JBI database of systematic reviews and implementation reports最新文献

Objectives: The aim of this systematic review was to identify the effectiveness of breast massage as a treatment for women with breastfeeding problems. More specifically, the objective was to identify if breast massage as an intervention led to less pain or increased milk supply, or assisted in a reduction or resolution of blocked ducts, breast engorgement and mastitis.

Introduction: Breastfeeding protects babies against many illnesses, and the health benefits for women have been well documented. However, breastfeeding rates steadily drop to approximately 15% by six months, which is the World Health Organization's recommended length of time for exclusive breastfeeding. Breastfeeding problems such as blocked ducts, breast engorgement and mastitis are major complications attributing to the decline in breastfeeding rates. Breast massage may relieve pain and resolve symptoms associated with conditions that contribute to discontinued breastfeeding.

Inclusion criteria: This review considered both experimental and epidemiological study designs and included breastfeeding women of any age, parity or geographical location. The types of interventions considered for inclusion were any type of breast massage that was offered to women for breastfeeding problems. Comparators included the usual care provided to women with breastfeeding problems. Primary outcomes of interest were an increase in breast milk supply, reduction of breast pain, and symptom resolution of blocked ducts, engorgement and mastitis. Secondary outcomes included duration of breastfeeding.

Methods: Studies published from 1980 to 2017 in English and Japanese were considered for inclusion in this review. The databases searched with the majority of results included CINAHL, Cochrane Library, Embase, PubMed, Science Direct, Scopus and Web of Science. Search for unpublished studies included Google Scholar, ClinicalTrials.gov and ProQuest Dissertations and Theses.

Results: There were six studies included in this review: three randomized controlled trials and three quasi-experimental studies. There was considerable heterogeneity of study outcome measures, and the use of unvalidated tools in many of the studies led to the inability to pool the results. Furthermore, the heterogeneity of the interventions themselves coupled with small sample sizes for each study greatly decreased generalizability of the outcomes and reduced the overall effectiveness of the interventions. However, all included studies reported a reduction in pain regardless of the breast massage technique used. Overall, varying types of breast massage were helpful in reducing immediate pain and resolving symptoms.

Conclusions: Overall, different types of breast massage were reported as effective in reducing immediate pain for the participants. However, the lack of detailed explanation of the breast massage

Objective: The objective of this review is to identify and map literature related to safe injection practices among anesthesia providers in developed nations. The mapped literature will be used to determine if there is sufficient literature available to pose specific questions that can be valuably addressed, through a future systematic review, to reduce the prevalence of unsafe injections.

Introduction: A safe injection is one that does not harm the recipient, does not expose the healthcare worker to avoidable risk, and does not result in waste that is a danger to the community. The literature is replete with examples of disease outbreaks connected to unsafe injections via the misuse of syringes, needles and medications. Many such outbreaks involve unsafe injections by anesthesia providers.

Inclusion criteria: This scoping review will consider any research article or policy document, including unpublished reports, that provides information related to safe injection practices by anesthesia providers in developed nations.

Methods: For studies published in English from 2000, the databases to be searched include Ovid MEDLINE, CINAHL and Google Scholar. The search for unpublished literature will include the websites of anesthesia organizations, the Centers for Disease Control and Prevention, and the National Institutes of Health. Results will be screened by two independent reviewers who will use a standardized tool to independently extract data from each included source. The results of the review will be presented as a map of the data extracted in a tabular form and in a narrative descriptive summary.

Objective: The objective of this review is to identify differences in quadriceps architectural parameters between healthy individuals and those with patellofemoral pain (PFP).

Introduction: Patellofemoral pain is one of the most common causes of knee pain among physically active populations. Muscular imbalance may play an important role in patellar malalignment or patellar maltracking. A systematic review will clarify the possible architectural changes of quadriceps muscles in persons with PFP.

Inclusion criteria: Eligible observational studies will include individuals younger than 50 years who have been diagnosed with unilateral or bilateral PFP. The comparator will be the contralateral, asymptomatic limb of the individual with PFP or a healthy matched subject. Studies that include measurement of quadriceps muscle size as the primary outcome will be considered. Studies in which participants had coexisting pathology, a history of lower limb surgery or injury, or pain originating from other joints will be excluded.

Methods: PubMed/MEDLINE (NLM), Scopus, Embase, Physiotherapy Evidence Database, Web of Science and CINAHL databases and multiple gray literature sources will be searched. Studies published since 1 January 1990 will be considered; there will be no language restriction. Retrieval of full-text studies, assessment of methodological quality and data extraction will be performed independently by two reviewers. If possible, meta-analyses will be performed, and a Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings presented.

Objective: The objective of this review is to determine the effectiveness of non-opioid pharmacological adjuncts for decreasing perioperative morphine equivalents and acute postoperative pain scores in adult surgical patients.

Introduction: Opioids are commonly administered during anesthesia to dull the senses, relieve pain and induce sleep. However, there are significant adverse effects associated with intraoperative opioid use. Anesthesia providers can impact the current opioid epidemic by administering non-opioid-centric anesthetic medications. A large-scale evidence-based review is needed to inform a standardized non-opioid pain treatment strategy in the perioperative period.

Inclusion criteria: This review will consider studies of adults 19 years or older who are undergoing surgical procedures and receiving non-opioid oral or intravenous perioperative analgesic medications administered by the anesthesia team. Studies that include patients who receive non-opioid medication as a local infiltrate by the surgical team will be excluded, as will studies with patients who receive regional or neuraxial opioid-sparing techniques. Only systematic reviews and meta-analyses published in English after 2007 will be considered.

