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Frontiers in Public Health 2021The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing...
The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes. This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects. The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia. The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.
Topics: Humans; Medicine, Chinese Traditional; Mind-Body Therapies; Quality of Life; Tai Ji
PubMed: 34988045
DOI: 10.3389/fpubh.2021.659075 -
PloS One 2016Research in the end-of-life context has explored the sense of dignity experienced by patients with advanced disease, examining the factors associated with it. Whereas... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Research in the end-of-life context has explored the sense of dignity experienced by patients with advanced disease, examining the factors associated with it. Whereas certain perspectives regard dignity as an intrinsic quality, independent of external factors, in the clinical setting it is generally equated with the person's sense of autonomy and control, and it appears to be related to patients' quality of life. This study aims to explore the relationship between perceived dignity, autonomy and sense of control in patients at the end of life.
METHODS
We conducted a systematic review and meta-ethnography using reciprocal translation and line-of-argument synthesis. The search strategy used MeSH terms in combination with free-text searching of the Pubmed, Web of Science, CINAHL, PsycINFO and Cochrane databases, from their inception until 2015. This identified 186 articles, after excluding duplicates. The inclusion criterion was primary qualitative studies in which dignity, autonomy and control at the end of life were explored. Studies were evaluated using the CASP guidelines.
RESULTS
Twenty-one studies recording the experiences of 400 participants were identified. Three themes emerged: a) dignity mediated by the loss of functionality, linked to the loss of control; b) dignity as identity; and c) autonomy as a determining factor of perceived dignity, understood as the desire for control over the dying process and the desire for self-determination. We propose an explanatory model which highlights that those patients with an intrinsic sense of dignity maintained a positive view of themselves in the face of their illness.
CONCLUSION
This synthesis illustrates how dignity and autonomy are intertwined and can be perceived as a multidimensional concept, one that is close to the notion of personal identity. The ability to regard dignity as an intrinsic quality has a positive impact on patients, and the design of care strategies should take this into account.
Topics: Anthropology, Cultural; Humans; Personal Autonomy; Personhood; Qualitative Research; Quality of Life; Right to Die; Suicide, Assisted; Terminal Care
PubMed: 27010323
DOI: 10.1371/journal.pone.0151435 -
Journal of Ethnopharmacology Jan 2024Condyloma acuminatum (CA) is a common sexually transmitted disease. Previous studies using randomized controlled trials (RCTs) have revealed that Paiteling (PTL), a... (Meta-Analysis)
Meta-Analysis
ETHNOPHARMACOLOGICAL RELEVANCE
Condyloma acuminatum (CA) is a common sexually transmitted disease. Previous studies using randomized controlled trials (RCTs) have revealed that Paiteling (PTL), a Chinese patent medicine formula, can effectively relieve CA symptoms. However, the evidence needs to be more cohesive and there is a need for a clear summary of the existing RCTs to assess the overall efficacy and safety profile of PTL.
AIMS OF THE STUDY
This study aimed to conduct a comprehensive review and meta-analysis of RCTs, to examine the efficacy of PTL and physical therapies in CA.
MATERIAL AND METHODS
A literature search was conducted in multiple databases, including PubMed, MEDLINE, Cochrane Library, etc. up to December 1, 2022. Revman 5.4 and Stata 15.0 was used for data statistics and sensitivity analyses.
RESULTS
31 trials with a total of 2868 patients were included in this review. The results showed that PTL plus physical therapies were significantly more effective than physical therapies used alone (RR = 1.60, 95% CI [1.38, 1.86]; P < 0.00001). Subgroup analysis showed that the type of physical therapies, gender, and wart location might be the primary sources of heterogeneity. Additionally, PTL can reduce recurrence rates (RR = 0.27, 95% CI [0.19, 0.39]; P < 0.00001), improve the negative conversion rate of HPV (RR = 1.15, 95% CI [1.02, 1.30]; P = 0.02), and improve immune function. No severe adverse reactions or physical injuries were observed, making it a better choice for women planning to become pregnant.
CONCLUSION
Compared with physical therapies, PTL can effectively eliminate CA symptoms and reduce the recurrence rates with safety ensured. However, due to the heterogeneity and methodological shortcomings, large sample sizes and high-quality rigorous RTCs are still needed to strengthen this clinical evidence.
Topics: Female; Humans; Nonprescription Drugs; Medicine, East Asian Traditional
PubMed: 37517567
DOI: 10.1016/j.jep.2023.116894 -
BMJ Open Nov 2016To assess the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing (TCMN) interventions in Chinese... (Review)
Review
A critical appraisal of the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing interventions: a systematic review of reviews.
