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Aims: This review aims to assess the effect of comprehensive nursing care on liver cancer patients undergoing interventional therapy in China. Methods: In accordance with PRISMA guidelines, we reviewed randomized controlled trials and observational studies assessing the effect of comprehensive nursing care against standard care on liver cancer patients undergoing specific interventional therapies in China, including PubMed, Embase, CENTRAL and CINAHL till June 2023. Data synthesis was conducted using a random‐effects model and reported as pooled odds ratio (OR) or mean difference (MD) or standardized mean differences (SMD). Results: Ten Chinese studies with 1682 participants were evaluated. Comprehensive nursing care significantly enhanced patient outcomes in liver cancer treatment. Quality of life improved markedly (OR: 0.16, 95% CI: 0.06–0.41). Notable reductions were observed in anxiety (MD: −8.96, 95% CI: −11.52 to −6.40) and depression (MD: −9.47, 95% CI: −11.79 to −7.14). Patients also experienced increased physical (SMD: 1.70, 95% CI: 1.15–2.25), social (SMD: 1.65, 95% CI: 1.14–2.16) and activity scores (SMD: 1.94, 95% CI: 1.49–2.39), alongside a decrease in post‐treatment complications (OR: 0.28, 95% CI: 0.21–0.37), demonstrating the multifaceted benefits of comprehensive care. Conclusion: Comprehensive nursing care may improve patient outcomes in liver cancer treatment, offering potential benefits in reducing the side effects of interventional therapy. Summary statement: What is already known about this topic? Liver cancer patients undergoing interventional therapy often experience significant physical and psychological challenges.Comprehensive nursing care has been hypothesized to offer potential benefits in addressing these challenges.There is limited evidence on the exact impacts of comprehensive nursing care on these patients, leading to knowledge gaps in its applicability and efficacy. What this paper adds? This review demonstrates that comprehensive nursing care can lead to significant improvements in the quality of life for liver cancer patients in China.This review provides evidence that comprehensive care reduces levels of anxiety and depression in these patients.This review shows that this approach boosts physical, social function and activity scores while also reducing post‐treatment complications. The implications of this paper: This paper suggests integrating comprehensive nursing care as a standard practice, given its potential to significantly improve patient outcomes and quality of life.This research emphasizes the importance of equipping oncology nurses with comprehensive care skills and expanding their roles to ensure optimal patient outcomes.Despite promising results, there is a need for further high‐quality, randomized controlled trials to confirm these findings and delve deeper into other potential benefits and best practices of comprehensive nursing care for liver cancer patients. [ABSTRACT FROM AUTHOR]

Aims: The primary aim of this systematic review and meta‐analysis is to evaluate the effects of home nurse visiting on infant weight and breastfeeding; the secondary aim is to determine the duration, frequency and content of home visits. Methods: A systematic search of the PubMed, CINAHL, Embase (Ovid), Web of Science, Google Scholar and DergiPark databases for publications between September 2000 and January 2019 was conducted using established methods in compliance with the PRISMA‐P declaration guideline. Two authors independently evaluated the studies for inclusion and bias, extracted the data and checked their accuracy. Results: This meta‐analysis includes a total of 34 studies, 28 on breastfeeding and nine on infant weight. The average effect size of the 28 studies investigating the effect on breastfeeding was found to be OR: 2.24; 95% CI: 1.73–2.90; p < 0.001. The average effect size of the nine studies investigating the effect on infant weight was found to be ES: 0.197; 95% CI: 0.027–0.368; p < 0.05. Conclusion: There is an association between nurse home visits and breastfeeding and infant weight. Home visits by nurses should continue to remain within the nursing role and be analysed appropriately for mother and baby health. Summary statement: What is already known about this topic? Two of the most important factors affecting infant morbidity and mortality are infant weight and breastfeeding.Although breastfeeding has numerous benefits for the baby, breastfeeding rates are decreasing in the world and in Turkey. Breastfeeding improves infant health and supports development.One of the factors that negatively affects infant health is low or below expected body weight. Inadequate weight gain will in turn negatively affect the healthy growth of the baby.It has been found that care, education and support related to breastfeeding and infant weight improve outcomes for babies and their mothers but there is no evidence that home visitation is an effective way to deliver this care. What this paper adds? Review results indicate home visits have a significant effect on improving infant health. A positive effect was detected between nurse home visits and breastfeeding and infant weight. The implications of this paper: Home visits should be presented and analysed appropriately for the mother and baby's health.Education, care and support during home visits help mothers breastfeed. [ABSTRACT FROM AUTHOR]

Background: Disability is typically correlated with lower quality of life and decreased capacity for self-care. It has been demonstrated that multimorbidity is closely linked to a variety of unfavorable events, such as disability. Researchers are still figuring out how and to what extent co-morbidities impact disability, though. In order to fill up this gap, this study examines the prevalence and contributing variables of disability in older patients who have multimorbidity. Methods: We conducted a systematic search of Pubmed, Cochrane Library, Web of Science, Embase, and CINAL databases for articles from their inception until September 2023. We selected co-morbid older adults aged > 60 years and used the ADL scale or any scale that assesses disability as an assessment tool. We excluded literature that did not meet the criteria, and literature that could not be included in the data we needed. We extracted data from the included literature and calculated synthetic prevalence rates, ORs, and 95% confidence intervals. Results: A total of 32 papers (71,135 older adults) were included in the study. The prevalence of disability among older patients with multimorbidity was around 34.9% (95% CI = 25.8-43.9%). Subgroup analysis showed higher rates of disability among comorbidities who were older, female, unmarried, and long-term users of health services. And the incidence of disability increased each year. Meanwhile, the regions of the United States, China, and Spain showed higher rates of disability. Conclusions: Disability rates in older patients with multimorbidity are higher, thus it's critical to focus on risk factors while fully accounting for regional variances. [ABSTRACT FROM AUTHOR]

Introduction. Ethiopia has made significant efforts to enhance family planning services despite variations in the community's use of modern contraception in different parts of the country. Various studies have reported the proportion and determinant factors of adolescents' contraceptive uptake in Ethiopia. These studies are not consistent in terms of size, scope, and geographic coverage, and the results need to be systematically collated to inform policies. Therefore, this review was aimed at analyzing the findings of those primary studies to obtain more representative evidence of adolescents' contraceptive uptake in Ethiopia. Methods. Five databases (MEDLINE via PubMed, Google Scholar, Scopus, ScienceDirect, and CINAHL) were searched for papers published from January 2000 up to June 2022 in English. Of thirty eligible studies, eight papers were included in this meta-analysis. Between-study heterogeneity was evaluated by the forest plot and inconsistency index ( I 2 ). A random-effects model was used to calculate the pooled estimates of adolescents' contraceptive uptake. Results. The overall pooled proportion of adolescents' contraceptive uptake was 40% ( I 2 = 99.70 , p ≤ 0.001 ; 95 % CI = 19 , 61). Adolescents' usage of contraception was influenced by a number of factors: individual-, sociocultural-, knowledge- (about contraceptive methods), and healthcare service-related factors. Individual-related factors include the educational status of adolescents, being of young age, and the income status of adolescents' families. Sociocultural-related factors comprise discussion with the family/relatives, parent disapproval and pressure from partners, and being married or having a partner. Healthcare service-related factors include the availability of youth clubs and inconvenient service hours for SRH services. Knowing contraceptive methods and SRH services was also positively associated with adolescents' contraceptive utilization. Conclusions. The proportion of adolescents who used contraception in Ethiopia was 40%. Adolescents' use of contraceptives was influenced by a variety of factors: individual-, sociocultural-, healthcare-, and knowledge-related factors. Hence, integrated interventions targeted at tackling barriers to contraceptive uptake may be helpful to improve adolescents' contraceptive utilization in Ethiopia. [ABSTRACT FROM AUTHOR]

Objectives: People following a vegetarian diet could be more prone to oral health problems than people following a nonvegetarian diet. The aim of this systematic review was to examine the possible impacts of following a vegetarian diet on dental hard tissues, focusing on caries development, dental erosion and number of natural teeth. Methods: PubMed, EMBASE, Web of Science and CINAHL were searched systematically up until 17 April 2019. Original studies comparing dental health (exclusively focusing on dental hard tissues) in vegetarians and nonvegetarians were selected. Study characteristics and outcome data were extracted, and the quality of the studies was assessed using the Newcastle‐Ottawa Scale. When a dental health characteristic was reported in three or more papers in a comparable way, a meta‐analysis was performed. Results: Twenty‐one papers reporting on 18 studies were included in this review. In meta‐analyses, the vegetarian diet was associated with a higher risk for dental erosion (odds ratio: 2.40 [95% confidence interval: 1.24, 4.66]; P =.009) and a lower decayed, missing and filled teeth (DMFT) score (mean difference: −0.15 [95% confidence interval: −0.29, −0.02]; P =.023), although the quality of most included studies was poor and the findings for DMFT score became insignificant when only studies on adults were included in the meta‐analysis. A meta‐analysis for the other dental characteristics was not possible due to the limited number of eligible studies. There was inconsistent evidence for a link between following a vegetarian diet and dental caries or the number of natural teeth. Conclusions: Within the limitations of the present study, the findings suggest that following a vegetarian diet may be associated with a greater risk of dental erosion. [ABSTRACT FROM AUTHOR]

Diarrhoea is common in enterally fed patients and can impact their nutritional and overall outcomes. This meta-analysis evaluates the potential benefits of fibre-supplemented (FS) feeds on incidence of diarrhoea and stool frequency in non-critically ill tube-fed adults. Databases including PubMed, Embase and CINAHL with full text were searched for randomised controlled trials (RCT) with adults on exclusive tube feeding, published until August 2022. The Cochrane Collaboration's tool was used for quality assessment. Studies with published results on incidence of diarrhoea and stool frequency were analysed using RevMan 5. Thirteen RCT with 847 non-critically ill patients between 20 and 90 years old without diarrhoea at the onset of enteral feeding were included. Study duration ranged from 3 to 35 d. Nine papers investigated the incidence of diarrhoea where intervention group was given FS and control was given non-fibre-supplemented (NFS) enteral feeds. Those receiving FS feeds were significantly less likely to experience diarrhoea as compared with those using NFS feeds (OR 0·44; 95 % CI 0·20, 0·95; P = 0·04; I2 = 71 %). Combined analysis showed no differences in stool frequency in those receiving NFS feeds (SMD 0·32; 95 % CI −0·53, 1·16; P = 0·47; I2 = 90 %). Results should be interpreted with caution due to considerable heterogeneity between study population, assessment tool for diarrhoea, potential conflict of interest and short duration of studies. This meta-analysis shows that FS feeds can reduce the incidence of diarrhoea in non-critically ill adults; however, the effects of stool frequency remain debatable. [ABSTRACT FROM AUTHOR]

