Joanna Briggs Institute Research Articles

Shared Decision-Making for Patients with Stroke in Neurocritical Care: A Qualitative Meta-Synthesis.

Decision-making for patients with stroke in neurocritical care is uniquely challenging because of the gravity and high preference sensitivity of these decisions. Shared decision-making (SDM) is recommended to align decisions with patient values. However, limited evidence exists on the experiences and perceptions of key stakeholders involved in SDM for neurocritical patients with stroke. This review aims to address this gap by providing a comprehensive analysis of the experiences and perspectives of those involved in SDM for neurocritical stroke care to inform best practices in this context. A qualitative meta-synthesis was conducted following the methodological guidelines of the Joanna Briggs Institute (JBI), using the thematic synthesis approach outlined by Thomas and Harden. Database searches covered PubMed, CIHAHL, EMBASE, PsycINFO, and Web of Science from inception to July 2023, supplemented by manual searches. After screening, quality appraisal was performed using the JBI Appraisal Checklist. Data analysis comprised line-by-line coding, development of descriptive themes, and creation of analytical themes using NVivo 12 software. The initial search yielded 7,492 articles, with 94 undergoing full-text screening. Eighteen articles from five countries, published between 2010 and 2023, were included in the meta-synthesis. These studies focused on the SDM process, covering life-sustaining treatments (LSTs), palliative care, and end-of-life care, with LST decisions being most common. Four analytical themes, encompassing ten descriptive themes, emerged: prognostic uncertainty, multifaceted balancing act, tripartite role dynamics and information exchange, and influences of sociocultural context. These themes form the basis for a conceptual model offering deeper insights into the essential elements, relationships, and behaviors that characterize SDM in neurocritical care. This meta-synthesis of 18 primary studies offers a higher-order interpretation and an emerging conceptual understanding of SDM in neurocritical care, with implications for practice and further research. The complex role dynamics among SDM stakeholders require careful consideration, highlighting the need for stroke-specific communication strategies. Expanding the evidence base across diverse sociocultural settings is critical to enhance the understanding of SDM in neurocritical patients with stroke.Trial registration This study is registered with PROSPERO under the registration number CRD42023461608.

Assessment of the Validity and Quality of Polycystic Ovarian Syndrome (PCOS) Screening Tools Available for Women Globally: A Systematic Review.

Background: This systematic review has the following aims: (1) to identify measurement tools used globally by healthcare providers to diagnose PCOS in women at elevated risk; (2) to assess the comprehensiveness of these tools regarding mental health and chronic pain; (3) to list strategies for validating, disseminating, and implementing these tools; and (4) to provide future recommendations for experts in healthcare settings. Methods: This review utilized the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and the Arksey and O'Malley York methodology. Studies were sourced from the PubMed, Embase, and Cochrane Library databases, with inclusion criteria focusing on peer-reviewed articles addressing PCOS diagnosis and associated comorbidities. Data extraction and analysis followed the Joanna Briggs Institute (JBI) recommendations. Results: A total of 63 studies met the inclusion criteria. Findings indicate that current screening tools for PCOS often lack comprehensive integration of mental health and chronic pain assessments. Tools like the PCOSQ and its updated version, PCOSQ-50, inadequately address pain-related symptoms, highlighting a gap in holistic patient evaluation. This review identified significant associations between PCOS and mental health disorders, including anxiety and depression, emphasizing the need for mental health screenings as part of PCOS management. Conclusions: There is a critical need for validated PCOS screening tools that encompass both physical and psychological aspects of the condition. Educating healthcare providers on the cultural and social determinants influencing PCOS can improve diagnosis and patient outcomes. Future research should focus on developing holistic screening tools and culturally relevant educational resources, aiming to enhance the overall quality of life for women with PCOS.

Exploring the contribution of carotid artery disease to the onset of non-arteritic ischemic optic neuropathies: A systematic review.

