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Romanian Journal of Ophthalmology 2023Granulomatosis with polyangiitis (GPA) is an autoimmune disorder characterized by necrotizing granulomatous inflammation of small and medium-sized vessels. This... (Review)
Review
Granulomatosis with polyangiitis (GPA) is an autoimmune disorder characterized by necrotizing granulomatous inflammation of small and medium-sized vessels. This systematic review aimed to highlight the most common ophthalmic manifestations and to uncover their associations with antineutrophil cytoplasmic antibody (ANCA) positivity and the presence of granulomas. A literature search of PubMed, Web of Science, and Scopus electronic databases was performed from journal inception to March 21, 2021, for case reports and a series of ophthalmic GPAs. Cytoplasmic-ANCA (c-ANCA), perinuclear-ANCA (p-ANCA), and granulomas were analyzed against many ophthalmic signs and symptoms. 306 patients with GPA were retrospectively studied. Granulomas were present in 47.7% of our sample, c-ANCA in 59.2%, and p-ANCA in 10.8%. Scleritis was significantly associated with higher odds for c-ANCA positivity. Eye discharge, episcleritis, proptosis, and central nervous system (CNS) involvement were each significantly associated with lower odds for c-ANCA positivity. Orbital mass was significantly associated with lower odds for p-ANCA positivity. CNS involvement was significantly associated with higher odds for p-ANCA positivity (OR:3.08, 95% CI:1.02, 9.36, p=0.047) and orbital mass was significantly associated with lower odds for p-ANCA positivity. We recommend that clinicians should consider ocular or orbital GPA in patients presenting with non-specific eye complaints, such as vision impairment, orbital mass, or proptosis, and obtain further assessments to determine the possible presence of granuloma, c-ANCA, or p-ANCA. GPA = Granulomatosis with Polyangiitis, ANCA = antineutrophil cytoplasmic antibody, c-ANCA = cytoplasmic-ANCA, p-ANCA = perinuclear-ANCA, CNS = central nervous system, AAVs = ANCA-associated vasculitides, SD = standard deviation, GU = genitourinary, ENT = ear nose and throat, OR = odds ratio, CI = confidence interval.
Topics: Humans; Granulomatosis with Polyangiitis; Antibodies, Antineutrophil Cytoplasmic; Retrospective Studies; Orbital Diseases; Granuloma; Exophthalmos
PubMed: 37876507
DOI: 10.22336/rjo.2023.38 -
Clinical Microbiology and Infection :... Apr 2024Centor and McIsaac scores are clinical prediction rules for diagnosing group A streptococcus (GAS) infection in patients with pharyngitis. Their recommended thresholds... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Centor and McIsaac scores are clinical prediction rules for diagnosing group A streptococcus (GAS) infection in patients with pharyngitis. Their recommended thresholds vary between guidelines.
OBJECTIVES
To estimate the sensitivity and specificity of the McIsaac and Centor scores to diagnose GAS pharyngitis and evaluate their impact on antibiotic prescribing at each threshold in patients presenting to secondary care.
DATA SOURCES
MEDLINE, Embase, and Web of Science were searched from inception to September 2022.
STUDY ELIGIBILITY CRITERIA
Studies of patients presenting with acute pharyngitis to emergency or outpatient clinics that estimated the accuracy of McIsaac or Centor scores against throat cultures and/or rapid antigen detection tests (RADT) as reference standards.
TESTS
Centor or McIsaac score.
REFERENCE STANDARD
Throat cultures and/or RADT.
ASSESSMENT OF RISK OF BIAS
Quality Assessment of Diagnostic Accuracy Studies.
METHODS OF DATA SYNTHESIS
The sensitivities and specificities of the McIsaac and Centor scores were pooled at each threshold using bivariate random effects meta-analysis.
