Search

Background: In recent years, some studies classified patients with sepsis and predicted their mortality by using some evaluation scales. Several studies reported significant differences in the predictive values of several tools, and the non‐uniformity of the cut‐off value. Aim: To determine and compare the prognostic accuracy of Sequential Organ Failure Assessment (SOFA) score, Modified Early Warning Score (MEWS), and Systemic Inflammatory Response Syndrome (SIRS) criteria in predicting the mortality of patients with sepsis. Methods: This study comprised of systematic literature review and meta‐analysis according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. We searched PubMed, Embase, Web of Science and Cochrane Library databases from their establishment to July 31, 2022. The research articles published in the index journals provide sufficient data (true positive, false positive, true negative, and false negative results) for patients with sepsis. The combined sensitivity and specificity of the 95% confidence interval (CI) were calculated using the bivariate random effect model (BRM). The hierarchical overall subject working characteristics (HSROC) curve was drawn to evaluate the accuracy of the overall prognosis. Results: Data of 55 088 patients from 32 studies were included in this meta‐analysis. SOFA had an intermediate sensitivity of 0.73 (95% CI: 0.67–0.78) and a specificity of 0.70 (0.63–0.76). SIRS criteria had the highest sensitivity of 0.75 (0.66–0.82) and the lowest specificity of 0.40 (0.29–0.52). MEWS had the lowest sensitivity of 0.49 (0.40–0.59) and the highest specificity of 0.82 (0.78–0.86). Conclusions: Among SOFA, MEWS, and SIRS criteria, SOFA showed moderate sensitivity and specificity for predicting mortality in patients with sepsis, the highest sensitivity of SIRS and the strongest specificity of MEWS for predicting mortality in patients with sepsis. The future research direction is to combine the relevant indicators of MEWS and SIRS to develop a measurement tool with high reliability and validity. Relevance to clinical practice: The review provides useful insights into the prognostic accuracy of different assessment tools in predicting mortality in sepsis patients, which will help clinicians choose the most appropriate tool for early identification and treatment of sepsis. The findings may also contribute to the development of more accurate and reliable prognostic models for sepsis. [ABSTRACT FROM AUTHOR]

Background: Traumatic brain injuries (TBIs) are one of the leading causes of death or long‐term disability around the world. As a result of improvements in supportive care, patients are surviving more severe insults with more pronounced dependency on their families, hospitals, and long‐term care facilities. The introduction of brain tissue oxygenation (PbtO2) monitoring aims to recognize episodes of reduced cerebral perfusion with and without associated increased intracranial pressure (ICP). Aim: The aim of this review is to determine the impact of PbtO2 on the Glasgow Outcome Scale/Glasgow Outcome Scale Extended (GOS/GOSE) in patients with moderate to severe TBI. Study Design: Systematic review with narrative and meta‐analysis. All original research in which adult patients undergoing PbtO2 were compared with a control group of traditional ICP/cerebral perfusion pressure (CPP) monitoring. Both randomized controlled trials and observational studies were included in this review. Methods: Databases were searched in September 2022. The primary outcome of the review was the impact of PbtO2 monitoring on GOS/GOSE, while secondary outcomes were mortality and length of stay (LOS) in the intensive care unit (ICU). Results: Seven studies with a combined number of 770 patients were included in the review. These patients were adults ≥16 years of age. Only two of the studies included found a statistically significant association between PbtO2 monitoring and improved long‐term neurological outcomes in patients with TBI (p =.01, p <.01). A meta‐analysis of the secondary outcomes identified an associated reduction of mortality in favour of the group treated with PbtO2 monitoring (p <.0001). Results from studies examining LOS in ICU have demonstrated an associated increase of LOS in ICU in patients treated with PbtO2‐guided therapy. Conclusion: From the studies included in this review, only two found a statistically significant association between PbtO2 monitoring and long‐term outcomes. It is unclear whether PbtO2 goal‐directed therapy has a positive impact on the long‐term neurological functions and mortality of patients suffering from TBI. A multicentre randomized controlled trial may provide further evidence, but not necessarily conclusive. Relevance to Clinical Practice: Further research is warranted to determine the efficacy of the introduction of this new monitoring system to guide local policy change. [ABSTRACT FROM AUTHOR]

Background: Delirium is the most common psychiatric diagnosis in the intensive care unit (ICU), and 55%‐80% of delirium cases are unrecognized and undocumented the most popular validated instruments available to diagnose delirium for critically ill patients are the Confusion Assessment Method for the ICU (CAM‐ICU). [Correction added on 16 October 2024, after first online publication: The Background section in Abstract has been added in this version.] Aim: To identify the validity and predictability of the confusion assessment method for the intensive care unit (CAM‐ICU) for delirium in critically ill patients in the ICU. Study Design: In this systematic review, PubMed, Embase, Cochrane Central Register of Controlled Trials, and MEDLINE databases were searched for observational studies investigating delirium screening tools for ICU patients. In the meta‐analysis, we combined the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) of SROC to analysis the predictive value of CAM‐ICU. Results: Twenty‐nine articles met the inclusion criteria. The pooled sensitivity and specificity values were 0.82 (95% confidence interval [CI]: 0.75–0.87) and 0.95 (95% CI: 0.93–0.97), respectively. The AUC point estimate of the SROC curve was 0.96 (95% CI: 0.94–0.97). Race (Asian or Others) could affect the pooled sensitivity and specificity, and the analysis method (Patient‐ or Scan‐based) and study design were not sources of heterogeneity for pooled sensitivity and specificity. Conclusions: The CAM‐ICU is a valid and reliable tool for delirium prediction among ICU patients. When introducing CAM‐ICU to assess delirium, it is necessary to localize its language and content to improve its predictive efficacy in different countries and different ethnic groups. Relevance to Clinical Practice: In clinical practice, nurses can use CAM‐ICU to evaluate delirium in critically ill patients in ICU. However, it is necessary to debug the language and content according to the application population. [ABSTRACT FROM AUTHOR]

This study estimated the social and economic costs of body dissatisfaction and appearance-based discrimination (specifically, weight and skin-shade discrimination) in the United States (USA) in the 2019 calendar year. We used a prevalence-based approach and a cost-of-illness method to estimate the annual cost of harmful appearance ideals for cases of body dissatisfaction and discrimination based on weight and skin shade. Impacts on conditions/illnesses such as eating disorders that are attributable to body dissatisfaction, weight discrimination and skin-shade discrimination were identified through a quasi-systematic literature review, which captured financial, economic, and non-financial costs. For each impact attributable to body dissatisfaction or appearance-based discrimination, annual health system and productivity costs (or labor market costs) were primarily estimated by using a population attributable fraction methodology. Only direct costs that resulted from body dissatisfaction and appearance-based discrimination were included (for example, costs associated with conditions such as depression attributable to body dissatisfaction or appearance-based discrimination). In contrast, indirect costs (e.g. costs associated with a health condition developed following skin bleaching, which was undertaken as a result of body dissatisfaction) were not included. In 2019 body dissatisfaction incurred $84 billion in financial and economic costs and $221 billion through reduced well-being. Financial costs of weight discrimination and skin-shade discrimination were estimated to be $200 billion and $63 billion, respectively, and reduced well-being was estimated to be $206.7 billion due to weight discrimination and $8.4 billion due to skin-shade discrimination. Sensitivity testing revealed the costs likely range between $226 billion and $507 billion for body dissatisfaction, between $175 billion and $537 billion for skin-shade discrimination, and between $126 billion and $265 billion for weight discrimination. This study demonstrates that the prevalence and economic costs of body dissatisfaction and weight and skin-shade discrimination are substantial, which underscores the urgency of identifying policy actions designed to promote prevention. Plain English Summary: Appearance ideals in the USA have been widely critiqued for placing unfair burden on people of color and women of all race/ethnicity groups, but little is known about the economic consequences of biased appearance standards. To attain a comprehensive understanding of the economic impact of these harmful appearance ideals on the US economy, we estimated the one-year financial, economic and non-financial costs to the economy caused by body dissatisfaction, weight discrimination, and skin-shade discrimination. We considered a wide range of costs, including costs to the healthcare system, workplace, and other costs for individuals, households, employers, and government. We found that the impact of harmful appearance ideals on the USA economy is substantial. In 2019 body dissatisfaction incurred $84 billion in financial and economic costs and $221 billion through reduced well-being. Financial costs of weight discrimination and skin-shade discrimination were estimated to be $200 billion and $63 billion, respectively, and reduced well-being was estimated to be $207 billion due to weight discrimination and $8 billion due to skin-shade discrimination. Women of all race/ethnicity groups bore the bulk of the burden, shouldering 58% of the costs for body dissatisfaction and 66% for weight discrimination. Women bore 50% of the costs for skin-shade discrimination. These costs are substantial and underscore the urgency of identifying effective policy actions to reduce the damaging effects of harmful appearance ideals. [ABSTRACT FROM AUTHOR]

