Systematic Review Of Scientific Evidence Research Articles

Groundwater Abstraction has Caused Extensive Ecological Damage to the Doñana World Heritage Site, Spain

Acreman et al. (Wetlands 42:63, 2022) reviewed evidence for ecological damage to the Doñana wetlands (UNESCO World Heritage Site [WHS] and Ramsar site), Spain, associated with intensification of groundwater use, particularly for agriculture. Acreman et al. presented a multistep methodology for evidence-based risk assessment that involves identification of conservation issues, and a systematic review of scientific evidence for ecological damage and its causes. However, they involved few local scientists, used a questionable methodology in stakeholder selection and involvement, used a flawed conceptual framework, and an incomplete literature review. We propose improvements to their methodology. They overlooked or misinterpreted key evidence, and underestimated the impacts that abstraction for irrigation for red fruits (mainly strawberries), rice and other crops has had on Doñana and its biodiversity. They reported groundwater level depletion of up to 10 m in the deep aquifer, but wrongly concluded that there is no evidence for impacts on the natural marsh ecosystem, the dune ponds or the ecotone. Groundwater drawdowns are actually up to 20 m, and have inverted the formerly ascending vertical hydraulic gradient in discharge areas. Phreatic levels have been lowered from 0.5 to 2 m in some areas. Groundwater abstraction has caused multiple ecological impacts to temporary ponds and marshes in the WHS, as well as to terrestrial vegetation, and should be urgently reduced. Furthermore, Acreman et al. focused on groundwater quantity while overlooking the importance of severe impacts on quality of both surface and groundwater, intimately connected to the use of agrochemicals for irrigated crops.

The science of child and adolescent mental health in Greece: a nationwide systematic review.

Evidence-based information is essential for effective mental health care, yet the extent and accessibility of the scientific literature are critical barriers for professionals and policymakers. To map the necessities and make validated resources accessible, we undertook a systematic review of scientific evidence on child and adolescent mental health in Greece encompassing three research topics: prevalence estimates, assessment instruments, and interventions. We searched Pubmed, Web of Science, PsycINFO, Google Scholar, and IATPOTEK from inception to December 16th, 2021. We included studies assessing the prevalence of conditions, reporting data on assessment tools, and experimental interventions. For each area, manuals informed data extraction and the methodological quality were ascertained using validated tools. This review was registered in protocols.io [68583]. We included 104 studies reporting 533 prevalence estimates, 223 studies informing data on 261 assessment instruments, and 34 intervention studies. We report the prevalence of conditions according to regions within the country. A repository of locally validated instruments and their psychometrics was compiled. An overview of interventions provided data on their effectiveness. The outcomes are made available in an interactive resource online [ https://rpubs.com/camhi/sysrev_table ]. Scientific evidence on child and adolescent mental health in Greece has now been cataloged and appraised. This timely and accessible compendium of up-to-date evidence offers valuable resources for clinical practice and policymaking in Greece and may encourage similar assessments in other countries.

Socio Economic Impact Assessment of Pre-harvest Sugarcane Burning: Empirical Data Around Wonji/Shoa and Matahara Sugar Factories

In Ethiopia, the area of sugarcane is rising rapidly in response to increased sugar demand for human consumption. Despite considerable diversity in production systems and contexts, sugarcane is particularly high impact crop with significant positive and negative environmental and socio economic influences. Depending on a systematic review of scientific evidence combined with data that was collected through household interviews, key informant interviews, focus group discussions, direct observation and field notes of the researcher as well as secondary data from various sources to complement the primary data, the present study assess the socio economic and environmental impacts resulting from pre-harvest burning of cane in Wonji/Shoa and Metahara sugarcane estates. The results of study Show that the pre-harvest burning of cane harvesting practices have negative impacts on local economy in terms of human health (both local communities and sugarcane workers) resulting from smokes and dust particles. Moreover, the pre-harvest burning sugarcane practices have negative environmental effects as demonstrated by clearing of vegetation cover, depletion of water resources and soil degradation. On the other hand, sugarcane trash resources can be used for animals' feed and alternative energy sources like sugarcane briquette charcoal. Our findings then will help to guide sugar industries and policy makers with new insights/strategies in understanding the situated environmental and social impacts associated with alternative sugarcane harvesting system by using green harvesting technologies (either manual or mechanical) and at the same time opening job opportunity to the local communities by utilization of trash as animals feed, energy source and compost. Finally, recommendations have been provided in order to address the socio-economic and environmental effects on local communities and sugarcane workers and air quality management. Keywords: Pre-harvest sugarcane burning, Wonji/Shoa, Metahara, impact DOI: 10.7176/RHSS/11-19-04 Publication date: October 31 st 2021

An opportunity to emphasize the relevance of laboratory medicine.

