Primary Research Studies Research Articles

The Health Needs of Sexual and Gender Minority Migrant Women in the United States: A Scoping Review.

Purpose: This scoping review characterizes the peer-reviewed evidence on the health of first-generation sexual and gender minority (SGM) migrant women to the United States and identifies research gaps and future priorities. Methods: On February 1, 2022, the following databases were searched: PubMed (MEDLINE), Embase, CINAHL Plus with Full Text, APA PsycINFO, and PAIS Index. Primary research studies based in the United States, in English, on first-generation SGM migrants (i.e., immigrants, refugees, asylum seekers) were included. Gray literature and review articles were excluded. Health outcome data were not extracted from nonbinary populations nor transgender men. Themes were generated using qualitative content analysis. Results: Thirty-three studies were reviewed, most were qualitative, and 11 focused on transgender women migrants (especially from Latin America), while only one was exclusively on sexual minority women (SMW) migrants. Premigration experiences of violence and discrimination were linked to high prevalence rates of post-traumatic stress disorder, depression, and anxiety. Postmigration stressors included lack of educational and employment opportunities, reduced access to social services, and experiences of stigma and discrimination, which were also associated with the development of depressive symptoms. Transgender women migrants reported not seeking formal medical care, given a lack of gender-affirming services and insurance resulting in reliance on unsafe informal care networks for hormone therapy and feminization procedures. Conclusion: Future interventions should focus on fostering social support networks of SGM migrant women to help improve their mental health outcomes. Research priorities should include studies on SMW migrants and more quantitative research that could identify additional health needs (i.e., sexual health) of SGM migrant women.

Practices and Perceptions of Community Pharmacists in the Management of Atopic Dermatitis: A Systematic Review and Thematic Synthesis.

Understanding the contributions of community pharmacists as first-line health providers is important to the management of atopic dermatitis, though little is known about their contribution. A systematic review was carried out to examine practices and perceptions of the role of community pharmacists. A literature search was conducted in five different databases. Full-text primary research studies, which involved practices and perceptions of the role of community pharmacists in the management of atopic dermatitis, previously published in peer reviewed journals were used. Critical appraisal of included studies was performed using the Mixed Methods Appraisal Tool. Data were extracted and thematically synthesized to generate descriptive and analytical themes. The confidence of the findings of the included studies was assessed via either GRADE or CERQual. Twenty-three studies were included. Findings showed that community pharmacists lacked knowledge of the uses of topical corticosteroids. The recommendations of other treatments were limited. Pharmacists generally undertook dermatology training after graduation. Analytical themes indicated that the practices of community pharmacists were poor and misled patients. Inappropriate education in initial training was identified as a potential reason for their poor practices. This systematic review reveals a gap between patients' needs in practice and dermatological education provided to community pharmacists. Novel approaches regarding education and training should be explored to improve pharmacists' dermatological knowledge and skills.

Current management of fluid balance in critically ill patients with acute kidney injury: A scoping review

ObjectiveThe overall objective of this scoping review is to assess the extent of the literature related to the fluid management of critically ill patients with acute kidney injury (AKI). IntroductionAKI is common in critically ill patients where fluid therapy is a mainstay of treatment. An association between fluid balance (FB) and adverse patient-centred outcomes in critically ill patients with AKI regardless of severity has been demonstrated. The evidence for the prospective intervention of FB and its impact on outcomes is unknown. Inclusion criteriaAll studies investigating FB in patients with AKI admitted to an intensive care unit were included. Literature not related to FB in the critically ill patient with AKI population was excluded. MethodsWe searched MEDLINE, EMBASE, and CINAHL from January 1st, 2012, onwards. We included primary research studies, experimental and observational, recruiting adult participants admitted to an intensive care unit who had an AKI. We extracted data on study and patient characteristics, as well as FB, renal-based outcomes, and patient-centred outcomes. Two reviewers independently screened citations for eligible studies and performed data extraction. ResultsOf the 13,767 studies reviewed, 22 met the inclusion criteria. Two studies examined manipulation of fluid input, 18 studies assessed enhancing fluid removal, and two studies applied a restrictive fluid protocol. Sixteen studies examined patients receiving renal replacement therapy, five studies included non–renal replacement therapy patients, and one study included both. Current evidence is broad with varied approaches to managing fluid input and fluid removal. The studies did not demonstrate a consensus approach for any aspect of the fluid management of critically ill patients. There was a limited application of a restrictive fluid protocol with no conclusions possible. ConclusionsThe current body of evidence for the management of FB in critically ill patients with AKI is limited in nature. The current quality of evidence is unable to guide current clinical practice. The key outcome of this review is to highlight areas for future research.

