Pub Date : 2019-09-01DOI: 10.11124/JBISRIR-2017-004035
Chee Keong See, Deborah Turnbull, Felix Ritson, Sean Martin, Phillip Tully, Gary Wittert
Objective: The objective of this review is to examine the association between serum testosterone concentration and the presence and severity of depression in men.
Introduction: Cross-sectional and longitudinal cohort studies examining the relationship between serum testosterone concentration and depression in men have produced mixed results. There has not, however, been any prior attempt to systematically interrogate the data. Clarification of the relationship has clinical importance because depression may be under-diagnosed in men.
Inclusion criteria: This review will consider studies involving community-dwelling men who are not receiving testosterone replacement therapy. The exposure of interest reviewed will include endogenous testosterone concentration measured through validated assays. Studies measuring total and testosterone fraction concentration will be included. This review will include studies with depression or incident depression outcomes as defined by either clinical diagnosis of depression or validated self-administered questionnaire assessing depression symptomatology.
Methods: This review will follow the JBI approach for systematic reviews of etiology and risk. The following sources will be searched: PubMed, PsycINFO, Embase, the Cochrane Central Register of Controlled Trials, Australian New Zealand Clinical Trials Registry and the ISRCTN Registry. Analytical observational studies including prospective and retrospective cohort studies, case control studies and analytical cross-sectional studies published in English or other languages with English translation will be considered. Retrieval of full-text studies, assessment of methodological quality and data extraction will be performed independently by two reviewers. Data will be pooled in statistical meta-analysis, where possible.
{"title":"Association of endogenous testosterone concentration with depression in men: a systematic review protocol.","authors":"Chee Keong See, Deborah Turnbull, Felix Ritson, Sean Martin, Phillip Tully, Gary Wittert","doi":"10.11124/JBISRIR-2017-004035","DOIUrl":"https://doi.org/10.11124/JBISRIR-2017-004035","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this review is to examine the association between serum testosterone concentration and the presence and severity of depression in men.</p><p><strong>Introduction: </strong>Cross-sectional and longitudinal cohort studies examining the relationship between serum testosterone concentration and depression in men have produced mixed results. There has not, however, been any prior attempt to systematically interrogate the data. Clarification of the relationship has clinical importance because depression may be under-diagnosed in men.</p><p><strong>Inclusion criteria: </strong>This review will consider studies involving community-dwelling men who are not receiving testosterone replacement therapy. The exposure of interest reviewed will include endogenous testosterone concentration measured through validated assays. Studies measuring total and testosterone fraction concentration will be included. This review will include studies with depression or incident depression outcomes as defined by either clinical diagnosis of depression or validated self-administered questionnaire assessing depression symptomatology.</p><p><strong>Methods: </strong>This review will follow the JBI approach for systematic reviews of etiology and risk. The following sources will be searched: PubMed, PsycINFO, Embase, the Cochrane Central Register of Controlled Trials, Australian New Zealand Clinical Trials Registry and the ISRCTN Registry. Analytical observational studies including prospective and retrospective cohort studies, case control studies and analytical cross-sectional studies published in English or other languages with English translation will be considered. Retrieval of full-text studies, assessment of methodological quality and data extraction will be performed independently by two reviewers. Data will be pooled in statistical meta-analysis, where possible.</p><p><strong>Systematic review registration number: </strong>PROSPERO CRD42018108273.</p>","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"17 9","pages":"1894-1900"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11124/JBISRIR-2017-004035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37277519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.11124/JBISRIR-2017-003943
Doreen Mucheru, M. Hanlon, M. McEvoy, A. Thakkinstian, L. MacDonald-Wicks
OBJECTIVES The objective of this review was to pool and rank the efficacy of lifestyle intervention strategies targeting weight, body mass index, waist circumference and waist-to-hip ratio in people with psychosis by comparing the effect size of these weight outcomes. Secondary to this, the objective was to stratify the lifestyle interventions according to their inclusion of dietary information that adheres to Australian Dietary Guidelines. INTRODUCTION People living with psychosis have a significantly increased risk of all-cause mortality, with cardiovascular disease a considerable contributor to this risk. Controlling lifestyle risk factors, which include smoking, poor diet and inadequate physical activity, leads to significant weight reduction and decreases cardiovascular disease risk. Previous reviews on this topic have not clearly identified essential components of lifestyle interventions in people with psychosis, mainly due to statistical limitations of analyses. This review employed the network meta-analysis, which compares more than two groups of interventions and ranks them according to efficacy, thus providing a global estimate of effect. Additionally, available reviews have not assessed compliance of dietary information offered in lifestyle interventions to established guidelines. INCLUSION CRITERIA This review considered randomized controlled studies that delivered lifestyle interventions to community-dwelling adults with psychotic disorders. Outcomes of interest were weight, body mass index, waist circumference and waist-to-hip ratio. METHODS The Cochrane Library, MEDLINE/PreMEDLINE, Embase, CINAHL, Scopus and PsycINFO were searched for studies published in English from 1985 to June 2018. Data were qualitatively summarized, during which lifestyle intervention subgroups were created (based on key similarities) and then compared in direct meta-analyses and network meta-analyses. Assessments of study adherence to Australian Dietary Guidelines was conducted in a narrative format. RESULTS Thirty-two randomized control studies were included, and the overall quality of these studies ranged from what appeared to be low to moderate. Lifestyle intervention studies contained both a dietary and physical activity component, with the exception of two studies that focused solely on physical activity. Delivery of dietary and physical activity information was mainly through education; however, some studies provided additional structure to the intervention by offering tailored advice or helping participants to set goals, and providing regular review of progress for diet, physical activity or both. Results from network-meta-analyses showed that only studies with a structured approach for both diet and physical activity demonstrated significant decreases in weight (effect size = -4.12, 95% confidence interval = -7.772 to -2.760, P = 0.000) and body mass index (effect size = -2.94, 95% confidence interval = -1.78 to -0.357, P = 0.003). Waist circ
{"title":"Comparative efficacy of lifestyle intervention strategies targeting weight outcomes in people with psychosis: a systematic review and network meta-analysis.","authors":"Doreen Mucheru, M. Hanlon, M. McEvoy, A. Thakkinstian, L. MacDonald-Wicks","doi":"10.11124/JBISRIR-2017-003943","DOIUrl":"https://doi.org/10.11124/JBISRIR-2017-003943","url":null,"abstract":"OBJECTIVES\u0000The objective of this review was to pool and rank the efficacy of lifestyle intervention strategies targeting weight, body mass index, waist circumference and waist-to-hip ratio in people with psychosis by comparing the effect size of these weight outcomes. Secondary to this, the objective was to stratify the lifestyle interventions according to their inclusion of dietary information that adheres to Australian Dietary Guidelines.\u0000\u0000\u0000INTRODUCTION\u0000People living with psychosis have a significantly increased risk of all-cause mortality, with cardiovascular disease a considerable contributor to this risk. Controlling lifestyle risk factors, which include smoking, poor diet and inadequate physical activity, leads to significant weight reduction and decreases cardiovascular disease risk. Previous reviews on this topic have not clearly identified essential components of lifestyle interventions in people with psychosis, mainly due to statistical limitations of analyses. This review employed the network meta-analysis, which compares more than two groups of interventions and ranks them according to efficacy, thus providing a global estimate of effect. Additionally, available reviews have not assessed compliance of dietary information offered in lifestyle interventions to established guidelines.