Clinical practice guidelines (CPGs) are recommendations based on a systematic review of scientific evidence that are intended to help healthcare professionals and patients make the best clinical decisions. CPGs must be evidence-based and are designed by multidisciplinary teams. The purpose of this study is to assess the topics related to the clinical laboratory addressed in CPGs and evaluate the involvement of laboratory professionals in the CPG development process. A total of 16 CPGs recommended by the Spanish Society of Laboratory Medicine and/or retrieved from PubMed-Medline were included. A review of the information provided in CPGs about 80 topics related to the clinical laboratory was performed. The authorship of laboratory professionals was assessed. On average, the 16 CPGs addressed 49% (standard deviation [SD]: 11%) of the topics evaluated in relation to the clinical laboratory. By order of frequency, CPGs contained information about 69% of postanalytical variables (SD: 20%); 52% of preanalytical variables (SD: 11%); and 43% of the analytical variables studied (SD: 18%). Finally, half the CPGs included a laboratory professional among its authors. CPGs frequently failed to provide relevant laboratory-related information. Laboratory professionals were co-authors in only half the CPGs. There is scope for improvement, and laboratory professionals should be included in multidisciplinary teams involved in the development of CPGs.

Central Serous Chorioretinopathy and Personality Characteristics: A Systematic Review of Scientific Evidence over the Last 10 Years (2010 to 2020)

Background and Objectives: to investigate the current state of art in the study of personality disorders in central serous chorioretinopathy (CSC), also taking into account the dimensional approach. Materials and Methods: this systematic review was conducted according to PRISMA guidelines. We included articles written in English or Italian, published in peer reviewed journals from 1 January 2010 to 31 December 2020. Results: after the screening, 10 studies were included. The results suggest that CSC patients are not characterized by the prevalence of a formal personality disorder, but they are better explained by typical personality traits that may alter their relationship with others. CSC patients seems to be characterized by high levels of aggressiveness and anxiety traits along with low sociability. We propose a model of disease where stress exacerbates prior specific traits in a vicious circle where some traits might be involved in disease progression and manifestation. Conclusions: maladaptive personality traits might be an essential feature of the disease and may represent a possible link between psychiatric symptoms, such as insomnia, anxiety, and depression, and endocrinological patterns. Further research should use a specific assessment scale evaluating both the level of interpersonal functioning and specific maladaptive traits.

Prevalence of Use of Preventive Services in Poland: Result from a Population-Based Nationwide Study.

Systematic reviews of scientific evidence have identified clinical services that prevent or ameliorate illness and reduce mortality. This study aimed to assess the prevalence of all recommended evidence-based preventive services in a publicly funded healthcare setting. We conducted a population-based nationwide cross-sectional computer-assisted telephone survey of 1000 Polish adults (response rate 42%). The self-reported use of all recommended clinical preventive services was assessed, including mammography, colonoscopy, blood glucose screening, vaccination, blood pressure screening, and preventive counselling. The results showed that only 6.4% of adults had received all recommended preventive screening, whereas only 4.3% had received appropriate counselling. General practitioner (GP) visits, blood pressure screening, blood glucose screening, and cervical smear were among the most commonly provisioned interventions, while flu vaccination, PSA assessment, and preventive counselling were among the least prevalent services. Despite the low uptake of preventive interventions, over 75% is interested in remote access to preventive services using telemedicine platforms and e-consultations. Our findings suggest that there are significant gaps in the receipt of preventive interventions. Further improvements require not only changes in the incentive system for healthcare providers, but also system-level innovation such as telemedicine solutions to deliver preventive services remotely and engage individuals in the monitoring process.

