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Research in Social & Administrative... Oct 2023Traditional and complementary medicines (T&CMs) are not typically covered in medical curricula despite 80% of the world's population using some form of herbal product as... (Review)
Review
BACKGROUND
Traditional and complementary medicines (T&CMs) are not typically covered in medical curricula despite 80% of the world's population using some form of herbal product as part of their healthcare. Concurrent use of T&CMs with conventional therapies is common, and both are primarily accessed in pharmacies. There is an expectation that pharmacists should be knowledgeable about T&CMs. Therefore, this review aimed to investigate what is currently known about pharmacists' T&CMs education and training to inform developments in pharmacy education.
METHODS
Eligible studies published between 01/01/2016 and 28/02/2023 were identified across six databases (PubMed, Scopus, Web of Science, EMBASE, ScienceDirect and MEDLINE). Data were extracted from included studies and categorized into key themes and sub-themes and reported descriptively.
FINDINGS
Fifty-eight studies were identified, conducted across 30 countries, that included information about pharmacists' T&CMs education and training. Within the four main themes extracted, six subthemes were identified including: T&CMs education and training received; inadequate education and training opportunities; knowledge, and confidence towards T&CMs in the pharmacy setting; professional practice behaviour associated with T&CM; university education for pharmacy students; and continuing professional development for practicing pharmacists, including T&CM-drug interactions, interpreting T&CM research, T&CM-specific communication skills, T&CM use in pregnancy and breastfeeding, and efficacy and safety of T&CM in specific conditions.
CONCLUSION
Overall pharmacists are receiving limited T&CM education in undergraduate and continuing professional training and report a lack of resources to inform the advice they provide to consumers. The findings of this review can inform developments in T&CMs curriculum and accreditation standards that support the training needs of pharmacists who play a role in fostering the safe and appropriate use of these products.
Topics: Female; Humans; Complementary Therapies; Pharmacists; Pharmacy; Medicine, Traditional; Education, Pharmacy; Community Pharmacy Services; Professional Role
PubMed: 37482480
DOI: 10.1016/j.sapharm.2023.07.007 -
Midwifery Sep 2023To conduct a systematic review exploring women's experiences, views and understanding of any vaginal examinations during intrapartum care, in any care setting and by any... (Review)
Review
OBJECTIVE
To conduct a systematic review exploring women's experiences, views and understanding of any vaginal examinations during intrapartum care, in any care setting and by any healthcare professional. Intrapartum vaginal examination is deemed both an essential assessment tool and routine intervention during labour. It is an intervention that can cause significant distress, embarrassment, and pain for women, as well as reinforce outdated gender roles. In view of its widespread and frequently reported excessive use, it is important to understand women's views on vaginal examination to inform further research and current practice.
DESIGN
A systematic search and meta-ethnography synthesis informed by Noblit and Hare (1988) and the eMERGe guidance (France et al. 2019) was undertaken. Nine electronic databases were searched systematically using predefined search terms in August 2021, and again in March 2023. Studies meeting the following criteria: English language, qualitative and mixed-method studies, published from 2000 onwards, and relevant to the topic, were eligible for quality appraisal and inclusion.
FINDINGS
Six studies met the inclusion criteria. Three from Turkey, one from Palestine, one from Hong Kong and one from New Zealand. One disconfirming study was identified. Following both a reciprocal and refutational synthesis, four 3rd order constructs were formed, titled: Suffering the examination, Challenging the power dynamic, Cervical-centric labour culture embedded in societal expectations, and Context of care. Finally, a line of argument was arrived at, which brought together and summarised the 3rd order constructs.
KEY CONCLUSIONS AND IMPLICATIONS OF PRACTICE
The dominant biomedical discourse of vaginal examination and cervical dilatation as central to the birthing process does not align with midwifery philosophy or women's embodied experience. Women experience examinations as painful and distressing but tolerate them as they view them as necessary and unavoidable. Factors such as context of care setting, environment, privacy, midwifery care, particularly in a continuity of carer model, have considerable positive affect on women's experience of examinations. Further research into women's experiences of vaginal examination in different care models as well as research into less invasive intrapartum assessment tools that promote physiological processes is urgently required.
