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Social Science & Medicine (1982) Oct 2021In a context of increasing international dialogue around the appropriate means and ends of newborn screening programmes, it is critical to explore the perspectives of... (Review)
Review
In a context of increasing international dialogue around the appropriate means and ends of newborn screening programmes, it is critical to explore the perspectives of those directly impacted by such screening. This meta-ethnography uses a systematic review process to identify qualitative studies that focus on parents' experiences of newborn screening published in English-language academic journals from 2000 to 2019 (n = 36). The included studies represent a range of moments, outcomes, and conditions that illuminate discrete elements of the newborn screening journey. We draw on these varied studies to construct a diagram of possible newborn screening pathways and through so-doing identify a critical window of time between the signalling of a positive newborn screen and the end of the screening process. During this critical window of time, families navigate complex emotional reactions, information, and decisions. From an in-depth analysis of this data, we develop the concept of "absorptive capacity" as a lens through which to understand parents' responses to new and emerging information. Alongside this, we identify how the "concertinaing of time" - the various ways that parents experience the expansion and compression of time throughout and beyond the screening pathway - affects their absorptive capacities. This study underscores the need to move away from viewing newborn screening as a discrete series of clinical events and instead understand it as a process that can have far-reaching implications across time, space, and family groups. Using this understanding of screening as a starting point, we make recommendations to facilitate communication and support for screened families, including the antenatal provision of information to parents and accommodations for the fluctuations in parents' absorptive capacities across the screening trajectory.
Topics: Anthropology, Cultural; Communication; Female; Humans; Infant, Newborn; Neonatal Screening; Parents; Pregnancy; Qualitative Research
PubMed: 34534781
DOI: 10.1016/j.socscimed.2021.114367 -
Psychiatria Danubina Jun 2017Though a number of reports on the use of electroconvulsive therapy (ECT) has been published from the Central-Eastern European region over the past two decades, a... (Comparative Study)
Comparative Study Review
Though a number of reports on the use of electroconvulsive therapy (ECT) has been published from the Central-Eastern European region over the past two decades, a systematic review of this literature has not been published. Thus the aim of this paper was to review recent trends in ECT practice in Central-Eastern Europe. Systematic literature search was undertaken using the Medline, PSYCHINFO and EMBASE databases covering the period between January 2000 and December 2013. Relevant publications were found from the following countries: Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Serbia, Slovakia, Ukraine, but none from Albania and Moldova. ECT practice in the region shows a heterogeneous picture in terms of utilization rate, main indications, and the technical parameters of application. On one end of the spectrum is Slovakia where the majority of psychiatric facilities offer ECT, on the other end is Slovenia, where ECT is banned. In about half of the countries schizophrenia is the main indication for ECT. In Ukraine, unmodified ECT is still in use. Clinical training is generally lacking in the region and only 3 countries have a national ECT protocol. Possible ways of improving ECT practice in the region are briefly discussed.
Topics: Cross-Cultural Comparison; Electroconvulsive Therapy; Europe; Humans; Mood Disorders; Schizophrenia; Schizophrenic Psychology; Utilization Review
PubMed: 28636570
DOI: 10.24869/psyd.2017.136 -
Medicine Sep 2022Epilepsy is a chronic encephalopathy caused by abnormal discharge of neurons in the brain, resulting in brain dysfunction. Cognitive impairment is one of the most common... (Meta-Analysis)
Meta-Analysis
BACKGROUNDS
Epilepsy is a chronic encephalopathy caused by abnormal discharge of neurons in the brain, resulting in brain dysfunction. Cognitive impairment is one of the most common complications of epilepsy. The current treatment of epilepsy in the control of symptoms at the same time cause a lot of side effects, especially the aggravation of cognitive impairment. Many literatures have stated that the efficacy and safety of integrated Traditional Chinese and western medicine in the treatment of epilepsy with cognitive impairment is superior to that of western medicine alone. In this systematic review and meta-analysis, we intend to evaluate the clinical efficacy and safety of removing stasis and resolving phlegm in the treatment of epilepsy with cognitive impairment.
OBJECTIVE
To systematically evaluate the clinical efficacy and safety of removing blood stasis and resolving phlegm in the treatment of epilepsy with cognitive impairment.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to conduct this systematic review. The Chinese Journal Full Text Database (CNKI), Wanfang Database, CQVIP Database (CQVIP), Cochrane Library, EMbase, and Pubmed were searched by computer, and randomized controlled studies on the efficacy of removing blood stasis and resolving phlegm in the treatment of epilepsy with cognitive disorders were included. Retrieval was carried out until January 2022, and relevant data were extracted for meta-analysis using Rev Man5.3 software.
