Original Intervention Studies Research Articles

Use of Surface Electromyography to Evaluate Effects of Therapeutic Methods on Masticatory Muscle Activity in Patients with Temporomandibular Disorders: A Narrative Review

The presented narrative review aims to present the impact of therapeutic methods on the masticatory muscle activity measured using surface electromyography (sEMG) in patients with temporomandibular disorders (TMDs). Original interventional studies with baseline data for diagnosed TMD groups with full-text articles in English published in scientific journals in the last ten years were included in the evaluation process. The following narrative review considered only clinical, controlled, and randomized studies. Articles that included the following parameters were qualified for this review: adult participants, diagnosis of temporomandibular disorder, the presence of a musculoskeletal dysfunction, no other severe comorbidities, use of therapeutic interventions, and sEMG measurement before and after the intervention. Ten papers were accepted and analyzed for the final evaluation in the presented review. Several studies using surface electromyographic examination prove the effectiveness of various therapies to normalize the bioelectrical activity of the masticatory muscles, either reduction during rest or increase during a functional task in patients diagnosed with temporomandibular disorders. This narrative review shows the influence of manual and physical treatments on electromyographic masticatory muscle activity, including soft tissue mobilization, transcutaneous electrical nerve stimulation, low-level laser therapy, and moist heat therapy. Changes in masticatory muscle activity coincided with changes in TMD-associated pain and range of mandibular mobility.

Efficacy of differential reinforcement of other behaviors therapy for tic disorder: a meta-analysis

IntroductionRecently, studies on behavioral tic suppression techniques have gained popularity as opposed to pharmacological alternatives that often have potentially dangerous side effects. Differential Reinforcement of Other Behaviors therapy (DRO) is one such behavioral technique whose efficacy in tic suppression has been experimentally demonstrated albeit in studies with very few patients, and lacking statistical power. Here, we conducted a meta-analysis of these studies to improve their overall power and explore whether DRO intervention is really effective for tic suppression.Materials and methodsPubMed, Embase, PsycINFO, and Cochrane Library were searched from inception to August 30, 2023. Only original interventional studies that examined the efficacy of DRO for tic suppression were included.ResultsA total of 8 no control interventional studies involving 79 children with tic disorders were recruited. Most of the children had moderate tic severity. The pooled mean Yale Global Tic Severity Scale (YGTSS) score was 24.64 (95% CI: 21.99 – 30.12, p = < 0.00001, I2 = 87%). In terms of efficacy of the DRO technique for tic suppression, the results showed that DRO was effective in reducing tic frequency among the children. The pooled standardized mean difference (SMD) was -10.25 (95% CI: -14.71 – -5.79, p = < 0.00001) with I2 = 94%.ConclusionIn conclusion, this study revealed that DRO is potentially an effective tic suppression technique for temporarily managing tic disorder. It also showed that DRO could be employed for both moderate and severe tic disorders. However, the technique bears crucial limitations that limit its implementation outside of experimental settings. More studies are needed to address these limitations and improve its applicability in the real world.

Digital games for rehabilitation of speech disorders: A scoping review.

Digital games are among the treatment methods for speech disorders that serve purposes other than mere entertainment. These games have been used for different speech disorders at any age. This study aims to review articles that have used digital games for rehabilitating speech disorders. This study was a scoping review. PubMed, Scopus, and Web of Science were searched on February 28, 2022, to access the articles on digital games used in rehabilitation of speech disorders without any date restrictions. The search strategy was as follows: ("video game [MeSH term]" OR "computer game" OR "mobile game" OR "serious game" OR gamification [MeSH term]) AND ("speech pathology" OR "speech therapy [MeSH term]" OR "speech disorder [MeSH term]" OR stuttering [MeSH term]). Original interventional and observational studies in English were included. The data were extracted from the relevant articles, including the first author's name, year of publication, country, target group, participants, mobile device/computer-based, type of game design, language level, number of sessions, and outcome. Descriptive statistics were used to analyze the data. Of 693 retrieved articles, 10 articles were included in this study. Digital games were used for different speech disorders such as apraxia (20%), dysarthria (10%), articulatory hypokinesia in Parkinson's disease (10%), dysphonic disorder (10%), hearing disability (10%), phonological impairment (10%), and speech disorder in autism (10%). Most of the articles (60%) used a mobile device-based game. Phonemes (30%), words (30%), and sentences (20%) were the most frequently used language levels in designing digital games. All the reviewed articles reported the positive effect of digital games on speech and the patients' motivation in therapy. Digital games can improve patients' speech and motivation in therapy. Although studies showed the positive impact of digital games on speech disorders, personalized speech therapy should be considered in designing these games.

