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Evidence-based Complementary and... 2020Sleep complaints are common health issues in the general population. These conditions are associated with poorer physical and psychological activity, and they may have... (Review)
Review
BACKGROUND
Sleep complaints are common health issues in the general population. These conditions are associated with poorer physical and psychological activity, and they may have important social, economic, and personal consequences. In the last years, several food supplements with different plant extracts have been developed and are currently taken for improving sleep. . The aim of this study is to systematically review recent literature on oral plant extracts acting on sleep disorders distinguishing their action on the different symptoms of sleep complaints: difficulty in initiating or maintaining sleep, waking up too early, and quality of sleep.
METHODS
We searched the PubMed database up to 05/03/2020 based on data from randomized, double-blind, placebo-controlled trials, noncontrolled trials, and cohort studies conducted in children and adult subjects. The search words used contained the following terms: oral food supplement and sleep disorders and the like. The most studied compounds were further analyzed with a second search using the following terms: name of the compound and sleep disorders. We selected 7 emerging compounds and 38 relevant reports.
RESULTS
Although nutraceutical natural products have been used for sleep empirically, there is a scarcity of evidence on the efficacy of each product in clinical studies. Valerian and lavender were the most frequently studied plant extracts, and their use has been associated (with conflicting results) with anxiolytic effects and improvements in quality and duration of sleep.
CONCLUSIONS
Sleep aids based on plant extracts are generally safe and well tolerated by the population. More high-quality research is needed to confirm the effectiveness of food supplements containing plant extracts in sleep complaints; in particular, it would be interesting to evaluate the association between plant extracts and sleep hygiene guidelines and to identify the optimal products to be used in a specific symptom of sleep complaint, giving more appropriate tools to the medical doctor.
PubMed: 32382286
DOI: 10.1155/2020/3792390 -
The American Journal of Occupational... 2020Children and youth are often challenged to maintain well-being, positive behavior, and social participation.
IMPORTANCE
Children and youth are often challenged to maintain well-being, positive behavior, and social participation.
OBJECTIVE
To identify evidence for occupational therapy interventions for children and youth with and at risk for mental health concerns.
DATA SOURCES
Articles published in English-language peer-reviewed journals between January 2010 and March 2017 identified through searches of MEDLINE, PsycINFO, CINAHL, ERIC, OTseeker, and Cochrane databases.
STUDY SELECTION AND DATA COLLECTIO
: The methodology in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to complete the review. Of 5,310 articles screened by title and abstract, 357 were retrieved for full-text review, and 62 met inclusion criteria. Articles describing interventions that were activity or occupation based were included. Conference proceedings, non-peer reviewed publications, dissertations, theses, and presentations were excluded.
FINDINGS
Of the 62 studies included in the review, 20 (32%) were Level I studies, 22 (36%) were Level II studies, and 20 (32%) were Level III studies. Articles were categorized by type: outdoor camps, video and computer games, productive occupations and life skills, meditation, animal-assisted interventions, creative arts, play, sports, and yoga. Moderate to strong evidence supports the use of yoga and sports. Moderate-strength evidence supports the use of play and creative arts. Evidence for the use of animal-assisted interventions, meditation, video and computer games, and productive occupations was of low strength.
CONCLUSION AND RELEVANCE
Substantial evidence exists to support the use of activity- and occupation-based interventions to address the mental health, behavioral, and social participation concerns of children and youth. Occupational therapy practitioners should match the desired outcome of therapy with the appropriate intervention to provide the best and most effective services to their clients.
WHAT THIS ARTICLE ADDS
This review provides additional support for the use of activity- and occupation-based interventions (i.e., those that involve active participation) to improve the behavior, social participation, and mental health of children and youth.
Topics: Adolescent; Child; Humans; Mental Health; Occupational Therapy; Social Participation
PubMed: 32204773
DOI: 10.5014/ajot.2020.038687 -
Archives of Physical Medicine and... Sep 2020To systematically review, summarize, and evaluate published evidence on measurement properties of real-world versions of the Multiple Errands Test (MET) following...
OBJECTIVE
To systematically review, summarize, and evaluate published evidence on measurement properties of real-world versions of the Multiple Errands Test (MET) following Consensus-based Standards for the Selection of Health Measurement Instruments guidelines.
DATA SOURCES
Four databases were searched in May 2019 using multiple variants of the name of the MET from 1991 onward following the publication of the original MET.
