scholarly journals Do manual therapies have a specific autonomic effect? An overview of systematic reviews

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260642
Author(s):  
Sonia Roura ◽  
Gerard Álvarez ◽  
Ivan Solà ◽  
Francesco Cerritelli

Background The impact of manual therapy interventions on the autonomic nervous system have been largely assessed, but with heterogeneous findings regarding the direction of these effects. We conducted an overview of systematic reviews to describe if there is a specific autonomic effect elicited by manual therapy interventions, its relation with the type of technique used and the body region where the intervention was applied. Methods We conducted an overview according to a publicly registered protocol. We searched the Cochrane Database of Systematic Reviews, MEDLINE, EPISTEMONIKOS and SCOPUS, from their inception to march 2021. We included systematic reviews for which the primary aim of the intervention was to assess the autonomic effect elicited by a manual therapy intervention in either healthy or symptomatic individuals. Two authors independently applied the selection criteria, assessed risk of bias from the included reviews and extracted data. An established model of generalisation guided the data analysis and interpretation. Results We included 12 reviews (5 rated as low risk of bias according the ROBIS tool). The findings showed that manual therapies may have an effect on both sympathetic and parasympathetic systems. However, the results from included reviews were inconsistent due to differences in their methodological rigour and how the effects were measured. The reviews with a lower risk of bias could not discriminate the effects depending on the body region to which the technique was applied. Conclusion The magnitude of the specific autonomic effect elicited by manual therapies and its clinical relevance is uncertain. We point out some specific recommendations in order to improve the quality and relevance of future research in this field.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Israel Júnior Borges do Nascimento ◽  
Dónal P. O’Mathúna ◽  
Thilo Caspar von Groote ◽  
Hebatullah Mohamed Abdulazeem ◽  
Ishanka Weerasekara ◽  
...  

Abstract Background Navigating the rapidly growing body of scientific literature on the SARS-CoV-2 pandemic is challenging, and ongoing critical appraisal of this output is essential. We aimed to summarize and critically appraise systematic reviews of coronavirus disease (COVID-19) in humans that were available at the beginning of the pandemic. Methods Nine databases (Medline, EMBASE, Cochrane Library, CINAHL, Web of Sciences, PDQ-Evidence, WHO’s Global Research, LILACS, and Epistemonikos) were searched from December 1, 2019, to March 24, 2020. Systematic reviews analyzing primary studies of COVID-19 were included. Two authors independently undertook screening, selection, extraction (data on clinical symptoms, prevalence, pharmacological and non-pharmacological interventions, diagnostic test assessment, laboratory, and radiological findings), and quality assessment (AMSTAR 2). A meta-analysis was performed of the prevalence of clinical outcomes. Results Eighteen systematic reviews were included; one was empty (did not identify any relevant study). Using AMSTAR 2, confidence in the results of all 18 reviews was rated as “critically low”. Identified symptoms of COVID-19 were (range values of point estimates): fever (82–95%), cough with or without sputum (58–72%), dyspnea (26–59%), myalgia or muscle fatigue (29–51%), sore throat (10–13%), headache (8–12%) and gastrointestinal complaints (5–9%). Severe symptoms were more common in men. Elevated C-reactive protein and lactate dehydrogenase, and slightly elevated aspartate and alanine aminotransferase, were commonly described. Thrombocytopenia and elevated levels of procalcitonin and cardiac troponin I were associated with severe disease. A frequent finding on chest imaging was uni- or bilateral multilobar ground-glass opacity. A single review investigated the impact of medication (chloroquine) but found no verifiable clinical data. All-cause mortality ranged from 0.3 to 13.9%. Conclusions In this overview of systematic reviews, we analyzed evidence from the first 18 systematic reviews that were published after the emergence of COVID-19. However, confidence in the results of all reviews was “critically low”. Thus, systematic reviews that were published early on in the pandemic were of questionable usefulness. Even during public health emergencies, studies and systematic reviews should adhere to established methodological standards.


2015 ◽  
Vol 9 (5) ◽  
pp. 18-24 ◽  
Author(s):  
Saman Aiubi ◽  
Nasroallah Moradi Kor ◽  
Omid Lakzaie Azar ◽  
Fatemeh Asadi Rahmani ◽  
Zeinab Hajian Berenjestanaki ◽  
...  