Effectiveness of Osteopathic Manipulative Treatment in Treating Symptoms of Irritable Bowel Syndrome: A Literature Review.

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects a patient for their entire life. Effective treatments for IBS are scarce, leading to an increased interest in alternative treatmentssuch as osteopathic manipulative treatment (OMT). OMT uses hands-on treatment to reduce pain through various methods. By focusing on visceral techniques, OMT can restore autonomic homeostasis and increase lymphatic flow. This literature review aims to investigate the efficacy of visceral OMT in reducing the severity of IBS symptoms. Five primary research studies were evaluated in this analysis. The concluding results show that visceral OMT effectively reduces the symptoms of IBS and improves patients' quality of life. Therefore, OMT should be considered an alternative therapy for treating IBS.

Public health intelligence challenges for local public health authorities responding to disease outbreaks: a mixed-methods systematic review protocol.

Information management capacity is crucial for controlling risks from health emergencies. But little is known about how sub-national public health bodies overcome public health intelligence challenges when responding to disease outbreaks. This paper describes a protocol for a mixed-methods systematic review to fill this knowledge gap. In addition to describing the evidence base and characterising public health intelligence responses, it will explore reported facilitators and barriers to response. Research on sub-national Public Health Intelligence disease outbreak responses will be synthesised. The review will be limited to articles published in English, during or after 2019. Key electronic databases will be searched for peer-reviewed, primary research studies. Two reviewers will independently screen articles for relevance. Articles that refer to a public health intelligence response to a propagated disease outbreak by a sub-national Public Health Authority will be included. Quality assessment of included articles will be undertaken using published tools. Data integration will be by the Pillar Integration Process (PIP). This review will describe and synthesise the recent literature on sub-national Public Health Authorities' responses to propagated disease outbreaks. The systematic design will limit bias and the inclusion of data from quantitative, qualitative and mixed-methods studies will ensure relevant evidence is considered regardless of the methodology used to produce it. The review is part of a larger research project which aims to explore the role of sub-national public health intelligence during the COVID-19 pandemic and investigate how public health intelligence preparedness could be improved in the future. This could provide information to support the development of training, preparedness indicators and/or ways of implementing directives. CRD42022308042 (08/02/2022).

Is Apical Root Resorption Greater When Using Clear Aligners as Compared to Conventional Fixed Appliances in Adult Patients Following Orthodontic Treatment? A literature Review

Background: Apical root resorption has been identified as a potential risk/adverse effect of conventional orthodontic treatment, however, with changing dental demand and increasing patient preference for clear aligners therapy, the availability of evidence-based information on its incidence/severity following treatment with either clear aligners or fixed appliance is of relevance to clinical practice in providing guidance on orthodontic treatment risk to patients and therefore contributing to the process of obtaining valid informed consent. Objectives: The aim of this study is to undertake a literature review to establish whether apical root resorption following orthodontic treatment is greater in adult patients treated with clear aligners as compared to conventional fixed appliances, to analyse and appraise the data, to make appropriate recommendations relevant to orthodontic practice and is widely referenced by orthodontists. Search Methods: A systematic literature search of three databases (Medline, Embase, Web of science), Google scholar and a hand search of relevant journals was done. Selection Criteria: Primary research studies high in the hierarchy of evidence that investigated/compared apical root resorption following extraction/non-extraction based orthodontic treatment with fixed appliance or clear aligners in adult patients equal to or greater than 18 years between January 2010 and December 2021 were selected for this systematic review. Data Collection and Analysis: Studies were accessed, duplicates eliminated, data extracted with the use of a customized data extraction form, and quality assessed using a critical appraisals skills programme tool. Results: A total of 67 studies were identified, and after the elimination of duplicates and quality assessment, six studies were selected for review. The Cochrane Rob 2 bias tool was used to assess the risk of bias of the selected studies. Apical root resorption prevalence/severity was measured using two different radiographic methods: 3-Dimesional (CBCT-scan) and 2-Dimensional (panoramic/periapical radiographs). Conclusions: The majority of the studies showed that the severity/prevalence of apical root resorption is less in clear aligners compared to fixed appliance treated patients, however, they are characterized by different baseline malocclusion/treatment duration/modalities, study design flaw, inconsistency in outcome measurement/calculation. Due to these limitations, it is difficult to arrive at a conclusion and make recommendations applicable to everyday clinical practice. The clinician should take into consideration factors that increase the risk of apical root resorption such as genetic predisposition, treatment duration, force application (types and location), types of tooth movement, initial malocclusion and extraction/ non-extraction-based treatment in deciding on the orthodontic treatment option and gaining patient consent.Limitations: The current evidence has a number of limitations including the lack of robust prospective studies on apical root resorption, different methods of outcome measurement and calculation, different baseline malocclusions, the evaluation of apical root resorption in only one treatment modality and short treatment duration which may influence the validity of the study conclusions. A meta-analysis could not be performed due to the heterogeneous outcome recording methods. Further research is recommended

