Search results for: systematic%20literature%20review

Authors: Addisu Tadesse Sahile, Mussie Wubshet Teka, Solomon Muluken Ayehu

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Background: Diabetes is one of the common public health problems of the century that was estimated to affect one in a tenth of the world population by the year 2030, where diabetes ketoacidosis is one of its common acute complications. Objectives: The aim of this review was to assess the magnitude of diabetes ketoacidosis among patients with type 1 diabetes in Ethiopia. Methods: A systematic data search was done across Google Scholar, PubMed, Web of Science, and African Online Journals. Two reviewers carried out the selection, reviewing, screening, and extraction of the data independently by using a Microsoft Excel Spreadsheet. The Joanna Briggs Institute's prevalence critical appraisal tool was used to assess the quality of evidence. All studies conducted in Ethiopia that reported diabetes ketoacidosis rates among type 1 diabetes were included. The extracted data was imported into the comprehensive meta-analysis version 3.0 for further analysis. Heterogeneity was checked by Higgins’s method, whereas the publication bias was checked by using Beggs and Eggers’s tests. A random-effects meta-analysis model with a 95% confidence interval was computed to estimate the pooled prevalence. Furthermore, subgroup analysis based on the study area (Region) and the sample size was carried out. Result and Conclusion: After review made across a total of 51 articles, of which 12 articles fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of diabetes ketoacidosis among type 1 diabetes in Ethiopia was 53.2% (95%CI: 43.1%-63.1%). The highest prevalence of DKA was reported in the Tigray region of Ethiopia, whereas the lowest was reported in the Southern region of Ethiopia. Concerned bodies were suggested to work on the escalated burden of diabetes ketoacidosis in Ethiopia.

Keywords: DKA, Type 1 diabetes, Ethiopia, systematic review, meta-analysis

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Authors: Haitham Assiri, Priyadarsi Nanda

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The world is gradually entering the fourth industrial revolution. E-Government services are scaling government operations across the globe. However, as promising as an e-Government system would be, it is also susceptible to malicious attacks if not properly secured. This study found out that, in Saudi Arabia, the e-Government website, Yesser is vulnerable to external attacks. Obviously, this can lead to a breach of data integrity and privacy. In this paper, a Systematic Literature Review was conducted to explore possible ways the Kingdom of Saudi Arabia can take necessary measures to strengthen its e-Government system using Blockchain. Blockchain is one of the emerging technologies shaping the world through its applications in finance, elections, healthcare, etc. It secures systems and brings more transparency. A total of 28 papers were selected for this SLR, and 19 of the papers significantly showed that blockchain could enhance the security and privacy of Saudi’s e-government system. Other papers also concluded that blockchain is effective, albeit with the integration of other technologies like IoT, AI and big data. These papers have been analysed to sieve out the findings and set the stage for future research into the subject.

Keywords: blockchain, data integrity, e-government, security threats

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Authors: Sara Zelman, Courtney Meyer, Hiren Patel, Lisa Philpotts, Sue Lahey, Thomas Burke

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Background: As the global burden of disease shifts from infectious diseases to noncommunicable diseases, there is growing urgency to provide treatment for time-sensitive illnesses, such as ST-Elevation Myocardial Infarctions (STEMIs). The standard of care for STEMIs in developed countries is Percutaneous Coronary Intervention (PCI). However, this is inaccessible in resource-limited settings. Before the discovery of PCI, Streptokinase (STK) and other thrombolytic drugs were first-line treatments for STEMIs. STK has been recognized as a cost-effective and safe treatment for STEMIs; however, in settings which lack access to PCI, it has not become the established second-line therapy. A systematic literature review was conducted to geographically map the use of STK for STEMIs in resource-limited settings. Methods: Our literature review group searched the databases Cinhal, Embase, Ovid, Pubmed, Web of Science, and WHO’s Index Medicus. The search terms included ‘thrombolytics’ AND ‘myocardial infarction’ AND ‘resource-limited’ and were restricted to human studies and papers written in English. A considerable number of studies came from Latin America; however, these studies were not written in English and were excluded. The initial search yielded 3,487 articles, which was reduced to 3,196 papers after titles were screened. Three medical professionals then screened abstracts, from which 291 articles were selected for full-text review and 94 papers were chosen for final inclusion. These articles were then analyzed and mapped geographically. Results: This systematic literature review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with 18 of 94 studies taking place in India. Furthermore, 13 studies occurred in Pakistan, followed by Iran (6), Sri Lanka (5), Brazil (4), China (4), and South Africa (4). Conclusion: Our systematic review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with the highest utilization occurring in India. This demonstrates that even though STK has high utility for STEMI treatment in resource-limited settings, it still has not become the standard of care. Future research should investigate the barriers preventing the establishment of STK use as second-line treatment after PCI.