RESULTS
Fourteen randomized controlled studies with a total of 1198 patients were included, including 601 patients in the control group and 597 patients in the treatment group (experimental group).
RESULTS
Meta-analysis results showed that compared with the treatment of epilepsy with cognitive impairment in the western anti-epileptic drugs group alone, the treatment of epilepsy with cognitive impairment combined with the method of removing blood stasis and resolving phlegm could significantly improve the clinical efficacy of epilepsy (OR = 3.41, 95% CI 2.39-4.88, P < .001). Improved the TCM symptom score (OR = 3.99, 95% CI 1.72-9.26, P < .001). Increased the EEG improvement rate (RR = 1.39, 95% CI 1.05-1.84, P = .02). Improved MOCA score and cognitive function (MD = 3.54, 95% CI 1.68-5.40, P < .001). Improved QOLIE-31 cognitive function score. Improved cognitive function (MD = 7.22, 95% CI 3.35-11.08, P < .001). Improved the incidence of adverse reactions (RR = 0.50, 95% CI 0.33-0.76, P = .001).
CONCLUSION
Compared with the treatment of epilepsy with cognitive impairment by western anti-epileptic drugs alone, the treatment of epilepsy with cognitive impairment combined with the method of removing blood stasis and resolving phlegm is superior to the treatment of epilepsy with cognitive impairment by western anti-epileptic drugs alone.
Topics: Cognition Disorders; Cognitive Dysfunction; Epilepsy; Humans; Medicine, Chinese Traditional; Treatment Outcome
PubMed: 36123849
DOI: 10.1097/MD.0000000000030212 -
Molecules (Basel, Switzerland) Jun 2022Different ethnomedicinal studies have investigated the relationship between various phytochemicals as well as organic extracts and their bioactive aspects. Studies on... (Review)
Review
Different ethnomedicinal studies have investigated the relationship between various phytochemicals as well as organic extracts and their bioactive aspects. Studies on biological effects are attributed to secondary metabolites such as alkaloids, phenolic compounds, and terpenes. Since there have been no reviews in the literature on the traditional, phytochemical, and ethnomedicinal uses of the genus so far, this article systematically reviews 141 published studies that analyze the associations between secondary metabolites present in organic extracts and their beneficial effects. Most studies found associations between individual secondary metabolites and beneficial effects such as anticancer activity, antibacterial, antioxidant activity, snake anti-venom and anti-inflammatory activity. The aim of this review was to analyze studies carried out in the period 2005-2021 to update the existing knowledge on different species of the genus for ethnomedicinal uses, as well as pharmacological aspects and therapeutic uses.
Topics: Aristolochia; Ethnopharmacology; Medicine, Traditional; Phenols; Phytochemicals; Phytotherapy; Plant Extracts
PubMed: 35745061
DOI: 10.3390/molecules27123937 -
PloS One 2012Since 1950, traditional Chinese medicine (TCM) cupping therapy has been applied as a formal modality in hospitals throughout China and elsewhere in the world. Based on a... (Review)
Review
BACKGROUND
Since 1950, traditional Chinese medicine (TCM) cupping therapy has been applied as a formal modality in hospitals throughout China and elsewhere in the world. Based on a previous systematic literature review of clinical studies on cupping therapy, this study presents a thorough review of randomized controlled trials (RCTs) to evaluate the therapeutic effect of cupping therapy.
METHOD
Six databases were searched for articles published through 2010. RCTs on cupping therapy for various diseases were included. Studies on cupping therapy combined with other TCM treatments versus non-TCM therapies were excluded.
RESULTS
135 RCTs published from 1992 through 2010 were identified. The studies were generally of low methodological quality. Diseases for which cupping therapy was commonly applied were herpes zoster, facial paralysis (Bell palsy), cough and dyspnea, acne, lumbar disc herniation, and cervical spondylosis. Wet cupping was used in most trials, followed by retained cupping, moving cupping, and flash cupping. Meta-analysis showed cupping therapy combined with other TCM treatments was significantly superior to other treatments alone in increasing the number of cured patients with herpes zoster, facial paralysis, acne, and cervical spondylosis. No serious adverse effects were reported in the trials.
CONCLUSIONS
Numerous RCTs on cupping therapy have been conducted and published during the past decades. This review showed that cupping has potential effect in the treatment of herpes zoster and other specific conditions. However, further rigorously designed trials on its use for other conditions are warranted.