Topics: Pregnancy; Female; Humans; Gynecological Examination; Anthropology, Cultural; Parturition; Labor, Obstetric; Midwifery; Qualitative Research
PubMed: 37315454
DOI: 10.1016/j.midw.2023.103746 -
International Journal of Environmental... May 2022Despite growing international interest, the caregiving body of literature lacks a recent understanding of young carers' experiences and their contact with the health... (Review)
Review
Despite growing international interest, the caregiving body of literature lacks a recent understanding of young carers' experiences and their contact with the health care system. We conducted a systematic review of qualitative studies to (1) synthesize more recent qualitative evidence on young carers' experience, and (2) to identify how these young carers interact with the health care system in their caregiving role. Using a meta-ethnographic synthesis, a total of 28 empirical studies met inclusion. Key findings helped inform an overarching framework of the experience of young carers as illustrated by a journey map. The journey map is a visual depiction of the stages these young carers go through when in a caregiving role framed by three themes: (1) encountering caregiving; (2) being a young caregiver, and (3) moving beyond caregiving. The caregiving experience is perceived by young people as challenging and complex, which could be improved with more informational navigation and emotional support. Understanding these experiences provides insight into gaps in health services and potential solutions that align with the stages outlined in the journey map.
Topics: Adolescent; Anthropology, Cultural; Caregivers; Delivery of Health Care; Empirical Research; Humans; Qualitative Research
PubMed: 35627362
DOI: 10.3390/ijerph19105826 -
Journal of Ethnopharmacology Apr 2024Many researchers have adopted resolving phlegm and unblocking fu-organs (RPUF) therapy for acute ischemic stroke (AIS) patients and yielded beneficial results in terms... (Meta-Analysis)
Meta-Analysis Review
ETHNOPHARMACOLOGICAL RELEVANCE
Many researchers have adopted resolving phlegm and unblocking fu-organs (RPUF) therapy for acute ischemic stroke (AIS) patients and yielded beneficial results in terms of clinical symptoms. However, there has been no systematically pooled analysis of RPUF therapy for AIS to date. Therefore, a well-designed systematic review and meta-analysis is necessary.
AIM
This systematic review aims to determine the efficacy and safety of traditional Chinese medicine (TCM) therapy for resolving phlegm and unblocking fu-organs (RPUF) for the treatment of acute ischemic stroke (AIS).
METHODS
Eight databases were searched to identify eligible randomized controlled trials (RCTs) involving RPUF therapy for AIS. The primary outcome included the modified Rankin Scale (mRS), and the secondary outcomes were the National Institute of Health Stroke Scale (NIHSS), the Neurological Deficit Score (NDS), Barthel Index (BI), Fugel-Meyer assessment (FMA), and the Glasgow Coma Scale (GCS). The Cochrane Handbook for Systematic Reviews of Interventions was used to assess risk of bias. The quantitative synthesis was analyzed using RevMan 5.3 and Stata 14.0 software.
RESULTS
The systematic review and meta-analysis comprised 61 RCTs with a total of 6056 participants. RPUF prescriptions combined with usual care were superior to usual care alone in individuals with AIS, as evidenced by decreased mRS (MD=-0.34; 95%CI [-0.65, -0.03]; P=0.03), NIHSS (MD=-3.38; 95%CI [-4.07, -2.68]; P<0.00001), and NDS (MD=-3.65; 95%CI [-4.07, -3.24]; P<0.00001), as well as improved BI (MD=10.4; 95%CI [8.21, 12.59]; P<0.00001), FMA (MD=20.41; 95%CI [17.40, 23.41]; P<0.00001), and GCS (MD=3.08; 95%CI [1.95, 4.20]; P<0.00001). No significant difference was observed in the incidence of adverse effects between the RPUF therapy group and the usual care group.
CONCLUSION
RPUF therapy appears to be an effective and safe approach for treating AIS; it could decrease mRS, NIHSS, and NDS while improving BI, FMA, and GCS. However, the methodological quality of the included RCTs was far from sufficient, and further high-quality, well-designed RCTs with long-term follow-up are still required.
Topics: Humans; Ischemic Stroke; Medicine, Chinese Traditional; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 38160868
DOI: 10.1016/j.jep.2023.117660 -
Journal of Ethnopharmacology Dec 2023Spatholobi caulis (SC), the dried vine stem of Spatholobus suberectus Dunn, is known as Ji Xue Teng in China, and has long been used as traditional Chinese medicine... (Review)
Review
ETHNOPHARMACOLOGICAL RELEVANCE
Spatholobi caulis (SC), the dried vine stem of Spatholobus suberectus Dunn, is known as Ji Xue Teng in China, and has long been used as traditional Chinese medicine (TCM) to treat anaemia, menstrual abnormalities, rheumatoid arthritis, purpura, etc. AIM OF THE REVIEW: The aim of this review is to provide a systematic and updated summary of the traditional uses, chemical constituents, biological activities and clinical applications of SC. In addition, several suggestions for future research on SC are also proposed.
