Behavioural weight management interventions for postnatal women: A systematic review of systematic reviews of randomized controlled trials

ABSTRACT Objective. This systematic review assessed the available published evidence on the efficacy and safety of using trigger point injection (TPI) to treat patients with chronic non-malignant musculoskeletal pain that had persisted for at least 3 months. Methods. All published systematic reviews or randomized controlled trials detailing the use of TPI in patients with chronic, non-malignant musculoskeletal pain (persisting for >3 months) were identified by systematically searching literature databases and the Websites of various health technology assessment agencies, research registers, and guidelines sites up to July 2006. Results. Although no systematic reviews were identified, 15 peer-reviewed randomized controlled trials met the inclusion criteria. However, deficiencies in reporting, small sample sizes, and marked inter-study heterogeneity precluded a definitive synthesis of the data. TPI is a safe procedure when used by clinicians with appropriate expertise and training. It relieved symptoms when used as a sole treatment for patients with chronic head, neck, shoulder, and back pain or whiplash syndrome, regardless of the injectant used, and may be a useful adjunct to intra-articular injection in the treatment of osteoarthritis pain. Although the addition of TPI to stretching exercises augments treatment outcomes, this was also true of other therapies such as ultrasound and laser. Conclusion. The efficacy of TPI is no more certain than it was a decade ago as, overall, there is no clear evidence of either benefit or ineffectiveness. The only advantage of injecting anesthetic into trigger points may be to reduce the pain of the needling process, which may not be an insignificant benefit.

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Quality assessment of randomized controlled trials in cochrane cardiac arrest systematic reviews: A systematic review

Atherosclerosis ◽

10.1016/j.atherosclerosis.2020.10.782 ◽

2020 ◽

Vol 315 ◽

pp. e248

Author(s):

N. Parnianfard

Keyword(s):

Systematic Review ◽

Cardiac Arrest ◽

Randomized Controlled Trials ◽

Quality Assessment ◽

Systematic Reviews ◽

Controlled Trials ◽

Randomized Controlled

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A systematic review of artificial intelligence chatbots for promoting physical activity, healthy diet, and weight loss

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01224-6 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Yoo Jung Oh ◽

Jingwen Zhang ◽

Min-Lin Fang ◽

Yoshimi Fukuoka

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Randomized Controlled Trials ◽

Weight Management ◽

Weight Status ◽

Experimental Studies ◽

Assessment Tools ◽

Controlled Trials ◽

Randomized Controlled ◽

Quasi Experimental

Abstract Background This systematic review aimed to evaluate AI chatbot characteristics, functions, and core conversational capacities and investigate whether AI chatbot interventions were effective in changing physical activity, healthy eating, weight management behaviors, and other related health outcomes. Methods In collaboration with a medical librarian, six electronic bibliographic databases (PubMed, EMBASE, ACM Digital Library, Web of Science, PsycINFO, and IEEE) were searched to identify relevant studies. Only randomized controlled trials or quasi-experimental studies were included. Studies were screened by two independent reviewers, and any discrepancy was resolved by a third reviewer. The National Institutes of Health quality assessment tools were used to assess risk of bias in individual studies. We applied the AI Chatbot Behavior Change Model to characterize components of chatbot interventions, including chatbot characteristics, persuasive and relational capacity, and evaluation of outcomes. Results The database search retrieved 1692 citations, and 9 studies met the inclusion criteria. Of the 9 studies, 4 were randomized controlled trials and 5 were quasi-experimental studies. Five out of the seven studies suggest chatbot interventions are promising strategies in increasing physical activity. In contrast, the number of studies focusing on changing diet and weight status was limited. Outcome assessments, however, were reported inconsistently across the studies. Eighty-nine and thirty-three percent of the studies specified a name and gender (i.e., woman) of the chatbot, respectively. Over half (56%) of the studies used a constrained chatbot (i.e., rule-based), while the remaining studies used unconstrained chatbots that resemble human-to-human communication. Conclusion Chatbots may improve physical activity, but we were not able to make definitive conclusions regarding the efficacy of chatbot interventions on physical activity, diet, and weight management/loss. Application of AI chatbots is an emerging field of research in lifestyle modification programs and is expected to grow exponentially. Thus, standardization of designing and reporting chatbot interventions is warranted in the near future. Systematic review registration International Prospective Register of Systematic Reviews (PROSPERO): CRD42020216761.