Toward a holistic approach to EdTech effectiveness: Lessons from Covid-19 research in Bangladesh, Ghana, Kenya, Pakistan, and Sierra Leone

During school closures prompted by the Covid-19 pandemic, educational technology (EdTech) was often used to continue educational provision. In this article, we consider EdTech effectiveness using a holistic framework, and synthesise findings from 10 primary research studies of EdTech interventions conducted in low- and middle-income countries during the pandemic. The framework includes five main lenses: learning outcomes, enhancing equity, implementation context, cost and affordability, and alignment and scale. While in-person schooling has largely resumed, there continues to be further integration of EdTech into education systems globally. This analysis provides evidence-based insights and highlights knowledge gaps to shape holistic analysis of both EdTech mainstreaming and future research into the effective use of EdTech to strengthen learning.

Towards a More Critical Public Health Understanding of Vaccine Hesitancy: Key Insights from a Decade of Research.

Vaccine hesitancy has gained renewed attention as an important public health concern worldwide. Against this backdrop, over the last decade, we have conducted various qualitative, social science studies with the broad shared aim of better understanding this complex phenomenon. This has included various Cochrane systematic reviews of qualitative research globally, systematic reviews of qualitative research in Africa, and primary research studies in South Africa. These studies have also explored vaccine hesitancy for various vaccines, including routine childhood vaccination, HPV vaccination and other routine vaccinations for adolescents, and, most recently, COVID-19 vaccination. In this reflective and critical commentary piece we reflect on seven key overarching insights we feel we have gained about this complex phenomenon from the varying studies we have conducted over the past decade. These insights comprise the following: (1) the relationship between vaccine knowledge and hesitancy is complex and may operate in multiple directions; (2) vaccine hesitancy is driven by multiple socio-political forces; (3) vaccine hesitancy may be many things, rather than a single phenomenon; (4) vaccine hesitancy may be an ongoing 'process', rather than a fixed 'stance'; (5) vaccine hesitancy may sometimes be about a 'striving', rather than a 'resisting'; (6) 'distrust' as a driver of vaccine hesitancy needs to be better contextualized and disaggregated; and (7) the 'demand-side' versus 'supply/access-side' distinction of the drivers of suboptimal vaccination may be misleading and unhelpful. In unpacking these insights, we problematize some of the common assumptions within the vaccine hesitancy literature and flag topics that we think could benefit from further scrutiny and debate. Our hope is that this can provide a platform for further engagement on these issues and ultimately contribute towards fostering a more critical public health understanding of vaccine hesitancy.

Pharmacokinetic Drug-Drug Interactions: A Systematic Review of the Cytochrome P450 (CYP) Isoenzyme 3A4

The cytochrome P450 (CYP) isoenzyme 3A4 or CYP3A4 is a major drug-metabolizing enzyme that has the potential to cause pharmacokinetic drug-drug interactions. Primary research studies have demonstrated CYP3A4-mediated drug-drug interactions through a variety of mechanisms. However, there has been no review during the last 10 years of pharmacokinetic drug-drug interactions mediated by CYP3A4 isoenzymes. It is necessary to systematically review the pharmacokinetic drug-drug interactions mediated by CYP3A4. Source review of articles were retrieved from the PubMed and Scopus databases. The preparation of keywords through the population, intervention, comparison, and outcomes (PICO) method written based on the Boolean operator. Reporting the results of the paper search is presented in the Prisma version 1 2020 flowchart. The risk of bias assessment used COHORT tools and Systematic Review Center for Laboratory Animal Experimentation (SYRCLE) tools. Data was analyzed narratively. Pharmacokinetic drug interactions are mediated by CYP3A4 through the mechanism of induction, activation, inhibition, and inactivation. Induction or activation of CYP3A4 can cause an increase in CYP3A4 expression, so that the drug is metabolized more quickly and has the potential to lose drug efficacy. Inhibition and inactivation of CYP3A4 causes plasma drug levels to increase and drug elimination time to last longer. CYP3A4 plays a major role in the bioactivation of drugs that cause hepatotoxicity through the formation of reactive metabolites. The use of drugs needs to be monitored to avoid pharmacokinetic drug interactions.

