What are the factors that contribute to the development of sexual dysfunction in breastfeeding women? A systematic scoping review protocol.
ABSTRACT: INTRODUCTION:Female sexual dysfunction is a public health problem. Evidence suggests that the population of nursing women is more vulnerable to the phenomenon due to breast feeding. Thus, this protocol was developed to explore the factors that contribute to the development of sexual dysfunction in breastfeeding women. METHODS AND ANALYSIS:The systematic scoping review will be conducted in six stages, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases used will be: PubMed, Excerpta Medica Database, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, Science Direct, Web of Science and Google Scholar. The searches were made until 1 June 2018, and no retrospective time limit was used. For the organisation of the literature retrieved from the databases, the EndNote Basic manager will be used. The Cochrane model will be used for the data extraction. The analysis of the quantitative data will be carried out through descriptive statistics and the qualitative data will be submitted to thematic analysis. The methodological quality of the empirical studies will be evaluated using the Mixed Methods Appraisal Tool. ETHICS AND DISSEMINATION:As it will be a review study, without human involvement, there will be no need for ethical approval. The results will be disseminated in a scientific journal, as well as in various media, such as: conferences, seminars, congresses or symposia.
Project description:INTRODUCTION:Eighty per cent of the sexually active population will get human papillomavirus (HPV) infection, which is the most prevalent sexually transmitted disease worldwide. Persistence of high-grade HPV infection may evolve to a cervical intraepithelial neoplasia (CIN), and these lesions may be precursors of cervical cancer. However, this progression can be prevented by the administration of therapeutic vaccines which use the main oncoproteins responsible for cancer development in an attempt to trigger a more specific and effective immunological response against this disorder. We aim to evaluate the safety, efficacy and immunogenicity of therapeutic vaccines in the treatment of patients with high-grade CIN 2/3 associated with HPV. METHODS AND ANALYSIS:A systematic review of clinical trials will be undertaken. Medline, Excerpta Medica Database, Cochrane Central Register of Controlled Trials, Web of Science, Latin American and Caribbean Health Sciences Literature, Scientific Electronic Library Online and Scopus will be searched, with no restriction regarding publication date. Primary outcomes will include measures related to safety, efficacy and the immunogenicity of the therapeutic vaccines used in these patients. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Methodological appraisal of the studies will be assessed by the Cochrane Risk-of-Bias Tool for randomised controlled trials, and the quality evidence of the risk of bias in single studies will be evaluated by Grading of Recommendations Assessment, Development and Evaluation. A narrative synthesis will be done for all included studies. Outcomes will be analysed according to the subgroups of HPV type, CIN grade, route of vaccine administration and vaccine type. Also, if sufficient data are available, a meta-analysis will be conducted. The effect sizes will be generated using Hedges' g score for both fixed and random effect models. I2 statistics will be used to assess heterogeneity and identify their potential sources. ETHICS AND DISSEMINATION:Ethical approval is not required as primary data will not be collected. Findings will be disseminated widely via peer-reviewed publication and in different media, for example, conferences, congresses or symposia. PROSPERO REGISTRATION NUMBER:CRD42017077428.
Project description:BACKGROUND:The aim of this study is to assess the clinical evidence for or against Mahaenggamseok-tang (MHGT) as a treatment for lower respiratory tract infections (LRTIs) in pediatric patients. METHOD:This systematic review will include randomized clinical trials (RCTs) of MHGT, as a treatment for LRTIs, compared with other therapies such as placebo and western medicine. The search terms will be selected according to the medical subject heading. We will search the following databases for systematic reviews from 2000 to Feb 2020: 5 English databases (The Cochrane Database of Systematic reviews, MEDLINE, Excerpta Medica dataBASE, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature), 1 Chinese database, 5 Korean databases (Oriental Medicine Advanced Searching Integrated System, DataBase Periodical Information Academic (DBPIA), Research Information Service System, Korean Studies Information Service System, and National Digital Science Library), and 1 Japanese database (J-Stage). All RCTs of decoctions or alternate forms of MHGT will be included. We will search for all parallel or crossover RCTs without language restrictions. The methodological quality of the RCTs will be assessed using Cochrane risk of bias. Furthermore, the studies will be limited to those performed in children under 16 years of age. RESULTS AND CONCLUSIONS:Our systematic review and meta-analysis will provide evidence for MHGT as a treatment for LRTI. The findings can help practitioners and patients recognize more effective and safer therapeutic methods. PROSPERO REGISTRATION NUMBER:CRD42020165698.
