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Mothers' experiences and perceptions of breastfeeding peer support: a qualitative systematic review.International Breastfeeding Journal Jan 2024The global issue of low breastfeeding rates has been widely reported. Quantitative studies have shown the positive effects of peer support on breastfeeding. However, the... (Review)
Review
BACKGROUND
The global issue of low breastfeeding rates has been widely reported. Quantitative studies have shown the positive effects of peer support on breastfeeding. However, the experiences of mothers who receive breastfeeding peer support have been found to vary. To date, no systematic qualitative summary has been conducted to document the impact of peer support, nor to provide advice for its implementation from the perspective of breastfeeding mothers. This review aims to systematically synthesize qualitative findings on mothers' experiences of breastfeeding peer support to provide evidence for optimizing peer support services and ultimately enhancing their role in promoting breastfeeding.
METHODS
PubMed, Embase, Cochrane Library, Ovid, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), WanFang Datebase, VIP Database and Chinese Biomedical Database (CBM) were searched from the inception of each database until January 2023, to collect qualitative studies and mixed methods studies that included qualitative findings on mothers' experiences with breastfeeding peer support. The Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to extract data and evaluate the quality of the included articles. The meta-integration method was used to explain and integrate the research findings. The review process was carried out by two authors independently, and the disagreements were resolved through consensus.
RESULTS
A total of 15 articles were included in the study, consisting of 13 qualitative studies and 2 mixed methods studies. The analysis identified four integrated themes: (1) obtaining psycho-emotional support; (2) acquiring knowledge and skills; (3) expectations for breastfeeding peer support; and (4) feeding perceptions and behavior change. It should be noted that the articles reviewed are in English and mostly originate from developed countries or regions. Therefore, the generalizability of the integrated findings to underdeveloped regions or non-English speaking countries may be limited.
CONCLUSION
Mothers perceived that peer support had a positive impact on breastfeeding. To improve the effectiveness of peer support in promoting breastfeeding, it is important to consider the individual needs of each mother. It is recommended that peer support services should be standardized in the future, including the accreditation, training, supervision, and management of peer supporters.
Topics: Female; Humans; Mothers; Breast Feeding; Counseling; Peer Group; Qualitative Research
PubMed: 38243287
DOI: 10.1186/s13006-024-00614-3 -
Frontiers in Oral Health 2023Some salivary proteins seem to be differently abundant among caries-free (CF) and caries-affected (CA) individuals, but previous results are contradictory precluding... (Review)
Review
OBJECTIVE
Some salivary proteins seem to be differently abundant among caries-free (CF) and caries-affected (CA) individuals, but previous results are contradictory precluding that definitive conclusion be drawn. A pooled analysis of the available evidence may provide more robust data on identifying oral cavity protein patterns among CF and CA individuals. This systematic review and meta-analysis (PROSPERO CRD42021269079) aimed to compare the oral cavity protein abundance among caries-free and caries-affected individuals.
METHODS
This study was conducted following PRISMA guidelines. PubMed, Embase, and Web of Science databases were systematically assessed (up to February 2023) to retrieve clinical studies written in English, German, or in Latin-based languages that compared the oral cavity protein abundance among CF and CA individuals. Data extraction and methodological quality assessment (NIH guidelines) were independently performed by two investigators. Qualitative synthesis was performed from all included studies and meta-analysis was performed using a random-effects model with inverse variance for studies that reported the concentration of proteins or enzymatic activity. Standardized mean difference (SMD) with respective 95% confidence interval (CI) were calculated for each outcome.
RESULTS
A total of 90 studies (two cohort and 88 cross-sectional designs) of more than 6,000 participants were selected for data extraction, being the quality of evidence graded as "fair" for most of them. The oral cavity of CF individuals presented lower total protein concentration [SMD = 0.37 (95% CI: 0.07-0.68; 18 studies)], lower total antioxidant capacity [SMD = 1.29 (95% CI: 0.74-1.85); 17 studies], and lower carbonic anhydrase activity [SMD = 0.83 (95% CI: 0.58-1.09); three studies], whereas CA individuals presented lower carbonic anhydrase concentration [SMD = -0.66 (95% CI: -1.00 to -0.32); three studies], urease [SMD = -0.95 (IC 95%: -1.72 to -0.17); four studies], and arginine deiminase system [SMD = -2.07 (95% CI: -3.53 to -0.62); three studies] activities. Antimicrobial peptides, secretory immunoglobulin-A concentrations and alpha-amylase activity were similar among individuals.
