Moderate Methodological Quality Research Articles

Greenspace exposure and associated health outcomes: a systematic review of reviews

Background Numerous systematic reviews and meta-analyses have sought to clarify the relationship between greenspace exposure and health outcomes, but the results are inconsistent. We aimed to synthesise all relevant systematic reviews and meta-analyses on this association. Methods We searched five databases (PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and the Cochrane Database of Systematic Reviews) and conducted a manual reference search for systematic reviews and meta-analyses written in English and published in peer-reviewed journals that used clearly defined measures of greenspace exposure and reported health outcomes directly attributable to greenspace exposure. A total of 36 systematic reviews published between January 2010 and December 2020 were identified for inclusion in this systematic review of reviews (PROSPERO: CRD42021227422). An updated review is underway, and the protocol is published in PROSPERO (CRD42022383421). The methodological quality and risk of bias of included systematic reviews were evaluated using the AMSTAR-2 and ROBIS tools, respectively. Results Beneficial effects of greenspace exposure were observed for all-cause and cardiovascular disease mortality, and mental health and cognitive function. Ambivalent results were found for cardiovascular and metabolic health, general health and quality of life (QOL), and respiratory health and allergies. Most of the systematic reviews included in the current umbrella review had a low to moderate methodological quality and a high risk of bias. Conclusions This umbrella review highlights the link between greenspaces and a variety of health outcomes, emphasising the importance of preserving existing greenspaces and integrating additional vegetation into urban areas to maintain public health.

The effects of different types of organisational workplace mental health interventions on mental health and wellbeing in healthcare workers: a systematic review.

To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing. Following PRISMA guidelines, we searched six scientific databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible. We identified 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type "Job and task modifications" and a moderate level of evidence for the types "Flexible work and scheduling" and "Changes in the physical work environment". For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed. Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses.

Can resistance training improve throwing performance in handball players? A Systematic review and meta-analysis

BackgroundThrowing is one of the most important movement in handball. Throwing performance is crucial for success in handball.ObjectiveΤo investigate the level of evidence for the effect of resistance training (RT) on throwing performance in handball players.MethodsSystematic searches of Pubmed, Medline complete, Cinahl, Sport Discus and Scopus were undertaken for peer reviewed articles published between 18 March 1995 to 18 March 2023. Randomized, controlled, clinical studies, written in English, aiming to investigate the effect at least one modality of RT on throwing performance (velocity or/and accuracy) in handball players were considered for inclusion in the study. The eligible studies were assessed for methodological quality using the Physical Therapy Evidence Database (PEDRO) scale. The Best Evidence Synthesis (BES) approach was used for synthesizing and reporting the results. Furthermore, the random-effects model was used for the meta-analysis and the Q-statistic was used to test the null hypothesis that all studies in the analysis share a common effect size.ResultsOne hundred ninety-eight studies were identified, of which 30 were included. A total of 727 handball players (males = 388, females = 292) were included. 28 of the 30 studies were rated as high methodological quality studies (PEDRO score > 70%) while the rest of the studies were rated as moderate methodological quality studies (PEDRO score ≤ 60%). The mean effect size for the effectiveness of resistance training (RT) in improving jumping throw, running throw, and standing throw velocity were 1.128 (95% CI 0.457 – 1.798), 1.756 (95% CI 1.111 – 2.400), and 1.098 (95% CI 0.689 – 1.507) correspondingly. Traditional weight training using barbells in mostly compound lifts yielded the most significant and robust results. Other RT modalities such as elastic bands, medicine balls, core training and ballistic training showed no significant results or positive effects due to the limited number of the studies.ConclusionStrong evidence exists only for the effectiveness of RT using barbells in increasing throwing velocity. In contrast, the remaining RT modalities, while yielding positive results, have limited support due to limited number of studies and the high heterogeneity between studies. Furthermore, there is insufficient evidence to support various forms of RT in increasing throw distance. Finally, medicine ball training and elastic band training demonstrated no benefits in improving throwing accuracy.Trial registrationPROSPERO ID: CRD42023393574.

Work-related musculoskeletal disorders in dockworkers. Systematic review and meta-analysis.