Intravenous chloral hydrate anesthesia provides appropriate analgesia for surgical interventions in male Sprague-Dawley rats.

The use of chloral hydrate as a sole maintenance anesthetic agent in rodent research has been controversial due to statements made in reference literature conflicting with results of primary research studies regarding its analgesic efficacy, and because of its associated tissue damage when administered intraperitoneally. Our aim was to assess the analgesic efficacy of chloral hydrate using an intravenous (i.v.) route of administration, in order to prevent the local tissue irritation or ileus that has been previously reported using intraperitoneal (i.p.) routes. We measured tail withdrawal latencies to a nociceptive thermal stimulus (infrared beam) in Sprague-Dawley rats-first when awake (unanesthetized), and then subsequently during i.v. chloral hydrate anesthesia. During anesthesia we also measured ongoing heart and respiration rates. Withdrawal latencies during chloral hydrate anesthesia were significantly higher, and often maximal, indicating a robust analgesic effect. Importantly, both respiration and heart rate remained unchanged following exposure to the nociceptive stimulus, and were comparable to values observed under other anesthetics and during natural sleep. Together with previous studies, these results demonstrate that i.v. chloral hydrate provides excellent anesthetic depth and analgesic efficacy for surgical manipulations in rats.

Authenticity and Inauthenticity in Adolescents: A Scoping Review

AbstractIn everyday life, adolescents’ authenticity and inauthenticity (sense of, and being, the real me/true self; or false self/not the real me) are assumed to be general indicators of their psychosocial health as they navigate developmental processes of identity exploration and relational connectedness on their way to adulthood. Authenticity is important for psychological thriving in adolescents and inauthenticity is considered maladaptive, but there was no broad and systematic evidence-based resource on the topic. Therefore, this scoping review maps: (1) how authenticity and inauthenticity in adolescents (12–18 years old) have been understood, defined, and characterized; (2) what is known about authenticity and inauthenticity; (3) contexts authenticity and inauthenticity have been explored in; and (4) methodological approaches utilized. This review followed a pre-registered protocol (2852 records identified; 39 peer-reviewed primary research studies included). The review revealed authenticity and inauthenticity are typically: characterized as dispositional, involving thoughts, feelings, awareness, and a sense of being one’s true self or a false self; investigated quantitatively; and contextualized in close social relationships (parents, friends, classmates). Authenticity and inauthenticity outcomes included friendship quality, wellbeing, self-esteem, depressive symptoms, internet addiction, and moral disengagement. Adolescents’ authenticity generally increases over time and social support is very important for that process. Adolescents can be more authentic if parents facilitate adolescents’ increasing independence and support role experimentation. Future research should target state (here-and-now) authenticity, as a critical finding was that autonomy satisfaction has an immediate and positive influence on adolescents’ state authenticity, which implies people interacting with adolescents can promptly boost their capacity for positive psychological development.

467-P: Reinterventions after Abdominal Aortic Aneurysm Repair in People with Diabetes Mellitus—A Systematic Review and Meta-analysis

