Full Text Research Articles

Protocol for a systematic review and critical discourse analysis of research on HIV pre-exposure prophylaxis programme use among gay, bisexual, and other men who have sex with men

Background HIV pre-exposure prophylaxis (PrEP) is a pill that prevents the transmission of HIV from sexual partners living with HIV; it is frequently taken by gay, bisexual, and other men who have sex with men (gbMSM). PrEP is often provided through formal PrEP programmes. Research on these programmes may employ discourses shaped by heteronormativity and homophobia. Given that expert language influences how HIV prevention is understood and delivered, problematic discourses in research likely extends into PrEP programme implementation. This review will use critical discourse analysis (CDA) to explore research on PrEP programme implementation for gbMSM. Within this literature, we will identify interpretive repertoires used to discuss gbMSM; the subject positions afforded to gbMSM; and the implications of these interpretive repertoires and subject positions for gbMSM engaging with HIV PrEP programmes. Methods Relevant articles will be identified through timebound searching (2012-present) in ProQuest ASSIA, EBSCOhost PsycInfo, OVID Medline, OVID Embase, and EBSCOhost CINAHL, with forward and backward citation searching of included studies. Grey literature will be identified through ProQuest and Google Scholar. Screening will be conducted by two independent reviewers, who will conduct double screening for titles, abstracts, and full texts. Data will be analysed and synthesised using CDA informed by critical realism (CR). CDA focuses on relationships between language and power, including how language enables inequality. The analytic process will explore the background of included studies, identify overarching themes, analyse external and internal relations in included studies, and interpret the meaning of identified themes and relations. Conclusions Highlighting issues with discourses in PrEP implementation may enhance reflective engagement with assumptions underlying this research, preventing further stigmatisation of gbMSM’s sexual and protective practices. As PrEP programmes become more common globally, more diverse and inclusive perspectives in PrEP programme research may inform interventions that enhance their acceptability and ultimately their implementation.

The role of polyphenols in atopic dermatitis: a literature review

Background: Atopic dermatitis (AD) is a chronic inflammatory skin with the appearance of pruritic eczema lesions, mostly found in young children, and impact their quality of life (QoL). In concordance with numerous treatment options, some adverse effect might. Recently, it has been discovered that polyphenols may provide satisfactory results for AD therapy and patient’s QoL.
 Objectives: This literature review objective to summarize recent research the use of polyphenols for AD therapy.
 Methods: This is a literature review. Literature search was conducted in Pubmed, EBSCOHOST, Proquest, and Google Scholar, using keywords: “atopic dermatitis”, “atopic eczema” and “polyphenols”. Inclusion criteria were: 1) Randomized clinical trials, case reports, case series, literature reviews, systematic reviews, meta-analysis, cohorts, and experimental studies, 2) Available in full text, 3) Written in English, 4) Research studies with intervention conducted in human, 5) Research studies from early 2000s . While article with lack of available data is excluded. The author use Dermatology Life Quality Index (DLQI) to assess the role of polyphenols in QoL for AD.
 Results: The use of polyphenols in AD shows satisfactory results through their antioxidant, anti-allergic and anti-inflammatory properties. Several studies have observed improvements in sleep disturbance scores, itchiness, and levels of skin moisture and elasticity levels in patients with AD.
 Conclusions: Polyphenols use in AD provide satisfactory results in reducing symptoms that interfere with QoL. However, due to the limited number of studies conducted on human, further studies of larger-scale participants are needed to confirm the effect of polyphenols in AD treatment.

Conditioned Medium Treatment for the Improvement of Functional Recovery after Spinal Cord Injury: A Meta-Analysis Study.