Objective: Cancer-related cognitive impairment involves changes in cognitive domains among people diagnosed with cancer. This review aimed to explore and synthesize the experiences of women with breast cancer disclosing cancer-related cognitive impairment symptoms to health professionals. Methods: A systematic review and meta-synthesis was conducted to generate synthesized findings from existing literature. Six databases were searched from inception until mid-October 2022, with eligible studies appraised using the QualSyst Quality Assessment Checklist. Results: Three synthesized findings were generated from eight included studies. Findings highlight that women initiated conversations disclosing symptoms and frequently experienced dismissal or minimization from health professionals. Women rarely received information about cognitive impairment symptoms before treatment. Women reported that health professionals could be more involved in managing cognitive impairment symptoms. Conclusion: This meta-synthesis highlights the importance of health professionals providing information before treatment and following up on cognitive impairment symptoms. [ABSTRACT FROM AUTHOR]

Background: Maintaining optimal hearing health and preventing ear infections is crucial across all life stages, spanning from before birth and infancy to middle age and beyond. The primary aim of the research was to evaluate and compare the effectiveness of the telemedicine-enabled otoscope (TEO) in diagnosing ear diseases with that of the conventional otoscope. Materials and Methods: The databases PubMed, Cochrane, and Embase were thoroughly searched to find original studies on TEO at the community as well as hospital levels along with meta-analysis for comparison with standard diagnostic methods using traditional otoscopes. Results: The telemedicine-equipped otoscope displays a sensitivity of 82% (confidence interval 0.78-0.95) and a specificity of 95% (confidence interval 0.93-0.96). When employed by physicians, the combined sensitivity and specificity become 84% (confidence interval 0.79-0.88) and 91% (confidence interval 0.87-0.94), respectively. Community Health Workers (CHWs) using telemedicine-enabled otoscopes exhibit a collective sensitivity of 80% (confidence interval 0.72-0.87) and a collective specificity of 97% (confidence interval 0.95-0.98). Snapping multiple photographs and removal of cerumen where necessary in increasing the quality of the photographs for diagnosis. Conclusions: The TEO holds the promise of substantially enhancing the accessibility of audiology services, encompassing evaluation, public outreach, and fundamental care. Its implementation has the potential to fortify primary health care environments, contributing to the prevention of ear diseases and assisting in mitigating the shortage of skilled ear care professionals. [ABSTRACT FROM AUTHOR]

Background: Information about the chikungunya disease burden by age groups and geographic distribution is necessary to guide appropriate control measures. With this, we conducted a systematic review and meta-analysis to estimate the disease burden of chikungunya fever in India. Material and Methods: We conducted this systematic review according to the Cochrane Collaboration guidelines. We retrieved relevant articles from PubMed and a free online search. Two investigators screened titles and abstracts and extracted data from the relevant articles. Our primary outcome is the proportion of laboratory-confirmed Chikungunya fever among clinically suspected patients. We used a random effect model to estimate the pooled proportion of Chikungunya fever. Result: A total of 20 articles were included in the quantitative syntheses. The pooled proportion of laboratory-confirmed chikungunya fever from 20 studies estimated using the random effects model is 24% (95%CI: 15-34%). We found the pooled proportion in the southern region was 35% (95%CI: 4-66%), 28% (95%CI: 3-58%) in the western region, 24% (95%CI: 1-48%) in the eastern region, 20% (95%CI: 12-29%) in the northern region, and 4% (95%CI: 1-6%) in North-eastern region. Conclusion: This review emphasizes the need to strengthen the surveillance of disease burden using multiple diagnostic tests and the need for an appropriate molecular diagnostic for early detection of the chikungunya virus. [ABSTRACT FROM AUTHOR]

There is a growing focus on understanding the role of the male microbiome in fertility issues. Although research on the bacterial communities within the male reproductive system is in its initial phases, recent discoveries highlight notable variations in the microbiome's composition and abundance across distinct anatomical regions like the skin, foreskin, urethra, and coronary sulcus. To assess the relationship between male genitourinary microbiome and reproduction, we queried various databases, including MEDLINE (available via PubMed), SCOPUS, and Web of Science to obtain evidence-based data. The literature search was conducted using the following terms "gut/intestines microbiome," "genitourinary system microbiome," "microbiome and female/male infertility," "external genital tract microbiome," "internal genital tract microbiome," and "semen microbiome." Fifty-one relevant papers were analyzed, and eleven were strictly semen quality or male fertility related. The male microbiome, especially in the accessory glands like the prostate, seminal vesicles, and bulbourethral glands, has garnered significant interest because of its potential link to male fertility and reproduction. Studies have also found differences in bacterial diversity present in the testicular tissue of normozoospermic men compared to azoospermic suggesting a possible role of bacterial dysbiosis and reproduction. Correlation between the bacterial taxa in the genital microbiota of sexual partners has also been found, and sexual activity can influence the composition of the urogenital microbiota. Exploring the microbial world within the male reproductive system and its influence on fertility opens doors to developing ways to prevent, diagnose, and treat infertility. The present work emphasizes the importance of using consistent methods, conducting long-term studies, and deepening our understanding of how the reproductive tract microbiome works. This helps make research comparable, pinpoint potential interventions, and smoothly apply microbiome insights to real-world clinical practices. [ABSTRACT FROM AUTHOR]

AIM The aimof this study was to analyze nursing student level of knowledge and understanding of current experiences of Indigenous people within the Canadian health care system to identify curricular gaps that need to be addressed. BACKGROUND In response to the 2015 Truth and Reconciliation Commission of Canada, nursing schools have begun incorporating Indigenous health content into curricula. However, few studies about the implementation and effectiveness of this education exist. METHOD Students wrote a reflection and engaged with colleagues' reflections after watching a video from the Aboriginal Peoples Television Network. Fifteen reflections were selected using systematic, random sampling to undergo thematic analysis. RESULTS Two themes were identified: 1) students' understanding of barriers Indigenous populations face when accessing the health care system and 2) students' perceptions of strategies to ensure culturally safe care for Indigenous populations. CONCLUSION Analysis of students' learning through a reflection activity can improve the Indigenous health content curriculum. [ABSTRACT FROM AUTHOR]

AIM This scoping study aimed to identify the applications for VoiceThread in nursing education. BACKGROUND VoiceThread can facilitate collaboration through asynchronous sharing of presentations, images, and videos. To date, no knowledge synthesis exists to inform nurse educators' use of this technology. METHOD Using the Updated Methodological Guidance for the Conduct of Scoping Reviews, relevant published articles and gray literature were identified through a standardized search and selection process, followed by data synthesis. RESULTS Thirty-two sources described applications including student presentations, asynchronous discussions, case studies, and instructor lectures. VoiceThread iswell accepted by students and faculty with few barriers to its use. There is limited scientific rigor in studies that measured efficacy; most sources did not evaluate the efficacy of VoiceThread. CONCLUSION Considering its many applications, more evidence is needed about the effectiveness of VoiceThread in nursing education. [ABSTRACT FROM AUTHOR]

AIM The aim of this systematic review was to evaluate the effectiveness of using objective structured clinical examinations (OSCEs) and standardized patient (SP) simulations in family nurse practitioner (FNP) education to increase students' knowledge and skill competency. BACKGROUND Many programs use OSCE and SP simulation, but there is limited empirical data demonstrating their effectiveness for Kirkpatrick's level of learning. METHODA systematic search of published and unpublished literature was conducted in seven databases/registries in February 2023. Quantitative, experimental studies and quasi-experimental studies with comparison and explicit FNP learner population were included. RESULTS Of 4,442 records, zero studies met the inclusion criteria. Some studies with eligible designs investigated different populations (e.g., acute care nurse practitioner, prelicensure students). CONCLUSION The absence of included studies in this systematic review upholds the established need for continued investigation and can be used to support funding opportunities addressing this critical gap in nursing education science. [ABSTRACT FROM AUTHOR]

Background: Sublime is a centuries old concept of emergent experience arising from immense and threatening awareness provoked by overwhelming fear and dread when faced with an incomprehensible situation as is common to autistic people. Extended Reality (XR) technologies have been used since the mid-1990s, in regulating emotions, behaviour and supporting social skill development for autistic people. Aims: To understand utility of XR technologies in creating immersive experiences for autistic people to alleviate anxiety and the relationship to the sublime. Method: A State of the Art literature review and narrative synthesis was conducted. PubMed, CINAHL, EMBASE, Cochrane Library, Scopus, Web of Science were searched with terms Autism AND Technology. In addition, fields of digital technologies and wellbeing, digital art and mental health, generative arts and the sublime were explored through web searches of grey literature, conversations with digital designers and explorations of extended reality platforms. No time limits were placed. Searches were done in English. Papers were screened and shortlisted using the inclusion criteria applied by two reviewers. Results: Fifty-eight papers/articles met the preliminary inclusion criteria for in-depth review of which 31 were found suitable for the narrative synthesis related to XR technologies and sublime experiences as related to autistic people. Narrative synthesis lent itself to four themes that is current utility of XR Technologies in autism, the impact of immersive experiences on Behavioural, phenomenological and biological markers of autistic people, the Benefits of increased sensory stimulation using XR on autism and an inquiry into the potential of the sublime for autism. Conclusions: Mixed reality environments that experiment with a broad range of XR technologies including incorporating notions of the sublime, might be beneficial in reducing emotional dysregulation and improving social development in autistic people especially if co-designed with them. [ABSTRACT FROM AUTHOR]