CONCLUSION
Differences on oral cavity protein abundance were observed among CF and CA individuals. These data indicate some protein patterns for the oral health and dental caries conditions. Even when statistically significant, some of the results were not very consistent. Cohort studies need to be conducted to validate these results.
PubMed: 37780687
DOI: 10.3389/froh.2023.1265817 -
Digital Health 2023There is growing evidence to suggest that EHRs may be associated with clinician stress and burnout, which could hamper their effective use and introduce risks to patient... (Review)
Review
BACKGROUND
There is growing evidence to suggest that EHRs may be associated with clinician stress and burnout, which could hamper their effective use and introduce risks to patient safety.
OBJECTIVE
This systematic review aimed to examine the association between EHR use and clinicians' stress and burnout in hospital settings, and to identify the contributing factors influencing this relationship.
METHODS
The search included peer-reviewed published studies between 2000 and 2023 in English in CINAHL, Ovid Medline, Embase, and PsychINFO. Studies that provided specific data regarding clinicians' stress and/or burnout related to EHRs in hospitals were included. A quality assessment of included studies was conducted.
RESULTS
Twenty-nine studies were included (25 cross-sectional surveys, one qualitative study, and three mixed methods), which focused on physicians (n = 18), nurses (n = 10) and mixed professions (n = 3). Usability issues and the amount of time spent on the EHR were the most significant predictors, but intensity of the working environment influenced high EHR-related workload and thereby also contributed to stress and burnout. The differences in clinicians' specialties influenced the levels of stress and burnout related to EHRs.
CONCLUSIONS
This systematic review showed that EHR use was a perceived contributor to clinicians' stress and burnout in hospitals, primarily driven by poor usability and excessive time spent on EHRs. Addressing these issues requires tailored EHR systems, rigorous usability testing, support for the needs of different specialities, qualitative research on EHR stressors, and expanded research in Non-Western contexts.
PubMed: 38130797
DOI: 10.1177/20552076231220241 -
Frontiers in Radiology 2023Image segmentation is an important process for quantifying characteristics of malignant bone lesions, but this task is challenging and laborious for radiologists. Deep... (Review)
Review
INTRODUCTION
Image segmentation is an important process for quantifying characteristics of malignant bone lesions, but this task is challenging and laborious for radiologists. Deep learning has shown promise in automating image segmentation in radiology, including for malignant bone lesions. The purpose of this review is to investigate deep learning-based image segmentation methods for malignant bone lesions on Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Positron-Emission Tomography/CT (PET/CT).
METHOD
The literature search of deep learning-based image segmentation of malignant bony lesions on CT and MRI was conducted in PubMed, Embase, Web of Science, and Scopus electronic databases following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A total of 41 original articles published between February 2017 and March 2023 were included in the review.
RESULTS
The majority of papers studied MRI, followed by CT, PET/CT, and PET/MRI. There was relatively even distribution of papers studying primary vs. secondary malignancies, as well as utilizing 3-dimensional vs. 2-dimensional data. Many papers utilize custom built models as a modification or variation of U-Net. The most common metric for evaluation was the dice similarity coefficient (DSC). Most models achieved a DSC above 0.6, with medians for all imaging modalities between 0.85-0.9.
DISCUSSION
Deep learning methods show promising ability to segment malignant osseous lesions on CT, MRI, and PET/CT. Some strategies which are commonly applied to help improve performance include data augmentation, utilization of large public datasets, preprocessing including denoising and cropping, and U-Net architecture modification. Future directions include overcoming dataset and annotation homogeneity and generalizing for clinical applicability.