Aim: To determine the effectiveness of brief reminiscence‐based psychosocial interventions in alleviating psychological distress in cancer patients. Background: Cancer patients suffer tremendous psycho‐spiritual pain, which affects their quality of life. Brief reminiscence‐based psychosocial interventions have demonstrated positive effects on the mental health of cancer patients; however, the efficacy of these interventions has been inconsistent. Design: A systematic review and meta‐analysis. Methods: This review was conducted and reported in accordance with the PRISMA 2020 checklist provided by the EQUATOR network. The Cochrane Library, Web of Science, PsycINFO, PubMed, Embase, CINAHL and Scopus databases were systematically searched from inception to 27 November 2022 to identify randomised controlled trials (RCTs) published in English. Results: Twenty studies involving 1744 cancer participants were included. The meta‐analysis showed statistically significant effects of brief reminiscence‐based psychosocial interventions on hope, anxiety and depression at post‐intervention. A separate analysis revealed that brief reminiscence‐based psychosocial interventions had a sustainable effect on hope, spiritual well‐being, anxiety and depression at 1 month after the intervention. However, no statistically significant effect on quality of life was found in our study either immediately after the intervention or at 1 month. Conclusions: Brief reminiscence‐based psychosocial interventions can significantly reduce anxiety and depressive symptoms and improve hope and spiritual well‐being in cancer patients. Relevance to Clinical Practice: This study further supports that brief reminiscence‐based psychosocial interventions should be incorporated into the routine care of cancer patients to address their psychosocial distress. Patient or Public Contribution: All authors of this article contributed to the study conception and design. All authors of the included studies provided original data for this paper. [ABSTRACT FROM AUTHOR]

To assess all published studies which describe what happens to the delivery of pressure ulcer/injury (PI/PU) care pathways as a result of detecting raised sub‐epidermal moisture (SEM) delta (∆ ≥ 0.6). We undertook a systematic review of the literature, and included original research studies using either a prospective or retrospective study design that report the impact that assessment using SEM assessments have on healthcare practitioners' delivery of PI/PU care pathways in adults at risk of developing PI/PUs. The review protocol was registered on PROSPERO (CRD42023416975). A literature search was conducted in May 2023, using PubMed, CINAHL, Scopus, Cochrane, EMBASE, Web of Science and Science Direct databases. Data were extracted using a data extraction tool including elements such as country, setting, sample size, intervention, control and quality appraisal was undertaken using the Evidence‐based Librarianship. We identified nine papers published between 2017 and 2022. The majority of these studies were conducted in England (n = 6; 67%). The systematic review included studies conducted across multiple care settings including acute care, medical‐surgical units, and palliative care, highlighting the importance of PI/PU prevention and management across diverse patient populations. The PI/PU care pathways implemented in the studies varied, but commonly included elements such as the application or increased use of pressure‐redistributing mattresses/cushions, implementation of repositioning plans, management of incontinence and moisture, regular skin inspection, and assessment of patient mobility. Out of the nine studies identified, seven reported PI/PU incidence. A meta‐analysis of seven studies (N = 18 451) demonstrated a statistically significant reduction in visual PI/PU development in favour of SEM‐guided care pathways compared to usual care (the odds ratio = 0.36 [95% confidence interval: 0.24–0.53, p < 0.00001]). This systematic review provides evidence that implementing SEM assessments in patients at risk of developing PI/PUs prompts anatomy‐specific clinical actions. The subsequent implementation of enhanced and targeted skin care interventions leads to consistent and sustained reductions in hospital‐acquired PU incidence. The findings emphasise the importance of incorporating SEM assessments as part of comprehensive PI/PU prevention strategies in all care settings and patient populations. This systematic review is limited by the predominance of observational studies and variable study quality. Future research should focus on randomised trials in different care settings that monitor the efficacy of preventive interventions and their impact in reducing PI/PU incidence when implemented based on SEM assessments. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Nurses often encounter traumatic events in their clinical practice.Trauma can have both negative effects, such as post‐traumatic stress disorder and positive effects, such as growth and positive emotions.Posttraumatic growth is beneficial for nurses, as it contributes to positive mental health outcomes and increases life satisfaction. What the paper adds to existing knowledge?: Our study confirms that nurses commonly experience posttraumatic growth after being exposed to traumatic events, and the level of growth is moderate.We have identified individual, work‐related, and social and organizational factors that may influence the occurrence of posttraumatic growth among nurses. What are the implications for practice?: Our findings provide valuable insights for interventions aimed at promoting posttraumatic growth among nurses. It is crucial to consider individual factors, work‐related factors, and social and organizational factors when designing these interventions. By addressing these factors, healthcare professionals can support nurses in coping with trauma and facilitate their posttraumatic growth. Introduction: While the negative effects of trauma on nurses have been well‐documented, it is equally important to focus on ways to promote posttraumatic growth (PTG) among nurses. Aim: This study aims to explore the levels and related factors of PTG among nurses. Method: A comprehensive search was conducted across nine databases up to 26 December 2022. The pooled mean score for PTG was calculated and presented with a 95% confidence interval. Subgroup and meta‐regression analyses were performed to identify potential moderators of PTG among nurses. Results: A total of 55 studies, involving 35,621 nurses from 11 countries and regions, were included in this review. The pooled scores of the PTG indicated that nurses experienced a moderate level of PTG (55.69, 95% CI: 50.67–60.72). Discussion: Nurses commonly experience PTG following exposure to traumatic events, with a moderate level of PTG. Our systematic review highlights the potential determinants of PTG among nurses, including individual, work‐related, and social and organizational factors. Implications for Practice: Targeting these factors in interventions can provide nurses with the necessary resources and support to effectively cope with stress and trauma, and potentially facilitate PTG. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate the effectiveness of educational interventions for nurses caring for patients with chronic kidney disease in improving knowledge, nurse–patient interaction, performance, skills competence and clinical decision‐making. Design: Systematic review. Methods: Search of literature for randomised controlled trials, quasi‐experimental studies and pre‐experimental studies on chronic kidney disease‐related educational interventions for nurses was conducted across 10 databases. Two reviewers independently screened articles, appraised studies and extracted data. Data Sources: PubMed, Cochrane, Embase, CINAHL Complete, ERIC, Social Science Database, ASSIA, Scopus, Web of Science and ProQuest Thesis and Dissertations Global databases were searched from date of inception to 21 December 2022. Results: Three randomised controlled trials and eight pre‐experimental studies were included in this review. Synthesis without meta‐analysis was conducted due to high heterogeneity among studies. Interventions with teaching sessions, learning activities, self‐study modules, discussion and a web‐based training system were effective in improving nurses' knowledge, nurse–patient interaction, performance, skills competence and clinical decision‐making. Patients experienced an improvement in nurse–patient interaction and no significant decrease in overall quality of life. Conclusion: This review has shown the effectiveness of educational interventions for nurses caring for people with chronic kidney disease in improving outcomes for both nurses and patients, with sustained improvements up to a period of 1 year. Implications for the Profession and/or Patient Care: Study findings can guide the scope of future training for nurses caring for patients with chronic kidney disease. Impact: Nurses often lack in‐service training on how to improve care for patients with chronic kidney disease. This study found that training nurses on how to care for such patients can improve outcomes for nurses, which can translate to higher quality of patient care. Reporting Method: This paper adhered to the synthesis without meta‐analysis (SWiM) reporting guideline. [ABSTRACT FROM AUTHOR]

Introduction: Situations involving increased workloads and stress (i.e., the COVID-19 pandemic) underline the need for healthcare professionals to minimize patient complications. In the field of vascular access, tunneling techniques are a possible solution. This systematic review and meta-analysis aimed to compare the effectiveness of tunneled Peripherally Inserted Central Catheters (tPICCs) to conventional Peripherally Inserted Central Catheters (cPICCs) in terms of bleeding, overall success, procedural time, and late complications. Methods: Randomized controlled trials without language restrictions were searched using PUBMED®, EMBASE®, EBSCO®, CINAHL®, and the Cochrane Controlled Clinical Trials Register from August 2022 to August 2023. Five relevant papers (1238 patients) were included. Results: There were no significant differences in overall success and nerve or artery injuries between the two groups (p = 0.62 and p = 0.62, respectively), although cPICCs caused slightly less bleeding (0.23 mL) and had shorter procedural times (2.95 min). On the other hand, tPICCs had a significantly reduced risk of overall complications (p < 0.001; RR0.41 [0.31–0.54] CI 95%), catheter-related thrombosis (p < 0.001; RR0.35 [0.20–0.59] IC 95%), infection-triggering catheter removal (p < 0.001; RR0.33 [0.18–0.61] IC 95%), wound oozing (p < 0.001; RR0.49 [0.37–0.64] IC 95%), and dislodgement (p < 0.001; RR0.4 [0.31–0.54] CI 95%). Conclusions: The tunneling technique for brachial access appears to be safe concerning intra-procedural bleeding, overall success, and procedural time, and it is effective in reducing the risk of late complications associated with catheterization. [ABSTRACT FROM AUTHOR]

Aims and Objective: To summarize evidence from systematic reviews (SRs)/meta‐analyses (MAs) regarding the impact of dyadic interventions delivered to both members of a cancer dyad, including a cancer patient and caregiver (e.g. family caregiver, intimate partner). Design: This overview of SRs was conducted in accordance with the preferred reporting items for overviews of reviews statement. Methods: A comprehensive search of multiple databases, including PubMed, Cochrane Library, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure and Wan Fang. The methodological and reporting quality of SRs and MAs was assessed using the Assessing the Methodological Quality of Systematic Reviews 2. The quality of the included SRs/MAs was evaluated using the Grades of Recommendations, Assessment, Development and Evaluation approach. Results: Eighteen SRs/MAs undertook quantitative synthesis to assess the impact of dyadic interventions on cancer dyads. Both the credibility of the SRs/MAs and the evidence quality of the outcome measures were below satisfactory standards. Prior SRs/MAs revealed several limitations such as lack of pre‐published protocols or research objectives, failure to report excluded studies and insufficient details on funding sources for individual studies. Conclusions: Dyadic interventions may prove advantageous for the physical health and dyadic adjustment of cancer dyads. Nevertheless, the reported results of dyadic interventions on the psychological health of patient–caregiver dyads affected by cancer are inconsistent. Thus, rigorous and comprehensive studies are requisite to establish reliable evidence for conclusive determinations. Relevance to Clinical Practice: The findings of this overview can guide healthcare practitioners when considering the use of dyadic interventions for cancer dyads. Moreover, these findings have the potential to enhance the integration of these approaches into clinical practice. Patient or Public Contribution: Our paper presents an overview of systematic reviews, and therefore, such specific details may not be relevant to our study. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) recommends that antenatal care (ANC) commence before 12 weeks' gestation to reduce the risk of obstetric and perinatal complications. Immigrants, refugees, and asylum seekers are at higher risk for late or non‐initiation of ANC, and exclusion from universal healthcare (UHC) may be a contributing factor. Aims: The aims were to synthesise evidence regarding uptake of ANC and to examine if this is associated with inadequate access to UHC and to evaluate the link between ANC and the risk of pregnancy outcomes in the immigrant, refugee and asylum seeker population. Methods: The review was performed according to meta‐analysis of observational studies in epidemiology (MOOSE) guidelines. Five databases were systematically searched. Abstracts were screened against inclusion criteria, and eligible papers underwent data extraction by two independent reviewers per paper. The ROBINS‐I tool was used to assess risk of bias. Results: Twelve studies were included in the final review. All studies reported that ANC was delayed for women who were classified as immigrants, refugees, and asylum seekers as per the WHO recommendations, and this was statistically significant compared to controls in 11 of 12 studies (P < 0.05). Findings regarding ANC uptake and pregnancy complications were too heterogeneous to conclusively report an association. Conclusion: Immigrants, refugees and asylum seekers who are excluded from UHC present significantly later to ANC than receiving‐country‐born women with full access to UHC. The link between delayed ANC due to inadequate UHC access and pregnancy complications remains unclear due to the heterogeneous nature of the studies. [ABSTRACT FROM AUTHOR]