Keywords: cardiovascular disease, global health, resource-limited setting, ST-Elevation Myocardial Infarction, Streptokinase

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Authors: Theresa Ukamaka Nwagha, Angela Ogechukwu Ugwu, Martins Nweke

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Background and Objectives: Blood transfusion is an effective and proven treatment for some severe complications of sickle cell disease. Recurrent transfusions have put patients with sickle cell disease at risk of developing antibodies against the various antigens they were exposed to. This study aims to investigate the frequency of red blood cell alloimmunization in patients with sickle disease in Africa. Materials and Methods: This is a systematic review of peer-reviewed literature published in English. The review was conducted consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data sources for the review include MEDLINE, PubMed, CINAHL, and Academic Search Complete. Included in this review are articles that reported the frequency/prevalence of red blood cell alloimmunization in sickle cell disease patients in Africa. Eligible studies were subjected to independent full-text screening and data extraction. Risk of bias assessment was conducted with the aid of the mixed method appraisal tool. We employed a random-effects model of meta-analysis to estimate the pooled prevalence. We computed Cochrane’s Q statistics and I2 and prediction interval to quantify heterogeneity in effect size. Results: The prevalence estimates range from 2.6% to 29%. Pooled prevalence was estimated to be 10.4% (CI 7.7.–13.8); PI = 3.0 – 34.0%), with significant heterogeneity (I2 = 84.62; PI = 2.0-32.0%) and publication bias (Egger’s t-test = 1.744, p = 0.0965). Conclusion: The frequency of red cell alloantibody varies considerably in Africa. The alloantibodies appeared frequent in this order: the Rhesus, Kell, Lewis, Duffy, MNS, and Lutheran

Keywords: frequency, red blood cell, alloimmunization, sickle cell disease, Africa

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Authors: Christina Cheong, Naomi Keena

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In the face of growing urbanization the construction of new buildings is inevitable and with current construction methods leading to environmental degradation much questioning is needed around reducing the environmental impact of buildings. This paper explores the global environmental issue of concrete production in parallel with the problem of plastic waste, and questions if new solutions into plastic waste additions in concrete is a viable sustainable solution with positive systematic implications to living systems, both human and non-human. We investigate how certification programs can be used to access the sustainability of the new concrete composition. With this classification we look to the health impacts as well as reusability of such concrete in a second or third life cycle. We conclude that such an approach has benefits to the environment and that taking a circular approach to its development, in terms of the overall life cycle of the new concrete product, can help understand the nuances in terms of the material’s environmental and human health impacts.

Keywords: Concrete, Plastic waste additions to concrete, sustainability ratings, sustainable materials

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Authors: Khaled Alshammari

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A facile approach to synthesizing highly active and stable Au/NiO catalysts for the hydrogenation of nitro-aromatics is reported. Preformed gold nanoparticles have been immobilized onto NiO using a colloidal method. In this article, the reduction of 4-nitrophenol with NaBH4 has been used as a model reaction to investigate the catalytic activity of synthesized Au/NiO catalysts. In addition, we report a systematic study of the reduction kinetics and the influence of specific reaction parameters such as (i) temperature, (ii) stirring rate, (iii) sodium borohydride concentration and (iv) substrate/metal molar ratio. The reaction has been performed at a substrate/metal molar ratio of 7.4, a ratio significantly higher than previously reported. The reusability of the catalyst has been examined, with little to no decrease in activity observed over 5 catalytic cycles. Systematic variation of Au loading reveals the successful synthesis of low-cost and efficient Au/NiO catalysts at very low Au content and using high substrate/metal molar ratios.

Keywords: nonochemistry, catalyst, nanoparticles supported, characterization of materials, colloidal nanoparticles

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Authors: K. D. Candido, A. Lissounov, I. Knezevic, N. Knezevic

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Background: The most commonly performed pain procedures in the USA is Lumbar Epidural Steroid Injections (LESI). There are three main types of these procedures: transforaminal (TF), interlaminar (IL) and caudal injections. It is expected for TF injections to have better outcomes than IL injections, based on the recently published systematic review. The studies presented in that review used a midline IL approach, but those with parasagittal IL approach were not taken into consideration. Our aim is to emphasize the efficacy of the lateral parasagittal (paramedian) IL approach in this review. Methods: We included five studies in this systematic review, which compared Parasagittal-IL (PIL) with either Midline-IL (MIL) or TF LESI. Total of 296 patients who had undergone different types of LESI were observed across the five studies, and the average pain and functional improvements were calculated and compared among groups. Results: Pain and function improvements with PIL approach is superior on 12 months follow up to MIL approach (53.4% vs. 14.7%) and (55% vs. 27.7%), respectively. A 12 months follow-up results between PIL and TF shows a near equivalent effectiveness for pain (58.9% vs. 63.2%) and function improvement (47.3% vs. 48.1%). An average follow-up of 17.1 days have shown better short-term pain relief for PIL than TF approach (45.8% vs. 19.2%), respectively. Number of repeated injections is lower for PIL injections than MIL. Number of weeks between 1st and 2nd injections: PIL averaged 15.8 weeks and MIL averaged 9.7 weeks. Third LESI injection is more common in TF group (30%) than PIL group (18.8%). Conclusion: Higher complication rates are associated with TF injections for which FDA7 issued an official warning. We have recorded better outcomes in pain and function improvement of Parasagittal-IL LESI as compared to midline-IL injection, in the presented systematic review. Parasagittal and TF injections have equivalent efficacy in Pain and Function improvements thus we advocate for Parasagittal-IL approach consideration as an alternative for TF injections.

