Phase 3 will involve dissemination of the ratified COS to facilitate uptake in future trials and the planning of further research to identify the most appropriate measurement instruments to use to capture the COS in research practice. DISCUSSION: Harmonising outcome measurement across future clinical trials should ensure that the outcomes measured are relevant to patients and health services, and allow for more meaningful results to be obtained. CORE OUTCOME SET REGISTRATION: COMET Initiative as study 118 .


Assuntos
Epilepsia , Projetos de Pesquisa , Adulto , Humanos , Técnica Delfos , Revisões Sistemáticas como Assunto , Avaliação de Resultados em Cuidados de Saúde , Epilepsia/diagnóstico , Epilepsia/terapia
8.
Syst Rev ; 11(1): 244, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36397127

RESUMO

BACKGROUND: Clinicians usually conduct diagnostic assessments in order to establish a diagnosis or to evaluate the effect of treatment. Two meta-analyses suggest that diagnostic assessment administered in collaboration with the patient and personalized feedback might have a therapeutic effect. METHODS: We aim to conduct a systematic review and meta-analysis of the effect on symptomatology when using assessment as a therapeutic intervention for patients with psychiatric illnesses. We will search in five relevant electronic databases. Two reviewers will independently select papers following pre-defined eligibility criteria, extract data, and assess the quality of included studies. Randomized controlled trials comparing the effect of psychological assessment with other psychotherapeutic interventions in populations of patients will be included in the meta-analysis. We will extract data on symptom-related outcomes, quality of life, dropout, and re-diagnosis and use meta-analysis techniques to compute the effect size of interventions using assessment as a psychotherapeutic intervention. The review will be conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Risk of bias will be assessed by using the Risk of Bias tool RoB 2.0 of the Cochrane Collaboration, and the certainty of the body of evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. DISCUSSION: THE RESULTS WILL BE ABLE TO INFORM CLINICIANS AND POLICYMAKERS ON THE EFFECT OF ASSESSMENT AND, DEPENDING ON THE RESULTS, COULD LEAD TO A RECOMMENDATION FOR MODIFIED ASSESSMENT PROCEDURES AND APPROACHES IN MENTAL HEALTH SERVICES. ULTIMATELY, IT MIGHT IMPROVE THE TREATMENT OUTCOME IN MENTAL HEALTH SERVICES.: SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021270567.


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Humanos , Qualidade de Vida , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Resultado do Tratamento , Relatório de Pesquisa , Metanálise como Assunto , Revisões Sistemáticas como Assunto
9.
Medicine (Baltimore) ; 101(43): e31532, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316854

RESUMO

BACKGROUND: Metabolic syndrome (MS) is showing an epidemic trend worldwide, and its annual incidence is increasing. Conventional treatment options have limitations and it is necessary to develop new management strategies for MS. METHODS: Eligible randomized controlled clinical trials (RCTs) were screened by searching multiple Chinese and English databases. References to the included literature, gray literature in OpenGrey, and other relevant literature, such as clinical studies registered in ClinicalTrials.gov, were also manually searched. Relevant data were extracted, and meta-analysis was performed using Reviewer Manager 5.4. RESULTS: This study provides a high-quality review of the efficacy and safety of acupuncture in the treatment of MS, and provides a basis for the clinical application of acupuncture in the treatment of MS. CONCLUSION: This study provides evidence of the effectiveness and safety of acupuncture in the treatment of MS.


Assuntos
Terapia por Acupuntura , Síndrome Metabólica , Humanos , Terapia por Acupuntura/métodos , Metanálise como Assunto , Síndrome Metabólica/terapia , Revisões Sistemáticas como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
Medicine (Baltimore) ; 101(43): e31162, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316870