The role of carotid artery disease (CAD) in the development of various types of ocular arterial occlusive disorders has often been reported. This systematic review aims to evaluate and review the current evidence regarding the role of CAD and the subsequent carotid artery hemodynamic alterations in the development of non-arteritic anterior (NA-AION) and posterior (NA-PION) ischemic optic neuropathy. We systematically reviewed studies following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We systematically searched PubMed, Embase, and Scopus databases for relevant studies that clearly assessed the role of CAD and the subsequent carotid artery hemodynamic alterations in the development of NA-AION and NA-PION. All studies that examined the associations between CAD and the development of NA-AION and NA-PION in adults aged 18 years or older were synthesized. Quality assessment using the Newcastle-Ottawa Scale (NOS), and Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports and Case-Series were also conducted. Our search identified 1933 manuscripts published in the English language. The number of participants with non-arteritic ischemic optic neuropathy (NA-ION) ranged from 1 to 191, with a total of 478 patients experiencing either NA-AION (410 out of 478), NA-PION (13 out of 478), or a combination of thereof (1 out of 478). The number of participants with NA-ION due to atherosclerosis ranged from 1 to 191, with a total of 376 patients. Although carotid artery disease may rarely contribute to the development of NA-ION, it should be considered as a possible cause of NA-ION.

Impactos ecológicos, económicos y sociales del sector cacaotero colombiano

Due to its excellent quality, Colombian cocoa has become a product that has made considerable inroads in the national and international market, increasing its demand and the effects inherent to its production practices. This scope review was carried out following the guidelines of the Joanna Briggs Institute (JBI), which allowed the selection of 72 documents, whose information extraction led to the identification and standardization of the economic, ecological and social impacts of the cocoa sector in the different producing cities of Colombia, of which Santander, Antioquia, Arauca, Huila and Tolima stand out since they generate 70 % of the cocoa production at the national level. In the review, a total of 13 social, 25 ecological and 21 economic impacts are clearly observed, which correspond to the most persistent impacts evidenced in the different investigations carried out in this country.

Prevalence and incidence of peripheral neuropathy, peripheral artery disease, foot disease, and lower extremity amputation in people with diabetes in Ireland; a systematic review protocol.

Internationally, the prevalence of diabetes is increasing, and with this comes an increase in diabetes related complications. Diabetic foot disease is the most common lower extremity complication in people with diabetes causing 2% of the global disease burden. It, is associated with major morbidity, mortality, and costs to health services. Despite this burden, the incidence and prevalence of diabetic foot disease is unknown in Ireland. This paper presents a protocol for a systematic review to examine the incidence and prevalence of diabetic foot disease in the Irish population. A systematic review will be performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Pubmed, EMBASE, and Lenus, the Irish Health Research repository, will be searched for publications in any language and without restrictions to date. Title, abstract, and full text screening will be carried out independently by two investigators. Publications reporting on the incidence or prevalence of peripheral neuropathy, peripheral artery disease, ulceration, or amputation in people with diabetes in Ireland, from a defined geographical catchment area of Ireland, will be included. Joanna Briggs Institute (JBI) Critical Appraisal tool will be used to assess included studies methodological quality. Results will be reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. The results of this systematic review can be used to inform appropriate stakeholders on the incidence and prevalence of diabetic foot disease in Irish populations, enabling decision making around appropriate use of resources to help prevent, and improve management of this disease. CRD42023472904.

Determinants of clinical nurses’ patient safety competence: a systematic review protocol

IntroductionPatient safety has become a fundamental element of healthcare quality. However, despite the ongoing efforts of various organisations, patient safety issues remain a problem in the healthcare system. Given the...

A Scoping Review Protocol to Map Knowledge and Attitudes about Patient Safety among Students in Healthcare Undergraduate Courses.