Topics: Acupuncture Therapy; Humans; Medicine, Chinese Traditional; Randomized Controlled Trials as Topic
PubMed: 22389674
DOI: 10.1371/journal.pone.0031793 -
Phytotherapy Research : PTR Dec 2022Although plenty of clinical trials have confirmed the efficacy and safety of integrated traditional Chinese and Western medicine (ITCWM) against COVID-19, the role of... (Meta-Analysis)
Meta-Analysis Review
Although plenty of clinical trials have confirmed the efficacy and safety of integrated traditional Chinese and Western medicine (ITCWM) against COVID-19, the role of ITCWM remains controversial. So we conducted a systematic review and meta-analysis of published studies in eight major databases that report the outcomes of interest in COVID-19 patients receiving ITCWM. RevMan5.4 software was used for meta-analysis, while the quality of RCTs was assessed by the Cochrane risk of bias tool and the retrospective studies were assessed by Newcastle-Ottawa Scale. Eventually, a total of 53 studies with 5425 COVID-19 patients was identified. The meta-analysis results showed that ITCWM was significantly better than western medicine treatment (WMT) alone in the percentage of cases changing to severe/critical [RR = 0.40, 95%CI (0.33, 0.49), p < .00001, I = 10%], overall clinical effectiveness [RR = 1.26, 95% CI (1.18, 1.35), p < .00001, I = 50%], time to defervescencer [MD = -1.45, 95% CI (-1.82, -1.07), p < .00001, I = 83%], disappearing time of cough [MD = -2.11, 95% CI (-2.98, -1.25), p < .00001, I = 93%], time of RT-PCR negativity [MD = -3.35, 95% CI (-4.74, -1.95), p < .00001, I = 92%], length of hospital stay [MD = -4.05, 95% CI (-5.24, -2.85), p < .00001, I = 91%], improvement in CT scan [RR = 1.22, 95% CI (1.17, 1.28), p < .00001, I = 46%], TCM syndrome score [MD = -3.95, 95% CI (-5.07, -2.82), p < .00001, I = 92%], disappearance rate of fever [RR = 1.23, 95% CI (1.10, 1.38), p < .00001, I = 85%], disappearance rate of cough [RR = 1.43, 95% CI (1.25, 1.63), p < .00001, I = 60%], level of CRP [MD = -9.23, 95% CI (-10.94, -7.52), p < .00001, I = 97%], and WBC [MD = -9.23, 95% CI (-10.94, -7.52), p < .00001, I = 97%]. There is no significant difference between ITCWM and WMT in the adverse reaction rate [RR = 0.85, 95% CI(0.71, 1.03), p = .10, I = 25%]. Our results showed evidence of clinical efficacy and safety benefit in COVID-19 patients treated with ITCWM. In spite of some limitations, the rapidly developing global pandemic warrants further high-quality and multicenter clinical studies to confirm the contribution of ITCWM.
Topics: Humans; COVID-19; Medicine, Chinese Traditional; Multicenter Studies as Topic; Retrospective Studies
PubMed: 36256518
DOI: 10.1002/ptr.7643 -
Journal of Pediatric Nursing 2023Decision-making during the end-of-life (EOL) phase for children with cancer is extremely difficult for parents. We synthesized the qualitative experiences of children... (Review)
Review
BACKGROUND
Decision-making during the end-of-life (EOL) phase for children with cancer is extremely difficult for parents. We synthesized the qualitative experiences of children with cancer, parents, and healthcare professionals (HCPs), and their social interactions during the EOL decision-making process in the pediatric oncology setting.
METHODS
Meta-ethnography was used to conduct a systematic review and meta-synthesis. We searched four online databases to identify original studies published in English and Japanese and examined 21 relevant studies. Two Japanese reviewers discussed the differences/relationships and included studies that synthesized the translated qualitative findings. A conceptual model of social interactions was created.
RESULTS
We identified four themes regarding children's, parents', and HCPs' experiences: hope and confrontation with the child's death, guidance and support during uncertainty, awareness of being protected and having hope, and mutual unspoken integration of values.
CONCLUSIONS
These themes evince the experiences of children, parents, and HCPs during the EOL decision-making process and suggests a complex three-way social interaction model. While considering such distinctive social interactions during a child's EOL, this study revealed the sharing of prudent information and psychosocial support by HCPs. The findings indicate that hope and uncertainty are key elements for effectively understanding the experiences of children and parents and that EOL decision-making should not be rushed but should be supported by leaving room for uncertainty and acknowledging parents' emotional needs and fostering new hope. Further research into how hope can be further supported in situations that are rife with uncertainty is needed.
Topics: Child; Humans; Qualitative Research; Parents; Anthropology, Cultural; Neoplasms; Death; Delivery of Health Care; Decision Making
PubMed: 36586777
DOI: 10.1016/j.pedn.2022.12.004 -
Nursing Open Jan 2024To explore and synthesise findings from qualitative studies on adult patients' experiences of day surgery and the processes of recovery. (Meta-Analysis)
Meta-Analysis Review
AIM
To explore and synthesise findings from qualitative studies on adult patients' experiences of day surgery and the processes of recovery.
