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Implementation Science : IS Feb 2024This study's goal is to identify the existing variation in how, why, and by whom anthropological practice is conducted as part of implementation science projects. As... (Review)
Review
BACKGROUND
This study's goal is to identify the existing variation in how, why, and by whom anthropological practice is conducted as part of implementation science projects. As doctorally trained anthropologists, we sought to characterize how and why the term "ethnography" was variously applied in the implementation science literature and characterize the practice of anthropology within and across the field.
METHODS
While we follow the PRISMA-ScR checklist, we present the work with a narrative approach to accurately reflect our review process. A health services librarian developed a search strategy using subject headings and keywords for the following databases: PubMed, Embase (Elsevier), Cochrane CENTRAL (Wiley), CIHAHL (EBSCO), PsycINFO (EBSCO), Web of Science Core Collection, and Anthropology Plus (EBSCO). We focused on the practice of anthropology in implementation research conducted in a healthcare setting, in English, with no date restrictions. Studies were included if they applied one or several elements of anthropological methods in terms of study design, data collection, and/or analysis.
RESULTS
The database searches produced 3450 results combined after duplicates were removed, which were added to Rayyan for two rounds of screening by title and abstract. A total of 487 articles were included in the full-text screening. Of these, 227 were included and received data extraction that we recorded and analyzed with descriptive statistics in three main domains: (1) anthropological methods; (2) implementation science methods; and (3) study context. We found the use of characteristic tools of anthropology like ethnography and field notes are usually not systematically described but often mentioned. Further, we found that research design decisions and compromises (e.g., length of time in the field, logistics of stakeholder involvement, reconciling diverse firsthand experiences) that often impact anthropological approaches are not systematically described.
CONCLUSIONS
Anthropological work often supports larger, mixed-methods implementation projects without being thoroughly reported. Context is essential to anthropological practice and implicitly fundamental to implementation research, yet the goals of anthropology and how its practice informs larger research projects are often not explicitly stated.
Topics: Humans; Implementation Science; Anthropology
PubMed: 38347574
DOI: 10.1186/s13012-024-01344-0 -
BMJ Global Health Dec 2021Globally, the burden of non-communicable diseases (NCDs) falls disproportionately on underserved populations. Migrants and refugees are particularly vulnerable due to...
Globally, the burden of non-communicable diseases (NCDs) falls disproportionately on underserved populations. Migrants and refugees are particularly vulnerable due to economic instability and systemic poverty. Despite the myriad of health risks faced by migrants and refugees, access to appropriate healthcare is hindered by structural, cultural and socioeconomic barriers. We conducted a systematic review and meta-ethnography to obtain critical insight into how the interplay of social capital and structural factors (eg, state policies and socioeconomic disadvantage) influences the prevention and treatment of NCDs in migrant and refugee populations. We included 26 studies of 14 794 identified articles, which reported qualitative findings on the structure and functions of social capital in NCD prevention and management among migrants and refugees. We synthesised findings, using the process outlined by Noblit and Hare, which indicated that migrants and refugees experienced weakened social networks in postmigration settings. They faced multiple barriers in healthcare access and difficulty navigating healthcare systems perceived as complex. Family as the core of social capital appeared of mixed value in their NCD prevention and management, interacting with cultural dissonance and economic stress. Community organisations were integral in brokering healthcare access, especially for information diffusion and logistics. Healthcare providers, especially general practitioners, were important bridges providing service-user education and ensuring a full continuum of quality care. While social capital reduced immediate barriers in healthcare access for NCD prevention and management, it was insufficient to address structural barriers. System-level interventions appear necessary to achieve equitable healthcare access in host countries. PROSPERO registration number: CCRD42020167846.
