scholarly journals Prevalence of self-medication in the adult population of Brazil: a systematic review

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Paulo Henrique Faria Domingues ◽  
Taís Freire Galvão ◽  
Keitty Regina Cordeiro de Andrade ◽  
Pedro Terra Teles de Sá ◽  
Marcus Tolentino Silva ◽  
...  
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Adult Population ◽  
Significant Proportion ◽  
Recall Period ◽  
Cochrane Library ◽  
Future Research ◽  
Publication Date ◽  
Self Medication ◽  
Cross Sectional

OBJECTIVE To evaluate the prevalence of self-medication in Brazil’s adult population.METHODS Systematic review of cross-sectional population-based studies. The following databases were used: Medline, Embase, Scopus, ISI, CINAHL, Cochrane Library, CRD, Lilacs, SciELO, the Banco de teses brasileiras(Brazilian theses database) (Capes) and files from the Portal Domínio Público (Brazilian Public Domain). In addition, the reference lists from relevant studies were examined to identify potentially eligible articles. There were no applied restrictions in terms of the publication date, language or publication status. Data related to publication, population, methods and prevalence of self-medication were extracted by three independent researchers. Methodological quality was assessed following eight criteria related to sampling, measurement and presentation of results. The prevalences were measured from participants who used at least one medication during the recall period of the studies.RESULTS The literature screening identified 2,778 records, from which 12 were included for analysis. Most studies were conducted in the Southeastern region of Brazil, after 2000 and with a 15-day recall period. Only five studies achieved high methodological quality, of which one study had a 7-day recall period, in which the prevalence of self-medication was 22.9% (95%CI 14.6;33.9). The prevalence of self-medication in three studies of high methodological quality with a 15-day recall period was 35.0% (95%CI 29.0;40.0, I2 = 83.9%) in the adult Brazilian population.CONCLUSIONS Despite differences in the methodologies of the included studies, the results of this systematic review indicate that a significant proportion of the adult Brazilian population self-medicates. It is suggested that future research projects that assess self-medication in Brazil standardize their methods.

scholarly journals Factors associated with the progression of deficit accumulation frailty among adults with an intellectual disability: a systematic review revealing research gaps

2021 ◽  
Vol 4 ◽  
pp. 58
Author(s):  
Brendan Dee ◽  
Eilish Burke ◽  
Roman Romero-Ortuno ◽  
Philip McCallion ◽  
Mary McCarron
Keyword(s):  
Systematic Review ◽  
Intellectual Disability ◽  
Longitudinal Design ◽  
Future Research ◽  
Publication Date ◽  
Deficit Accumulation ◽  
Cross Sectional ◽  
Factors Associated ◽  
Frailty Status ◽  
Over Time

Background: People with an intellectual disability are more likely to experience frailty earlier in life and with greater severity compared to the general population. There is growing consideration of determinants of frailty and identifying factors which may influence the change in frailty status over time. The objective of this review was to investigate factors associated with the progression of frailty over time among adults with an intellectual disability. Methods: A systematic review of literature was conducted using PRISMA guidelines to identify studies reporting factors associated with transitions and trajectories in deficit accumulation frailty among adults with an intellectual disability. The following eligibility criteria was used: defined frailty as deficit accumulation; longitudinal design; reported at least one individual characteristic associated with change in frailty status; sample was people with an intellectual disability aged ≥18 years; English language. No limitation on publication date was applied. Studies which did not measure frailty according to deficit accumulation, did not report the frailty measure used, or had a cross-sectional design were excluded. Selected studies were assessed for quality using the Critical Appraisal Skills Programme (CASP) framework. Results: In total, two studies qualified for inclusion in this review. Findings revealed that frailty defined as deficit accumulation is a dynamic process and improvements are possible. Changes in the direction of frailty states over time among adults with an intellectual disability may be influenced by several factors including baseline frailty status, age, the presence of Down syndrome, functional ability, cognitive ability, living in a group home, and the use of nursing services and therapies. Conclusions: There is a relative paucity of research on frailty among adults with an intellectual disability and the evidence base must be grown. Exploration of the social domain of frailty in this group should be a priority of future research. PROSPERO registration: 179803 (05/07/2020)

scholarly journals Prognostic disclosure and quality of life in palliative care: a systematic review