Background: Decreasing suicide mortality has become an overarching goal for societies worldwide. Suicide registers and other monitoring systems are a valuable source of information that can be used for addressing the suicide phenomenon and evaluating preventative interventions. Aims: This scoping review provides an overview of literature published in the last decade that has focussed on the operations (functioning) and characteristics of suicide registers and other suicide monitoring systems. Methods: Four electronic databases were searched in 2020 for identifying published material from January 2010 to October 2020. The searches were updated in October 2023 to include material from 2020 to date. Grey literature through Google searches and mental health commissions websites and the reference lists of selected documents were also searched. Results: Twenty-five articles were included in this review. Nearly half the articles were from the United States, followed by Australia. Nine countries were identified as having used suicide registers or suicide-specific monitoring systems to inform suicide prevention. Monitoring mechanisms varied across the countries examined. No article provided evidence that definitively linked suicide registers or other monitoring systems for suicide with the prevention of suicide or reduction in suicide rates. However, a variety of benefits of suicide monitoring for preventative and public health interventions were identified. Conclusions: The number of nations with surveillance systems for suicide prevention is low. Further, there is a lack of consistency in the systematic collection, analysis and interpretation of suicide-related information across the countries examined. Efforts to establish high-quality suicide surveillance systems that can be accessed in a timely and easy manner are needed to inform tailored strategies for suicide prevention. [ABSTRACT FROM AUTHOR]

Background: The literature indicates an increasing interest in the mental health of refugees (R) and asylum seekers (AS) – particularly how it could be affected by previous exposure to trauma and violence – but less has been written about the issues they are forced to face during the post-migration period and how these also can affect mental health. Research shows that the mental health of R/AS is highly influenced by their post-migration conditions and may deteriorate due to post-migration social health-related determinants; in addition, a lack of language skills, discrimination, separation from family, poverty, and other stressors can contribute to social isolation. The difficulty in asking for help in case of psychological distress and, consequently, in accessing care, contributes to the worsening of their clinical condition. Aims: The primary purpose of this study is to identify and provide a review of the clinical tools used to screen migrants (R/AS) at risk of developing psychological distress, identifying post-migration difficulties. Methods: We searched studies in PubMed, Embase, Scopus, Cochrane (Central), and Cinahl (ultimate) with the last search on 14 April 2023, using a combination of keywords and Medical Subject Headings (MeSH). Results: Our systematic search identified 1,878 records. After removing duplicates, we screened 1,238 records by title and abstract, retaining 97 for full text review. Of these, 68 met full eligibility criteria (1995–2023). A total of 30 social scales have been identified, as well as structured or semi-structured questionnaires and interviews. Translated into multiple languages, the tools can be self-administered or administered by trained professionals. PMLD is known for its effectiveness in evaluating the post-migration period and predicting mental health issues. Conclusions: Considering the limited number of studies and, consequently, the limited number of tools found, it can be inferred that not enough attention is given to post-migration in the broader sense. [ABSTRACT FROM AUTHOR]

Background: Some physiotherapists find assessing and managing clients experiencing psychological distress challenging and are uncertain regarding the boundaries of the profession's scope. Objective: To map the approaches recommended for physiotherapists in scholarly literature, with respect to the assessment and management of clients experiencing psychological distress. Methods: A systematic mapping review was conducted. CINAHL, APA PsycINFO, Embase, and Medline ALL databases were systematically searched for secondary and tertiary literature relevant to the research objective. Recommended approaches were extracted from each article and analyzed descriptively and thematically. Results: 3884 records were identified with 40 articles meeting the inclusion/exclusion criteria. Most recommendations related to identifying, assessing, and managing pain-related distress, with depression screening and referral also receiving some attention. Three approaches to detecting and assessing psychological distress were identified: 1) brief depression screen; 2) integrated suicide/nonsuicidal self-harm and depression screen; and 3) multidimensional screen and health-related distress assessment. Regarding the management of psychological distress the main approaches identified were: 1) education and reassurance; 2) cognitive-behavioral approaches; 3) mindfulness; and 4) case management. Conclusion: While assessment and management of health-related distress by physiotherapists is commonly recommended, further guidance is needed to differentiate various forms of distress. [ABSTRACT FROM AUTHOR]

The present study has two main goals: to conduct a systematic review of musculoskeletal injuries experienced by badminton players, and to examine the management of such injuries. Searches were conducted of the PROSPERO, PubMed, Scopus, and SPORTDiscus databases, from their inception until March 2023. The papers analysed were all based on a study population consisting of individuals aged 18 years or more, diagnosed with badminton-related injuries. The methodological quality assessments was using the Newcastle-Ottawa Scale and REVMAN. A total of 28 studies were included in the systematic review. In total, the analysis included 2435 participants. Of these athletes, 35.6% (1012) were female and 64.4% (1503) were male. By type of injury, sprains were the most commonly studied and the most prevalent, accounting for 36.06% of the sample. These were followed by muscle injuries, representing 23.86% of the total. Injuries to the joints were the least prevalent, accounting for 4.97% of the sample. Lower limb injuries accounted for 52.15% of the total. Of these, ankle injuries were the most common. Despite the generally low quality of the studies considered, the evidence suggests that musculoskeletal injuries, especially to the lower limb, most commonly affect badminton players of all levels. [ABSTRACT FROM AUTHOR]

This study verified the relationship between internal load (IL) and external load (EL) and their association on injury risk (IR) prediction considering machine learning (ML) approaches. Studies were included if: (1) participants were male professional soccer players; (2) carried out for at least 2 sessions, exercises, or competitions; (3) correlated training load (TL) with non-contact injuries; (4) applied ML approaches to predict TL and non-contact injuries. TL included: IL indicators (Rating of Perceived Exertion, RPE; Session-RPE, Heart Rate, HR) and EL indicators (Global Positioning System, GPS variables); the relationship between EL and IL through index, ratio, formula; ML indicators included performance measures, predictive performance of ML methods, measure of feature importance, relevant predictors, outcome variable, predictor variable, data pre-processing, features selection, ML methods. Twenty-five studies were included. Eleven addressed the relationship between EL and IL. Five used EL/IL indexes. Five studies predicted IL indicators. Three studies investigated the association between EL and IL with IR. One study predicted IR using ML. Significant positive correlations were found between S-RPE and total distance (TD) (r = 0.73; 95% CI (0.64 to 0.82)) as well as between S-RPE and player load (PL) (r = 0.76; 95% CI (0.68 to 0.84)). Association between IL and EL and their relationship with injuries were found. RPE, S-RPE, and HR were associated with different EL indicators. A positive relationship between EL and IL indicators and IR was also observed. Moreover, new indexes or ratios (integrating EL and IL) to improve knowledge regarding TL and fitness status were also applied. ML can predict IL indicators (HR and RPE), and IR. The present systematic review was registered in PROSPERO (CRD42021245312). [ABSTRACT FROM AUTHOR]

Background: Many morphological and histological changes take place in aging skin. Topical tretinoin is the gold standard anti-aging agent used to reduce signs of aging through stimulation of epidermal growth and differentiation and inhibition of collagenase. Objective: The aim of this systematic review is to summarize studies evaluating the efficacy of tretinoin compared with other topical medications and cosmeceuticals in reducing the appearance of skin aging. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. The literature search was conducted using the PubMed and Embase databases from conception to December 2023. Studies were included if they compared anti-aging outcomes of topical medications with those of topical tretinoin (also called all-trans retinoic acid and retinoic acid). Studies were excluded if they compared non-topical anti-aging treatments with tretinoin or were conducted on animal models. Results: The literature search resulted in 25 studies that met all inclusion and exclusion criteria. The most common study comparators to tretinoin included other forms of vitamin A. Outcomes were reported on the basis of visual reduction of aging signs, histological assessment of the epidermis and dermis, and protein expression. Although comparators to tretinoin had variable efficacy (greater in 7 studies, equivalent in 13 studies, and less in 3 studies), most studies found the comparator to be less irritating and better tolerated by patients than tretinoin. Discussion: Tretinoin is currently the gold standard therapy for the treatment of photoaging, but its poor tolerability often limits its use. Unfortunately, given that most studies comparing topical therapies with tretinoin are of poor quality and/or demonstrate bias, there is a lack of substantial evidence to support an alternative first-line therapy. However, given there are some data to support the efficacy of retinoid precursors, namely retinaldehyde, pro-retinal nanoparticles, and conjugated alpha-hydroxy acid and retinoid (AHA-ret), these agents can be considered a second-line option for anti-aging treatment in patients who cannot tolerate tretinoin. [ABSTRACT FROM AUTHOR]

Unloader braces are a treatment modality for medial compartment knee osteoarthritis. The functional mechanisms involved are not yet fully understood. Therefore, this two-part systematic review examines the following research questions: How is muscle activation altered by medial compartment knee osteoarthritis, and do medial tibiofemoral compartment unloader braces alter muscle activation? If so, could this alteration be part of the unloading mechanism by affecting the altered muscle activity in medial compartment knee osteoarthritis? A systematic literature search was conducted using PubMed, LIVIVO, Web of Science, Google Scholar, and CENTRAL for articles published until August 2023. The first systematic review, examining neuromuscular alterations, identified 703 articles, with a final inclusion of 20. The second systematic review, which evaluated the neuromuscular effects of unloader braces, identified 123 articles with the final inclusion of 3. Individuals with medial compartment knee osteoarthritis demonstrated increased activity and co-contraction of the periarticular knee muscles, whereas medial tibio-femoral compartment unloader braces seemed to reduce activity and co-contraction. In contrast to the belief that unloader braces result in muscle weakness as they decrease muscle activity and co-contraction, our limited insights indicate that they rather might reduce the pathological increase. This may result in joint load reduction due to lower compressive forces. However, further investigation is required. [ABSTRACT FROM AUTHOR]