Keywords: parasagital approach, lumbar, back pain, epidural steroid injection

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Authors: Daniella Hirwa

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Attention Deficit Hyperactivity Disorder (ADHD) is associated with several risk-taking behaviors, including drug use and smoking. Such risk-taking behaviors are often a result of an attempt to self-manage symptoms associated with ADHD. The present review investigates the effects of nicotine on symptoms associated with ADHD. This systematic literature review was conducted for 2005-2020 using keywords ADHD, smoking, nicotine, and adulthood. The results indicate that individuals with ADHD start smoking earlier than those without ADHD, and it is believed that this prevalence and the higher rates of smoking are due to improvements in cognitive and executive function, attention, and impulsivity due to the effect that nicotine has on dopamine release. Longitudinal studies with larger sample sizes and comprehensive health history and cognitive testing are required to gain more insight into the ways that nicotine affects ADHD symptoms and the context by which smoking is used as a method of self-treatment to help aid the development of nicotine-based treatment options that do not pose the same health risks as smoking.

Keywords: ADHD, nicotine, risk-taking behaviors, smoking

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Authors: Sumudu Sameera Perera Kimmantudawage, Chapal Khasnabis

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Technology is changing at a rapid rate, with innovations in robotics being hailed and tested in countries such as Japan, the United States and Australia, however the conversation in a public health context is stagnant. While obvious barriers to robotics use in low and middle-income countries and regions exist, the avoidance of attempting to address these regions of the world may potentially lead to an ever-increasing divide between those of high income countries and those of less. A systematic review was undertaken to determine the number of projects involving research, development and testing of robotics considered low and middle-income regions. Major findings indicate that an overwhelmingly significant number of projects failed to consider low and middle-income countries or regions. These results are unsurprising however alarming, as bridging the divide is an important step forward in achieving the UN Sustainable Development Goals by 2030. It is hoped that this research would spawn future robotics research that focusses on lower and middle-income regions.

Keywords: assistive technology, health equality, robotics, socioeconomic

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Authors: Parvin Goli, Amirhosein Kefayat, Rezvan Goli

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Background: It is well established that parents can influence their offspring's neurodevelopment. It is shown that paternal environment and lifestyle is beneficial for the progeny's fitness and might affect their metabolic mechanisms; however, the effects of paternal exercise on the brain in the offspring have not been explored in detail. Objective: This study aims to review the impact of paternal physical exercise on memory and learning, neuroplasticity, as well as DNA methylation levels in the off-spring's hippocampus. Study design: In this systematic review and meta-analysis, an electronic literature search was conducted in databases including PubMed, Scopus, and Web of Science. Eligible studies were those with an experimental design, including an exercise intervention arm, with the assessment of any type of memory function, learning ability, or any type of brain plasticity as the outcome measures. Standardized mean difference (SMD) and 95% confidence intervals (CI) were computed as effect size. Results: The systematic review revealed the important role of environmental enrichment in the behavioral development of the next generation. Also, offspring of exercised fathers displayed higher levels of memory ability and lower level of brain-derived neurotrophic factor. A significant effect of paternal exercise on the hippocampal volume was also reported in the few available studies. Conclusion: These results suggest an intergenerational effect of paternal physical activity on cognitive benefit, which may be associated with hippocampal epigenetic programming in offspring. However, the biological mechanisms of this modulation remain to be determined.

Keywords: hippocampal plasticity, learning ability, memory, parental exercise

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Authors: Atiq U. Zaman, Juliet Arnott

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This paper analyses the various benefits and barriers of residential deconstruction in the context of environmental performance and circular economy based on a case study project in Christchurch, New Zealand. The case study project “Whole House Deconstruction” which aimed, firstly, to harvest materials from a residential house, secondly, to produce new products using the recovered materials, and thirdly, to organize an exhibition for the local public to promote awareness on resource conservation and sustainable deconstruction practices. Through a systematic deconstruction process, the project recovered around 12 tonnes of various construction materials, most of which would otherwise be disposed of to landfill in the traditional demolition approach. It is estimated that the deconstruction of a similar residential house could potentially prevent around 27,029 kg of carbon emission to the atmosphere by recovering and reusing the building materials. In addition, the project involved local designers to produce 400 artefacts using the recovered materials and to exhibit them to accelerate public awareness. The findings from this study suggest that the deconstruction project has significant environmental benefits, as well as social benefits by involving the local community and unemployed youth as a part of their professional skills development opportunities. However, the project faced a number of economic and institutional challenges. The study concludes that with proper economic models and appropriate institutional support a significant amount of construction and demolition waste can be reduced through a systematic deconstruction process. Traditionally, the greatest benefits from such projects are often ignored and remain unreported to wider audiences as most of the external and environmental costs have not been considered in the traditional linear economy.