While there is no certain treatment for spinal cord injury (SCI), stem cellbased therapy may be an attractive alternative, but the survival and differentiation of cells in the host tissue are poor. Conditioned medium (CM) has several beneficial effects on cells. In this meta-analysis study, we examined the effect of CM on SCI treatment. After searching on MEDLINE, SCOPUS, EMBASE, and Web of Science, first and secondary screening were performed based on title, abstract, and full text. The data were extracted from the included studies, and meta-analysis was performed using STATA.14 software. A standardized mean difference (SMD) with a 95% confidence interval was used to report findings. Quality control and subgroup analysis were also performed. The results from 52 articles and 61 separate experiments showed that CM had a significantly strong effect on improving motor function after SCI (SMD = 2.58; 95% CI: 2.17 to 2.98; p < 0.001) and also analysis of data from 12 articles demonstrated that CM reduced the expression of GFAP marker (SMD = -4.16; p < 0.0001) compared to SCI group without any treatment. Subgroup analysis showed that treatment with CM of neural stem cells was better than CM of mesenchymal stem cells. It was more effective after a mild lesion than a moderate or severe one. The improvement was more pronounced with <4 weeks than >4 weeks follow-up. CM had a significant effect in improving motor function after SCI, especially in cases of mild lesions. It has been observed that if CM originates from the neural stem cells, it has a more significant effect than mesenchymal cells.

Sexual Medicine Society of North America (SMSNA)/American Urological Association (AUA) telemedicine and men's health white paper.

The purpose of this white paper is to educate health care professionals about the evolution of telemedicine (TM) and to propose a hybrid model that leverages the strengths of traditional in-person medicine as well as virtual medicine while maximizing the safety and quality of men's sexual health care. A literature search focused on the use of TM in urology and men's health was performed through PubMed/MEDLINE, Embase, and Web of Science (January 1, 2012-April 26, 2022). Keywords included all known permutations of the terminology used to refer to virtual health, care as well as the terminology used to refer to urologic diseases, issues specific to men's health, and men's sexual health concerns. Publications that emerged after the literature search that met this criterion also were incorporated. Opinion pieces, letters to the editor, meeting abstracts, and conference proceedings were excluded. Additional resources were retrieved, such as governmental technical reports, legislative updates and reviews, and blogs. This search strategy yielded 1684 records across databases after removal of duplicates. Abstracts from the retrieved records were reviewed for relevance. Relevant publications were defined as those that reported data on any aspect of TM use specific to urology, men's health, and/or men's sexual health. If relevance was unclear from the abstract, then the full text of the article was retrieved for a more detailed review. In addition, the published evidence-based practice guidelines relevant to care for erectile dysfunction, Peyronie's disease, ejaculatory dysfunction, and hypogonadism were retrieved. The most common reasons for article exclusions were a focus on TM use in disciplines other than urology and the absence of data (ie, opinion pieces). After exclusions, a total of 91 publications remained and constituted the evidence base for this paper.

First experience in laparoscopic surgery in low and middle income countries: A systematic review.

Laparoscopic surgery has reduced morbidity and mortality rates, shorter postoperative recovery periods and lower complication rates than open surgery. It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources. However, introducing laparoscopic surgery in low-and-middle-income countries (LMIC) can be expensive and requires resources, equipment, and trainers. To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources. MEDLINE, EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC. Included studies were published between 1996 and 2022 with full text available in English. Exclusion criteria were studies considering only open surgery, ear, nose, and throat, endoscopy, arthroscopy, hysteroscopy, cystoscopy, transplant, or bariatric surgery. Ten studies out of 3409 screened papers, from eight LMIC were eligible for inclusion in the final analysis, totaling 2497 patients. Most reported challenges were related to costs of equipment and training programmes, equipment problems such as faulty equipment, and access to surgical kits. Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff. The benefits of introducing laparoscopic surgery were economic and clinical, including a reduction in hospital stay, complications, and morbidity/mortality. The introduction of laparoscopic surgery also provided training opportunities for junior doctors. Despite financial and technical challenges, many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients. While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported, more support is critically required, in particular regarding training.

Lifestyle Behavioral Interventions and Health-Related Outcomes Among People with Epilepsy: A Review of Randomized Controlled Trials.