OBJECTIVE
To assess the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing (TCMN) interventions in Chinese journals. These interventions include acupressure, massage, Tai Chi, Qi Gong, electroacupuncture and use of Chinese herbal medicines-for example, in enemas, foot massage and compressing the umbilicus.
DESIGN
A systematic literature search for systematic reviews and meta-analyses of TCMN interventions was performed. Review characteristics were extracted. The methodological quality and the quality of the evidence were evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches.
RESULT
We included 20 systematic reviews and meta-analyses, and a total of 11 TCMN interventions were assessed in the 20 reviews. The compliance with AMSTAR checklist items ranged from 4.5 to 8 and systematic reviews/meta-analyses were, on average, of medium methodological quality. The quality of the evidence we assessed ranged from very low to moderate; no high-quality evidence was found. The top two causes for downrating confidence in effect estimates among the 31 bodies of evidence assessed were the risk of bias and inconsistency.
CONCLUSIONS
There is room for improvement in the methodological quality of systematic reviews/meta-analyses of TCMN interventions published in Chinese journals. Greater efforts should be devoted to ensuring a more comprehensive search strategy, clearer specification of the interventions of interest in the eligibility criteria and identification of meaningful outcomes for clinicians and patients (consumers). The overall quality of evidence among reviews remains suboptimal, which raise concerns about their roles in influencing clinical practice. Thus, the conclusions in reviews we assessed must be treated with caution and their roles in influencing clinical practice should be limited. A critical appraisal of systematic reviews/meta-analyses of TCMN interventions is particularly important to provide sound guidance for TCMN.
Topics: Chronic Disease; Evidence-Based Medicine; Humans; Medicine, Chinese Traditional; Practice Guidelines as Topic; Quality Control; Review Literature as Topic
PubMed: 28186925
DOI: 10.1136/bmjopen-2016-011514 -
Pharmaceutical Biology Dec 2023Chaihu Jia Longgu Muli Decoction (CLMD) is a traditional Chinese medicine for treating depression. (Meta-Analysis)
Meta-Analysis Review
Effect-enhancing and toxicity-reducing effects of Chaihu Jia Longgu Muli decoction in the treatment of multimorbidity with depression: a systematic review and meta-analysis.
CONTEXT
Chaihu Jia Longgu Muli Decoction (CLMD) is a traditional Chinese medicine for treating depression.
OBJECTIVE
This study investigated the effect of CLMD combined with antidepressants on multimorbidity with depression (MMD).
METHOD
Published randomized controlled trials were collected from PubMed, Web of Science, Chinese National Knowledge Infrastructure, China Science and Technology Journal, Wanfang and China Biomedical Literature Service System Databases. Participants were divided into study groups (CLMD combined with antidepressants) and control groups (antidepressants). RevMan5.4 software was used for data analysis.
RESULTS
Hamilton's Depression Scale score was significantly lower (MD = -5.62, 95%CI [-5.86, -5.37], < 0.00001), and the effective rate was significantly higher (RR = 1.23, 95%CI [1.17, 1.29], < 0.00001) in study groups. National Institute of Health Stroke Scale score and Pittsburgh Sleep Quality Index score of study groups were significantly lower (MD = -2.82, 95%CI [-3.84, -1.81], < 0.00001; MD = -2.26, 95%CI [-3.19, -1.34], < 0.00001). 5-HT, DA, NE and IL-1β level were significantly lower (SMD = 1.99, = 0.003; SMD = 1.99, < 0.00001; SMD = 0.86, < 0.00001; MD = -14.64, = 0.003) in study groups. Adverse reaction rate in study groups was significantly lower (RR = 0.47, 95%CI [0.24, 0.91], = 0.03). The gastrointestinal tract and autonomic nervous system disorders were reduced in study groups.
DISCUSSION AND CONCLUSIONS
CLMD combined with antidepressants enhances the effect of antidepressants and reduces their adverse reactions, performing a synergistic effect; it may be considered as an effective option in the treatment of MMD.
Topics: Humans; Depression; Medicine, Chinese Traditional; Multimorbidity
PubMed: 37439185
DOI: 10.1080/13880209.2023.2228356 -
Annals of Palliative Medicine Nov 2021This meta-analysis was performed to evaluate the clinical efficacy and safety of Chinese patent medicines in the treatment of subacute thyroiditis (SAT). (Meta-Analysis)
Meta-Analysis
BACKGROUND
This meta-analysis was performed to evaluate the clinical efficacy and safety of Chinese patent medicines in the treatment of subacute thyroiditis (SAT).