Keywords: circular economy, construction and demolition waste, resource recovery, systematic deconstruction, sustainable waste management

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Authors: Eyal Rosen

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This study is aimed to report a possible effect of the presence of dental implants on the development of crown or root fractures in adjacent natural teeth. A series of 26 cases of teeth diagnosed with crown or root fractures following the placement of adjacent dental implants is presented. In addition, a comprehensive systematic review of the literature was performed to detect other studies that evaluated this possible complication. The case series analysis revealed that all crown-fractured teeth were non-endodontically treated teeth (n=18), and all root fractured teeth were endodontically treated teeth (n=8). The time from implant loading to the diagnosis of a fracture in an adjacent tooth was longer than 1 year in 78% of cases. The majority of crown or root fractures occurred in female patients, over 50 years of age, with an average age of 59 in the crown fractures group, and 54 in the root fractures group. Most of the patients received 2 or more implants. Nine (50%) of the teeth with crown fracture were molars, 7 (39%) were mandibular premolars, and 2 (11%) were incisor teeth. The majority of teeth with root fracture were premolar or mandibular molar teeth (6 (75%)). The systematic review of the literature did not reveal additional studies that reported on this possible complication. To the best of the author’s knowledge this case series, although limited in its extent, is the first clinical report of a possible serious complication of implants, associated fractures in adjacent endodontically and non-endodontically treated natural teeth. The most common patient profile found in this series was a woman over 50 years of age, having a fractured premolar tooth, which was diagnosed more than 1 year after reconstruction that was based on multiple adjacent implants. Additional clinical studies are required in order to shed light on this potential serious complication.

Keywords: complications, dental implants, endodontics, fractured teeth

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Authors: Karima Chaabna, Sohaila Cheema, Amit Abraham, Hekmat Alrouh, Ravinder Mamtani, Javaid I. Sheikh

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We aimed to assess the production of systematic reviews (SRs) that synthesize observational studies discussing population health issues in the Middle East and North Africa (MENA). Two independent reviewers systematically searched MEDLINE through PubMed. Between 2008-2016, 5,747 articles (reviews, systematic reviews, and meta-analyses) were identified. Following a multi-stage screening process, 387 SRs (with or without meta-analysis) on population health issues in the MENA were included in our overview. Citation numbers for each SR were retrieved from Google Scholar. Impact factor of the journal during the publication year for the included SRs was retrieved from the Institute of Scientific Information’s Journal Citation Report. We conducted linear regression analysis to assess time trends of number of publications according to SRs’ characteristics. We characterized a linear statistically significant increase in the annual numbers of SRs that summarize observational studies on the MENA population health (p-value<0.0001, R2=0.95), from 15 in 2008 to 81 in 2016. Our analysis reveals also linear statistically significant increases in numbers of SRs published by authors affiliated to institutions located inside MENA and/or neighboring countries (N=113, p-value < 0.0001, R²=0.90), by authors located outside MENA (N=155, p-value=0.0007, R²=0.82), and by collaborating authors affiliated to institutions located outside MENA and inside the region and/or in MENA’s neighboring countries (total number of SRs (N)= 119, p-value=0.0004, R²=0.85). Furthermore, these SRs were published in journals with an IF ranging from 0 to 47.8 (median=2.1). Linear statistically significant increases in numbers of published SRs were demonstrated in journals’ impact factor (IF) categories (IF=[0-2[: R²=0.79, p-value=0.0012; IF=[2-4[:R²=0.86, p-value=0.0003; and IF=[4-6[:R²=0.53, p-value=0.026). Additionally, annual numbers of citations to the SRs varied between 0 and 471 (median=7). While each year, a couple of SRs were getting more than 50 annual citations, there were linear statistically significant increases in numbers of published SRs with an annual number of citations at [0-10[(R²=0.89, p-value=0.00014) and at [10-50[ (R²=0.76, p-value=0.0021). Between 2008-2016, increasingly SRs that summarize observational studies on population health issues in the MENA were published. Authors of these SRs were located inside and/or outside the MENA region and an increasing number of collaborations were seen. Increasing numbers of SRs were predominantly observed in journals with an IF between zero and six. Interestingly, SRs covering MENA region countries were being increasingly cited, indicating an escalation of interest in this region’s population health issues.

Keywords: bibliometric, citation, impact factor, Middle East and North Africa, population health, systematic review

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Authors: Monir Ahmed

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The main purpose of this literature review was to investigate the existing quantitative clinical studies on the relationship between transcendence and psychological well-being. The primary objective of the literature review is to determine whether the existing studies adequately demonstrate the relationship between transcendence and psychological well-being, including spiritual well-being. A further objective of this literature review is to see if the ‘creatio ex nihilo’ doctrine is necessary to understand transcendence and its relationship with psychological well-being. Systematic literature review methods including studies identified from search engines, extracting data from the studies and assessing their quality for the planned review were used. The outcome of this literature review indicates that self-transcendence (STa), spiritual transcendence (STb) are positively related to psychological well-being. However, such positive relationships present limited scope for understanding transcendence and its relationship with well-being. The findings of this review support the need for further research in the area of transcendence and well-being. This literature review reveals the importance of developing a new transcendence tool for determining an individual’s ability to transcend and the relationship between his/her ability for transcendence and psychological well-being. The author of this paper proposes that the inclusion of the theological doctrine (‘creatio ex nihilo’) in understanding transcendence and psychological well-being is crucial, necessary and unavoidable.