To gather and assess current literature on the prevalence and efficacy of lifestyle behavioral interventions (sleep, nutrition, physical activity) for health outcomes, including QOL, psychological well-being, behavioral changes, and seizure frequency, among PWE. A review was conducted of English-language articles identified from PubMed, Scopus, and Embase between January 2013 to January 2023. Inclusion criteria were randomized controlled trials (RCT) with human subjects diagnosed with epilepsy who participated in a lifestyle behavioral intervention. Two researchers independently completed the title, abstract, and full-text reviews. Information extracted includes study population, duration, type of intervention, findings, and outcomes. Data was narratively synthesized to show level of evidence and degree of consistency in findings. Results: 4001 studies identified, 66 full texts reviewed, and 24 included. A majority (n = 16) of studies utilized diet specific RCTs, and some focused on physical activity (n = 7) and sleep (n = 1). Diet-specific RCTs (eg, ketogenic, Modified Atkins) reported reduced seizure frequency with adverse effects, such as gastrointestinal complications. Physical activity-based interventions found that maintained levels of exercise improved QOL and psychological well-being. However, physical activity and diet-based interventions did not have lasting effects after study conclusion. Only the behavioral sleep intervention reported that sleep quality improved significantly and was maintained post-intervention. Future research is needed to establish the relationship between lifestyle behavioral interventions on QOL and other health outcomes (eg, seizure frequency).

The utility of elective flexible bronchoscopy to improve quality of life and clinical outcomes for children: A systematic review.

Elective flexible bronchoscopy (FB) is now widely available and standard practice for a variety of indications in children with respiratory conditions. However, there is limited evidence regarding the utility of elective FB in children. This systematic review (SRs) aimed to determine the utility of FB on its impact in clinical decision making and quality of life (QoL). We searched Pubmed, Cochrane central register of controlled trials, Embase, World Health Organization Clinical Trials Registry Platform and Cochrane database of SRs from inception to April 20, 2023. We included SRs and randomized controlled trials (RCTs) that used parallel group design (comparing use of elective FB vs. no FB, or a wait-list approach [early FB vs. usual wait FB]) in children aged ≤ 18 years. Our protocol was prospectively registered and used Cochrane methodology for systemic reviews of interventions. Our search identified 859 articles; 102 duplicates were removed, and 753 articles were excluded by title and abstract. Four full text articles were reviewed and subsequently excluded, as none met the inclusion criteria outlined in our patient, intervention, comparator, outcome measures framework. There is a paucity of high-quality RCT evidence to support the routine use of elective FB in children with respiratory conditions. However, available retrospective and a single prospective study demonstrate the high utility of FB in the elective pediatric setting. PROSPERO CRD42021291305.

Risk factors for short-term all-cause mortality in patients with end stage renal disease: a scoping review

ObjectivesThere is a lack of prognostic information to guide the prediction of short-term all-cause mortality in patients with end-stage renal disease (ESRD). The aim was to review the risk factors that influenced the risk of short-term all-cause mortality in patients with ESRD.MethodsMEDLINE, Embase, PubMed, CINAHL, the Cochrane Library and Web of Science databases were searched for articles published between 2000 and 2020. Articles describing risk factors predicting short-term mortality (≤ 3 years) in patients with ESRD were included. Four reviewers independently performed title, abstract, full text screening and data extraction. Assessment of risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool checklist.Results20,840 articles were identified and 113 papers were included for this review. Of the 113 papers, 6.2% included only peritoneal dialysis (PD) patients, 67.3% included only hemodialysis (HD) patients, 20.4% included both PD and HD patients, with the remaining papers featuring patients on conservative management or awaiting renal transplant. Risk factors were categorised into 13 domains: 1)demographics/ lifestyle, 2) comorbidities 3)intradialytic blood pressure, 4)biomarkers, 5)cardiovascular measurements, 6)frailty status, 7)medications, 8)treatment related indicators, 9)renal related parameters, 10)health status, 11)cause of ESRD, 12)access to healthcare care/ information and, 13)proxy measures for poor health. C-reactive protein(CRP), age, and functional status were observed to have higher percentage of instances of being significantly associated with all-cause mortality.ConclusionCommonly examined risk factors observed from this review may be used to build a general prognostic model for patients with ESRD, with specific treatment related risk factors added on to enhance the accuracy of the models.