Patient safety is a global challenge in healthcare, with adverse events representing a significant concern. The integration of patient safety education in undergraduate curricula is crucial in developing a culture of safety and safe practices among future professionals. However, there is a gap in research assessing the levels of knowledge and attitudes about patient safety among undergraduate students in healthcare using validated instruments. This scoping review aims to map the levels of knowledge and attitudes about patient safety among students in healthcare courses, allowing for national and international comparisons. The review will follow the methodological frameworks proposed by the Joanna Briggs Institute (JBI) for scoping reviews. The search will include published and unpublished studies in six databases, with no date or language restrictions. This scoping review was prospectively registered with the Open Science Framework on 17 July 2024. This scoping review will provide a comprehensive overview of knowledge and attitudes about patient safety among undergraduate students in healthcare, identifying gaps in patient safety education and areas for improvement in curricula. The results may guide teachers in creating teaching strategies to prepare future healthcare professionals, reducing knowledge gaps and improving the quality of care.

Healthcare Professionals' Knowledge, Attitudes, and Practices in Providing Care to Southeast Asian Immigrants with Cardiometabolic Syndrome: A Scoping Review.

There is a growing emphasis on healthcare professionals' (HCPs) role in managing cardiometabolic risk factors to reduce health disparity for immigrants in developed countries. This scoping review aimed to analyse evidence about HCPs' knowledge, attitudes, and practices (KAP) of managing cardiometabolic risk factors among Southeast Asian (SEA) immigrants in developed countries. Primary studies from inception to July 17, 2023, from four databases: PubMed/Medline, Embase, PsycINFO, and CINAHL were included. This review followed the Joanna Briggs Institute (JBI) scoping review methodology and reported in line with PRISMA-ScR. Of 619 identified studies, seven met the inclusion criteria. All studies discussed HCPs' knowledge, six explored attitudes, and three described practices specific to SEA immigrants. The extracted data were analysed using descriptive qualitative content analysis and classified into barriers and facilitators. Barriers included cultural discordance and acculturation challenges (patient level); gaps in cultural understanding, communication and clinical skills (healthcare team level); limited immigrant-specific resources (organisation level); and funding constraints (environment level). Facilitators included community and provider support (patient level), awareness and desires to provide immigrant-specific care (healthcare team level), availability of culturally appropriate services (organisation level), and multicultural agendas and policies (environment level). The barriers and facilitators faced by HCPs caring for SEA immigrants with cardiometabolic syndromes share similarities with other immigrant groups. Future research focused on co-production involving immigrant patients, their communities, and HCPs in healthcare service design is required to support HCPs in providing culturally appropriate care and promoting health equity regardless of ethnic, cultural, or linguistic backgrounds.

Variations in the Appearance and Interpretation of Interpersonal Eye Contact in Social Categorizations and Psychiatric Populations Worldwide: A Scoping Review with a Critical Appraisal of the Literature.

Eye contact is one of the most fundamental forms of interhuman communication. However, to date, there has been no comprehensive research comparing how eye contact is made and interpreted in all possible populations worldwide. This study presents a summary of the existing literature on these modalities stratified to social categorizations and psychiatric disorders. A scoping review with critical appraisal of the literature according to the Joanna Briggs Institute (JBI) methodology. Databases AnthroSource, Medline, CINAHL, the Psychology and Behavioral Sciences Collection (EBSCO) and PsychInfo were searched. 7068 articles were screened for both the grey literature and reference lists, of which 385 were included, 282 for social categorizations and 103 for psychiatric disorders. In total, 603 thematic clustered outcomes of variations were included. Methodological quality was generally moderate to good. There is a great degree of variation in the presentation and interpretation of eye contact between and within populations. It remains unclear why specific variations occur in populations. Additionally, no gold standard for how eye contact should be used or interpreted emerged from the studies. Further research into the reason for differences in eye contact between and within populations is recommended.

Intention to leave the current health facility among healthcare workers in Ethiopia: Systematic review and meta-analysis.