Background: There is a known negative association between diabetes (DM) and abdominal aortic aneurysm (AAA). Patients with DM have a higher long-term mortality following AAA repair. However, whether that is related to their AAA is unclear. Aims: To determine the rates of reinterventions in patients with DM post-AAA repair. Outcomes included; AAA sac enlargement, reinterventions, endoleaks, AAA rupture, and conversion. Methods: Pubmed, Embase and Cochrane databases were searched for primary research studies between 2005 and 2022 according to PRISMA guidelines. Patients undergoing AAA repair either via endovascular aneurysm repair or open surgical repair were included. Meta-analysis was conducted using Review Manager. Results: Eight studies were identified totalling 75678 patients in the control group, and 22284 in the DM group. Patients with DM had a lower rate of reintervention compared to the control group, (6.63% v 9.15%; OR 0.80, 95%CI[0.67, 0.94], P=0.007). There was no significant difference in rate of all endoleaks (8.54% v 12.38%; OR 0.91, 95%CI[0.53-1.58], P=0.74), which remained non-significantly in favour of DM when comparing type 1 and 2 separately, with similar results with sac expansion. There was a significant reduction in rates of conversion to open surgery in those with DM (3.07% v 4.21%; OR 0.75, 95%CI[0.55-0.99], P=0.04), and a reduction in post op AAA rupture (3.35% v 5.69%; OR 0.53, 95%CI[0.49-0.58], P<0.001). Conclusion: Postoperative AAA ruptures, reinterventions, and conversion to open surgery were lower in patients with DM. However, the rates of endoleaks were not significantly different, so the reason for higher complication rates remains unknown. Disclosure K.Dhatariya: Other Relationship; Novo Nordisk, AstraZeneca, Boehringer-Ingelheim, Eli Lilly and Company. E.A.A.Otify: None. M.A.E.Mekki: None. P.W.Stather: None.

The Selected Effects Embedded from Illegal Occupation and Theft of Medicinal Plants: A Systematic Study on Rural Areas of Limpopo Province

The aim of this study explore the selected effects of illegal occupation and theft of medicinal plants, focusing on Limpopo Province rural areas. Notably, these plants can be used for primary health care and food purposes, amongst others. This stemmed from the associated selective effects imposed on availability of these plants by illegal occupation in the ‘traditional herbal medicine’ and related theft by local people. As a result, the depletion of these plants is negatively witnessed due to illegal occupation and theft. From a qualitative standpoint, this study used the non-empirical research design: Systematic review. Keywords were used to obtain relevant information on this subject, using non-probability: Purposefully sampling. The analysed grey literature and primary research studies from peer-reviewed and published databases were restricted to 1987-2021 [Not in order of sequence nor importance], while exercising the exclusion and inclusion criteria throughout this process. The collected data was analysed using the inductive Textual Content Analysis (TCA) method. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Critical Appraisal Skill Programme (CASP) were employed to ensure trustworthiness of the findings of this study. The results of this study reveals that illegal occupation in the traditional herbal medicine market and theft of medicinal plants drastically affect their availability, as some of the local illegal traders seem to be lacking adequate conservation methods to minimise unfortunate current depletions. Notable studies on illegal occupation and theft of these plants strongly indicates that their trading can endanger these plants, leading to extinctions. For recommendations, this study can be used as a framework to educate relevant stakeholders and to create awareness on the associated effects of illegal occupation and theft of medicinal plants. In addition, Law Enforcement Agencies (LEA) deterrent strategies should be urgently applied when necessary.

Exploring Cybercrime: An Emerging Phenomenon and Associated Challenges in Africa

This study traces the emergence, highlights the trends, strategies and associated challenges of policing cybercrime in Africa. The researcher also displayed the evolving complexities and escalations of related criminal activities. This qualitative study employed a non-empirical research design: Systematic review methodology to analyse grey literature and primary research studies peer-reviewed and published, restricted from 2002-2021, with non-sequential preference adoption considered. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Critical Appraisal Skill Programme (CASP) were employed to ensure the trustworthiness of the findings of this study based on reviewed conventional and seminal literature studies on this subject. This study revealed that for a long time in Africa, this crime existed and remains uncoded; however, relevant stakeholders paid limited attention in terms of offering strategies to effectively prevent, combat and investigate this crime, while the documented nature, effects and effects were at maximum scale. Moreover, the associated challenges for policing cybercrime in Africa are currently uncontrollable, as this crime is presently rising beyond unacceptable levels in the cited African countries. The opportunistic organised criminal networks are taking advantage of these existing loopholes. This study concludes and recommends that African countries should realise the importance of efficiently responding to this scourge in the affected countries, the envisaged strategies should be geared towards the African landscape, within a larger global context, while strongly introducing the use of technological advances and improvements, among others. This can aid in the correct usage of computers; staging of the database system; proper facilitation of cybercrime trends; and, surveillance, to eradicate increasing incidences of this crime in African countries. The relevant stakeholders should have access to, and share, information, irrespective of African geographical locations.