Keywords: transcendence, psychological well-being, self-transcendence, spiritual transcendence, ‘creatio ex nihilo’

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Authors: Mine Koyaz, M. Cem Altun

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Selection of the materials satisfying the expected performances is significantly important for any design. Today, with the constantly evolving and developing technologies, the material options are so wide that the necessity of the use of some support tools in the selection process is arising. Therefore, as a sub process of building element design, a systematic material selection tool is developed, that defines four main steps of the material selection; definition, research, comparison and decision. The main purpose of the tool is being an educational instrument that would show a methodic way of material selection in architectural detailing for the use of architecture students. The tool predefines the possible uses of various material databases and other sources of information on material properties. Hence, it is to be used as a guidance for designers, especially with a limited material knowledge and experience. The material selection tool not only embraces technical properties of materials related with building elements’ functional requirements, but also its sensual properties related with the identity of design and its environmental impacts with respect to the sustainability of the design. The method followed in the development of the tool has two main sections; first the examination and application of the existing methods and second the development of trial versions and their applications. Within the scope of the existing methods; design support tools, methodic approaches for the building element design and material selection process, material properties, material databases, methodic approaches for the decision making process are examined. The existing methods are applied by architecture students and newly graduate architects through different design problems. With respect to the results of these applications, strong and weak sides of the existing material selection tools are presented. A main flow chart of the material selection tool has been developed with the objective to apply the strong aspects of the existing methods and develop their weak sides. Through different stages, a different aspect of the material selection process is investigated and the tool took its final form. Systematic material selection tool, within the building element design process, guides the users with a minimum background information, to practically and accurately determine the ideal material that is to be chosen, satisfying the needs of their design. The tool has a flexible structure that answers different needs of different designs and designers. The trial version issued in this paper shows one of the paths that could be followed and illustrates its application over a design problem.

Keywords: architectural education, building element design, material selection tool, systematic approach

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Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

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Background: The risk of sudden cardiac arret/death (SCA/D) in athletes is controversial. There is a lack of meta-analyses assessing the sex differences in the risk of SCA/D in competitive athletes. Purpose: The aim of the present study was to evaluate sex differences in the incidence of SCA/D in competitive athletes using meta-analyses. Methods: The systematic review was registered in the PROSPERO database (registration ID: CRD42023432022) and was conducted according to the PRISMA guidelines. PubMed, Embase, Scopus, SPORT Discus and Cochrane Library were searched up to July 2023. To avoid systematic bias in data pooling, only studies with data for both sexes were included. Results: From the 18 included studies, 2028 cases of SCA/D were observed (males 1821 (89.79%), females 207 (10.21%)). The age ranges from the adolescents (<26 years) to the elderly (>45 years). The incidence in male athletes was 1.32/100,000 AY (95% CI: [0.90, 1.93]) and in females was 0.26/100,000 AY (95% CI: [0.16, 0.43]), the incidence rate ratio (IRR) was 6.43 (95% CI: [4.22, 9.79]). The subgroup synthesis showed a higher incidence in males than in females in both age groups <25 years and ≤35 years, the IRR was 5.86 (95% CI: [4.69, 7.32]) and 5.79 (95% CI: [4.73, 7.09]), respectively. When considering the events, the IRR was 6.73 (95%CI: [3.06, 14.78]) among studies involving both SCA/D events and 7.16 (95% CI: [4.93, 10.40]) among studies including only cases of SCD. The available clinical evidence showed that cardiac events were most frequently seen in long-distance running races (26, 35.1%), marathon (16, 21.6%) and soccer (10, 13.5%). Coronary artery disease (14, 18.9%), hypertrophic cardiomyopathy (8, 10.8%), and arrhythmogenic right ventricular cardiomyopathy (7, 9.5%) are the most common causes of SCA/D in competitive athletes. Conclusion: The meta-analysis provides evidence of sex differences in the incidence of SCA/D in competitive athletes. The incidence of SCA/D in male athletes was 6 to 7 times higher than in females. Identifying the reasons for this difference may have implications for targeted the prevention of fatal evets in athletes.

Keywords: incidence, sudden cardiac arrest, sudden cardiac death, sex difference, athletes

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Authors: Catarina Ramos Pereira, Jorge Rodrigues, Natália Oliveira, Jorge Machado, Maria Begoña Criado, Jorge Machado, Henri J. Greten

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Background: Parkinson's disease is a multi-system neurodegenerative disorder characterized by motor and non-motor symptoms. To slow disorder progression, different treatment options are now available, but in most cases, these therapeutic strategies also involve the presence of important side effects. This has led many patients to pursue complementary therapies, such as acupuncture, to alleviate PD symptoms. Therefore, an update on the efficacy of this treatment for patients of PD is of great value. This work presents a systematic review of the efficacy of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central), and Scielo databases were systematically searched from January 2011 through July 2021. Randomized controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles were conducted by two blinding authors through the Rayyan application. Results: 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Additional evidence should be supported by rigorous methodological strategies. Although firm conclusions cannot be drawn, acupuncture treatment, in the framework of an interdisciplinary care team, appears to have positive effects on PD symptoms.