\u0000\u0000\u0000INCLUSION CRITERIA\u0000This review considered randomized controlled studies that delivered lifestyle interventions to community-dwelling adults with psychotic disorders. Outcomes of interest were weight, body mass index, waist circumference and waist-to-hip ratio.\u0000\u0000\u0000METHODS\u0000The Cochrane Library, MEDLINE/PreMEDLINE, Embase, CINAHL, Scopus and PsycINFO were searched for studies published in English from 1985 to June 2018. Data were qualitatively summarized, during which lifestyle intervention subgroups were created (based on key similarities) and then compared in direct meta-analyses and network meta-analyses. Assessments of study adherence to Australian Dietary Guidelines was conducted in a narrative format.\u0000\u0000\u0000RESULTS\u0000Thirty-two randomized control studies were included, and the overall quality of these studies ranged from what appeared to be low to moderate. Lifestyle intervention studies contained both a dietary and physical activity component, with the exception of two studies that focused solely on physical activity. Delivery of dietary and physical activity information was mainly through education; however, some studies provided additional structure to the intervention by offering tailored advice or helping participants to set goals, and providing regular review of progress for diet, physical activity or both. Results from network-meta-analyses showed that only studies with a structured approach for both diet and physical activity demonstrated significant decreases in weight (effect size = -4.12, 95% confidence interval = -7.772 to -2.760, P = 0.000) and body mass index (effect size = -2.94, 95% confidence interval = -1.78 to -0.357, P = 0.003). Waist circ","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73998117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-28DOI: 10.11124/JBISRIR-2017-004021
Shu-Hua Yang, P. Mu, Hsiu-ling Wu, Marianne Curia
OBJECTIVES This aim of this project was to promote best practice in fluid balance monitoring in congestive heart failure patients. INTRODUCTION Fluid overload or pulmonary/vascular congestion is a common clinical feature of patients with heart failure and is associated with adverse outcomes. Maintaining records of patients' fluid intake and output (I&O) has long been considered an important aspect of nursing care to assess hydration status. In clinical practice, a prevalence of incongruence between I&O results and clinical signs and symptoms has been noted. We postulate that this incongruence may be due to an inaccurate or non-comprehensive collection of fluid I&O and/or the patient's and their families' inadequate recognition of the importance of I&O recording. METHODS This implementation project was conducted in a cardiology ward of a medical hospital using the Joanna Briggs Institute Practical Application of Clinical Evidence System. Three audit criteria were utilized to represent best practice recommendations for fluid balance monitoring. A pre-implementation audit was conducted, followed by development of multiple interventions identified from a Getting Research into Practice analysis. Two post-implementation audits were conducted to determine the change in practice. RESULTS The post-implementation audit data demonstrated significantly improved outcomes across the measured best practice criteria. Specifically, improvement in compliance was noted in: i) fluid balance charts being utilized in conjunction with physical assessment and electrolyte monitoring to assess the hydration status of a patient (from 58% to 100% compliance); ii) patient involvement in more accurate documentation (from 42% to 75% compliance); and iii) staff education in fluid balance monitoring and documentation (from 53% to 100% compliance). CONCLUSION Fluid record omission was reduced at the completion of the project secondary to an increased awareness of the fluid record omission standards among patients as well as physical assessment and fluid overload correlation among the nursing staff in the unit. The findings demonstrate how audits can be utilized to promote best practice in healthcare. Additionally, the data indicates that focused education and the provision of relevant resources can have an immediate and positive impact on clinical practice.
{"title":"Fluid balance monitoring in congestive heart failure patients in hospital: a best practice implementation project.","authors":"Shu-Hua Yang, P. Mu, Hsiu-ling Wu, Marianne Curia","doi":"10.11124/JBISRIR-2017-004021","DOIUrl":"https://doi.org/10.11124/JBISRIR-2017-004021","url":null,"abstract":"OBJECTIVES\u0000This aim of this project was to promote best practice in fluid balance monitoring in congestive heart failure patients.\u0000\u0000\u0000INTRODUCTION\u0000Fluid overload or pulmonary/vascular congestion is a common clinical feature of patients with heart failure and is associated with adverse outcomes. Maintaining records of patients' fluid intake and output (I&O) has long been considered an important aspect of nursing care to assess hydration status. In clinical practice, a prevalence of incongruence between I&O results and clinical signs and symptoms has been noted. We postulate that this incongruence may be due to an inaccurate or non-comprehensive collection of fluid I&O and/or the patient's and their families' inadequate recognition of the importance of I&O recording.\u0000\u0000\u0000METHODS\u0000This implementation project was conducted in a cardiology ward of a medical hospital using the Joanna Briggs Institute Practical Application of Clinical Evidence System. Three audit criteria were utilized to represent best practice recommendations for fluid balance monitoring. A pre-implementation audit was conducted, followed by development of multiple interventions identified from a Getting Research into Practice analysis. Two post-implementation audits were conducted to determine the change in practice.\u0000\u0000\u0000RESULTS\u0000The post-implementation audit data demonstrated significantly improved outcomes across the measured best practice criteria. Specifically, improvement in compliance was noted in: i) fluid balance charts being utilized in conjunction with physical assessment and electrolyte monitoring to assess the hydration status of a patient (from 58% to 100% compliance); ii) patient involvement in more accurate documentation (from 42% to 75% compliance); and iii) staff education in fluid balance monitoring and documentation (from 53% to 100% compliance).\u0000\u0000\u0000CONCLUSION\u0000Fluid record omission was reduced at the completion of the project secondary to an increased awareness of the fluid record omission standards among patients as well as physical assessment and fluid overload correlation among the nursing staff in the unit. The findings demonstrate how audits can be utilized to promote best practice in healthcare. Additionally, the data indicates that focused education and the provision of relevant resources can have an immediate and positive impact on clinical practice.","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83495613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-28DOI: 10.11124/JBISRIR-2018-004039
Ying Ren, Xiang-rong Luo, Cuihua Xie, Ping Zhang, M. Meng, Huijuan Song
INTRODUCTION Pain caused by dressing change has adverse effects on patients with a diabetic foot ulcer, including sleep disturbances, immobility, depression and anxiety. It is crucial that healthcare professionals use a standardized tool to assess and document pain during dressing change and then use this information to inform strategies to alleviate the pain. OBJECTIVES The aim of this project was to implement evidence-based practice in assessment and management of pain during dressing change among patients with diabetic foot ulcers in an endocrinology unit in a tertiary hospital. METHODS The JBI Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool were used for auditing clinical practice and translating evidence into practice. A baseline audit was performed to assess compliance with six criteria, followed by the implementation of evidence-based interventions to improve compliance. The follow-up audit using the same audit criteria was conducted to assess the effect of targeted strategies on compliance with best practice. RESULTS The baseline audit revealed that compliance with evidence-based practice was low, with only one of the six audit criteria achieving a compliance rate above 60%. After brainstorming and synthesizing the literature, the project team identified barriers and strategies for implementing best practice. The follow-up audit showed improvements in compliance across all six criteria, although there was only a small improvement in one of the criteria. The compliance rate of the other five criteria improved to greater than 67%. CONCLUSION A best practice implementation project that involved standardizing pain assessment and management, and delivering education materials to nursing staff and patients was completed using JBI PACES and GRiP. The project improved nurses' compliance with best practice. Nurses attach importance to relieving patients' pain when they accept wound care, while patients with a diabetic foot ulcer gain access to high-quality wound care. Future studies will be conducted to address new barriers that emerged during the follow-up audit.
