Risultati per: Il dolore neuropatico: review

Introduction
Cancer is the second leading cause of death in the USA. Cancer genetics and genomic studies have improved our understanding of risk, onset and progression. However, disparities by race and ethnicity have resulted in a lack of representation for minorities in these studies, contributing to unequal reductions in the cancer burden across populations. Moreover, the reasons why some individuals decline to participate in cancer genetics and/or genomic studies across diverse populations remain unclear. This review will summarise the main reasons (concerns) associated with declining to participate in cancer genetics and/or genomic studies for individuals with a history of cancer living in the USA and Puerto Rico (PR), considering race and ethnicity.

Methods and analysis
We will follow the methodology presented by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews Statement extended to Scoping Reviews to guide manuscript generation. A standardised search strategy developed in collaboration with a health sciences librarian will be deployed in Medline (PubMed), Embase (Ovid) and Scopus from database inception till present. The search strategy consists of three concepts: (1) cancer; (2) genetics and genomic research; (3) declination to participate in research studies. Title and abstract screening, followed by full-text review, will be conducted by independent reviewers to determine study inclusion. Only the peer-reviewed literature in English, conducted in the USA and PR will be considered. Findings will be presented as a numerical summary, graphical presentation and narrative review of the literature.

Ethics and dissemination
Ethical review is not required for scoping reviews. This review aims to facilitate the development of targeted strategies to increase participation in cancer genetics and/or genomic studies across diverse populations. Results will be disseminated through a peer-reviewed publication and conference presentations. The protocol is registered in the Open Science Framework (www.osf.io).

Objectives
This systematic review and meta-analysis synthesised the evidence and evaluated the effect of exercise programmes delivered using instructional videos compared with control on physical performance and falls in community-dwelling older people aged 60 years and older.

Design
A systematic review and meta-analysis conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources
MEDLINE, EMBASE, CINAHL, PsycINFO, The Cochrane Central Register of Controlled Trials, TRIP and PEDro. Grey literature sources included theses and dissertations from Ethos and ProQuest.

Eligibility criteria
Studies were included if they involved community-dwelling older people (aged >60 years) participating in exercise programmes delivered through instructional videos.

Data extraction and synthesis
Treatment effects were estimated using a random-effects model, reporting 95% CIs, mean differences (MD) and standardised MDs (SMD, Hedges’ g) for outcomes measured in different units. The risk of bias was assessed using ROB2, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results
A total of 7487 records were screened, with 16 studies (n=1910) meeting the inclusion criteria. Meta-analysis of 11 studies revealed significant effects of video-delivered exercise programmes in lower extremity strength (SMD=0.35, 95% CI 0.11 to 0.59; I2=70.35%, p

Introduction
Kinesiophobia is a significant factor which influences the prognosis of patients with chronic non-specific low back pain (CNLBP). The restriction of functional training can severely impede functional recovery and contribute to negative emotional states (including anxiety and depression) and a heightened risk of insomnia while exacerbating the economic burden on patients. Although several randomised controlled trials have evaluated the effects of various non-pharmacological interventions on kinesiophobia in CNLBP, their relative efficacy and potential adverse effects remain ambiguous. This study will conduct a systematic review and network meta-analysis to identify which non-pharmacological intervention may represent the most effective treatment for kinesiophobia in patients with CNLBP.

Methods and analysis
Comprehensive searches will be conducted across English and Chinese databases (including The Cochrane Library, PubMed, Scopus, Springer, Embase, Wanfang Data, the Chongqing VIP Database and China National Knowledge Infrastructure) from the date of their inception to 20 November 2024. Only Chinese or English studies will be considered for analysis. The primary outcomes will include a significant reduction in secondary movement phobia associated with CNLBP, pain alleviation and enhancement of the functional status of the lumbar muscles. The Cochrane Bias Risk Assessment Tool will be used to conduct a bias risk assessment.
Pairwise meta-analysis will be performed by Review Manager V.5.3 software, Stata V.16.0 and Open BUGS V.3.2.3 software will be used to conduct a network meta-analysis. The Grading of Recommendations, Assessment, Development and Evaluation framework will be employed to assess the quality of evidence.

Ethics and dissemination
All of the data included in this study will be derived from the literature; therefore, ethical approval is not necessary. The findings will be disseminated via peer-reviewed journals and academic conferences.

PROSPERO registration number
CRD42024605343.

Objectives
Frail older adults need to improve their health through exercise, and effective interventions are necessary to ensure their participation. Exercise with music has been shown to enhance adherence among older adults and improve both physical and mental health outcomes, making it a suitable intervention for frail older adults. This study evaluated the impact of exercise with music on the physical and emotional health of frail, community-dwelling older adults.

Design
A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.

Data sources
MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane Library, PsycINFO, Google Scholar and the Virginia Henderson International Nursing Library were last searched on 14 March 2025.

Eligibility criteria for selecting studies
We included randomised controlled trials (RCTs) and non-RCTs that applied exercise with music to community-dwelling frail older adults.