Strengthening workforce management to address retention challenges is worldwide concern. Ethiopia did different human resource reforms to improve retention and performance of available health workforce to step up towards universal health coverage. However, there is limited and fragmented research on intention to leave their current facility and related factors on health workers. This review was done to assess pooled national prevalence of intention to leave their current health facility and related factors among Ethiopian health workers. This systematic review and meta-analysis followed PRISMA guidelines. Authors prepared a review protocol per Joanna Briggs Institute (JBI) manual for evidence synthesis and got registered from PROSPERO for transparency. The authors conducted a comprehensive search of PubMed, Web of Science, Cochrane, Google Scholar and African Index Medicus databases and grey literature like WHO library from 8 June 2022 to 30 May 2023. Pooled prevalence of intention to leave current health facility and related factors was computed using MedCalk, Meta Essentials and R software. Publication bias was assessed using Egger's test and a funnel plot. Pooled prevalence of intention to leave among health workers in Ethiopian healthcare setting was found to be 63.52% (95% CI (58.606-67.904)) for random effects model at Q = 141.5689 (I2(inconsistency) = 90.82%, P < 0.0001). Only organizational justice OR = 0.29 (0.14-0.61) was found to be a significantly associated factor for health workers' intention to leave their current healthcare setting in Ethiopia. More than 6 in 10 of the health workers in Ethiopia were ready to leave their current healthcare facility. This result was higher than studies done in other parts of the world, even in African countries. The associated factor for health workers' intention to leave their current health facility was only organizational justice. So, health authorities should improve their organizational justice to retain their employees.

A scoping review exploring people's perceptions of healthcare uniforms.

Healthcare staff uniforms are a subject of debate in the UK, and this is particularly true in the case of less understood roles such as advanced nurse practitioners. Aim: This review explores what is known about people's perceptions of health professionals' uniforms. A mixed methods scoping review following the Joanna Briggs Institute (JBI) methodology. Five databases (CINAHL, ASSIA, PsycINFO, and EMBASE) and several search engines were searched. Eligible reports were peer-reviewed English-language studies using any methodology to explore people's perceptions of different uniforms for health professionals. Forty-six studies (mainly from North America) were included, presenting a variety of perspectives on the uniforms worn by doctors, nurses and other health professionals. Culture and context likely influence how uniforms are understood. Practitioners should consider how this may affect communication with both patients and colleagues. What health professionals wear matters, particularly in relation to less well understood roles.

Curriculum Indigenization in oral health professions' education worldwide: A scoping review.

To explore the literature on Indigenous content within the oral health professions' education curricula. This scoping review included all types of literature on oral health care educational programs on Indigenous content, following the JBI (Joanna Briggs Institute) methodology. An initial search using "Indigenous," "education," and "oral health" as keywords informed a full search strategy for MEDLINE, CINAHL, Embase, Scopus, ERIC, EPPI, MedEdPORTAL, Google Scholar, ProQuest Dissertations and Theses Global, Australian Government Department of Health, and Australian Indigenous HealthInfoNet. The search included literature available until November 1, 2023, irrespective of language. Two reviewers independently screened the studies, and data were extracted and presented in tabular and narrative summary formats. A total of 948 records were identified, and 101 studies were chosen for full-text review. Twenty-three studies met the criteria for data extraction. Of all studies, 95.6% were published between 2007 and 2021, mostly from Australia and New Zealand. The most frequently covered content included Indigenous culture, followed by history, Indigenous oral health, and Indigenous Peoples' health. Rural and clinical placements were the most employed delivery methods, and evaluation surveys were the most employed assessment technique. Barriers to delivering an Indigenous curriculum included students' disinterest and limited interaction with Indigenous communities, while facilitators included cultural immersion and supportive mentorship. Despite progress in integrating Indigenous content into oral health education, challenges persist. Prioritizing Indigenous perspectives, community partnerships, and standardized assessment tools is needed. Future research should focus on long-term impacts and best practices for Indigenous curriculum development and delivery.