Background: Current guidelines stress the importance of exercise, especially multicomponent exercise to older adults with chronic conditions. Aim: To critically synthesise evidence that evaluates the effects of multicomponent exercise on quality of life, depression and anxiety after stroke. Design: Systematic review and meta‐analysis followed the PRISMA 2020 statement. Methods: A systematic search of PubMed, Embase, Web of Science, Cochrane Library, CINAHL and PsycINFO from inception to 12 June 2023 was performed. Risk of bias was assessed using the Revised Cochrane risk‐of‐bias tool for randomised trials (RoB 2). Meta‐analyses were conducted using Review Manager 5.4 and narrative syntheses were adopted whenever meta‐analysis was inappropriate. The overall certainty of the evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results: Of 15,351 records identified, nine were eligible and data were available for seven randomised controlled trials, three of which were identified as having a high risk of bias, one as low risk, and five as having some concerns. Subgroup pooled analyses indicated that multicomponent exercise engaged in longer exercise sessions (>60 min) was effective in improving quality of life immediately post‐intervention and through 3–6 months post‐intervention. However, multicomponent exercise did not significantly affect depression and anxiety. Conclusions: Multicomponent exercise with longer duration of exercise sessions has promising effects on both short‐ to medium‐term quality of life among stroke survivors. Patient or Public Contribution: This does not apply to our work as it is a review paper. Relevance to Clinical Practice: Healthcare providers could consider encouraging the patients to participate in multicomponent exercise sessions for more than 60 min. It is important to note that stroke survivors should be supervised by trained personnel at the beginning of the training. Registration: The protocol was registered on PROSPERO. [ABSTRACT FROM AUTHOR]

Aims: This meta‐analysis aimed to synthesize the available evidence on the effectiveness of psychoeducational interventions on family function among families after stroke. Background: Family function may be improved by psychoeducational intervention, but findings about the effect of psychoeducation on family function among families after stroke have been mixed. Methods: This was a meta‐analysis carried out by searching five international electronic databases, including Cochrane Library, PubMed, EMBASE, Web of Science and CINAHL, as well as four national electronic databases, including Chinese Biological Medicine (CBM), China National Knowledge Infrastructure (CNKI), VIP and Wanfang. Two groups of researchers screened the studies independently, assessed the quality of the studies and extracted data. Meta‐analysis was performed by using the RevMan 5.3 software. Results: Five studies on psychoeducational interventions were included. Pooled analysis of these studies showed a small effect of the interventions on improving family function (WMD: −0.13, 95% CI: −0.24 to −0.01, P < 0.05). Subgroup analysis showed significant differences between the psychoeducation and control groups at 1 month postintervention (WMD: −0.12, 95% CI: −0.18 to −0.05, P < 0.05) and more than 6 months postintervention (WMD: −0.14, 95% CI: −0.24 to −0.04, P < 0.05). The psychoeducational interventions also had positive effect on improving the problem solving (WMD: −0.22, 95% CI: −0.14 to −0.03, P < 0.05) and communication (WMD: −0.23, 95% CI: −0.41 to −0.05, P < 0.05) functions of the family. There were significant differences in the group of dyad intervention (WMD: −0.14, 95% CI: −0.25 to −0.02, P < 0.05) and the group using face to face method (WMD: −0.58, 95% CI: −0.84 to −0.32, P < 0.05). Conclusions: Synthesized results demonstrated the favourable effect of psychoeducational interventions on the improvement of the family function among families after stroke, especially in terms of family problem solving and family communication. Future psychoeducational intervention research design should consider the combination of multiple intervention methods and the applicable population of intervention. Summary statement: What is already known about this topic? Good family function can promote the physical and mental health of family caregivers, improve the life quality of stroke survivors and lighten a heavy burden on the whole family.Family function may be improved by psychoeducational intervention, but findings about the effect of psychoeducation on family function among families after stroke have been mixed.What this paper adds? The psychoeducational intervention has a positive effect on family function among families after stroke, especially in terms of family problem solving and family communication.The implications of this paper: The psychoeducational intervention can be an acceptable method to improve family function among families after stroke. [ABSTRACT FROM AUTHOR]

Simple Summary: Testicular cancer is a prevalent malignancy in young men aged 15 to 35 years. Sonoelastography is an emerging technique for distinguishing between non-neoplasms, benignities, and malignancies by characterizing the tissue stiffness of testes. This review provides a summary of studies on the diagnostic accuracy of sonoelastography for identifying benign and malignant lesions, as well as tumors and non-tumors. The objective of this review was to summarize the applications of sonoelastography in testicular tumor identification and inquire about their test performances. Two authors independently searched English journal articles and full conference papers from CINAHL, Embase, IEEE Xplore®, PubMed, Scopus, and Web of Science from inception and organized them into a PIRO (patient, index test, reference test, outcome) framework. Eleven studies (n = 11) were eligible for data synthesis, nine of which (n = 9) utilized strain elastography and two (n = 2) employed shear-wave elastography. Meta-analyses were performed on the distinction between neoplasm (tumor) and non-neoplasm (non-tumor) from four study arms and between malignancy and benignity from seven study arms. The pooled sensitivity of classifying malignancy and benignity was 86.0% (95%CI, 79.7% to 90.6%). There was substantial heterogeneity in the classification of neoplasm and non-neoplasm and in the specificity of classifying malignancy and benignity, which could not be addressed by the subgroup analysis of sonoelastography techniques. Heterogeneity might be associated with the high risk of bias and applicability concern, including a wide spectrum of testicular pathologies and verification bias in the reference tests. Key technical obstacles in the index test were manual compression in strain elastography, qualitative observation of non-standardized color codes, and locating the Regions of Interest (ROI), in addition to decisions in feature extractions. Future research may focus on multiparametric sonoelastography using deep learning models and ensemble learning. A decision model on the benefits–risks of surgical exploration (reference test) could also be developed to direct the test-and-treat strategy for testicular tumors. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the effects of daily sedation interruption on the mechanical ventilation duration and relevant outcomes in mechanically ventilated patients in the intensive care unit (ICU). Background: Previously, three meta‐analyses on the association of daily sedation interruption with the mechanical ventilation duration have reported conflicting findings, and these did not support current guideline recommendations that daily sedation interruption can be routinely used in mechanically ventilated adult ICU patients. Design This was a systematic review and meta‐analysis of randomized controlled studies. Data sources Data were from PubMed, Embase, Cochrane Library, CINAHL, ProQuest dissertation and theses, Airiti Library, China National Knowledge Infrastructure, Wanfang Data Chinese, Science Direct and PsycINFO databases. Review methods: Two reviewers independently assessed, extracted and appraised the included studies. Then, pooled estimates were calculated using a random‐effects model. Results: In total, 45 studies involving 5493 participants were included. Compared with controls, daily sedation interruption significantly reduced the mechanical ventilation duration, ICU stay length, sedation duration, and tracheostomy and ventilator‐associated pneumonia risks (all p ≤ 0.001). Moreover, the Acute Physiology and Chronic Health Evaluation II score and study quality were significant moderators. Conclusion: Daily sedation interruption could substantially reduce the duration of mechanical ventilation, particularly when it was applied to patients with high disease severity. Summary statement: What is already known about this topic? Daily sedation interruption has been associated with reductions in excessive sedation and excessive use of sedative agents.The findings on the effects of daily sedation interruption on the mechanical ventilation duration have been inconsistent. What this paper adds? Daily sedation interruption could effectively reduce the mechanical ventilation duration, intensive care unit stay length, sedation duration, and tracheostomy and ventilator‐associated pneumonia risks in intensive care unit patients.Applying daily sedation interruption to patients with high disease severity yielded a larger reduction in the mechanical ventilation duration. The implications of this paper: There is a need to adopt daily sedation interruption as routine care to reduce the mechanical ventilation duration, especially in higher disease severity population [ABSTRACT FROM AUTHOR]

Perinatal (antenatal and postpartum) depression is increasingly becoming a global public health problem. Studies have shown that the presence of depression during the perinatal period impact on a mother's ability to adequately provide nutritional care for herself and her infants and young children. This may thus negatively influence the nutritional status of these vulnerable children resulting in poor growth, such as stunting which is currently a public health problem in low- and middle-income countries (LMICs). The aim of this systematic review and meta-analysis was to determine the association between maternal postpartum depression and child growth in LMICs. Electronic databases were systematically reviewed by screening abstracts, titles, full text and additional data sources of eligible papers. Articles were eligible for inclusion if based on children aged 0 to 59 months, if reporting maternal postpartum depression as an exposure, if based on observational studies evaluating the relation between maternal postpartum depression and child growth, if reporting at least one physical growth indicator such as stunting as an outcome, and if published after 2000. Article selection was based on the PRISMA guidelines for reporting systematic reviews. Twelve articles were included in the quantitative synthesis (12 for stunting, 8 for underweight and 2 for wasting). Maternal postpartum depression was observed to be associated with an increased risk of child stunting (1.87 (95% CI: 1.52, 2.30; I2 = 41.6%, p = 0.064)) and underweight (1.81 (95% Cl: 1.25, 2.62; I2 = 70.7%, p = 0.001)). These results were confirmed after influence analyses, with publication bias being negligible. Conclusion: Maternal depression is a risk factor for poor child growth in LMICs. This study contributes to the knowledge on this topic and calls on policymakers to improve on its understanding, screening and treatment to alleviate the potential negative impact on child growth. What is Known: • Maternal postpartum depression is currently a public health relevance in low- and middle-income countries (LMICs). • Maternal postpartum depression is a risk factor for poor nutritional status in children from LMICs. What is New: • Maternal postpartum depression is associated with an 80 to 90% increased risk of childhood stunting and underweight in LMICs. • The association between risk of childhood stunting and underweight with maternal postpartum depression is slightly influenced by geographical area, rural or urban location, by factors such as study design, study quality and sample size. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta‐analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. Methods: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta‐analysis. Subgroup analyses and meta‐regression were employed to explore potential moderating variables and heterogeneity. Results: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%–59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%–47.6%). Subgroup analyses and meta‐regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. Conclusions: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population. Key points: Informal carers of people with dementia contend with unique circumstances that render them susceptible to both loneliness and social isolation.There is a significant prevalence of loneliness and social isolation in informal carers of individuals with dementia.Several significant moderators influence the prevalence of loneliness and social isolation among informal carers of individuals with dementia.Moderator analysis can guide targeted interventions and support systems for at‐risk informal carers of people with dementia to alleviate loneliness and social isolation. [ABSTRACT FROM AUTHOR]