RESULTS
Fourteen studies were included (eight McIsaac and six Centor scores). Eight studies had unclear and six had a high risk of bias. The McIsaac score had higher estimated sensitivity and lower specificity relative to Centor scores at equivalent thresholds but with wide and overlapping confidence regions. Using either score as a triage to RADT to decide antibiotic treatment would reduce antibiotic prescription to patients with non-GAS pharyngitis relative to RADT test for everyone, but also reduce antibiotic prescription to patients with GAS.
DISCUSSION
Centor and McIsaac scores are equally ineffective at triaging patients who need antibiotics presenting with pharyngitis at hospitals. At high thresholds, too many true positive cases are missed, whereas at low thresholds, too many false positives are treated, leading to the over prescription of antibiotics. The former may be compensated by adequate safety netting by clinicians, ensuring that patients can seek help if symptoms worsen.
Topics: Humans; Secondary Care; Streptococcal Infections; Pharyngitis; Streptococcus pyogenes; Anti-Bacterial Agents; Sensitivity and Specificity
PubMed: 38182052
DOI: 10.1016/j.cmi.2023.12.025 -
Heliyon Jan 2023Dark tourists experience negative and positive feelings in Holocaust places, suggesting emotional ambivalence. The research question of this study is, "is feeling...
Dark tourists experience negative and positive feelings in Holocaust places, suggesting emotional ambivalence. The research question of this study is, "is feeling well-being, as a consequence of dark tourism, a way of banalizing the horror?". The purpose of this study is threefold: to provide an updated systematic literature review (SLR) of dark tourism associated with Holocaust sites and visitors' well-being; to structure the findings into categories that provide a comprehensive overview of the topics; and to identify which topics are not well covered, thus suggesting knowledge gaps. Records to be included should be retrievable articles in peer-reviewed academic journals, books, and book chapters, all focused on the SLR's aims and the research question; other types of publications were outrightly excluded. The search was performed in Web of Science, Scopus, and Google Scholar databases with three keywords and combinations: "dark tourism", "Holocaust", and "well-being". Methodological decisions were based on the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. During the process, 144 documents were included, of which 126 were journal articles, 8 were books, and 10 were book chapters. The results point out a hierarchical structure with the main category (Dark tourism - Holocaust - Well-being) and three second-order categories (Dark tourism - Holocaust, Dark tourism - Well-being, and Holocaust - Well-being), from which different subcategories emerge: motivations for visiting places and guiding; ambivalent emotional experience that leads to the transformation of the self; and intergenerational trauma. The gaps identified were the trivialization of horror in Holocaust places; dark tourist profile; motivations and constraints behind visiting dark places; Holocaust survivors and their descendants' well-being; how dark tourism associated with the Holocaust positively or negatively impacts well-being. Major limitations included: lack of randomized allocation; lack of standard outcome definitions; and suboptimal comparison groups. Positive and negative impacts on the well-being of the Holocaust dark tourist were sought, as they are associated with the marketing and management, promotion, digital communication, guiding, or storytelling design of such locations.
PubMed: 36711286
DOI: 10.1016/j.heliyon.2023.e13064 -
JMIR Perioperative Medicine Jun 2022Mindfulness-based cognitive therapy and isometric exercise training (IET) interventions are relatively new approaches to maintain physical functioning, alleviate pain,... (Review)
Review
BACKGROUND
Mindfulness-based cognitive therapy and isometric exercise training (IET) interventions are relatively new approaches to maintain physical functioning, alleviate pain, prevent joint stiffness and muscular atrophy, and positively influence other postoperative care outcomes.
OBJECTIVE
The aim of this review was to identify the impacts of mindfulness-based interventions (MBIs) and IET and, more specifically, their combination, which have not previously been assessed to our knowledge.
METHODS
Studies were identified by searching the PubMed and Cochrane databases within the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) algorithm format and using relevant keyword combinations, which resulted in 39 studies meeting the inclusion criteria.
RESULTS
In general, MBI was shown to positively impact both pain relief and physical functioning, while IET positively impacted physical functioning. Numerous other benefits, including improved quality of life and decreased postoperative opioid use, were also described from both interventions; however, further research is needed to confirm these findings as well as to determine other possible benefits. No studies were found that combined MBI and IET.