RESUMO

BACKGROUND: In recent years, many studies have found possible links between gene polymorphisms and venous thromboembolism (VTE). By identifying genetic risk factors before facing environmental risk factors such as surgical interventions and COVID-19 vaccination, we could rapidly respond to the risk of VTE. The aim of this study was to perform an umbrella review of genetic variants related to VTE. Integrative gene analysis of VTE was performed to identify critical genetic variations. METHODS: This study conducted an umbrella review of systematic reviews and meta-analyses. All included studies were selected from the PubMed/MEDLINE database. To select eligible studies, the following variables were extracted: first author name; effect size of each study genetic variant; year of publication; the number of studies included in each article; ethnicity, sample size, P values, and heterogeneity estimates. To assess cumulative evidence in genetic epidemiology about effects of gene polymorphisms on VTE, Human Genome Epidemiology Network's Venice criteria were used. Methodological quality assessment was conducted with JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. RESULTS: Genes provided in the present study with genetic variants associated with VTE were FVL (G1691A), Prothrombin (G20210A), MTHFR (C677T, A1298C), PAI-1 (4G/5G), factor VII activating protease (1601G > A), and endothelial protein C receptor (g.6936A_G, c.4600A_G). Among them, variants in FVL, Prothrombin, MTHFR, and PAI-1 showed high significance. Particularly, variants in Prothrombin (G20210A), MTHFR (C677T), and PAI-1 (4G/5G) had more than 2 types of model significance. CONCLUSION: The present study performed a systematic review of genetic variants associated with VTE. Our results could lead to a more comprehensive understanding of VTE etiology. These results could give a strategy of prediagnosis about evaluating individual risks of VTE who might be exposed to environmental risk factors.


Assuntos
COVID-19 , Tromboembolia Venosa , Humanos , Vacinas contra COVID-19 , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Inibidor 1 de Ativador de Plasminogênio/genética , Protrombina/genética , Revisões Sistemáticas como Assunto , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/genética , Metanálise como Assunto
11.
Medicine (Baltimore) ; 101(43): e31234, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316909

RESUMO

BACKGROUND: Dry eye disease (DED) is a condition occurring worldwide. Studies have found that coronavirus disease 2019 (COVID-19) patients may have persistent dry eye symptoms for weeks and months after recovery, and the prevalence of dry eye is higher in COVID-19 patients than in people without COVID-19 infection. As one of the common ophthalmic diseases, the clinical application of acupuncture in the treatment of DED is not widely used nowadays. METHODS: According to the retrieval strategies, randomized controlled trials (RCT) on the acupuncture for DED after recovery from COVID-19 were obtained from Embase, The Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure database, Chinese Biomedical Database, Chinese Science and Technology Periodical database, The WanFang database. Studies were screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool was used to evaluate the quality of the studies. The meta-analysis was performed using Review Manager (RevMan 5.3) and STATA 14.2 software. Ultimately, the evidentiary grade for the results will be evaluated. RESULTS: The study will provide a high-quality and convincing assessment of the efficacy and safety of acupuncture for DED after recovery from COVID-19 and will be published in peer-reviewed journals. CONCLUSION: Our findings will provide references for future clinical decision and guidance development.


Assuntos
Terapia por Acupuntura , COVID-19 , Síndromes do Olho Seco , Humanos , COVID-19/terapia , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Terapia por Acupuntura/métodos , Síndromes do Olho Seco/terapia , Projetos de Pesquisa
12.
Medicine (Baltimore) ; 101(43): e31597, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316912

RESUMO

BACKGROUND: Functional dyspepsia (FD) is a common digestive system disease in pediatrics, usually affects normal growth and increases health care expenditure. Many investigations have demonstrated that external treatment of traditional Chinese medicine (TCM) has certain advantages in the treatment of FD children, but the effectiveness, safety, and advantages of various methods have not been confirmed by high-quality meta-analyses. This study will conduct a systematic review and network meta-analysis to evaluate the differences and effectiveness in external treatments of TCM, in order to provide a reference for further clinical treatment for FD in children. METHODS: Nine electronic databases, including PubMed, Medline, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, Wan-Fang Database and one clinical trial register platforms: ClinicalTrials.gov (www.ClinicalTrials.gov/) will be searched using English and Chinese search strategies. All eligible studies are randomized controlled trials of TCM external treatment for FD in children, published on or before July 20, 2022. The screening process will be developed by 2 independent authors, and network meta-analysis will be performed with RevMan (V5.3) software. RESULTS: This study will provide a high-quality synthesis to assess the effectiveness and safety on the external treatment of TCM for children with FD. CONCLUSION: The results of this study will provide evidence to judge whether the external treatment of TCM are effective interventions for children with FD. ETHICS AND DISSEMINATION: The results of this meta-analysis and meta-regression will be disseminated through publication in a peer-reviewed journal and presented at a relevant conference. The information used in the network meta-analysis does not contain individual patient data. Therefore, ethical approval was not required. PROSPERO REGISTRATION NUMBER: CRD42022360429.