{"title":"Assessment and management of pain during dressing change in patients with diabetic foot ulcers: a best practice implementation project.","authors":"Ying Ren, Xiang-rong Luo, Cuihua Xie, Ping Zhang, M. Meng, Huijuan Song","doi":"10.11124/JBISRIR-2018-004039","DOIUrl":"https://doi.org/10.11124/JBISRIR-2018-004039","url":null,"abstract":"INTRODUCTION\u0000Pain caused by dressing change has adverse effects on patients with a diabetic foot ulcer, including sleep disturbances, immobility, depression and anxiety. It is crucial that healthcare professionals use a standardized tool to assess and document pain during dressing change and then use this information to inform strategies to alleviate the pain.\u0000\u0000\u0000OBJECTIVES\u0000The aim of this project was to implement evidence-based practice in assessment and management of pain during dressing change among patients with diabetic foot ulcers in an endocrinology unit in a tertiary hospital.\u0000\u0000\u0000METHODS\u0000The JBI Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool were used for auditing clinical practice and translating evidence into practice. A baseline audit was performed to assess compliance with six criteria, followed by the implementation of evidence-based interventions to improve compliance. The follow-up audit using the same audit criteria was conducted to assess the effect of targeted strategies on compliance with best practice.\u0000\u0000\u0000RESULTS\u0000The baseline audit revealed that compliance with evidence-based practice was low, with only one of the six audit criteria achieving a compliance rate above 60%. After brainstorming and synthesizing the literature, the project team identified barriers and strategies for implementing best practice. The follow-up audit showed improvements in compliance across all six criteria, although there was only a small improvement in one of the criteria. The compliance rate of the other five criteria improved to greater than 67%.\u0000\u0000\u0000CONCLUSION\u0000A best practice implementation project that involved standardizing pain assessment and management, and delivering education materials to nursing staff and patients was completed using JBI PACES and GRiP. The project improved nurses' compliance with best practice. Nurses attach importance to relieving patients' pain when they accept wound care, while patients with a diabetic foot ulcer gain access to high-quality wound care. Future studies will be conducted to address new barriers that emerged during the follow-up audit.","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86345824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-23DOI: 10.11124/JBISRIR-D-19-00050
L. Ellwood, Gizemnur Torun, Z. Bahar, R. Fernandez
OBJECTIVE The objective of this systematic review was to synthesize the best available research evidence on the effectiveness of flavonoid rich fruits in the treatment of hypertension. INTRODUCTION Hypertension is a serious public health concern as it contributes to a significant burden of disease, attributable for millions of deaths globally. Complementary therapies including flavonoids have generated interest in assisting the treatment of hypertension. Flavonoids are a type of polyphenol abundant in fruits and a growing body of evidence suggests antihypertensive effects of the flavonoids due to its antioxidant properties. To date, no systematic review has been performed to collate the evidence on the effects of flavonoid rich fruits on hypertension in adults. INCLUSION CRITERIA This systematic review included only randomized controlled trials (RCTs) that compared the administration of any type of flavonoid rich fruit or equivalent supplement with a placebo or other intervention in adults with hypertension. Trials that measured blood pressure using objective outcome measures such as a manual mercury sphygmomanometer were included. Studies that did not specify the flavonoid component of the fruit or fruit supplement were excluded in the review. Secondary outcomes, including change in weight, blood glucose level, triglycerides and total blood cholesterol levels were also assessed. METHODS A three-step search was undertaken, including a comprehensive search of the MEDLINE, Embase, Cochrane Trials (CENTRAL) and CINAHL databases, in September 2018. We also searched Dissertation Abstracts International, ProQuest Dissertations and Theses, MedNar and ClinicalTrials.gov to identify unpublished studies. The title and abstracts of the studies were reviewed by two independent reviewers against the inclusion/exclusion criteria. The methodological quality of the potential studies for inclusion were assessed using the critical appraisal checklist for randomized controlled trials as recommended by the Joanna Briggs Institute. Data were pooled in a statistical meta-analysis model. Subgroup-analysis according to type of intervention and length of intervention period was performed. Where statistical pooling was not possible, the findings have been presented in a narrative form. RESULTS Fifteen randomized controlled trials involving 572 participants were included in the review. The subclasses of flavonoids assessed included: anthocyanins, naringin, narirutin and flavan-3-ols. The overall methodological quality of the trials was high. Six trials investigated the effect of the flavonoid intervention on blood pressure within four weeks. Meta-analysis of five of the trials demonstrated evidence of no effect of flavonoids on systolic or diastolic blood pressure when compared to placebo (systolic mean difference = -1.02, 95% CI -3.12, 1.07; p = 0.34, I = 0%; diastolic mean difference = -0.90, 95% CI -2.10, 0.31; p = 0.15, I = 0%). Similarly, pooled results from t