Does heterogeneous media sentiment matter the ‘green premium’? An empirical evidence from the Chinese bond market

This paper selects 346 green bonds issued in China from 2016 to 2021 as the sample, and the Propensity Score Matching (PSM) method is employed to confirm the existence of ‘green premium’ in the Chinese bond market. On this basis, data on internet media sentiment and print media sentiment are collected from ‘Sina Weibo’ and ‘China Important Newspaper Full Text Database’ by both Web Crawler Technology and Textual Analysis Methods to explore the impact and the mechanism of heterogeneous media sentiments on the ‘green premium’. The results show that both the optimism of internet media and print media can significantly promote the ‘green premium’ of green bonds, and the influence of print media sentiment on the ‘green premium’ is greater than that of internet media sentiment. In addition, the Bootstrap method verifies the mediating effect of print media sentiment in the influence of internet media sentiment on ‘green premium’, indicating that print media sentiment is an important transmission path. Moreover, the results of the heterogeneity test show that the more optimistic the media is, the more significant the ‘green premium’ effect is in the regions with higher institutional environments and financial subsidies. The ‘green premium’ of green bonds is most pronounced for higher levels of institutional environment and green bond preferential policies.

Contributions of mobile applications to pre-hospital care: integrative review

Objective: Analyze the scientific contribution of mobile applications developed for pre-hospital care. Methods: Integrative literature review study; the databases used were the following: Scopus, Web of Science, CINAHL, SciELO, Embase, Lilacs, BDENF, Medline/PubMed, Brazilian Digital Library of Theses and Dissertations, and ProQuest Dissertations &amp; Theses Global; (period 2017-2022), including all article categories (with abstract and full texts available with free access) in Portuguese, English, or Spanish, containing the keywords “Pre-Hospital Assistance”, “Pre-Hospital Care”, “Pre-Hospital Services”, “Pre-Hospital Emergency Care”, “Nursing”, “Mobile applications”, “Portable Software Applications”, and “Mobile Apps” in titles and/or abstracts. Two researchers applied the eligibility criteria of the studies and collected data using a previously prepared instrument. Results: From a total of 944 studies, seven were selected for evaluation. Mobile applications developed for the pre-hospital care area are technological tools that have contributed to triage, pediatric first aid, patient safety, preparation of medications during cardiac arrest, quality of cardiopulmonary resuscitation, and communication between the emergency team and the electronic nursing record. Conclusions: The studies highlighted the potential related to the use of mobile applications in pre-hospital care, contributing especially to improving patient safety and the quality of care provided in pre-hospital urgency and emergencies. The optimization of assistance and early diagnosis times was also shown as a contribution of applications to assistance, in addition to alerting to details that may be unnoticed.

Informing nursing policy: An exploration of digital health research by nurses in England

AimsDigital health technologies are designed, implemented, and evaluated to support clinical practice, enable patients to self-manage illness, and further public and global health. Nursing and health policies often emphasise the importance of evidence-based digital health services to deliver better care. However, the contribution nurses make to digital health research in many countries is unknown. Hence, this study aims to examine digital health research conducted by nurses in England. DesignA bibliometric analysis. MethodsThe CINAHL, MEDLINE, and Scopus databases were searched between 2000 and 2022, and supplemented with a hand search of nurses’ research profiles. Results were screened by title, abstract, and full text against eligibility criteria. Data were extracted and bibliometric analysis used to summarise the findings. ResultsMental health nurses produced the most digital health research in England, followed by nurses working in community care, with several disciplines underrepresented or missing. Web/online health services or information was the most researched technology, followed by mobile health and telehealth. Nurses based in the south-east and north-west of England produced the most digital health research, with other regions less well represented. ConclusionNurse leaders should support nurses to conduct more digital health research by providing dedicated time, funding, and professional development opportunities, particularly in under researched clinical areas, technologies, and geographic regions to further evidence-based practice and patient care. More digital nursing data is needed to support nurse led research in areas like artificial intelligence and data science. The findings supported the national Philips Ives Review by identifying areas of digital nursing research that need more investment in England.