Assuntos
Dispepsia , Medicina Tradicional Chinesa , Criança , Humanos , China , Dispepsia/tratamento farmacológico , Medicina Tradicional Chinesa/métodos , Metanálise como Assunto , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
13.
Open Heart ; 9(2)2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36344107

RESUMO

INTRODUCTION: Cardiac rehabilitation has proven beneficial in cardiovascular patients and is strongly recommended for secondary prevention after a coronary event. However, overall utilisation of cardiac rehabilitation is often low. The addition of novel methods of rehabilitation may increase overall compliance with cardiac rehabilitation. The use of virtual reality (VR) has been adopted in a variety of therapeutic ways such as physical rehabilitation in neurological diseases, rehabilitation for various psychiatric illnesses and postcancer rehabilitation in breast cancer survivors. In our meta-analysis, we wish to assess whether the addition of VR (fully immersive or non-immersive) leads to an improvement in anxiety and functional capacity compared with standard cardiac rehabilitation at any phase of the rehabilitation process. METHOD AND ANALYSIS: This systematic review and meta-analysis protocol was structured according to the published Preferred Reporting for Systematic Review and Meta-analysis-Protocol guidelines. We will devise a search strategy to use online databases to search for the randomised controlled trials. Inclusion criteria and exclusion criteria will be defined. The articles will be reviewed by two independent reviewers and any conflict will be adjudicated through discussion. The bias in the selected studies will be assessed using Cochrane risk-of-bias tool for randomised trials (RoB 2). The outcome of interest will be anxiety and functional capacity. Effect estimates will be reported as standardised mean difference with 95% CI. Fixed effect model will be used if I2 <60%, otherwise random effect model will be used to estimate the effect size. ETHICS AND DISSEMINATION: There will be no direct involvement of the patient or the public in the conception, design, data collection and analysis of this systematic review and meta-analysis. Results of this systematic review and meta-analysis will be disseminated via journal articles. In accordance with the guidelines, our systematic review protocol is prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 07 August 2022. PROSPERO ID: CRD 42022342736.


Assuntos
Reabilitação Cardíaca , Realidade Virtual , Humanos , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Ansiedade/diagnóstico
14.
Nutrients ; 14(21)2022 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-36364750

RESUMO

Women's nutrition has been highlighted as a global priority to ensure the health and well-being of both them and future generations. This systematic review summarises the available literature on the integration of nutrition services for girls and women of reproductive age (GWRA) into existing public health systems across low- and middle-income countries, as well as any barriers to integration. We searched PubMed and Cochrane Database of Systematic Reviews for articles published since 2011 according to eligibility criteria. A total of 69 articles were included. Evidence suggested that several services for GWRA are well integrated into public health systems, including antenatal care services, nutrition education and counselling, and micronutrient supplementation programmes. However, there was limited evidence on the integration of family planning, adolescent health, and reproductive health services. Barriers to integration fell into five main themes: lack of training and capacity building, poor multisectoral linkages and coordination, weak advocacy, lack of M&E systems, and inequity. We identified a lack of evidence and services for non-pregnant GWRA and for women postpartum. Addressing barriers to integration and gaps in nutrition services for GWRA would increase service coverage and contribute to improving health outcomes for GWRA and future generations.