Dockworkers are exposed to physical overloads that can contribute to the development of musculoskeletal disorders, leading to functional disability and absenteeism. to map, critically appraise, and synthesize the available evidence on the prevalence of musculoskeletal diseases associated with port occupational activities. A comprehensive search was conducted in structured and unstructured databases in August 2023, with no date or language restriction, to identify observational studies evaluating the prevalence of musculoskeletal disorders in dockworkers' occupational activity. The risk of bias was assessed using validated tools based on the included study designs. Data from studies were pooled in meta-analyses. The certainty of the evidence was assessed using the GRADE approach. We identified 12 analytical cross-sectional studies involving 7821 participants in ports of five countries. Most studies (75%) had a moderate methodological quality according to the Joanna Briggs Institute tool. Considering the overall worker categories and any musculoskeletal disorders, the meta-analysis showed a prevalence of 58% (95% Confidence Interval [95% CI] 37% to 78%), with degenerative spinal diseases 42% (95% CI -0.6% to 91%) and low back pain 36% (95% CI 21% to 50%) being the most prevalent conditions. Symptoms were predominantly in foremen and stevedores. The certainty of the evidence was very low. Musculoskeletal disorders seem prevalent among dockworkers, mainly degenerative spinal diseases and low back pain. Studies with greater methodological consistency are still needed to validate these hypotheses and assist in decision-making for implementing preventive and informational policies in maritime port management organizations. PROSPERO registry CRD42021257677.

Traditional Chinese medicine for idiopathic membranous nephropathy: A systematic review and meta-analysis

BackgroundIdiopathic membranous nephropathy (IMN) is a rare autoimmune disorder that causes nephrotic syndromes in adults. Conventional immunosuppressive therapies often exhibit limited efficacy in achieving remission and may result in notable adverse reactions, warranting the exploration of novel therapeutic approaches for IMN treatment. Traditional Chinese medicine (TCM), which is extensively used for kidney disease management, is a promising alternative. ObjectiveThis study aimed to examine the safety and efficacy of TCM alone or in combination with Western medicine for the management of patients diagnosed with IMN. MethodsThis study employed a systematic search of English and Chinese electronic databases to identify randomized controlled trials (RCTs) that examined the application of TCM in the treatment of IMN. RCTs that met the predetermined inclusion and exclusion criteria and assessed the safety and efficacy of TCM alone or in combination with Western medicine in patients with IMN were included in the analysis. The methodological quality of the included studies was evaluated by using a risk-of-bias tool. All statistical analyses were performed using the RevMan software (version 5.4.2). The evidence was evaluated on the https://www.gradepro.org/website. ResultsThis study included 29 randomized controlled trials (RCTs) involving 1982 patients with moderate methodological quality that met the inclusion criteria. The results showed that, compared to Western medicine alone therapy, the use of TCM alone or in combination with Western medicine significantly improved total remission (TR) rate (risk ratios [RR] 1.38, 95% confidence interval [CI] 1.29–1.46, I2 = 0%, P < 0.00001), complete remission (CR) rate (RR 1.78, 95% CI 1.48–2.15, I2 = 0, P < 0.00001), partial remission (PR) rate (RR 1.27, 95% CI 1.161.40, I2 = 0%, P < 0.00001), and serum albumin (ALB) levels (MD: 4.05, 95% CI: 3.02–5.09, I2 = 91%, P < 0.00001). TCM alone or in combination with Western medicine also reduced proteinuria levels (mean difference [MD]: 1.05, 95% CI: 1.30 to −0.79, I2 = 95%, P < 0.00001), serum creatinine (SCr) levels (MD: 7.47, 95% CI: 13.70 to −1.24, I2 = 97%, P = 0.02), and serum antibodies against M-type phospholipase A2 receptor levels (aPLA2Rab) (MD: 19.24, 95% CI: 33.56 to −4.93, I2 = 87%, P = 0.008). Moreover, the efficacy of combined TCM and Western medicine is superior to that of Western medicine alone in reducing the incidence of infection, hepatotoxicity, and thrombosis. Although the primary and secondary outcomes were consistent, the evidence was generally moderate. ConclusionThe results of this study suggest that TCM alone or in combination with Western medicine may be a feasible alternative therapeutic approach for the treatment of IMN. Nevertheless, additional, rigorously designed, high-quality, and extensive clinical trials are imperative to provide substantial evidence regarding the effectiveness of TCM in managing IMN.

