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Asian Journal of Surgery Sep 2023Postoperative pulmonary complications (PPCs) most commonly occur after thoracic surgery. Not only prolonged hospital stay and increased financial expenses but also... (Meta-Analysis)
Meta-Analysis Review
Postoperative pulmonary complications (PPCs) most commonly occur after thoracic surgery. Not only prolonged hospital stay and increased financial expenses but also morbidity and even mortality may be troublesome for those with PPCs. Herein, we aimed to conduct a comprehensive systematic review and meta-analysis of available data to examine the effectiveness of incentive spirometry (IS) to reduce PPCs and shorten hospital stay. This systematic review and meta-analysis included 5 randomized controlled trials (RCT) and 3 retrospective cohort study (10,322 patients in total) in PubMed, Embase and Cochrane Library until September 31, 2021. We assessed the clinical efficacy of IS using length of hospital stay, PPCs, postoperative pneumonia, and postoperative atelectasis with meta-analysis, meta-regression and trial sequential analysis (TSA). With this meta-analysis, the length of hospital stay in patients undergoing IS was significantly shorter (1.8 days) than that in patients not receiving IS (MD = -1.80, 95% CI = -2.95 to -0.65). Patients undergoing IS also had reduced risk of PPCs (32%) and postoperative pneumonia (17.9%) with statistical significance than patients not undergoing IS (PPC: OR = 0.68, 95% CI = 0.51-0.90) (Pneumonia: OR = 0.821, 95% CI = 0.677-0.995).In meta-regression, the benefits of undergoing IS in patients with preoperative predicted FEV of <80% in a linear fashion with decreasing PPCs. IS is an effective modality to improve the quality of postoperative care for patients after pulmonary resection, compared with the control group without using IS; and applying IS has favorable outcomes of shorter length of hospital stay (1.8 days) and lower occurrence of PPCs (32% of risk reduction), which are conclusive and robust based on our validation via TSA. Moreover, the IS device is more beneficial for patients with preoperative predicted FEV of <80% than that in others.
Topics: Humans; Postoperative Care; Motivation; Pneumonia; Physical Therapy Modalities; Spirometry; Postoperative Complications; Length of Stay; Randomized Controlled Trials as Topic
PubMed: 36437210
DOI: 10.1016/j.asjsur.2022.11.030 -
Pharmaceutical Biology Dec 2023Worldwide access to medication remains a major public health problem that forces pregnant women to self-medicate with several sources, such as medicinal plants. This... (Review)
Review
CONTEXT
Worldwide access to medication remains a major public health problem that forces pregnant women to self-medicate with several sources, such as medicinal plants. This alternative medicine is increasing in many low- and high-income countries for several reasons.
OBJECTIVE
This a systematic literature review on the prevalence of herbal use during pregnancy from the World Health Organization (WHO) Eastern Mediterranean Regional Office.
METHODS
Cross-sectional studies were searched from January 2011 to June 2021 on PubMed, Scopus, and Web of Science. We used the Rayyan website to identify the relevant studies by screening the abstracts and titles. These were followed by reading the full texts to identify the final studies to be included. The data were extracted, and the quality of the studies was assessed using the quality appraisal tool.
RESULTS
Of the 33 studies included in this review, 19 were conducted in Iran, 5 in Saudi Arabia, 4 in Palestine, 2 in Egypt, and 1 each in Oman, Iraq, and Jordan; the prevalence of herbal medicine use among pregnant women varied from 19.2% to 90.2%. Several plants were mentioned for pain management during the pregnancy period. The findings suggest family and friends are major motivating sources for the use of herbal medicine.
CONCLUSIONS
The wide variety of herbal products used in this study reflects the traditions and geographic diversity of the region. Despite the importance of literature-based data about the use of herbal medicine, it is necessary to obtain knowledge, attitude, and motivation for herbal consumption among pregnant women.