Developing Literature Search Strategies and Strings to Identify Fate, Exposure and Physical-Chemical Property References

While the process for developing search strings for physical-chemical properties is relatively straight-forward due to availability of existing data presented in a controlled manner, identifying published fate and human environmental chemical exposure-related studies is difficult. Challenges also exist for identifying health-related studies, but controlled vocabularies for indexing and PubMed Medical Subject Headings (MeSH) help to identify such studies, while relatively fewer developed vocabularies exist for identifying fate and exposure studies. In addition, the scope of ‘exposure’ is broad and comprises several sub-categories. Provision of these search strings will facilitate and standardize the approach for systematic review of scientific evidence needed for transparent chemical assessment. To develop the search strings, a team of topic-specific experts and librarians was assembled and developed keyword lists. To create the physical-chemical string, librarians used the keyword list and a series of iterative exchanges with the expert to draft, and revise strings based on performance. For fate strings, librarians drafted strings utilizing the keyword list and analysis tools such as the Keyword Analysis Tool (KAT) and SWIFT-Review’s fingerprinting feature, and on-topic reference lists to determine performance; exposure strings will be developed in a similar manner. The quality of all test strings will be further evaluated by human manual screening of on- and off-topic search string generated results. This presentation overviews various approaches taken to develop the fate, chemical-physical property and exposure literature search strings, including development and testing of broad verses minimal search strings (where we identify terms that are unambiguous and/or necessary to retrieve the greatest number of on-topic references while minimizing retrieval of off-topic references); discusses the organization of keywords and search strings into main and subcategory headings; and outlines the process for incorporating keyword analysis tools. The recall and precision performance results of the broad versus minimal search strings are also presented.

Paradoxical Hidradenitis Suppurativa in Patients Receiving TNF-α Inhibitors: Case Series, Systematic Review, and Case Meta-Analysis

Background/Aims: TNF-α inhibitors represent the most advanced approved therapeutic option for moderate and severe forms of hidradenitis suppurativa (HS). However, in recent years, cases of paradoxical HS secondary to the use of these biological drugs have been described, with very few cases reported in the literature. The aims of this study are (1) to present 2 new cases of paradoxical HS and (2) to perform a systematic review of scientific evidence regarding paradoxical HS with TNF-α inhibitors. Material and Methods: This is a retrospective study in which we searched all the cases of paradoxical HS secondary to the use of TNF-α inhibitors published in the literature and included two additional cases observed in our clinical practice. Results: A total of 34 patients under TNF-α inhibitor treatment were included (adalimumab = 21; infliximab = 9; etanercept = 4). The median delay from exposure to TNF-α inhibitor and the development of paradoxical HS was 12 months (range 1–72). The majority of patients were Hurley stage II (58.8%). Clinical improvement and complete remission were more frequent when the TNF-α inhibitor was stopped or switched to another biological agent with a different therapeutic target rather than maintenance or change to another TNF-α inhibitor. Conclusions: Paradoxical HS is an unusual adverse effect of TNF-α inhibitors. When this adverse effect appears, interruption or substitution of treatment is associated with a better clinical outcome.

CLINICAL PRACTICE GUIDELINES: A STRATEGY FOR EVALUATING PERCEPTION AND QUALITY

Clinical practice guidelines (CPG) are recommendations based on a systematic review of scientific evidence and generally these documents are under constant assess. For this matter, a group of health-professionals which belong to Fundación Centro Colombiano de Hipoterapia evaluated the use and quality of the used CPG using AGREE II instrument. The obtained results evidence correlation between both parameters since health-professionals trust in their acquired experience without detracting from the benefits that can be obtained with the use of guidelines. Among the mentioned benefits, improving the quality of care, effectiveness in clinical decisions, and the optimization of costs related to health care can be mentioned. Nonetheless, health-professionals reflect uncertainty in the recommendations generated by the guidelines because of the barriers presented such as strictness in its elaboration, it lacks in updates, audits and evaluations.
 Key words: Clinical practice guidelines, assessment, quality.

The Impact of co-morbid severe mental illness and HIV upon mental and physical health and social outcomes: a systematic review

ABSTRACTOur aim was to review the evidence related to the impact of co-morbid severe mental illness SMI (schizophrenia, schizoaffective and bipolar disorder) and HIV upon mental health, physical health and social outcomes. We carried out a systematic review of scientific evidence, searching online databases (MEDLINE, PsychInfo, EMBASE, Global Health and Scopus) for studies between 1983 and 2017 using search terms for SMI and HIV. Studies were included if they compared health or social outcomes between people living with co-morbid SMI and HIV and people living with either: a) HIV only; or b) SMI only. Outcomes of interest were: mortality, health service use, HIV/SMI-related, co-morbidities, and social outcomes. We identified 20 studies which met our inclusion criteria. Although studies were generally high quality, there was heterogeneity in both selection of outcomes and choice of measure. It was therefore difficult to draw strong conclusions regarding the impact of co-morbid SMI and HIV across any outcome. We found little evidence that co-morbid SMI and HIV were associated with lower levels of treatment, care or poorer clinical outcomes compared to people living with SMI or HIV alone. However, mortality appeared to be higher among the co-morbid group in three out of four analyses identified. Physical and mental co-morbidities and social outcomes were rarely measured. Limited data mean that the impact of co-morbid SMI and HIV is uncertain. In order to develop evidence-based guidelines, there is an urgent need for further research. This may be realized by exploring opportunities for using data from existing cohort studies, routinely collected data and data linkage to investigate important questions relating to this neglected but potentially important area.