The purpose of this scoping review was to identify existing strategies to reduce modifiable risk factors for musculoskeletal (MSK) injury in adaptive athletes. Medline, Embase, Web of Science, and CINAHL were searched. Inclusion criteria required studies written in English, samples of adaptive athletes, and evaluation of any injury prevention programs that would reduce risk factors associated with MSK injury. The literature search resulted in 785 unique articles. Thirty-two full text articles were screened for inclusion. Four studies of wheelchair basketball and wheelchair rugby injury prevention programs were included in the final analysis, and these studies demonstrated increase in shoulder range of motion, decreased shoulder pain, and decreased cumulative traumatic disorders; all of which was proposed to reduce risk of shoulder injury. However, these studies were small and did not include control groups. Future research is needed to implement programs that reduce risk factors of MSK injuries and reduce health disparities for adaptive athletes. [ABSTRACT FROM AUTHOR]

Objective: To provide a strong foundation for the use of high-intensity laser therapy in carpel tunnel syndrome, we conducted a systematic review and meta-analysis to investigate the outcomes of short- and long-term follow-up studies. Design: This is a systematic review and meta-analysis. Results: Sample sizes of included studies ranged from 16 to 98 patients (N = 308). Overall, a significant difference between the treatment and control groups were found across majority of the measures. Studies using a 4-wk follow-up period, however, only found significantly greater benefits for high-intensity laser therapy in visual analog scale compared with placebo (P = 0.0191), transcutaneous electrical nerve stimulation (P = 0.0026), and low-intensity laser therapy 20 J/cm2 (P < 0.0002), and exercise (P < 0.0001). For improvement in visual analog scale score over a long treatment period, high-intensity laser therapy was also preferred over control group (P < 0.0071). Insufficient evidence exists to determine effect of high-intensity laser therapy on nerve conduction examinations. The only statistically significant differences observed in examinations were in relation to sensory nerve action potential (P = 0.0083) and sensory nerve conduction velocity (P = 0.0468). Conclusions: Moderate evidence exists regarding efficacy of high-intensity laser therapy compared with placebo, high-intensity laser therapy + wrist splint, and exercise in a short period of follow-up time but evidence on long-term follow-up is limited. [ABSTRACT FROM AUTHOR]

Objective: To analyze the effects on pain and disability recovery after a whiplash of a guided neck-specific exercise therapy, compared to a different or an unguided neck-specific exercise therapy. Design: A literature search was conducted from inception to May 31, 2023, in three electronic databases: PubMed, ScienceDirect, and Web of Science. Eleven randomized controlled trials were included. Metaanalyses were performed with Review Manager software. The standardized mean difference with a 95% confidence interval was used to measure the effect sizes and only short-term time points were considered. Results: Not all studies reported a significant decrease of pain and disability in the neck-specific exercise group compared to controls. However, meta-analyses demonstrated a significantly greater decrease in neck pain (standardized mean difference: −0.25; 95% confidence interval: [−0.38, −0.12]; P=0.0002) and neck-disability index (standardized mean difference: −0.35; 95% confidence interval: [−0.54, −0.15]; P=0.0005) in the neck-specific exercise group. Conclusions: In addition to the benefits that a guided neck-specific exercise therapy has on motivation and program adherence, it provides greater benefits in pain and disability than a different or unguided neck-specific exercise therapy. Positive results are observed primarily with intervention periods of more than 6 wks and at least two sessions per week. [ABSTRACT FROM AUTHOR]

Objectives: Previous evidence suggests that bisphosphonates (BPs) may lower the risk of recurrent fractures and enhance functional recovery in patients with fractures. However, there has been controversy regarding the optimal timing of treatment initiation for patients with fragility fractures. We conducted a meta-analysis to evaluate the available evidence on the use of BPs during the perioperative period and compared it to both non-perioperative periods and non-usage. Methods: Electronic searches were performed using PubMed, EMBASE, Web of Science and the Cochrane Library published before February 2023, without any language restrictions. The primary outcomes included fracture healing rate, healing time, and new fractures. We also examined a wide range of secondary outcomes. Random effects meta-analysis was used. Results: A total of 19 clinical trials involving 2543 patients were included in this meta-analysis. When comparing patients with non-perioperative BPs use in 4-6 weeks and approximately 10-12 weeks post-surgically, the overall risk ratios (RRs) of perioperative BPs use for healing rate were 1.06 (95% CI: 0.81, 1.38, p=0.69) and 1.02 (95% CI: 0.94, 1.11, p=0.65), respectively, suggesting no difference in healing rate between perioperative and non-perioperative BP initiation. For healing time, the overall mean difference between perioperative and non-perioperative periods was -0.19 week (95% CI: -1.03, 0.64, p=0.65) at approximately 10-12 weeks, indicating no significant impact of perioperative BP initiation on healing time. In terms of new fractures, the overall RR with BP use was 0.35 (95% CI: 0.17-0.73, p=0.005), when compared to patients without BPs use. This suggests a protective impact of BP use against new fractures compared to patients without BP use. Perioperative BP use was associated with a markedly higher likelihood of having adverse experiences, including fever (RR: 23.78, 95% CI: 8.29, 68.21, p< 0.001), arthralgia (RR: 10.20, 95% CI: 2.41, 43.16, p=0.002), and myalgia (RR: 9.42, 95% CI: 2.54, 34.87, p< 0.001), compared with non-BPs use. Conclusions: Treatment with BP during the perioperative period does not affect the healing process and has positive effects on therapy for patients with fragility fractures. These compelling findings underscore the potential efficacy of BP use during the perioperative period as a viable treatment option for patients with fragility fractures. [ABSTRACT FROM AUTHOR]

The importance of osteoporosis assessment before lumbar surgery is well recognized. The MRI-based Vertebral Bone Quality (VBQ) score is introduced to evaluate bone quality; however, its diagnostic value has not been well documented. The purpose of this meta-analysis was to summarize the diagnostic value of the VBQ score for osteoporosis or osteopenia in patients undergoing lumbar surgery. We comprehensively searched electronic databases for studies exploring the diagnostic accuracy of the VBQ score for osteoporosis/osteopenia in patients with lumbar disease following the PRISMA guidelines. The quality of the included studies was assessed. The VBQ scores were compared between the groups, and the pooled sensitivity, specificity, and summary receiver operating characteristic (ROC) were calculated. Publication bias was assessed, and meta-regression was conducted. We included 17 studies with a total of 2815 patients, with a mean age of 66.4 years and a percentage of females of 72.5%. According to the QUADAS-2 tool, the quality of the included studies was relatively high. The results showed a significantly higher VBQ score in the osteoporosis/osteopenia group compared with the control group. According to the mean VBQ cutoff value of 3.02 ± 0.38 for the diagnosis of osteoporosis, the pooled sensitivity and specificity were 0.76 and 0.74, respectively, and the AUC was 0.81. According to the mean VBQ cutoff value of 2.31 ± 0.18 for the diagnosis of osteopenia, the pooled sensitivity and specificity were 0.78 and 0.58, respectively, and the AUC was 0.76. The MRI-based VBQ score could provide useful information for identifying patients with low bone mass who need further evaluation. Future prospective studies are still needed to evaluate the complementary role of the VBQ score. [ABSTRACT FROM AUTHOR]

Background: Self‐harm in children and young people is increasing. Parents are vital in supporting young people; however, parents may experience distress linked to the self‐harm. Previous reviews have highlighted the emotional impact and need for information and support, however, have not elucidated the relationships between these themes, nor examined the quantitative data examining parents' well‐being. Methods: We conducted a mixed methods review, with qualitative meta‐synthesis focusing on links between themes and quantitative synthesis of parental well‐being findings, including pooled means. PsycInfo, Medline, EMBASE, AMED, CINHAL and Web of Science were searched to identify relevant records. References of included studies were also searched. Every abstract was screened by two authors. Data were extracted by one author and checked by another. Results: We identified 39 reports of 32 studies: 16 with qualitative data and 17 with quantitative data (one had both). Qualitative findings showed how parents' emotions were associated to their knowledge and beliefs about self‐harm. Parents' emotions often evidenced the need to self‐care, but emotions of guilt reduced engagement in self‐care. How parents supported their young person was linked to their knowledge, and the management of their own emotions, and influenced if they could engage in self‐care. Quantitative findings were mixed, however suggested poor general mental health amongst these parents. Conclusions: Further good quality quantitative studies are needed, with measurement of psychological mechanisms that may underpin parental distress. Current evidence supports peer‐support and interventions that go beyond information provision to address the connected factors of knowledge, emotion, self‐care, and parenting behaviours. [ABSTRACT FROM AUTHOR]