STUDY SELECTION
We included peer-reviewed original research articles in English that provided data on measurement properties (reliability, validity, and responsiveness to change) on real-world versions of the MET in any clinical population.
DATA EXTRACTION
Data on the MET characteristics, study population, and evidence for each measurement property were extracted using predefined criteria. The review team critically appraised the methodological quality and rated the results from each study as sufficient (+), insufficient (-), or indeterminate (?).
DATA SUMMARY
Data on each measurement property were pooled. Pooled results were rated as sufficient (+), insufficient (-), mixed (±), or indeterminate (?). The overall quality of evidence per measurement property was graded based on risk of bias, sample size, and consistency of results. The overall evidence for each measurement property was determined as high, moderate, low, or very low.
RESULTS
We found 33 studies that provided data on measurement properties of real-world versions of the MET. Pooled results revealed high-quality evidence for interrater reliability and moderate-quality evidence for known-group validity. Limited support for other kinds of reliability and validity was found.
CONCLUSIONS
This review suggests the MET should be used cautiously. Reasons for the limited psychometric support are discussed, the value of generic forms of the MET that do not require site specific adaptations is noted, and areas for further psychometric work are highlighted.
Topics: Executive Function; Humans; Neuropsychological Tests; Psychometrics; Reproducibility of Results
PubMed: 32113973
DOI: 10.1016/j.apmr.2020.01.019 -
Implementation Science : IS Feb 2020Application of knowledge translation (KT) theories, models, and frameworks (TMFs) is one method for successfully incorporating evidence into clinical care. However,...
BACKGROUND
Application of knowledge translation (KT) theories, models, and frameworks (TMFs) is one method for successfully incorporating evidence into clinical care. However, there are multiple KT TMFs and little guidance on which to select. This study sought to identify and describe available full-spectrum KT TMFs to subsequently guide users.
METHODS
A scoping review was completed. Articles were identified through searches within electronic databases, previous reviews, grey literature, and consultation with KT experts. Search terms included combinations of KT terms and theory-related terms. Included citations had to describe full-spectrum KT TMFs that had been applied or tested. Titles/abstracts and full-text articles were screened independently by two investigators. Each KT TMF was described by its characteristics including name, context, key components, how it was used, primary target audience, levels of use, and study outcomes. Each KT TMF was also categorized into theoretical approaches as process models, determinant frameworks, classic theories, implementation theories, and evaluation frameworks. Within each category, KT TMFs were compared and contrasted to identify similarities and unique characteristics.
RESULTS
Electronic searches yielded 7160 citations. Additional citations were identified from previous reviews (n = 41) and bibliographies of included full-text articles (n = 6). Thirty-six citations describing 36 full-spectrum were identified. In 24 KT TMFs, the primary target audience was multi-level including patients/public, professionals, organizational, and financial/regulatory. The majority of the KT TMFs were used within public health, followed by research (organizational, translation, health), or in multiple contexts. Twenty-six could be used at the individual, organization, or policy levels, five at the individual/organization levels, three at the individual level only, and two at the organizational/policy level. Categorization of the KT TMFs resulted in 18 process models, eight classic theories, three determinant frameworks, three evaluation frameworks, and four that fit more than one category. There were no KT TMFs that fit the implementation theory category. Within each category, similarities and unique characteristics emerged through comparison.
CONCLUSIONS
A systematic compilation of existing full-spectrum KT TMFs, categorization into different approaches, and comparison has been provided in a user-friendly way. This list provides options for users to select from when designing KT projects and interventions.
TRIAL REGISTRATION
A protocol outlining the methodology of this scoping review was developed and registered with PROSPERO (CRD42018088564).
Topics: Delivery of Health Care; Humans; Models, Organizational; Research Design; Translational Research, Biomedical
PubMed: 32059738
DOI: 10.1186/s13012-020-0964-5 -
Physical Therapy in Sport : Official... May 2020
Review
PubMed: 32044525
DOI: 10.1016/j.ptsp.2020.01.016 -
Globalization and Health Feb 2020Due to unrestricted entry of wastewater into the environment and the transportation of microbial contaminants to humans and organisms, environmental protection requires...
BACKGROUND
Due to unrestricted entry of wastewater into the environment and the transportation of microbial contaminants to humans and organisms, environmental protection requires the use of appropriate purification systems with high removal efficiency for microbial agents are needed. The purpose of this study was to determine the efficacy of current wastewater treatment systems in removing microbes and their contaminants.
