scholarly journals Environmental conservation activities for health: building on systematic review methods to consider a disparate, dispersed, and limited evidence base

The Lancet ◽  
2014 ◽  
Vol 384 ◽  
pp. S46
Author(s):  
Rebecca Lovell ◽  
Kerryn Husk ◽  
Chris Cooper ◽  
Will Stahl-Timmins ◽  
Ruth Garside
Keyword(s):  
Systematic Review ◽  
Evidence Base ◽  
Environmental Conservation ◽  
Limited Evidence ◽  
Systematic Review Methods

scholarly journals Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality: a systematic review

2014 ◽  
Vol 43 (5) ◽  
pp. 604-615 ◽  
Author(s):  
Chris Fox ◽  
Toby Smith ◽  
Ian Maidment ◽  
Wei-Yee Chan ◽  
Nelson Bua ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Function ◽  
Physical Function ◽  
Methodological Quality ◽  
Evidence Base ◽  
Significant Decline ◽  
Limited Evidence ◽  
Cholinergic Activity ◽  
Cholinergic Drug

Abstract Objectives: to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes. Design: electronic published and unpublished literature/trial registries were systematically reviewed. Studies evaluating medications with anti-cholinergic activity on cognitive function, delirium, physical function or mortality were eligible. Results: forty-six studies including 60,944 participants were included. Seventy-seven percent of included studies evaluating cognitive function (n = 33) reported a significant decline in cognitive ability with increasing anti-cholinergic load (P < 0.05). Four of five included studies reported no association with delirium and increasing anti-cholinergic drug load (P > 0.05). Five of the eight included studies reported a decline in physical function in users of anti-cholinergics (P < 0.05). Three of nine studies evaluating mortality reported that the use of drugs with anti-cholinergic properties was associated with a trend towards increased mortality, but this was not statistically significant. The methodological quality of the evidence-base ranged from poor to very good. Conclusion: medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function, but limited evidence exists for delirium or mortality outcomes.

Development of a Range of Plausible Noncancer Toxicity Values for 2,3,7,8-Tetrachlorodibenzo-p-Dioxin Based on Effects on Sperm Count: Application of Systematic Review Methods and Quantitative Integration of Dose Response Using Meta-Regression

2020 ◽  
Author(s):  
Daniele S Wikoff ◽  
Jonathan D Urban ◽  
Caroline Ring ◽  
Janice Britt ◽  
Seneca Fitch ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dose Response ◽  
Animal Studies ◽  
Sperm Count ◽  
Human Health Risk ◽  
Evidence Base ◽  
Risk Of Bias ◽  
Systematic Review Methods ◽  
Meta Regression ◽  
Tetrachlorodibenzo P Dioxin

Abstract Regulatory agencies have derived noncancer toxicity values for 2,3,7,8-tetrachlorodibenzo-p-dioxin based on reduced sperm counts relying on single studies from a large body of evidence. Techniques such as meta-regression allow for greater use of the available data while simultaneously providing important information regarding the uncertainty associated with the underlying evidence base when conducting risk assessments. The objective herein was to apply systematic review methods and meta-regression to characterize the dose-response relationship of gestational exposure and epididymal sperm count. Twenty-three publications (20 animal studies consisting of 29 separate rat experimental data sets, and 3 epidemiology studies) met inclusion criteria. Risk of bias evaluation was performed to critically appraise study validity. Low to very low confidence precluded use of available epidemiological data as candidate studies for dose-response due to inconsistencies across the evidence base, high risk of bias, and general lack of biological coherence, including lack of clinical relevance and dose-response concordance. Experimental animal studies, which were found to have higher confidence following the structured assessment of confidence (eg, controlled exposure, biological consistency), were used as the basis of a meta-regression. Multiple models were fit; points of departure were identified and converted to human equivalent doses. The resulting reference dose estimates ranged from approximately 4 to 70 pg/kg/day, depending on model, benchmark response level, and study validity integration approach. This range of reference doses can be used either qualitatively or quantitatively to enhance understanding of human health risk estimates for dioxin-like compounds.

scholarly journals What Contributes to the Variation of Dairy Recommendations in Global Food-Based Dietary Guidelines

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1264-1264
Author(s):  
Zhaoli Dai ◽  
Cynthia Kroeger ◽  
Sally Mcdonald ◽  
Lisa Bero
Keyword(s):  
Systematic Review ◽  
Health Equity ◽  
Guideline Development ◽  
Evidence Base ◽  
Dietary Guidelines ◽  
Dietary Recommendations ◽  
Systematic Review Methods ◽  
Dairy Consumption ◽  
Evidence Quality ◽  
Global Food

Abstract Objectives Dairy consumption remains controversial due to uncertainty about its health impacts and effects on food sustainability. There are variations in dairy recommendations in global food-based dietary guidelines (FBDGs). Yet, how methods used to develop recommendations contribute to such variation is unknown. In this study, we assessed this dietary context in dairy recommendations. Methods We search the FBDG database at the Food and Agricultural Organization website in 2019 to identify dietary guidelines published since 2009. Eligible guidelines needed to include dietary recommendations and describe the guideline development processes. Protocols for this review were registered (CRD42019125258; CRD42019126452) and published previously. Two reviewers independently reviewed the guidelines and extracted information on dairy recommendations. Systematic review methods, quality of evidence assessment, evidence underpinning the recommendations, and information on health equity were evaluated. We used descriptive statistics to summarize the findings. Results We included 26 eligible FBDGs, including the Dietary Guidelines for Americans 2020–2025. Serving sizes of dairy recommendations varied, ranging from 1 ser/d (11.5%) to 3–5 ser/d (3.9%), with 27% of the guidelines recommending 2 ser/d and another 27% having no or unclear recommendations. The majority of the guidelines (n = 19, 73%) endorsed low-fat or skimmed fat dairy, while 7 (27%) did not emphasize fat contents. All guidelines recommended dairy as a dietary source for calcium (n = 16, 61.5%) and/or vitamin D (n = 10, 38.5%). Only 8 guidelines (31%) recommended dairy alternatives, among which 4 (18%) recommended soy products. Systematic review methods and evidence quality assessment were implemented in 5 guidelines (19%). Only 12 guidelines (46%) considered health equity to address cultural/regional aspects to formulate dietary recommendations. Conclusions Most dietary guidelines recommend reduced-fat dairy consumption, but only 31% recommend plant-based protein as dairy alternatives, despite lactose intolerance and food sustainability as global concerns. Methodological rigor in the evidence base and health equity considerations remain a challenge in dietary guideline development. Funding Sources The Australian National Health and Medical Research Council.