The Effectiveness of Hand Exercise on Limb Function in Patient Coronary Artery Disease Posttransradial Artery Catheterization: Systematic Review

Coronary Artery Disease (CAD) is leading cause of mortality worldwide. Catheterization using the transradial arterial (TRA) technique has been able to reduce morbidity and mortality rates from CAD, but this procedure also contributes to the occurrence of complications. The aim of this study was to search literature and analyse articles discussing the use of hand exercise on improving limb function in patients posttransradial cardiac catheterization. Methods: The design used was a systematic review with PRISMA adaptation. Articles were searched using databases: ScienceDirect, ProQuest, PubMed, Scopus and Hand Searching in Google Scholar. The keywords of article search were using “Coronary artery disease” AND “transradial artery catheterization” OR “Trans cardiac Catheterization” AND “hand exercise” AND “limb function. In the initial stage of information search on 5 October 2023, the total number of articles obtained before selection was carried out based on inclusion and exclusion criteria was 7273 articles. From the five databases used, selection was then carried out according to the inclusion and exclusion criteria. The inclusion criteria were research articles published in the last 10 years (2013-2023); use English; a journal article and open access; Involves adult respondents and full text articles. Exclusion criteria were encyclopedia articles, book chapters, conferences, correspondence, editorials, news, practice guidelines, protocols, systematic reviews, literature reviews and meta analysis. The results are discussing 7 articles published from 2013-2023. Conclusions Hand exercises are useful for restoring limb function within two hours after the procedure and over a long period of time.

Systematic Review of Interventions with Some School Involvement for School Refusal in High School–Age Adolescents

Abstract Chronic absenteeism is a public health concern. School refusal due to emotional distress is one reason students exhibit chronic absenteeism. The objective of this systematic review was to determine potential aspects of interventions, in school settings or involving a school-based component, that are successful in addressing school refusal among high school–age adolescents. After duplicated records were excluded, 1,864 studies were identified from searches. The abstracts and full text articles were independently reviewed and received two votes from each of the five reviewers using the eligibility criteria. Two reviewers independently evaluated the remaining articles and met to discuss findings with a third reviewer. The 10 articles included eight studies that noted techniques in cognitive–behavioral therapy (CBT) as promising and two studies that considered CBT as effective as other approaches. The study design for three studies were randomized controlled trials. The remaining seven studies were quasiexperimental. Only three of the 10 studies received a high rating using the Quality Appraisal Tool. There was a limited number of quality studies that used rigorous scientific methods and variation in how each study engaged schools. Further exploration and development of interventions with an integral school-based component are needed.

In‐situ Polymerized Single Lithium‐ion Conducting Binder as an Integrated Strategy for High Voltage LNMO Electrodes

AbstractInvited for this month's cover picture is the Electrochemical Energy laboratory at Universidad Autónoma Metropolitana Iztapalapa in Mexico City in collaboration with ESIQIE IPN and ESFM IPN. The front cover displays a schematic representation of the in‐situ preparation of the electrode using single‐ion‐conductive binders; this process results in reduced degradation of both the LMNO electrode and electrolyte. In the background, there is an image of the landmark mural entitled “Death of Ignorance and Transformation of Society” by A. Belkin, located at the premises of UAM‐I, the institute where the primary research was conducted. The mural picture and logos are used with the permission of UAM president. The graphic composition is credited to D.G. Liliana Hidalgo Sánchez de Tagle. Read the full text of the Research Article at 10.1002/batt.202300383.

New Model of Inclusive Higher Education Practices in Megacities’ Universities

This study analyzes the problem of higher professional education for people with disabilities in multinational megacities from different countries. The aim of this paper is to investigate the emerging changes and perspectives of educational inclusion in the universities of Moscow, Jakarta, Barcelona, and Cairo and to develop a new model of inclusive educational practice for universities based on an inclusive ideology of understanding the position of people with disabilities in the education system and society overall. To perform this study and verify the new model proposed by the authors, participants were selected from ten universities that indicated parameters such as accessibility, participation, quality, students’ education results, and government funding. The survey aimed to collect participants’ perspectives and experiences from diverse elements of the higher education community in the aforementioned locations. 751 participants were selected for the survey with a balanced gender distribution: 48.6% men and 51.4% women. Age distribution was rather diverse: the age group of 18–24 years was 25,7%, the age group of 25–34 years was 27,3%, the age group of 35–44 years was 25,6%, and the age group of 45 years 21,4%. Another distribution was people without disabilities (N=250) and with disabilities (N=551). The reliability of the research was achieved using several methods, including ANOVA. The results of this research show similarities and differences in implementing inclusive education practices across selected locations, providing a detailed picture of the current state and future perspectives of higher inclusive education. The scientific novelty of this research lies in the theoretical-methodological rationale of the new model of inclusive higher education practices in universities of major megacities and in forming the propositions on this model’s implementation in higher education institutions. Doi: 10.28991/ESJ-2024-SIED1-03 Full Text: PDF