Data extraction and synthesis
Five independent reviewers used standardised methods to search, screen and code included studies. Study quality was assessed using the revised Cochrane Risk of Bias 2 tool and the Risk of Bias in Non-Randomized Studies of Interventions tool. A meta-analysis and narrative synthesis were conducted, and the findings were summarised using Grading of Recommendation, Assessment, Development, and Evaluation evidence profiles. Publication bias was checked, and sensitivity analyses were used to assess the robustness of the results.

Results
After screening the initial 1425 studies, 17 studies (13 RCTs and 4 non-RCTs) were analysed. The overall risk of bias indicated that two had high risk and three had serious risk among the RCTs, and two had serious risk and two had moderate risk among the non-RCTs included in the meta-analysis. As for physical health outcomes, studies reported on frailty, Timed Up and Go (TUG), handgrip strength, falls, balance, gait speed, endurance and other performance. As for emotional health outcomes, studies reported on depression, social support and activities, quality of life or satisfaction and cognitive function. The pooled analysis suggested that exercise with music may have a positive effect on reducing frailty (standardised mean difference (SMD)=–0.20, 95% CI=–0.34 to –0.07, p=0.003, I2=0%; very low certainty) and decreasing depression levels (SMD=–0.40, 95% CI=–0.65 to –0.15, p=0.002, I2=0%; very low certainty) compared with control group outcomes in non-RCTs. However, there was no effect on the TUG and handgrip strength. A narrative synthesis of evidence suggested potential beneficial effects on frailty and depression.

Conclusions
Exercise with music may help improve frail older adults’ physical and emotional health and potentially reduce the burden of frailty. However, further rigorous investigation is needed, as the evidence has a very low level of certainty. Additionally, results from this review should be interpreted with caution because of concerns associated with the risk of bias. Community-based health professionals should consider using music when providing exercise interventions to frail older adults, while applying tailored approaches that consider their unique needs.

PROSPERO registration number
CRD42022369774.

This past year, 2024, brought many exciting practice-changing publications to JAMA Oncology across a wide variety of topics. Throughout the year, we published several randomized clinical trials that changed the course of clinical care and a substantial number of studies on cancer survivorship. These articles addressed how to ameliorate the long-term adverse effects of treatment and also how to identify long-term health risks. We continued to receive works defining the persistent impacts of COVID-19 infections and mandates on oncology patients. The science of oncology also filled our journal with topics ranging from unraveling the microbiome and how its composition affects oncologic outcomes, defining new biomarkers to better predict responses to immunotherapy, and advances in circulating or cell-free DNA analysis as prognostic or predictive tools. We have also seen machine learning and artificial intelligence address important clinical questions that will add precision to everyday practice, and we look forward to informatics as a growing sector of the journal.

This survey study examines potential barriers to the integration of holistic review into dermatology resident selection.

JAMA Dermatology thrived in 2024. The editorial team evaluated a 15% increase in the number of article submissions in the past year (Table). A total of 1103 of 3182 submissions were research articles. Acceptance rates were reduced, with 9% of submissions overall and 9% of research articles accepted for publication. The journal continued to maintain its goal of reducing the time to publication, keeping the median days of acceptance to publication to 70 days while offering timely editorial decisions, including a median time from receipt to first decision without peer review of 4 days and median time to first decision with peer review of 56 days. JAMA Dermatology’s Impact Factor remained high at 11.5 and is the second-highest ranking among dermatology journals.

The US is entering a time of great chaos and uncertainty in medicine, health care, and public health. Amid this background, the need for peer-reviewed scientific evidence has never been greater. JAMA Internal Medicine renews its unwavering commitment to providing this evidence base for medicine and health care and reaffirms its fundamental mission of advancing the equitable, person-centered, and evidence-based practice of internal medicine through publication of scientifically rigorous, innovative, and inclusive articles.

When I give presentations about JAMA Psychiatry, people often ask me what our “strategy” is and how we decide what papers to publish. I respond that our guiding lights are scientific rigor and clinical relevance. This has never been truer than at the present time, when medical research and practice are under scrutiny like never before. We strive to publish original research that will stand the test of time, informed opinion pieces about current challenges, and insightful review articles taking stock of progress. When we succeed in that goal, our readers recognize that our journal showcases the most impactful developments in our field. In 2024, we published a key phase 3 clinical trial on the first new antipsychotic medication with a nondopaminergic mechanism of action in history (xanomeline-trospium) and a study on the positive impact of GLP-1 receptor agonists on alcohol use disorder outcomes in a national registry. We also covered ongoing debates concerning revisions of psychiatric nosology and continued to cover all aspects of the therapeutic potential and pitfalls of psychedelics and even devoted 3 of our popular podcasts to the topic.

There are numerous gaps in the available evidence on medical procedures used in CS that require additional research. There is an urgent need for international recommendations to guide healthcare providers and policymakers in ensuring safer, evidence-based, care for women undergoing CS.