2020 ◽  
pp. bmjspcare-2020-002460
Author(s):  
Sanhapan Wattanapisit ◽  
Richard Wagland ◽  
Katherine Hunt
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Cochrane Library ◽  
Future Research ◽  
Prognostic Information ◽  
Social Functions ◽  
Cross Sectional ◽  
Emotional Aspects

IntroductionPrognostic disclosure is an important component of communication in palliative care. Disclosing information on poor prognosis may affect quality of life (QoL) of palliative care patients. However, the effects of prognostic disclosure on QoL across different cultures and countries are unclear.ObjectiveTo review the effects of prognostic disclosure on QoL of palliative care patients.MethodsA systematic review was conducted across seven databases (AMED, CINAHL plus, Cochrane Library, Medline (via the PubMed interface), Embase, Scopus and Web of Science). All primary studies, of any design, that explored the effects of prognostic disclosure on QoL of adult palliative care patients were eligible.ResultsA total of 1926 records were screened for eligibility. Twenty-five articles were included (11 cross-sectional, 10 cohort, 3 mixed methods and 1 qualitative study). Studies were conducted in 11 countries. Five studies reported the sources of prognostic disclosure, while 20 studies did not. Emotional QoL was the most reported domain among the studies. The effects of prognostic disclosure on emotional aspects, overall QoL and other domains, including symptoms, physical functions, role functions, social functions and cognitive functions, were inconsistent.ConclusionsThe effects of prognostic disclosure on QoL across cultures and countries are inconsistent. Cultural differences are not sufficient to explain the effects. Future research is needed to explore the association between prognostic disclosure and QoL, and develop tools to support clinicians to share prognostic information in the most sensitive and supportive way.

scholarly journals Representation of gender in migrant health studies – a systematic review of the social epidemiological literature

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Lisa Wandschneider ◽  
Stephanie Batram-Zantvoort ◽  
Oliver Razum ◽  
Céline Miani
Keyword(s):  
Systematic Review ◽  
Gender Roles ◽  
Synergistic Effects ◽  
Cochrane Library ◽  
Future Research ◽  
Sex And Gender ◽  
Comprehensive Overview ◽  
Cross Sectional ◽  
And Gender ◽  
The Individual

Abstract Background Gender as a social construct contributes to determine who migrates and which migration-related risks and opportunities emerge in all phases of the migration trajectory. Simultaneously, migration influences the individual as well as societal definition and perception of gender roles. An explicit gender perspective in migration-related epidemiological research can contribute to adequately analyse and interpret the health of migrants. This systematic review gives a comprehensive overview on how gender has been conceptualised, operationalised and measured in social epidemiologic studies aiming to assess the influence of gender on health among migrants. Methods We searched PubMed, Embase, CINAHL, the Cochrane Library, EconLit and PsycINFO and conducted backward reference searching. Reviewers independently selected studies, extracted data and conducted the quality assessment. Eligible studies actively aimed to understand, identify or explain the influence of gender on migrants’ health, whereby the role of gender can encompass a variety of mechanisms, processes or states of differentiation, discrimination and/or inequality. Results Almost all of the 43 studies were cross-sectional and focussed on health outcomes in the post-migration phase. The most common theme of research was the health of male migrants in the US, and in particular of men who have sex with men (MSM). All studies treated gender as a binary variable (men vs. women), without discussing additional types of gender identities. A minority of studies differentiated clearly between sex and gender. Gender was mostly operationalised through attitudes toward gender roles and gender-based discrimination, experienced at the individual level. Community and societal level gender measures capturing structural gender determinants were underrepresented. Conclusions The intersections of migration and gender suggested synergistic effects on health that only become visible when considering those two social determinants together. Future research needs to embrace a multilevel and non-binary understanding of gender and reflect on the influence of gender in the different phases of the migration journey. Systematic review registration PROSPERO CRD42019124698.

scholarly journals The use of teledermoscopy in the accurate identification of cancerous skin lesions in the adult population: A systematic review

2017 ◽  
Vol 24 (2) ◽  
pp. 75-83 ◽  
Author(s):  
Amy F Bruce ◽  
Jennifer A Mallow ◽  
Laurie A Theeke
Keyword(s):  
Systematic Review ◽  
Rural Communities ◽  
Web Applications ◽  
Adult Population ◽  
Skin Lesions ◽  
Telecommunication Networks ◽  
Future Research ◽  
Measurement Tool ◽  
Accurate Identification ◽  
Cross Sectional