Topics: Humans; Female; Pregnancy; Pregnant Women; Plants, Medicinal; Prevalence; Motivation; Cross-Sectional Studies; Plant Extracts
PubMed: 37452524
DOI: 10.1080/13880209.2023.2229388 -
The Lancet. Infectious Diseases Sep 2023This mixed-method systemic review estimated the pooled prevalence of non-prescription antibiotic dispensing in community pharmacies worldwide and identified associated... (Review)
Review
This mixed-method systemic review estimated the pooled prevalence of non-prescription antibiotic dispensing in community pharmacies worldwide and identified associated factors influencing the practice. 162 studies covering 52 countries were included. The pooled prevalence of community pharmacy non-prescription antibiotic dispensing was 63·4% (95% CI 59·6-67·1). The prevalence was significantly higher in low-income countries than in high-income countries. Additionally, the situation of dispensing antibiotics without prescriptions has not improved over time in the past two decades. Quantitative studies showed that pharmacies located in poorer economic areas, pharmacy staff who were also the pharmacy owners, and private pharmacies were more likely to dispense non-prescription antibiotics. Qualitative findings suggested four major factors driving antibiotics being dispensed without a prescription. First, strong customer demand for non-prescription antibiotics and a lack of relevant knowledge; second, pharmacy staff motivated by financial or personal viewpoints; third, alternative health-care services being expensive or inconvenient, or having irregular prescribing practices; and finally, weak social, industry, and legal regulation. The current antibiotic stewardship needs to be strengthened.
Topics: Humans; Anti-Bacterial Agents; Pharmacies; Drug Prescriptions; Community Pharmacy Services; Pharmacists
PubMed: 37105212
DOI: 10.1016/S1473-3099(23)00130-5 -
The Cochrane Database of Systematic... Feb 2024Stimulant use disorder is a continuously growing medical and social burden without approved medications available for its treatment. Psychosocial interventions could be... (Review)
Review
BACKGROUND
Stimulant use disorder is a continuously growing medical and social burden without approved medications available for its treatment. Psychosocial interventions could be a valid approach to help people reduce or cease stimulant consumption. This is an update of a Cochrane review first published in 2016.
OBJECTIVES
To assess the efficacy and safety of psychosocial interventions for stimulant use disorder in adults.
SEARCH METHODS
We searched the Cochrane Drugs and Alcohol Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, three other databases, and two trials registers in September 2023. All searches included non-English language literature. We handsearched the references of topic-related systematic reviews and the included studies.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) comparing any psychosocial intervention with no intervention, treatment as usual (TAU), or a different intervention in adults with stimulant use disorder.
DATA COLLECTION AND ANALYSIS
We used the standard methodological procedures expected by Cochrane.
MAIN RESULTS
We included a total of 64 RCTs (8241 participants). Seventy-three percent of studies included participants with cocaine or crack cocaine use disorder; 3.1% included participants with amphetamine use disorder; 10.9% included participants with methamphetamine use disorder; and 12.5% included participants with any stimulant use disorder. In 18 studies, all participants were in methadone maintenance treatment. In our primary comparison of any psychosocial treatment to no intervention, we included studies which compared a psychosocial intervention plus TAU to TAU alone. In this comparison, 12 studies evaluated cognitive behavioural therapy (CBT), 27 contingency management, three motivational interviewing, one study looked at psychodynamic therapy, and one study evaluated CBT plus contingency management. We also compared any psychosocial intervention to TAU. In this comparison, seven studies evaluated CBT, two contingency management, two motivational interviewing, and one evaluated a combination of CBT plus motivational interviewing. Seven studies compared contingency management reinforcement related to abstinence versus contingency management not related to abstinence. Finally, seven studies compared two different psychosocial approaches. We judged 65.6% of the studies to be at low risk of bias for random sequence generation and 19% at low risk for allocation concealment. Blinding of personnel and participants was not possible for the type of intervention, so we judged all the studies to be at high risk of performance bias for subjective outcomes but at low risk for objective outcomes. We judged 22% of the studies to be at low risk of detection bias for subjective outcomes. We judged most of the studies (69%) to be at low risk of attrition bias. When compared to no intervention, we found that psychosocial treatments: reduce the dropout rate (risk ratio (RR) 0.82, 95% confidence interval (CI) 0.74 to 0.91; 30 studies, 4078 participants; high-certainty evidence); make little to no difference to point abstinence at