scholarly journals Typical Challenges of Governance for Sustainable Regional Development in Globalized Latin America: A Multidimensional Literature Review

2020 ◽  
Vol 12 (7) ◽  
pp. 2702
Author(s):  
Alejandro Balanzo ◽  
Leonardo Garavito ◽  
Héctor Rojas ◽  
Lenka Sobotova ◽  
Oscar Pérez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Latin America ◽  
Literature Review ◽  
Regional Development ◽  
Environmental Conservation ◽  
Environmental Concerns ◽  
Regional Sustainability ◽  
Governance Challenges ◽  
Sustainable Regional Development ◽  
Do So

The paper aims to identify and analyze what types of governance challenges for sustainable regional development in the context of globalization are more frequently found in scholarship regarding Latin America. In order to do so, we carried out a systematic review of scholarly works discussing regional sustainability issues across the region. Analytically, it provides a heuristic multidimensional framework for organizing and typifying the most frequent sustainable regional development governance challenges under study, offering a nuanced and interrelated account of economic, environmental, political, and socio-spatial scientific discussions. According to our findings, scholarship on Latin America shows a bricolage-like scenery where political atomization linked to economic factionalism and fragmentation stand out as frequently analyzed situations. Another frequent topic relates to discussions about political endeavors linked to environmental concerns, connecting incidence strategies with collective environmental conservation approaches.

scholarly journals Assessing Parent Behaviours in Parent–Child Interactions with Deaf and Hard of Hearing Infants Aged 0–3 Years: A Systematic Review

2021 ◽  
Vol 10 (15) ◽  
pp. 3345
Author(s):  
Martina Curtin ◽  
Evelien Dirks ◽  
Madeline Cruice ◽  
Rosalind Herman ◽  
Lauren Newman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Child Language ◽  
Evidence Base ◽  
Deaf Children ◽  
Clinical Tool ◽  
Coding Systems ◽  
Child Interaction ◽  
Parent Child Interaction ◽  
Parent Child

Background: Despite early identification and advancements in cochlear implant and hearing aid technology, delays in language skills in deaf children continue to exist. Good-quality parent–child interaction (PCI) is a key predictor for the successful development of deaf children’s signed and/or spoken language. Though professionals have standard assessments to monitor child language, a clinical tool to observe the quality of parental interaction is yet to be developed. Aims and methods: This systematic review with narrative synthesis aims to uncover which parent behaviours are assessed in PCI studies with deaf infants aged 0–3 years, how these behaviours are assessed, and which are correlated with higher scores in child language. Results: Sixty-one papers were included, spanning 40 years of research. Research included in the review assessed parents’ skills in gaining attention, joint engagement, emotional sensitivity, and language input. PCI was mostly assessed using coding systems and frame-by-frame video analysis. Some of the parent behaviours mentioned previously are associated with more words produced by deaf children. Conclusion: The results of the review provide the evidence base required to develop the content of a future clinical assessment tool for parent–child interaction in deafness.

scholarly journals Quality of life in primary sclerosing cholangitis: a systematic review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Elena Marcus ◽  
Paddy Stone ◽  
Anna-Maria Krooupa ◽  
Douglas Thorburn ◽  
Bella Vivat
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Research ◽  
Disease Progression ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Small Sample ◽  
Limited Evidence ◽  
Research Studies

Abstract Background Primary sclerosing cholangitis (PSC) is a rare bile duct and liver disease which can considerably impact quality of life (QoL). As part of a project developing a measure of QoL for people with PSC, we conducted a systematic review with four review questions. The first of these questions overlaps with a recently published systematic review, so this paper reports on the last three of our initial four questions: (A) How does QoL in PSC compare with other groups?, (B) Which attributes/factors are associated with impaired QoL in PSC?, (C) Which interventions are effective in improving QoL in people with PSC?. Methods We systematically searched five databases from inception to 1 November 2020 and assessed the methodological quality of included studies using standard checklists. Results We identified 28 studies: 17 for (A), ten for (B), and nine for (C). Limited evidence was found for all review questions, with few studies included in each comparison, and small sample sizes. The limited evidence available indicated poorer QoL for people with PSC compared with healthy controls, but findings were mixed for comparisons with the general population. QoL outcomes in PSC were comparable to other chronic conditions. Itch, pain, jaundice, severity of inflammatory bowel disease, liver cirrhosis, and large-duct PSC were all associated with impaired QoL. No associations were found between QoL and PSC severity measured with surrogate markers of disease progression or one of three prognostic scoring systems. No interventions were found to improve QoL outcomes. Conclusion The limited findings from included studies suggest that markers of disease progression used in clinical trials may not reflect the experiences of people with PSC. This highlights the importance for clinical research studies to assess QoL alongside clinical and laboratory-based outcomes. A valid and responsive PSC-specific measure of QoL, to adequately capture all issues of importance to people with PSC, would therefore be helpful for clinical research studies.

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