Background The use of teledermoscopy in the diagnostic management of pre-cancerous and cancerous skin lesions involves digital dermoscopic images transmitted over telecommunication networks via email or web applications. Teledermoscopy may improve the accuracy in clinical diagnoses of melanoma skin cancer if integrated into electronic medical records and made available to rural communities, potentially leading to decreased morbidity and mortality. Objective and method The purpose of this paper is to present a systematic review of evidence on the use of teledermoscopy to improve the accuracy of skin lesion identification in adult populations. The PRISMA method guided the development of this systematic review. A total of seven scholarly databases were searched for articles published between the years of 2000 and 2015. All studies were critically appraised using the Rosswurm and Larrabee critique worksheet, placed in a matrix for comparison evaluating internal and external validity and inspected for homogeneity of findings. Results Sixteen articles met inclusion criteria for this review. A majority of the studies were cross-sectional and non-experimental. Ten of the 16 focused on interobserver concordance and diagnostic agreement between teledermoscopy and another comparator. Instrumentation in conducting the studies showed inconsistency with reported results. Discussion Higher level evidence is needed to support clinical application of teledermoscopy for accuracy of diagnostic measurement in the treatment of pre-cancerous and cancerous skin lesions in adults. Future research is needed to develop a standardized, reliable and valid measurement tool for implementation in clinical practice.

scholarly journals Prevalence of hypertension among adolescents: systematic review and meta-analysis

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Vivian Siqueira Santos Gonçalves ◽  
Taís Freire Galvão ◽  
Keitty Regina Cordeiro de Andrade ◽  
Eliane Said Dutra ◽  
Maria Natacha Toral Bertolin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Web Of Science ◽  
Meta Analysis ◽  
Publication Date ◽  
Cross Sectional ◽  
School Population ◽  
School Based ◽  
Brazilian Students

ABSTRACT OBJECTIVE To estimate the prevalence of hypertension among adolescent Brazilian students. METHODS A systematic review of school-based cross-sectional studies was conducted. The articles were searched in the databases MEDLINE, Embase, Scopus, LILACS, SciELO, Web of Science, CAPES thesis database and Trip Database. In addition, we examined the lists of references of relevant studies to identify potentially eligible articles. No restrictions regarding publication date, language, or status applied. The studies were selected by two independent evaluators, who also extracted the data and assessed the methodological quality following eight criteria related to sampling, measuring blood pressure, and presenting results. The meta-analysis was calculated using a random effects model and analyses were performed to investigate heterogeneity. RESULTS We retrieved 1,577 articles from the search and included 22 in the review. The included articles corresponded to 14,115 adolescents, 51.2% (n = 7,230) female. We observed a variety of techniques, equipment, and references used. The prevalence of hypertension was 8.0% (95%CI 5.0–11.0; I2 = 97.6%), 9.3% (95%CI 5.6–13.6; I2 = 96.4%) in males and 6.5% (95%CI 4.2–9.1; I2 = 94.2%) in females. The meta-regression failed to identify the causes of the heterogeneity among studies. CONCLUSIONS Despite the differences found in the methodologies of the included studies, the results of this systematic review indicate that hypertension is prevalent in the Brazilian adolescent school population. For future investigations, we suggest the standardization of techniques, equipment, and references, aiming at improving the methodological quality of the studies.

scholarly journals The Current State and Diagnostic Accuracy of Digital Mental Health Assessment Tools for Psychiatric Disorders: Protocol for a Systematic Review and Meta-analysis (Preprint)

2020 ◽  
Author(s):  
Nayra A Martin-Key ◽  
Thea S Schei ◽  
Eleanor J Barker ◽  
Benedetta Spadaro ◽  
Erin Funnell ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Adult Population ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Future Research ◽  
Digital Assessment ◽  
Question And Answer

BACKGROUND Despite the rapidly growing number of digital assessment tools for screening and diagnosing mental health disorders, little is known about their diagnostic accuracy. OBJECTIVE The purpose of this systematic review and meta-analysis is to establish the diagnostic accuracy of question- and answer-based digital assessment tools for diagnosing a range of highly prevalent psychiatric conditions in the adult population. METHODS The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) will be used. The focus of the systematic review is guided by the population, intervention, comparator, and outcome framework (PICO). We will conduct a comprehensive systematic literature search of MEDLINE, PsychINFO, Embase, Web of Science Core Collection, Cochrane Library, Applied Social Sciences Index and Abstracts (ASSIA), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for appropriate articles published from January 1, 2005. Two authors will independently screen the titles and abstracts of identified references and select studies according to the eligibility criteria. Any inconsistencies will be discussed and resolved. The two authors will then extract data into a standardized form. Risk of bias will be assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool, and a descriptive analysis and meta-analysis will summarize the diagnostic accuracy of the identified digital assessment tools. RESULTS The systematic review and meta-analysis commenced in November 2020, with findings expected by May 2021. CONCLUSIONS This systematic review and meta-analysis will summarize the diagnostic accuracy of question- and answer-based digital assessment tools. It will identify implications for clinical practice, areas for improvement, and directions for future research. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42020214724; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020214724. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/25382