the end of treatment (RR 1.15, 95% CI 0.94 to 1.41; 12 studies, 1293 participants; high-certainty evidence); make little to no difference to point abstinence at the longest follow-up (RR 1.22, 95% CI 0.91 to 1.62; 9 studies, 1187 participants; high-certainty evidence); probably increase continuous abstinence at the end of treatment (RR 1.89, 95% CI 1.20 to 2.97; 12 studies, 1770 participants; moderate-certainty evidence); may make little to no difference in continuous abstinence at the longest follow-up (RR 1.14, 95% CI 0.89 to 1.46; 4 studies, 295 participants; low-certainty evidence); reduce the frequency of drug intake at the end of treatment (standardised mean difference (SMD) -0.35, 95% CI -0.50 to -0.19; 10 studies, 1215 participants; high-certainty evidence); and increase the longest period of abstinence (SMD 0.54, 95% CI 0.41 to 0.68; 17 studies, 2118 participants; high-certainty evidence). When compared to TAU, we found that psychosocial treatments reduce the dropout rate (RR 0.79, 95% CI 0.65 to 0.97; 9 studies, 735 participants; high-certainty evidence) and may make little to no difference in point abstinence at the end of treatment (RR 1.67, 95% CI 0.64 to 4.31; 1 study, 128 participants; low-certainty evidence). We are uncertain whether they make any difference in point abstinence at the longest follow-up (RR 1.31, 95% CI 0.86 to 1.99; 2 studies, 124 participants; very low-certainty evidence). Compared to TAU, psychosocial treatments may make little to no difference in continuous abstinence at the end of treatment (RR 1.18, 95% CI 0.92 to 1.53; 1 study, 128 participants; low-certainty evidence); probably make little to no difference in the frequency of drug intake at the end of treatment (SMD -1.17, 95% CI -2.81 to 0.47, 4 studies, 479 participants, moderate-certainty evidence); and may make little to no difference in the longest period of abstinence (SMD -0.16, 95% CI -0.54 to 0.21; 1 study, 110 participants; low-certainty evidence). None of the studies for this comparison assessed continuous abstinence at the longest follow-up. Only five studies reported harms related to psychosocial interventions; four of them stated that no adverse events occurred.
AUTHORS' CONCLUSIONS
This review's findings indicate that psychosocial treatments can help people with stimulant use disorder by reducing dropout rates. This conclusion is based on high-certainty evidence from comparisons of psychosocial interventions with both no treatment and TAU. This is an important finding because many people with stimulant use disorders leave treatment prematurely. Stimulant use disorders are chronic, lifelong, relapsing mental disorders, which require substantial therapeutic efforts to achieve abstinence. For those who are not yet able to achieve complete abstinence, retention in treatment may help to reduce the risks associated with stimulant use. In addition, psychosocial interventions reduce stimulant use compared to no treatment, but they may make little to no difference to stimulant use when compared to TAU. The most studied and promising psychosocial approach is contingency management. Relatively few studies explored the other approaches, so we cannot rule out the possibility that the results were imprecise due to small sample sizes.
Topics: Adult; Humans; Psychosocial Intervention; Cognitive Behavioral Therapy; Substance-Related Disorders; Counseling; Motivational Interviewing
PubMed: 38357958
DOI: 10.1002/14651858.CD011866.pub3 -
Einstein (Sao Paulo, Brazil) 2024To identify, synthesize, and analyze the scientific knowledge produced regarding the implications of using clinical simulation for undergraduate nursing or medical... (Review)
Review
OBJECTIVE
To identify, synthesize, and analyze the scientific knowledge produced regarding the implications of using clinical simulation for undergraduate nursing or medical students' motivation for learning.
METHODS
The search for articles was conducted between July 28 and August 3, 2022, on the PubMed/MEDLINE, Scopus, Web of Science, and SciELO databases. The following was used for the search: P - undergraduate students attending Nursing or Medicine courses; C - motivation for learning, and C - skills and clinical simulation laboratory. The following research question guided the study: "What are the implications of clinical simulation on the motivation for learning of undergraduate students of nursing and medicine?" Of the 1,783 articles found, 13 were included in the sample for analysis. All stages of the selection process were carried out by two independent evaluators. The results were presented as charts and a discursive report.
RESULTS
The studies analyzed indicated the beneficial effects of clinical simulation on students' motivation, in addition to other gains such as competencies, technical and non-technical skills, knowledge, belonging, autonomy, clinical judgment, critical and reflective thinking, self-efficacy and decreased anxiety, self-management, and improvements in learning and learning climate.
CONCLUSION
Clinical simulation provides a positive learning environment favorable to the development of technical and interpersonal skills and competencies, and raising the level of motivational qualities.