Assuntos
Países em Desenvolvimento , Estado Nutricional , Adolescente , Feminino , Humanos , Gravidez , Renda , Cuidado Pré-Natal , Revisões Sistemáticas como Assunto
15.
Eur J Psychotraumatol ; 13(2): 2138059, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36340009

RESUMO

Background: Experiencing potentially morally injurious events (PMIEs) has been found to be significantly associated with poor mental health outcomes in military personnel/veterans. Currently, no manualised treatment for moral injury-related mental health difficulties for UK veterans exists. This article describes the design, methods and expected data collection of the Restore & Rebuild (R&R) protocol, which aims to develop procedures to treat moral injury related mental ill health informed by a codesign approach. Methods: The study consists of three main stages. First, a systematic review will be conducted to understand the best treatments for the symptoms central to moral injury-related mental ill health (stage 1). Then the R&R manual will be co-designed with the support of UK veteran participants with lived experience of PMIEs as well as key stakeholders who have experience of supporting moral injury affected individuals (stage 2). The final stage of this study is to conduct a pilot study to explore the feasibility and acceptability of the R&R manual (stage 3). Results: Qualitative data will be analysed using thematic analysis. Conclusions: This study was approved by the King's College London's Research Ethics Committee (HR-20/21-20850). The findings will be disseminated in several ways, including publication in academic journals, a free training event and presentation at conferences. By providing information on veteran, stakeholder and clinician experiences, we anticipate that the findings will not only inform the development of an acceptable evidence-based approach for treating moral injury-related mental health problems, but they may also help to inform broader approaches to providing care to trauma exposed military veterans.


Antecedentes: Se ha encontrado que experimentar eventos potencialmente dañinos para la moral (PMIE, por sus siglas en inglés) se asocia significativamente con malos resultados de salud mental en el personal militar/veteranos. Actualmente no existe un tratamiento manualizado para los problemas de salud mental relacionadas con daño moral para los veteranos del Reino Unido. Este artículo describe el diseño, los métodos y la recopilación de datos esperada del protocolo Restore & Rebuild (R&R), que tiene como objetivo desarrollar procedimientos para tratar la salud mental relacionada con el daño moral informado por un enfoque de codiseño.Métodos: El estudio consta de tres etapas principales. Primero, se realizará una revisión sistemática para comprender los mejores tratamientos para los síntomas centrales de la enfermedad mental relacionada con el daño moral (etapa 1). Luego, el manual de R&R se diseñará conjuntamente con el apoyo de participantes veteranos del Reino Unido con experiencia vivida de PMIE, así como con partes interesadas clave que tengan experiencia en el apoyo a las personas afectadas por daño moral (etapa 2). La etapa final de este estudio es realizar un estudio piloto para explorar la factibilidad y aceptabilidad del manual R&R (etapa 3).Resultados: Los datos cualitativos se analizarán mediante análisis temático.Conclusiones: Este estudio fue aprobado por el Comité de Ética en Investigación del King's College London (HR-20/21-20850). Los hallazgos se difundirán de varias maneras, incluida la publicación en revistas académicas, un evento de capacitación gratuito y presentaciones en conferencias. Al proporcionar información sobre las experiencias de veteranos, partes interesadas y médicos, anticipamos que los hallazgos no solo informarán el desarrollo de un enfoque basado en evidencia aceptable para tratar problemas de salud mental relacionados con daño moral, sino que también pueden ayudar a transmitir enfoques más amplios para proporcionar atención a veteranos militares expuestos a traumas.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Veteranos , Humanos , Transtornos de Estresse Pós-Traumáticos/terapia , Veteranos/psicologia , Saúde Mental , Projetos Piloto , Estudos de Viabilidade , Reino Unido , Revisões Sistemáticas como Assunto
16.
PLoS One ; 17(11): e0277227, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36342938

RESUMO

Environmental footprints are indicators that can be used to estimate the impacts of diet on the environment. Since contemporary dietary practices are related to negative environmental impacts, this paper aims to describe a systematic review protocol to investigate the environmental footprints of food consumption by adults and elderly individuals worldwide. This protocol was developed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Search strategies and records of evidence searched in previously defined electronic databases will be defined. Original, population-based articles investigating the environmental footprints of food consumption by adults and the elderly will be included. Two independent reviewers will conduct the study selection and data extraction steps. Critical appraisal of the included studies will be based on the Newcastle-Ottawa Scale. For data synthesis, a narrative synthesis and, if possible, also a meta-analysis will be performed. The systematic review produced from this protocol will provide evidence for data synthesis of the environmental impact through environmental footprints of food consumption of the adult and elderly population from different territories and the footprint assessment tools used around the world. Therefore, it is a gap that needs to be filled because knowing these impacts will be important to inform the development of public policies that encourage healthy and sustainable food in the face of climate and epidemiological changes. PROSPERO registration number: CRD42021281488.


