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Eating and Weight Disorders : EWD Apr 2023Acculturation, or the dual process of cultural change that takes place due to the interaction between two or more cultural identities, may contribute to the... (Review)
Review
PURPOSE
Acculturation, or the dual process of cultural change that takes place due to the interaction between two or more cultural identities, may contribute to the susceptibility of developing an eating disorder (ED). We conducted a systematic review exploring the relationship between acculturation-related constructs and ED pathology.
METHODS
We searched the PsychINFO and Pubmed/Medline databases up to December 2022. Inclusion criteria were: (1) having a measure of acculturation or related constructs; (2) having a measure of ED symptoms; and (3) experiencing cultural change to a different culture with Western ideals. 22 articles were included in the review. Outcome data were synthesized by narrative synthesis.
RESULTS
There was variability in the definition and measure of acculturation in the literature. Overall, acculturation, culture change, acculturative stress, and intergenerational conflict were associated with ED behavioral and/or cognitive symptoms. However, the nature of the specific associations differed depending on the specific acculturation constructs and ED cognitions and behaviors measured. Furthermore, cultural factors (e.g., in-group vs. out-group preferences, generational status, ethnic group, gender) impacted the relationship between acculturation and ED pathology.
DISCUSSION
Overall, this review highlights the need for more precise definitions of the different domains of acculturation and a more nuanced understanding of the specific relationship between various acculturation domains and specific ED cognitions and behaviors. Most of the studies were conducted in undergraduate women and in Hispanic/Latino samples, limiting generalizability of results.
LEVEL OF EVIDENCE
Level V, Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
Topics: Humans; Female; Acculturation; Stress, Psychological; Ethnicity; Feeding and Eating Disorders
PubMed: 37076614
DOI: 10.1007/s40519-023-01563-2 -
Age and Ageing Jan 2023walking is crucial for an active and healthy ageing, but the perspectives of individuals living with walking impairment are still poorly understood.
BACKGROUND
walking is crucial for an active and healthy ageing, but the perspectives of individuals living with walking impairment are still poorly understood.
OBJECTIVES
to identify and synthesise evidence describing walking as experienced by adults living with mobility-impairing health conditions and to propose an empirical conceptual framework of walking experience.
METHODS
we performed a systematic review and meta-ethnography of qualitative evidence, searching seven electronic databases for records that explored personal experiences of walking in individuals living with conditions of diverse aetiology. Conditions included Parkinson's disease, multiple sclerosis, chronic obstructive pulmonary disease, hip fracture, heart failure, frailty and sarcopenia. Data were extracted, critically appraised using the NICE quality checklist and synthesised using standardised best practices.
RESULTS
from 2,552 unique records, 117 were eligible. Walking experience was similar across conditions and described by seven themes: (i) becoming aware of the personal walking experience, (ii) the walking experience as a link between individuals' activities and sense of self, (iii) the physical walking experience, (iv) the mental and emotional walking experience, (v) the social walking experience, (vi) the context of the walking experience and (vii) behavioural and attitudinal adaptations resulting from the walking experience. We propose a novel conceptual framework that visually represents the walking experience, informed by the interplay between these themes.
CONCLUSION
a multi-faceted and dynamic experience of walking was common across health conditions. Our conceptual framework of the walking experience provides a novel theoretical structure for patient-centred clinical practice, research and public health.
Topics: Humans; Qualitative Research; Anthropology, Cultural; Walking
PubMed: 36729471
DOI: 10.1093/ageing/afac233 -
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 -
Journal of Ethnopharmacology Sep 2023Functional dyspepsia (FD), a chronic upper gastrointestinal syndrome, seriously affects the quality of life of patients and poses a significant economic burden. Since... (Meta-Analysis)
Meta-Analysis Review
ETHNOPHARMACOLOGICAL RELEVANCE
Functional dyspepsia (FD), a chronic upper gastrointestinal syndrome, seriously affects the quality of life of patients and poses a significant economic burden. Since the pathological mechanisms of FD have not been fully elucidated, conventional therapies such as prokinetics, proton pump inhibitors, and antidepressants have some limitations. Siho-sogan-san (SHS) is commonly used as a therapeutic alternative in traditional medicine; however, scientific and clinical evidence supporting its application in FD remains insufficient.
AIM OF THE STUDY
This review aimed to assess the safety and effectiveness of SHS and in combined with Western medicine (WM) for the treatment of FD.
METHODS
Eleven databases, including EMBASE, Medline, and Cochrane Library, were searched for randomized controlled trials (RCTs) on FD published before December 31, 2022. After two independent reveiwers sceened and selected studies according to the inclusion and exclusion criteria, clinical data was pooled and synthesized via Review Manager software. The outcome parameters included total clinical effectiveness rate (TCE), time for symptom improvement, levels of motilin and corticotropin-releasing hormone (CRH), and adverse events. Cochrane's risk of bias tool was used for quality assessment.