METHODS
A systematic review was conducted for all articles published in 5 Iranian environmental health journals in 11 years. The data were collected according to the inclusion and exclusion criteria and by searching the relevant keywords in the articles published during the years (2008-2018), with emphasis on the efficacy of wastewater treatment systems in removing microbial agents. Qualitative data were collected using a preferred reporting items for systematic reviews and meta-analyzes (PRISMA) standard checklist. After confirming the quality of the articles, information such as the name of the first author and the year of publication of the research, the type of study, the number of samples, the type of purification, the type of microbial agents and the rate of removal of microbial agents were entered into the checklist. Also the removal rates of the microbial agents mentioned in the studies were compared with united states environmental protection agency (US-EPA) standards.
RESULTS
In this study, 1468 articles retrieved from 118 issues of 5 environmental health journals were reviewed. After reviewing the quality of the articles in accordance with the research objectives, 14 articles were included in the study that were published between 2010 and 2018. In most studies, two main indicators Total coliforms and Fecal coliforms in wastewater were investigated. Removing fungi and viral contamination from wastewater was not found in any of the 14 studies. Different systems (activated sludge, stabilization ponds, wetlands, and low and medium pressure UV disinfection systems were used to remove microbial agents in these studies. Most articles used active sludge systems to remove Total coliforms and Fecal coliforms, which in some cases were not within the US-EPA standard. The removal of Cysts and Parasitic eggs was only reporte from stabilization pond systems (SPS) where removal efficiency was found in accordance with US-EPA standards.
CONCLUSIONS
Different types of activated sludge systems have higher efficacy to remove microbial agents and are more effective than other mentioned systems in removing the main indicators of sewage contamination including Total coliforms and Fecal coliforms. However, inappropriate operation, maintenance and inadequate handling of activated sludge can also reduce its efficiency and reduce the removal of microbial agents, which was reported in some studies. Therefore, it is recommended to conduct research on how to improve the operation, maintenance, and proper management of activated sludge systems to transfer knowledge to users of sludge systems and prevent further health issues related to microbial agents.
Topics: Conservation of Natural Resources; Humans; Iran; Wastewater; Water Purification
PubMed: 32013988
DOI: 10.1186/s12992-020-0546-y -
The Cochrane Database of Systematic... Jan 2020Onychomycosis refers to fungal infections of the nail apparatus that may cause pain, discomfort, and disfigurement. This is an update of a Cochrane Review published in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Onychomycosis refers to fungal infections of the nail apparatus that may cause pain, discomfort, and disfigurement. This is an update of a Cochrane Review published in 2007; a substantial amount of new research warrants a review exclusively on toenails.
OBJECTIVES
To assess the clinical and mycological effects of topical drugs and device-based therapies for toenail onychomycosis.
SEARCH METHODS
We searched the following databases up to May 2019: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase and LILACS. We also searched five trials registers, and checked the reference lists of included and excluded studies for further references to relevant randomised controlled trials.
SELECTION CRITERIA
Randomised controlled trials of topical and device-based therapies for onychomycosis in participants with toenail onychomycosis, confirmed by positive cultures, direct microscopy, or histological nail examination. Eligible comparators were placebo, vehicle, no treatment, or an active topical or device-based treatment.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane. Primary outcomes were complete cure rate (normal-looking nail plus fungus elimination, determined with laboratory methods) and number of participants reporting treatment-related adverse events.