Objective: Studies using proton magnetic resonance spectroscopy reveal substantial inconsistencies in the levels of brain glutamate, glutamine and glutamate + glutamine across schizophrenia spectrum disorders. This systematic review employs qualitative and quantitative methods to analyse the patterns and relationships between glutamatergic metabolites, schizophrenia spectrum disorders and brain regions. Methods: A literature search was conducted using various databases with keywords including glutamate, glutamine, schizophrenia, psychosis and proton magnetic resonance spectroscopy. Inclusion criteria were limited to case-control studies that reported glutamatergic metabolite levels in adult patients with a schizophrenia spectrum disorder diagnosis – i.e. first-episode psychosis, schizophrenia, treatment-resistant schizophrenia and/or ultra-treatment-resistant schizophrenia – using proton magnetic resonance spectroscopy at 3 T or above. Pooled study data were synthesized and analysed. Results: A total of 92 studies met the inclusion criteria, including 2721 healthy controls and 2822 schizophrenia spectrum disorder participants. Glu levels were higher in the basal ganglia, frontal cortex and medial prefrontal of first-episode psychosis participants, contrasting overall lower levels in schizophrenia participants. For Gln, strong differences in metabolite levels were evident in the basal ganglia, dorsolateral prefrontal cortex and frontal cortex, with first-episode psychosis showing significantly higher levels in the basal ganglia. In glutamate + glutamine, higher metabolite levels were found across schizophrenia spectrum disorder groups, particularly in the basal ganglia and dorsolateral prefrontal cortex of treatment-resistant schizophrenia participants. Significant relationships were found between metabolite levels and medication status, clinical measures and methodological variables. Conclusion: The review highlights abnormal glutamatergic metabolite levels throughout schizophrenia spectrum disorders and in specific brain regions. The review underscores the importance of standardized future research assessing glutamatergic metabolites using proton magnetic resonance spectroscopy due to considerable literature heterogeneity. [ABSTRACT FROM AUTHOR]

How do play and playfulness contribute to adult mental health? We evaluated empirical evidence from 20 psychological interventions through a lens emphasizing playfulness in participants and playing processes as a putative change agent. We found (1) preliminary evidence supporting play as a causal agent of positive changes in adult mental health, likely via two mechanisms—as a mediator and as a medium, and (2) limited, unclear evidence surrounding the moderating effect of participant playfulness on intervention effectiveness. Our findings highlight the need for more rigorous quantitative assessment of play-related processes and health outcomes, and a clearer trait-state distinction when examining playfulness as an intervention outcome. We call for greater theoretical integration and a more holistic, developmentally-sensitive approach, emphasizing understanding boundary-crossing change mechanisms to harness play's transformative, therapeutic power for improving adult health and wellbeing. [ABSTRACT FROM AUTHOR]

Background Assessment for vitamin C deficiency (VCD) is rarely undertaken in an acute hospital setting in high-income countries. However, with growing interest in VCD in community settings, there is emerging evidence investigating the prevalence and impact of VCD during hospitalization. Objectives In this scoping review, the prevalence of VCD in adult hospitalized patients is explored, patient characteristics are described, and risk factors and clinical outcomes associated with VCD are identified. Methods A systematic scoping review was conducted in accordance with the PRISMA-ScR framework. The Ovid MEDLINE, Ovid Embase, Scopus, CINAHL Plus, Allied and Complementary Medicine Database, and the Cochrane Library databases were searched for interventional, comparative, and case-series studies that met eligibility criteria, including adult hospital inpatients in high-income countries, as defined by the Organization for Economic Co-operation and Development, that reported VCD prevalence using World Health Organization reference standards. These standards define VCD deficiency as plasma or serum vitamin C level <11.4 µmol/L, wholeblood level <17 µmol/L, or leukocytes <57 nmol/108 cells. Results Twenty-three articles were included, representing 22 studies. The cumulative prevalence of VCD was 27.7% (n = 2494; 95% confidence interval [CI], 21.3-34.0). High prevalence of VCD was observed in patients with severe acute illness and poor nutritional status. Scurvy was present in 48% to 62% of patients with VCD assessed in 2 studies (n = 71). Being retired (P  = 0.015) and using excessive amounts of alcohol and tobacco (P  = 0.0003) were independent risk factors for VCD (n = 184). Age was not conclusively associated with VCD (n = 631). Two studies examined nutrition associations (n = 309); results were inconsistent. Clinical outcomes for VCD included increased risk of frailty (adjusted odds ratio, 4.3; 95%CI, 1.33–13.86; P  = 0.015) and cognitive impairment (adjusted odds ratio, 2.93; 95%CI, 1.05–8.19, P  = 0.031) (n = 160). Conclusions VCD is a nutritional challenge facing the healthcare systems of high-income countries. Research focused on early identification and treatment of patients with VCD is warranted. Systematic Review Registration Open Science Framework (https://doi.org/10.17605/OSF.IO/AJGHX). [ABSTRACT FROM AUTHOR]

Context Diabetes is a global health concern, and diet is a contributing factor to diabetes. Findings regarding the connection between nitrate, nitrite, and nitrosamine and diabetes risk are inconsistent. Objective The aim was to examine the effects of these dietary compounds on diabetes risk. Data Sources The data were sourced from PubMed, EMBASE, Scopus, and Web of Science until February 28, 2023. Studies that reported individual-level consumption of these compounds were included. Review articles or ecological studies were excluded. Data Extraction The number of events and total observations were recorded. Data Analysis The pooled odds ratio (OR) was calculated and displayed in a forest plot. Subgroup and sensitivity analyses were predefined. A dose–response meta-analysis was conducted to determine the exposure intervals that may increase the risk of disease. Six observational reports that met the inclusion criteria were included, involving 108 615 individuals. Participants in the highest quantile of nitrite intake had a greater risk of diabetes compared with those in the lowest quantile (OR, 1.61; 95% confidence interval [CI], 1.08–2.39; I2 = 74%, P = 0.02). Higher nitrosamine consumption tended to increase diabetes risk (OR, 1.52; 95% CI, 0.76–3.04; I2 = 76%; P = 0.24). The relationship was stronger for type 1 (OR, 1.79; 95% CI, 1.20–2.67; I2 = 58%; P < 0.01) than for type 2 diabetes (OR, 1.42; 95% CI, 0.86–2.37; I2 = 71%; P = 0.17). Additionally, nitrite consumption had a dose-dependent association with both phenotypes. No association was found between diabetes risk and high nitrate intake (OR, 1.01; 95% CI, 0.87–1.18; I2 = 28%; P = 0.87). Conclusion Attention should be paid to the consumption of nitrite-containing foods. Systematic Review Registration PROSPERO registration no. CRD42023394462 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=394462). [ABSTRACT FROM AUTHOR]

Context Poor anthropometric data quality affect the prevalence of malnutrition and could harm public policy planning. Objective This systematic review and meta-analysis was designed to identify different methods to evaluate and clean anthropometric data, and to calculate the frequency of implausible values for weight and height obtained from these methodologies. Data Sources Studies about anthropometric data quality and/or anthropometric data cleaning were searched for in the MEDLINE, LILACS, SciELO, Embase, Scopus, Web of Science, and Google Scholar databases in October 2020 and updated in January 2023. In addition, references of included studies were searched for the identification of potentially eligible studies. Data Extraction Paired researchers selected studies, extracted data, and critically appraised the selected publications. Data Analysis Meta-analysis of the frequency of implausible values and 95% confidence interval (CI) was estimated. Heterogeneity (I 2) and publication bias were examined by meta-regression and funnel plot, respectively. Results In the qualitative synthesis, 123 reports from 104 studies were included, and in the quantitative synthesis, 23 studies of weight and 14 studies of height were included. The study reports were published between 1980 and 2022. The frequency of implausible values for weight was 0.55% (95%CI, 0.29–0.91) and for height was 1.20% (95%CI, 0.44–2.33). Heterogeneity was not affected by the methodological quality score of the studies and publication bias was discarded. Conclusions Height had twice the frequency of implausible values compared with weight. Using a set of indicators of quality to evaluate anthropometric data is better than using indicators singly. Systematic Review Registration PROSPERO registration no. CRD42020208977. [ABSTRACT FROM AUTHOR]

Context The safety and efficacy of nutritional management for pressure injuries (PIs) have been the subjects of ongoing interest. Some evidence demonstrated that nutrition is essential for skin and tissue viability, supporting tissue repair for healing the pressure injury. Objective This investigation aimed to systematically review clinical practice guidelines (CPGs) for the nutritional management of PIs and furnish an evidence map to assess research trends and CPG gaps. Methods The PubMed, Embase, and guidelines databases, and society websites were searched for CPGs for the nutritional management of PIs. The basic recommendations for the nutritional management of PIs, method quality, and reporting CPGs quality were identified and imported into Excel. Four researchers independently elucidated each CPG's quality via the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist. All bubble charts were generated using Excel software. Results This review included 12 CPGs with a combined 23 recommendations. The nutrition screening and assessment were summarized on the basis of the PI recommendations for 6 major items, 12 items on nutrition management, and 3 on PI education. The assessed CPGs had mixed quality, and the highest score  ± standard deviation based on the clarity of presentation was 83.46 ± 7.62, whereas the lowest mean score based on AGREE II applicability was 53.31 ± 16.90. Field 1 (basic information) in the RIGHT checklist had the greatest reporting rate (68.06%), whereas field 5 (review and quality assurance) had the lowest CPGs quality (41.67%). Conclusion This investigation furnishes an evidence map and provides new perspectives on the CPGs for the nutritional management of PIs. However, the CPGs included still need improvement, especially in the applicability and editorial independence domains. [ABSTRACT FROM AUTHOR]