PubMed: 37614529
DOI: 10.3389/fradi.2023.1241651 -
Frontiers in Aging Neuroscience 2023This meta-analysis evaluates the efficacy and safety of amyloid-β (Aβ) targeted therapies for delaying cognitive deterioration in Alzheimer's disease (AD).
BACKGROUND
This meta-analysis evaluates the efficacy and safety of amyloid-β (Aβ) targeted therapies for delaying cognitive deterioration in Alzheimer's disease (AD).
METHODS
PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov were systematically searched to identify relevant studies published before January 18, 2023.
RESULTS
We pooled 33,689 participants from 42 studies. The meta-analysis showed no difference between anti-Aβ drugs and placebo in the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and anti-Aβ drugs were associated with a high risk of adverse events [ADAS-Cog: MDs = -0.08 (-0.32 to 0.15), = 0.4785; AEs: RR = 1.07 (1.02 to 1.11), = 0.0014]. Monoclonal antibodies outperformed the placebo in delaying cognitive deterioration as measured by ADAS-Cog, Clinical Dementia Rating-Sum of Boxes (CDR-SB), Mini-Mental State Examination (MMSE) and Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL), without increasing the risk of adverse events [ADAS-Cog: MDs = -0.55 (-0.89 to 0.21), = 0.001; CDR-SB: MDs = -0.19 (-0.29 to -0.10), < 0.0001; MMSE: MDs = 0.19 (0.00 to 0.39), = 0.05; ADCS-ADL: MDs = 1.26 (0.84 to 1.68), < 0.00001]. Intravenous immunoglobulin and γ-secretase modulators (GSM) increased cognitive decline in CDR-SB [MDs = 0.45 (0.17 to 0.74), = 0.002], but had acceptable safety profiles in AD patients. γ-secretase inhibitors (GSI) increased cognitive decline in ADAS-Cog, and also in MMSE and ADCS-ADL. BACE-1 inhibitors aggravated cognitive deterioration in the outcome of the Neuropsychiatric Inventory (NPI). GSI and BACE-1 inhibitors caused safety concerns. No evidence indicates active Aβ immunotherapy, MPAC, or tramiprosate have effects on cognitive function and tramiprosate is associated with serious adverse events.
CONCLUSION
Current evidence does not show that anti-Aβ drugs have an effect on cognitive performance in AD patients. However, monoclonal antibodies can delay cognitive decline in AD. Development of other types of anti-Aβ drugs should be cautious.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (https://www.crd.york.ac.uk/prospero/), identifier CRD42023391596.
PubMed: 38020763
DOI: 10.3389/fnagi.2023.1257973 -
Frontiers in Medicine 2024Methylene blue is an interesting approach in reducing fluid overload and vasoactive drug administration in vasodilatory shock. The inhibition of guanylate cyclase...
BACKGROUND
Methylene blue is an interesting approach in reducing fluid overload and vasoactive drug administration in vasodilatory shock. The inhibition of guanylate cyclase induced by methylene blue infusion reduces nitric oxide production and improves vasoconstriction. This systematic review and meta-analysis aimed to assess the effects of methylene blue administration compared to placebo on the hemodynamic status and clinical outcomes in patients with sepsis and septic shock.
METHODS
The authors specifically included randomized controlled trials that compared the use of methylene blue with placebo in adult patients with sepsis and septic shock. The outcomes were length of intensive care unit stay, hemodynamic parameters [vasopressor use], and days on mechanical ventilation. We also evaluated the abnormal levels of methemoglobinemia. This systematic review and meta-analysis were recorded in PROSPERO with the ID CRD42023423470.
RESULTS
During the initial search, a total of 1,014 records were identified, out of which 393 were duplicates. Fourteen citations were selected for detailed reading, and three were selected for inclusion. The studies enrolled 141 patients, with 70 of them in the methylene blue group and 71 of them in the control group. Methylene blue treatment was associated with a lower length of intensive care unit stay (MD -1.58; 95%CI -2.97, -0.20; = 25%; = 0.03), decreased days on mechanical ventilation (MD -0.72; 95%CI -1.26, -0.17; = 0%; = 0.010), and a shorter time to vasopressor discontinuation (MD -31.49; 95%CI -46.02, -16.96; = 0%; < 0.0001). No association was found with methemoglobinemia.