Project description:INTRODUCTION:The world's older population continues to grow at an unprecedented rate. An ageing population poses a great challenge to our healthcare system that requires new tool to tackle the complexity of health services as well as the increasing expenses. Mobile health applications (mHealth app) is seen to have the potential to address these challenges, alleviating burdens on the healthcare system and enhance the quality of life for older adults. Despite the numerous benefits of mHealth apps, relatively little is known about whether older adults perceive that these apps confer such benefits. Their perspectives towards the use of mobile applications for health-related purposes have also been little studied. Therefore, in this paper, we outline our scoping review protocol to systematically review literature specific to older adults' willingness, perceived barriers and motivators towards the use of mobile applications to monitor and manage their health. METHODS AND ANALYSIS:Arksey and O'Malley's scoping review methodology framework will guide the conduct of this scoping review. The search strategy will involve electronic databases including PubMed, Excerpta Medica Database, Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Google Scholar and ScienceDirect, in addition to grey literature sources and hand-searching of reference lists. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data will be charted and sorted through an iterative process by the research team. The extracted data will undergo a descriptive analysis and simple quantitative analysis will be conducted using descriptive statistics. Engagement with relevant stakeholders will be carried out to gain more insights into our data from different perspectives. ETHICS AND DISSEMINATION:Since the data used are from publicly available sources, this study does not require ethical approval. Results will be disseminated through academic journals, conferences and seminars. We anticipate that our findings will aid technology developers and health professionals working in the area of ageing and rehabilitation.
Project description:Uptake of nutritional supplementation during pulmonary rehabilitation (PR) for people with chronic obstructive pulmonary disease (COPD) has been limited by an absence of rigorous evidence-based studies supporting use. The objective was to report and summarise the current evidence supporting the use of nutritional supplementation to improve outcomes during PR in stable COPD patients. A systematic search was conducted up to 7 August 2019 (registration number CRD42018089142). The preferred reporting items for systematic reviews and meta-analyses guidelines were used. Six databases were included: Medical Literature Analysis and Retrieval System Online or MEDLARS Online, Allied and Complementary Medicine Database, the Cochrane Database of Systematic Reviews, Excerpta Medica dataBASE, Cumulative Index of Nursing and Allied Health Literature and Web of Science. This systematic search generated 580 initial matches, of which 22 studies (917 COPD participants) met the pre-specified criteria and were included. Sixteen of 19 studies that used nutritional supplements in addition to PR did not show additional benefit compared to PR alone when measuring exercise capacity. Nutritional supplements significantly increased body weight in 7 of 11 studies. Body mass index increased significantly in two of six studies. Handgrip strength did not improve, while quadriceps muscle strength significantly improved in 3 of 11 studies. Four of eight studies showed a significant improvement in inspiratory muscle function. Only 2 of 14 studies demonstrated a significant improvement in quality of life with supplementation in addition to PR. There remains insufficient evidence on the effect of nutritional supplementation on improving outcomes during PR in patients with COPD due to heterogeneity in supplements, outcome measures and PR programmes. Therefore, controversy remains and further research is needed.
Project description:This systematic review synthesizes the literature on incidence of obesity during childhood.We searched PubMed, Excerpta Medica database (EMBASE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL), and used the Web of Science tool in June 2015. Studies were included if they were published in English, presented results from primary or secondary analyses, used data about children in the US, provided obesity incidence data on children 0 to 18 years born after 1970, and did not pertain to clinically defined populations (disease, medication use, etc.). Author(s), study year, study design, location, sample size, age, and obesity incidence estimates were abstracted.Nineteen studies were included, three of which used nationally representative data. The median study-specific annual obesity incidences among studies using U.S. Centers for Disease Control and Prevention (CDC) growth charts were 4.0%, 3.2%, and 1.8% for preschool (2.0-4.9 years), school aged (5.0-12.9 years), and adolescence (13.0-18.0 years), respectively. This pattern of declining obesity incidence with age was consistent between and within studies.Studies of childhood obesity in the US indicate declining incidence with age. Childhood obesity prevention efforts should be targeted to ages before obesity onset. Longitudinal data and consistent obesity definitions that correlate with long-term morbidity are needed to better characterize the life history of obesity.