Non-violent communication as a technology in interpersonal relationships in health work: a scoping review

BackgroundWorking in healthcare environments is highly stressful for most professionals and can trigger problems in interpersonal relationships that can result in horizontal violence. In order to prevent violence and improve the working environment, some strategies can be implemented to provide well-being for all those involved, whether directly or indirectly in health care, such as non-violent communication. The aim of this study was to map and synthesize the available scientific evidence on the use of Nonviolent Communication as a technology for a culture of peace in interpersonal relationships in healthcare.MethodsThis is a scoping review carried out in the National Library of Medicine (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Excerpa Medica DataBASE (Embase), PsycINFO - APA/ PsycNET (American Psychological Association) and Latin American and Caribbean Health Sciences Literature (LILACS) databases between March and August 2023. The eligibility criteria used were studies that addressed the topic of NVC in the area of health, published in Portuguese, Spanish or English, with no time restrictions.Results53 studies were found in the databases. Two additional studies were extracted from of primary research. In the first exclusion phase, 16 texts were removed due to being duplicated. 39 articles were potentially relevant, and full-texts were reviewed for eligibility along with the inclusion and exclusion criteria Thus, seven studies were included in this review, published in English (five) and Portuguese (two), two of which were carried out in Brazil, one in the United States of America, one in South Korea, one in France, one in Canada and one in Thailand. In terms of the type of study/publication, two studies were reflections, one was a review, one was a mixed study, one was an experience report and two were experimental. The studies were predominantly of high and moderate methodological quality (85.7%). The total number of participants in the studies was 185. The studies showed that NVC is a technology that has made it possible to improve interpersonal relationships between health professionals. Training programs or educational intervention projects on the subject are useful for familiarizing professionals with the subject and demonstrating situations in which the technique can be included.ConclusionThe global scientific literature indicates that Nonviolent Communication is a significant resource for improving interpersonal relationships in healthcare work. This approach can be adopted as a strategy by managers and decision-makers, both to resolve conflicts and to prevent aggressive situations between health professionals, especially when it comes to moral or psychological aspects.

Platelet-rich Plasma Superiority over Hyaluronic Acid as a Conservative Treatment for Early Knee Osteoarthritis: A Systematic Review

AIM:This study aimed to perform a systematic review (SR) of SR to elucidate prior findings regarding favorable outcomes between platelet-rich plasma (PRP) and hyaluronic acid (HA) injections for early knee osteoarthritis (KOA). MATERIALS AND METHODS: We conducted a thorough literature search adhering to the Preferred Reporting Items for SR and Meta-analyses only for SRs from PubMed, ScienceDirect, and Google Scholar from 2020 to 2023. The inclusion and exclusion criteria were determined using the population, intervention, comparison, outcome, and study design model. A measurement tool to assess SR-2 was used to grade the included SRs. Two researchers independently searched, extracted, and assessed the risk of bias in the included studies. Cohen’s kappa coefficient was used to calculate the inter-observer disparities in study eligibility and risk of bias. The corrected covered area (CCA) metric addressed the overlap issue with the original studies. RESULTS: One SR yielded high methodological quality whereas three SRs yielded moderate methodological quality. The overall CCA among the four SRs was 30.77%, and all SRs used the Western Ontario and McMaster Universities Osteoarthritis Index score as a patient-reported outcome (PRO) and revealed that the PRP group improved more than the HA group. One SR used the Tegner score as a PRO and found no distinction between the PRP and HA groups. The incidence of substantial pain was lower in the PRP group than in the HA group. One SR reported considerably lower local pain post-injection in the HA groups. Overall, three SRs showed that PRP yielded better outcomes than the HA, and one showed that PRP showed advantages over HA injections for knee pain at 6 and 12 months; however, the clinical outcomes were not different. CONCLUSION: Our findings supported the superiority of PRP over HA as a long-term alternative therapy for early-stage KOA.

The Evidence for the Use of Osteobiologics in Hybrid Constructs (Anterior Cervical Discectomy and Fusion and Total Disc Replacement) in Multilevel Cervical Degenerative Disc Disease: A Systematic Review.