MATERIALS AND METHODS
Extensive information and data on SC were obtained from electronic databases (ScienceDirect, Web of Science, PubMed, CNKI, Baidu Scholar, Google Scholar, ResearchGate, SpringerLink and Wiley Online). Additional information was collected from Ph.D. and MSc dissertations, published books, and classic material medica.
RESULTS
To date, phytochemical studies have revealed that approximately 243 chemical ingredients have been isolated from SC and identified, including flavonoids, glycosides, phenolic acids, phenylpropanoids, volatile oils, sesquiterpenoids and other compounds. Many studies have indicated that extracts and pure constituents from SC possess a wide spectrum of in vitro and in vivo pharmacological effects, such as anti-tumour, haematopoietic, anti-inflammatory, antidiabetic, antioxidant, antiviral and antibacterial effects, as well as other activities. SC could be applied to the treatment of leukopenia, aplastic anemic, endometriosis, etc. according to the clinical reports. The traditional efficacies of SC is due to the biological functions of its chemical compounds, especially flavonoids. However, research investigating the toxicological effects of SC is relatively limited.
CONCLUSIONS
SC is widely used in TCM formulae and its some traditional efficacies has been confirmed by extensive recent pharmacological and clinical studies. Most the biological activities of the SC may be attributed to flavonoids. However, in-depth studies on the molecular mechanisms of the effective ingredients and extracts of SC are limited. Further systematic studies focusing on pharmacokinetics, toxicology and quality control are needed to ensure the effective and safe application of SC.
Topics: Ethnopharmacology; Medicine, Chinese Traditional; Phytotherapy; Drugs, Chinese Herbal; Phytochemicals; Flavonoids; Plant Extracts
PubMed: 37393029
DOI: 10.1016/j.jep.2023.116854 -
Journal of Complementary & Integrative... Mar 2023Sexual dysfunction can adversely affect the quality of life and interpersonal relationships. nowadays, a lot of attention is paid to traditional Chinese medicine with... (Review)
Review
OBJECTIVES
Sexual dysfunction can adversely affect the quality of life and interpersonal relationships. nowadays, a lot of attention is paid to traditional Chinese medicine with better curative effects and less adverse events. Recent studies have implied the promising effect of acupuncture on sexual function. This systematic review evaluate the effectiveness and safety of acupuncture in treating female and male sexual dysfunction.
CONTENT
PubMed, Cochrane Central of Controlled Trials (CENTRAL), EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Scopus, and Google Scholar were searched up to 2021. No limitation to language and date. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT).
SUMMARY
Among 160 initially assessed papers, 13 articles were included. The findings showed that acupuncture improve sexual dysfunction in domains of desire, libido, erectile dysfunction and impotency. Most studies did not report any serious side effects from acupuncture, and only three studies reported minor adverse events.
OUTLOOK
The available evidence indicate that acupuncture has positive on improvement of sexual dysfunction with no serious side effects. Although acupuncture has gained increasing popularity for the management of sexual dysfunction, high methodological quality evidence regarding its efficacy is lacking.
Topics: Male; Humans; Female; Quality of Life; Acupuncture Therapy; Medicine, Chinese Traditional; Erectile Dysfunction
PubMed: 34704431
DOI: 10.1515/jcim-2021-0194 -
Neurourology and Urodynamics Mar 2022To understand the experience of urinary tract infection (UTI) by synthesizing primary qualitative research findings and developing a conceptual model that illustrates... (Review)
Review
AIM
To understand the experience of urinary tract infection (UTI) by synthesizing primary qualitative research findings and developing a conceptual model that illustrates this experience.
METHOD
A systematic search of Medline, PsychInfo, Embase, and CINAHL from inception to August 2020 to find qualitative research exploring the experience of UTI. Qualitative evidence synthesis in the form of meta-ethnography was undertaken. Findings are reported in keeping with eMERGe guidance.
RESULTS
We included 16 qualitative studies in the synthesis of evidence, providing data from over 1038 participants aged 13-97 years. We developed nine themes: the impact of UTI on my whole body; impact on quality of life, activities, and the associated psychological toll; I know my body and my experience has taught me when I need to seek care; worry and the transition to medicalization; antibiotics are a valuable treatment approach; antibiotics are a last resort; being heard, seen, and cared for with dignity; self-judgment; and the end of the road, a need for information and cure. These themes supported a conceptual model to illustrate the patient experience of UTI.
CONCLUSIONS
The conceptual model communicates the wide and varied symptoms of patients' UTI experiences and how they process this and make care decision based on past health experiences. For some, there appears to be a sense of hopelessness and frustration. This model may be used to highlight the need for improvements in diagnostic and treatment pathways. Future research to further understand the nuances of acute, recurrent, and persistent UTI is needed.