The Effectiveness and Safety of Acupuncture on Suicidal Behavior: A Systematic Review.

In situations where death by suicide is a major global issue and effective prevention and management approaches are lacking, acupuncture improves some risk factors for suicide, including depression, and it has been used for a long time in clinical settings. Herein, we aimed to assess the effectiveness and safety of acupuncture in the treatment of suicidal behaviors. Fourteen electronic databases were searched for studies published up to 7 September 2022. Original interventional studies of acupuncture in suicide prevention were included. The primary outcome was the validated measure of suicidal ideation. The risk of bias in the included studies was assessed using an appropriate assessment tool. Due to the heterogeneity of the included studies, only qualitative analyses were conducted. Eight studies on manual acupuncture (50%), electro-acupuncture (37.5%), and acupressure (12.5%) were included. In particular, three studies (37.5%) used the National Acupuncture Detoxification Association protocol to stimulate the bilateral sympathetic, Shenmen, kidney, liver, and lung auricular points. Acupuncture was effective in direct and indirect outcomes related to suicidal behavior, not only for participants with suicidal behavior, but also for those with other conditions, including depression. A decrease in salivary cortisol was the only biological indicator of acupuncture in patients with suicidal ideation. However, the methodological quality of the included studies was not optimal. In conclusion, acupuncture may reduce the risk of suicidal behavior in clinical and non-clinical populations. Owing to clinical heterogeneity, low methodological quality, and the small number of included studies, further high-quality studies should assess the effectiveness of acupuncture.

Effect of digital health, biomarker feedback and nurse or midwife-led counselling interventions to assist pregnant smokers quit: a systematic review and meta-analysis

ObjectiveTo assess the effect of digital health (DH), biomarker feedback (BF) and nurse or midwife-led counselling (NoMC) interventions on abstinence in pregnant smokers during pregnancy and postpartum.SettingsAny healthcare setting servicing...

Visual learning strategies for oral health promotion and treatment interventions in children and adolescents with hearing impairment - A systematic review.

People with hearing impairment (HI) prefer visual learning strategies in daily activities owing to their reliance on vision. The aim of this systematic review is to evaluate the effectiveness of visual learning as a communication strategy in improving oral hygiene and dental care of children and adolescents with HI. Four electronic databases were searched and complemented by hand searching for original intervention studies published till December 2021. Eligible studies were screened, data was extracted as per priori data collection form and analyzed by thematic content analysis. The quality of studies was assessed as per the validated tools appropriate for study designs including ROB2, ROBINS-I, and NIH quality assessment tool. Out of 4159 records identified and 1302 duplicates removed, 24 original studies were identified and the visual learning strategies were classified into sign language, visual aids with or without sign language, customized educational demonstrations and the interim role of training the teachers. These strategies helped in improving oral hygiene status, oral health-related knowledge and attitude as well as dental anxiety during treatment. Participants were found to be satisfied with these strategies, however, significant heterogeneity in the included studies precluded meaningful meta-analysis. ROB2 and ROBINS were rated as high and serious in all included trials, respectively, and NIH Quality Assessment Tool for Pre-Post Studies With No Control as fair in five studies and poor in three. Our findings emphasize the significance of visual learning, however, long-term rigorously designed trials are needed to better understand effective and patient-centered communication methods for people with HI.