Systematic review. Examine the clinical evidence for the use of osteobiologics in hybrid surgery (combined anterior cervical discectomy and fusion (ACDF) and total disc replacement (TDR)) in patients with multilevel cervical degenerative disc disease (DDD). PubMed and Embase were searched between January 2000 and August 2020. Clinical studies investigating 18-80 year old patients with multilevel cervical DDD who underwent hybrid surgery with or without the use of osteobiologics were considered eligible. Two reviewers independently screened and assessed the identified articles. The methodological index for non-randomized studies (MINORS) tool and the risk of bias (RoB 2.0) assessment tool were used to assess risk of bias. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to evaluate quality of evidence across studies per outcome. Eleven studies were included. A decrease in cervical range of motion was observed in most studies for both the hybrid surgery and the control groups consisting of stand-alone ACDF or TDR. Fusion rates of 70-100% were reported in both the hybrid surgery and control groups consisting of stand-alone ACDF. The hybrid surgery group performed better or comparable to the control group in terms of adjacent segment degeneration. Studies reported an improvement in visual analogue scale for pain and neck disability index values after surgery compared to preoperative scores for both treatment groups. The included studies had moderate methodological quality. There is insufficient evidence for assessing the use of osteobiologics in multilevel hybrid surgery and additional high quality and controlled research is deemed essential.

Feasibility and effectiveness of communication tools for addressing intimacy and sexuality in patients with cancer: a systematic review

PurposePatients diagnosed with cancer might experience changes in intimacy and sexuality due to the illness itself, treatment, or psychological and social factors. Healthcare professionals (HCPs) often feel reluctant to discuss these changes. This study aimed to provide an overview of the feasibility and effectiveness of communication tools that support communication regarding changes in intimacy or sexuality among patients with cancer.MethodsThis is a systematic review. Databases are PubMed, Embase, CINAHL, PsycInfo, Web of Science and Cochrane Library from inception to June 2023. The Mixed Methods Appraisal Tool was used to assess included studies. Data were summarized in data charting forms.ResultsIn total 35 studies were included, published between 2001 and 2023. Most had a quantitative design and moderate methodological quality. In 11 studies, the PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy) was used. Tools were integrated in counselling sessions or training programmes for individual patients, couples, groups of patients, or HCPs. All tools were considered feasible by patients or HCPs. Twenty studies reported significant improvement in sexual functioning, quality of life, quality of care or combined outcomes.ConclusionTools to support communication about changes in intimacy and sexuality among patients with cancer seem feasible and effective. The most commonly used tool, the PLISSIT model, proved to be feasible for HCPs and to have a positive effect on patients’ and partners’ sexual functioning and quality of life. Giving attention to changes in intimacy and sexuality seems to be important in itself, regardless of the communication tool or approach used.

Outcome of Core Stability Exercises versus General Exercises in Improving Function and Pain Levels in Chronic Low Back Pain: Systematic Review of Randomized Clinical Trials

Core muscles (lumbo-pelvic region) instability influences the lumbo-pelvic control, an imperative precipitating factor for Chronic Low Back Pain (CLBP), leading to appreciable activity limitations and participation restrictions. This systematic review of randomized clinical trials (RCTs) aims to explore the efficacy of core stability exercises (CSEs) compared with general exercises (GEs) in improving the function and pain among individuals with CLBP. The RCTs evaluating CSEs and GEs in people with CLBP were searched in Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica Database (EMBASE), Clinical Index of Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), The Cochrane Central Register of Controlled Trials (CENTRAL), Google scholar, and PubMed from January 1992 to July 2019. The primary outcomes were pain and disability that were measured using validated pain and disability instruments, respectively. Two of the five RCTs were of high methodological quality (PEDro score; 7-8/10), while the remaining three RCTs were of moderate methodological quality (PEDro score; 5-6/10). Lack of blinding was the major methodological concern of the included studies. Only three studies supported that CSEs was more effective than GEs, while remaining two studies demonstrated that CSEs and GEs were equally effective in reducing pain and disability in CLBP. The CSEs in CLBP is more effective in treating pain and disability compared with GEs. However, evidence don't strongly support CSEs as an optimal therapeutic choice for the patients with CLBP, hence more comprehensive systematic reviews and meta-analyses are warranted.

Early pregnancy bleeding after assisted reproductive technology: a systematic review and secondary data analysis from 320 patients undergoing hormone replacement therapy frozen embryo transfer.

Early pregnancy bleeding after assisted reproductive technology: a systematic review and secondary data analysis from 320 patients undergoing hormone replacement therapy frozen embryo transfer.

A systematic review of nonpharmacological interventions to reduce procedural anxiety among patients undergoing radiation therapy for cancer.