Due to the unfamiliarity of the surroundings, children having surgery endure worry and tension. Untreated anxiety in children impairs postoperative healing and causes changes in postoperative behavior. The purpose of this review was to determine the efficacy of distraction therapies on anxiety in children undergoing surgery. The systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. PubMed via MEDLINE, CINAHL, ProQuest, Web of Science, and the Cochrane Central Register of Controlled Trials were used to find relevant trials. Full-text papers published in English from January 1, 2000 to December 31, 2021 were included. Children undergoing surgery aged 1 to 18 years were included. A data extraction form was created to extract data from the selected studies. According to the Cochrane risk of bias assessment tool, studies were classified as "low risk," "high risk," or "unclear risk." Review Manager software was used to do a quantitative meta-analysis. Thirteen studies looked at the effect of distraction intervention on children. Nine of them were selected for meta-analysis. The distraction interventions included in this review were: handheld video game, play dough and play with blocks and puzzles, tablet-based interactive distraction, animated video, painting and storytelling, age-appropriate video, distraction with video glasses, watching a movie, and bringing favorite toy during hospital stay. Meta-analysis showed that distraction interventions are effective on preoperative anxiety in children (standardized mean difference = –17.07, 95% confidence interval: 27.11–7.02, p = 0.0009). [ABSTRACT FROM AUTHOR]

Background Hyperlactatemia, is common in patients undergoing neurosurgical procedures. Several studies have identified potential risk factors for developing hyperlactatemia in neurosurgical patients, including body mass index, surgery duration, tumour volume, and certain drugs such as volatile anesthetic agents and corticosteroids. This systematic review and meta-analysis examined the evidence of the association between perioperative lactate levels in patients undergoing brain surgery and postoperative morbidity and mortality. Methods Using PubMed, Scopus, Web of Science, Embase, CINAHL, Medline, Google Scholar, and the Cochrane Central Register of Controlled Trials databases, a systematic literature search was conducted for studies examining the association between perioperative hyperlactatemia and postoperative outcomes in patients undergoing brain surgery. Two authors independently evaluated the full-text papers for eligibility, and then data extraction and meta-analyses of similar studies were conducted (using a random effect model for each outcome measure). The Newcastle Ottawa Scale was used to evaluate the risk of bias (NOS scale). Results Seven observational studies were included, and a total of 1,832 patients were assessed in the systematic review and meta-analysis. The quality of the included studies ranged from poor to high quality according to the NOS quality assessment tool. Meta-analysis results revealed no significant association between perioperative hyperlactatemia and postoperative new neurological deficits (five studies: odds ratio [OR] = 0.97, 95% confidence interval [CI] [0.50–1.87], p = 0.92; heterogeneity: I2 = 38%, p = 0.18). Similarly, perioperative hyperlactatemia was neither significantly associated with increased 30-day postoperative mortality (two studies; OR = 0.20, 95% CI [0.02–2.00], p = 0.17; heterogeneity: I2 = 0%, p = 0.59) nor 6 months survival rate (three studies; OR = 1.05, 95% CI [0.75–1.47], p = 0.79; heterogeneity: I2 = 0%, p = 0.51). Moreover, there was no difference in the length of hospital stay between the two groups (four studies: mean difference = –0.85, 95% CI [–1.73 to 0.03], p = 0.06). Pooled studies were not homogenous (I2 = 68%, p = 0.03). Conclusion Perioperative hyperlactatemia is benign in neurosurgical patients and is not associated with significant postoperative outcomes, such as developing new postoperative neurological deficit, 30-day mortality, 6-month survival, or prolonged hospital stay. [ABSTRACT FROM AUTHOR]

Background:There is a lack of evidence-based knowledge about the effectiveness of home-based OT for older adults aimed at improving occupational performance by practicing activities and tasks. Aim:This review synthesizes and discusses evidence for the effectiveness of occupation-focused and occupation-based OT for older adults at home. Material and methods:Peer-reviewed quantitative papers were included. Participants: ≥ 60-year-old adults with functional limitations. Intervention: OT aiming at improving occupational performance, primarily through the practice of activities and tasks. Outcome: Occupational performance. Context: Home. Three reviewers critically appraised 13 of 995 detected papers. Extracted data were presented and summarized descriptively. Results:Eight high-quality papers showed that occupation-focused and occupation-based OT using cognitive, behavioral and environmental strategies may significantly improve occupational performance in older, home-dwelling adults with physical health problems. Maintaining achieved improvements was a consistent challenge. Conclusions and significance:Evidence suggests that older adults’ occupational performance can be significantly improved through low-intensity occupation-focused and occupation-based intervention. It is recommended to develop and test high-intensity OT programs and maintenance programs. [ABSTRACT FROM PUBLISHER]

Purpose: This meta-analysis addressed the research question: In adults with traumatic brain injury (TBI), does cognitive rehabilitation improve pragmatic language? Method: Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, a systematic literature search was conducted to identify empirical studies that met inclusion criteria including (a) adults (18 years and older) with TBI, (b) a cognitive-based intervention, and (c) reported quantitative pragmatic language outcome measures data. A meta-analysis was conducted on pragmatic language outcome measures. Cohen's d and a 95% confidence interval were used to evaluate the intervention effect. Results: After applying the inclusion and exclusion criteria to 640 eligible papers, six studies (N = 76 participants combined across articles) remained. Results showed that cognitive rehabilitation targeting skills used in communication has a large, positive effect (Cohen's d = 0.89 [0.54,1.24]) on improving pragmatic language abilities in adults with TBI. Conclusions: This meta-analysis provides evidence that cognitive rehabilitative protocols created in collaboration with speech-language pathologists (SLPs) have a significant impact on improving pragmatic language abilities of adults with TBI. This is important for SLPs to consider when determining a treatment approach when working with adults diagnosed with a TBI who have deficits in the area of pragmatic language. [ABSTRACT FROM AUTHOR]

Varicose veins are a common disorder for which different treatments with varied efficacy have been introduced so far. In this study, we review the results of previous studies to evaluate the efficacy of ClosureFast endovenous radiofrequency ablation (RFA) in treating varicose veins. The present study was performed based on the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) protocols, and the results were reported based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. Searches were conducted in all authentic online databases, and the retrieved papers were conducted until March 2021 using Mesh keywords. Study data with the necessary quality to enter the meta-analysis were extracted. Data were analyzed using comprehensive meta-analysis (CMA) software version 2. The cutoff level for significance was determined at 0.05. In total, 36 studies with sample size 7404 procedures were included. Radiofrequency ablation success, recurrence, and recanalization rates in the treatment of varicose veins were estimated to be 95%, 7%, and 3% respectively. The most common complications were bruising 13%, induration 11.6%, edema 8%, ecchymosis 7.4%, and numbness 6.3%. This study showed that the radiofrequency ablation method is a high-performance method with few and often transient complications, and the risk of significant complications in using this method to treat varicose veins is low. More studies are needed to evaluate the effectiveness of this method compared to other treatments. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to critically review and synthesize the best available evidence about the effectiveness of therapist-guided internet-delivered cognitive behavioral therapy (iCBT) in terms of reducing sickness absence (SA). Methods: We searched Medline (PubMed), Embase, PsycInfo, CINAHL, and Cochrane Central (up to November 2020) for English language peer-reviewed papers that described randomized controlled trials of therapist-guided iCBT compared with usual treatment for SA in adults with common mental disorders. Eligible studies were assessed with the Cochrane Risk of Bias 1 tool, meta-analysis was conducted using a random-effects model, and standardized mean differences (SMD) with 95% confidence intervals (CI) were reported. A subgroup analysis investigated potential moderating variables (diagnosis, SA at baseline, and estimated accuracy of self-report). Results: We identified 2788 references, of which 68 remained after the completion of the systematic screening process. A hand search of reference lists yielded no additional studies. The full texts of these 68 studies were appraised critically, and 11 were deemed to be suitable for a meta-analysis. SA was similar for iCBT and usual treatment groups (SMD: 0.02, 95% CI, –0.08 to 0.11), and remained similar even after the removal of two studies in which the recall time was over 3 months (SMD: 0.00, –0.11 to 0.12). Similar SA levels in intervention and control groups at 6-month and 12-month follow-up were observed in studies of participants with depression symptoms. Conclusions: iCBT did not appear to be effective in terms of reducing (largely self-assessed) SA in adults with common mental disorders. There is a need to improve the method and consistency of assessing SA. [ABSTRACT FROM AUTHOR]

BACKGROUND: There has been extensive literature examining the efficacy of exercise interventions in the treatment of depression over the past few decades. However, there is ongoing debate regarding the optimal dosage, and the implications of utilising physiotherapists for the management of clinically depressed adults using exercise has not been examined. OBJECTIVES: This review aimed to examine the effectiveness of exercise as a treatment for depression (without comorbidities) and to determine the most effective dosage/mode to treat this population. This review strived to appraise the literature for a potential role for physiotherapists in depression management. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, a search for randomized controlled trials was conducted on the nine databases. All studies were appraised for quality using the Physiotherapy Evidence Database (PEDro) scale and Cochrane Risk of Bias Tool (RoB). Data was manually extracted, and pre- and post-intervention depression scores and program variables were analysed. RESULTS: Of the 5036 papers retrieved, 7 papers met this review's inclusion criteria. The results of the meta-analysis reveal that exercise as a sole treatment and as an add-on is significantly effective in reducing depressive symptoms. The findings support the use of moderate intensity aerobic exercise for three sessions per week. CONCLUSIONS: Exercise was shown to significantly improve depressive symptoms in depressed adults. This review adds to the growing body of evidence regarding the important role of physiotherapists in the treatment of psychiatric disorders in the design and implementation of exercise interventions. [ABSTRACT FROM AUTHOR]

Patients with mild cognitive impairment (MCI) and dementia are more prone to depression than people without MCI or dementia. Some studies have found nonpharmacological multi‐component intervention to be more effective than single‐component intervention in improving the condition of patients with MCI and dementia; however, their effect on depressive symptoms is still inconsistent. Therefore, it is necessary to explore the effectiveness of nonpharmacological multi‐component intervention in improving depressive symptoms in patients with MCI and dementia. This review retrieved papers from PubMed, Embase, Cochrane Library, CINAHL, PsycINFO and CNKI. The retrieval time limit was set from 1 January 1990 to 25 November 2022. The PRISMA 2020 guideline was used to report the included studies. The result showed that nonpharmacological multi‐component intervention could improve depressive symptoms in patients with MCI and dementia. Among them, nonpharmacological multi‐component intervention with a duration of <6 months, physical and cognitive activities, or other activities had significant effects. However, each study differed in terms of specific measures, duration and frequency of intervention methods. Accordingly, more randomized controlled trials with larger samples are required to discover the best scheme for nonpharmacological multi‐component intervention. [ABSTRACT FROM AUTHOR]