Cardiovascular disease as part of Long COVID: A systematic review.

Long COVID syndrome has had a major impact on million patients' lives worldwide. The cardiovascular system is an important aspect of this multifaceted disease that may manifest in many ways. We have hereby performed a narrative review in order to identify the extent of the cardiovascular manifestations of the Long COVID syndrome. An in-depth systematic search of the literature has been conducted for this narrative review. The systematic search of PubMed and Cochrane databases yielded 3,993, of which 629 underwent full text screening. A total of 78 studies were included in the final qualitative synthesis and data evaluation. The pathophysiology of the cardiovascular sequelae of Long COVID syndrome and the cardiac manifestations and complications of Long COVID syndrome are critically evaluated. In addition, potential cardiovascular risk factors are assessed, and preventive methods and treatment options are examined in this review. This systematic review poignantly summarises the evidence from the available literature regarding the cardiovascular manifestations of Long COVID syndrome and reviews potential mechanistic pathways, diagnostic approaches, preventive measures and treatment options.

Nutrition interventions for body composition, physical function, cognition in hospitalized older adults: A systematic review of individuals 75 years and older.

Globally, the oldest old population is expected to triple by 2050. Hospitalization and malnutrition can result in progressive functional decline in older adults. Minimizing the impact of hospitalization on functional status in older adults has the potential to maintain independence, reduce health and social care costs, and maximize years in a healthy state. This study aimed to systematically review the literature to identify nutritional interventions that target physical function, body composition, and cognition in the older population (≥ 75 years). A systematic review was conducted to evaluate the efficacy of nutritional interventions on physical function, body composition, and cognition in adults aged ≥ 75 years or mean age ≥80 years. Searches of PubMed (National Institutes of Health, National Library of Medicine), Scopus (Elsevier), EMBASE (Elsevier), Cumulative Index to Nursing and Allied Health Literature (CINAHL) with Full Text (EBSCOhost), and PsycInfo (EBSCOhost) were conducted. Screening, data extraction, and quality assessment were performed in duplicate and independently (CRD42022355984; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=355984). Of 8311 citations identified, 2939 duplicates were excluded. From 5372 citations, 189 articles underwent full-text review leaving a total of 12 studies for inclusion. Interventions were food-based, protein-based, carbohydrate-based, personalized, or used parenteral nutrition. Ten studies monitored anthropometric or body composition changes with three showing maintenance or improvements in lean mass, body mass index, triceps skinfold, and mid-upper arm circumference compared with the control group. Six studies monitored physical function but only the largest study found a beneficial effect on activities of daily living. Two of three studies showed the beneficial effects of nutritional intervention on cognition. There are few, high-quality, nutrition-based interventions in older adults ≥75 years. Despite heterogeneity, our findings suggest that large, longer-term (>2 weeks) nutritional interventions have the potential to maintain body composition, physical function, and cognition in adults aged 75 years and older during hospitalization.

Quality of Nursing Work Life (QNWL) in Indonesia: Scoping Review

QNWL must continue to be considered to improve the welfare of nurses, especially during the COVID-19 pandemic. The purpose of this study was to determine the description and factors associated with QNWL in Indonesia. This research is a Scoping Review, namely the identification of articles through 3 databases including Google Scholer, Science Direct and Pubmed with the keywords "Quality of Nursing Work-life" AND "Hospital" AND "Public Health Center". The inclusion criteria for the article are published in 2017-2022, full text, research in Indonesia Hospitals/Puskesmas, DOI/ISSN, quantitative research and discusses the quality of working life of nurses. The search identified 320 articles and 12 articles were selected for analysis. The results showed that the QNWL both in the Hospital/Puskesmas on average were in the sufficient/moderate/moderate category. Then, there is a significant relationship between job satisfaction, marital status, nurse performance, education, number of teams and salary/income, quality of life/quality of life during the COVID-19 pandemic with QNWL. Preferably, the management of the Hospital/Puskesmas continues to improve QNWL to improve the welfare of nurses so that they can provide optimal services.