Context Polyphenols are plant-based compounds with potential anti-inflammatory, antioxidant, and anti-obesogenic properties. However, their effects on health outcomes remain unclear. Objective To evaluate the effects of polyphenols on anthropometric and cardiometabolic markers. Data Sources Six electronic databases—namely, EMBASE, CINAHL, PubMed, Scopus, The Cochrane Library (reviews only), and Web of Science—were searched for relevant systematic reviews with meta-analyses (SRMAs). Data Extraction Three reviewers performed the data extraction via a data-extraction Microsoft Excel spreadsheet. Data Analysis An umbrella review and meta-analysis of existing SRMAs was conducted. Eighteen SRMAs published from 2015 to 2023, representing 445 primary studies and 838 unique effect sizes, were identified. Meta-analyses were conducted using random-effects models with general inverse variance. Polyphenol-containing foods were found to significantly improve weight (-0.36 kg; 95% confidence interval [CI]: −0.62, 0.77 kg; P  < 0.01, I 2 = 64.9%), body mass index (−0.25 kg/m2; 95% CI: −0.34, −0.17 kg/m2; P  < 0.001, I 2 = 82.4%), waist circumference (−0.74 cm; 95% CI: −1.34, −0.15 cm; P  < 0.01, I 2 = 99.3%), low-density-lipoprotein cholesterol (−1.75 mg/dL; 95% CI: −2.56, −0.94; P  < 0.001, I 2 = 98.6%), total cholesterol (−1.23 mg/dL; 95% CI: −2.00, −0.46; P  = 0.002, I 2 = 94.6%), systolic blood pressure (−1.77 mmHg; 95% CI: −1.77, −0.93 mmHg; P  < 0.001, I 2 = 72.4%), diastolic blood pressure (−1.45 mmHg; 95% CI: −2.09, −0.80 mmHg; P  < 0.001, I 2 = 61.0%), fat percentage (−0.70%; 95% CI: −1.03, −0.36%; P  < 0.001, I 2 = 52.6%), fasting blood glucose (−0.18 mg/dL; 95% CI: −0.35, −0.01 mg/dL; P  = 0.04, I 2 = 62.0%), and C-reactive protein (CRP; including high-sensitivity-CRP [hs-CRP]) (−0.2972 mg/dL; 95% CI: −0.52, −0.08 mg/dL; P  = 0.01, I 2 = 87.9%). No significant changes were found for high-density-lipoprotein cholesterol (−0.12 mg/dL; 95% CI: −1.44, 0.69; P  = 0.67, I 2 = 89.4%) and triglycerides (−1.29 mg/dL; 95% CI: −2.74, 0.16; P  = 0.08, I 2 = 85.4%). Between-study heterogeneity could be explained by polyphenol subclass differences. Conclusion The findings of this umbrella review support the beneficial effects of polyphenols on anthropometric and metabolic markers, but discretion is warranted to determine the clinical significance of the magnitude of the biomarker improvements. Systematic Review Registration International Prospective Register of Systematic Reviews no. CRD42023420206. [ABSTRACT FROM AUTHOR]

High concentrations of immunoglobulins, bioactive peptides, and growth factors are found in bovine colostrum (BC), the milk produced by cows in the first few days after parturition. Various biological functions make it increasingly used to provide nutritional support and immune protection to the offspring of many species, including humans. These biological functions include cell growth stimulation, anti-infection, and immunomodulation. The primary components and biological functions of colostrum were reviewed in the literature, and the authors also looked at its latent effects on the growth and development of neonates as well as on conditions such as infections, necrotizing enterocolitis, short bowel syndrome, and feeding intolerance. The importance of BC in neonatal nutrition, immune support, growth and development, and gut health has been demonstrated in a number of experimental and animal studies. BC has also been shown to be safe at low doses without adverse effects in newborns. BC supplementation has been shown to be efficient in preventing several disorders, including rotavirus diarrhea, necrotizing enterocolitis, and sepsis in animal models of prematurity and some newborn studies. Therefore, BC supplementation should be considered in cases where maternal milk is insufficient or donor milk is unavailable. The optimal age, timing, dosage, and form of BC administration still require further investigation. [ABSTRACT FROM AUTHOR]

Context The impact of unhealthy foods and beverages, namely those high in sugar, salt, and saturated or trans fats, has been studied extensively in relation to weight, body composition, and noncommunicable diseases, but less so in relation to the risk of dental caries. Few previous reviews have examined the evidence from all countries globally. Objective A systematic review was conducted to assess the impact of unhealthy food and beverage consumption on the risk of dental caries in children aged ≤10 years, commissioned by the World Health Organization to inform updated complementary feeding recommendations. Data Sources Systematic searches were conducted in the PubMed, Cochrane, and Embase databases for articles meeting the inclusion criteria dating from January 1971 to March 2022; supplementary searches were undertaken for articles from that period to June 2022. Data Extraction Unhealthy foods and beverages were identified using nutrient- and food-based approaches. Risk of bias was assessed using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I). Data Analysis A total of 30 023 unique citations were screened, yielding 37 studies for inclusion. Studies were conducted in high-income (n = 23 [62.2%]) or middle-income countries (n = 14 [37.8%]). Evidence synthesis was performed narratively, stratified by age (0 years to <2 years, 2 years to <5 years, and 5 years to ≤10 years) and exposure (unhealthy foods and unhealthy beverages). The heterogeneity of the exposures and comparators across studies was high. Almost all studies (n = 34) reported positive associations between the consumption of sugar-sweetened beverages or foods high in free sugars and dental caries. However, 67.6% of studies were assessed as having serious risk of bias. Conclusion The evidence indicates that the consumption of unhealthy food and beverages in children ≤10 years appears to increase the risk of dental caries. Further longitudinal studies with high-quality dietary assessments, including studies in low-income countries and children aged >5 years at baseline, are recommended in order to build a more robust evidence base for use in the development of policy recommendations. Systematic Review Registration PROSPERO registration no. CRD42020218109. [ABSTRACT FROM AUTHOR]

Context Ramadan fasting (RF) is associated with various physiological and metabolic changes among fasting Muslims. However, it remains unclear whether these effects are attributable to changes in meal timing or changes in dietary energy and macronutrient intakes. Furthermore, the literature on the associations between RF, meal timing, and energy and macronutrient intakes is inconclusive. Objectives This systematic review aimed to estimate the effect sizes of RF on energy and macronutrient intakes (carbohydrates, protein, fats, dietary fiber, and water) and determine the effect of different moderators on the examined outcomes. Data Sources The Cochrane, CINAHL, EMBASE, EBSCOhost, Google Scholar, PubMed/MEDLINE, ProQuest Medical, Scopus, ScienceDirect, and Web of Science databases were searched from inception to January 31, 2022. Data Extraction The studies that assessed energy, carbohydrate, protein, fat, fiber, and water intakes pre- and post-fasting were extracted. Data Analysis Of the 4776 identified studies, 85 relevant studies (n = 4594 participants aged 9–85 y) were selected. The effect sizes for the studied variables were as follows: energy (number of studies [K] = 80, n = 3343 participants; mean difference [MD]: −142.45; 95% confidence interval [CI]: −215.19, −69.71), carbohydrates (K = 75, n = 3111; MD: −23.90; 95% CI: −36.42, −11.38), protein (K = 74, n = 3108; MD: −4.21; 95% CI: −7.34, −1.07), fats (K = 73, n = 3058; MD: −2.03; 95% CI: −5.73, 1.67), fiber (K = 16, n = 1198; MD: 0.47; 95% CI: −1.44, 2.39), and water (K = 17, n = 772; MD: −350.80; 95% CI: −618.09, 83.50). Subgroup analyses showed age significantly moderated the 6 dietary outcomes, and physical activity significantly moderated water intake. There were significant reductions in energy, carbohydrate, and protein intakes during RF. Conclusions The change in meal timing rather than quantitative dietary intake may explain various physiological and health effects associated with RF. [ABSTRACT FROM AUTHOR]

Aims High diet quality is related to better health outcomes in general. During pregnancy, a high-quality diet is of paramount importance to promote optimal maternal and neonatal outcomes. This is a scoping review of research available on diet quality indexes (DQIs) for use during pregnancy that summarizes the DQIs in terms of development, country of origin, population used, components, scoring and weighting of components, and evaluation. Furthermore, the DQIs are discussed narratively to inform and direct the development of improved and country-specific DQIs for pregnancy. Methods The EBSCOhost database was used to identify English-language, peer-reviewed articles published between 2000 and 2023, from which 11 publications were identified that describe the development of pregnancy-specific DQIs. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews model. Results Almost all DQIs (n = 9 of 11) were developed in high-income countries, using dietary intake data from food frequency questionnaires. Several DQIs (n = 5 of 11) used the US Healthy Eating Index as basis and modified it in various ways. Almost all DQIs included both foods and nutrients as components (n = 9 of 11), with vegetables being the most commonly included component alone (n = 8 of 11) or combined with fruit (n = 2 of 11). Conclusion Because most DQIs were developed using dietary guidelines, recommendations, and dietary intake data from high-income countries, it is recommended that pregnancy-specific DQIs be developed and validated to reflect the nutrition guidelines for lower-income and culturally diverse countries. [ABSTRACT FROM AUTHOR]