Allergies are diseases of the immune system that cause an overreaction to substances called "allergens." Allergies are grouped by the kind of trigger, time of year or where symptoms appear on the body: indoor and outdoor allergies (also called "hay fever," "seasonal," "perennial" or "nasal" allergies), food allergies, latex allergies, insect allergies, skin allergies and eye allergies. People who have allergies can live healthy and active lives. The search strategy has been devised on ovid medline and then adapted for the other databases (see Additional file 1 for full search strategies). In all cases the databases will be searched from 1 January 2000 to 30 September 2012, and limited to Europe based on the definition provided by the Organization for Economic Cooperation and Development (OECD).The resulting quality assessment scores are given alongside other study parameters in three tables. We assessed the systematic reviews based on the type of intervention or subject assessed for the prevention of food allergy or food sensitization. In this overview of systematic reviews concerning the etiology and prevention of food allergy, we identified 14 eligible publications. This systematic review will provide the most up to date estimates of the frequency of food allergy in Europe. Given the presumed increase in IgE mediated food allergy in the recent past, there is much interest in identifying the causes of food allergy and primary preventive strategies. These advances are creating the opportunities for novel therapies for food allergy. However, at the current time, the only treatment is avoidance.DOI: http://dx.doi.org/10.3126/ijls.v9i5.12701


2018 ◽  
Vol 39 (12) ◽  
pp. 1449-1456 ◽  
Author(s):  
Lesley Price ◽  
Jennifer MacDonald ◽  
Lucyna Gozdzielewska ◽  
Tracey Howe ◽  
Paul Flowers ◽  
...  

AbstractObjectiveTo synthesize the existing evidence base of systematic reviews of interventions to improve healthcare worker (HCW) hand hygiene compliance (HHC).MethodsPRISMA guidelines were followed, and 10 information sources were searched in September 2017, with no limits to language or date of publication, and papers were screened against inclusion criteria for relevance. Data were extracted and risk of bias was assessed.ResultsOverall, 19 systematic reviews (n=20 articles) were included. Only 1 article had a low risk of bias. Moreover, 15 systematic reviews showed positive effects of interventions on HCW HHC, whereas 3 reviews evaluating monitoring technology did not. Findings regarding whether multimodal rather than single interventions are preferable were inconclusive. Targeting social influence, attitude, self-efficacy, and intention were associated with greater effectiveness. No clear link emerged between how educational interventions were delivered and effectiveness.ConclusionsThis is the first systematic review of systematic reviews of interventions to improve HCW HHC. The evidence is sufficient to recommend the implementation of interventions to improve HCW HHC (except for monitoring technology), but it is insufficient to make specific recommendations regarding the content or how the content should be delivered. Future research should rigorously apply behavior change theory, and recommendations should be clearly described with respect to intervention content and how it is delivered. Such recommendations should be tested for longer terms using stronger study designs with clearly defined outcomes.


Author(s):  
Wan Nur Syahida Wan Ismail ◽  
Mohd Zulkifli Mokhtar ◽  
Azwadi Ali ◽  
Mohd Shaari Abdul Rahman

Nowadays, competition is everywhere in the business environment. The survival of Small and medium-sized enterprises (SMEs) depend on their ability to take full advantage of the resources available. Prior research had identified that IT is an important resource to the success of the firms. However, despite the common consensus that IT influences firm’s performance, results of previous studies on the effect of IT resources on firm’s performance are often inconsistent. Given these inconsistent results, it is unclear whether any direct effect exists between IT resources in organizations and their firm’s performance. For that reason, several authors highlighted the need for more research to investigate the impact of IT adoption on the firm’s performance. In response to this, this conceptual paper attempts to analyze relevant literatures on whether IT investment would help firms gain better performance. Understanding whether and how IT has affected firm’s performance is an important research issue as it allows the firms to know the value of IT investment and whether such innovation is worth to be adopted. Grounding in RBV theory, this study concluded that the combination of IT assets and IT capabilities (IT infrastructure) provides competitive advantage to the firm. This study also suggested that SMEs that adopt IT would perform better than those that do not adopt IT. This conceptual analysis is hoped to consolidate the body of knowledge in the area and significant to the researchers as it directs to the hypotheses development for future research.


2019 ◽  
Author(s):  
Youfa Wang ◽  
Jungwon Min ◽  
Jacob Khuri ◽  
Hong Xue ◽  
Bo Xie ◽  
...  