The activity of different brain regions in fatigued and drowsy drivers: A systematic review based on EEG findings

Introduction: Drowsiness and fatigue during driving is one of the major causes of traffic accidents, morbidity, and mortality in societies. Known electroencephalography (EEG) as a gold standard in fatigue detection, this study aims to determine the alterations in different brain regions in fatigued and drowsy drivers. Methods: The databases PubMed, Scopus, Web of Science, and Embase have been systematically searched for published studies until September 1, 2023. Also, the references of the relevant articles have been searched manually. Reporting the quality assessment of the studies has been done by the Joanna Briggs Institute (JBI) critical appraisal tool for experimental studies. The study purpose was achieved using appropriate statistical methods. Results: Sixty-five eligible studies consisting of 1450 participants were included. The most common age and gender between participants is young males. The majority of the studies were held in high-income countries. Simulated car driving studies are utilized frequently in the studies. Common brain-wave changes seen in various regions include increased alpha in the occipital area (51.7%) and decreased alpha in the frontal region (eight out of eight simulated driving studies), decreased beta in the frontal region (25.8% of driving simulated studies), increased theta in the frontal region (36.2%), and decreased gamma in the central and temporal areas. Delta waves increase throughout the brain in an equal proportion. Conclusion: The occipital alpha increase, frontal beta decrease, frontal theta increase, and central and temporal gamma decrease, are frequent findings among the studies reporting fatigue and drowsiness. Based on the discrepancies and inconsistencies reported in EEG results, the detection of fatigue and drowsiness in the driving task via EEG data should be done with caution.

Spiritual care interventions for palliative care patients: A scoping review.

To identify and map spiritual care interventions to address spiritual needs and alleviate suffering of patients in the context of palliative care. A scoping review using the PRISMA ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist was conducted according to the JBI (Joanna Briggs Institute) guidelines. The search was conducted from October 2022 to January 2023 using 9 electronic databases and gray literature. Studies on spiritual care interventions in palliative care were included. Disagreements between the 2 reviewers were resolved by discussion or a third reviewer. A total of 47 studies were included in this review. All selected articles were published between 2003 and 2022. In total, 8 types of spiritual care interventions were identified to assess spiritual needs and/or alleviate suffering: conversations between the patient and a team member, religious practice interventions, therapeutic presence, guided music therapy, multidisciplinary interventions, guided meditation, art therapy, and combined interventions with multiple components such as music, art, integrative therapy, and reflection. Our study identified few spiritual care interventions in palliative care worldwide. Although this review noted a gradual increase in studies, there is a need to improve the reporting quality of spiritual care interventions, so they can be replicated in other contexts. The different interventions identified in this review can be a contribution to palliative care teams as they provide a basis for what is currently being done internationally to alleviate suffering in palliative care and what can be improved. No patient or public contribution was required to design or undertake this methodological research.

Clinical Effects of Glucagon-Like Peptide-1 Agonist Use for Weight Loss in Women With Polycystic Ovary Syndrome: A Scoping Review.

Glucagon-like peptide-1 (GLP-1) is a gastrointestinal regulatory hormone that stimulates insulin release from the pancreas. While GLP-1 receptor agonists (GLP-1 RAs) have traditionally been utilized to address insulin resistance, their potential application in treating polycystic ovary syndrome (PCOS) has recently garnered attention. This study aimed to investigate the therapeutic efficacy of GLP-1 RAs use for weight loss in women diagnosed with PCOS. We conducted a scoping review following the Joanna Briggs Institute (JBI) methodology and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our investigation delved into the clinical effects experienced by women of diverse racial and ethnic backgrounds with PCOS who were prescribed GLP-1 RAs for weight loss. Peer-reviewed articles from Ovid Medline, Web of Science, CINAHL, Cochrane CENTRAL, SCOPUS, and ClinicalTrials.gov spanning from 2012 to 2023 were scrutinized. After eliminating duplicates, 811 articles were identified, and ultimately, eight met the eligibility criteria for inclusion. All studies were published in English and exhibited wide geographic diversity. The included studies uniformly reported reductions in weight and body mass index (BMI) among patients who were prescribed GLP-1 RAs, specifically liraglutide or exenatide. Additionally, evidence pointed towards improvements in anthropometric parameters (MF1) (including total body weight, BMI, reduction in waist circumference, and total fat percentage), glucose homeostasis, cardiovascular inflammatory markers (midregional pro-atrial natriuretic peptide (MR-proANP) and mid-regional pro-adrenomedullin (MR-proADM)), rates of pregnancy, and menstrual regulation. However, findings regarding the impact of GLP-1 RAs on lipid profiles were inconsistent. Although some short-term adverse effects were noted, long-term effects of GLP-1 RAs use remain undetermined. GLP-1 RA use demonstrated promising clinical outcomes for women with PCOS, including reduced BMI, improved metabolic parameters, menstrual regularity, and increased rates of natural pregnancy. While the current evidence is encouraging, further research is warranted to elucidate both short- and long-term adverse effects of GLP-1 RAtherapy for PCOS.