Assuntos
Dieta , Humanos , Adulto , Idoso , Revisões Sistemáticas como Assunto , Metanálise como Assunto
17.
PLoS One ; 17(11): e0278122, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36417449

RESUMO

BACKGROUND: Suicide is the second leading cause of death among young people worldwide and remains a major public health concern. Research indicates that negative social contexts involving familial and peer relationships, have far-reaching influences on levels of suicidal behaviours in later life. Previous systematic reviews have focused on evaluating associations between negative life events such as abuse and bullying in childhood and subsequent self-harm or suicidality. However, the association between adolescent experiences of humiliation and shame, and subsequent self-harm or suicidal behaviour among children and young adults has not been well examined. As such, this systematic review is conducted to examine the prevalence and association between humiliation and shame and self-harm, suicidal ideation, and death by suicide among adolescents and young adults. METHODS: A systematic literature search in extant electronic databases including; MEDLINE, Web of Science Core Collection, CINAHL, PsycINFO, and Embase will be conducted to identify potential studies. Google Scholar, and the reference list of the retrieved articles and/or previous systematic reviews in this area, will also be scanned to identify further potential studies. ProQuest will be searched to identify relevant studies available within grey literature. There are no restrictions on the date of publications. Based on our initial review, the following terms were identified: Population: Adolescent (MESH), young adult (MESH), teen, teenage. Exposure: Humiliation, degradation, shame (MESH) or embarrassment (MESH), harassment victimisation, abasement. Outcome: Self-injurious behaviour (MESH), suicide (MESH), suicide attempted (MESH), suicide completed (MESH), self-harm, intentional self-injury, deliberate self-harm, overdose, deliberate self-poisoning, non-suicidal self-injury, self-mutilation, suicidal thought, suicidal ideation, suicidal intent, suicide. At least one term from each category will be used for conducting the literature search. All original quantitative studies published in the English language which examined the prevalence or association between humiliation or shame and self-harm and/or suicidal ideation and/or completed suicide will be included. The studies will be assessed for methodological quality using the Joanna Briggs Institute critical appraisal tools. Narrative synthesis will be performed for all of the studies. If the studies are sufficiently homogenous, the results will be pooled for a meta-analysis. This systematic review protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P) guidelines. The protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) [CRD42022289843]. DISCUSSION: This is the first review to synthesise evidence on the prevalence of, and associations between the experiences of humiliation and shame and subsequent self-harm and/or suicidal behaviours among adolescents and young adults. As there is growing evidence on increased self-harm among this age group, it is important to identify population-specific risk factors for self-harm and suicidality which will have significance in formulating tailored and effective treatment and therapeutic services for adolescents and young adults.


Assuntos
Comportamento Autodestrutivo , Ideação Suicida , Adolescente , Adulto Jovem , Humanos , Criança , Comportamento Autodestrutivo/epidemiologia , Constrangimento , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Vergonha
18.
BMJ Open ; 12(11): e062452, 2022 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-36414296