Project description:Sexual harassment experienced by nurses and nursing students is common and significantly associated with negative consequences. This study is a meta-analysis of the pooled prevalence of sexual harassment of nurses and nursing students in China. Electronic databases (PubMed, EMBASE, PsycINFO, Web of Science and Ovid, China National Knowledge Internet, WanFang, SinoMed and Chinese VIP Information) were independently and systematically searched by two reviewers from their commencement date to 12 March 2018. Forty-one studies that reported the prevalence of sexual harassment were analyzed using the random-effects model. The pooled prevalence of sexual harassment was 7.5% (95% CI: 5.5%-10.1%), with 7.5% (5.5%-10.2%) in nurses and 7.2% (3.0%-16.2%) in nursing students. Subgroup analyses showed that the year of survey and sample size were significantly associated with the prevalence of sexual harassment, but not the seniority of nursing staff, department, hospital, economic region, timeframe, age, working experience or subtypes of harassment. In China, sexual harassment was found to be common in nurses and nursing students. Considering the significant negative impact of sexual harassment, effective preventive and workplace measures should be developed.
Project description:Although the proportion of women in science, and in evolutionary biology in particular, has substantially increased over the last century, women remain underrepresented in academia, especially at senior levels. In addition, their scientific achievements do not always receive the same level of recognition as do men's, which can be reflected in a lower relative representation of women among invited speakers at conferences or specialized courses. Using announcements sent to the EvolDir mailing list between April 2016 and September 2017, and the symposium programs of three large evolutionary biology congresses held in summer 2017, we quantified the representation of women announced as invited speakers in conferences, congress symposia, and specialized courses. We compared the proportion of invited women to a baseline estimated using membership data of the associated scientific societies, and surveyed organizers to investigate their influence and that of potential gender-ratio guidelines on the proportion of invited women. We find that the average proportion of invited women is comparable (conferences), significantly lower (specialized courses), or significantly higher (congress symposia) than the current baseline (32% women). It is positively correlated to the proportion of women among the organizers, and it is on average higher for events whose organizers considered gender when choosing speakers than for those whose organizers did not. To investigate the impact of Equal Opportunity guidelines, we then collected longitudinal data on the proportion of invited women at two series of congresses, covering the 2001-2017 period. The proportion of invited women is higher when Equal Opportunity guidelines are announced. Encouraging women to sit on organizing committees of scientific events, and the establishment of visible Equal Opportunity guidelines, thus could be ways to ensure higher number of invited female speakers in the future. Our results suggest that change, if desired, requires deliberate actions.
Project description:INTRODUCTION:Osteoarthritis is a common degenerative joint disease that eventually leads to disability and poor quality of life. The main symptoms are joint pain and mobility disorders. If the patient has severe pain or other analgesics are contraindicated, opioids may be a viable treatment option. To evaluate and compare the efficacy and safety of opioids in the treatment of knee or hip osteoarthritis, we will integrate direct and indirect evidence using a Bayesian network meta-analysis to establish hierarchies of these drugs. METHODS AND ANALYSIS:We will search the Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Web of Science and PsycINFO databases as well as published and unpublished research in international registries and regulatory agency websites for osteoarthritis reports published prior to 5 January 2018. There will be no restrictions on the language. Randomised clinical trials that compare oral or transdermal opioids with other various opioids, placebo or no treatment for patients with knee or hip osteoarthritis will be included. The primary outcomes of efficacy will be pain and function. We will use pain and function scales to evaluate the main outcomes. The secondary outcomes of safety will be defined as the proportion of patients who have stopped treatment due to side effects. Pairwise meta-analyses and Bayesian network meta-analyses will be performed for all related outcome measures. We will conduct subgroup analyses and sensitivity analyses to assess the robustness of our findings. The Grading of Recommendations, Assessment, Development and Evaluations framework will be used to assess the quality of the evidence contributing to each network assessment. ETHICS AND DISSEMINATION:This study does not require formal ethical approval because individual patient data will not be included. The findings will be disseminated through peer-reviewed publications or conference presentations. PROSPERO REGISTRATION NUMBER:CRD42018085503.