A sweet deal? Sugarcane, water and agricultural transformation in Sub-Saharan Africa

Abstract Globally, the area of sugarcane is rising rapidly in response to growing demands for bioethanol and increased sugar demand for human consumption. Despite considerable diversity in production systems and contexts, sugarcane is a particularly “high impact” crop with significant positive and negative environmental and socio-economic impacts. Our analysis is focused on Sub-Saharan Africa (SSA), which is a critical region for continued expansion, due to its high production potential, low cost of production and proximity, and access, to European markets. Drawing on a systematic review of scientific evidence, combined with information from key informants, stakeholders and a research-industry workshop, we critically assess the impacts of sugarcane development on water, soil and air quality, employment, food security and human health. Our analysis shows that sugarcane production is, in general, neither explicitly good nor bad, sustainable nor unsustainable. The impacts of expansion of sugarcane production on the environment and society depend on the global political economy of sugar, local context, quality of scheme, nature of the production system and farm management. Despite threats from climate change and forthcoming changes in the trade relationship with the European Union, agricultural development policies are driving national and international interest and investment in sugarcane in SSA, with expansion likely to play an important role in sustainable development in the region. Our findings will help guide researchers and policy makers with new insights in understanding the situated environmental and social impacts associated with alternative sugar economy models, production technologies and qualities of management.

Scientific Evidence of Therapeutic Rehabilitation Techniques in Neonatal Dysphagia: Systematic Review

Introduction: Systematic reviews are useful in the knowledge production, professional development, and evidence-based practice. The neonatal dysphagia is a disorder with a major impact on health and quality of life. Therefore, studies that present effective and efficient techniques are important to support in clinical decisions.

Nonmedical Interventions for Children With ASD: Recommended Guidelines and Further Research Needs

To use the findings of a systematic review of scientific evidence to develop consensus guidelines on nonmedical interventions that address cognitive function and core deficits in children with autism spectrum disorders (ASDs) and to recommend priorities for future research. The guidelines were developed by a Technical Expert Panel (TEP) consisting of practitioners, researchers, and parents. A systematic overview of research findings was presented to the TEP; guideline statements were drafted, discussed, debated, edited, reassessed, and presented for formal voting. The strength of evidence of efficacy varied by intervention type from insufficient to moderate. There was some evidence that greater intensity of treatment (hours per week) and greater duration (in months) led to better outcomes. The TEP agreed that children with ASD should have access to at least 25 hours per week of comprehensive intervention to address social communication, language, play skills, and maladaptive behavior. They agreed that applied behavioral analysis, integrated behavioral/developmental programs, the Picture Exchange Communication System, and various social skills interventions have shown efficacy. Based on identified gaps, they recommend that future research focus on assessment and monitoring of outcomes, addressing the needs of pre/nonverbal children and adolescents, and identifying the most effective strategies, dose, and duration to improve specific core deficits. The creation of treatment guidelines and recommendations for future research represents an effort by leading experts to improve access to services for children with ASDs while acknowledging that the research evidence has many gaps.

A new section for IJPH: knowledge synthesis, translation and exchange

For the past 10–15 years, and following the lead of clinical medicine, there has been a strong movement within public health to foster evidence-based practices, programs and policies. Various agencies, mainly in the Anglo-Saxon world, have been implemented to further this agenda. In the US, the Centres for Disease Control and Prevention has created ‘‘The Guide to Community Preventive Services’’ to support the work of the Task Force on Community Preventive Services whose mandate includes ‘‘making recommendations for interventions that promote population health based on systematic reviews of scientific evidence’’ (http://www.thecommunityguide.org/about/taskforce-members.html). In the UK, the National Institute for Health and Clinical Excellence (NICE) comprises three centres among which the Centre for Public Health Excellence has the mandate to ‘‘develop guidance on the promotion of good health and the prevention of ill health’’ (http://www.nice.org.uk/aboutnice/whoweare/structureofnice/ structure_of_nice.jsp). In Canada, the National Collaborating Centres for Public Health is a network of six centres whose mandate is to ‘‘promote and improve the use of scientific research of other knowledge to strengthen public health practices and policies in Canada’’ (http://www.nccph.ca/en/home.aspx). There is undoubtedly an increasing demand for high quality syntheses of primary evaluation of public and population health programs (the knowledge synthesis part), and for their formatting into products that will support the development of a professional ethos of research informed practice (the translation and exchange part). IJPH wants to contribute to this movement and is now developing a new section devoted to research in knowledge synthesis, translation and exchange. In this section, we plan to publish original contributions in the form of empirical studies and commentaries that will support the development of a research culture in public health practice and strengthen public health research practices that are relevant for public health interventions. In terms of empirical studies, we are interested in publishing different kinds of synthesis of evaluation studies about a wide range of public health interventions. Syntheses can take two forms:

Consensus recommendations for managing asymptomatic persistent non-virus non-alcohol related elevation of aminotransferase levels: Suggestions for diagnostic procedures and monitoring

A persistent increase in non-virus non-alcohol related aminostransferase levels can have multiple causes, which differ in terms of prevalence and clinical importance. In the general population, the most frequent cause is non-alcoholic hepatic steatosis, which can evolve into steato-hepatitis and cirrhosis. The treatment for steatosis and non-alcoholic steato-hepatitis consists of modifying lifestyles, whereas the effectiveness of drug treatment remains to be determined. Other much less frequent (yet not rare) causes of persistent non-virus non-alcohol related elevations in aminotransferase levels are celiac disease and hemochromatosis, whereas autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, and alpha-1-anti-trypsin deficit are rare. Given that some of these conditions are susceptible to treatment, early diagnosis is important. No epidemiological data are available for evaluating the prevalence of elevated aminotransferase levels correlated with the toxicity of drugs or other xenobiotics, including herbal products. The present document, created by a panel of experts based on a systematic review of scientific evidence, is mainly geared towards physicians working in General Medicine and Transfusion Centres, who generally represent the first contact of persons with elevated aminotransferase levels. The document includes suggestions for diagnosing causes of persistent non-virus non-alcohol related increases in aminotransferase levels, considering the frequency and response to treatment. The conditions requiring specialized visits are also indicated.

The importance of size and growth in infancy: integrated findings from systematic reviews of scientific evidence and lay perspectives

Associations between growth and size during infancy and adult disease have led some to recommend that interventions in infancy might benefit lifelong health. Any such recommendations should be informed by both the scientific evidence for relationships between infancy and later outcomes and the views and opinions of those who care for babies. Separate, but interlinked, systematic reviews were conducted of the epidemiological evidence relating infant size or growth to later health and of lay perspectives on infant size and growth. Findings were compared and integrated to consider policy implications. Lay and scientific perspectives both cast infant growth and size as an indicator of other aspects of an infant's life, rather than being of fundamental importance. While the scientific literature is most often concerned with infants at the extreme ends of the population distribution, and towards long-term outcomes, the literature on lay perspectives suggests a focus on defining the 'normal' range, and on current health. Differences and similarities between scientific and lay perspectives on health can highlight areas of agreement, as well as areas of potential misunderstanding or miscommunication.

Calcitonin measurement to detect medullary thyroid carcinoma in nodular goiter: German evidence-based consensus recommendation.

Serum calcitonin (CT) has become a very specific and sensitive marker for human medullary thyroid carcinoma (MTC), a neuroendocrine tumor affecting about 1 % of patients with nodular thyroid disease. MTC is characterized by early micrometastasis and a lack of curative non-surgical treatment, so that early diagnosis is desirable. Based on a systematic review of scientific evidence, we propose multidisciplinary consensus recommendations for the clinical use of CT in patients with nodular goiter. To exclude MTC, serum CT should be determined in patients with nodular thyroid disease, using a two-site CT immunoassay. If basal serum CT exceeds 10 pg/ml, CT should be analysed by pentagastrin stimulation testing, after renal insufficiency and proton pump inhibitor medication have been ruled out. As the risk for MTC is higher than 50 % in patients with stimulated CT values > 100 pg/ml, thyroidectomy is advised in these individuals. If stimulated CT exceeds 200 pg/ml, thyroidectomy and lymphadenectomy is strongly recommended. Pentagastrin-stimulated CT values < 100 pg/ml are associated with a low risk of MTC, or very rarely, non-metastasizing micro-MTC (size < 10 mm). Therefore, regular clinical and biochemical follow-up is the preferred treatment in such patients, unless thyroid malignancy is suspected otherwise.