Topics: Humans; Clinical Competence; Education, Medical, Undergraduate; Learning; Motivation; Simulation Training; Students, Medical; Students, Nursing
PubMed: 38695476
DOI: 10.31744/einstein_journal/2024RW0792 -
Scandinavian Journal of Medicine &... Oct 2023This systematic review and meta-analysis aimed to examine the effects of out-of-school physical activity (PA) interventions, based on Self-Determination Theory (SDT), on... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review and meta-analysis aimed to examine the effects of out-of-school physical activity (PA) interventions, based on Self-Determination Theory (SDT), on basic psychological needs (BPN), motivation toward PA, and PA levels in youths.
DESIGN
Systematic review and meta-analyses.
METHOD
We searched for intervention studies examining the effects of PA interventions based on SDT implemented outside the school published in English and Spanish in six electronic databases up to January 2022.
RESULTS
Outcomes of interest were BPN, motivation, and PA levels. In total, nine studies were included in this review. Seven individual meta-analyses were conducted for each variable, revealing nonsignificant clustered effects for the outcomes autonomy satisfaction (g = 0.12, 95% CI [-0.31, 0.55]), competence satisfaction (g = 0.02, 95% CI [-0.28, 0.32]), relatedness satisfaction (g = 0.13, 95% CI [-0.43, 0.68]), autonomous motivation (g = 0.15, 95% CI [-0.38, 0.67]), controlled motivation (g = 0.12, 95% CI [-0.32, 0.55]), amotivation (g = -0.36, 95% CI [-0.88, 0.16]), and PA behavior (g = 0.02, 95% CI [-0.08, 0.12]).
CONCLUSION
Meta-analyses suggest that out-of-school PA interventions based on SDT are not effective in increasing levels of needs satisfaction, types of motivation, and PA levels.
Topics: Humans; Adolescent; Child; Exercise; Motivation; Personal Autonomy; Personal Satisfaction; Schools
PubMed: 37381660
DOI: 10.1111/sms.14436 -
Heliyon Aug 2023Return migration, the process of migrants returning to their countries of origin, is a vital aspect of migration that has received growing attention in recent years. One... (Review)
Review
BACKGROUND
Return migration, the process of migrants returning to their countries of origin, is a vital aspect of migration that has received growing attention in recent years. One area of focus in the study of return migration is understanding the motivations that drive migrants to return home. Conducting a regional literature review on the dynamics and factors influencing return migration can provide valuable insights into this complex and dynamic phenomenon. It can inform policy development, help to address economic and social issues and contribute to our understanding of migration patterns and trends in the region.
PURPOSE
This study, therefore, aims to understand the dynamics and factors that influence return migration to Sub-Saharan Africa, a region that has experienced significant outflows of migration over the past few decades. This study provides an understanding of the drivers of and barriers to return migration and how far they resonate with factors of mobility and immobility.
METHODS
A two-decade systematic literature review was conducted to determine the driving factors and barriers that influence return migration to Sub-Saharan Africa (SSA). Multivariate factors of return migration were examined based on the central question: why do migrants return to their homeland? The multiple-step systematic literature search covers a broad range of factors of return migration to sub-Saharan Africa.
RESULT
The findings indicate complex scenarios influencing decisions to return to the region, with the interplay of driving factors as well as barriers to return. Social, personal, economic, and policy factors were among the major drivers of return migration, but social and personal drivers were found to be the major motivating factors of decisions to return to SSA, compared to policy and economic issues. The observed drivers and barriers to returning migration in SSA were categorized and discussed under thematic sections considering structural, individual and policy issues.
CONCLUSION
The study concludes that migrants' decisions to return could be determined by numerous structural factors, such as economic, political, social and environmental circumstances, both at the place of origin and at the destination. Therefore, the review could be a useful contribution to future research, governments, mobility-oriented organizations and policymakers for effective return-migration strategies.
PubMed: 37576201
DOI: 10.1016/j.heliyon.2023.e18791 -
Public Health Nutrition Nov 2023To review and synthesize studies on household food security in South Africa. (Review)
Review
OBJECTIVE
To review and synthesize studies on household food security in South Africa.
DESIGN
Systematic mapping review of metrics (methodological review).
SETTING
Electronic databases, including EBSCOHost, Scopus and Web of Science, were searched for studies and reports on household food security in South Africa, reporting household food security published between 1999 and 2021. Searching, selecting and reporting were performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement.