BACKGROUND Diabetes and obesity have become epidemics and costly chronic diseases. The impact of mobile health (mHealth) interventions on diabetes and obesity management is promising; however, studies showed varied results in the efficacy of mHealth interventions. OBJECTIVE This review aimed to evaluate the effectiveness of mHealth interventions for diabetes and obesity treatment and management on the basis of evidence reported in reviews and meta-analyses and to provide recommendations for future interventions and research. METHODS We systematically searched the PubMed, IEEE Xplore Digital Library, and Cochrane databases for systematic reviews published between January 1, 2005, and October 1, 2019. We analyzed 17 reviews, which assessed 55,604 original intervention studies, that met the inclusion criteria. Of those, 6 reviews were included in our meta-analysis. RESULTS The reviews primarily focused on the use of mobile apps and text messaging and the self-monitoring and management function of mHealth programs in patients with diabetes and obesity. All reviews examined changes in biomarkers, and some reviews assessed treatment adherence (n=7) and health behaviors (n=9). Although the effectiveness of mHealth interventions varied widely by study, all reviews concluded that mHealth was a feasible option and had the potential for improving patient health when compared with standard care, especially for glycemic control (−0.3% to −0.5% greater reduction in hemoglobin A<sub>1c</sub>) and weight reduction (−1.0 kg to −2.4 kg body weight). Overall, the existing 6 meta-analysis studies showed pooled favorable effects of these mHealth interventions (−0.79, 95% CI −1.17 to −0.42; I2=90.5). CONCLUSIONS mHealth interventions are promising, but there is limited evidence about their effectiveness in glycemic control and weight reduction. Future research to develop evidence-based mHealth strategies should use valid measures and rigorous study designs. To enhance the effectiveness of mHealth interventions, future studies are warranted for the optimal formats and the frequency of contacting patients, better tailoring of messages, and enhancing usability, which places a greater emphasis on maintaining effectiveness over time.


Author(s):  
Gitte Valentin ◽  
Lotte Groth Jensen

AbstractObjectivesThe aim of this overview was to systematically identify and synthesize existing evidence from systematic reviews on the impact of prehospital physician involvement.MethodsThe Medline, Embase, and Cochrane library were searched from 1 January 2000 to 17 November 2017. We included systematic reviews comparing physician-based with non–physician-based prehospital treatment in patients with one of five critical conditions requiring a rapid response.ResultsTen reviews published from 2009 to 2017 were included. Physician treatment was associated with increased survival in patients with out-of-hospital cardiac arrest and patients with severe trauma; in the latter group, the result was based on more limited evidence. The success rate of prehospital endotracheal intubation (ETI) has improved over the years, but ETI by physicians is still associated with higher success rates than intubation by paramedics. In patients with severe traumatic brain injury, intubation by paramedics who were not well skilled to do so markedly increased mortality.ConclusionsCurrent evidence is hinting at a benefit of physicians in selected aspects of prehospital emergency services, including treatment of patients with out-of-hospital cardiac arrest and critically ill or injured patients in need of prehospital intubation. Evidence is, however, limited by confounding and bias, and comparison is hampered by differences in case mix and the organization of emergency medical services. Future research should strive to design studies that enable appropriate control of baseline confounding and obtain follow-up data for the proportion of patients who die in the prehospital setting.


2020 ◽  
Vol 4 (19) ◽  
pp. 4929-4944
Author(s):  
Andrea J. Darzi ◽  
Allen B. Repp ◽  
Frederick A. Spencer ◽  
Rami Z. Morsi ◽  
Rana Charide ◽  
...  

Abstract Multiple risk-assessment models (RAMs) for venous thromboembolism (VTE) in hospitalized medical patients have been developed. To inform the 2018 American Society of Hematology (ASH) guidelines on VTE, we conducted an overview of systematic reviews to identify and summarize evidence related to RAMs for VTE and bleeding in medical inpatients. We searched Epistemonikos, the Cochrane Database, Medline, and Embase from 2005 through June 2017 and then updated the search in January 2020 to identify systematic reviews that included RAMs for VTE and bleeding in medical inpatients. We conducted study selection, data abstraction and quality assessment (using the Risk of Bias in Systematic Reviews [ROBIS] tool) independently and in duplicate. We described the characteristics of the reviews and their included studies, and compared the identified RAMs using narrative synthesis. Of 15 348 citations, we included 2 systematic reviews, of which 1 had low risk of bias. The reviews included 19 unique studies reporting on 15 RAMs. Seven of the RAMs were derived using individual patient data in which risk factors were included based on their predictive ability in a regression analysis. The other 8 RAMs were empirically developed using consensus approaches, risk factors identified from a literature review, and clinical expertise. The RAMs that have been externally validated include the Caprini, Geneva, IMPROVE, Kucher, and Padua RAMs. The Padua, Geneva, and Kucher RAMs have been evaluated in impact studies that reported an increase in appropriate VTE prophylaxis rates. Our findings informed the ASH guidelines. They also aim to guide health care practitioners in their decision-making processes regarding appropriate individual prophylactic management.