目的对富含类黄酮的水果治疗高血压的有效性进行系统综述。高血压是一个严重的公共卫生问题,因为它是造成全球数百万人死亡的重要疾病负担。包括类黄酮在内的辅助疗法已引起人们对协助治疗高血压的兴趣。黄酮类化合物是水果中富含的一种多酚,越来越多的证据表明,由于其抗氧化特性,黄酮类化合物具有抗高血压作用。到目前为止,还没有系统的综述来整理富含类黄酮的水果对成人高血压的影响。纳入标准:本系统综述仅纳入随机对照试验(RCTs),比较任何类型的富含类黄酮的水果或等效补充剂与安慰剂或其他干预措施对高血压成人的影响。使用客观结果测量方法(如手动水银血压计)测量血压的试验被纳入研究。没有明确指明水果或水果补充剂中黄酮类成分的研究被排除在综述之外。次要结果,包括体重、血糖水平、甘油三酯和总血胆固醇水平的变化也被评估。方法于2018年9月对MEDLINE、Embase、Cochrane Trials (CENTRAL)和CINAHL数据库进行三步检索。我们还检索了Dissertation Abstracts International、ProQuest Dissertation and Theses、MedNar和ClinicalTrials.gov,以确定未发表的研究。研究的标题和摘要由两名独立的审稿人根据纳入/排除标准进行审查。采用乔安娜布里格斯研究所推荐的随机对照试验关键评估清单对纳入的潜在研究的方法学质量进行评估。数据汇总在统计荟萃分析模型中。按干预类型和干预时间长短进行亚组分析。在无法进行统计汇总的情况下,调查结果以叙述形式提出。结果纳入15项随机对照试验,572名受试者。评估的黄酮类化合物亚类包括:花青素、柚皮苷、水杨柳素和黄烷-3-醇。试验的总体方法学质量很高。六项试验调查了类黄酮干预在四周内对血压的影响。五项试验的荟萃分析显示,与安慰剂相比,黄酮类化合物对收缩压或舒张压没有影响(收缩压平均差= -1.02,95% CI -3.12, 1.07;p = 0.34, I = 0%;舒张平均差= -0.90,95% CI -2.10, 0.31;p = 0.15, I = 0%)。同样,24小时内两次给药干预的两项交叉随机对照试验的汇总结果显示,舒张压的降低没有效果(p = 0.38),但收缩压的降低有证据(p = 0)。六项评估黄酮类干预后血压的试验在超过四周的随访中显示,对两种收缩压均无影响(平均差异= -0.95,95%CI -3.58, 1.68;p = 0.478, I = 0%)或舒张压(平均差值= 0.86,95%CI -1.11, 2.82;p = 0.393, I = 0%)。结论:本系统综述的结果来自小样本量的单中心试验,因此应谨慎解读。鉴于本综述提供的结果,有证据表明黄酮类化合物对收缩压和舒张压没有影响。需要进一步使用基于功率计算的样本量进行可靠的随机对照试验,为使用富含类黄酮的水果治疗高血压提供证据。
{"title":"Effects of flavonoid rich fruits on hypertension in adults: a systematic review.","authors":"L. Ellwood, Gizemnur Torun, Z. Bahar, R. Fernandez","doi":"10.11124/JBISRIR-D-19-00050","DOIUrl":"https://doi.org/10.11124/JBISRIR-D-19-00050","url":null,"abstract":"OBJECTIVE\u0000The objective of this systematic review was to synthesize the best available research evidence on the effectiveness of flavonoid rich fruits in the treatment of hypertension.\u0000\u0000\u0000INTRODUCTION\u0000Hypertension is a serious public health concern as it contributes to a significant burden of disease, attributable for millions of deaths globally. Complementary therapies including flavonoids have generated interest in assisting the treatment of hypertension. Flavonoids are a type of polyphenol abundant in fruits and a growing body of evidence suggests antihypertensive effects of the flavonoids due to its antioxidant properties. To date, no systematic review has been performed to collate the evidence on the effects of flavonoid rich fruits on hypertension in adults.\u0000\u0000\u0000INCLUSION CRITERIA\u0000This systematic review included only randomized controlled trials (RCTs) that compared the administration of any type of flavonoid rich fruit or equivalent supplement with a placebo or other intervention in adults with hypertension. Trials that measured blood pressure using objective outcome measures such as a manual mercury sphygmomanometer were included. Studies that did not specify the flavonoid component of the fruit or fruit supplement were excluded in the review. Secondary outcomes, including change in weight, blood glucose level, triglycerides and total blood cholesterol levels were also assessed.\u0000\u0000\u0000METHODS\u0000A three-step search was undertaken, including a comprehensive search of the MEDLINE, Embase, Cochrane Trials (CENTRAL) and CINAHL databases, in September 2018. We also searched Dissertation Abstracts International, ProQuest Dissertations and Theses, MedNar and ClinicalTrials.gov to identify unpublished studies. The title and abstracts of the studies were reviewed by two independent reviewers against the inclusion/exclusion criteria. The methodological quality of the potential studies for inclusion were assessed using the critical appraisal checklist for randomized controlled trials as recommended by the Joanna Briggs Institute. Data were pooled in a statistical meta-analysis model. Subgroup-analysis according to type of intervention and length of intervention period was performed. Where statistical pooling was not possible, the findings have been presented in a narrative form.\u0000\u0000\u0000RESULTS\u0000Fifteen randomized controlled trials involving 572 participants were included in the review. The subclasses of flavonoids assessed included: anthocyanins, naringin, narirutin and flavan-3-ols. The overall methodological quality of the trials was high. Six trials investigated the effect of the flavonoid intervention on blood pressure within four weeks. Meta-analysis of five of the trials demonstrated evidence of no effect of flavonoids on systolic or diastolic blood pressure when compared to placebo (systolic mean difference = -1.02, 95% CI -3.12, 1.07; p = 0.34, I = 0%; diastolic mean difference = -0.90, 95% CI -2.10, 0.31; p = 0.15, I = 0%). Similarly, pooled results from t","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80073200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-22DOI: 10.11124/JBISRIR-D-18-00010
Vivienne Leigh, Cindy Stern, Rosalind M. Elliott, C. Tufanaru
OBJECTIVE The objective of this review was to synthesize the best available evidence on the effectiveness and harms of pharmacological interventions for the treatment of delirium in adult patients in the intensive care unit (ICU) after cardiac surgery. INTRODUCTION Patients who undergo cardiac surgery are at high risk of delirium (incidence: 50-90%). Delirium has deleterious effects, increasing the risk of death and adversely affecting recovery. Clinical interventional trials have been conducted to prevent and treat postoperative delirium pharmacologically including antipsychotics and sedatives. These trials have provided some evidence about efficacy and influenced clinical decision making. However, much reporting is incomplete and provides biased assessments of efficacy; benefits are emphasized while harms are inadequately reported. INCLUSION CRITERIA Participants were ≥ 16 years, any sex or ethnicity, who were treated postoperatively in a cardiothoracic ICU following cardiac surgery and were identified as having delirium. Any pharmacological intervention for the treatment of delirium was included, regardless of drug classification, dosage, intensity or frequency of administration. Outcomes of interest of this review were: mortality, duration and severity of delirium, use of physical restraints, quality of life, family members' satisfaction with delirium management, duration/severity of the aggressive episode, associated falls, severity of accidental self-harm, pharmacological harms, harms related to over-sedation, ICU length of stay, hospital length of stay (post ICU), total hospital length of stay, need for additional intervention medication and need for rescue medication. Randomized controlled trials were considered first and in their absence, non-randomized controlled trials and quasi-experimental would have been considered, followed