A systematic review of the conceptualization, interpretation, and implementation of shared governance in post-secondary contexts

ABSTRACT Shared governance has emerged as an incrementally inclusive modification to common Western forms of governance, which are often top-down, bureaucratic, and individualistic in nature. Anti-oppressive movements call for structural changes which necessarily involve examining where and how decisions are made in post-secondary institutions. This systematic literature review synthesizes scholarship on shared governance in post-secondary settings. This research is guided by the Joanna Briggs Institute (JBI) guidelines for conducting systematic reviews, a priori protocol to steer the research process, and the PRISMA guidelines for reporting systematic reviews. A review of 48 empirical papers published in peer-reviewed journals resulted in five main themes for shared governance in higher education: potentially interested parties; characteristics of governing leaders; principles and values of shared governance; processes of shared governance; and models of shared governance. We also identified gaps in the shared governance literature: underrepresentation of community (Indigenous and non-Indigenous) as well as Indigenous and diverse ways of knowing, and lack of attention to the diverse identities within the interested parties. We proceed to propose inclusive governance as a more appropriate term than shared governance.

2304 Models of care and the role of clinical pharmacists in UK primary care for older people: findings from a scoping review

Abstract Introduction Pharmacists have traditionally worked in primary care, in the community, and with GPs. However, the role of the clinical pharmacist in primary care is evolving and there are plans to employ more clinical pharmacists in the NHS. With an ageing UK population, there is an increase in the number of people living with multiple long-term conditions, accompanied by polypharmacy, posing numerous challenges to healthcare systems. This review investigates the evidence about the varied roles and services delivered by clinical pharmacists in primary care, capturing the perspectives of health and care professionals, older adults, and their carers. Method Our scoping review followed the framework for scoping reviews in accordance with the Joanna Briggs Institute (JBI) methodology. A broad search was conducted in 2023 in CINAHL, Cochrane, Medline, SCOPUS, and Web of Science. We included articles that explored the landscape of clinical pharmacy services for older people in the UK, focusing on roles and services delivered, perceptions, and experiences. Results A total of 23 articles was included. These shed light on the multifaceted responsibilities of clinical pharmacists for older people. Stakeholder perspectives, including healthcare professionals and care home staff, emphasise the positive outcomes of clinical pharmacist involvement, from reducing other practitioners’ workloads to improving patient safety. However, communication gaps among the primary care team and those living with dementia, concerns about competence, and the need for clear role definitions of clinical pharmacists emerge as challenges. Conclusions and implications The review enhances our understanding of the clinical pharmacist service in the UK and identifies gaps in research evidence, emphasising the need for empirical studies on the experiences of older people with cognitive impairment and those from minority ethnic backgrounds. The findings can be used for policymaking, workforce planning, and healthcare provision to improve the services for older people in the UK.