The primary objective was to assess the efficacy of nonpharmacological interventions delivered to adults with cancer, in the radiation oncology department, just prior to, or during radiation therapy, in reducing levels of self-reported procedural anxiety. The secondary objectives were to assess the efficacy of these interventions in reducing physiological symptoms of procedural anxiety and anxiety-related treatment disruptions. Systematic review. Electronic databases (MEDLINE, CINAHL, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials) were searched from inception up until February 2022. Population: Adult patients with cancer undergoing external beam radiation therapy. Nonpharmacological interventions delivered within the radiation therapy department. Comparison: standard care controls, or standard care plus an alternative intervention. level of self-reported procedural anxiety (primary), physiological symptoms of anxiety (secondary) and measures of anxiety-related treatment disruptions (secondary). Two reviewers independently extracted data. A meta-analysis was originally planned but deemed not feasible as the studies could not be confidently pooled for meta-analysis, due to the variability in the interventions, study designs and the generally low number of studies. Therefore, a narrative synthesis is presented. Screening of 2363 records identified nine studies that met inclusion criteria: six studies of music interventions, two of video-based patient education and one of aromatherapy. Overall, three studies received a global rating of strong methodological quality and low risk of bias. Three studies reported a significant effect of the intervention on reducing the primary outcome of self-reported procedural anxiety: two music interventions (both strong methodological quality), and one video-based patient education (moderate methodological quality). One of the studies (a music intervention) also reported a significant reduction in the secondary outcome of physiological symptoms of procedural anxiety (systolic blood pressure). The evidence for nonpharmacological interventions delivered to adults with cancer just prior to, or during radiation therapy, in reducing levels of self-reported procedural anxiety is limited, with very few well-designed studies. There is a need for interventions for procedural anxiety during radiation therapy to be evaluated through rigorous randomised controlled trials.

Spaced Retrieval Effects on Learning Capacity in Patients With Mild-to-Moderate Cognitive Impairment

Abstract: Spaced retrieval (SR) improves the learning capacity of patients with memory deficits, while evidence on its long-term and generalization to other untrained measures is quite inconsistent. This systematic review was to analyze evidence on the SR effectiveness on recall performance, follow-up, and generalization measures in patients with cognitive impairment. A systematic search on PUBMED, MEDLINE, Web of Science, PubPsych, and ProQuest was performed between November 2020 and January 2021. The benefit effect of SR on direct, generalization, and long-term measures did not significantly differ from other learning techniques and the effect sizes even increased when SR was combined with another method. Effects on generalization depended on the similarity between the trained and untrained material. Existing evidence on SR remains quite scarce, mainly based on studies with moderate methodological quality giving rise to very heterogeneous results. Further investigation is still needed to overcome previous methodological limits and extend evidence to the immediate and long-term effects of the simultaneous application of different learning methods.

Schistosomiasis, soil-transmitted helminthiases and sanitation in Latin America and the Caribbean: a systematic reviewRelación entre la prevalencia de esquistosomiasis y geohelmintiasis y las condiciones sanitarias en América Latina y el Caribe: una revisión sistemática

To investigate the relationship between the prevalence of schistosomiasis and soil-transmitted helminthiasis with variables related to access to water, sanitation and solid waste in Latin American and Caribbean (LAC) countries. A systematic review was performed in the LILACS, PubMed, Web of Science, and SciELO databases. Studies published between 1950 and August 2021, with an ecological design and a focus on population groups (states, municipalities and/or districts), having the prevalence of infection by Schistosoma mansoni, Ancylostoma sp., Necator americanus, Ascaris lumbricoides or Trichuris trichiura as primary variable and access to water, sewage and/or solid waste as explanatory variables were included. Open access articles with full text available in English, Spanish, or Portuguese were considered. The risk of bias and the quality of the studies were assessed according to the Joanna Briggs Institute manual. Of 2 714 articles, nine were eligible, published between 1994 and 2021 and covering 22 LAC countries and 14 350 municipalities. All articles had moderate methodological quality. Environmental variables indicated an association between water supply and solid waste collection with schistosomiasis; water supply with ascariasis, trichuriasis and hookworm; and sewage with ascariasis and hookworm. Except for one article, which had regional coverage for LAC, all the others were developed in Brazil. There is a clear need to expand research on the association between household and collective health conditions and parasitic diseases for all endemic countries in LAC to support environmental strategies to control these diseases.

Association between thyroid stimulating hormone levels and papillary thyroid cancer risk: A meta-analysis.