by analytical observational studies. METHODS A search was conducted in PubMed, Embase, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials, Scopus, Epistemonikos, Australian New Zealand Clinical Trials Registry, ClinicalTrials.gov, Clinical Trials in New Zealand, and ProQuest Dissertations and Theses to locate both published and unpublished studies. There was no date limit for the search. A hand search for primary studies published between January 1, 2012 and November 17, 2018 in relevant journals was also conducted. Only studies published in English were considered for inclusion. Two reviewers independently assessed the methodological quality using standardized critical appraisal instruments from JBI and McMaster University. Quantitative data were extracted using the standardized JBI data extraction tool. A meta-analysis was not performed, as there was too much clinical and methodological heterogeneity in the included studies. Results have been presented in a narrative form. Standard GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) evidence assessment of outco
目的本综述的目的是综合现有的关于药物干预治疗心脏手术后重症监护病房(ICU)成人患者谵妄的有效性和危害的最佳证据。心脏手术患者谵妄的发生率高(50-90%)。谵妄具有有害的影响,增加死亡的风险并对康复产生不利影响。对术后谵妄进行了包括抗精神病药物和镇静剂在内的药物预防和治疗的临床介入试验。这些试验提供了一些关于疗效的证据,并影响了临床决策。然而,许多报告是不完整的,并提供了有偏见的疗效评估;好处被强调,而危害没有得到充分的报道。入选标准:参与者年龄≥16岁,不分性别或种族,在心脏手术后在心胸重症监护室接受治疗,并确定患有谵妄。任何治疗谵妄的药物干预都包括在内,无论药物分类、剂量、强度或给药频率如何。本综述关注的结果是:死亡率、谵妄的持续时间和严重程度、身体约束的使用、生活质量、家属对谵妄管理的满意度、攻击性发作的持续时间/严重程度、相关跌倒、意外自残的严重程度、药理学危害、过度镇静相关的危害、ICU住院时间、住院时间(ICU后)、总住院时间、额外干预药物的需要和抢救药物的需要。首先考虑随机对照试验,如果没有随机对照试验,则考虑非随机对照试验和准实验,然后考虑分析性观察研究。方法检索PubMed、Embase、CINAHL、Web of Science、Cochrane Central Register of Controlled Trials、Scopus、Epistemonikos、Australian New Zealand ClinicalTrials Registry、ClinicalTrials.gov、ClinicalTrials in New Zealand、ProQuest disserthesis and Theses,查找已发表和未发表的研究。搜索没有日期限制。对2012年1月1日至2018年11月17日在相关期刊上发表的初步研究进行了手工检索。只有以英文发表的研究才被纳入考虑。两位审稿人使用来自JBI和麦克马斯特大学的标准化关键评估工具独立评估方法质量。采用标准化的JBI数据提取工具提取定量数据。由于纳入的研究中存在太多的临床和方法学异质性,因此未进行荟萃分析。结果以叙述的形式呈现。标准GRADE(建议、评估、发展和评价的分级)证据评估结果已被报道。结果纳入吗啡与氟哌啶醇对照(n = 53)、昂丹西酮与氟哌啶醇对照(n = 72)、右美托咪定与咪达唑仑对照(n = 80) 3项随机对照试验。由于异质性和不完整的报告,荟萃分析是不可行的。总体而言,这些研究的方法学质量较低。此外,本综述发现,所有三项研究对危害的报告都是不充分和肤浅的,并且不符合危害报告的要求标准,如CONSORT声明扩展对危害的定义。结论吗啡与氟哌啶醇、昂丹司琼与氟哌啶醇、右美托咪定与咪达唑仑治疗心脏手术后谵妄的有效性尚不能得出有效结论。这是由于研究数量少,进行和报告的方法学质量差以及研究之间的异质性。
{"title":"Effectiveness and harms of pharmacological interventions for the treatment of delirium in adults in intensive care units after cardiac surgery: a systematic review.","authors":"Vivienne Leigh, Cindy Stern, Rosalind M. Elliott, C. Tufanaru","doi":"10.11124/JBISRIR-D-18-00010","DOIUrl":"https://doi.org/10.11124/JBISRIR-D-18-00010","url":null,"abstract":"OBJECTIVE\u0000The objective of this review was to synthesize the best available evidence on the effectiveness and harms of pharmacological interventions for the treatment of delirium in adult patients in the intensive care unit (ICU) after cardiac surgery.\u0000\u0000\u0000INTRODUCTION\u0000Patients who undergo cardiac surgery are at high risk of delirium (incidence: 50-90%). Delirium has deleterious effects, increasing the risk of death and adversely affecting recovery. Clinical interventional trials have been conducted to prevent and treat postoperative delirium pharmacologically including antipsychotics and sedatives. These trials have provided some evidence about efficacy and influenced clinical decision making. However, much reporting is incomplete and provides biased assessments of efficacy; benefits are emphasized while harms are inadequately reported.\u0000\u0000\u0000INCLUSION CRITERIA\u0000Participants were ≥ 16 years, any sex or ethnicity, who were treated postoperatively in a cardiothoracic ICU following cardiac surgery and were identified as having delirium. Any pharmacological intervention for the treatment of delirium was included, regardless of drug classification, dosage, intensity or frequency of administration. Outcomes of interest of this review were: mortality, duration and severity of delirium, use of physical restraints, quality of life, family members' satisfaction with delirium management, duration/severity of the aggressive episode, associated falls, severity of accidental self-harm, pharmacological harms, harms related to over-sedation, ICU length of stay, hospital length of stay (post ICU), total hospital length of stay, need for additional intervention medication and need for rescue medication. Randomized controlled trials were considered first and in their absence, non-randomized controlled trials and quasi-experimental would have been considered, followed by analytical observational studies.\u0000\u0000\u0000METHODS\u0000A search was conducted in PubMed, Embase, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials, Scopus, Epistemonikos, Australian New Zealand Clinical Trials Registry, ClinicalTrials.gov, Clinical Trials in New Zealand, and ProQuest Dissertations and Theses to locate both published and unpublished studies. There was no date limit for the search. A hand search for primary studies published between January 1, 2012 and November 17, 2018 in relevant journals was also conducted. Only studies published in English were considered for inclusion. Two reviewers independently assessed the methodological quality using standardized critical appraisal instruments from JBI and McMaster University. Quantitative data were extracted using the standardized JBI data extraction tool. A meta-analysis was not performed, as there was too much clinical and methodological heterogeneity in the included studies. Results have been presented in a narrative form. Standard GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) evidence assessment of outco","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"7 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78645819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-13DOI: 10.11124/JBISRIR-D-19-00025
M. Hickson, A. Wanner, A. Collinson