PARTICIPANTS
South African households.
RESULTS
Forty-eight articles reporting on six national surveys (one repeated annually since 2002) and forty sub-national studies meeting the inclusion criteria were selected. Various metrics, with different recall periods and ways of categorizing food security levels, were identified. Surveys that used similar metrics showed that the percentage of South African households that have experienced food insecurity and hunger has decreased over the review period yet remains concerning. However, the multitude of metrics used to assess the different components and levels of food security limits the comparability of the results to evaluate the scope and scale of the problem.
CONCLUSIONS
There is growing support for developing multi-variable approaches for food security research in sub-Saharan Africa. Future research should focus on finding the most appropriate combination of complementary metrics that would allow comparable data while holistically capturing food security and providing insight into the causes and consequences.
Topics: Humans; South Africa; Food Supply; Surveys and Questionnaires; Hunger; Food Insecurity
PubMed: 37771235
DOI: 10.1017/S1368980023001878 -
Neuroscience and Biobehavioral Reviews Sep 2023Binge-Eating Disorder (BED) involves anticipatory craving and urges, subjective loss-of-control during binge-eating episodes, and post-feeding psychological distress and... (Meta-Analysis)
Meta-Analysis Review
Binge-Eating Disorder (BED) involves anticipatory craving and urges, subjective loss-of-control during binge-eating episodes, and post-feeding psychological distress and guilt. Evidence indicates neurocognitive dysfunctions contribute to BED onset, maintenance, and treatment response. However, an integrated understanding of how cognitive processes underpin BED symptomology is lacking. We utilised a multi-stage decision-making model defining ten cognitive processes underpinning Preference Formation, Choice Implementation, Feedback Processing, and Flexibility/Shifting, to comprehensively review research published since 2013. We used preregistered PICOS criteria to assess 1966 articles identified from PubMed, PsycInfo, and Scopus database searches. This yielded 50 studies reporting behavioural cognitive tasks outcomes, comparing individuals with BED to controls with normal and higher weight. Meta-analyses revealed a unique profile of cognitive dysfunctions that spanned all decision-making stages. Significant deficits were evident in Uncertainty Evaluation, Attentional Inhibition, Choice Consistency, and Cognitive Flexibility/Set-shifting. We propose a novel model of dysfunctional decision-making processes in BED and describe their role in binge-eating behaviour. We further highlight the potential for cognitive interventions to target these processes and address the significant treatment gap in BED.
Topics: Humans; Binge-Eating Disorder; Overweight; Attention; Cognitive Dysfunction; Craving
PubMed: 37263530
DOI: 10.1016/j.neubiorev.2023.105250 -
Frontiers in Public Health 2023Gamification has proven to be a significant tool for health promotion, with a particular focus on physical activities such as Exergames, which improve not only physical,... (Review)
Review
BACKGROUND
Gamification has proven to be a significant tool for health promotion, with a particular focus on physical activities such as Exergames, which improve not only physical, but also cognitive health. However, it is still not clear what effect the practice of Exergames has on changing the emotional experience.
PURPOSE
The objective of this systematic review is to evaluate the impact of Exergames training on emotional experience.
METHODS
A systematic search was conducted in the PUBMED and SCOPUS databases. The relevant articles were screened independently by three researchers. Data concerning emotional measures and Exergame practice were extracted for analysis.
RESULTS
The search yielded 38 articles, of which 16 were included. Exergames were found to significantly impact happiness, anxiety, depressive symptoms, mental health-related quality of life, self-worth, self-esteem, self-efficacy, perceived behavioral control, vigor, vitality, intrinsic motivation, perceived energy, and relaxation.
CONCLUSION
Our review supports the evidence that the practice of physical activity through Exergames, on the emotional experience generally generates an increase in positive emotions. In this sense, the results found support both the use of Exergames as a leisure activity that promotes wellbeing and emotional regulation, as well as for health promotion, public health, and clinical practice purposes. Our review strongly supports the notion that engaging in physical activity through Exergames generally leads to an increase in positive emotions. As a result, these findings endorse the utilization of Exergames as a leisure activity to promote well-being and emotional regulation. Moreover, Exergames hold potential for health promotion, public health, and clinical practice purposes.
Topics: Exergaming; Quality of Life; Emotions; Exercise; Anxiety
PubMed: 37744509
DOI: 10.3389/fpubh.2023.1209520