CONCLUSION
Administering methylene blue to patients with sepsis and septic shock leads to reduced time to vasopressor discontinuation, length of intensive care unit stay, and days on mechanical ventilation.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023423470, CRD42023423470.
PubMed: 38698779
DOI: 10.3389/fmed.2024.1366062 -
Heliyon Jul 2023Reciprocal Teaching a type of cooperative teaching and learning strategy involving learners with similar academic backgrounds sharing teacher and student roles. Its use... (Review)
Review
Reciprocal Teaching a type of cooperative teaching and learning strategy involving learners with similar academic backgrounds sharing teacher and student roles. Its use was not explored to the same degree as other types of peer-assisted strategy, including students at different levels. The goal of the systematic review was to investigate the impact of Reciprocal Teaching on existing literature in the field of education which include the use of Reciprocal Teaching for all student's level to enhancing academic achievement and ROSES (Reporting Standards for Systematic Evidence Syntheses) was carried out as a review protocol to conduct Systematic Literature Review (SLR). A literature review performed between January 2013 and February 2022 using the relevant electronic databases (Eric Plus Text, PubMed, Web of Science, Scopus) as well as searching for the keywords. Twenty-eight researches met the set inclusion requirements for this review. The results found that Reciprocal Teaching improved comprehension of the subject under review, enhanced cooperative learning, improved academic achievement, communication, metacognition, teaching skills, developed a positive impact in learners understanding, especially in evaluating learning performance and reciprocal teaching which may improve the understanding of reading, solving word problems in scientific fields.
PubMed: 37519655
DOI: 10.1016/j.heliyon.2023.e18269 -
JAMA Network Open Oct 2023Despite its prohibition by the United Nations Convention against Torture and other international treaties, torture has been perpetrated against countless individuals... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Despite its prohibition by the United Nations Convention against Torture and other international treaties, torture has been perpetrated against countless individuals worldwide, and health care practitioners globally are increasingly encountering refugee torture survivors in their clinical practices. The methods, geographic distribution, and frequency of torture globally are not well described, which limits health care practitioners' ability to adequately diagnose and treat the sequelae of torture.
OBJECTIVE
To rank the commonness of torture methods and identify the regions of the world with which they are associated.
DATA SOURCES
For this systematic review and meta-analysis, Ovid MEDLINE, Ovid Embase, Web of Science, and The Cochrane Library were searched from inception to July 2021.
STUDY SELECTION
Included studies were peer-reviewed articles in English, contained an independent sample population of individuals who experienced torture, and outlined the type(s) of torture experienced. Excluded studies were not peer reviewed, lacked an independent sample population, or did not specify torture methods. Articles were chosen for inclusion by 2 independent and blinded reviewers, and a third, independent reviewer resolved discrepancies. Overall, 266 articles-15.3% of the 1739 studies initially identified for full review-met the inclusion criteria.
DATA EXTRACTION AND SYNTHESIS
Data abstraction and quality assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 2 independent and blinded reviewers into predefined templates, and a third, independent reviewer resolved discrepancies. The risk of bias was evaluated using the Downs and Black Checklist.
MAIN OUTCOMES AND MEASURES
Torture methods were ranked by their average frequencies, numbers of reporting studies, and numbers of countries wherein the methods occurred.
RESULTS
A total of 9937 titles and abstracts were screened, and 266 studies encompassing 103 604 individuals (13 350 men, 5610 women, and 84 644 unspecified) were analyzed. Torture was reported for 105 countries; 21 methods accounted for 84% of all reported methods and 10 methods accounted for 78% of all physical tortures. The top 3 methods were beating or blunt-force trauma (reported in 208 studies and 59 countries; average frequency, 62.4%; 95% CI, 57.7%-67.1%), electrical torture (reported in 114 studies and 28 countries; average frequency, 17.2%; 95% CI, 15.0%-19.4%), and starvation or dehydration (reported in 65 studies in 26 countries; average frequency, 12.7%; 95% CI, 10.2%-15.2%). According to the Downs and Black appraisal tool, 50 studies were rated as good or excellent and 216 as fair or poor.