Keywords: systematic review, Parkinson disease, acupuncture, traditional Chinese medicine

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Authors: Fabiane Alves Farias Guimarães, Rodrigo Otávio Moretti-Pires, Ana Lúcia Schaefer Ferreira de Mello

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Introduction: Considering the last changes in Brazilian Health and Higher Educational Systems, the production of scientific knowledge regarding dental education and training has been increasing. The National Curriculum Guidelines for undergraduate courses in Dentistry established in 2002 the principles and procedures to perform a more generalist dental professional profile. Objectives: To perform a systematic review of the Brazilian scientific literature about dental education and training. Methods: The systematic review was conducted considering the Lilacs - Latin American Literature in Health Sciences and SciELO - Scientific Electronic Library Online data bases, using the combination of key words dentistry, education, teaching or training. It was select original research articles, published between 2010 and 2013, in Portuguese. Results: Based on the selection criteria, it was found 23 articles. In order to organize the outcomes, the analysis was separated in three themes: Ethical aspects of education (3 articles), integrating dental service with training (10 articles) and Dental education and the Brazilian curriculum guidelines (10 articles). Most of the studies were published between 2011 and 2012 (35% each) and were held in public universities. The studied populations included dental students, teachers, universities directors, health managers and dentists. The qualitative methodological approach was predominant. Conclusion: It was possible to identify a transience time in Brazilian undergraduate courses in Dentistry after curricular changes. The produced literature shows some advances, as the incorporation of ethical values on dental education and the inclusion of new practices environments for students by integrating education and training in diversified dental services scenarios.

Keywords: Teaching, Dental Students, Human resources in dentistry

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Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

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Introduction: Primary biliary cirrhosis (PBC) is a cholestatic cholangitis of unknown etiology. It is frequently associated with autoimmune diseases, which explains their systematic screening. The aim of our study was to determine the prevalence and the type of autoimmune disorders associated with PBC and to assess their impact on the prognosis of the disease. Material and methods: It is a retrospective study over a period of 16 years (2000-2015) including all patients followed for PBC. In all these patients we have systematically researched: dysthyroidism (thyroid balance, antithyroid autoantibodies), type 1 diabetes, dry syndrome (ophthalmologic examination, Schirmer test and lip biopsy in case of Presence of suggestive clinical signs), celiac disease(celiac disease serology and duodenal biopsies) and dermatological involvement (clinical examination). Results: Fifty-one patients (50 women and one men) followed for PBC were collected. The Mean age was 54 years (37-77 years). Among these patients, 30 patients(58.8%) had at least one autoimmune disease associated with PBC. The discovery of these autoimmune diseases preceded the diagnosis of PBC in 8 cases (26.6%) and was concomitant, through systematic screening, in the remaining cases. Autoimmune hepatitis was found in 12 patients (40%), defining thus an overlap syndrome. Other diseases were Hashimoto's thyroiditis (n = 10), dry syndrome (n = 7), Gougerot Sjogren syndrome (n=6), celiac disease (n = 3), insulin-dependent diabetes (n = 1), scleroderma (n = 1), rheumatoid arthritis (n = 1), Biermer Anemia (n=1) and Systemic erythematosus lupus (n=1). The two groups of patients with PBC with or without associated autoimmune disorders were comparable for bilirubin levels, Child-Pugh score, and response to treatment. Conclusion: In our series, the prevalence of autoimmune diseases in PBC was 58.8%. These diseases were dominated by autoimmune hepatitis and Hashimoto's thyroiditis. Even if their association does not seem to alter the prognosis, screening should be systematic in order to institute an early and adequate management.

Keywords: autoimmune diseases, autoimmune hepatitis, primary biliary cirrhosis, prognosis

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Authors: Yassir Mohammed

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The study examines the impact of skilled parental migration on left-behind children. It uses the SCOPUS database to evaluate the existing literature from 1972 to 2022 and synthesizes data using the PRISMA framework and bibliometric method of analysis. 49 articles out of 202 papers were involved in the synthesis. International migration, outcome migration, consequence, parental migration, high-skill and left-behind children, and left-behind preschool were all searched. The research found that mental health issues, self-isolation, and physical harm have negative impacts, while sending children to good schools, having good academic records, and better medical care have positive impacts. The study also found that gender gaps increase in some countries while decreasing in others. Further research is needed on child maltreatment, academic performance, subjective well-being, societal effects, behavioral difficulties, and quality of life. The study only included peer-reviewed English publications in the final analysis.

Keywords: parental migration, impact of migration, systematic review, left-behind children

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Authors: Dhruv Sharma, Lynne Blair, Stephen Clune