Topics: Anthropology, Cultural; Humans; Noncommunicable Diseases; Refugees; Social Capital; Transients and Migrants
PubMed: 34952855
DOI: 10.1136/bmjgh-2021-006828 -
Journal of Acupuncture and Meridian... Mar 2010Meridian theory is a major part of Chinese medicine and has guided acupuncture and clinical practice for thousands of years. Meridian theory describes many important... (Review)
Review
Meridian theory is a major part of Chinese medicine and has guided acupuncture and clinical practice for thousands of years. Meridian theory describes many important concepts about the rules of human body function and regulation, but has comparatively huge differences with the basic concepts of modern medicine. These differences have caused deep concern and attracted attention from scholars, both inside and outside of China. The interest in meridian theory lies in determining the structural nature of meridians. Not only is this information still unclear, it is very difficult to achieve clear results in a short period of time. Despite this, the phenomena of meridians can be used as the entry point for meridian studies. After many years of effort, although the physical structure of meridians has not been found, the existence of the meridian phenomena has been fully confirmed. Although there is a lack of morphological evidence for the existence of the meridian, concluding non-existence may be incorrect as morphology techniques develop and structures previously not determined are being found. Since the phenomenon of meridians exists, some biological basis behind its occurrence must be present. This implies that research on meridians needs to continue as research techniques advance and may eventually reveal the biological basis of the meridian phenomenon. In the present review, we analyze the history of meridian studies in China.
Topics: Acupuncture; Animals; Biomedical Research; China; History, 20th Century; History, 21st Century; Humans; Medicine, Chinese Traditional; Meridians
PubMed: 20633509
DOI: 10.1016/S2005-2901(10)60001-5 -
Journal of Health, Population, and... Apr 2018Recommended immediate newborn care practices include thermal care (immediate drying and wrapping, skin-to-skin contact after delivery, delayed bathing), hygienic cord... (Review)
Review
BACKGROUND
Recommended immediate newborn care practices include thermal care (immediate drying and wrapping, skin-to-skin contact after delivery, delayed bathing), hygienic cord care and early initiation of breastfeeding. This paper systematically reviews quantitative and qualitative data from sub-Saharan Africa on the prevalence of key immediate newborn care practices and the factors that influence them.
METHODS
Studies were identified by searching relevant databases and websites, contacting national and international academics and implementers and hand-searching reference lists of included articles. English-language published and unpublished literature reporting primary data from sub-Saharan Africa (published between January 2001 and May 2014) were included if it met the quality criteria. Quantitative prevalence data were extracted and summarized. Qualitative data were synthesized through thematic analysis, with deductive coding used to identify emergent themes within each care practice. A framework approach was used to identify prominent and divergent themes.
RESULTS
Forty-two studies were included as well as DHS data - only available for early breastfeeding practices from 33 countries. Results found variation in the prevalence of immediate newborn care practices between countries, with the exception of skin-to-skin contact after delivery which was universally low. The importance of keeping newborn babies warm was well recognized, although thermal care practices were sub-optimal. Similar factors influenced practices across countries, including delayed drying and wrapping because the birth attendant focused on the mother; bathing newborns soon after delivery to remove the dirt and blood; negative beliefs about the vernix; applying substances to the cord to make it drop off quickly; and delayed breastfeeding because of a perception of a lack of milk or because the baby needs to sleep after delivery or does not showing signs of hunger.
CONCLUSION
The majority of studies included in this review came from five countries (Ethiopia, Ghana, Malawi, Tanzania and Uganda). There is a need for more research from a wider geographical area, more research on newborn care practices at health facilities and standardization in measuring newborn care practices. The findings of this study could inform behaviour change interventions to improve the uptake of immediate newborn care practices.
Topics: Africa South of the Sahara; Body Temperature; Breast Feeding; Cross-Cultural Comparison; Culture; Delivery, Obstetric; Fathers; Female; Health Knowledge, Attitudes, Practice; Home Childbirth; Humans; Hypothermia; Infant Care; Infant Health; Infant, Newborn; Kangaroo-Mother Care Method; Male; Midwifery; Mothers; Perinatal Care; Postnatal Care; Pregnancy; Qualitative Research; Umbilical Cord
PubMed: 29661239
DOI: 10.1186/s41043-018-0141-5 -
The Cochrane Database of Systematic... Feb 2013Female genital cutting (FGC) refers to all procedures that involve the partial or total removal of the external female genitalia, or other injury to the female genital... (Review)
Review
BACKGROUND
Female genital cutting (FGC) refers to all procedures that involve the partial or total removal of the external female genitalia, or other injury to the female genital organs for cultural or other non-therapeutic reasons. There are no known medical benefits to FGC, and it can be potentially dangerous for the health and psychological well-being of women and girls who are subjected to the practice resulting in short- and long-term complications. Health problems of significance associated with FGC faced by most women are maternal and neonatal mortality and morbidity, the need for assisted delivery and psychological distress. Under good clinical guidelines for caring for women who have undergone genital cutting, interventions could provide holistic care that is culturally sensitive and non-judgemental to improve outcomes and overall quality of life of women. This review focuses on key interventions carried out to improve outcome and overall quality of life in pregnant women who have undergone FGC.
