Is metformin use associated with a reduced risk of oesophageal cancer? A systematic review and meta-analysis

ObjectivesStudies on the association between metformin use and the risk of oesophageal cancer (OC) have generated controversial findings. This updated meta-analysis was conducted to reassess the effects of metformin on OC.MethodsA comprehensive search strategy was conducted to select relevant studies from origination to February 2021. Heterogeneity was evaluated through the Q test and I2 statistics. HRs and 95% CIs were pooled through either random-effect or fixed-effect models. Meta-regression, subgroup analyses, sensitivity analysis and publication bias diagnosis were also performed.ResultsSeven studies with 5 426 343 subjects were included. Metformin use was associated with reduced risk of OC (HR=0.69, 95% CI 0.54 to 0.87, p<0.001). Sensitivity analysis suggested that the results were relatively stable.ConclusionMetformin is associated with a reduced risk of OC. More well-designed studies are still needed to further elaborate on these associations.PROSPERO registration numberCRD42021237127.

Group Therapy for Survivors of Adult Sexual Assault: A Scoping Review

Across the world, women experience significant rates of sexual assault and there is a need to strengthen support services offered to survivors. Group therapy could provide an important addition to services that support healing and growth; however, the effectiveness of group therapy interventions with survivors of adult sexual assault is not well understood and clearer insights into designing and running group therapy interventions require further exploration. This review synthesizes literature exploring group therapy for survivors of adult sexual assault to inform future interventions and research implementing group therapy. A systematic approach was used to gather literature describing and evaluating group therapy interventions with survivors of adult sexual assault. Of the initial 466 articles identified through a comprehensive search strategy including database and hand searches, 32 met the inclusion criteria by describing a group therapy intervention conducted with survivors of adult sexual assault. A thematic approach to analysis was conducted to synthesize and collate the literature. Findings explore potentially useful strategies and characteristics of group therapy with survivors of adult sexual assault and make recommendations for the design and evaluation of future interventions. Group therapy has potential as a valuable support service provided to survivors but further rigorous research and evaluations are required to better capture outcomes and understand how to design and implement effective interventions.

Is Childhood Maltreatment Associated with Body Image Disturbances in Adulthood? A Systematic Review and Meta-Analysis

Purpose We aimed to synthesize the evidence for an association between childhood maltreatment and body image disturbances in adulthood. Information on maltreatment subtypes and mediator variables was included to gain further insights into the mechanisms of the association. In addition, we aimed to examine the role of body image disturbances in the development of negative mental health outcomes associated with childhood maltreatment. Methods Based on a comprehensive search strategy, eligible studies were identified in PubMed, Scopus, and Web of Science. The eligibility assessment was performed by two reviewers, and 132 articles were studied full-text. To reduce heterogeneity, only non-clinical samples were included in the meta-analysis. A meta-regression was computed to examine the influence of maltreatment subtype on body image disturbances. Results Our results provide evidence for a robust association between childhood maltreatment and cognitive-affective body image, both in clinical and community samples. Included studies (N = 40) indicate that body image disturbances are especially pronounced in individuals suffering from Posttraumatic Stress Disorder (PTSD) after childhood maltreatment. The meta-analysis included 12 studies with a total of 15.481 participants, and indicates a small overall effect size (r = 0.21, 95% CI = [0.16, 0.26], p < .001). Meta-regression revealed no significant impact of maltreatment subtype in non-clinical samples. Conclusion Childhood maltreatment should be considered as a distal risk factor for the development of a negative cognitive-affective body image. We argue for future longitudinal studies which allow a better understanding of the pathways linking childhood maltreatment, body image disturbances and associated psychopathology.