Reference accuracy of primary studies published in peer-reviewed scholarly journals: A scoping review

Objective. The objective of this scoping review was to identify key characteristics of primary research studies in peer-reviewed journals about reference accuracy. Characteristics of studies include the publication year, field of study, journal name and publication year of verified references, number of references verified, reference elements examined, definition of major, intermediate, and minor errors, whether punctuation or typographical errors were counted, overall error rate, major, intermediate, and minor error rates, and most common error type. Introduction. Reference accuracy has been studied across several decades and remains a persistent issue in peer-reviewed publications. Reference accuracy is typically reported as an error rate that represents the proportion of references with at least one error. Inclusion criteria for this scoping review included primary studies published in peer-reviewed journals that verified references in articles. Methods. Library, Information Science and Technology Abstracts (LISTA), Medline via EBSCOhost, and Web of Science were searched with final searches conducted in all three databases on November 26, 2022. No grey literature sources were searched given the focus of the project on peer-reviewed scholarly journals. Results. A total of 105 studies were included. The overall error rate across all studies was 32.7%. The error rates within specific fields of study were relatively similar. There is a lack of clarity about whether studies counted punctuation or typographical errors. The most common error was related to author names. Conclusions. There is a lack of studies to understand the most effective means to increase reference accuracy that are feasible to implement on a wide scale. Future research is warranted to understand how best to improve reference accuracy across fields of study.

Evidence-Based Guidelines for the Management of Allergic Bronchopulmonary Aspergillosis (ABPA) in Children and Adolescents with Asthma.

Allergic bronchopulmonary aspergillosis (ABPA) frequently complicates asthma. There is urgent need to develop evidence-based guidelines for the management of ABPA in children. The Evidence Based Guideline Development Group (EBGDG) of the Indian Academy of Pediatrics (IAP) National Respiratory Chapter (NRC) addressed this need. The EBGDG shortlisted clinical questions relevant to the management of ABPA in asthma. For each question, the EBGDG undertook a systematic, step-wise evidence search for existing guidelines, followed by systematic reviews, followed by primary research studies. The evidence was collated, critically appraised, and synthesized. The EBGDG worked through the Evidence to Decision (EtD) framework, to formulate recommendations, using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Seven clinical questions were prioritized, and the following recommendations formulated. (1) Children with poorly controlled asthma should be investigated for ABPA (conditional recommendation, moderate certainty of evidence). (2) Low dose steroid therapy regimen (0.5mg/kg/d for the first 2 wk, followed by a progressive tapering) is preferable to higher dose regimens (conditional recommendation, very low certainty of evidence). (3) Oral steroid regimens longer than 16 wk (including tapering), should not be used (conditional recommendation, very low certainty of evidence). (4) Antifungals may or may not be added to steroid therapy as the evidence was neither in favour nor against (conditional recommendation, low certainty of evidence). (5) For clinicians using antifungal agents, the EBGDG recommends against using voriconazole instead of itraconazole (conditional recommendation, very low certainty of evidence). (6) No evidence-based recommendation could be framed for using pulse steroid therapy in preference to conventional steroid therapy. (7) Immunotherapy with biologicals including omalizumab or dupilumab is not recommended (conditional recommendation, very low certainty of evidence). This evidence-based guideline can be used by healthcare providers in diverse clinical settings.

Polyphenol supplementation and executive functioning in overweight and obese adults at risk of cognitive impairment: A systematic review and meta-analysis.

Increasing evidence indicates a link between obesity and cognitive impairment. Furthermore, there is limited literature regarding the effect of polyphenols, a plant derived compounds, on executive functioning in an overweight/obese population at-risk of cognitive impairment. The aim of the present systematic review and meta-analysis of randomized controlled trials is to examine the effect of polyphenol supplementation on executive functions in overweight and/or obese populations at risk of cognitive impairment. A comprehensive literature search was conducted from inception to March 2023 using four electronic databases: PubMed/Medline, PsycInfo, Scopus and Cochrane trials library. Published primary research studies in English that compared the effect of polyphenols with placebo on executive function in overweight/obese adults were considered eligible for the meta-analysis. Jadad scale was used for the methodological quality rating of the included studies. Hedges g with 95% confidence intervals (CI) for endpoints were calculated using random effect model where applicable. Rosenthal's Fail-safe N, funnel plots, the Begg and Mazumdar's rank correlation test (Kendall's S statistic P-Q), Egger's linear regression test, and Duval and Tweedie's trim-and-fill test were identified for potential use as appropriate, to examine publication bias. Sensitivity analysis was conducted to examine the robustness of the results. A total of 23 RCT studies involving N = 1,976 participants were included in the review. The results of the meta-analysis revealed a non-significant effect for polyphenol supplementation on executive function (g = 0.076, CI = -0.018 to 0.170). Observations from primary studies within the meta-analysis showed a potential positive effect of polyphenol supplementation in a younger population at-risk of cognitive impairment and it is recommended to investigate this further in future studies. Moreover, the variability of the tasks used to examine executive functions as well as the adequate reporting of supplement's phenolic composition is a limitation that future work should also consider.