scholarly journals Antibiotic Use and Misuse in Dentistry in India—A Systematic Review

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1459
Author(s):  
Aarthi Bhuvaraghan ◽  
Rebecca King ◽  
Harriet Larvin ◽  
Vishal R. Aggarwal
Keyword(s):  
Systematic Review ◽  
General Population ◽  
Antibiotic Use ◽  
Fixed Dose ◽  
Secondary Outcome ◽  
Publication Date ◽  
Self Medication ◽  
Cross Sectional ◽  
Low Middle Income Countries ◽  
Dental Practitioners

Infections caused by antibiotic resistance pose a serious global health threat, undermining our ability to treat common infections and deliver complex medical procedures. Antibiotic misuse, particularly in low-–middle-income countries, is accelerating this problem. Aim: The aim of this systematic review was to investigate the use and misuse of antibiotics in dentistry in India. Method: We included studies carried out on Indian populations evaluating the prescription of prophylactic or therapeutic antibiotics by dental practitioners or other healthcare providers, along with antibiotic self-medication by the general population. The primary outcome measure was prescription rate/use of antibiotics for dental/oral problems. The secondary outcome measures included indications for antibiotic use in dentistry, their types and regimens, factors influencing practitioners’ prescription patterns and any differences based on prescriber and patient characteristics. Multiple databases were searched with no restrictions on language or publication date. The quality assessment of all included studies was carried out using the AXIS tool for cross-sectional studies and the Joanna Briggs Institute checklist for qualitative studies. Results: Of the 1377 studies identified, 50 were eligible for review, comprising 35 questionnaire surveys, 14 prescription audits and one qualitative study (semi-structured interviews). The overall quality of the included studies was found to be low to moderate. The proportion of antibiotic prescriptions amongst all prescriptions made was found to range from 27% to 88%, with most studies reporting antibiotics in over half of all prescriptions; studies also reported a high proportion of prescriptions with a fixed dose drug combination. Worryingly, combination doses not recommended by the WHO AWaRe classification were being used. The rate of antibiotic self-medication reported for dental problems varied from 5% to 35%. Conclusions: Our review identified the significant misuse of antibiotics for dental diseases, with inappropriate use therapeutically and prophylactically, the use of broad spectrum and combination antibiotics not recommended by WHO, and self-medication by the general population. There is an urgent need for targeted stewardship programmes in this arena.

scholarly journals Knowledge of Resident Doctors Regarding Palliative Care: A Systematic Review

2020 ◽  
Author(s):  
Arlene Sousa Barcelos Oliveira ◽  
Janete Capel Hernandes ◽  
Viviane Cruvinel Di Castro ◽  
Cristina Celia Almeida Pereira Santana ◽  
Marcos Luis Montagnini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Life Quality ◽  
Geographic Location ◽  
Cochrane Library ◽  
Publication Date ◽  
Cross Sectional ◽  
Public And Private ◽  
Life Threatening ◽  
Teaching Learning

Abstract Background: Palliative care aims to improve life quality of patients and their families, preventing and relieving people's suffering in coping life-threatening diseases. Many challenges are linked to palliative care, such as the lack of specific disciplines in doctors training; the scarcity of services and specialized programs in palliative care in public and private health systems and the lack of training for resident doctors. Objective: To identify knowledge of resident doctors regarding palliative care. Method: A systematic review according to PRISMA (2009), with searches carried out in Cochrane Library, MEDLINE / PubMed, Scopus, Web of Science databases and gray literature of Brazilian Digital Library of Theses and Dissertations (BDTD), with the acceptance of articles in English, Portuguese and Spanish, without delimitation of publication date, geographic location and type of study. Only studies with resident doctors were included. Results: During the search, 931 articles were found. Of these, 363 were discarded because they were duplicated and 568 were discarded after reading titles and abstracts, leaving 24 articles for complete reading, which after reading and consensus of the three researchers, only 07 of these articles were included in the comparative synthesis. Three intervention studies, two cross-sectional and two qualitative studies were found. In the observed data, all the analyzed studies had a sample of less than 100 subjects, with a total of 442 subjects, of which 137 (30.99%) were women and 111 (25.12%) men, with average age ranging from 26.6 to 32.1. Conclusions: The studies analyzed in this review indicate that the knowledge of resident doctors was limited and insufficient related to palliative care, what indicates the need of greater investments in training, through teaching-learning methods based on rotation, simulation and others, thus improving not only knowledge, but also the practice in palliative care. PROSPERO record: CRD42020159428