CONCLUSIONS
Despite many positive results from each individual intervention, there is a lack of information about how the combination of MBI and IET might impact postoperative care. The combination of these two interventions might prove to be more effective than each individual intervention alone, and the findings from this review show that they could even be complementary. Going forward, research should be expanded to study the possible benefits of the combination of MBI and IET in postoperative care routines as well as other possible combinations.
PubMed: 35687415
DOI: 10.2196/34651 -
The Gerontologist Sep 2021During past years, gamification has become a major trend in technology, and promising results of its effectiveness have been reported. However, prior research has...
BACKGROUND AND OBJECTIVES
During past years, gamification has become a major trend in technology, and promising results of its effectiveness have been reported. However, prior research has predominantly focused on examining the effects of gamification among young adults, while other demographic groups such as older adults have received less attention. In this review, we synthesize existing scholarly work on the impact of gamification for older adults.
RESEARCH DESIGN AND METHODS
A systematic search was conducted using 4 academic databases from inception through January 2019. A rigorous selection process was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS
Twelve empirical peer-reviewed studies written in English, focusing on older adults aged ≥55, including a gameful intervention, and assessing subjective or objective outcomes were identified. Eleven of the 12 studies were conducted in the health domain. Randomized controlled study settings were reported in 8 studies. Positively oriented results were reported in 10 of 12 studies on visual attention rehabilitation, diabetes control, increasing positive emotions for patients with subthreshold depression, cognitive training and memory tests, engagement in training program, perceptions of self-efficacy, motivation and positive emotions of social gameplay conditions, increased physical activity and balancing ability, and increased learning performance and autonomy experiences. The results are, however, mostly weak indications of positive effects.
DISCUSSION AND IMPLICATIONS
Overall, the studies on gameful interventions for older adults suggest that senior users may benefit from gamification and game-based interventions, especially in the health domain. However, due to methodological shortcomings and limited amount of research available, further work in the area is called for.
Topics: Aged; Cognition; Humans; Motivation
PubMed: 32530026
DOI: 10.1093/geront/gnaa047 -
Cancers Apr 2021The worldwide prevalence of Epstein-Barr virus-positive (EBV+) diffuse large B-cell lymphoma (DLBCL) is undetermined. There is no clearly defined cut-off for EBV-encoded... (Review)
Review
The worldwide prevalence of Epstein-Barr virus-positive (EBV+) diffuse large B-cell lymphoma (DLBCL) is undetermined. There is no clearly defined cut-off for EBV-encoded RNA (EBER) positivity in tumor cells by in-situ hybridization. The purpose of this study was to establish the proportions of EBV+ DLBCL patients and influence of the different cut-offs for EBER positivity, geographical location, and age on the prevalence of EBV+ DLBCL. PubMed and EMBASE were searched for studies published up to May 28, 2020 that reported proportions of EBER positivity in immunocompetent and de novo DLBCL patients. The pooled proportions were computed by an inverse variance method for calculating the weights and the DerSimonian-Laird method. Multiple subgroup analyses were conducted to explore any heterogeneity. Thirty-one studies (8249 patients) were included. The pooled proportion of EBV+ DLBCL was 7.9% (95% CI, 6.2-10.0%) with significant heterogeneity among studies ( < 0.001). The prevalence of EBV+ DLBCL was significantly higher in Asia and South America compared with Western countries ( < 0.01). The cut-offs for EBER positivity (10%, 20%, 50%) and patients' age (≥50 years vs. <50 years) did not significantly affect the prevalence ( ≥ 0.10). EBV+ DLBCL is rare with a pooled proportion of 7.9% in patients with DLBCL and the geographic heterogeneity was confirmed.
PubMed: 33917961
DOI: 10.3390/cancers13081785 -
BMC Medical Education Jul 2023Situation, background, assessment, and recommendation (SBAR) has been extensively used in clinical and nursing education. A structured communication program increases...