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The Efficacy of Multimodal Prehabilitation in Elderly Patients Undergoing Elective Major Abdominal Surgery: A Systematic Review Protocol

10.21203/rs.3.rs-471200/v1 ◽

2021 ◽

Author(s):

Yu Xiang Tan ◽

Miny Samuel ◽

Ning Qi Pang

Keyword(s):

Systematic Review ◽

Abdominal Surgery ◽

Elderly Patients ◽

Randomized Controlled Trials ◽

Systematic Reviews ◽

The Elderly ◽

Major Abdominal Surgery ◽

Walking Distance ◽

Controlled Trials ◽

Randomized Controlled

Abstract Introduction Multimodal prehabilitation has been touted as a potential strategy to better prepare our elderly and frail patients for major surgery. While randomized controlled trials and systematic reviews have been done to investigate the effect of prehabilitation on various surgical cohorts, most of these studies have focused on single modality prehabilitation and without an emphasis on the elderly. This systematic review aims to assess the effect of a multimodal prehabilitation program on elderly patients undergoing major abdominal surgery. MethodsThis protocol has been written according to the PRISMA-P statement and is registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number 250281). MEDLINE, EMBASE, CENTRAL, CINAHL and PsychINFO databases will be searched. Only randomized controlled trials with an average study population age ≥65 that has undergone major abdominal operation with at least two components (physical, nutritional, psychological) of prehabilitation will be included. Clinical outcomes that will be collected include post-operative morbidity and mortality, length of stay, 30-day readmission and peri-operative 6-minute walking distance. The risk of bias in included studies will be assessed. Data will be pooled where possible. DiscussionThis systematic review will evaluate and establish the effectiveness of multimodal prehabilitation for the elderly, who represents the group of patients most likely to benefit from prehabilitation. This review with its focus on the elderly will provide us with fresh insight into the utility of prehabilitation that will better inform policy makers in its implementation.PROSPERO Registration: On 20/04/2021, ID 250281

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Psychedelic-Assisted Psychotherapy for Post-Traumatic Stress Disorder, Anxiety Disorders, Mood Disorders, or Substance Use Disorders

Canadian Journal of Health Technologies ◽

10.51731/cjht.2021.90 ◽

2021 ◽

Vol 1 (6) ◽

Author(s):

Yi-Sheng Chao ◽

Jennifer Horton

Keyword(s):

Systematic Review ◽

Substance Use ◽

Randomized Controlled Trials ◽

Systematic Reviews ◽

Small Sample ◽

Mental Illnesses ◽

Controlled Trials ◽

Motivational Enhancement Therapy ◽

Post Traumatic Stress ◽

Randomized Controlled

Two systematic reviews, 3 randomized controlled trials, and 2 single-arm safety trials were identified that evaluated several combinations of psychedelic-assisted psychotherapy. Psilocybin was the psychedelic most tested. Other psychedelics identified in the systematic reviews and primary studies were 3,4-methylenedioxymethamphetamine (or MDMA), lysergic acid diethylamide (or LSD), ayahuasca (also named N,N-dimethyltryptamine [or DMT]), ibogaine, ketamine, and nitrous oxide. Manualized therapy (not defined) and non-directive support (not defined) were the psychotherapies most studied in the relevant primary studies in the 2 systematic reviews. Other psychotherapies identified included integrative psychotherapy, cognitive behavioural therapy (CBT), CBT and motivational enhancement therapy, psychosocial interventions, non-directive support, group talk therapy, and guided support. Clinical effectiveness lasting weeks to months was observed in 1 systematic review that reviewed primary studies examining various combinations of psychedelics and psychotherapy in patients with various mental health conditions. Significant improvement in symptom scores related to mental illnesses and no serious and long-term adverse events were reported in the other systematic review. Various combinations of psychedelics and psychotherapies were evaluated in 3 randomized controlled trials (RCTs) and 2 safety studies. Ketamine-assisted psychotherapies were associated with improvements in the symptoms related to substance use disorder in 2 RCTs. Psilocybin-assisted psychotherapy was reported to be efficacious in treating MDD in 1 RCT. No serious adverse effects were reported in the RCTs or in 2 safety trials using MDMA-assisted psychotherapy. There were several limitations to the included studies, including small sample sizes (less than 20 in the majority of primary studies), relatively short follow-ups (1 week to 3 years; less than or equal to 1 year in 27 out of 31 relevant publications), differences in psychotherapy classification between systematic reviews, considerable heterogeneity between studies, and unclear generalizability and availability of the interventions in Canadian contexts. Therefore, findings should be interpreted with caution. No relevant guidelines were identified.

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