OBJECTIVE This scoping review aims to examine and map the existing evidence exploring and/or evaluating the implementation, cost and/or effectiveness of dietitian-led clinics in primary care. INTRODUCTION Dietitians may be able to offer new models of care within the primary care setting for relevant diagnosed patients, providing cheaper, more efficient and effective service in comparison to the traditional approach of general practitioner support and referral for specialist treatment. There is some evidence for the efficacy of dietetic care in primary care, but there is a lack of information concerning the broader contribution dietitians may make, including cost effectiveness and the range of conditions that dietitians may successfully manage. INCLUSION CRITERIA Eligible studies will explore dietitian or nutritionist-led clinics treating patients with any condition, and will be based in primary care or general practice settings in developed countries. Studies may include experimental, quasi-experimental, observational and qualitative studies. METHODS The searches will be limited to the past 10 years to ensure retrieved information will be relevant to today's healthcare setting. There will be no limit for language. The following databases will be searched: MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), AMED (EBSCO), British Nursing Index (ProQuest), and Cochrane Database of Systematic Reviews (Wiley). Retrieved papers will be screened for inclusion by at least two reviewers. Where a decision is not possible, full text will be retrieved and reviewed. Data will be extracted from the included papers and a narrative summary will accompany the charted results and will describe how the results relate to the review's objective.
目的:本综述旨在检查和绘制现有的证据,探索和/或评估营养师主导的初级保健诊所的实施、成本和/或有效性。与传统的全科医生支持和专科治疗转诊相比,营养师可能能够在初级保健环境中为相关确诊患者提供新的护理模式,提供更便宜、更高效和更有效的服务。有一些证据表明饮食保健在初级保健中的有效性,但缺乏关于营养师可能做出的更广泛贡献的信息,包括成本效益和营养师可能成功管理的条件范围。纳入标准:符合条件的研究将探索营养学家或营养学家领导的治疗任何疾病患者的诊所,并将以发达国家的初级保健或全科医疗机构为基础。研究可能包括实验、准实验、观察和定性研究。方法搜索将限于过去10年,以确保检索到的信息与当今的医疗保健环境相关。语言将没有限制。将检索以下数据库:MEDLINE (Ovid)、Embase (Ovid)、PsycINFO (Ovid)、CINAHL (EBSCO)、AMED (EBSCO)、British Nursing Index (ProQuest)和Cochrane Database of Systematic Reviews (Wiley)。检索到的论文将由至少两名审稿人筛选纳入。如果无法作出决定,将检索全文并进行审查。数据将从纳入的论文中提取,图表结果将附有叙述性摘要,并将描述结果与综述目标的关系。
{"title":"Dietitian-led clinics in primary care: a scoping review protocol.","authors":"M. Hickson, A. Wanner, A. Collinson","doi":"10.11124/JBISRIR-D-19-00025","DOIUrl":"https://doi.org/10.11124/JBISRIR-D-19-00025","url":null,"abstract":"OBJECTIVE\u0000This scoping review aims to examine and map the existing evidence exploring and/or evaluating the implementation, cost and/or effectiveness of dietitian-led clinics in primary care.\u0000\u0000\u0000INTRODUCTION\u0000Dietitians may be able to offer new models of care within the primary care setting for relevant diagnosed patients, providing cheaper, more efficient and effective service in comparison to the traditional approach of general practitioner support and referral for specialist treatment. There is some evidence for the efficacy of dietetic care in primary care, but there is a lack of information concerning the broader contribution dietitians may make, including cost effectiveness and the range of conditions that dietitians may successfully manage.\u0000\u0000\u0000INCLUSION CRITERIA\u0000Eligible studies will explore dietitian or nutritionist-led clinics treating patients with any condition, and will be based in primary care or general practice settings in developed countries. Studies may include experimental, quasi-experimental, observational and qualitative studies.\u0000\u0000\u0000METHODS\u0000The searches will be limited to the past 10 years to ensure retrieved information will be relevant to today's healthcare setting. There will be no limit for language. The following databases will be searched: MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), AMED (EBSCO), British Nursing Index (ProQuest), and Cochrane Database of Systematic Reviews (Wiley). Retrieved papers will be screened for inclusion by at least two reviewers. Where a decision is not possible, full text will be retrieved and reviewed. Data will be extracted from the included papers and a narrative summary will accompany the charted results and will describe how the results relate to the review's objective.","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74422523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.11124/JBISRIR-2017-004013
Michelle Cork, Alexa McArthur, Helen Douglas, Fiona Wood
Objective: The objective of this review is to determine whether perioperative enteral feeding improves outcomes in patients with burns.
Introduction: Literature has identified many positive benefits of nutrition support for patients with burn injuries, including preservation of lean body mass, improved wound healing, reduced gastrointestinal permeability and enhanced immunity. Fasting for surgery can undermine the nutritional care of these patients by causing nutrient deficits. It may also negatively affect patient well-being and insulin resistance. Perioperative fasting is intended to protect patients from regurgitation and pulmonary aspiration. This research aims to investigate whether perioperative feeding impacts outcomes in patients with burn injuries.
Inclusion criteria: This systematic review will consider studies whose participants have a burn injury. The intervention is perioperative enteral feeding (either intragastric or post-pyloric). Patients who received perioperative feeding will be compared with patients who had enteral nutrition withheld during the perioperative period. A number of outcome measures will be investigated, including mortality, length of stay, wound infection, wound healing rate and aspiration pneumonia.
Methods: The key databases searched will be PubMed, CINAHL, Embase, Web of Science and Cochrane Central Register of Controlled Trials and Scopus. Only studies published in English will be considered. There will be no date limits. Full texts of selected studies will be retrieved and assessed against inclusion criteria. Studies that do not meet the inclusion criteria will be excluded, with reasons provided. Data synthesis will be pooled in a statistical meta-analysis. Subgroup analysis will be conducted where possible. Where statistical pooling is not possible, the findings will be presented in narrative form.