MAIN RESULTS
We included 56 studies (12,501 participants, average age: 27 to 68 years), with mainly mild-to-moderate onychomycosis without matrix involvement (where reported). Participants had more than one toenail affected. Most studies lasted 48 to 52 weeks; 23% reported disease duration (variable). Thirty-five studies specifically examined dermatophyte-caused onychomycosis. Forty-three studies were carried out in outpatient settings. Most studies assessed topical treatments, 9% devices, and 11% both. We rated three studies at low risk of bias across all domains. The most common high-risk domain was performance bias. We present results for key comparisons, where treatment duration was 36 or 48 weeks, and clinical outcomes were measured at 40 to 52 weeks. Based on two studies (460 participants), compared with vehicle, ciclopirox 8% lacquer may be more effective in achieving complete cure (risk ratio (RR) 9.29, 95% confidence interval (CI) 1.72 to 50.14; low-quality evidence) and is probably more effective in achieving mycological cure (RR 3.15, 95% CI 1.93 to 5.12; moderate-quality evidence). Ciclopirox lacquer may lead to increased adverse events, commonly application reactions, rashes, and nail alteration (e.g. colour, shape). However, the 95% CI indicates that ciclopirox lacquer may actually make little or no difference (RR 1.61, 95% CI 0.89 to 2.92; low-quality evidence). Efinaconazole 10% solution is more effective than vehicle in achieving complete cure (RR 3.54, 95% CI 2.24 to 5.60; 3 studies, 1716 participants) and clinical cure (RR 3.07, 95% CI 2.08 to 4.53; 2 studies, 1655 participants) (both high-quality evidence) and is probably more effective in achieving mycological cure (RR 2.31, 95% CI 1.08 to 4.94; 3 studies, 1716 participants; moderate-quality evidence). Risk of adverse events (such as dermatitis and vesicles) was slightly higher with efinaconazole (RR 1.10, 95% CI 1.01 to 1.20; 3 studies, 1701 participants; high-quality evidence). No other key comparison measured clinical cure. Based on two studies, compared with vehicle, tavaborole 5% solution is probably more effective in achieving complete cure (RR 7.40, 95% CI 2.71 to 20.24; 1198 participants), but probably has a higher risk of adverse events (application site reactions were most commonly reported) (RR 3.82, 95% CI 1.65 to 8.85; 1186 participants (both moderate-quality evidence)). Tavaborole improves mycological cure (RR 3.40, 95% CI 2.34 to 4.93; 1198 participants; high-quality evidence). Moderate-quality evidence from two studies (490 participants) indicates that P-3051 (ciclopirox 8% hydrolacquer) is probably more effective than the comparators ciclopirox 8% lacquer or amorolfine 5% in achieving complete cure (RR 2.43, 95% CI 1.32 to 4.48), but there is probably little or no difference between the treatments in achieving mycological cure (RR 1.08, 95% CI 0.85 to 1.37). We found no difference in the risk of adverse events (RR 0.60, 95% CI 0.19 to 1.92; 2 studies, 487 participants; low-quality evidence). The most common events were erythema, rash, and burning. Three studies (112 participants) compared 1064-nm Nd:YAG laser to no treatment or sham treatment. We are uncertain if there is a difference in adverse events (very low-quality evidence) (two studies; 85 participants). There may be little or no difference in mycological cure at 52 weeks (RR 1.04, 95% CI 0.59 to 1.85; 2 studies, 85 participants; low-quality evidence). Complete cure was not measured. One study (293 participants) compared luliconazole 5% solution to vehicle. We are uncertain whether luliconazole leads to higher rates of complete cure (very low-quality evidence). Low-quality evidence indicates there may be little or no difference in adverse events (RR 1.02, 95% CI 0.90 to 1.16) and there may be increased mycological cure with luliconazole; however, the 95% CI indicates that luliconazole may make little or no difference to mycological cure (RR 1.39, 95% CI 0.98 to 1.97). Commonly-reported adverse events were dry skin, paronychia, eczema, and hyperkeratosis, which improved or resolved post-treatment.
AUTHORS' CONCLUSIONS
Assessing complete cure, high-quality evidence supports the effectiveness of efinaconazole, moderate-quality evidence supports P-3051 (ciclopirox 8% hydrolacquer) and tavaborole, and low-quality evidence supports ciclopirox 8% lacquer. We are uncertain whether luliconazole 5% solution leads to complete cure (very low-quality evidence); this outcome was not measured by the 1064-nm Nd:YAG laser comparison. Although evidence supports topical treatments, complete cure rates with topical treatments are relatively low. We are uncertain if 1064-nm Nd:YAG laser increases adverse events compared with no treatment or sham treatment (very low-quality evidence). Low-quality evidence indicates that there is no difference in adverse events between P-3051 (ciclopirox hydrolacquer), luliconazole 5% solution, and their comparators. Ciclopirox 8% lacquer may increase adverse events (low-quality evidence). High- to moderate-quality evidence suggests increased adverse events with efinaconazole 10% solution or tavaborole 5% solution. We downgraded evidence for heterogeneity, lack of blinding, and small sample sizes. There is uncertainty about the effectiveness of device-based treatments, which were under-represented; 80% of studies assessed topical treatments, but we were unable to evaluate all of the currently relevant topical treatments. Future studies of topical and device-based therapies should be blinded, with patient-centred outcomes and an adequate sample size. They should specify the causative organism and directly compare treatments.