Expressivity of Interleukin-8 and Gastric Cancer Prognosis Susceptibility: A Systematic Review and Meta-Analysis

Background The relationship between interleukin-8 (IL-8) expression and the prognosis of gastric cancer (GC) patients has been reported, but the results are contradictory. Aim To investigate the effect of IL-8 expression on the prognosis of patients with GC. Method A comprehensive search strategy was used to search the PubMed, Web of Science and Cochrane Library databases. The total survival time was analysed using the RevMan 5.4 software. Through extensive search and meta-analysis of relevant studies, studies examining the relationship between IL-8 expression and prognosis in patients with GC were conducted to obtain more accurate estimates. Findings Eight studies (1843 patients) were included. The combined results of all the studies showed that high expression of IL-8 was a risk factor for poor prognosis in patients with GC (hazard ratio (HR): 2.08; 95% CI: 1.81–2.39). Sensitivity analysis suggested that the pooled HR was stable, and omitting a single study did not change the significance of the pooled HR. Funnel plots revealed no significant publication bias in the meta-analysis. Conclusion High IL-8 expression could be a negative prognostic biomarker for patients with GC.

Caste Exclusion and Health Discrimination in South Asia: A Systematic Review

The caste system is social stratification system that has been used over the last 3 millennia. This review aims to investigate caste-based inequity in health care utilization in South Asia, particularly focusing those at the bottom of the caste hierarchy, commonly known as Dalit communities. A systematic methodology was followed; key databases (including CINAHL, Medline, SocINDEX, PubMed, Nepjol, JSTOR, and ASSIA) were searched for relevant articles published before October 2019, using comprehensive search strategy in accordance with the PRISMA guidelines. In total 15,109 papers were found, and from these, 9 selected papers were included in the review. The papers focused on studies in both India (n = 7) and Nepal (n = 2) and utilized a range of methods including qualitative (n = 2), quantitative (n = 3), and mixed methods (n = 4) approaches. The review identified 4 main themes: stigma, poverty, cultures and beliefs, and health care. Caste-based inequity impacts upon all aspects of an individual’s well-being including violence and everyday life risks. Caste also impacts upon individuals’ opportunities to access education, employment, and health care. Dalits appear to experience this more significantly due to both poverty and their caste status, which increases their vulnerability to health risks.

Obesity management in primary care: systematic review exploring the influence of therapeutic alliance

Purpose To identify the influence of the therapeutic alliance on the effectiveness of obesity interventions delivered in primary care. Method Systematic review of randomized controlled trials of primary care interventions for adult patients living with obesity. Comprehensive search strategy using the terms ‘obesity’, ‘primary care’ and ‘intervention’ of seven databases from 1 January 1998 to March 2018. Primary outcome was difference in weight loss in interventions where a therapeutic alliance was present. Results From 10 636 studies, 11 (3955 patients) were eligible. Only one study had interventions that reported all aspects of therapeutic alliance, including bond, goals and tasks. Meta-analysis was not included due to high statistical heterogeneity and low numbers of trials; as per our protocol, we proceeded to narrative synthesis. Some interventions included the regular primary care practitioner in management; very few included collaborative goal setting and most used prescriptive protocols to direct care. Conclusions We were surprised that so few trials reported the inclusion of elements of the therapeutic alliance when relational aspects of primary care are critical for effectiveness. Interventions could be developed to maximize therapeutic relationships and research reports should describe interventions comprehensively. Systematic review registration number CRD42018091338 in PROSPERO (International prospective register of systematic reviews).

Establishing a comprehensive search strategy for Indigenous health literature reviews

Background Appropriate search strategies are essential to ensure the integrity and reproducibility of systematic and scoping reviews, as researchers seek to capture as many relevant resources as possible. In the case of Indigenous health reviews, researchers are met with the special challenge of creating a search strategy that can encompass this large, diverse population group with no universally agreed upon identification criteria. Main body With an aim to promote improved review methodologies that uphold standards of justice, autonomy, and equity for Indigenous peoples and other heterogeneous populations, we describe critical gaps and approaches to close them. We report organizational and transparency issues around how Indigenous populations are indexed in several major databases, and draw on examples of published reviews and protocols to demonstrate the challenges inherent to creating a comprehensive search strategy. Conclusions The conduct and communication of results from health literature research on global Indigenous populations are compromised by challenges of methodology that are rooted in the complexities inherent to defining Indigenous peoples. These challenges must be urgently addressed to improve this important field of inquiry moving forward.