Background: Male youth soccer players competing at a high level will typically engage in large volumes of soccer training from a young age. However, it is not known whether the high levels of habitual training that these high-performing players are exposed to limit their ability to respond to strength, plyometric or combined training interventions. Objective: The primary aim of our systematic review and meta-analysis was to compare the specific effects of strength, plyometric and combined training with active controls (standard soccer training) on the strength, power and speed characteristics of high-level, highly trained young male soccer players. Methods: We performed a literature search across PubMed, Scopus, CINAHL, Web of Science and SPORTDiscus to identify controlled studies that implemented strength, plyometric or combined training in high-level male youth soccer players. Participants were defined as high level or highly trained based on established guidelines related to either competition level or age-related weekly hours spent in soccer training. Studies needed to report at least one outcome of lower body strength, squat jump, countermovement jump, horizontal power, acceleration (0–10 m), speed (15–40 m) or change of direction speed. A meta-analysis was then performed using a random-effects model to determine the magnitude (Hedge's g) of training responses and whether effects differed across modes of training. Results: From an initial return of 5464 papers, n = 34 studies met the inclusion criteria and provided a total sample of n = 1396 high-level male youth soccer players. Strength, plyometric and combined training resulted in improvements in strength, squat and countermovement jump, horizontal power, acceleration, change of direction speed (all p < 0.05; g = 0.73–1.08, moderate) and speed (p < 0.05; g = 0.40–0.59, small). Lower body strength was the only outcome where training mode had a significant effect (p < 0.05), with plyometric training producing small effects (g = 0.27, p < 0.05) compared with moderate effects for strength (g = 1.07, p < 0.05) and combined (g = 0.75, p < 0.05) training. Prediction intervals for overall effects (all training modes combined) showed that the greatest confidence that future training will lead to positive effects was in the squat and countermovement jump, horizontal power and acceleration (prediction intervals = 0.03–1.81). Conclusions: High-level, highly trained male youth soccer players can experience positive gains in indices of strength, power and speed from strength, plyometric and combined training, and the magnitude of gains are mostly similar across modes of training. Based on prediction intervals, there is a good level of certainty that future strength, plyometric and combined training in this population would lead to positive improvements in vertical and horizontal power and sprint acceleration. [ABSTRACT FROM AUTHOR]

Rapid internet penetration and technological advancements have facilitated accessibility to internet-enabled devices globally. Since Asia lacks comprehensive data on internet addiction among college students, this review aims to estimate its pooled prevalence. This was a systematic review and meta-analysis. Searches were conducted in PubMed, Scopus, CINAHL, and MEDLINE from their inception through August 2022 using terms appropriate to internet addiction and Asian countries/territorial for publications in English peer-reviewed journals. The studies included those done on current college students and provided unambiguous indicators of the threshold of internet addiction. The pooled prevalence was calculated through a random-effects meta-analysis by RStudio software, and I 2 statistic was used to assess heterogeneity. The Joanna Briggs Institute critical appraisal checklist was used for quality assessment. Overall, between 2007 and 2021, 39 papers comprising 45 effect sizes and totaling 58,058 participants met the inclusion criteria. The pooled prevalence of internet addiction among Asian college students was 24.3% (95% confidence interval: 19.8%–29.5%, Q = 6234, df = 44, τ2 = 0.79, I 2 = 99.29%), and strikingly, this percentage increased over time. A high degree of heterogeneity was seen, and no publication bias was found. To our knowledge, this is the first comprehensive review report on Asian college students, which found that one-fifth suffer from internet addiction. The findings emphasize the significance of multidisciplinary prevention and management strategies to mitigate the harmful effects of internet addiction. Further research is warranted to develop a standardized diagnostic tool for a more precise estimation of internet addiction among this population. [ABSTRACT FROM AUTHOR]

Simple Summary: This is a systematic and meta-analysis of proportions study that investigated the distribution of head and neck cutaneous squamous cell carcinoma between men and women. Males were disproportionally affected by HNcSCC overall, and this was most evident in the ear subtype, while this disparity was less obvious for the eyelid subtype. This paper underscores the risk of metastatic progression of HNcSCC and denotes further research is warranted to elucidate the mechanisms for these sex differences. Improving our understanding of this will better inform clinical practices, and eventually improve patient outcomes for all—males and females. The incidence of head and neck cutaneous squamous cell carcinoma (HNcSCC) is unevenly distributed between men and women. At present, the mechanism behind this disparity remains elusive. This study conducted a systematic review and meta-analysis of proportions to investigate the disparity between sexes for patients with HNcSCC. PubMed, Scopus, EMBASE, MEDLINE, Emcare and CINAHL were searched in November 2021 and June 2022 (N > 50, English, human), and studies which examined the association between sex and HNcSCC were included. Analysis was conducted using RStudio with data and forest plots displaying males as a proportion of total patients with HNcSCC. Two independent researchers performed study selection, data extraction, data analysis and risk of bias. Eighty-two studies (1948 to 2018) comprising approximately 186,000 participants (67% male, 33% female) from 29 countries were included. Significantly more males had HNcSCC overall (71%; CI: 67–74). Males were also significantly more affected by cSCC of the ear (92%; CI: 89–94), lip (74%; CI: 66–81), and eyelid (56%; CI: 51–62). This study found HNcSCC disproportionately affected males overall and across all subtypes. Improving our understanding of sex-specific mechanisms in HNcSCC will better inform our preventive, therapeutic and prognostic practices. [ABSTRACT FROM AUTHOR]

Aim: To assess the effects of self‐management interventions on systolic blood pressure, diastolic blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension. Background: Effective treatment of hypertension may require the practice of self‐management behaviours. However, evidence on effects of self‐management interventions on blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension is lacking. Design A systematic review and meta‐analysis. Data sources: CINAHL, Cochrane Library, Embase, Ovid‐Medline, PubMed, Scopus, Web of Science and other sources were searched to October 2020. Review methods: Data were analysed using Comprehensive Meta‐Analysis 2.0 and quality assessment was done using ROB 2.0. The pooled effect sizes were reported as Hedges' g values with corresponding 95% confidence intervals using a random‐effects model. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self‐management interventions significantly decreased blood pressure and increased self‐efficacy and medication adherence in older adult patients with hypertension, with no significant effect on body mass index. Conclusions: Self‐management interventions have considerable beneficial effects in older adults with hypertension. Health care providers should implement self‐management interventions to strengthen the patient's role in managing their health. SUMMARY STATEMENT: What is already known about this topic? Current evidence suggests self‐management interventions as a potential strategy for decreasing blood pressure in patients with hypertension.There is limited evidence of the effectiveness of self‐management interventions on blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension. What this paper adds? Self‐management interventions can decrease systolic blood pressure, diastolic blood pressure and improve self‐efficacy and medication adherence in older adults with hypertension. The implication of this paper: Findings highlight the importance of implementing self‐management programs in older adult patients with hypertension.Health care providers should implement self‐management interventions that are tailored to the individual's level of self‐efficacy to strengthen the patient's role in managing their health care. [ABSTRACT FROM AUTHOR]

Background the prevalence of adverse drug reactions (ADRs) in hospitalised older patients, their clinical presentations, causative drugs, severity, preventability and measurable outcomes are unclear, ADRs being an increasing challenge to older patient safety. Methods we systematically searched PubMed, Embase, EBSCO-CINAHL, the Cochrane Library, 'rey' literature and relevant systematic review bibliographies, published from database inception to March 2020. We included any study reporting occurrence of in-hospital ADRs as primary or secondary outcomes in hospitalised older adults (mean age ≥ 65 years). Two authors independently extracted relevant information and appraised studies for bias. Study characteristics, ADR clinical presentations, causative drugs, severity, preventability and clinical outcomes were analysed. Study estimates were pooled using random-effects meta-analytic models. Results from 2,399 abstracts, we undertook full-text screening in 286, identifying 27 studies (29 papers). Final analysis yielded a pooled ADR prevalence of 16% (95%CI 12–22%, I 2 98%, τ 2 0.8585), in a population of 20,153 hospitalised patients aged ≥65 years of whom 2,479 patients experienced ≥ one ADR. ADR ascertainment was highly heterogeneous. Almost 48.3% of all ADRs involved five presentations: fluid/electrolyte disturbances (17.3%), gastrointestinal motility/defaecation disorders (13.3%), renal disorders (8.2%), hypotension/blood pressure dysregulation disorders/shock (5.5%) and delirium (4.1%). Four drug classes accounted for 57.8% of causative medications i.e. diuretics (19.8%), anti-bacterials (14.8%), antithrombotic agents (12.2%) and analgesics (10.9%). Pooled analysis of severity was not feasible. Four studies reported the majority of ADRs as preventable (55–95%). Conclusions on average, 16% of hospitalised older patients experience significant ADRs, varying in severity and mostly preventable, with commonly prescribed drug classes accounting for most ADRs. [ABSTRACT FROM AUTHOR]

Simple Summary: Ovarian cancer and its treatment are associated with energy balance-related problems, such as overweight, malnourishment, compromised muscle mass and quality, and physical inactivity. This may impact the quality of life and treatment outcome. These factors may be modifiable, and women with ovarian cancer have indicated that they want to do something themselves to help improve their treatment outcome. In order to better understand the role of energy-balance-related problems in patients treated for ovarian cancer, this study synthesized the available research on (i) the association of body weight, body composition, diet, and physical activity or exercise with survival or treatment-related complications and (ii) the evidence from exercise- and/or dietary interventions. The results indicate that body mass index has a limited prognostic value, while other measures of body composition may have more prognostic potential. Additionally, the findings provide important leads for future research directions. Background: This systematic review and meta-analysis synthesized evidence in patients with ovarian cancer at diagnosis and/or during first-line treatment on; (i) the association of body weight, body composition, diet, exercise, sedentary behavior, or physical fitness with clinical outcomes; and (ii) the effect of exercise and/or dietary interventions. Methods: Risk of bias assessments and best-evidence syntheses were completed. Meta-analyses were performed when ≥3 papers presented point estimates and variability measures of associations or effects. Results: Body mass index (BMI) at diagnosis was not significantly associated with survival. Although the following trends were not supported by the best-evidence syntheses, the meta-analyses revealed that a higher BMI was associated with a higher risk of post-surgical complications (n = 5, HR: 1.63, 95% CI: 1.06–2.51, p = 0.030), a higher muscle mass was associated with a better progression-free survival (n = 3, HR: 1.41, 95% CI: 1.04–1.91, p = 0.030) and a higher muscle density was associated with a better overall survival (n = 3, HR: 2.12, 95% CI: 1.62–2.79, p < 0.001). Muscle measures were not significantly associated with surgical or chemotherapy-related outcomes. Conclusions: The prognostic value of baseline BMI for clinical outcomes is limited, but muscle mass and density may have more prognostic potential. High-quality studies with comprehensive reporting of results are required to improve our understanding of the prognostic value of body composition measures for clinical outcomes. Systematic review registration number: PROSPERO identifier CRD42020163058. [ABSTRACT FROM AUTHOR]