Application of Roy’s Adaptation Model in Clinical Nursing: A Systematic Review

Background: Adaptation is a process in which a person is actively involved for a period of time and uses different strategies. Roy’s adaptation model sees individuals as an adaptive system in a stable interaction with internal and external environment; therefore, they constantly change and try to adapt. When the individual does not make the desired adaptation and hence ineffective responses, nurses learn about it. The present study aimed to systematically review the studies conducted in Iran on the Roy’s adaptation model.&#x0D; Methods: This is a systematic review study, and it has been done purposefully by focusing on research purpose. A computerized search was performed systematically with no time limitation till October 2021, by using keywords: Roy’s adaptation model, Nursing and Iran in Web of Sciences, PubMed, Scopus, Google Scholar, IranDoc, SID and Magiran databases. The articles were evaluated using the Consort checklist. A total of 235 articles were found, and the systematic review of the articles was performed based on PRISMA. Finally, full text of 34 suitable articles were selected and analyzed after several steps of evaluation.&#x0D; Results: Out of the reviewed articles, 23.52% were published in international journals in English and 76.47% were published in Iranian journals in Persian and English. All the articles were original researches and intervention studies that 5.88, 47.05, 41.17, and 5.88% of them were experimental, quasi-experimental, clinical trial, and randomized controlled trials, respectively. Also, in all the studies pre-test and post-test were used, 5.88, 88.23, and 5.88% of them utilized random, availability, and block sampling, respectively.&#x0D; Conclusion: Application of care program based on the Roy’s adaptation model increased physical and psychological adaptive (healthy) behaviors in patients with chronic diseases, which might improve the patients’ psychological adaptation to the disease, proper disease control, reduction of complications, and quality of nursing care.

Application of cinnarizine in migraine prevention: A systematic review and meta-analysis.

To investigate and analyze the available data on the prophylactic effectiveness of cinnarizine in migraine disorder. Cinnarizine has demonstrated encouraging potential in preventing the attacks of migraine. Therefore, we opted to evaluate whether its sole administration leads to positive outcomes. The PubMed, Scopus, Web of Science, and Embase databases were searched for English-only original interventional studies published until April 2022, then screened for relevancy and eligibility. The resulting data from the included studies, including the primary (ie, headache episode frequency, intensity, duration, monthly timing, and analgesic intake frequency) and secondary (ie, reported adverse events, quality of life, and activities of daily living) outcome changes compared to placebo and active controls (e.g., sodium valproate and propranolol) were then recorded by two independent assessors. Ultimately, these data were synthesized qualitatively and quantitatively (achieved by determining the mean difference via the random-effects model). A total of 10 studies comprising seven randomized controlled trials and three quasi-experimental studies were included. Compared to placebo, cinnarizine demonstrated significant improvements in migraine episode frequency (Mean difference=-3.10; Confidence interval=[-3.33, -2.88]; p-value < 0.001; I2 < 0.001%), and intensity (Mean difference=-1.54; Confidence interval=[-2.08, -0.99]; p-value < 0.001; I2 < 37.97%). Moreover, cinnarizine led to similar or better results when compared to active controls, including sodium valproate, topiramate, and propranolol. Cinnarizine can be considered a safe and effective medication for migraine prophylaxis. However, the relatively small sample size made reaching a definite conclusion impossible. Therefore, a higher number of randomized controlled trials are recommended to be taken place to clarify the situation further.

Latent change modeling of Latino parent–child conflict and pathways to mental health

AbstractObjectiveThis secondary analysis of longitudinal data on Latino immigrant parents applied latent change modeling to investigate the association between within‐family change in parent–child conflict and within‐individual change in parent's psychological distress, and how within‐individual change in parenting stress mediates that association over time.BackgroundImmigrant parents face additional challenges when parenting their children. There is limited research regarding how parent–child conflict may influence parenting stress and parents' overall well‐being, in particular in Latino immigrant families.MethodSecondary analysis was conducted on data from a sample of 344 Latino immigrant parents who participated in a community‐based parenting skills invention. In the original intervention study, they were assigned randomly to intervention or waitlist control groups and assessed at three points: baseline, 4 months (post‐intervention), and a follow‐up 10 months after the baseline assessment.ResultsAcross 4 months, change in parent–child conflict was significantly associated with changes in parenting stress and psychological distress, whereas across 10 months, change in parent–child conflict was only associated with change in psychological distress. The indirect effects through parenting stress were non‐significant. However, participating in the intervention had a protective indirect effect by reducing parenting stress across 4 months and reducing psychological distress across 10 months via change in parent–child conflict.ConclusionChanges in parent–child relations were related to changes in parents' individual well‐being, with those associations varying across different time periods.

