RESUMO
Tuberculosis is a major cause of morbidity and mortality in women of childbearing age (15-44 years). Despite increased tuberculosis risk during pregnancy, optimal clinical treatment remains unclear: safety, tolerability, and pharmacokinetic data for many tuberculosis drugs are lacking, and trials of promising new tuberculosis drugs exclude pregnant women. To advance inclusion of pregnant and postpartum women in tuberculosis drug trials, the US National Institutes of Health convened an international expert panel. Discussions generated consensus statements (>75% agreement among panelists) identifying high-priority research areas during pregnancy, including: (1) preventing progression of latent tuberculosis infection, especially in women coinfected with human immunodeficiency virus; (2) evaluating new agents/regimens for treatment of multidrug-resistant tuberculosis; and (3) evaluating safety, tolerability and pharmacokinetics of tuberculosis drugs already in use during pregnancy and postpartum. Incorporating pregnant women into clinical trials would extend evidence-based tuberculosis prevention and treatment standards to this special population.
Assuntos
Antituberculosos/uso terapêutico , Ensaios Clínicos como Assunto/métodos , Tuberculose Latente/tratamento farmacológico , Período Pós-Parto , Tuberculose Resistente a Múltiplos Medicamentos/prevenção & controle , Tuberculose/tratamento farmacológico , Tuberculose/prevenção & controle , Adulto , Antituberculosos/farmacocinética , Ensaios Clínicos como Assunto/ética , Ensaios Clínicos como Assunto/legislação & jurisprudência , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Tuberculose Latente/sangue , Tuberculose Latente/microbiologia , Gravidez , Tuberculose/microbiologia , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/microbiologia , Estados UnidosRESUMO
Background: Traumatic experiences during childhood have been suggested to alter the course of sensory and motor development due to the impact on neural connections within the brain at integral periods. This connection has been alluded to in literature and is discussed anecdotally by practitioners suggesting the impact is commonly seen in practice. Previous scoping reviews in this area have focused solely on the process of sensory modulation without exploring the connection to motor planning. Objective: This scoping review considers what is known from the existing literature about the impact of childhood trauma on sensory processing and motor skills. Method: This scoping review followed the JBI methodology for scoping reviews (Peters et al., 2020), searching CINAHL plus, Proquest, Scopus, PsycINFO, EThOS, as well as a search of the reference lists of the articles and citation chaining, to locate both published and unpublished sources. Articles were reviewed by two reviewers independently, with a third reviewer verifying those that met inclusion criteria where there was disagreement. Results: Six articles were identified that met the inclusion criteria for the study. While all included studies suggested the concurrence of sensory processing and motor difficulties in individuals who have experienced childhood trauma they did not conclusively make the link between the two suggesting an overall low level of evidence. Commonalities were identified in relation to the areas of the brain impacted and the nature of difficulties experienced with some suggestion of this varying according to stage of development and the specific nature of the trauma. Conclusions: This study suggests emerging evidence in relation to the connection between trauma, sensory processing and motor development but that further empirical research is needed to verify this and inform practice.