Background: Patients with colorectal cancer (CRC) are more likely to develop severe course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and experience increased risk of mortality compared to SARS-CoV-2 patients without CRC. Objectives: To estimate the prevalence of SARS-CoV-2 infection in CRC patients and analyse the demographic parameters, clinical characteristics and treatment outcomes in CRC patients with COVID-19 illness. Methods: For this systematic review and meta-analysis, we searched Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature for studies on the incidence of SARS-CoV-2 infection in CRC patients, published from December 1, 2019 to December 31, 2021, with English language restriction. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). Sub-group analyses were performed to minimize heterogeneity. Binary logistic regression model was used to explore the effect of various demographic and clinical characteristics on patient's final treatment outcome (survival or death). Results: Of the 472 papers that were identified, 69 articles were included in the systematic review and meta-analysis (41 cohort, 16 case-report, 9 case-series, 2 cross-sectional, and 1 case-control studies). Studies involving 3362 CRC patients with confirmed SARS-CoV-2 (all patients were adults) were analyzed. The overall pooled proportions of CRC patients who had laboratory-confirmed community-acquired and hospital-acquired SARS-CoV-2 infections were 8.1% (95% CI 6.1 to 10.1, n = 1308, 24 studies, I2 98%, p = 0.66), and 1.5% (95% CI 1.1 to 1.9, n = 472, 27 studies, I2 94%, p < 0.01). The median patient age ranged from 51.6 years to 80 years across studies. The majority of the patients were male (n = 2243, 66.7%) and belonged to White (Caucasian) (n = 262, 7.8%), Hispanic (n = 156, 4.6%) and Asian (n = 153, 4.4%) ethnicity. The main source of SARS-CoV-2 infection in CRC patients was community-acquired (n = 2882, 85.7%; p = 0.014). Most of those SARS-CoV-2 patients had stage III CRC (n = 725, 21.6%; p = 0.036) and were treated mainly with surgical resections (n = 304, 9%) and chemotherapies (n = 187, 5.6%), p = 0.008. The odd ratios of death were significantly high in patients with old age (≥ 60 years) (OR 1.96, 95% CI 0.94–0.96; p < 0.001), male gender (OR 1.44, 95% CI 0.41–0.47; p < 0.001) CRC stage III (OR 1.54, 95% CI 0.02–1.05; p = 0.041), CRC stage IV (OR 1.69, 95% CI 0.17–1.2; p = 0.009), recent active treatment with chemotherapies (OR 1.35, 95% CI 0.5–0.66; p = 0.023) or surgical resections (OR 1.4, 95% CI 0.8–0.73; p = 0.016) and admission to ICU (OR 1.88, 95% CI 0.85–1.12; p < 0.001) compared to those who survived. Conclusion: SARS-CoV-2 infection in CRC patient is not uncommon and results in a mortality rate of 26.2%. Key determinants that lead to increased mortality in CRC patients infected with COVID-19 include older age (≥ 60 years old); male gender; Asian and Hispanic ethnicity; if SARS-CoV-2 was acquired from hospital source; advanced CRC (stage III and IV); if patient received chemotherapies or surgical treatment; and if patient was admitted to ICU, ventilated or experienced ARDS. [ABSTRACT FROM AUTHOR]

Simple Summary: HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) is unique amongst oropharyngeal cancers in its high responsiveness to treatment and its lower mortality rate. As a result, numerous clinical trials have been conducted to identify treatment modalities and protocols. In order for these trials to have meaningful impact on HPV-associated OPSCC patients, proper demographic representation by trial participants is essential. The aim of our systematic review and meta-analysis was to assess the demographics of trial participants for HPV-associated OPSCC clinical trials and compare them with those reported by national databases. We determined that clinical-trial participants were predominately non-smoking white men, with tonsils as the primary tumor site. These findings reflect the demographics reported by the National Cancer Database. Our results imply that HPV-associated OPSCC clinical trials appropriately represent the target population and offer immense benefit. The objective of our paper was to answer the following question: how do patients with HPV-related oropharyngeal squamous cell carcinoma OPSCC (Population) enrolled in clinical trials (Intervention), compared with national database reports of HPV-associated OPSCC patients (Comparison), present demographically (Outcome)? We conducted a systematic review and meta-analysis of studies pertaining to clinical trials of HPV-associated OPSCC and participant demographics in the United States. PubMed, Scopus, CINAHL, and the Cochrane Library were searched from inception to 2 February 2022. Studies of overlapping participant cohorts and/or studies conducted outside of the United States were excluded. Primary outcomes were patient age, sex, and race. Secondary outcomes were smoking history, alcohol history, history of prior cancer, and tumor origin site. Meta-analysis of single means (mean, N for each study, and standard deviation) for age, pack years, and smoking years was performed. Pooled prevalence rates of gender, race, alcohol history, tobacco history, and tumor origin site were expressed as a percentage, with 95% confidence intervals. Meta-analysis found patients to be predominately non-smoking white males, with tumors originating from the tonsil. Our findings reflected the demographics reported by the National Cancer Database (NCDB) for HPV-associated OPSCC. This indicates that HPV-associated OPSCC patients are appropriately represented in clinical trial demographics. [ABSTRACT FROM AUTHOR]

Objective To examine the association between residential remoteness and stage of cancer at diagnosis, treatment uptake, and survival within the Australian Indigenous population. Design Systematic review and matched retrospective cohort study. Setting Australia. Participants Systematic review: published papers that included a comparison of cancer stage at diagnosis, treatment uptake, mortality and/or survival for Indigenous people across remoteness categories were identified (n = 181). Fifteen papers (13 studies) were included in the review. Original analyses: new analyses were conducted using data from the Queensland Indigenous Cancer Study (QICS) comparing cancer stage at diagnosis, treatment uptake, and survival for Indigenous cancer patients living in rural/remote areas (n = 627, 66%) and urban areas (n = 329, 34%). Main Outcome Measures Systematic review: Papers were included if there were related to stage of disease at diagnosis, treatment, mortality and survival of cancer. Restrictions were not placed on the outcome measures reported (e.g. standardised mortality ratios versus crude mortality rates). Original analyses: Odds ratios (OR, 95%CI) were used to compare stage of disease and treatment uptake between the two remoteness groups. Treatment uptake (treated/not treated) was analysed using logistic regression analysis. Survival was analysed using Cox proportional hazards regression. The final multivariate models included stage of cancer at diagnosis and area-level socioeconomic status (SEIFA). Results Existing evidence of variation in cancer outcomes for Indigenous people in remote compared with metropolitan areas is limited. While no previous studies have reported on differences in cancer stage and treatment uptake by remoteness within the Indigenous population, the available evidence suggests Indigenous cancer patients are less likely to survive their cancer the further they live from urban centres. New analysis of QICS data indicates that Indigenous cancer patients in rural/remote Queensland were less likely to be diagnosed with localised disease and less likely to receive treatment for their cancer compared to their urban counterparts. Conclusion More research is needed to fully understand geographic differentials in cancer outcomes within the Indigenous population. Knowing how geographical location interacts with Indigenous status can help to identify ways of improving cancer outcomes for Indigenous Australians. [ABSTRACT FROM AUTHOR]

Aims: To assess the effect of peer support intervention on diabetes distress in people with type 2 diabetes. Background: Diabetes distress may be decreased by peer support intervention, but findings about the effect of peer support on diabetes distress have been mixed. Design A systematic review and meta‐analysis of randomized controlled studies. Data sources PubMed, Embase, CENTRAL, PsycINFO, Web of Science, and CINAHL databases were searched for randomized controlled trials from inception to 30 June 2018. Review methods: Investigators assessed eligibility, extracted data, and assessed methodological quality. Standardized mean difference and 95% confidence intervals were calculated for pooled effect size. Results: A total of 13 studies included in systematic review and 10 in meta‐analysis. In the random‐effects model, the pooled effect size showed current peer support intervention did not significantly reduce diabetes distress in type 2 diabetes population compared with usual care. Conclusion: High quality and well‐designed studies targeting at reducing diabetes distress are needed to further test the effect of peer support intervention on diabetes distress. SUMMARY STATEMENT: What is already known about this topic? Diabetes distress is prevalent in type 2 diabetes and associated with adverse diabetes outcomes.Diabetes distress may be decreased by peer support intervention, but findings about the effect of peer support on diabetes distress have been mixed. What this paper adds? Existing peer support interventions were not more effective in reducing diabetes distress for people with type 2 diabetes when compared with usual care.Most current peer support interventions mainly targeted education and behaviour change and not directly targeted diabetes distress. The implications of this paper: There is a need to design the peer support interventions targeted at reducing diabetes distress. The baseline score of diabetes distress should be considered in the design of peer support interventions. [ABSTRACT FROM AUTHOR]

To systematically review literature on nutritional intake, nutritional status and nutritional interventions, and to study their association with short- and long-term clinical outcomes in people with a major dysvascular lower limb amputation. PubMed, Ovid, CINAHL, and The Cochrane Library were searched. Studies were included if nutritional intake, nutritional status, or nutritional interventions in people with a major dysvascular lower limb amputation were analyzed. Of the 3038 unique papers identified, 30 studies were included. Methodological quality was moderate (1 study) or weak (29 studies). Limited information was available on nutritional intake (2 studies) and nutritional interventions (1 study). Nutritional intake and nutritional status were assessed by diverse methods. The percentage of people with a poor nutritional status ranged from 1% to 100%. In some studies, measures of poor nutritional status were associated with adverse short- and long-term clinical outcomes. The percentage of people with a poor nutritional status is inconclusive in the major dysvascular lower limb amputation population, because of the heterogeneity of the assessment methods used. Some included studies reported a negative association between poor nutritional status and clinical outcomes. However, these results should be interpreted with caution, because of the limited quality of the studies available. Studies high in methodological quality and high in hierarchy of evidence are needed. The proportion of people with a poor nutritional status in the major dysvascular lower limb amputation population is inconclusive. Poor nutritional status seems to affect clinical outcomes negatively. More uniformity in assessment of malnutrition in the major dysvascular lower limb amputation population is needed. [ABSTRACT FROM AUTHOR]