OBJECTIVES
To evaluate the impact of interventions to improve all outcomes in pregnant women or women planning a pregnancy who have undergone genital cutting. The comparison group consisted of those who have undergone FGC but have not received any intervention.
SEARCH METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2012) and organisations engaged in projects regarding FGC.
SELECTION CRITERIA
Randomised controlled trials (RCTs), cluster-randomised trials or quasi-RCTs with reported data comparing intervention outcomes among pregnant women or women planning a pregnancy who have undergone genital cutting compared with those who did not receive any intervention.
DATA COLLECTION AND ANALYSIS
We did not identify any RCTs, cluster-randomised trials or quasi-RCTs.
MAIN RESULTS
There are no included studies.
AUTHORS' CONCLUSIONS
FGC research has focused mainly on observational studies to describe the social and cultural context of the practice, and we found no intervention trials conducted to improve outcomes for pregnant women presenting with complications of FGC. While RCTs will provide the most reliable evidence on the effectiveness of interventions, there remains the issue of what is considered ethically appropriate and the willingness of women to undergo randomisation on an issue that is enmeshed in cultural traditions and beliefs. Consequently, conducting such a study might be difficult.
Topics: Circumcision, Female; Female; Humans; Pregnancy; Pregnancy Outcome
PubMed: 23450610
DOI: 10.1002/14651858.CD009872.pub2 -
Patient Education and Counseling Jan 2023Communication at the end-of-life (EOL) is complex and multidimensional. Although culture is acknowledged as a key influence, there remains a gap in knowledge about... (Review)
Review
OBJECTIVE
Communication at the end-of-life (EOL) is complex and multidimensional. Although culture is acknowledged as a key influence, there remains a gap in knowledge about intracultural aspects of EOL communication in the Chinese context. This review presents a synthesis of practitioners' accounts of communication at the EOL in Hong Kong, Mainland China and Taiwan.
METHODS
This review was registered prospectively on PROSPERO (CRD42021297052). Five databases were systematically searched using the terms 'communication', 'End-of-Life', 'Hong Kong', 'China' and 'Taiwan'. Empirical research published between 2015 and 2021 was downloaded and appraised. Fifteen articles were included in the review.
RESULTS
Findings highlight the influence of Chinese culture and philosophy, inadequate communication skills training and psychological support for practitioners and legislative and organisational factors.
CONCLUSION
Education and training for practitioners and public education about the EOL needs strengthening. Enhanced understanding of how culture influences EOL communication will strengthen service delivery and enhance awareness in multicultural communities.
PRACTICE IMPLICATIONS
EOL workers need practical and workplace-based support to engage in meaningful communication practices. The influence of culture and the readiness of patients and families to engage in communication are also important considerations.
Topics: Humans; China; Hong Kong; Counseling; Cultural Diversity; Taiwan
PubMed: 36273978
DOI: 10.1016/j.pec.2022.10.007 -
Health Expectations : An International... Dec 2023Patient engagement, encompassing both patient experience and opportunities for involvement in care, has been associated with increased patient satisfaction and the... (Review)
Review
INTRODUCTION
Patient engagement, encompassing both patient experience and opportunities for involvement in care, has been associated with increased patient satisfaction and the overall quality of care. Despite its importance, there is limited knowledge regarding patient engagement in the transition from nondialysis-dependent chronic kidney disease (CKD) to dialysis-dependent treatment. This systematic review employs meta-ethnography to synthesize findings from qualitative studies examining patients' experiences of engagement during this transition, with the aim of developing a comprehensive theoretical understanding of patient engagement in the transition from nondialysis-dependent CKD to dialysis.