Context There are contradictory findings about the relationship between various animal protein sources and the risk of gestational diabetes mellitus (GDM). Objective The purpose of our study was to understand better the associations between total protein, animal protein, and animal protein sources and the risk of developing GDM. Data Sources A systematic literature search was conducted in PubMed, Scopus, and Web of Science encompassing the literature up until August 2022. A random-effects model was used to combine the data. For estimating the dose–response curves, a one-stage linear mixed-effects meta-analysis was conducted. Data Extraction Data related to the association between animal protein consumption and the risk of GDM in the general population was extracted from prospective cohort studies. Data Analysis It was determined that 17 prospective cohort studies with a total of 49 120 participants met the eligibility criteria. It was concluded with high certainty of evidence that there was a significant association between dietary animal protein intake and GDM risk (1.94, 95% CI 1.42 to 2.65, n = 6). Moreover, a higher intake of total protein, total meat, and red meat was positively and significantly associated with an increased risk of GDM. The pooled relative risks of GDM were 1.50 (95% CI: 1.16, 1.94; n = 3) for a 30 g/d increment in processed meat, 1.68 (95% CI: 1.25, 2.24; n = 2) and 1.94 (95% CI: 1.41, 2.67; n = 4) for a 100 g/d increment in total and red meat, and 1.21 (95% CI: 1.10, 1.33; n = 4) and 1.32 (95% CI: 1.15, 1.52; n = 3) for a 5% increment in total protein and animal protein, respectively. GDM had a positive linear association with total protein, animal protein, total meat consumption, and red meat consumption, based on non-linear dose–response analysis. Conclusion Overall, consuming more animal protein–rich foods can increase the risk of GDM. The results from the current study need to be validated by other, well-designed prospective studies. Systematic Review Registration PROSPERO registration no. CRD42022352303. [ABSTRACT FROM AUTHOR]

Purpose: A scoping review of randomized controlled trials (RCTs) of parenting and family-based interventions that aim to reduce severe and persistent conduct problems among 10–17 year-olds. The review also examined feasibility for conducting a network meta-analysis of common therapy elements measured by RCTs. Materials and methods: The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA- ScR). Searches were conducted in ERIC, PsycINFO, and MEDLINE without limits on publication year, language or publication country. Study methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for RCTs. Results: Twenty-five eligible RCTs were identified. The studies trialed nine interventions, with Multisystemic Therapy (MST) being the most evaluated (N = 10), followed by Functional Family Therapy (FFT, N = 4), and Treatment Foster Care Oregon (TFCO, N = 3). Only 10 of the 25 RCTs revealed treatment effect on conduct problems, including 6 of 9 MST, 1 of 4 FFT and all 3 TFCO trials. Discussion: Surprisingly few RCTs of parenting and family-based interventions have been carried out exclusively with this population. Available data suggests that MST and FFT have uncertain effectiveness for reducing severe and persistent conduct problems. While the quality of the reviewed studies was generally high, only two reported substantive data on common therapy elements. Conclusion: There is need for more RCTs of parenting and family-based interventions delivered for older children and adolescents with severe and persistent conduct problems. Future RCTs should systematically measure common therapy elements with a view to advancing intervention science. [ABSTRACT FROM AUTHOR]

The advancement of health apps and wearables has garnered substantial academic attention, particularly in examining why individuals decide to use or not use them. In response to the extensive body of research on this topic, we conducted a scoping review of 61 articles published from 2007 to 2022, aiming to examine the dominant theoretical frameworks and antecedents of health apps and wearables use. The findings demonstrated that the dominant theoretical frameworks within this domain were rooted in the human-computer interaction theories, notably the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology. Next, our review identified four levels of antecedents: technological, individual, societal, and policy. At the technological level, emphasis was placed on functionality, reliability, and technological infrastructure. Individual antecedents encompassed socio-demographics, personality traits, cognitive responses to benefits and risks, emotional and affective responses, self-efficacy, and digital literacy. Societal antecedents highlighted the role of social networks and social norms, while policy antecedents elaborated on laws, regulations, and guidelines that encouraged health technology adoption. Our discussion illuminated that the evolving trend of theoretical frameworks in health apps and wearables use research, initially rooted in human-computer interaction, is progressively moving toward more comprehensive perspectives. We further underscored the importance of delving into societal and policy antecedents, which often are overshadowed by the more commonly discussed technological and individual factors. In conclusion, we advocated for a multi-stakeholder collaborative network approach, as this would enable communication researchers to understand the use of health apps and wearables more comprehensively. [ABSTRACT FROM AUTHOR]

Problematic integration theory is a theory in communication that deals with the processing of messages by humans. It is helpful to study challenges and their solutions in the health communication context to develop effective relationships, treat patients, and, ultimately, ensure the well-being of society. A scoping review was conducted. Three databases were searched following the PRISMA‐ScR statement without a time frame. Independent screening of titles, abstracts, and full texts was performed, and the studies selected based on the inclusion and exclusion criteria were assessed. The required information was then extracted from the studies and entered into Excel software. A total of 43 studies related to PI theory were identified in the databases. The results indicated that PI theory is used to interpret feelings, beliefs, challenges, concerns, and problematic dilemmas in five thematic categories: elderly care, cancer care, infertility, pregnancy, and childbirth care, illness care, and sexual care. Each of the papers also offers distinctive and valuable considerations for interventions such as communication strategies, coping mechanisms, uncertainty and certainty management, information management, education, training, support groups, and campaigns to improve decision-making and meet the challenges of health communication. [ABSTRACT FROM AUTHOR]

The internet has revolutionized how we live, providing unprecedented convenience and up-to-date information. Consequently, an increasing number of individuals are turning to the internet for health-related information, despite research suggesting a correlation between this behavior and health anxiety. Therefore, drawing on cognitive – behavioral theory, we explore the link between online health information seeking and health anxiety via a systematic review and meta-analysis of cross-sectional studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-analysis, we ran searches in multiple databases, including PubMed, Web of Science, Embase, Elsevier/Science Direct, Cochrane Database, China National Knowledge Infrastructure, VIP Chinese Database, and Wanfang Data. Our searches identified 16 studies eligible for review, involving 4,920 participants across seven countries. The random-effects meta-analysis revealed a significant positive correlation between online health information seeking and health anxiety (r = 0.28, 95% confidence interval [0.16, 0.41], p <.0001), despite considerable heterogeneity. Furthermore, meta-regression analysis demonstrated that the identity characteristics of the sample, female percentage, sample size, and country all contributed to the heterogeneity across studies. Overall, this meta-analysis provides support for the association between online health information seeking and health anxiety, and helps to elucidate the cognitive – behavioral theory underpinning this phenomenon. [ABSTRACT FROM AUTHOR]

Research has demonstrated that multilingual exposure does not inherently impede language development or academic achievement in autistic children. Nevertheless, autistic students who are multilingual learners may experience unique challenges in the United States, where systemic barriers constrain both the diagnosis and the delivery of education. This review synthesizes 46 US-based studies to assess how educational and, to a lesser extent, medical systems are (or are not) prepared to offer adequate support to autistic individuals from multilingual families. Results reveal varied patterns of systemic inequity faced by multilingual children on the autism spectrum, elucidating the issues of disproportionality as well as unequal access to educational and medical resources. While the majority of studies emphasize the benefits of multilingual environments for autistic students, a persistent trend in favor of monolingual instructional strategies remains. Despite this, emerging publications present experimental evidence that drawing on students' first languages can bolster academic and behavioral performance and strengthen executive functioning. Research has found that autistic children can navigate multilingual schools and communities without harming their language skills or school success. However, they may encounter specific challenges within the United States, where educational and healthcare systems are insufficiently equipped to meet their needs. This review examined 46 US-based studies on the topic and findings reveal persistent deficit-based ideas about multilingualism and autism (e.g., professionals recommending that autistic students only speak and learn in English) accompanied by patterns of unequal identification of autism among multilingual children. These findings highlight issues of disproportionality and inadequate access to educational and healthcare resources. However, recent studies indicate that incorporating a child's native language in education not only enhances learning and behavioral outcomes but also boosts cognitive functions like problem-solving and planning. Taken as a whole, current research suggests that intentionally addressing linguistic diversity will allow educational and medical systems to better serve autistic children. [ABSTRACT FROM AUTHOR]