目的:本综述的目的是确定围手术期肠内喂养是否能改善烧伤患者的预后。文献表明,营养支持对烧伤患者有许多积极的好处,包括保持瘦体重,改善伤口愈合,降低胃肠道通透性和增强免疫力。手术禁食会导致营养缺乏,从而破坏这些患者的营养护理。它还可能对患者的健康和胰岛素抵抗产生负面影响。围手术期禁食旨在保护患者免受反流和肺误吸。本研究旨在探讨围手术期喂养是否会影响烧伤患者的预后。纳入标准:本系统综述将考虑受试者有烧伤的研究。干预措施是围手术期肠内喂养(胃内或幽门后)。接受围手术期喂养的患者将与围手术期停止肠内营养的患者进行比较。将调查一些结果指标,包括死亡率、住院时间、伤口感染、伤口愈合率和吸入性肺炎。方法:检索PubMed、CINAHL、Embase、Web of Science、Cochrane Central Register of Controlled Trials和Scopus等数据库。只考虑以英文发表的研究。没有日期限制。将检索选定研究的全文,并根据纳入标准进行评估。不符合纳入标准的研究将被排除,并说明原因。数据综合将汇集在统计荟萃分析中。如有可能,将进行分组分析。如果统计汇集不可能,调查结果将以叙述形式提出。系统评价注册号:PROSPERO CRD42018119034。
{"title":"Effectiveness and safety of perioperative enteral feeding in patients with burn injuries: a systematic review protocol.","authors":"Michelle Cork, Alexa McArthur, Helen Douglas, Fiona Wood","doi":"10.11124/JBISRIR-2017-004013","DOIUrl":"https://doi.org/10.11124/JBISRIR-2017-004013","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this review is to determine whether perioperative enteral feeding improves outcomes in patients with burns.</p><p><strong>Introduction: </strong>Literature has identified many positive benefits of nutrition support for patients with burn injuries, including preservation of lean body mass, improved wound healing, reduced gastrointestinal permeability and enhanced immunity. Fasting for surgery can undermine the nutritional care of these patients by causing nutrient deficits. It may also negatively affect patient well-being and insulin resistance. Perioperative fasting is intended to protect patients from regurgitation and pulmonary aspiration. This research aims to investigate whether perioperative feeding impacts outcomes in patients with burn injuries.</p><p><strong>Inclusion criteria: </strong>This systematic review will consider studies whose participants have a burn injury. The intervention is perioperative enteral feeding (either intragastric or post-pyloric). Patients who received perioperative feeding will be compared with patients who had enteral nutrition withheld during the perioperative period. A number of outcome measures will be investigated, including mortality, length of stay, wound infection, wound healing rate and aspiration pneumonia.</p><p><strong>Methods: </strong>The key databases searched will be PubMed, CINAHL, Embase, Web of Science and Cochrane Central Register of Controlled Trials and Scopus. Only studies published in English will be considered. There will be no date limits. Full texts of selected studies will be retrieved and assessed against inclusion criteria. Studies that do not meet the inclusion criteria will be excluded, with reasons provided. Data synthesis will be pooled in a statistical meta-analysis. Subgroup analysis will be conducted where possible. Where statistical pooling is not possible, the findings will be presented in narrative form.</p><p><strong>Systematic review registration number: </strong>PROSPERO CRD42018119034.</p>","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"17 8","pages":"1607-1615"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11124/JBISRIR-2017-004013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10145837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.11124/JBISRIR-2017-003864
John B Ngobi, Kevin Pottie, Lynne Leonard, Peter Tugwell, Steven J Hoffman, Vivian Welch
Objective: The proposed scoping review will identify psychosocial outcomes immediately following human immunodeficiency virus (HIV) testing and their measurements, specifically among individuals with a new negative or positive test result.
Introduction: No systematic study has described psychosocial outcomes and their measurements in persons immediately following HIV testing. Also, to our knowledge, there is no consensus on a core set of psychosocial outcomes and measurements following HIV diagnosis, which are essential for quality improvement.
Inclusion criteria: All study designs will be considered. Participants with a new positive or negative HIV test result, regardless of sex or age, in any setting will be included. Any measured beneficial or harmful outcomes in the mental and social domains following a new diagnosis will be included. Psychosocial outcomes of participants undergoing treatment and care will be excluded.
Methods: The databases Ovid MEDLINE, Embase and PsycINFO will be searched, and published articles in English from 2007 to the present date will be included. The methods for scoping reviews outlined by the Joanna Briggs Institute will be followed. Data will be extracted from included studies by two reviewers. Any disagreements between the two reviewers will be solved through discussion in a team of five members. To define the specific concepts or outcome (sub)-domains and their measurements, the models proposed by the Outcome Measures in Rheumatology initiative and the Core Outcome Measures in Effectiveness Trials initiative, respectively, will be used. To analyze the data, this study will rely on a multi-level social-ecological model.