METHODS
A systematic search of six databases, namely the Cochrane Library, PsycINFO, Scopus, Embase, PubMed and Web of Science was conducted to identify eligible articles published between 1990 and 2022. Meta-ethnography was utilized to translate and synthesize the findings and develop a novel theoretical interpretation of 'patient engagement' during the transition to dialysis.
RESULTS
A total of 24 articles were deemed eligible for review, representing 21 studies. Patient engagement during a transition to dialysis was found to encompass three major domains: psychosocial adjustment, decision-making and engagement in self-care. These three domains could be experienced as an iterative and mutually reinforcing process, guiding patients toward achieving control and proficiency in their lives as they adapt to dialysis. Additionally, patient engagement could be facilitated by factors including patients' basic capability to engage, the provision of appropriate education, the establishment of supportive relationships and the alignment with values and resources.
CONCLUSIONS
The findings of this review underscore the necessity of involving patients in transitional dialysis care, emphasizing the need to foster their engagement across multiple domains. Recommendations for future interventions include the provision of comprehensive support to enhance patient engagement during this critical transition phase. Additional research is warranted to explore the effects of various facilitators at different levels.
PATIENT OR PUBLIC CONTRIBUTION
The studies included in our review involved 633 participants (547 patients, 14 family members, 63 healthcare providers and 9 managers). Based on their experiences, views and beliefs, we developed a deeper understanding of patient engagement and how to foster it in the future.
Topics: Humans; Renal Dialysis; Patient Participation; Anthropology, Cultural; Qualitative Research; Renal Insufficiency, Chronic
PubMed: 37641530
DOI: 10.1111/hex.13850 -
Annals of Palliative Medicine Dec 2021Traditional Chinese medicine (TCM) may improve the prognosis management of cholelithiasis patients after gallbladder-preserving lithotripsy. To explore the evidence for... (Meta-Analysis)
Meta-Analysis
Systematic review and pathway enrichment analysis of Chinese medicine in preventing recurrence and improving prognosis of cholelithiasis after gallbladder-preserving lithotripsy.
BACKGROUND
Traditional Chinese medicine (TCM) may improve the prognosis management of cholelithiasis patients after gallbladder-preserving lithotripsy. To explore the evidence for this view, we systematically reviewed the efficacy and safety of TCM for improving the prognosis of cholelithiasis after gallbladder-preserving lithotripsy and performed functional pathway enrichment analysis of TCM target genes.
METHODS
In this systematic review (SRs), we searched six Chinese or international databases to collect randomized controlled clinical trials (RCTs) of TCM in preventing the recurrence of cholelithiasis after gallbladder-preserving lithotripsy. The literature was independently screened by 2 reviewers, who then extracted the data. The Cochrane risk-of-bias and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tools were used to assess the included studies' risk of bias and quality of evidence, respectively. And, the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses would be conducted on the TCM prescriptions in the included literature to find the effective component and mechanism of TCM in the prognosis management of gallbladder-preserving lithotripsy. Analysis in this research would be conducted by R 3.5.2 software.
RESULTS
A total of 1,024 articles were retrieved, and 9 RCTs involving 926 participants were included after the step-by-step screening. The risk of bias for each important outcome in all the studies was "uncertain". The meta-analysis showed that compared with blank control, TCM prevented cholelithiasis by decreasing the recurrence rate, complications incidence, gallbladder wall thickness, and gallbladder contraction degree. But, there were no significant differences in the rate of the adverse reaction. The result of the GO and KEGG analysis revealed that the mechanism of prevention of TCM in gallstone recurrence may be related to the cholesterol metabolic pathway and that naringin from Glycyrrhiza may be the effective component in the prevention of recurrence.
CONCLUSIONS
Existing evidence suggests that the use of TCM may reduce the recurrence rate after gallbladder-preserving lithotripsy and this effect may be related to the flavonoid glycoside naringin from Glycyrrhiza uralensis, but more RCTs with high quality in this area may be needed to have a robust conclusion.
Topics: Cholelithiasis; Drugs, Chinese Herbal; Gallbladder; Humans; Lithotripsy; Medicine, Chinese Traditional; Prognosis
PubMed: 34498482
DOI: 10.21037/apm-20-1135 -
Journal of Racial and Ethnic Health... Aug 2022Asian Americans are underutilizing mental health services. The aim of the current systematic review was to identify protective and risk factors of mental health... (Review)
Review
OBJECTIVE
Asian Americans are underutilizing mental health services. The aim of the current systematic review was to identify protective and risk factors of mental health help-seeking patterns among the disaggregated Asian Americans and to classify types of help.