BACKGROUND
Situation, background, assessment, and recommendation (SBAR) has been extensively used in clinical and nursing education. A structured communication program increases effective communication, positivity, and education satisfaction during inter-professional collaboration among nursing students. This systematic review aimed to identify and synthesize evidence on the effectiveness of SBAR-based simulation training for nursing students.
METHODS
A research protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The protocol for this study was registered in PROSPERO (CRD42021234068). Eight bibliographical databases were searched for studies published between 2001 and 2021, using relevant search terms. Searches were conducted in PubMed, Embase, Cumulative Index to Nursing and Allied Health, and Cochrane Central Register of Controlled Trials for literature in English, and DBpia, Research Information Sharing Service, Korean Studies Information Service System, and Korea Institute of Science and Technology Information for literature in Korean. After screening titles, abstracts, and full-text papers, pertinent data were extracted, and critical appraisals of the retrieved studies were performed. Data were analyzed using the framework approach, and the findings were presented in a narrative summary. The Effective Public Health Practice Project "Quality Assessment Tool for Quantitative Studies" was used to assess the quality of the included studies.
RESULTS
Twelve studies were included: 3 randomized controlled trials and 9 quasi-experimental studies. Two overarching themes were noted, namely communication clarity and critical thinking. The results of six out of 12 studies produced significant results in favor of SBAR-based simulation in terms of communication clarity. Divergent results were obtained regarding communication ability, critical thinking, confidence, learning self-efficacy, and attitude toward patient safety. The results of these studies highlight that communication clarity ultimately leads to positive results in terms of nursing students' behaviors related to patient safety.
CONCLUSIONS
This review provides a comprehensive update of the literature on the effectiveness of SBAR-based nursing simulation programs for nursing students. These programs were found to have positive learning outcomes because of clear and concise communication. Further studies on the effectiveness of various learning outcomes derived from SBAR-based programs are required.
Topics: Humans; Communication; Education, Nursing; Learning; Simulation Training; Students, Nursing
PubMed: 37452348
DOI: 10.1186/s12909-023-04495-8 -
BMC Infectious Diseases Sep 2016Hepatitis C virus (HCV) infection causes significant morbidity and mortality among people who inject drugs (PWID) and HIV+ men who have sex with men (MSM).... (Meta-Analysis)
Meta-Analysis Review
Spontaneous viral clearance of hepatitis C virus (HCV) infection among people who inject drugs (PWID) and HIV-positive men who have sex with men (HIV+ MSM): a systematic review and meta-analysis.
BACKGROUND
Hepatitis C virus (HCV) infection causes significant morbidity and mortality among people who inject drugs (PWID) and HIV+ men who have sex with men (MSM). Characterizing spontaneous viral clearance of HCV infection among PWID and HIV+ MSM is important for assessing the burden of disease and treatment strategies in these populations.
METHODS
Electronic and other searches of medical literature were conducted. Reports were eligible if they presented original data from upper-middle- and high-income countries on laboratory-confirmed HCV infection and spontaneous viral clearance among PWID or HIV+ MSM. Pooled estimates of spontaneous viral clearance were generated using fixed-effect and random-effects models. Meta-regression examined potential predictors related to individual characteristics and research methodology.
RESULTS
The meta-analysis estimated that spontaneous viral clearance occurs in 24.4 % of PWID and 15.4 % of HIV+ MSM. In univariate meta-regression among PWID, male sex and age were significantly associated with spontaneous viral clearance, and in multivariate analysis, male sex and HIV positivity were predictors of spontaneous viral clearance; among HIV+ MSM no variables were found to affect spontaneous viral clearance.
CONCLUSION
The variability in estimates of spontaneous viral clearance between HIV+ MSM and PWID suggests the impact of HIV co-infection and HCV re-infection. Due to limited data on additional factors that may affect the natural history of HCV, more research is needed to further understand spontaneous viral clearance in these risk groups.