Assessment of Challenging Behavior Exhibited by People with Intellectual and Developmental Disabilities: A Systematic Review.

The assessment of challenging behavior exhibited by people with intellectual and developmental disabilities is essential for the planning of prevention and intervention programs. This review aimed to identify and analyze the standardized instruments that exclusively focus on the assessment of challenging behavior. We identified and organized 141 articles into four categories: original instrument studies, validation studies, relational studies, and intervention studies. The results identified 24 instruments that generally show high-quality psychometric properties and other utilities beyond the observation of the presence of challenging behavior and diagnostic categorization. Age, level of adaptive behavior, disability, presence of autism spectrum disorder, and medication are some of the variables that were found to be possibly related to the occurrence of challenging behavior. Additionally, the results suggest that interventions focused on supporting positive behavior or providing training on behavior to professionals and caregivers significantly reduced the occurrence of these behaviors. Instruments that help us to understand and measure the challenging behavior exhibited by people with intellectual and developmental disabilities are essential for the design of effective evaluation and intervention protocols.

Interventions with physical activity counseling for adults without diagnosed diseases - a systematic review

Counseling interventions have been broadly used to modify the level of physical activity in the population. The scope of this study was to conduct a systematic review on physical activity counseling interventions. Original intervention studies with physical activity counseling as an outcome were included and published between January 2010 and April 2020 in the Medline/PubMed, BVS, and Scielo databases, in English and Portuguese, with an adult population without diagnosed diseases. Methodological quality was assessed using the PEDro scale. We found 2,152 articles and after screening, eight manuscripts remained, writtem in seven countries. Regarding the evaluation of the quality of the work, the scores vary between 4/10 and 8/10 on the PEDro scale. The measures with counseling for PA, lasted one month and were effective in seven of the eight selected studies. The studies use the following forms of counseling: calls, SMS, cell phone apps, face-to-face counseling, e-mail, materials posted on websites, handouts, booklets and telegrams. The results of this review showed that counseling for PA practice increases the PA level of healthy adults, irrespective of the heterogeneity of methods.

Non-small cell lung cancer with EGFR exon 20 insertion mutation: a systematic literature review and pooled analysis of patient outcomes

Introduction EGFR exon 20 insertion mutation-positive non-small cell lung cancer (NSCLC) is rare, has a poor prognosis, and outcomes are not fully established. We describe and evaluate outcomes from real-world and clinical evidence in these patients. Methods: A systematic literature review (SLR) identified interventional and real-world evidence (RWE) studies reporting clinical outcomes for EGFR exon 20 insertion mutation-positive NSCLC. Meta-analyses were conducted by line of therapy to synthesize pooled survival and response outcomes across RWE. Published evidence from interventional studies was summarized individually. Results: The SLR identified 23 RWE and 19 original interventional studies. In the meta-analysis of RWE, pooled response and survival outcomes were low for first-line EGFR-tyrosine kinase inhibitors (TKIs) and immuno-oncology (IO) agents. First-line chemotherapy resulted in a pooled ORR 25.7%, pooled PFS 5.6 months, and pooled OS 18.3 months. Pooled outcomes were further reduced in second or later lines (≥2L): pooled ORR was 5.0%, 3.3%, and 13.9%; pooled PFS was 2.1 months, 2.3 months, and 4.4 months; and pooled OS was 14.1 months, 8.8 months, and 17.1 months (not a pooled result) for EGFR-TKIs, IO agents, and chemotherapy, respectively. Interventional studies reported outcomes for TKIs (mobocertinib, poziotinib, osimertinib, afatinib, CLN-081, DZD9008), a monoclonal antibody (amivantamab), and a heat shock protein 90 inhibitor (luminespib). While there is limited RWE for the recently approved agents mobocertinib and amivantamab, which specifically target exon 20 insertion mutations, interventional evidence supports their potential as effective treatment options. Conclusions: Conventional treatments used in patients with EGFR exon 20 insertion mutation-positive NSCLC have limited efficacy, though chemotherapy appeared to be associated with better response and survival outcomes than non-exon 20 targeting EGFR-TKIs and IO agents. This supports the need to identify EGFR exon 20 insertion mutations as the availability of new targeted treatments may offer additional therapeutic options to these patients.