Scoping Review on Ageism against Younger Populations

Systematic efforts have been carried out to study ageism against older populations. Less is known about ageism against younger populations, including how it is defined, how it manifests, its effects, and how it can be addressed. A scoping review was conducted aimed at identifying available evidence on these topics. A comprehensive search strategy was used across thirteen databases, including PubMed, EMBASE, and CINAHL. Records were screened by two independent reviewers. Data extraction was done by one rater and independently reviewed by a second rater. Of the 9270 records identified, 263 were eligible for inclusion. Most of the evidence focused on the manifestation of ageism (86%), followed by a focus on the determinants of ageism (17%), available interventions to address ageism (9%), and the effects of ageism (5%). This study points to the inconsistent terminology used to describe ageism against younger populations and the relatively limited theoretical rationale that guides existing studies. It also highlights key research gaps and points to the strengths of existing research.

UPSELLING STRATEGY: A REVIEW

The purpose of this study is to systematically review the existing literature on Upselling and its major impacts on consumer behaviours. In addition, this study seeks to shed light on trends and dynamics in Service sector and Retail sector, so as to find the effectiveness of Upselling strategy. A systematic literature review of published peer-reviewed articles on Upselling was conducted. A comprehensive search strategy was applied on different databases, including Google Scholar, JSTOR, ScienceDirect, Pro quest, Emerald, Academia and the likes and the renowned articles were then selected from leading journals published between 1995 and 2020.The research finding suggest that a company may get the profitability at times but not all the time using the upselling strategy. To get the profitability firm should focus on Customer loyalty and satisfaction of the consumer for that the results show that there is a need to replace the Upselling strategy with Up-buying strategy in studies focused on consumer behaviour analysis. The studies included in this review are extensively based on peer-reviewed 40 articles published in high-ranked marketing journals and articles within a span of 30 days which may be perceived as a limitation in the present study. The relationship between Upselling and the Customer satisfaction in many occasion prove to be negative hence there is a requirement of change in strategy so as to shift focus from salesforce centric strategy to customer centric strategy, of which the companies will have a considerable practical implication aiming to increase profit and simultaneously increase in Customer Lifetime value along with Customer Loyalty. The authors hereby expect the current review to significantly find the effectiveness of Upselling strategy in consumer behaviour. This review provides a strong contribution to Upselling literature by recommending the need to find the effectiveness of Upselling strategy in Services and Retail sector. No exclusive paper is available which evaluates effectiveness of UpSelling strategy which can be further studied for strategic purpose.

Use of geographical information systems in multiple sclerosis research: A systematic scoping review

Introduction: Geographical Information System (GIS) and spatial analysis have an emerging role in the understanding and management of health-related outcomes. However, there is a knowledge gap about the extent to which GIS has supported Multiple Sclerosis (MS) research. Therefore, this review aimed to explore the types of GIS applications and the complexity of their visualisation in MS research. Methods: A systematic scoping review was conducted based on York’s five-stage framework. PubMed, Scopus and Web of Science were searched for relevant studies published between 2000 and 2020 using a comprehensive search strategy based on the main concepts related to GIS and MS. Grounded, inductive analysis was conducted to organize studies into meaningful application areas. Further, we developed a tool to assess the visualisation complexity of the selected papers.Results: Of 3,723 identified unique citations, 42 papers met our inclusion criteria for the final review. One or more of the following types of GIS applications were reported by these studies: (a) thematic mapping (37 papers); (b) spatial cluster detection (16 papers); (c) risk factors detection (16 papers); and (d) health access and planning (two papers). In the majority of studies (88%), the score of visualisation complexity was relatively low: three or less from the range of zero to six. Conclusions: Although the number of studies using GIS techniques has dramatically increased in the last decade, the use of GIS in the areas of MS access and planning is still under-researched. Additionally, the capacity of GIS in visualising complex nature of MS care system is not yet fully investigated.