PROTOCOL REGISTRATION
The protocols for the PWID and HIV+ MSM research were registered with PROSPERO (CRD42014008805; CRD42013006462).
Topics: Coinfection; HIV Infections; Hepacivirus; Hepatitis C; Homosexuality, Male; Humans; Male; Substance Abuse, Intravenous
PubMed: 27595855
DOI: 10.1186/s12879-016-1807-5 -
The International Journal of Behavioral... Nov 2017While the role of parenting in children's eating behaviors has been studied extensively, less attention has been given to its potential association with children's... (Review)
Review
BACKGROUND
While the role of parenting in children's eating behaviors has been studied extensively, less attention has been given to its potential association with children's snacking habits. To address this gap, we conducted a systematic review to describe associations between food parenting and child snacking, or consuming energy dense foods/foods in between meals.
METHODS
Six electronic databases were searched using standardized language to identify quantitative studies describing associations of general and feeding-specific parenting styles as well as food parenting practices with snacking behaviors of children aged 2-18 years. Eligible peer-reviewed journal articles published between 1980 and 2017 were included. Data were extracted using a standard protocol by three coders; all items were double coded to ensure consistency.
RESULTS
Forty-seven studies met inclusion criteria. Few studies focused on general feeding (n = 3) or parenting styles (n = 10). Most studies focused on controlling food parenting practices (n = 39) that were not specific to snacking. Parental restriction of food was positively associated with child snack intake in 13/23 studies, while pressure to eat and monitoring yielded inconsistent results. Home availability of unhealthy foods was positively associated with snack intake in 10/11 studies. Findings related to positive parent behaviors (e.g. role modeling) were limited and yielded mixed results (n = 9). Snacking was often assessed using food frequency items and defined post-hoc based on nutritional characteristics (e.g. energy-dense, sugary foods, unhealthy, etc.). Timing was rarely included in the definition of a snack (i.e. chips eaten between meals vs. with lunch).
CONCLUSIONS
Restrictive feeding and home access to unhealthy foods were most consistently associated with snacking among young children. Research is needed to identify positive parenting behaviors around child snacking that may be used as targets for health promotion. Detailed definitions of snacking that address food type, context, and purpose are needed to advance findings within the field. We provide suggested standardized terminology for future research.
Topics: Adolescent; Child; Child, Preschool; Diet; Food Preferences; Health Promotion; Humans; Observational Studies as Topic; Parent-Child Relations; Parenting; Snacks
PubMed: 29096640
DOI: 10.1186/s12966-017-0593-9 -
Revista Brasileira de Psiquiatria (Sao... Sep 2006The relationship between religiosity and mental health has been a perennial source of controversy. This paper reviews the scientific evidence available for the... (Review)
Review
OBJECTIVE
The relationship between religiosity and mental health has been a perennial source of controversy. This paper reviews the scientific evidence available for the relationship between religion and mental health.
METHOD
The authors present the main studies and conclusions of a larger systematic review of 850 studies on the religion-mental health relationship published during the 20th Century identified through several databases. The present paper also includes an update on the papers published since 2000, including researches performed in Brazil and a brief historical and methodological background.
DISCUSSION
The majority of well-conducted studies found that higher levels of religious involvement are positively associated with indicators of psychological well-being (life satisfaction, happiness, positive affect, and higher morale) and with less depression, suicidal thoughts and behavior, drug/alcohol use/abuse. Usually the positive impact of religious involvement on mental health is more robust among people under stressful circumstances (the elderly, and those with disability and medical illness). Theoretical pathways of the religiousness-mental health connection and clinical implications of these findings are also discussed.
CONCLUSIONS
There is evidence that religious involvement is usually associated with better mental health. We need to improve our understanding of the mediating factors of this association and its use in clinical practice.
Topics: Depression; Humans; Life Style; Mental Disorders; Mental Health; Religion and Psychology; Spirituality; Substance-Related Disorders; Suicide
PubMed: 16924349
DOI: 10.1590/s1516-44462006000300018