RESULTS
A total of 12 studies that included 867 participants comparing WM with SHS or combination therapy (SHS plus WM) were identified. Through a meta-analysis of five studies including 363 patients, SHS compared with WM showed a positive result in safely increasing TCE [risk ratio = 1.36, 95% confidence interval (CI) 1.22 to 1.51, P < 0.00001]. The time for symptom improvement, including abdominal pain, belching, nausea, vomiting, and abdominal distension, was significantly more shortened in the combination therapy than WM group. Furthermore, combination therapy resulted in greater secretion of motilin than WM alone [mean difference = 67.95, 95% CI 39.52 to 96.39, P < 0.00001]. No remarkable difference was observed in CRH levels between the combination therapy and WM groups. For a subgroup analysis, the administration of SHS based on the type of pattern identification (PI) showed larger effect size than in the group that do not consider PI.
CONCLUSIONS
These results suggest that SHS and combination therapy can be considered effective and safe options for the treatment of FD. However, owing to the low quality of the included studies, more well-designed investigational studies and RCTs with longer treatment and follow-up period are needed.
Topics: Humans; Dyspepsia; Motilin; Drugs, Chinese Herbal; Phytotherapy; Plants, Medicinal; Medicine, Traditional
PubMed: 37127143
DOI: 10.1016/j.jep.2023.116518 -
Complementary Therapies in Medicine Oct 2023Diminished ovarian reserve (DOR) refers to the decreased number and quality of oocytes in the ovary. Acupuncture and moxibustion has a certain effect on DOR; however,... (Review)
Review
OBJECTIVE
Diminished ovarian reserve (DOR) refers to the decreased number and quality of oocytes in the ovary. Acupuncture and moxibustion has a certain effect on DOR; however, the number of studies and reports of research evidence are limited. This study aimed to conduct a scoping review of the clinical research status of acupuncture and moxibustion for treating patients with DOR.
METHOD
PubMed, Cochrane Library, Excerpta Medica database, Allied and Complementary Medicine Database, Chinese Biological Medicine, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, and Wanfang database were searched from January 2010 to May 2022 using keywords and medical subject heading terms. After applying the inclusion and exclusion criteria, relevant studies were selected. Structured tables and descriptive charts were made to visually express research features by using Excel, Original, IBM SPSS Model 18.0, Adobe Illustrator and other software packages. Report quality was evaluated for Cochrane bias using Review Manager 5.3.
RESULTS
Overall, 851 studies were identified; of these, 90 met the inclusion criteria. The results extracted from these studies were classified into four categories: research characteristics, study type, acupuncture and moxibustion prescriptions, and efficacy observation.
CONCLUSIONS
The quality assessment of acupuncture and moxibustion for DOR is not ideal. Therefore, standardisation and normalisation should be strengthened, and high-quality evidence is needed to further demonstrate the effectiveness of this approach. Due to heterogeneity in DOR diagnosis, the observation index should be updated with reference to the latest research to improve efficacy evaluation.
Topics: Female; Humans; Acupuncture Therapy; Asian People; Medicine, East Asian Traditional; Moxibustion; Ovarian Reserve; Ovarian Diseases
PubMed: 37598724
DOI: 10.1016/j.ctim.2023.102973 -
Frontiers in Cellular and Infection... 2023Traditional Chinese medicine (TCM) has been used for the treatment of chronic liver diseases for a long time, with proven safety and efficacy in clinical settings....
OBJECTIVE
Traditional Chinese medicine (TCM) has been used for the treatment of chronic liver diseases for a long time, with proven safety and efficacy in clinical settings. Previous studies suggest that the therapeutic mechanism of TCM for hepatitis B cirrhosis may involve the gut microbiota. Nevertheless, the causal relationship between the gut microbiota, which is closely linked to TCM, and cirrhosis remains unknown. This study aims to utilize two-sample Mendelian randomization (MR) to investigate the potential causal relationship between gut microbes and cirrhosis, as well as to elucidate the synergistic mechanisms between botanical drugs and microbiota in treating cirrhosis.
METHODS
Eight databases were systematically searched through May 2022 to identify clinical studies on TCM for hepatitis B cirrhosis. We analyzed the frequency, properties, flavors, and meridians of Chinese medicinals based on TCM theories and utilized the Apriori algorithm to identify the core botanical drugs for cirrhosis treatment. Cross-database comparison elucidated gut microbes sharing therapeutic targets with these core botanical drugs. MR analysis assessed consistency between gut microbiota causally implicated in cirrhosis and microbiota sharing therapeutic targets with key botanicals.
RESULTS
Our findings revealed differences between the Chinese medicinals used for compensated and decompensated cirrhosis, with distinct frequency, dosage, properties, flavors, and meridian based on TCM theory. were the main botanicals. Botanical drugs and gut microbiota target MAPK1, VEGFA, STAT3, AKT1, RELA, JUN, and ESR1 in the treatment of hepatitis B cirrhosis, and their combined use has shown promise for cirrhosis treatment. MR analysis demonstrated a positive correlation between increased ClostridialesvadinBB60 and Ruminococcustorques abundance and heightened cirrhosis risk. In contrast, Eubacteriumruminantium, Lachnospiraceae, Eubacteriumnodatum, RuminococcaceaeNK4A214, Veillonella, and RuminococcaceaeUCG002 associated with reduced cirrhosis risk. Notably, Lachnospiraceae shares key therapeutic targets with core botanicals, which can treat cirrhosis at a causal level.