High thyroid stimulating hormone (TSH) levels may stimulate papillary thyroid cancer (PTC) cell proliferation; however, the relationship between TSH levels and PTC risk remains controversial. We aim to ascertain the association through a meta-analysis. Literature searches were conducted in PubMed, Embase, and Web of Science databases. After literature screening, the methodological quality was assessed using the Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality methods. Cochran's Q and I 2 tests were used to evaluate heterogeneity in the meta-analysis. Egger's test was applied to assess publication bias. A total of 12 eligible studies were included in this meta-analysis; all were of moderate and high methodological quality. The pooled results suggested that increased TSH levels were significantly associated with PTC risk; however, the included studies were significantly heterogeneous. Stratification analysis indicated that the heterogeneity might be from the area or type of control. Although significant publication bias existed among the studies, the trim-and-fill method and sensitivity analysis revealed that the combined results were stable and robust. TSH levels are significantly associated with the PTC risk; however, more high-quality studies in large sample sizes are recommended to verify the extrapolation of these findings.

A systematic review evaluating the effectiveness of exercise training on physical condition in prostate cancer patients undergoing androgen deprivation therapy.

Androgen deprivation therapy (ADT) is an effective prostate cancer (PCa) treatment strategy that can curb the development or progression of the disease. This review aimed to examine and summarize available systematic reviews/meta-analyses (SRs/MAs) of exercise training on physical condition of PCa patients undergoing ADT. A comprehensive search of 8 databases was conducted for relevant literature published before April 25, 2022 with the language restrictions of Chinese and English. Two reviewers independently assessed the methodological quality, risk of bias, reporting quality, and evidence quality of the included SRs/MAs using a range of evaluation tools, including A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE). This review included 8 SRs/MAs which included a total of 94 studies. Ultimately, A total of 51 outcomes was included, regarding 11 different outcome categories. The AMSTAR-2 tool showed that 3 SRs/MAs had moderate methodological quality, 4 SRs/MAs had very low quality, and the remaining 1 had low quality. According to the ROBIS scale, 3 SRs/MAs had a high risk of bias. The PRISMA checklist showed that the primary reporting faults were protocol registration and funding source. The GRADE system was used to analyze the evidence quality of the 51 outcomes, and no high-quality evidence was found. However, moderate-quality evidence indicated that exercise training may improve body composition [by lowering body fat mass (BFM) and body fat rate (BFR)], muscular strength, and quality of life (QoL) in PCa patients undergoing ADT. Low-quality evidence demonstrated that exercise training could improve such symptoms as fatigue, depression, sexual function, and cardiometabolic changes. Available evidence suggests that exercise training may be used as an adjuvant treatment for PCa patients undergoing ADT to improve several aspects of general health. Studies with more rigorous designs and larger sample sizes are needed to support our findings with more robust evidence.

Effects of the pilates method on the pelvic floor muscles: a systematic review

Background: Among the methods used by physiotherapists for strengthening and controlling the pelvic floor muscles, Pilates method can be mentioned. Although recent studies have investigated the effects of the method on urinary incontinence, no recent systematic literature reviews on the subject have been found. Objectives: To conduct a systematic literature review demonstrating the effects of the Pilates method on urinary incontinence.. Methods: A search was conducted in the databases MEDLINE, Scielo, LILACS, and PEDro, supplemented by a manual search. The search terms included the descriptors: urinary incontinence, Pilates method, pelvic floor strengthening, as well as these terms in English. The studies were analyzed by two independent evaluators, with no language or publication date restrictions. The methodological quality of the studies was evaluated using the PEDro scale. Results: Seven articles met the inclusion criteria and were included in this systematic review. Overall, the studies showed that there are significant results in the use of the Pilates method for urinary incontinence and pelvic floor muscle function, as well as improvements in quality of life. However, compared to conventional physiotherapy, the Pilates method is not superior, as both are effective interventions for the treatment of urinary incontinence. Conclusion: Although the Pilates method appears to be an effective intervention for the pelvic floor muscles and, consequently, improves urinary incontinence, this method is not superior to specific conventional physiotherapy targeting this musculature. However, these conclusions are based on only seven studies with low to moderate methodological quality.