Methods: MEDLINE, CINAHL and Embase will be searched, as well as two trial registers and two sources of unpublished reviews. Titles and abstracts will be screened to identify potentially relevant papers. Retrieval of full-text studies, assessment of methodological quality and data extraction will be performed independently by two reviewers. Meta-analyses will be performed if possible, and a Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings presented.

Systematic review registration number: PROSPERO CRD42019135852.

Objective: The objective of this review is to summarize the evidence on the effectiveness and safety of hypodermoclysis (HDC) for the rehydration of children with mild or moderate dehydration.

Introduction: Children are particularly susceptible to dehydration, which can lead to severe gastrointestinal disturbances. Hypodermoclysis, the infusion of fluids and electrolytes via subcutaneous tissue, is an alternative route of administering fluid replacement when oral or intravenous routes are contraindicated. Although HDC is primarily used in elderly patients, there are no restrictions on its use in children. A review is needed to synthesize the evidence on the effectiveness of HDC for treating dehydration in children.

Inclusion criteria: Eligible studies will include infants and children up to 10 years of age with mild or moderate dehydration based on the Gorelick scale. Studies that compare fluid infusion with HDC to intravenous administration, at either hospital or home, will be considered. Outcomes of interest will include dehydration level, safety and pain. Studies published in English, Spanish or Portugese since database inception will be considered for inclusion.

Methods: PubMed, CINAHL, Web of Science, Embase and Scopus will be searched, as well as multiple sources of unpublished studies. Two independent reviewers will screen titles and abstracts against the inclusion criteria, retrieve and assess the full text of selected studies, critically appraise studies for methodological quality and extract data using a standardized extraction tool. Data will be pooled in a statistical meta-analysis, when feasible. A Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings will be presented.

Objective: The objective of this scoping review is to identify and describe existing research on the impact of sport and physical activity programs on social outcomes among Aboriginal and Torres Strait Islander people in Australia.

Introduction: Physical activity can be particularly beneficial for groups such as Indigenous populations, who have increased rates of chronic disease. Systematic reviews have demonstrated the positive impact of physical activity on a range of health indicators, and there is also support for the positive impact of physical activity on wider social outcomes. However, there is a lack of evidence for the benefits of physical activity for broader social outcomes among Aboriginal and Torres Strait Islander people.

Inclusion criteria: This scoping review will consider studies that include Aboriginal and Torres Strait Islander people of any age from any setting or region of Australia. Studies will be considered if they report on programs or activities that use physical activity and sport participation as a component or tool to improve one or more of six social and community outcomes: education, employment, culture, social wellbeing, life skills and crime prevention.

Methods: Nine databases will be searched, as well as a selection of websites containing resources related to physical activity, sport and social outcomes for Aboriginal and Torres Strait Islander people. Studies published in English will be included. No date limits will be set. After screening the titles and abstracts of identified citations, potentially relevant studies will be retrieved in full. Data extraction will be presented in a table with accompanying narrative.

Objective: The objective of this scoping review is to map the available literature on school-based obesity prevention programs in rural communities.

Introduction: Significant health disparities are associated with childhood obesity, and these disparities disproportionately affect children in disadvantaged communities, such as rural areas. Youth in rural areas are 26% more likely to be obese than youth in urban communities. To combat obesity in children, schools have become an avenue for educating children about the importance of healthy diet and physical activity. Although many school-based obesity prevention programs have been implemented in recent years, more information is needed on programs in rural communities.

Inclusion criteria: This scoping review will consider studies that include children 5 to 18 years of age who are enrolled in elementary, middle or high school in a rural setting and that investigate school-based obesity prevention programs. Studies that include children who are in non-rural areas, who are home-schooled, who are in an alternative setting (e.g. juvenile detention) or who are hospitalized will be excluded. Studies published in English since 1990 will be included.

Methods: Multiple databases will be searched, including PubMed, CINAHL, ERIC, Embase, Scopus and Academic Search Premier. Trials registers and gray literature will also be searched. After screening the titles and abstracts of identified citations, potentially relevant studies will be retrieved in full. Data will be extracted by independent reviewers and presented in a diagrammatic or tabular form, accompanied by a narrative summary.

Objective: The objective of this review is to determine the diagnostic accuracy of computed tomography coronary angiography (CTCA) using recent scan technologies for detecting coronary artery disease (CAD) in adults with high heart rates.

Introduction: Invasive coronary angiography is the gold standard for detecting significant CAD, but it is costly and carries risks of complications. Computed tomography coronary angiography has a high sensitivity for diagnosing CAD, although image quality may be affected by elevated heart rates. Recent technological advances in scanner design may increase the diagnostic accuracy of CTCA.

Inclusion criteria: This review will consider diagnostic test accuracy studies that include adults 18 years and older with a heart rate greater than 65 beats per minute who have undergone CTCA to diagnose CAD (greater than 50% stenosis). Eligible studies will compare invasive coronary angiography with computed tomography scanner technologies that use either single- or dual-source scanner configuration in prospective electrocardiogram scan acquisition mode, and with a total scanner coverage equal to or greater than 128 detector-rows. Studies published in English from 2007 will be considered.

Methods: PubMed, Embase, CINAHL and Scopus will be searched, along with Google Scholar, the NIHR-HTA register, computed tomography vendors and conference abstracts. Screening of potential titles and abstracts, retrieval of full-text studies, assessment of methodological quality and data extraction will be performed independently by two reviewers. Meta-analyses will be performed, if possible, and a Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings presented.