CONCLUSION
We identified 6 core botanical drugs for managing compensated and decompensated hepatitis B cirrhosis, despite slight prescription differences. The core botanical drugs affected cirrhosis through multiple targets and pathways. The shared biological effects between botanicals and protective gut microbiota offer a potential explanation for the therapeutic benefits of these key herbal components in treating cirrhosis. Elucidating these mechanisms provides crucial insights to inform new drug development and optimize clinical therapy for hepatitis B cirrhosis.
Topics: Humans; Medicine, Chinese Traditional; Gastrointestinal Microbiome; Mendelian Randomization Analysis; Drugs, Chinese Herbal; Liver Cirrhosis; Data Mining; Hepatitis B
PubMed: 38029250
DOI: 10.3389/fcimb.2023.1273031 -
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 Affective Disorders Mar 2021Breastfeeding is recommended to improve maternal and infant health globally. Depression has been posited to negatively impact breastfeeding, although potential causal... (Review)
Review
BACKGROUND
Breastfeeding is recommended to improve maternal and infant health globally. Depression has been posited to negatively impact breastfeeding, although potential causal and bidirectional pathways between these two phenomena have not been sufficiently characterized. We therefore conducted a systematic review to critically evaluate available evidence on the relationship between perinatal depressive symptoms and breastfeeding behaviors; to identify knowledge gaps and propose a biosocial research agenda to advance our understanding of this topic.
METHODS
A systematic search strategy was applied across seven databases. Data were extracted and aggregated using the matrix method to provide a narrative synthesis of findings.
RESULTS
Thirty-eight studies from 20 countries spanning 1988 through 2018 fit the inclusion criteria. In general, methods across studies were heterogeneous. Fourteen different tools were used to measure perinatal depressive symptoms. Nearly half the studies did not provide breastfeeding definitions. No studies from low-income countries met inclusion criteria. More than half (63%) of studies demonstrated a negative association between depressive symptoms across the perinatal period and less exclusive breastfeeding and/or shorter breastfeeding durations.
LIMITATIONS
Heterogeneity in study design, definitions, assessment tools, and measurement time points limited the comparability of study findings. Causality cannot be assessed.
CONCLUSIONS
Available evidence suggests perinatal depressive symptoms negatively associated with breastfeeding exclusivity and duration, which can lead to suboptimal infant nutrition and detrimental impacts on maternal mental and physical health. To better understand this relationship, we propose including consistent operationalization and assessment of depression and breastfeeding globally and concurrent repeated measures of key biological and social factors.
Topics: Breast Feeding; Depression; Depression, Postpartum; Female; Humans; Infant; Poverty; Pregnancy; Time Factors
PubMed: 33272686
DOI: 10.1016/j.jad.2020.11.080 -
Medicine Aug 2022Research into acupuncture and moxibustion and their application for chronic fatigue syndrome (CFS) has been growing, but the findings have been inconsistent. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Research into acupuncture and moxibustion and their application for chronic fatigue syndrome (CFS) has been growing, but the findings have been inconsistent.
OBJECTIVE
To evaluate the existing randomized clinical trials (RCTs), compare the efficacy of acupuncture, moxibustion and other traditional Chinese medicine (TCM) treatments.
DATA SOURCES
Three English-language databases (PubMed, Embase, Web of Science, and The Cochrane Library) and 4 Chinese-language biomedical databases (Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were searched for RCTs published from database inception through August 2021.
STUDY SELECTION
RCTs include acupuncture, moxibustion, traditional Chinese herbal medicine, western medicine and no control.
DATA EXTRACTION AND SYNTHESIS
Data were screened and extracted independently using predesigned forms. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. We conducted a random-effects network meta-analysis within a frequentist framework. We assessed the certainty of evidence contributing to network estimates of the main outcomes with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.
MAIN OUTCOMES AND MEASURES
The primary outcomes were the overall response rate and FS-14 scale.
RESULTS
A total of 51 randomized controlled trials involving 3473 patients with CFS were included in this review. Forty one studies indicate low risk or unknown risk, and the GRADE scores of the combined results show low levels. Among the main indicators, traditional Chinese medicine therapies have excellent performance. However, the overall response rate is slightly different from the results obtained from the Fatigue Scale-14 total score. Moxibustion and traditional Chinese medicine (Odds ratios 48, 95% CrI 15-150) perform better in the total effective rate, while moxibustion plus acupuncture (MD 4.5, 95% CrI 3.0-5.9) is better in the FS-14 total score.
CONCLUSIONS
The effect of acupuncture and moxibustion in the treatment of CFS was significantly higher than that of other treatments. Traditional Chinese medicine should be used more widely in the treatment of CFS.
Topics: Acupuncture Therapy; Fatigue Syndrome, Chronic; Humans; Medicine, Chinese Traditional; Moxibustion; Network Meta-Analysis
PubMed: 35945779
DOI: 10.1097/MD.0000000000029310 -
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