Project description:INTRODUCTION:Increased life expectancy has led to an increased demand for family members to provide informal care for their older relatives in the home. Many studies suggest informal caregivers are at greater risk of experiencing symptoms of depression. However, there is a lack of research examining the effectiveness of psychological interventions targeting these symptoms alongside clinical and methodological moderators potentially associated with intervention effectiveness. This review aims to address this gap and will inform the development of a psychological intervention targeting depression among adult-child caregivers of older parents, given many studies show that among informal caregivers of older adults, adult children experience specific difficulties and needs for psychological support. Further, the lack of studies targeting adult children specifically necessitates conducting this review targeting caregivers of older adults in general. METHODS AND ANALYSIS:Randomised controlled trials of psychological interventions targeting symptoms of depression among informal caregivers will be identified via a systematic search of electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica DataBase, PsycINFO, Cochrane Library and Web of Science) and supplemented by handsearching of previous systematic reviews, reference and forward citation checking, and expert contact. If possible, a meta-analysis will be conducted to examine the: (1) effectiveness of psychological interventions for depression among informal caregivers of older adults, (2) effectiveness of psychological interventions for secondary outcomes such as anxiety, stress, caregiver burden, psychological distress, quality of life, well-being and self-efficacy and (3) moderating effects of clinical and methodological factors on effectiveness. ETHICS AND DISSEMINATION:Ethical approval will not be necessary for this study given primary data will not be collected. Results will inform the development of a psychological intervention for adult-child caregivers of older parents and will be disseminated through publication in peer-reviewed journals and conference presentations. PROSPERO REGISTRATION NUMBER:CRD42020157763.
Project description:BACKGROUND:The high demand for health care services and the growing capability of artificial intelligence have led to the development of conversational agents designed to support a variety of health-related activities, including behavior change, treatment support, health monitoring, training, triage, and screening support. Automation of these tasks could free clinicians to focus on more complex work and increase the accessibility to health care services for the public. An overarching assessment of the acceptability, usability, and effectiveness of these agents in health care is needed to collate the evidence so that future development can target areas for improvement and potential for sustainable adoption. OBJECTIVE:This systematic review aims to assess the effectiveness and usability of conversational agents in health care and identify the elements that users like and dislike to inform future research and development of these agents. METHODS:PubMed, Medline (Ovid), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and the Association for Computing Machinery Digital Library were systematically searched for articles published since 2008 that evaluated unconstrained natural language processing conversational agents used in health care. EndNote (version X9, Clarivate Analytics) reference management software was used for initial screening, and full-text screening was conducted by 1 reviewer. Data were extracted, and the risk of bias was assessed by one reviewer and validated by another. RESULTS:A total of 31 studies were selected and included a variety of conversational agents, including 14 chatbots (2 of which were voice chatbots), 6 embodied conversational agents (3 of which were interactive voice response calls, virtual patients, and speech recognition screening systems), 1 contextual question-answering agent, and 1 voice recognition triage system. Overall, the evidence reported was mostly positive or mixed. Usability and satisfaction performed well (27/30 and 26/31), and positive or mixed effectiveness was found in three-quarters of the studies (23/30). However, there were several limitations of the agents highlighted in specific qualitative feedback. CONCLUSIONS:The studies generally reported positive or mixed evidence for the effectiveness, usability, and satisfactoriness of the conversational agents investigated, but qualitative user perceptions were more mixed. The quality of many of the studies was limited, and improved study design and reporting are necessary to more accurately evaluate the usefulness of the agents in health care and identify key areas for improvement. Further research should also analyze the cost-effectiveness, privacy, and security of the agents. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):RR2-10.2196/16934.