In this paper, we verify the effect of physical exercise on the functional capacity of people diagnosed with liver cirrhosis (LC). Inclusion criteria were people with LC, at any stage of the disease, over 18 years of age, of either sex, who performed any type of physical exercise in comparison with any other intervention or no intervention, obtaining functional capacity as the outcome, of the controlled and randomized experimental studies. The search for articles was carried out in 11 databases. The descriptors considered for the search were physical exercise, functional capacity, LC, and their synonyms. Methodological quality and study bias were assessed using the Jadad scale and the risk of bias 2 scale, respectively. Review Manager 5.4 was used for the meta-analysis of the data. Functional capacity was considered a continuous variable. The difference in standardized means was considered as the effect measure. The random effect analysis model was used. The confidence level adopted was 0.05. The level of evidence of the meta-analysis result was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The 113 participants with LC, who belonged to the physical exercise group, had a standardized mean difference in functional capacity of 0.57 (0.01–1.13); p = 0.05, more than the 107 participants who were in the control situation. The level of evidence from the meta-analysis assessed through the GRADE was considered moderate. Physical exercise caused a significant increase of moderate clinical relevance in the functional capacity of patients diagnosed with LC. [ABSTRACT FROM AUTHOR]

Introduction: Long COVID is a term that encompasses a range of signs, symptoms, and sequalae that continue or develop after an acute COVID-19 infection. The lack of early recognition of the condition contributed to delays in identifying factors that may contribute toward its development and prevention. The aim of this study was to scope the available literature to identify potential nutritional interventions to support people with symptoms associated with long COVID. Methods: This study was designed as a systematic scoping review of the literature (registration PROSPERO CRD42022306051). Studies with participants aged 18 years or older, with long COVID and who underwent a nutritional intervention were included in the review. Results: A total of 285 citations were initially identified, with five papers eligible for inclusion: two were pilot studies of nutritional supplements in the community, and three were nutritional interventions as part of inpatient or outpatient multidisciplinary rehabilitation programs. There were two broad categories of interventions: those that focused on compositions of nutrients (including micronutrients such as vitamin and mineral supplements) and those that were incorporated as part of multidisciplinary rehabilitation programs. Nutrients included in more than one study were multiple B group vitamins, vitamin C, vitamin D, and acetyl-l-carnitine. Discussion: Two studies trialed nutritional supplements for long COVID in community samples. Although these initial reports were positive, they are based on poorly designed studies and therefore cannot provide conclusive evidence. Nutritional rehabilitation was an important aspect of recovery from severe inflammation, malnutrition, and sarcopenia in hospital rehabilitation programs. Current gaps in the literature include a potential role for anti-inflammatory nutrients such as the omega 3 fatty acids, which are currently undergoing clinical trials, glutathione-boosting treatments such as N-acetylcysteine, alpha-lipoic acid, or liposomal glutathione in long COVID, and a possible adjunctive role for anti-inflammatory dietary interventions. This review provides preliminary evidence that nutritional interventions may be an important part of a rehabilitation program for people with severe long COVID symptomatology, including severe inflammation, malnutrition, and sarcopenia. For those in the general population with long COVID symptoms, the role of specific nutrients has not yet been studied well enough to recommend any particular nutrient or dietary intervention as a treatment or adjunctive treatment. Clinical trials of single nutrients are currently being conducted, and future systematic reviews could focus on single nutrient or dietary interventions to identify their nuanced mechanisms of action. Further clinical studies incorporating complex nutritional interventions are also warranted to strengthen the evidence base for using nutrition as a useful adjunctive treatment for people living with long COVID. [ABSTRACT FROM AUTHOR]

Illicit opioid use in pregnancy is associated with adverse maternal, neonatal, and childhood outcomes. Opioid substitution is recommended, but whether methadone or buprenorphine is the optimal agent remains unclear. We searched EMBASE, PubMed, Web of Science, Scopus, Open Gray, CINAHL and the Cochrane Central Registry of Controlled Trials (CENTRAL) from inception to April 2020 for randomized controlled trials (RCTs) and cohort studies comparing methadone and buprenorphine treatment for opioid-using mothers. Included studies assessed maternal and or neonatal outcomes. We used random-effects meta-analyses to estimate summary measures for outcomes and report these separately for RCTs and cohort studies. Of 408 abstracts screened, 20 papers were included (4 RCTs, 16 cohort, 223 and 7028 participants respectively). All RCTs (4/4) had a high risk of bias and median (IQR) Newcastle Ottawa Scale for cohort studies was 7.5 (6–9). In both RCTs and cohort studies, buprenorphine was associated with; greater offspring birth weight (weighted mean difference [WMD] 343 g (95% CI: 40–645 g) in RCT and 184 g (95% CI: 121–247 g) in cohort studies); body length at birth (WMD 2.28 cm (95% CI: 1.06–3.49 cm) in RCTs and 0.65 cm (95% CI: 0.31–0.98 cm) in cohort studies); and reduced risk of prematurity (risk ratio [RR] 0.41 (95% CI: 0.18–0.93) in RCTs and 0.63 [95% CI: 0.53–0.75] in cohort studies) when compared to methadone. All other clinical outcomes were comparable. Compared to methadone, buprenorphine was consistently associated with improved birthweight and gestational age, however given potential biases, results should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Purpose This study was conducted to investigate the relationships between different frailty stages and the fall incidence rates of community-dwelling older adults. The differences between various frailty indicators regarding assessment accuracy of the fall incidence rates of community-dwelling elders were also analyzed. Finally, the relationship between frailty and recurrent falls was explored. Methods This study comprised a systematic literature review and meta-analysis. Two researchers independently examined and extracted the related literature. The key search terms included frailty, frail, fall, older people, older, geriatric, and senior. The literature sampling period was from January 2001 to December 2016. The quality of each paper was assessed according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases of the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and MEDLINE were used to conduct a systematic literature search by using the random effect mode to analyze the compiled papers. Findings A total of 102,130 community-dwelling older adults ≥65 years of age and 33,503 older adults who had experienced a fall were compiled to investigate the relationship between frailty and falls. The meta-analysis results revealed that compared with robust older adults, frail older adults demonstrated the greatest risk for falls, followed by prefrail older adults. Furthermore, the use of different frailty indicators to predict the fall incidence rates of older adults yielded nonsignificantly different outcomes. In short, studies of either cardiovascular health or osteoporotic fracture indicators are effective for predicting the risk for falls in older people. Finally, this study confirmed that compared with robust older adults, frail older adults were more likely to experience recurrent falls. Conclusions Frailty is a crucial healthcare topic of people with geriatric syndromes. Frail older adults are likely to experience recurrent falls. In addition, the evidence-based study indicated that once older people enter the prefrail stage, they are likely to experience falls. Therefore, older adults should be evaluated for the possibility of geriatric syndromes such as frailty, which may be addressed to reduce the risk for bone fractures and death. Clinical Relevance Professional nurses should use frailty assessment indicators as early as possible to evaluate the possibility of frailty in community-dwelling older people. Meanwhile, effective frailty prevention strategies should be applied to prevent frailty, thereby reducing the incidence of falls and enhancing older persons' quality of life. [ABSTRACT FROM AUTHOR]

Background: Postpartum hemorrhage or postpartum bleeding (PPH) is often defined as loss of > 500 ml of blood after vaginal delivery or > 1000 ml after cesarean delivery within 24 h. Postpartum hemorrhage is a leading direct cause of maternal morbidity and mortality in Ethiopia. Therefore, the main objective of this systematic review and meta-analysis was to estimate the pooled magnitude of postpartum hemorrhage and the pooled effect size of the associated factors in Ethiopia. Methods: Primary studies were searched from PubMed/MEDLINE online, Science Direct, Hinari, Cochrane Library, CINAHL, African Journals Online, Google and Google Scholars databases. The searching of the primary studies included for this systematic review and meta-analysis was limited by papers published from 2010 to October 10/2021. The data extraction format was prepared in Microsoft Excel and extracted data was exported to Stata Version 16.0 statistical software for analysis. A random effect meta-analysis model was used. Statistical heterogeneity was evaluated by the I2 test and Egger's weighted regression test was used to assess publication bias. Result: A total of 21 studies were included in this meta-analysis. The pooled magnitude of postpartum hemorrhage in Ethiopia was 8.24% [(95% CI 7.07, 9.40]. Older age [OR = 5.038 (95% CI 2.774, 9.151)], prolonged labor [OR = 4.054 (95% CI 1.484, 11.074)], absence of anti-natal care visits (ANC) [OR = 13.84 (95% CI 5.57, 34.346)], grand-multiparty [OR = 6.584 (95% CI 1.902, 22.795)], and history of postpartum hemorrhage [OR = 4.355 (95% CI 2.347, 8.079)] were factors associated with the occurrence of postpartum hemorrhage. Conclusions: The pooled magnitude of postpartum hemorrhage among post-natal mothers in Ethiopia was moderately high. The finding of this study will strongly help different stakeholder working in maternal and child health to focus on the main contributors' factors to reduce post-partum hemorrhage among postnatal mothers. Health professionals attending labor and delivery should give more attention to advanced aged mothers, grand-multipara mothers and mothers who had a history of post-partum hemorrhage due to higher risk for postpartum hemorrhage. Encouraging to continue ANC visit and prevent prolonged labor should also be recommended to decrease postpartum hemorrhage. Plain Language summary: Even though other complications occur during pregnancy, post-partum hemorrhage (PPH) is the most serious complication and most critically important cause during pregnancy and child birth. It can cause severe anemia, acute respiratory distress syndrome (ARDS), acute renal failure (ARF), coma, and cardiac arrest. Uterine atony, retained tissue, genital tract tear, coagulation problem, and uterine rupture are most common causes of post-partum hemorrhage. In developing countries, PPH is one of the leading causes of maternal mortality, accounting for 25–43% of maternal death. It is also a leading cause of maternal morbidity and mortality in Ethiopia. This systematic review and meta-analysis were performed following the preferred reporting items for systematic reviews and Meta-Analyses (PRISMA). Primary studies were searched from different databases and random effect meta-analysis model was used. This systematic review and meta-analysis included 21 primary studies with a total of 93,898 study participants. The pooled magnitude of postpartum hemorrhage in Ethiopia was 8.24%. Advanced maternal age, prolonged labor, absence of antenatal care (ANC) visits, grand multi-parity, previous history of postpartum hemorrhage were significantly associated with postpartum hemorrhage. The finding of this systematic review and meta-analysis will strongly help different stakeholders working in maternal and child health to focus on the main contributor factors to reduce PPH If postpartum hemorrhage is reduced, it is the fact that maternal death will be decreased. [ABSTRACT FROM AUTHOR]