Models of pre-registration student supervision in allied health: a scoping review

Introduction: The aim of this scoping review was to identify, organise and synthesise existing evidence in relation to the supervision of allied health students on clinical placement.Methods: Five databases were searched for peer reviewed articles published from 2000 onwards. Data were extracted and analysed according to approaches to supervision, and student and/or educator outcomes for different models used. Each outcome was aligned to modified Kirkpatrick levels of evaluation.Results: 39 articles were reviewed. The terms models and approaches were poorly defined and used interchangeably in the clinical placement literature. Studies varied in the methods employed and were typically of low to moderate methodological quality with a dominance of Kirkpatrick level 2a outcomes reported.Conclusions: This review has proposed a definition of supervision models to enable future research comparisons between models and to provide clarity to placement providers’ decision making. Overall evidence for reported outcomes is mixed and not strong enough to draw conclusions in favour of any one model. Approaches to supervision, not student ratio, may well be the catalyst for positive outcomes for all stakeholders and therefore should be the focus of future research.

Scientific studies on Krav Maga: state of the art

This study aimed to analyze and synthesize the main concepts about Krav Maga in the last four decades. This is a review of the academic literature with a qualitative approach and a narrative nature. The searched databases are PubMed/Medline, Scopus, Web of Science, SciELO, Index Medicus, Capes Platform, ProQuest Digital Dissertations, Brazilian Digital Library of Theses and Dissertations (BDTD) and Google Scholar, between the years 1982 and 2022. Empirical studies with cross-sectional, longitudinal, case, control and randomized design were included, and books and private websites were excluded. The textual corpus was processed by the IRaMuTeQ software. Forty-four studies met the eligibility criteria, of which eighteen conceptualized Krav Maga as “self-defense”, twelve as “fighting”, seven as “hand-to-hand combat”, four as “self-defense art”, three as “cultural heritage” and immaterial” and another as a “hybrid system”. The main aspects evoked and addressed in the research were: Operational and Military, Historical, Pedagogical, Psychosocial and Physiological. Most studies had low to moderate methodological quality, indicating the need for greater control of biases in future research. In addition, it was evidenced that Krav Maga is a system, or method developed for self-defense, however, it is a polysemic term, and cannot be understood in a uniform and linear way.

Depression after stoma surgery: a systematic review and meta-analysis

BackgroundDepression is the leading cause of global disability and can develop following the change in body image and functional capacity associated with stoma surgery. However, reported prevalence across the literature is unknown. Accordingly, we performed a systematic review and meta-analysis aiming to characterise depressive symptoms after stoma surgery and potential predictive factors.MethodsPubMed/MEDLINE, Embase, CINAHL and Cochrane Library were searched from respective database inception to 6 March 2023 for studies reporting rates of depressive symptoms after stoma surgery. Risk of bias was assessed using the Downs and Black checklist for non-randomised studies of interventions (NRSIs), and Cochrane RoB2 tool for randomised controlled trials (RCTs). Meta-analysis incorporated meta-regressions and a random-effects model. Registration: PROSPERO, CRD42021262345.ResultsFrom 5,742 records, 68 studies were included. According to Downs and Black checklist, the 65 NRSIs were of low to moderate methodological quality. According to Cochrane RoB2, the three RCTs ranged from low risk of bias to some concerns of bias. Thirty-eight studies reported rates of depressive symptoms after stoma surgery as a proportion of the respective study populations, and from these, the median rate across all timepoints was 42.9% 42.9% (IQR: 24.2–58.9%). Pooled scores for respective validated depression measures (Hospital Anxiety and Depression Score (HADS), Beck Depression Inventory (BDI), and Patient Health Questionnaire-9 (PHQ-9)) across studies reporting those scores were below clinical thresholds for major depressive disorder according to severity criteria of the respective scores. In the three studies that used the HADS to compare non-stoma versus stoma surgical populations, depressive symptoms were 58% less frequent in non-stoma populations. Region (Asia–Pacific; Europe; Middle East/Africa; North America) was significantly associated with postoperative depressive symptoms (p = 0.002), whereas age (p = 0.592) and sex (p = 0.069) were not.ConclusionsDepressive symptoms occur in almost half of stoma surgery patients, which is higher than the general population, and many inflammatory bowel disease and colorectal cancer populations outlined in the literature. However, validated measures suggest this is mostly at a level of clinical severity below major depressive disorder. Stoma patient outcomes and postoperative psychosocial adjustment may be enhanced by increased psychological evaluation and care in the perioperative period.