Interventions to support parents who use methamphetamine: A narrative systematic review

Substance misuse can have a negative impact on parenting. For children, having a parent who misuses substances can lead to physical, mental health and social challenges. Parents who use methamphetamine are less likely to have co-resident children than parents who use other substances so it is important to consider how we support these parents, particularly those with children in their care. The aim of this review was to identify, critique and synthesise interventions that support parents who use methamphetamine and who are caring for children. Three original empirical intervention studies involving parents as primary caregivers of children under 18 years of age were found: two postnatal interventions and one group-training intervention for parents with young children. The findings suggest that interventions may have a positive effect on minimising methamphetamine use and supporting parenting but the small number of studies reviewed suggest the evidence is, at best, emerging. It is not clear whether efforts should be directed to support parents and/or their parenting skills and what effect these might have on children’s outcomes. Further research is needed to identify the most effective approaches to supporting this population.

Hazards of phthalate exposure on fish reproduction – a review

Phthalates (diesters of phthalic acid) are widely used as plasticizers and additives in many consumer products. Laboratory animal studies have reported the endocrine-disrupting and reproductive effects of phthalates and human exposure to this class of chemicals is a concern. Several phthalates including DEHP, BBP, DBP and etc. have been recognized as substances of high concern. This study aims to systematically review the literature on effects of exposure to phthalates including ovarian effects, testicular effects, effects on reproductive hormonal level as well as gene level and effects on breeding performances in fishes. Related literature search was done through Scopus, Google Scholar, Pub-Med and the reference lists of previous review articles to identify relevant articles published in each subject area. The inclusion criteria were original research, cross-sectional studies, case-control studies, interventional studies and review articles. The search was limited to English language papers. Finally, this review paper provides all current information on the hazards of various phthalate exposures on fish reproduction. The available data demonstrate that phthalate exposure is associated with reproductive disorders in both male and female fishes. Exposure of phthalates causes alteration in reproductive gene expression level as well hormonal level, changes in gamete quality parameters and also has impacts on spawning performances in both sexes.

The Effect of Physician Communication on Inpatient Satisfaction.

(1) Background: The importance of physician-patient communication and its effect on patient satisfaction has become a hot topic and has been studied from various aspects in recent years. However, there is a lack of systematic reviews to integrate recent research findings into patient satisfaction studies with physician communication. Therefore, this study aims to systematically examine physician communication’s effect on patient satisfaction in public hospitals. (2) Methods: Using a keywords search, data was collected from five databases for the papers published until October 2021. Original studies, observational studies, intervention studies, cross-sectional studies, cohort studies, experimental studies, and qualitative studies published in English, peer-reviewed research, and inpatients who communicated with the physician in a hospital met the inclusion criteria. (3) Results: Overall, 11 studies met the inclusion criteria from the 4810 articles found in the database. Physicians and organizations can influence two determinants of inpatient satisfaction in physician communication. Determinants of patient satisfaction that physicians influence consist of amounts of time spent with the patient, verbal and nonverbal indirect interpersonal communication, and understanding the demands of patients. The organization can improve patient satisfaction with physician communication by the organization’s availability of interpreter service and physician workload. Physicians’ communication with inpatients can affect patient satisfaction with hospital services. (4) Conclusions: To improve patient satisfaction with physician communication, physicians and organizational determinants must be considered.

Telemedicine for Patients with Schizophrenia: A Systematic Literature Review on Applications and Outcomes