BACKGROUND
There has been a shift in the practice of elective surgery, from inpatient to ambulatory treatment. Accordingly, more patients are undergoing day surgery and expected to care for themselves at home. To our knowledge, an updated metasynthesis on patients' experiences of day surgery across diverse contexts and continents is lacking.
DESIGN
Meta-ethnography.
METHODS
MEDLINE, EMBASE and CINAHL were systematically searched for qualitative research in English published between 2006 and 2023. Noblit and Hare's meta-ethnographic approach guided the synthesis of findings from 12 qualitative studies, and the eMERGe Reporting Guidance was used in the writing of this article.
RESULTS
Four themes were revealed: (1) requests for tailored information, (2) challenges of recognising and understanding postoperative symptoms, (3) being dependent on continuous professional and personal support and (4) calling for individual adaptation.
CONCLUSION
Our meta-ethnography indicates there is a need to improve information provision to better prepare patients for the processes of day surgery and recovery and promote their self-care abilities. Our findings highlight the importance of ensuring adequate levels of individualised care and support throughout the treatment process.
RELEVANCE TO CLINICAL PRACTICE
To improve quality of care in day surgery practice, implementation of interventions to enhance information provision and promote self-care during recovery at home may be considered. Pre-admission appointments that incorporate provision of tailored information and assessment of the patients' individual needs of care and support, home conditions and access to assistance from family/friends can be recommended.
Topics: Adult; Humans; Ambulatory Surgical Procedures; Anthropology, Cultural; Elective Surgical Procedures; Qualitative Research
PubMed: 38268268
DOI: 10.1002/nop2.2055 -
BMJ Sexual & Reproductive Health Jul 2022This systematic review aimed to identify and describe the factors that influence female genital mutilation/cutting (FGM/C). (Review)
Review
BACKGROUND
This systematic review aimed to identify and describe the factors that influence female genital mutilation/cutting (FGM/C).
METHODS
Searches were conducted in Medline, PsycInfo, Web of Science, Embase and the grey literature from 2009 to March 2020 with no language restrictions, using related MESH terms and keywords. Studies were included if they were quantitative and examined factors associated with FGM/C. Two researchers independently screened studies for inclusion, extracted data and assessed study quality. The direction, strength and consistency of the association were evaluated for determinants, presented as a descriptive summary, and were disaggregated by age and region.
RESULTS
Of 2230 studies identified, 54 published articles were included. The majority of studies were from the African Region (n=29) followed by the Eastern Mediterranean Region (n=18). A lower level of maternal education, family history of FGM/C, or belonging to the Muslim religion (in certain contexts) increased the likelihood of FGM/C. The majority of studies that examined higher paternal education (for girls only) and living in an urban region showed a reduced likelihood of FGM/C, while conflicting evidence remained for wealth. Several studies reported that FGM/C literacy, and low community FGM/C prevalence were associated with a reduced likelihood of FGM/C.
CONCLUSIONS
There were several characteristics that appear to be associated with FGM/C, and these will better enable the targeting of policies and interventions. Importantly, parental education may be instrumental in enabling communities and countries to meet the Sustainable Development Goals.
Topics: Circumcision, Female; Educational Status; Family; Female; Humans; Prevalence
PubMed: 35264420
DOI: 10.1136/bmjsrh-2021-201399 -
TheScientificWorldJournal 2014There has been little attempt to summarise and synthesise qualitative studies concerning the experience and perception of living with Parkinson's disease. Bringing this... (Meta-Analysis)
Meta-Analysis Review
There has been little attempt to summarise and synthesise qualitative studies concerning the experience and perception of living with Parkinson's disease. Bringing this information together would provide a background to understand the importance of an individual's social identity on their well-being and hope. Three primary aims were identified (a) understanding the importance of social identity and meaningful activities on individuals' well-being, (b) identifying factors and strategies that influence well-being and hope, and (c) establishing a model that relates to an individual's hope and well-being. Three stages were undertaken including a traditional electronic search, a critical appraisal of articles, and a synthesis of studies. Qualitative articles were included that considered the experience of living with Parkinson's disease. Thirty seven articles were located and included in the review. Five themes were identified and the themes were used to inform development of a new model of hope enablement. The current review furthered understanding of how physical symptoms and the experience of Parkinson's disease affect the individual's well-being and hope. Social identity was established as a key factor that influenced an individual's well-being. Being able to maintain, retain, or develop social identities was essential for the well-being and hope of individuals with Parkinson's disease. Understanding the factors which prevent or can facilitate this is essential.
Topics: Aged; Aged, 80 and over; Anthropology, Cultural; Female; Humans; Male; Models, Biological; Parkinson Disease
PubMed: 25525623
DOI: 10.1155/2014/613592