CONCLUSIONS AND RELEVANCE
The findings of this study suggest that torture remains widespread. Although innumerable torture methods exist, a limited number account for the vast majority of reported tortures. So that targeted therapies may be developed, additional investigation is needed to better elucidate the sequelae associated with the most common torture methods, described here.
Topics: Male; Humans; Female; Torture; Checklist; Concept Formation; Disease Progression; Health Facilities
PubMed: 37787994
DOI: 10.1001/jamanetworkopen.2023.36629 -
Prevalence and Psychosocial Impacts of Stalking on Mental Health Professionals: A Systematic Review.Trauma, Violence & Abuse Dec 2023Research examining the prevalence and impacts of stalking on mental health professionals (MHPs) has grown over the last two decades. Yet only one previous review has... (Review)
Review
Research examining the prevalence and impacts of stalking on mental health professionals (MHPs) has grown over the last two decades. Yet only one previous review has been undertaken examining impacts on staff and focusing on clients as stalkers, with prevalence estimated between 10% and 13%. This systematic review sought to assess prevalence of stalking, and associated impacts and methods of coping reported by MHPs, irrespective of perpetrator type. The search included all healthcare professional groups working in a mental health setting, reported in English or with available translation. Secondary searches were conducted through references cited in primary papers. Of the 7,060 papers identified in five databases, 11 peer-reviewed papers met rigorous inclusion criteria and were quality appraised. Reviewed studies reported prevalence rates between 10.2% and 50%, with higher quality papers reporting a narrower band, 13.9% and 14.3%. However, substantial variability in stalking definitions, and quality of methodology precluded precise prevalence estimation. Participants within the included studies disclosed significant adverse impacts on confidence and competence at work as a consequence of their experiences. Staff invoked substantial workplace and lifestyle changes to mitigate impacts of stalking. However, studies revealed staff disclosed stalking by perpetrators other than clients, notably colleagues and intimate partners, as often or more frequently than by clients. Limitations of the included research and future directions are discussed.
Topics: Humans; Stalking; Mental Health; Prevalence; Health Personnel; Sex Offenses
PubMed: 36373712
DOI: 10.1177/15248380221129581 -
Journal of Criminal Justice 2023Previous work has shown that direct comparison of recidivism rates between jurisdictions without accounting for potential sources of their variation can be misleading.... (Review)
Review
OBJECTIVES
Previous work has shown that direct comparison of recidivism rates between jurisdictions without accounting for potential sources of their variation can be misleading. We aimed to systemically review data on recidivism rate internationally and explore sources of between-country variation.
METHODS
We reviewed recidivism rates in individuals released from prison and given community sentences. We systematically searched peer-reviewed and gray literature focusing on publications since a systematic review in mid-2019. We extracted data on reoffending, reimprisonment, and re-arrests. To examine the association between index offences and recidivism rates, we calculated risk ratios. We used meta-regression to estimate the association between recidivism in released prisoners and country-level variables. We also summarised reported effects of the COVID-19 pandemic on recidivism rates.
RESULTS
Recidivism data were found for 33 countries. Released prisoners had 2-year reconviction rates between 18% and 55%, while individuals given community sentences had rates between 10% and 47%. Recidivism rates varied based on proportions of index offences. Country-level factors like homicide, robbery, and imprisonment rates were associated with prisoner recidivism. Lower rates during COVID-19 were linked to disruptions in criminal justice processes, reduced prison populations, and fewer crime opportunities.
CONCLUSIONS
Interpreting recidivism rates requires considering individual and country-level factors. Transparent reporting of these factors is needed.
PubMed: 38486817
DOI: 10.1016/j.jcrimjus.2023.102115