Our goal was to systematically identify, appraise and synthesise the qualitative research on parents' experiences of the autism assessment process. The empirical studies were quality appraised using the Critical Appraisal Skills Programme tool. We synthesised the data using a meta-synthesis approach. Parents' experiences were categorised into four phases namely: the pre-identification phase, the identification process, emotional reactions to the identification of the children as autistic and the post-identification phase. Informed by the social and human rights discourse on disability, we provide recommendations for future research, respecting the rights of all concerned. We discuss the implications of this review for future research into the autism assessment process. Parents consistently mentioned the importance of professional communication and we make recommendations for research on parent–professional partnerships. Given the sensitivities of the issues, we draw attention to ethical considerations when conducting research on the autism assessment process. Finally, we address the strategies that professionals can adopt in applying neurodiversity-affirmative approaches when identifying autistic children and supporting their parents. Hearing about parents' experiences of having their child recognised as autistic could help improve the supports offered to parents. Our article may also help guide future research on this topic. We made a list of the type of research that interested us. We searched the studies already completed, only studying the research that matched our interests. After reading the studies, we rated their quality using the Critical Appraisal Skills Programme tool. It became clear that parents went through four phases during the identification process. The first phase occurred before their child was identified as autistic. The second involved the actual assessment of their child. Parents' emotional reactions to the news were the focus of the third phase. The final phase occurred after their child was identified as autistic. We discuss the findings of our research. As there are sensitivities involved in conducting research on this topic, we identify how researchers can ensure that their research is of the best quality. We are committed to respecting the human rights of all involved, so we emphasise the need for professionals to develop good relationships with the parents of autistic children. Researchers have recently come to see autism as typical of human diversity. We encourage the professionals involved to adopt this understanding of autistic children and make practical suggestions to enable them to do so. [ABSTRACT FROM AUTHOR]

Many autistic people are unemployed. Of those who are employed, many are in roles that do not reflect their skills, qualifications and/or capabilities, and little is known about how autistic people progress throughout their careers. This study aimed to review and synthesise the existing evidence about career progression for autistic people. In total, 33 studies met the criteria for inclusion, though no study directly aimed to explore the topic. Our findings suggest that underemployment is common within the autistic population. Indirectly, we identified several potential barriers and facilitators of career progression for autistic people. Possible barriers included personal (e.g. gaps in education and employment history), relational (e.g. disclosing an autism diagnosis) and organisational factors (e.g. inadequate employment support). Adequate employment support was the most frequently discussed facilitator. Future research should seek to identify the most successful employment supports for autistic people over the long term to ensure that all autistic people are able to live – and work – in ways that are meaningful to them. Lots of autistic people are unemployed. Even when they are employed, autistic people might be given fewer opportunities than non-autistic people to progress in their careers. For example, assumptions about autistic people's differences in social communication might mean they are not given as many promotions. Indeed, we know that many autistic people are in jobs lower than their abilities (known as 'underemployment'). We reviewed 33 studies that tell us something about career progression for autistic people. Our review found that lots of autistic people want to progress in their careers, but there are many barriers in their way. For example, when they told their employer about being autistic, some people were given fewer opportunities. Research has also shown that autistic people do not get enough support to progress and that gaps in their employment history can make it difficult to progress. Our review suggested that good employment support (e.g. mentors) might help autistic people to progress in their careers. However, not much research has evaluated employment support for autistic people, which means we do not know how useful it is. Future research should find the best support that allows autistic people to live and work in ways that are meaningful to them. [ABSTRACT FROM AUTHOR]

Ecological validity refers to the meaningfulness or practical significance of research outcomes in everyday settings or the extent to which an intervention can be implemented by typical people during naturally occurring opportunities. In education, ecological validity may contribute to the adoption of interventions by teachers working with students in school settings. Our purpose in this review was to examine the evidence for ecological validity of functional communication training (FCT) used to address challenging behavior in school-age individuals with disabilities. We reviewed 19 single-case experimental design (SCED) studies published between 1985 and 2023. First, we used the What Works Clearinghouse (WWC) Standards to evaluate the empirical evidence of each study. Second, we evaluated the extent to which behavioral assessment and FCT procedures were described in the 15 studies that met the WWC Standards. Third, we conducted a systematic analysis of the evidence for ecological validity of behavioral assessment and FCT. Results indicate that 95% of the SCED studies met the WWC Standards. The description of procedures was complete for 50% of the behavioral assessments and for 11% of the FCT. The overall evidence for ecological validity was moderate for 16.7% and low for 83.3% of the behavioral assessments. The evidence for ecological validity for all FCT procedures was low. Future research and implications related to ecological validity are discussed. [ABSTRACT FROM AUTHOR]

The aim of this qualitative evidence synthesis (QES) is to critically appraise the contemporary literature to gain a comprehensive understanding of the barriers and enablers of workplace integration needs of internationally educated nurses (IENs). An electronic search was conducted across multiple databases, and eligibility criteria were applied to identify papers published between January 2013 and July 2023. Out of the 830 studies initially retrieved, six met the inclusion criteria. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) tool. Thematic analysis of the included studies revealed various barriers and enablers for workplace integration experienced by IENs. Barriers were: (a) IEN-related factors (cultural differences, language barriers, and disparities in the scope of nursing practice), (b) organizational factors (poor leadership), and (c) contextual factors (racism and discrimination). Enablers emerged were: (a) IEN-related factors (commitment to learn and adapt) and (b) organizational factors (structured multifaceted program, supportive workplace environment, and mentorship). Dynamic interaction exists among these factors, therefore interventions should address multiple barriers simultaneously. The QES has illuminated essential factors which impact the integration of IENs, and emphasizes the necessity of a comprehensive approach that considers the diverse challenges and opportunities that arise. [ABSTRACT FROM AUTHOR]

Xylazine, a veterinary sedative, has emerged as a concerning element in the landscape of substance use in the United States. This integrative review synthesizes evidence from a systematic examination of 14 selected studies conducted between 2008 and 2023. The primary objective is to comprehensively understand the epidemiology and prevalence of xylazine use, particularly its involvement in drug-related deaths, regional variations, national impact, co-occurrence with opioids, and challenges associated with detection and intervention. The results underscore stark regional disparities in xylazine prevalence. West Virginia and Miami-Dade County have experienced alarming surges in xylazine-involved drug-related deaths. Nationally, its influence extends beyond regional boundaries, predominantly affecting white males in the Northeast. The co-occurrence of xylazine with opioids, especially fentanyl and heroin, significantly amplifies the risks of fatal overdoses. Detecting xylazine presents formidable challenges due to its frequent presence alongside other substances, necessitating enhanced surveillance and more effective detection methods. User perspectives emerge as pivotal, emphasizing the importance of user-informed harm reduction strategies. In conclusion, this review has significant policy implications. Tailored, region-specific strategies are imperative to address the diverse prevalence of xylazine use. A nationwide response is indispensable, prioritizing harm reduction initiatives, enhanced detection methods, and active user engagement. The multifaceted nature of the xylazine issue requires comprehensive approaches to mitigate its profound risks effectively. Policymakers are urged to consider regional disparities and the co-occurrence of xylazine with opioids when crafting targeted interventions. Immediate, user-informed harm reduction is vital to address the evolving landscape of xylazine use in the United States. [ABSTRACT FROM AUTHOR]

This scoping review explored available research focused on ways emergency women's shelters address substance use issues with survivors of intimate partner violence. Twenty-one studies met the inclusion criteria. The articles tended to identify more barriers (e.g., concerns about safety of all residents and staff) and fewer facilitators (e.g., clear policies to guide practice) to implementing harm reduction within women's shelters. Comprehensive training and education about substance use and harm reduction for shelter staff and residents was suggested for successful implementation. More high-quality evidence is needed to understand the viability of implementing harm reduction in emergency women's shelters. Practice Points: An organizational philosophy supporting harm reduction should be accompanied by appropriate and clear guiding policy and procedures. Staff require adequate training in substance use, intimate partner violence, and harm reduction in order to support women who use substances and are accessing emergency women's shelters. Implement flexible harm reduction approaches that support the needs of women who are using but also balance/consider safety for all residents and staff. Staff should interact with residents in a way that allows residents to feel comfortable and safe discussing their substance use. Harm reduction services and supports should be offered to all residents, whether directly by the shelter, or through referrals to other community organizations. [ABSTRACT FROM AUTHOR]

PROBLEM IDENTIFICATION: Previous reviews have reported the efficacy of acupuncture in managing cancer-related symptoms. However, there is a lack of comprehensive reviews examining how patients' expectancy regarding acupuncture influences treatment outcomes in the context of cancer survivorship. LITERATURE SEARCH: 9 databases were searched for articles published through August 2023. The authors included acupuncture studies that reported on patient expectancy for the effectiveness of acupuncture. DATA EVALUATION: 10 studies were included in this review. Study quality was assessed using the Cochrane risk-of-bias tool and the ROBINS-I (Risk Of Bias In Non-randomised Studies-of Interventions) tool. SYNTHESIS: 5 studies explored the relationship between expectancy and cancer-related outcomes, and in 3, expectancy was significantly associated with reduced pain, frequency of bowel movements, and severity of insomnia. Male and older patients, nonresponders to acupuncture, and those with lower education levels had lower expectancy regarding acupuncture. IMPLICATIONS FOR NURSING: Healthcare providers should assess patient expectancy to comprehensively understand its role in improving acupuncture outcomes. [ABSTRACT FROM AUTHOR]