METHODS
Chinese databases were searched using a combination of "patent Chinese medicine", "traditional Chinese medicine", "traditional Chinese and western medicine", "sub-thyroiditis", and "subacute thyroiditis". Studies that set Chinese patent medicine treatment of SAT as the experimental group were selected. Then, meta-analysis was performed by RevMan 5.3.
RESULTS
A total of 12 studies were included, and most of them had a high risk of bias (low quality). The heterogeneity test results of clinical efficacy showed that Chi2=6.21, df=7, P=0.52>0.1, and I2=0%<50%. Then, the fixed effects model (FEM) was used, with OR =2.80; 95% confidence interval (CI): 1.89-4.13. The heterogeneity test of recurrence rate showed that Chi2=10.69, df=9, P=0.30>0.1, and I2=16%<50%. The heterogeneity test of erythrocyte sedimentation rate showed that I2=97%, P<0.00001, MD =-10.02; 95% CI: -12.88 to -7.16, and P<0.00001. The heterogeneity test of free triiodothyronine showed that Chi2=500.75, I2=99%>50%, P<0.00001, MD =-2.88; 95% CI: -3.85 to -1.91; Z=5.83, and P<0.00001. The heterogeneity test of free thyroid hormone showed that Chi2=25.15, I2=72%>50%, P=0.0007, MD =-2.48; 95% CI: -3.69 to -1.26; Z=3.99, and P<0.0001. The heterogeneity test of the occurrence of adverse reactions showed that Chi2=11.28, df=11, P=0.42>0.1, and I2=3%<50%, and the combined effect size was Z=6.49 and P<0.00001, with OR =0.21; 95% CI: 0.13-0.34.
DISCUSSION
The meta-analysis of this study confirms that Chinese patent medicines have considerable clinical effects in the treatment of SAT. They can reduce the recurrence rate, adjust the levels of free triiodothyronine and free thyroid hormone, and have good safety.
Topics: China; Humans; Medicine, Chinese Traditional; Nonprescription Drugs; Thyroiditis, Subacute; Treatment Outcome
PubMed: 34872266
DOI: 10.21037/apm-21-2248 -
International Journal of Environmental... Jan 2021Community care nurses educate adolescents about body image, but their interventions appear to be ineffective. Body dissatisfaction predicts unhealthy behaviors among... (Review)
Review
Community care nurses educate adolescents about body image, but their interventions appear to be ineffective. Body dissatisfaction predicts unhealthy behaviors among adolescents. This study aimed to understand the meanings and factors that influence the concept of body image through a systematic review and meta-ethnography of qualitative studies from the perspective of adolescents. Ten studies published from 2009-2019 were identified by a search of relevant systematic databases between September and December 2019. The review followed the seven steps of meta-ethnography developed by Noblit and Hare, including a line-of-argument. The synthesis revealed six themes: self-perception of body image; opinions of friends and colleagues; opinions of family; specific features of the school environment; expectations perceived across the mass-media; and strategies, practices, and self-management of body image. An explanatory model was developed that showed adolescents' development of body image and the path towards its establishment. In conclusion, these results should be considered to implement strategies to promote a healthy body image in adolescents by community health and mental health nurses.
Topics: Adolescent; Anthropology, Cultural; Body Image; Health Status; Humans; Qualitative Research; Self Concept
PubMed: 33561092
DOI: 10.3390/ijerph18031140 -
Social Science & Medicine (1982) Dec 2015Idioms of distress communicate suffering via reference to shared ethnopsychologies, and better understanding of idioms of distress can contribute to effective clinical... (Review)
Review
Idioms of distress communicate suffering via reference to shared ethnopsychologies, and better understanding of idioms of distress can contribute to effective clinical and public health communication. This systematic review is a qualitative synthesis of "thinking too much" idioms globally, to determine their applicability and variability across cultures. We searched eight databases and retained publications if they included empirical quantitative, qualitative, or mixed-methods research regarding a "thinking too much" idiom and were in English. In total, 138 publications from 1979 to 2014 met inclusion criteria. We examined the descriptive epidemiology, phenomenology, etiology, and course of "thinking too much" idioms and compared them to psychiatric constructs. "Thinking too much" idioms typically reference ruminative, intrusive, and anxious thoughts and result in a range of perceived complications, physical and mental illnesses, or even death. These idioms appear to have variable overlap with common psychiatric constructs, including depression, anxiety, and PTSD. However, "thinking too much" idioms reflect aspects of experience, distress, and social positioning not captured by psychiatric diagnoses and often show wide within-cultural variation, in addition to between-cultural differences. Taken together, these findings suggest that "thinking too much" should not be interpreted as a gloss for psychiatric disorder nor assumed to be a unitary symptom or syndrome within a culture. We suggest five key ways in which engagement with "thinking too much" idioms can improve global mental health research and interventions: it (1) incorporates a key idiom of distress into measurement and screening to improve validity of efforts at identifying those in need of services and tracking treatment outcomes; (2) facilitates exploration of ethnopsychology in order to bolster cultural appropriateness of interventions; (3) strengthens public health communication to encourage engagement in treatment; (4) reduces stigma by enhancing understanding, promoting treatment-seeking, and avoiding unintentionally contributing to stigmatization; and (5) identifies a key locally salient treatment target.