PHYSICAL ACTIVITY AND ß-AMYLOID BRAIN LEVELS IN HUMANS: A SYSTEMATIC REVIEW

2015 ◽  
pp. 1-8
Author(s):  
P. de Souto Barreto ◽  
B. Vellas ◽  
S. Andrieu ◽  
Y. Rolland
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Cochrane Library ◽  
Future Research ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Apoe Ε4 ◽  
Allele Specific ◽  
Study Population ◽  
Β Amyloid

Physical activity (PA) contributes to brain health and plasticity, which suggests that PA would protect against the development of Alzheimer’s disease (AD). However, research on PA and AD biomarkers is very scarce. The objective of the present study was to perform a systematic review of studies that investigated the associations between PA and β-amyloid brain deposition in humans. Electronic searches were performed in PubMed, Cochrane Library, SportDiscus, PEDro, and PsychInfo databases. Articles were eligible if they have assessed both PA and β-amyloid brain deposition in humans. Five articles, published between 2010 and 2013, met eligibility criteria (study population varied across studies from 54 to 515, according with the β-amyloid measure. All five studies assessed both PA and PET-amyloid; among them, two studies also assessed CSF Aβ42 levels). All studies were based on cross-sectional data, from non-demented populations. Among the five included studies, three found significant associations between PA and β-amyloid brain deposition, and the other two did not find any significant association; limited evidence suggests that PA-amyloid plaques associations would be APOE ε4 allele-specific. In sum, no solid conclusions can be drawn on the associations between PA and human β-amyloid brain deposition currently. Future research on this topic should particularly pay attention to the operationalisation of clinically relevant and valid PA variables and should include important confounders in multivariate analysis. More information is needed on the potential interactions between PA and other AD risk factors (e.g., cognitive activities, APOE ε4 status, nutrition, smoking) and their combined effects on AD biomarkers.

scholarly journals The Current State and Diagnostic Accuracy of Digital Mental Health Assessment Tools for Psychiatric Disorders: Protocol for a Systematic Review and Meta-analysis

10.2196/25382 ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. e25382
Author(s):  
Nayra A Martin-Key ◽  
Thea S Schei ◽  
Eleanor J Barker ◽  
Benedetta Spadaro ◽  
Erin Funnell ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Adult Population ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Future Research ◽  
Digital Assessment ◽  
Question And Answer

Background Despite the rapidly growing number of digital assessment tools for screening and diagnosing mental health disorders, little is known about their diagnostic accuracy. Objective The purpose of this systematic review and meta-analysis is to establish the diagnostic accuracy of question- and answer-based digital assessment tools for diagnosing a range of highly prevalent psychiatric conditions in the adult population. Methods The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) will be used. The focus of the systematic review is guided by the population, intervention, comparator, and outcome framework (PICO). We will conduct a comprehensive systematic literature search of MEDLINE, PsychINFO, Embase, Web of Science Core Collection, Cochrane Library, Applied Social Sciences Index and Abstracts (ASSIA), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for appropriate articles published from January 1, 2005. Two authors will independently screen the titles and abstracts of identified references and select studies according to the eligibility criteria. Any inconsistencies will be discussed and resolved. The two authors will then extract data into a standardized form. Risk of bias will be assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool, and a descriptive analysis and meta-analysis will summarize the diagnostic accuracy of the identified digital assessment tools. Results The systematic review and meta-analysis commenced in November 2020, with findings expected by May 2021. Conclusions This systematic review and meta-analysis will summarize the diagnostic accuracy of question- and answer-based digital assessment tools. It will identify implications for clinical practice, areas for improvement, and directions for future research. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020214724; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020214724. International Registered Report Identifier (IRRID) DERR1-10.2196/25382

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