Context: Schizophrenia is one of the most severe mental disorders that affect all aspects of a patient's lives. Telemedicine can be helpful for this population. Objectives: This study aimed to review the studies for investigating the applications and outcomes of telemedicine in providing healthcare services for patients with schizophrenia. Evidence Acquisition: We searched PubMed and Scopus databases to find relevant studies in July 2020. The combination of two “Schizophrenia” AND “Telemedicine” keywords were used to search databases. Original observational and interventional studies, which have used a telemedicine service in schizophrenia disease, were included in this review. Results: Of 309 gathered studies, 26 studies were entered into this research. The synchronous modality (58%) and videoconference communication (38.5%) were used in most studies. Most studies (84.5%) have shown that telemedicine was a beneficial method. More than half of the studies (58%) had therapeutic goals. The rest of the studies were for diagnostic (19%), educational (11.5%), and both therapeutic and educational (11.5%) purposes. Only one study (4%) showed that telemedicine was not cost-effective. In nine studies (34.5%), users were satisfied with the use of telemedicine services. Conclusions: Telemedicine is a useful method for the management of patients with schizophrenia, especially to improve treatment adherence and prevent relapse. It would be better to pay more attention to the educational issues because of the positive impact on adherence to treatment and prevent relapse.

The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review

IntroductionDiet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and...

Determining a safe upper limit of oxygen supplementation for adult patients: a systematic review

ObjectiveThis systematic review aimed to describe the connection between the inspired oxygen fraction and pulmonary complications in adult patients, with the objective of determining a safe upper limit of oxygen...

Programas de intervención a través de Internet para la reducción de peso en adultos con sobrepeso y obesidad: una revisión sistemática

Introducción: el auge de la tecnología ha posibilitado el desarrollo de programas vía Internet para abordar el problema de la obesidad, como apoyo complementario a programas presenciales. El presente estudio evalúa la evidencia sobre programas vía Internet realizados en personas adultas con sobrepeso y obesidad, analizando los recursos y componentes principales de las intervenciones. Material y métodos: Se realizó una revisión sistemática en las bases de datos Web of Science y Scopus. Se seleccionaron estudios de intervención en línea para la reducción de peso en población adulta. Bajo los lineamientos PRISMA, se analizó la información extrayendo datos de autoría, año de publicación, diseño del estudio, duración de la intervención, variables para evaluar la eficacia y resultados. Resultados: Se analizaron 21 artículos, mismos que reportan diferencias significativas en peso tras intervención en línea contrastados con modalidades presenciales o grupos control. Los programas enfatizan cambios en dieta, incremento de actividad física, auto monitoreo, fijación de metas y disponibilidad de redes sociales como variables que garantizan eficacia. La retroalimentación por parte de profesionales y las redes de apoyo parecen ser cruciales para la adherencia y el logro de reducciones de peso significativas. Conclusiones: El aprovechamiento de la tecnología puede ser un aliado que lleve a cambios significativos en el peso de personas que viven con sobrepeso u obesidad.

Effectiveness of ongoing face-to-face anti-tobacco intervention in children with asthma.

Background: Interventions to help parents quit smoking may yield important benefits for children with asthma. Children's exposure to environmental tobacco smoke can be measured by reporting of an adult in the household and testing the child's biomarker, e.g., cotinine. Objective: The aim of the study was to assess the effectiveness of "face-to-face" intervention carried out since 2016 in families with children diagnosed with asthma 3 years after beginning the anti-tobacco intervention. Methods: This study was a follow-up to an interventional study that assessed the effectiveness of direct patient education versus educational leaflets alone about parental tobacco smoking. The patients with asthma (ages 4-17 years) enrolled in our original intervention study conducted in 2016 were under the care of the allergy outpatient clinic. The active group was individually educated about the harmful effects of environmental tobacco smoke on their children. The control group included patients and parents, among whom only leaflets were distributed. After 3 years of ongoing intervention, in patients from both groups, exposure to tobacco smoking was evaluated with a questionnaire addressed to parents and/or caregivers and measurement of cotinine in children's urine. The forced expiratory volume in the first second of expiration and fractional exhaled nitric oxide levels were measured. Results: Seventy participants completed the study: 37 in the active group and 33 in the control group. In the active group, 27% of the parents quit smoking entirely compared with 9.4% of parents in the control group. In the group of active intervention, a significant decrease in the cotinine level (p < 0 .001) and the number of cigarettes smoked daily were observed (p < 0.001) 3 years after the active intervention compared with values right after the intervention. In the control group, there were no significant changes in the above-mentioned parameters. Conclusion: "Face-to-face" intervention among families with smokers were effective and lowered cotinine levels in children with asthma and the number of cigarettes smoked assessed 3 years after the intervention.