METHODS
A systematic literature review was conducted using the PRISMA guidelines. The Health Belief Model served as the theoretical framework for this review. Thirty-four articles were reviewed, and the studies investigated one of the following Asian ethnic subgroups: Chinese, Filipino, Asian Indian, Korean, or Vietnamese. Data were extracted based on the study characteristics, sample characteristics, and protective and risk factors to mental health help-seeking patterns.
RESULTS
Predisposing factors like female gender, higher levels of English proficiency, and history of mental illness increased the likelihood for help-seeking across several ethnic groups. Interestingly, cues to action and structural factors were under-examined. However, cues to action like having a positive social network did increase the likelihood of using formal support services among Chinese and Filipinx participants. Structural factors like lacking ethnic concordant providers and access to healthcare served as barriers for Korean and Vietnamese participants.
DISCUSSION
The findings showed a need for ethnic tailored approaches when supporting mental health help-seeking patterns. Asian ethnic group's immigration status, acculturation level, and psychological barriers to help-seeking should continue to be emphasized. Psychoeducational groups can be beneficial to expand the knowledge base surrounding mental illness and to link group members to culturally responsive resources.
Topics: Acculturation; Asian; Female; Humans; Mental Disorders; Mental Health; Mental Health Services
PubMed: 34076864
DOI: 10.1007/s40615-021-01068-7 -
Journal of Ethnopharmacology Apr 2012The clinical use of Chinese herbal medicine granules is gradually increasing. However, there is still no systematic review comparing the effectiveness and safety of... (Comparative Study)
Comparative Study Review
BACKGROUND
The clinical use of Chinese herbal medicine granules is gradually increasing. However, there is still no systematic review comparing the effectiveness and safety of granules with the more traditional method of herbal decoctions.
METHOD
A literature search was conducted using China National Knowledge Infrastructure Databases (CNKI), Chinese Science and Technology Periodical Database (VIP), China Biomedical Database web (CBM), Wanfang Database, PubMed, and the Cochrane Library until March 10, 2011. Clinical controlled trials (CCTs) including randomized trials (RCTs) comparing the effectiveness and safety between Chinese herbal medicine granules and decoction were included. Two authors conducted the literature searches, and extracted data independently. The assessment of methodological quality of RCTs was based on the risk of bias from the Cochrane Handbook, and the main outcome data of trials were analyzed by using RevMan 5.0 software. Risk ratio (RR) or mean difference (MD) with a 95% confidence interval (CI) were used as effect measure.
RESULTS
56 clinical trials (n=9748) including 42 RCTs and 14 CCTs were included, and all trials were conducted in China and published in Chinese literature. 40 types of diseases and 15 syndromes of traditional Chinese medicine (TCM) were reported. Granules were provided by pharmaceutical companies in 13 trials. The included RCTs were of generally low methodological quality: 7 trials reported adequate randomization methods, and 2 of these reported allocation concealment. 10 trials used blinding, of which 5 trials used placebo which were delivered double blind (blinded participants and practitioners). 98.2% (55/56) of studies showed that there was no significant statistical difference between granules and decoctions of Chinese herbal medicine for their effectiveness. No severe adverse effects in either group were reported.
CONCLUSIONS
Due to the poor methodological quality of most of the included trials, it is not possible to reach a definitive conclusion whether both Chinese herbal medicine granules and decoctions have the same degree of effectiveness and safety in clinical practice, but this preliminary evidence supports the continued use of granules in clinical practice and research. Standardization of granules and further more rigorous pharmacological, toxicological and clinical studies are needed to demonstrate the equivalence with decoctions.
Topics: Drug Delivery Systems; Drug-Related Side Effects and Adverse Reactions; Drugs, Chinese Herbal; Herbal Medicine; Humans; Medicine, Chinese Traditional; Phytotherapy; Plants, Medicinal; Treatment Outcome
PubMed: 22343092
DOI: 10.1016/j.jep.2012.01.031