目标:拟议的范围界定综述将确定人类免疫缺陷病毒(HIV)检测后的即时社会心理结果及其测量值,特别是在新的阴性或阳性检测结果的个体中:导言:目前还没有系统性的研究描述过 HIV 检测后的心理社会结果及其测量值。此外,据我们所知,目前还没有就 HIV 诊断后的一套核心社会心理结果及其测量方法达成共识,而这对提高质量至关重要:所有研究设计都将被考虑。纳入标准:所有研究设计都将被考虑,HIV 检测结果呈阳性或阴性的参与者,无论性别或年龄,在任何情况下都将被纳入。新诊断后在精神和社会领域的任何有益或有害的测量结果都将包括在内。正在接受治疗和护理的参与者的社会心理结果将被排除在外:将检索 Ovid MEDLINE、Embase 和 PsycINFO 数据库,并纳入 2007 年至今发表的英文文章。将遵循乔安娜-布里格斯研究所(Joanna Briggs Institute)概述的范围界定综述方法。数据将由两名审稿人从纳入的研究中提取。两位审稿人之间的意见分歧将由五人小组讨论解决。在定义具体概念或结果(子)领域及其测量方法时,将分别采用风湿病学结果测量方法倡议和有效性试验核心结果测量方法倡议提出的模型。为了分析数据,本研究将采用多层次的社会生态模型。
{"title":"Human immunodeficiency virus testing and psychosocial outcomes: a scoping review protocol.","authors":"John B Ngobi, Kevin Pottie, Lynne Leonard, Peter Tugwell, Steven J Hoffman, Vivian Welch","doi":"10.11124/JBISRIR-2017-003864","DOIUrl":"10.11124/JBISRIR-2017-003864","url":null,"abstract":"<p><strong>Objective: </strong>The proposed scoping review will identify psychosocial outcomes immediately following human immunodeficiency virus (HIV) testing and their measurements, specifically among individuals with a new negative or positive test result.</p><p><strong>Introduction: </strong>No systematic study has described psychosocial outcomes and their measurements in persons immediately following HIV testing. Also, to our knowledge, there is no consensus on a core set of psychosocial outcomes and measurements following HIV diagnosis, which are essential for quality improvement.</p><p><strong>Inclusion criteria: </strong>All study designs will be considered. Participants with a new positive or negative HIV test result, regardless of sex or age, in any setting will be included. Any measured beneficial or harmful outcomes in the mental and social domains following a new diagnosis will be included. Psychosocial outcomes of participants undergoing treatment and care will be excluded.</p><p><strong>Methods: </strong>The databases Ovid MEDLINE, Embase and PsycINFO will be searched, and published articles in English from 2007 to the present date will be included. The methods for scoping reviews outlined by the Joanna Briggs Institute will be followed. Data will be extracted from included studies by two reviewers. Any disagreements between the two reviewers will be solved through discussion in a team of five members. To define the specific concepts or outcome (sub)-domains and their measurements, the models proposed by the Outcome Measures in Rheumatology initiative and the Core Outcome Measures in Effectiveness Trials initiative, respectively, will be used. To analyze the data, this study will rely on a multi-level social-ecological model.</p>","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":" ","pages":"1616-1625"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37051837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.11124/JBISRIR-2017-003881
Katie C Hall, Jennifer C Robinson
Objective: The objective of this review was to determine if there was an association between maternal exposure to pollutant particulate matter 2.5 during the first trimester of pregnancy and congenital heart defects within the first year of life.
Introduction: The environment is recognized as an important determinant of health for both the individual and population. Air pollution specifically is a major environmental risk factor impacting health with links to asthma, heart disease, obesity, and fetal developmental complications. Of the commonly monitored air pollutants, particulate matter 2.5 has associations with health, especially among vulnerable populations such as children and pregnant women. A congenital heart defect is a fetal complication that impacts 34.3 million infants globally, with more than 80% of the diagnoses having an unknown etiology. Although environmental risk factors such as air pollution are thought to be a risk factor in the diagnosis of a congenital heart defect, epidemiologic research evidence is limited.
Inclusion criteria: This review considered studies that evaluated maternal exposure to the air pollutant particulate matter 2.5 during the first trimester (weeks 1-12) of fetal development. The primary outcome was a diagnosis of a congenital heart defect in an infant within the first year of life.
Methods: A three-step search strategy was utilized in this review and included 11 databases and two websites. Studies published from January 2002 to September 2018 were eligible for inclusion. Only papers published in English were included. Eligible studies underwent critical appraisal by two independent reviewers using standardized critical appraisal instruments from JBI. Quantitative data were extracted from the included studies independently by two reviewers. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted for the individual outcome measures, specifically atrial septal defect, ventricular septal defect, and tetralogy of fallot, respectively. The defects were identified and pooled, where possible, in statistical meta-analysis. Where statistical pooling was not possible, findings were reported narratively.
Results: Five studies were identified that met the inclusion criteria, including three cohort and two case-control designs. Each individual study identified at least one statistically significant increase or inverse association between particulate matter 2.5 and a congenital heart defect. An increased risk was identified with more than seven isolated and two groupings of congenital heart defects. An inverse risk was identified with two isolated and one grouping of congenital heart defects. Meta-analysis results were: atrial septal defect, OR = 0.65 (95% CI, 0.37 to 1.15); ventricular septal defect, OR = 1.02 (95% CI, 075 to 1.37); and tetralogy of fallot, OR = 1.16 (95% CI, 0.78 to 1.73), indica
{"title":"Association between maternal exposure to pollutant particulate matter 2.5 and congenital heart defects: a systematic review.","authors":"Katie C Hall, Jennifer C Robinson","doi":"10.11124/JBISRIR-2017-003881","DOIUrl":"https://doi.org/10.11124/JBISRIR-2017-003881","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this review was to determine if there was an association between maternal exposure to pollutant particulate matter 2.5 during the first trimester of pregnancy and congenital heart defects within the first year of life.</p><p><strong>Introduction: </strong>The environment is recognized as an important determinant of health for both the individual and population. Air pollution specifically is a major environmental risk factor impacting health with links to asthma, heart disease, obesity, and fetal developmental complications. Of the commonly monitored air pollutants, particulate matter 2.5 has associations with health, especially among vulnerable populations such as children and pregnant women. A congenital heart defect is a fetal complication that impacts 34.3 million infants globally, with more than 80% of the diagnoses having an unknown etiology. Although environmental risk factors such as air pollution are thought to be a risk factor in the diagnosis of a congenital heart defect, epidemiologic research evidence is limited.</p><p><strong>Inclusion criteria: </strong>This review considered studies that evaluated maternal exposure to the air pollutant particulate matter 2.5 during the first trimester (weeks 1-12) of fetal development. The primary outcome was a diagnosis of a congenital heart defect in an infant within the first year of life.</p><p><strong>Methods: </strong>A three-step search strategy was utilized in this review and included 11 databases and two websites. Studies published from January 2002 to September 2018 were eligible for inclusion. Only papers published in English were included. Eligible studies underwent critical appraisal by two independent reviewers using standardized critical appraisal instruments from JBI. Quantitative data were extracted from the included studies independently by two reviewers. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted for the individual outcome measures, specifically atrial septal defect, ventricular septal defect, and tetralogy of fallot, respectively. The defects were identified and pooled, where possible, in statistical meta-analysis. Where statistical pooling was not possible, findings were reported narratively.</p><p><strong>Results: </strong>Five studies were identified that met the inclusion criteria, including three cohort and two case-control designs. Each individual study identified at least one statistically significant increase or inverse association between particulate matter 2.5 and a congenital heart defect. An increased risk was identified with more than seven isolated and two groupings of congenital heart defects. An inverse risk was identified with two isolated and one grouping of congenital heart defects. Meta-analysis results were: atrial septal defect, OR = 0.65 (95% CI, 0.37 to 1.15); ventricular septal defect, OR = 1.02 (95% CI, 075 to 1.37); and tetralogy of fallot, OR = 1.16 (95% CI, 0.78 to 1.73), indica","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":" ","pages":"1695-1716"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11124/JBISRIR-2017-003881","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40559904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}