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Journal of Evidence-based Medicine Nov 2019To systematically evaluate evidence against male circumcision (MC).
OBJECTIVE
To systematically evaluate evidence against male circumcision (MC).
METHODS
We searched PubMed, Google Scholar, EMBASE and Cochrane databases.
RESULTS
Database searches retrieved 297 publications for inclusion. Bibliographies of these yielded 101 more. After evaluation we found: Claims that MC carries high risk were contradicted by low frequency of adverse events that were virtually all minor and easily treated with complete resolution. Claims that MC causes psychological harm were contradicted by studies finding no such harm. Claims that MC impairs sexual function and pleasure were contradicted by high-quality studies finding no adverse effect. Claims disputing the medical benefits of MC were contradicted by a large body of high-quality evidence indicating protection against a wide range of infections, dermatological conditions, and genital cancers in males and the female sexual partners of men. Risk-benefit analyses reported that benefits exceed risks by 100-200 to 1. To maximize benefits and minimize risks, the evidence supported early infant MC rather than arguments that the procedure should be delayed until males are old enough to decide for themselves. Claims that MC of minors is unethical were contradicted by balanced evaluations of ethical issues supporting the rights of children to be provided with low-risk, high-benefit interventions such as MC for better health. Expert evaluations of case-law supported the legality of MC of minors. Other data demonstrated that early infant MC is cost-saving to health systems.
CONCLUSIONS
Arguments opposing MC are supported mostly by low-quality evidence and opinion, and are contradicted by strong scientific evidence.
Topics: Circumcision, Male; Evidence-Based Medicine; Humans; Male
PubMed: 31496128
DOI: 10.1111/jebm.12361 -
European Journal of Orthodontics Jun 2020Social media are one of the most common and easily accessible ways of gaining information about orthodontic treatment.
BACKGROUND
Social media are one of the most common and easily accessible ways of gaining information about orthodontic treatment.
OBJECTIVE
The main objective of this study was to systematically search the literature and determine the various aspects of the interrelationship between social media and orthodontics from the patient's perspective.
SEARCH METHODS
Electronic database searches of published and unpublished literature were performed. The reference lists of all eligible articles were hand-searched for additional studies.
SELECTION CRITERIA
Randomized clinical trials (RCTs), prospective, retrospective, and cross-sectional studies were included.
DATA COLLECTION AND ANALYSIS
Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate by the first two authors.
RESULTS
One RCT, three retrospective, and four cross-sectional studies were deemed as eligible for inclusion in this review. The studies included patient's statements in social media or results from questionnaires given to patients. The social media reported were with order of frequency: Twitter, YouTube, Facebook, Google+, Pinterest, and Instagram. The feelings the patients expressed seemed to be more positive than negative: enthusiasm, self-esteem and pleasure, excitement about the aesthetic result, excitement after braces removal but also antipathy, annoyances, reduced self-esteem, and impatience for removing mechanisms. In addition, one study referred to bullying through Twitter.
LIMITATIONS
The high amount of heterogeneity precluded a valid interpretation of the results through pooled estimates.
CONCLUSIONS AND IMPLICATIONS
This systematic review demonstrated that information about orthodontics, how the patient feels, and other psychosocial facets are spread through social media. It is intuitive that research relating to the effects and impact of orthodontic interventions should account not only for the physical impacts of treatment but also to encompass patient-centered outcomes.
REGISTRATION
The protocol of this study was not registered in publicly assessable database.
CONFLICTS OF INTEREST
None to declare.
Topics: Dental Care; Esthetics, Dental; Humans; Orthodontics; Retrospective Studies; Social Media
PubMed: 31107943
DOI: 10.1093/ejo/cjz029 -
Nicotine & Tobacco Research : Official... Jan 2020When animals undergo nicotine deprivation, rewards become less rewarding (ie, anhedonia occurs). We searched for tests of whether anhedonia occurs in abstinent smokers.
INTRODUCTION
When animals undergo nicotine deprivation, rewards become less rewarding (ie, anhedonia occurs). We searched for tests of whether anhedonia occurs in abstinent smokers.
METHODS
The major inclusion criterion was a within-participants comparison of behavioral measures of reward sensitivity or self-reported anhedonia during smoking versus during abstinence among daily smokers. A computerized search of PubMed, PsychInfo, and Cochrane databases and other methods located 13 studies. All but one were laboratory studies.
RESULTS
The number of studies and participants were small and the results mixed. In terms of anticipatory anhedonia (ie, wanting a reward), abstinence appeared to decrease willingness to work for immediately available rewards, but did not appear to influence how much adding rewards to a task increased responding. Abstinence also appeared to produce small increases in self-reported anticipatory anhedonia. In terms of consummatory anhedonia (ie, liking a reward), self-report measures found anhedonia decreased pleasure from rewards in some but not all tests. In terms of learning (ie, learning to choose a more frequent reward), abstinence did not reliably decrease allocating responding to high versus low frequency reward options.
CONCLUSIONS
Although results were mixed, abstinence appears to increase anticipatory anhedonia. It is unclear if abstinence increases consummatory or reward learning-based anhedonia. Further studies of anhedonia in clinical settings are needed (1) to estimate the reliability and clinical significance of anhedonia as a symptom of tobacco withdrawal, (2) to assess if effects represent withdrawal versus offset processes, and (3) to assess if anhedonia interferes with the ability to stop smoking.
IMPLICATIONS
Anticipatory anhedonia appears to be a symptom of tobacco withdrawal and should be added to tobacco withdrawal checklists and diagnostic criteria. Further study of consummatory and learning-based anhedonia is warranted.
Topics: Anhedonia; Humans; Inhibition, Psychological; Smokers; Smoking Cessation; Substance Withdrawal Syndrome; Tobacco Use Disorder
PubMed: 30726957
DOI: 10.1093/ntr/nty171