Topics: Anxiety; Culture; Depression; Ethnopsychology; Humans; Language; Mental Health; Stress, Psychological; Thinking
PubMed: 26584235
DOI: 10.1016/j.socscimed.2015.10.044 -
PloS One 2015Negative attitudes towards people with obesity are common even in health care settings. So far, the attitudes and causal beliefs of dietitians and nutritionists have not... (Meta-Analysis)
Meta-Analysis Review
AIM
Negative attitudes towards people with obesity are common even in health care settings. So far, the attitudes and causal beliefs of dietitians and nutritionists have not been investigated systematically. The aim of this article was to review the current state of quantitative research on weight-related stigma by dietitians and nutritionists.
METHOD
A systematic literature review was conducted in 2014 using PubMed, PsycINFO, Web of Science and Cochrane Library.
RESULTS
Eight studies were found that differ in regard to study characteristics, instruments and the origin of the sample. Six out of eight studies reported weight stigma expressed by dietitians and nutritionists. Their believed causes of obesity indicated a defined preference for internal factors rather than genetics or biology.
DISCUSSION
Results of studies were not homogenous. The degree of negative attitudes by dietitians and nutritionists towards people with obesity appeared to be slightly less pronounced compared to the general public and other health care professionals. Stigma and its consequences should be included into educational programs to optimally prepare dietitians and nutritionists.
Topics: Attitude of Health Personnel; Culture; Health Personnel; Humans; Nutritionists; Obesity; Social Stigma
PubMed: 26466329
DOI: 10.1371/journal.pone.0140276 -
The British Journal of Clinical... Nov 2018Rates of self-harm and suicide are increasing in young people. The literature suggests that individuals who identify with alternative subcultures (e.g., Goth) may be at... (Review)
Review
BACKGROUND
Rates of self-harm and suicide are increasing in young people. The literature suggests that individuals who identify with alternative subcultures (e.g., Goth) may be at a greater risk.
OBJECTIVE
To explore the prevalence of self-harm and suicide in alternative subcultures and the factors that might contribute to this increased risk.
METHOD
Using a systematic strategy, the databases PsycINFO, Scopus, MEDLINE and Web of Science, and the E-Thesis online service (ETHOS) were searched for English language only papers, with no restrictions in terms of date of publication. Papers were selected that included data on the relationship between either alternative subculture identity (e.g., Goth) or preference for alternative music (e.g., Heavy Metal) and self-harm or suicide. Ten quantitative papers were included: seven cross-sectional, two longitudinal and one cross-sectional state-level comparison study. Two qualitative papers were also included. Studies were assessed by two reviewers for risk of bias.
RESULTS
The findings indicated that individuals who associated with alternative subcultures were at a greater risk of self-harm and suicide. Whilst qualitative papers identified potential mechanisms (e.g., exposure to self-harm and the way self-harm is presented or normalized), there remains limited support for these mechanisms.
CONCLUSIONS
More research is required to understand the association between self-harm, suicide and alternative subculture affiliation, and the factors underlying it. Longitudinal studies and studies focusing on mechanism are particularly important.
PRACTITIONER POINTS
The review supports the suggestion that those who identify as belonging to an alternative subculture may be at a higher risk of self-harm and suicidal behaviour. It also presents preliminary evidence that alternative affiliation predicts self-harm over time, and that this effect holds whilst adjusting for a number of likely confounders. The findings highlight the importance of increasing the awareness of the victimization and potential risk that these groups hold and suggests areas for intervention in health, educational, and social services. The review does not, however, indicate specifically what it is about alternative subculture affiliation (or alternative music preference) that could contribute to the risk of self-harm. Consequently, studies with a greater focus on mechanisms are needed. Methodological limitations (e.g., cross-sectional studies, small sample of 'alternative' participants, westernized samples) restricted the reliability and validity of the results which impacted on the extent to which the findings could be generalized more widely.
Topics: Adolescent; Culture; Female; Humans; Male; Self-Injurious Behavior; Suicidal Ideation; Suicide; Suicide, Attempted
PubMed: 29577344
DOI: 10.1111/bjc.12179