Topics: Anthropology, Cultural; Anti-Bacterial Agents; Female; Humans; Male; Qualitative Research; Quality of Life; Urinary Tract Infections
PubMed: 35114012
DOI: 10.1002/nau.24884 -
Genus Suaeda: Advances in phytology, chemistry, pharmacology and clinical application (1895 - 2021).Pharmacological Research May 2022More than 100 species of annual herb genus Suaeda widely distribute (Asia, North America, northern Africa and Europe), are rich in resources (about hundreds of millions... (Review)
Review
More than 100 species of annual herb genus Suaeda widely distribute (Asia, North America, northern Africa and Europe), are rich in resources (about hundreds of millions of tons/Y) and have a long historical application. Most of them are mainly used for traditional food, feed and medicine. Recently, they have been employed to repair saline-alkali land and beautify the environment. So far, only 27 species have been reported on the bioactivity diversity, broad spectrum and effectiveness in clinical practice. Therefore, the in-depth and extensive research of Suaeda has become a research hotspot around the world. However, only one review summarized the nutritional, chemical and biological values of Suaeda. By searching the international authoritative databases (ACS Publications, ScienceDirect, PubMed, Springer, web of Science and Bing International etc.) and collecting 103 literatures closely related to Suaeda (1895-2021), herewith a comprehensive and systematic review was conducted on the phytology, chemistry, pharmacology and clinical application, enveloping the classification evolution between Amaranthaceae and Chenopodiaceae, distribution and common botanical characteristics; involving 9 chemical categories of 163 derivatives covering 14 new and 6 first-isolated ones, and appraising the content determination of 6 categories of components; mainly including the pharmacology of 13 species in vivo and vitro; estimating the clinical application of 16 species cured the related diseases of eight human physiological system except for the motor system. It is expected that this paper will provide forward-looking scientific ideas and literature support for the further modern research, development and utilization of the genus.
Topics: Chenopodiaceae; Ethnopharmacology; Europe; Humans; Phytochemicals; Phytotherapy; Plant Extracts
PubMed: 35381342
DOI: 10.1016/j.phrs.2022.106203 -
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 -
Complementary Therapies in Clinical... May 2022Conjunctivitis is the inflammation of the conjunctiva. Although data on clinical efficacy and safety of various ayurvedic treatments in conjunctivitis is published,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Conjunctivitis is the inflammation of the conjunctiva. Although data on clinical efficacy and safety of various ayurvedic treatments in conjunctivitis is published, systematic review is not done. This systematic review and meta-analysis aims to evaluate the efficacy and safety of ayurvedic treatments in conjunctivitis.
METHODS
A literature search of the Cochrane Library (Cochrane central register of controlled trials: issue 6 of 12, June 2018), Pub Med, AYUSH research portal (Govt. of India), DHARA portal, Google scholar and online clinical trials registers was done. Randomized controlled trials (RCTs), quasi-randomized controlled trials (QRCTs), controlled clinical trials (CCTs) and multiple arms clinical trials were identified in which Ayurveda treatments with any dose, type, schedule, drug, dosage form, and advised Pathayapathya (lifestyle changes) were selected.
RESULTS
We identified 13 eligible RCTs, five CCTs and two multiple arms clinical trials which includes a total of 816 participants. Meta analysis of data from five trials showed that ayurvedic treatments benefitted more compared with non-ayurveda interventions in symptoms like itching (SMD = -0.98, 95% CI (-1.30,-0.65) p < 0.00001, I = 38%), pain (SMD = -0.57, 95% CI (-0.87, -0.29, P = 0.0001, I = 0%), ropy discharge (SMD = -1.02, 95% CI(-1.45, -0.59), P < 0.00001, I = 0%), conjunctival congestion (SMD = -0.67, 95% CI (-0.91, -0.43), p < 0.00001, I = 0%), foreign body sensation (SMD = -0.68, 95% CI(-1.06, -0.29), p = 0.0006, I = 46%, Fig. 8) and lid heaviness (SMD = -0.66, 95% CI(- 0.98, -0.33), p < 0.0001, I = 0%).
CONCLUSIONS
Although some findings confirm the benefit of ayurveda as opposed to non ayurveda for the treatment of conjunctivitis, since the studies have high risk of bias and are of lower quality, the findings could not be generalized. There is a need for high quality studies in ayurveda in this regard.
PROSPERO REGISTRATION
CRD42019129436.
Topics: Conjunctivitis; Humans; India; Medicine, Ayurvedic; Treatment Outcome
PubMed: 35259570
DOI: 10.1016/j.ctcp.2022.101568