Objective To establish the efficacy of medications, incidence of adverse events (AEs), and withdrawal rates associated with the pharmacological management of chronic spinal cord injury pain. Methodology PubMed, MEDLINE, Embase, CINAHL, Web of Science, CENTRAL, and PsycINFO were searched (November 2017) and updated (January 2020). Two independent review authors screened and identified papers for inclusion. Results Twenty-one studies met inclusion requirements for efficacy analysis and 17 for AE and withdrawal rate analysis; no additional papers were included from the updated 2020 search. Treatments were divided into six categories: anticonvulsants (n = 6), antidepressants (n = 3), analgesics (n = 8), anti-spasticity medications (n = 2), cannabinoids (n = 1), and other (n = 2). Trials of anticonvulsants, antidepressants, and cannabinoids included long-term follow-up trials (2 weeks to 4 months), and trials of analgesics and anti-spasticity medications, among others, were short-term trials (0–2 days). Effectiveness for neuropathic pain was found for pregabalin (3/3 studies) and lidocaine (2/3 studies). Studies using ketamine also reported effectiveness (2/2), but the quality of these papers was rated as poor. The most frequently reported AEs included dizziness, dry mouth, nausea, and constipation. Pregabalin was associated with a higher risk of somnolence (risk ratio [RR] 3.15, 95% confidence interval [CI]: 2.00–4.98) and dizziness (RR 2.9, 95% CI: 1.58–5.30). Ketamine was associated with a higher risk of reduced vision (RR 9.00, 95% CI: 0.05–146.11), dizziness (RR 8.33, 95% CI: 1.73–40.10), and somnolence (RR 7.00, 95% CI: 1.73–40.1). Withdrawal rates ranged from 18.4% for antidepressants to 0–30% for anticonvulsants, 0–10% for anti-spasticity medications, 0–48% for analgesics, 28.6% for cannabinoids, and 0–22.2% for other medications. Conclusion Pregabalin was found to be effective for neuropathic pain vs placebo. Cannabinoids were ineffective for neuropathic pain. AEs are a common cause for withdrawal. The nature of AEs was poorly reported, and AE reporting should be improved in future randomized controlled trials. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Family history of alcohol use problems is a reliable determinant of alcohol use and problems in the population at large, but findings are inconsistent when this issue is examined in college and university students. No quantitative summary of this literature has been reported to date. The purpose of this study was to conduct a meta-analysis on the effects of family history on substance use and abuse in college and university students. Methods A two-group contrast meta-analysis was conducted to evaluate the differences in substance use and abuse between family history-positive and -negative students pursuing higher education. The studies that contributed data to this meta-analysis were conducted in five countries, with the majority of studies from the United States. A total of 65 published papers (53 samples) contributed data from 89 766 participants attending university or college. Effect sizes were coded for alcohol consumption, problems and use disorder symptoms, as well as other illegal drug use and abuse. Two independent coders calculated effect sizes and coded descriptive content about the papers, and discrepancies were reconciled. Family history was used as the grouping variable. Results Family history had a minimal effect on alcohol consumption, with stronger effects on alcohol consequences (Cohen's d: 0.21-0.25), alcohol use disorder symptoms (Cohen's d: 0.24) and other drug involvement (Cohen's d: 0.37-0.86). Conclusions Relative to students without a family history of alcohol problems, students with positive family histories do not drink more, but may be at greater risk for difficulties with alcohol and drugs. [ABSTRACT FROM AUTHOR]

Aim To review the effects of bioimpedance spectroscopy (BIS) to measure dry weight (DW) in haemodialysis (HD) patients when compared to clinical examination. Methods The review was conducted according to the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MasARI). Meta-analysis was performed using Review Manager 5 software. The search was limited to English language papers published from 2005 to 2017. A standard JBI three-step search strategy was used. We searched all quantitative studies from major databases for investigations of the BIS for measuring DW in HD patients. Results A total of four randomised controlled trials (RCTs) met the inclusion criteria. These studies all involved patients with end-stage kidney disease (ESKD) receiving HD and the comparison of BIS versus physician's clinical judgement using cardiovascular parameters and mortality outcomes. The meta-analysis of BIS when compared with clinical judgement found no significant differences in the reduction of the mortality rate, hospitalisation rate or other cardiovascular parameters after 12 months of the intervention; only significant improvement in pre-dialysis systolic BP (WMD -5.41, 95% CI -9.00 to -1.82; p=0.003) was reported. However, individual RCTs found that BIS is an effective intervention for HD patients in the reduction of the mortality rate (HR 0.100, 95% CI, 0.013 to 0.805; p=0.04) after 2.5 years of the intervention. Conclusion The small number of participants and restricted participant selection criteria all has considerable impact with regard to generalising these findings to wider HD populations. [ABSTRACT FROM AUTHOR]

Objective: In a non-athletic population, to (1) investigate the effectiveness of high-intensity interval training in an aquatic environment (A-HIIT) on aerobic performance, strength, and body composition and (2) report on safety of this approach. Method: A systematic search was undertaken of six databases until May 2018. Trials were eligible for inclusion if they compared the effect of A-HIIT in a non-athletic population with a control group that received no exercise training. Data were extracted independently by two reviewers and meta-analyses were undertaken using a random effects model to produce standardized mean difference (SMD) and 95% confidence intervals (CIs). Risk of bias was assessed using Cochrane's risk of bias tool. All studies were graded using Physiotherapy Evidence Database (PEDro) and Consensus for Exercise Reporting Template (CERT) scales to determine quality of reporting. Results: Eight studies reported over 13 papers met study criteria (n = 377). Compared with a control group, those who completed a program of A-HIIT demonstrated greater aerobic performance (SMD 0.69 (95% CI 0.39–0.98); I2 = 0%; n = 191) and lower limb muscle strength (SMD 0.30 (95% CI 0.04–0.56); I2 = 0%; n = 237). No differences were seen in measures of body composition or the number of adverse events. All studies were at risk of performance bias. The (mean ± SD) PEDro and CERT scores were 4.9 ± 1.5 and 15.1 ± 2.1, respectively. Conclusion: In a non-athletic population, A-HIIT was safe and may have improved aerobic performance and lower limb strength. The exercise interventions were well described and monitoring and reporting of exercise intensity in water was feasible. [ABSTRACT FROM AUTHOR]

Aims and Objectives: Research examining the effectiveness of resistance band exercises for improving physical and psychological dimensions among frail older adults has been inconsistent. We aimed to examine the effects of resistance band exercises for improving outcomes in frail older adults. Background: To provide robust evidence regarding the effectiveness of resistance band exercises and explore other potential outcomes in frail older adults, a systematic review of RCTs remains necessary. Design: Systematic literature review and meta‐analysis were conducted in accordance with the PRISMA guidelines. Methods: Four databases were searched. English language papers were retrieved from 2006 to 2020. Three reviewers reviewed the methodology of the selected studies using the Joanna Briggs Institute tool for randomised controlled trials. The pooled standardised mean difference was calculated using a random‐effects model. Heterogeneity among pooled studies was assessed using the τ2, Q and I2 statistics, and publication bias was evaluated using Egger's test and the visual inspection of funnel plots. Results: A total of 15 studies met the eligibility criteria for this study. Overall, resistance band exercise reduced frailty after 24 weeks (SMD: −0.29; 95% CI: −0.55 to −0.03) and reduced depression after both 12 weeks (SMD: −0.19; 95% CI: −0.38 to −0.01) and 24 weeks (SMD: −0.30; 95% CI: −0.52 to −0.09). However, no significant effects were observed for frailty after 12 weeks, and no significant effects were observed for grip strength, leg strength, activities of daily living or quality of life at any time. Conclusion: Resistance band exercise might be considered a viable strategy for frail older adults in the community or in long‐term care facilities. More research implementing a standardised protocol remains necessary to identify the effects of different training volumes and the dose–response relationship for the very old and frail population. Relevance to clinical practice: As a safe complementary intervention for frail older adults, health providers should consider resistance band exercises when caring for frail older adults because this intervention has clinical benefits. [ABSTRACT FROM AUTHOR]

Background: Hamstrings neuromuscular function is a crucial component of functional movement, and changes after anterior cruciate ligament (ACL) injury contribute to risk factors for secondary injury and long-term sequelae. To effectively treat muscular impairments, an accurate understanding of hamstrings neuromuscular function in patients with ACL reconstruction (ACLR) is needed. Objective: A systematic review and meta-analysis were undertaken to describe and quantify hamstrings neuromuscular function in individuals with ACLR compared to controls. Methods: We searched PubMed, Web of Science, SPORTDiscus, CINAHL, and EBSCOhost databases in October of 2020 for studies evaluating the difference between hamstrings electromyography (EMG) between individuals with ACLR and controls. Two independent reviewers assessed each paper for inclusion and quality. Means and standard deviations were extracted from each included study to allow random-effect size (ES) meta-analysis calculations for comparison of results. Results: Thirty-four studies were included for final review. From these, 5 categories of neuromuscular outcomes were identified, and studies were grouped accordingly: (1) muscle activation levels (EMG amplitude), (2) co-activation, (3) onset timing, (4) electromechanical delay, and (5) time-to-peak activity. Moderate to strong evidence indicates that individuals with ACLR demonstrate higher hamstrings EMG amplitude (normalized to % maximum voluntary isometric contraction) and hamstrings-to-quadriceps co-activation during gait and stair ambulation compared to controls. In addition, there was moderate evidence of longer electromechanical delay during knee flexion and greater hamstrings-to-quadriceps co-activation during knee extension compared to controls. Conclusions: Greater hamstrings EMG amplitude and co-activation during gait and ambulation tasks and longer electromechanical delay of the hamstrings in individuals with ACLR align with clinical impairments following ACLR and have implications for re-injury risk and long-term joint health, thus warranting attention in rehabilitation. [ABSTRACT FROM AUTHOR]

To systematically review studies assessing (1) psychometric properties of the maximal oxygen uptake (VO2max) test in PD, (2) VO2max levels in persons with PD (pwPD) compared to healthy controls (HCs), and (3) reported VO2max associations in PD. Six databases were searched. Descriptive data synthesis was used to summarize psychometric properties and reported VO2max associations. The VO2max means and test end-criteria were calculated using linear mixed models. Simple linear regression was used for associations. The review included 25 studies. Psychometric properties of the VO2max test, reported in one study, showed intraclass correlations of 0.90–0.94 for VO2max. Thirteen studies reported test end-criteria, with only mean respiratory exchange ratio (on medication) and percentage of predicted maximal heart rate (off medication) fulfilling standardized minimum values for the VO2max test. The VO2max was comparable between pwPD and HC as well as between different PD-medication states. Associations between VO2max and age, sex, and fatigue were reported. In mildly to moderately affected pwPD, limited evidence exists on the psychometric properties of the VO2max test and end-criteria were sparsely reported. Surprisingly, VO2max was comparable between pwPD and HC as well as between different PD-medication states, and only age, sex, and fatigue were associated with VO2max. In mildly to moderately affected persons with PD (pwPD), only one study has examined psychometric properties of the VO2max test, reporting excellent test–retest reliability. A general lack of consistency on how to measure and report VO2max end-criteria was observed, but when reported, the end-criteria were most often not met. No difference was found in VO2max between mildly to moderately affected pwPD and HC, or between pwPD across different medication states. The identified negative association between VO2max and fatigue suggests aerobic exercise as a potential symptomatic treatment of fatigue when rehabilitation professionals are treating pwPD. [ABSTRACT FROM AUTHOR]