RESUMO

INTRODUCTION: Paediatric cancer affects children and families from diverse backgrounds. However, there is a limited understanding of how diversity/cultural factors play a role, especially in survivorship. This protocol outlines a systematic review on the cultural influences in survivors of childhood cancer. METHODS AND ANALYSIS: This protocol is reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines checklist and is registered with PROSPERO. EMBASE, MEDLINE and PsycINFO are searched. Eligibility criteria include original research studies published in English, and an assessment of culture on survivors of childhood cancer. Search terms are developed with a medical librarian. Primary objective will be to describe culture (ethnic and population groups, migration status, acculturation, cultural characteristics) in survivors of paediatric cancer and study characteristics and methods. Secondary objective will be to identify the role of culture in outcomes of survivors of paediatric cancer. Data extraction will include participant characteristics such as the number of participants and/or controls, sex, age at diagnosis. Extraction will also include analytical approaches, type of cultural variables (predictor, moderator, mediator, outcome) and effect measures. ETHICS AND DISSEMINATION: Ethical approval was not required for this systematic review. Results from this systematic review will be disseminated in line with PRISMA guidelines through peer-reviewed publications and conference presentations. Findings will also be shared with our target communities, including survivors of childhood cancer and their families, through the creation of lay summaries and/or educational workshops in the community. Knowledge gathered from this review may help to identify gaps in knowledge and directions for future research. They may also inform the development of clinical recommendations for healthcare providers of survivors of childhood cancer. PROSPERO REGISTRATION NUMBER: CRD42021234101.


Assuntos
Sobreviventes de Câncer , Características Culturais , Criança , Humanos , Neoplasias/etnologia , Neoplasias/terapia , Revisões Sistemáticas como Assunto , Masculino , Feminino
19.
BMJ Open ; 12(11): e065662, 2022 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-36414279

RESUMO

INTRODUCTION: Most definitions of pain require individuals experiencing pain to report their pain. There are three groups who may not always report pain including those who: (1) lack the cognitive ability to verbally communicate their pain and also lack a proxy/surrogate to report pain for them; (2) lack the cognitive ability to verbally communicate their pain but have a proxy to report the pain; and (3) have the cognitive ability to verbally report pain but are unable or unwilling to do so. Clinicians may not be able to determine which patients are at risk for unidentified pain. Therefore, in this study, we present a protocol for an integrative review with the aim of identifying existing theoretical approaches to understanding unidentified pain. METHODS AND ANALYSIS: We propose a systematic overview of the existing theoretical approaches to understanding 'unidentified pain'. We will use Campbell and colleagues' criteria for systematic reviews of theory and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Our search will be broad to cover theoretical approaches to 'unidentified pain' using MEDLINE, CINAHL, Embase and Google Scholar. Covidence systematic review software will be used for data extraction and analysis. Then, qualitative content analysis will take place. The content analysis will be presented as a narrative. ETHICS AND DISSEMINATION: No human or animal subjects will be involved. The results are to be published in peer-reviewed journals and presented at conferences in the USA and internationally.


Assuntos
Dor , Humanos , Revisões Sistemáticas como Assunto
20.
BMJ Open ; 12(11): e063689, 2022 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-36414305

RESUMO

INTRODUCTION: The prescription of an intervention plan can be challenging for the physical therapist, considering clinical phenotypes, individual prognosis and the rapid, progressive and deteriorating nature of amyotrophic lateral sclerosis (ALS). In this context, therapeutic exercises (eg, resistance and aerobic exercises) for patients with ALS remain controversial and may influence the treatment plan. Therefore, this review aims to critically assess whether physical therapy interventions are effective for improving functional capacity, quality of life and fatigue of individuals with ALS. METHODS AND ANALYSIS: Studies will be selected according to eligibility criteria, and language, geographical area or publication date will not be restricted. Four databases will be used: MEDLINE, EMBASE, Cochrane Library (CENTRAL) and Physiotherapy Evidence Database (PEDro). Searches will also be conducted on ClinicalTrials.gov and references from included studies. We plan to conduct the searches between October and December 2022. Two independent authors will examine titles and abstracts and exclude irrelevant studies and duplicates. We will assess the quality of studies and quality of evidence, and disagreements will be resolved with a third researcher. The findings will be presented in the text and tables; if possible, we will perform meta-analyses. ETHICS AND DISSEMINATION: No ethical approval is required because this study does not involve human beings. We will publish our findings in peer-reviewed journals. PROSPERO REGISTRATION NUMBER: CRD42021251350.


Assuntos
Esclerose Amiotrófica Lateral , Modalidades de Fisioterapia , Humanos , Esclerose Amiotrófica Lateral/terapia , Terapia por Exercício , Qualidade de Vida , Revisões Sistemáticas como Assunto
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