Systematic review and meta-analysis of the etiology of heavy menstrual bleeding in 2,770 adolescent females

BackgroundAdolescent heavy menstrual bleeding(HMB), menorrhagia or abnormal uterine bleeding commonly occur in adolescent women. The differential diagnosis can be challenging. The pneumonic: PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified), is commonly used but it does not stratify as to the likelihood of a disorder. We have sought to develop a probability-based differential diagnosis for Adolescent HMB, menorrhagia or abnormal uterine bleeding.MethodsA comprehensive literature search was conducted using PubMed, EMBASE, and SCOPUS databases. Case series describing adolescents from 10–19 years of age with HMB, menorrhagia or abnormal uterine bleeding was acceptable if: more than 10 patients were included; editorials, case reports, and secondary sources such as review articles, or book chapters were excluded. No language filter was used, but an English abstract was required. The etiology of HMB, menorrhagia or abnormal uterine bleeding, and the country of origin was extracted from articles that met inclusion criteria. Cumulative rate estimates were determined by Bayesian probability modeling.ResultsSeventeen full text articles were reviewed in detail; 2,770 patients were included. The most frequent causes of HMB were Ovarian Uterine Disorders (23.7%; 95% CredI 22–25.5%), Coagulation Disorders (19.4%; 95% CredI 17.8—21.1%), and Platelet Disorders (6.23%; 95% CredI 5.27–7.27%) with 45.9% (95% CredI 43.8—47.%9) of the cases of indeterminate origin.ConclusionsThe leading causes of HMB in healthy adolescent females were varied. The sub-analysis identified distinct etiologies, suggesting that multiple factors must be considered in the evaluation of HMB. While PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified) provides us with a comprehensive picture of the possible causes of HMB in females, this systematic review assigns probabilities to the etiologies of HMB in adolescent females, providing physicians with a more focused and efficient pathway to diagnosis.

The burden, risk factors and prevention strategies for drowning in Türkiye: a systematic literature review

IntroductionDrowning is a public health problem in Türkiye, as in the rest of the world. This study aims to systematically review the literature on drowning in Türkiye with a focus on data sources, epidemiology, risk factors and prevention strategies. Methods: Literature searches were conducted using PubMed, SPORTSDiscus, Scopus, Web of Science, Turk MEDLINE, Google Scholar and Google Akademik (Turkish language). Studies (limited to original research written in English and Turkish) reporting drowning (unintentional and intentional; fatal and non-fatal) of residents and tourists in Türkiye were independently dual screened at the title and abstract and full text stages. Study quality was assessed using JBI checklists and evidence level assessed based on study design. Results: From a total of 917 studies, 49 met the inclusion criteria. Most (51%) focused on unintentional fatal drowning. Included studies were most commonly analytical cross-sectional studies (n = 23) and case series (n = 20) meaning the evidence level was low or very low for 48 (98%) studies. Fifteen studies examined drowning at the national level, while sub-national studies (n = 30) focused on urban areas across three provinces: Antalya (n = 6), Istanbul (n = 6), Izmir (n = 4). There was little consensus on risk factors beyond male drowning risk, and no data reported on implemented or evaluated drowning prevention interventions. Discussion: There is a need for more national-level studies to identify the causes of drowning and to guide intervention implementation and evaluation to inform policy makers and donors. Currently official data is limited in its detail, providing age and gender data only, hampering efforts to identify, and thus address, causal factors for drowning. Practical applications: There is currently very little evidence to inform investment in effective drowning prevention interventions in Türkiye. To improve this, data collection systems on drowning in Türkiye need to be strengthened via the development a national drowning registry.Trial Registration#CRD42022382615.