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Later life loneliness is a social issue that is increasing alongside an upward global population trend. As a society, one way that we have responded to this social challenge is through developing non-pharmacological interventions such as befriending services, activity clubs, meet-ups, etc. Through a systematic literature review, this paper suggests that currently there is an underrepresentation of radical innovation, and underutilization of digital technologies in developing loneliness interventions for older adults. This paper examines intervention studies that were published in English language, within peer reviewed journals between January 2005 and December 2014 across 4 electronic databases. In addition to academic databases, interventions found in grey literature in the form of websites, blogs, and Twitter were also included in the overall review. This approach yielded 129 interventions that were included in the study. A systematic approach allowed the minimization of any bias dictating the selection of interventions to study. A coding strategy based on a pattern analysis approach was devised to be able to compare and contrast the loneliness interventions. Firstly, interventions were categorized on the basis of their objective to identify whether they were preventative, supportive, or remedial in nature. Secondly, depending on their scope, they were categorized as one-to-one, community-based, or group based. It was also ascertained whether interventions represented an improvement, an incremental innovation, a major advance or a radical departure, in comparison to the most basic form of a loneliness intervention. Finally, interventions were also assessed on the basis of the extent to which they utilized digital technologies. Individual visualizations representing the four levels of coding were created for each intervention, followed by an aggregated visual to facilitate analysis. To keep the inquiry within scope and to present a coherent view of the findings, the analysis was primarily concerned the level of innovation, and the use of digital technologies. This analysis highlights a weak but positive correlation between the level of innovation and the use of digital technologies in designing and deploying loneliness interventions, and also emphasizes how certain existing interventions could be tweaked to enable their migration from representing incremental innovation to radical innovation for example. This analysis also points out the value of including grey literature, especially from Twitter, in systematic literature reviews to get a contemporary view of latest work in the area under investigation.

Keywords: ageing, loneliness, innovation, digital

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Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

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Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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Authors: Kelsey Kimball

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Generalized anxiety disorder (GAD) is a common mental health illness affecting approximately 10% of the perinatal population. Research examining cognitive behavioral therapy in this population has only recently become more prevalent though exploring this subject is long overdue. This research examines the impact of cognitive behavioral therapy (CBT) on GAD during the perinatal period. The aim of this project was to identify the most effective way to manage GAD during the perinatal period to provide clinicians with evidence-based methods of caring for this population’s mental health. The research was conducted using several databases to identify ten primary research articles involving anxiety management. A critique and a systematic review of the literature was done. The results of the systematic literature review suggested that CBT had a significant positive impact on perinatal anxiety. Three main themes were derived from the literature: CBT for managing GAD in the general population, CBT for managing GAD in the perinatal population, and CBT’s effect on worry and problematic behaviors in both populations. Nurse practitioners are central in improving access to and treatment of perinatal anxiety disorders.

Keywords: anxiety, cognitive behavioral therapy, nurse practitioner, perinatal

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Authors: Tarela J. Ike

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Over the years, the hemorrhagic acts of Boko Haram have led to the adoption of counter-terrorism measures which mostly takes the form of military repressive measures. These measures have wrought flagrant violation of human rights worthy of concern. Hence, the need to examine the efficacy of the counter-terrorism measures adopted by the Nigeria government in combatting terrorism. This article addresses this issue by relying on a systematic literature review which examines the impact of Nigeria counter-terrorism measures from 2009 to 2016 in combating terrorism. The review of literature includes 42 article. Of the 42 articles, 14 met the peer-reviewed requirement which finds that most of Nigeria’s counter-terrorism policies are geared toward the use of state repressive military approach which violates the human right. Thus, the study concludes that to effectively address the terrorist uprising; Nigeria should adopt a non-aggressive counter-terrorism approach which incorporates religious clerics, and community active engagement strategy in combatting terrorism as opposed to military retaliation which violates human right and so far proved ineffective.

Keywords: Boko Haram, counter-terrorism, human rights, military retaliation

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Authors: Kuni Vergauwen, Ivan P. J. Huijnen, Astrid Depuydt, Jasmine Van Regenmortel, Mira Meeus

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A lower activity level and imbalanced activity pattern are frequently observed in persons with chronic fatigue syndrome (CFS) / myalgic encephalomyelitis (ME) due to debilitating fatigue and post-exertional malaise (PEM). Identification of measurement instruments to evaluate the activity level and pattern is therefore important. The objective is to identify measurement instruments suited to evaluate the activity level and/or pattern in patients with CFS/ME and review their psychometric properties. A systematic literature search was performed in the electronic databases PubMed and Web of Science until 12 October 2016. Articles including relevant measurement instruments were identified and included for further analysis. The psychometric properties of relevant measurement instruments were extracted from the included articles and rated based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 49 articles and 15 unique measurement instruments were found, but only three instruments were evaluated in patients with CFS/ME: the Chronic Fatigue Syndrome-Activity Questionnaire (CFS-AQ), Activity Pattern Interview (API) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), three self-report instruments measuring the physical activity level. The IPAQ-SF, CFS-AQ and API are all equally capable of evaluating the physical activity level, but none of the three measurement instruments are optimal to use. No studies about the psychometric properties of activity monitors in patients with CFS/ME were found, although they are often used as the gold standard to measure the physical activity pattern. More research is needed to evaluate the psychometric properties of existing instruments, including the use of activity monitors.