Data linkage studies of primary care utilisation after release from prison: a scoping review

BackgroundPrimary care plays a central role in most, if not all, health care systems including the care of vulnerable populations such as people who have been incarcerated. Studies linking incarceration records to health care data can improve understanding about health care access following release from prison. This review maps evidence from data-linkage studies about primary care use after prison release.MethodsThe framework by Arksey and O’Malley and guidance by the Joanna Briggs Institute (JBI) were used in this review. This scoping review followed methods published in a study protocol. Searches were performed (January 2012-March 2023) in MEDLINE, EMBASE and Web of Science Core Collection using key-terms relating to two areas: (i) people who have been incarcerated and (ii) primary care. Using eligibility criteria, two authors independently screened publication titles and abstracts (step 1), and subsequently, screened full text publications (step 2). Discrepancies were resolved with a third author. Two authors independently charted data from included publications. Findings were mapped by methodology, key findings and gaps in research.ResultsThe database searches generated 1,050 publications which were screened by title and abstract. Following this, publications were fully screened (n = 63 reviewer 1 and n = 87 reviewer 2), leading to the inclusion of 17 publications. Among the included studies, primary care use after prison release was variable. Early contact with primary care services after prison release (e.g. first month) was positively associated with an increased health service use, but an investigation found that a large proportion of individuals did not access primary care during the first month. The quality of care was found to be largely inadequate (measured continuity of care) for moderate multimorbidity. There were lower levels of colorectal and breast cancer screening among people released from custody. The review identified studies of enhanced primary care programmes for individuals following release from prison, with studies reporting a reduction in reincarceration and criminal justice system costs.ConclusionsThis review has suggested mixed evidence regarding primary care use after prison release and has highlighted challenges and areas of suboptimal care. Further research has been discussed in relation to the scoping review findings.

Antimicrobial effectiveness and Ag+ release in antimicrobial-modified PMMA: A systematic review

Silver, a long-term ionic release antimicrobial, is incorporated into polymethylmethacrylate (PMMA) in order to reduce bacterial adhesion to polymeric materials and increase the longevity of rehabilitation, given the prevalence of pathologies. The aim was to answer: "What is the correlation between ionic release and antimicrobial activity of acrylic resins incorporated with silver?". The search strategy was applied to the PubMed, ScienceDirect, Embase and Scopus databases. The articles were selected in two phases according to eligibility criteria. The risk of bias was assessed using the quasi experimental studies (non-randomized experimental studies) tool from the Joanna Briggs Institute (JBI). A total of 538 articles were found in the databases, of which 28 were duplicated and were excluded. After first reading, 6 studies were selected for full reading, 5 of which made up this review. Silver was evaluated in different incorporations, which had proven antimicrobial efficacy, given its ionic release. No meta-analysis was carried out due to the heterogeneity of the data. The included studies showed a directly proportional correlation between ionic release and antimicrobial activity in PMMA incorporated with silver-containing agents.

Salivary 8-hydroxy-2′-deoxyguanosine levels in patients with oral cancer: a systematic review and meta-analysis

BackgroundDNA is an important target for oxidative attack and its modification may increase the risk of mutagenesis. The aim of this study was to evaluate and compare salivary levels of the oxidative stress biomarker 8-hydroxy-2′-deoxyguanosine (8-OHdG) in patients with oral cancer (OC) compared to the control group by a comprehensive search of the available literature.MethodsThe present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and was registered in Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/X3YMR. Four electronic databases were used to identify studies for this systematic review: PubMed, Scopus, ScienceDirect, and Web of Science from January 15, 2005, to April 15, 2021. The Joanna Briggs Institute (JBI) tool was used to assess article quality.ResultsOf the 166 articles identified, 130 articles were excluded on the basis of title and abstract screening (duplicates, reviews, etc.). Thirty-six articles were evaluated at full text and 7 articles met the inclusion criteria. Of these, only 5 studies had compatible data for quantitative analysis. An increase in salivary 8-OHdG levels was found in patients with OC compared to healthy subjects, but without statistical significance. 8-OHdG: SMD = 2,72 (95%CI= -0.25–5.70); *p = 0.07.ConclusionsThis systematic review and meta-analysis suggests a clear trend of increased 8-OHdG levels in saliva of OC patients compared to the control group. However, further studies are required to clarify and understand the altered levels of this oxidative stress marker.