Epidemiological measures: application and interpretation in real-life scenarios according to epidemiological study designs

Frequency, association and impact measures are key concepts in clinical epidemiology; however, it has been found that a considerable proportion of health students and professionals have no knowledge of how to use or interpret them when reading a scientific paper or conducting research. This article aims to explain the main epidemiological measures, how they are used, derived and interpreted. They are approached from the perspective of each of the most frequently used types of primary quantitative research studies (randomized clinical trials, cohort studies, case-control estudies and cross-sectional studies) in order to provide the reader with the context in which they are used. Moreover, the process for calculating and interpreting each result in a real setting is explained using clinical examples for a better understanding of these concepts and in order to prevent their use from becoming just a mechanical or repetitive exercise.

Culturally Tailored Strategies for Prenatal Physical Activity for South Asian Women: A Scoping Review.

Low levels of physical activity (PA) are reported in South Asian pregnant women. This scoping review summarizes culturally tailored strategies in prenatal PA studies for South Asian women and identifies barriers and facilitators. A search strategy was developed with the keywords "Physical Activity" AND Pregnant AND "South Asian" and was carried out on Medline, SportDiscus, EMBASE, Web of Science and Proquest Theses and Dissertations. Primary research studies were included. Forty-six studies were included of which 40 were from South Asian countries. No interventions were identified outside of South Asian countries. Offering material in different languages was the most common tailoring strategy. Reported barriers were possible social norms favouring inactivity, lack of awareness on safe exercises, and physical symptoms (e.g., fatigue). Facilitators included social support and relief from physical symptoms. Future PA interventions for South Asian pregnant women should account for population-specific barriers and facilitators to increase PA initiation and maintenance.

Effectiveness of Music on Perinatal Anxiety Among Pregnant Women and Newborn Behaviors: A Systematic Review and Narrative Synthesis.

Perinatal anxiety affects the antenatal woman, the growing fetus, and the newborn. This systematic review evaluated the effect of listening to music on perinatal anxiety among pregnant women and on newborn behaviors. No available reviews focus on interventions that include only classical forms of music or its benefit on perinatal anxiety among low-risk pregnant women or on newborn behaviors. We included peer-reviewed primary research studies on the effect of music on perinatal anxiety, published in English, between January 2010 and August 2022. PubMed, Embase, Scopus, and ProQuest were searched using specific keywords, resulting in 225 studies for screening by title, abstract, and full text. Two independent reviewers screened them and assessed the quality of the included randomized controlled trials (RCTs) using Cochrane's Risk of Bias 2.0 tool (RoB2) and non-randomized controlled trial studies using the Joanna Briggs Institute Critical Appraisal tool. Due to the heterogeneity of outcome measures, the review's findings were summarized qualitatively. Nine studies with 1646 pregnant women and one with 260 pregnant women and their neonates were included. Results of all studies suggest that listening to classical music reduces the anxiety levels among pregnant women, as measured by the State-Trait Anxiety Inventory (STAI). Only one study reported the beneficial effect of antenatal exposure to music on improving newborn behaviors like orientation (ES 1.13, 95% CI: 0.82-1.44, P < 0.0001) and habituation (ES 1.05, 95% CI: 0.53-1.57, P = 0.0001). The risk of bias was unclear in most of the studies. Listening to classical music during the perinatal period may be an effective non-pharmacological intervention for reducing anxiety and pain and improving sleep quality and newborn behaviors. There is a need to conduct further interventional studies on the types of music provided and their effects on perinatal health outcomes. The review was prospectively registered in PROSPERO 2021 CRD42021256806.