2019 ◽  
Vol 11 (1) ◽  
pp. 125-148
Author(s):  
Andrew Dillon ◽  
Ram Fishman

Hydrological investments, particularly irrigation dams, have multiple potential benefits for economic development. Dams also have financial, environmental, and distributional impacts that can affect their benefits and costs. This article reviews the evidence on the impact of dams on economic development, focusing on the levels and variability of agricultural productivity, and its effect on poverty, health, electricity generation, and flood control. We also review the evidence on irrigation efficiency and collective action of dam maintenance. Throughout the discussion, we highlight the empirical challenges that restrict the body of causally interpretable impact estimates and areas in which the evidence is particularly thin. We conclude with a discussion of emerging issues pertaining to the long-term sustainability of dams’ impacts and suggest directions for future research.


Author(s):  
Paul Allatson

The second issue of PORTAL Journal of Multidisciplinary International Studies for 2006 features a special selection of essays grouped under the title ‘Women in Asia’ and guest-edited by Devleena Ghosh and Barbara Leigh, both from the University of Technology Sydney. The essays in this special issue had their first incarnations at the Eighth Women in Asia Conference, ‘Shadow Lines’, organised by the Women’s Caucus of the Asian Studies Association of Australia and the University of Technology Sydney (convened by Ghosh and Leigh), and held at the University of Technology Sydney from 26 to the 28 September 2005. Aiming self-consciously and tacitly to toy with, and dispute, the historical and discursive valencies accruing to the key, twined terms ‘women’ and ‘Asia’, the ten essays grouped here combine to form a rich repository of contemporary research about the status of women in many parts of that vast, arguably incoherent, geocultural space called Asia. All of the contributing authors thus ‘attempt to unsettle discourses about limits,’ to cite from co-editor Devleena Ghosh’s opening paper. That attempt is far from straightforward, as Ghosh elaborates: ‘That lines, borders and boundaries exist, whether of prejudice, politics, economics, or culture, is undeniable. But how do we analyse these issues without ossifying them, creating implacable alterities that refuse the liminal spaces that people occupy?’ Multivalent solutions are called for, Ghosh suggests, and these are to be found not simply in ‘counter-politics and interventions’, but also through the excavation and recognition of multiple subjectivities from/in ‘a thousand plateaus, [and] felt and experienced through the body, historical landscapes, domestic spaces, through performance as well as through the realm of the imaginary, in the impact of ideals and the weight of history’. In addition to the special section on ‘Women in Asia’, this edition of PORTAL contains two essays in its general academic section. François Provenzano’s ‘Francophonie et études francophones: considérations historiques et métacritiques sur quelques concepts majeurs’ offers a sustained meditation and critique of the discourse of Francophonic unity, and suggests a range of possible critical directions for future research into the study of French-speaking zones, peoples and cultures. Barbara Elizabeth Hanna and Juliana de Nooy’s ‘The Seduction of Sarah: Travel Memoirs and Intercultural Learning’, focuses on a big-selling memoir that was also something of a media-sensation on its publication in Australia in 2002, expatriate Australian journalist Sarah Turnbull’s account of her ambivalent ‘new life’ in Paris, France, after her marriage to a local: Almost French: A New Life in Paris. Interested in Turnbull’s autobiography as a potentially useful and productive classroom text for demonstrating, and enabling discussion of, intercultural difference, the authors’ rich analysis demonstrates that such texts present a host of problems to the teacher keen to work with students’ self-critical capacities to locate themselves in international and transcultural frameworks. We are delighted, as well, to present three cultural works in this issue: Katherine Elizabeth Clay’s evocative ‘comic’ narrative of study abroad, ‘From Penrith to Paris,’ itself a lively visual-textual antidote to Turnbull’s ambivalently romanticized view of (not-quite)-belonging in Paris (as discussed by Hanna and de Nooy in this issue); a typically idiosyncratic satire about the current German Chancellor, Angela Merkel, from Anthony Stephens, expertly deploying an ancient Celtic narrative verse form; and California-based Chicana writer Susana Chávez-Silverman’s code-switching chronicle/crónica, ‘Oda a la ambigüedad Crónica,’ a beautifully concise exploration of loss and the sensory regime of memorialisation. Paul Allatson, Chair, PORTAL Editorial Commitee


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