Keywords: chronic fatigue syndrome, data collection, physical activity, psychometrics

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Authors: Fasil Wagnew, Kefyalew Addis Alene, Setegn Eshetie, Tom Wingfield, Matthew Kelly, Darren Gray

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Introduction: Undernutrition is a major and under-appreciated risk factor for TB, which is estimated to be responsible for 1.9 million TB cases per year globally. The effectiveness of micronutrient supplementation on TB treatment outcomes and its prognostic markers such as sputum conversion and serum zinc, retinol, and hemoglobin levels has been poorly understood. This systematic review and meta-analysis aimed to determine the association between zinc and vitamin A supplementation and TB treatment outcomes and its prognostic markers. Methods: A systematic literature search for randomized controlled trials (RCTs) was performed in PubMed, Embase, and Scopus databases. Meta-analysis with a random effect model was performed to estimate risk ratio (RR) and mean difference (MD), with a 95% confidence interval (CI), for dichotomous and continuous outcomes, respectively. Results: Our search identified 2,195 records. Of these, nine RCTs consisting of 1,375 participants were included in the final analyses. Among adults with pulmonary TB, zinc (RR: 0.94, 95%CI: 0.86, 1.03), vitamin A (RR: 0.90, 95%CI: 0.80, 1.01), and combined zinc and vitamin A (RR: 0.98, 95%CI: 0.89, 1.08) supplementation were not significantly associated with TB treatment success. Combined zinc and vitamin A supplementation was significantly associated with increased sputum smear conversion at 2 months (RR: 1.16, 95%CI: 1.03, 1.32), serum zinc levels at 2 months (MD of 0.86umol/l, 95% CI: 0.14, 1.57), serum retinol levels at 2 months (MD: 0.06umol/l, 95 % CI: 0.04, 0.08) and 6 months (MD: 0.12umol/l, 95 % CI: 0.10, 0.14), and serum hemoglobin level at 6 months (MD: 0.29 ug/dl, 95% CI: 0.08 to 0.51), among adults with TB. Conclusions: Providing zinc and vitamin A supplementation to adults with pulmonary TB during treatment may increase early sputum smear conversion, serum zinc, retinol, and hemoglobin levels. However, the use of zinc, vitamin A, or both were not associated with TB treatment success.

Keywords: zinc and vitamin A supplementation, tuberculosis, treatment outcomes, meta-analysis, RCT

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Authors: Saba Aziz

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Social enterprises are playing a growing role in transforming the lives of individuals and communities around the world, providing innovative solutions to critical social and environmental issues such as education, job creation, and health care. Women are increasingly utilising services of these enterprises to overcome socio-economic constraints and increase their access to business and market. This article systematically reviews the available literature on the role of social enterprises on women's empowerment in South Asia. Twelve key terms were specified and researched on five databases. Some of the literature was excluded based on the lack of evidence on the involvement of social enterprises. Remaining literature was rated according to the quality; due to methodological inconsistency, the findings are presented in a descriptive form. The relevant studies review the impact of social enterprises on women’s economic, social, relational, health, personal and political aspects of empowerment. In discussion, we outline areas for further research on social enterprises activity that impacts women’s overall empowerment specifically in South Asia.

Keywords: social enterprise, women empowerment, systematic review, well-being, social impact, micro finance, South Asia, Pakistan

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Authors: Laura Rodrigues Carmona, Maria José Chambel, Vânia Sofia Carvalho

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Background: In peacekeeping operations, military personnel are often exposed to the same traumatic stress factors found during conventional war and may also be subject to the physical risks and psychological stressors associated with posttraumatic stress disorder (PTSD). Objectives: To discuss the prevalence of PTSD among peacekeepers as well as the risks of and protective factors against this disorder and its comorbidities and/or consequences. Methods: A systematic literature search was performed with relevant keywords, and 53 articles were identified for this review. Results and conclusions: Military personnel deployed in peacekeeping operations have a higher prevalence of PTSD than nonmilitary personnel, a prevalence similar to that of military personnel deployed in war situations. Concerning the salient risk factors, the contextual factors are highlighted, and in regard to the protective factors, the individual factors are highlighted. This study thus demonstrates that there are factors in which the role of the military is essential, via both its selection and monitoring of peacekeepers during and after their deployment, to protect deployed personnel’s mental health.

Keywords: peacekeepers, peacekeeping, military, PTSD, post-traumatic stress disorder, posttraumatic stress disorder

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Authors: Gabriela Estrada, Joaquim Lloveras

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Design for error-proofing assembly is a new DFX approach to prevent assembly issues since early design stages. Assembly issues that can happen during the life phases of a system such as: production, installation, operation, and replacement phases. This prevention is possible by designing the product with poka-yoke or error-proofing characteristics. This approach guide designers to make decisions based on poka-yoke assembly design requirements. As a result of applying these requirements designers are able to create solutions to prevent assembly issues for the product in development stage. This paper integrates the needs to design products in an error proofing way into the systematic approach of design process by Pahl and Beitz. A case study is presented applying this approach.

Keywords: poka-yoke, error-proofing, assembly issues, design process, life phases of a system

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Authors: Gabriela Estrada, Joaquim Lloveras

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Design for error-proofing assembly is a new DFX approach to prevent assembly issues since early design stages. Assembly issues that can happen during the life phases of a system such as: production, installation, operation and replacement phases. This prevention is possible by designing the product with poka-yoke or error-proofing characteristics. This approach guide designers to make decisions based on poka-yoke assembly design requirements. As a result of applying these requirements designers are able to create solutions to prevent assembly issues for the product in development stage. This paper integrates the needs to design products in an error proofing way into the systematic approach of design process by Pahl and Beitz. A case study is presented applying this approach.

Keywords: poka-yoke, error-proofing, assembly issues, design process, life phases of a system

Procedia PDF Downloads 292