Topics: Administration, Topical; Adult; Aged; Antifungal Agents; Female; Humans; Male; Middle Aged; Onychomycosis; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 31978269
DOI: 10.1002/14651858.CD012093.pub2 -
BMC Health Services Research Dec 2019In the original publication of this article [1], one author's name needs to be revised from Pavaneh Isfahani to Parvaneh Isfahani.
In the original publication of this article [1], one author's name needs to be revised from Pavaneh Isfahani to Parvaneh Isfahani.
PubMed: 31822274
DOI: 10.1186/s12913-019-4766-x -
Journal of Affective Disorders Feb 2020Emotional disorders, such as anxiety and depression, are one of the main causes of disability worldwide. Recent reviews suggest that Acceptance and Commitment Therapy is...
BACKGROUND
Emotional disorders, such as anxiety and depression, are one of the main causes of disability worldwide. Recent reviews suggest that Acceptance and Commitment Therapy is effective in treating emotional disorders. However, they appraise mainly individual approaches. This review aimed to analyze published studies regarding the usefulness of Acceptance and Commitment Therapy, applied on a group basis, in the treatment of anxiety and depression.
METHODS
A systematic review of the literature was conducted using the Web of Science, from 2008 to 2019. Fifteen articles fulfilled the inclusion criteria.
RESULTS
Those patients who received interventions based on Acceptance and Commitment Therapy showed a better emotional state and greater psychological flexibility than patients in control groups without treatment. No differences are found with Cognitive Therapy and Cognitive-Behavioral Therapy.
LIMITATIONS
the studies reviewed show limitations, principally regarding sample characteristics, study design and manner in which mechanisms responsible for changes are evaluated.
CONCLUSION
Group-based Acceptance and Commitment Therapy proved to be useful in the psychological treatment of emotional disorders. However, the heterogeneity and limitations of the studies, make it impossible to determine the exact therapeutic elements, and if they are specific to the approach and procedure of this therapy. More research would be necessary to ascertain what patient and/or intervention characteristics might improve results and what the active and specific ingredients of the therapy are. This has clinical relevance because group-based interventions could be more cost-efficient, and it would help facilitate health-care decisions aimed at giving the public access to useful treatments.
Topics: Acceptance and Commitment Therapy; Anxiety; Anxiety Disorders; Cognitive Behavioral Therapy; Depression; Humans
PubMed: 31818766
DOI: 10.1016/j.jad.2019.11.154 -
European Journal of Clinical... Nov 2019Poorly described placebo/sham controls make it difficult to appraise active intervention benefits and harms. The 12-item Template for Intervention Description and...
BACKGROUND
Poorly described placebo/sham controls make it difficult to appraise active intervention benefits and harms. The 12-item Template for Intervention Description and Replication (TIDieR) checklist was developed to improve the reporting of active interventions. The extent to which TIDieR has been used to improve description of placebo or sham control is not known.
MATERIALS AND METHODS
We systematically identified and examined all placebo/sham-controlled randomised trials published in 2018 in the top six general medical journals. We reported how many of the TIDieR checklist items were used to describe the placebo/sham control(s). We supplemented this with a sample of 100 placebo/sham-controlled trials from any journal and searched Google Scholar to identify placebo/sham-controlled trials citing TIDieR.
RESULTS
We identified 94 placebo/sham-controlled trials published in the top journals in 2018. None reported using TIDieR, and none reported placebo or sham components completely. On average eight TIDieR items were addressed, with placebo/sham control name (100%) and when and how much was administered (97.9%) most commonly reported. Some items (rationale, 8.5%, whether there were modifications, 25.5%) were less often reported. In our sample of less well-cited journals, reporting was poorer (average of six items) and followed a similar pattern. Since TIDieR's first publication, six placebo-controlled trials have cited it according to Google Scholar. Two of these used the checklist to describe placebo controls; neither one completely desribed the placebo intervention.
CONCLUSIONS
Placebo and sham controls are poorly described within randomised trials, and TIDieR is rarely used to guide these descriptions. We recommend developing guidelines to promote better descriptions of placebo/sham control components within clinical trials.
Topics: Checklist; Control Groups; Humans; Placebos; Randomized Controlled Trials as Topic; Research Report
PubMed: 31519047
DOI: 10.1111/eci.13169