In areas with high P. falciparum sulfadoxine-pyrimethamine resistance, dihydroartemisinin-piperaquine offers superior antimalarial efficacy than sulfadoxine-pyrimethamine. However, replacing sulfadoxine-pyrimethamine with dihydroartemisinin-piperaquine alone may not lead to improved maternal and infant health outcomes. Instead, it could result in slightly reduced gestational weight gain and a modest increase in the risk of small-for-gestational age births, and poor infant growth by two months of age.

Introduction
Metastatic disease of the hip causes severe pain and is a serious threat to the patient’s motor function. Surgery is required, but the actual efficacy is unclear, and there are many concerns for both patients and doctors. The purpose of this protocol is to conduct a scoping review for helping decisions of the intended audience.

Methods and analysis
This scoping review will be conducted according to the framework proposed by Arksey and O’Malley and reported in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols Extension for Scoping Reviews criteria. To answer our research questions, we will search Chinese and English databases using appropriate search terms, comb through clinical studies on surgical procedures for metastatic bone disease of the hip and incorporate visual charts and graphs to provide a comprehensive analysis and evaluation of the literature according to the criteria for basic characteristics, interventions and outcome indicators.

Ethics and dissemination
Since the data are publicly available, no ethical approval or participant consent is required. The results of the review will be published in an open-access peer-reviewed journal and presented at national and international conferences.

Introduction
The number of young and middle-aged adult patients with multimorbid and/or complex chronic conditions is rising, presenting challenges for healthcare systems. Advanced practice nurses (APNs) are crucial in treating these patients due to their expertise and advanced nursing skills. The article outlines the scope of practice (SOP), competencies and impact of APNs in APN-led models of care for this patient group in hospital settings.

Objectives
Description of the SOP, competencies and impact of APNs within APN-led care models for young and middle-aged adult patients in hospital settings.

Design
Scoping review based on the methodological framework by Arksey and O’Malley, incorporating the methodological enhancement of Levac and collegues, complying with the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews guidelines of Tricco and collegues.

Data sources
Systematic research was conducted in the databases MEDLINE (PubMed), CINAHL (EBSCO), EMBASE (Ovid), CENTRAL and PsycINFO (Ovid) using all recognised keywords, item terms and search strings, and OpenGrey was scanned until December 2023. Studies published in English, German or translatable to English using translation tools were included.

Eligibility criteria
Studies of APN-led models of care in hospitals were included if they involved adult participants aged 18–64 years with multimorbidity (two or more chronic conditions) and/or complex chronic conditions and provided information on SOP, competencies or impact.

Data extractions and synthesis
Data from full-text articles meeting the inclusion criteria were extracted independently by two reviewers, and a narrative summary was developed to present the results related to the objectives and questions of the study.

Results
A total of 2119 records were retrieved, with five studies ultimately included. The results included predischarge, postdischarge and bridging transition SOP. The competencies of APNs varied in both form and intensity, due to the heterogeneity of the APN-led models. Direct clinical practice competencies were most frequently described, especially regarding nursing or medical tasks, and shaped and influenced competencies in leadership, collaboration, guidance and coaching, and evidence-based practice. Indirect care activities were often mentioned. These studies indicated that APNs in APN-led care models positively impact clinical and patient outcomes, although high-intensity integrated care did not lead to cost reductions.

Conclusion
The review aims to highlight the heterogeneity and current state of knowledge about the potential role of APNs in the integrated care of this increasing patient group in hospitals. The findings emphasise the significance of focusing on the unique needs of this patient population and may serve as a foundation for developing an APN-led model of care for this group in the clinical setting. However, further research is necessary to better elucidate the role of APNs within APN-led care models in relation to the care needs of this patient group.

Trial registration number
OSF 4PM38.

Introduction
Anterior cruciate ligament (ACL) injuries are a common yet significant musculoskeletal problem and are increasingly prevalent outside of elite athlete populations. As a result, individuals may undergo ACL reconstruction (ACLR), but long-term complications frequently persist. Individuals commonly believe that post-ACLR, they will eventually return to preinjury levels of function. However, for multiple reasons, the reality is that more than half fail to reach this preinjury level. Rehabilitation has traditionally focused on physical factors, which have been researched extensively. More recently, psychological factors affecting recovery have been examined. However, most literature focuses on ‘outcome’, with the patient voice, in terms of their views and perceptions of ACLR neglected. Therefore, the aim of this systematic review is to understand individuals’ perceptions, expectations and experiences pre-ACLR and post-ACLR and to understand key factors influencing this journey. Such knowledge would assist in maximising the chances of successful recovery.

Methods and analysis
This meta-aggregative systematic review protocol is reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Medline, CINAHL, EMBASE and SportDiscus databases, grey literature and key journals will be searched from inception. Qualitative research of any study design that includes individuals aged 16+ years who are awaiting or have undergone ACL reconstruction will be included. Studies focusing on ACL revision, ACL repair or multiligament reconstruction surgeries will be excluded. Two independent reviewers will conduct searches, determine study eligibility, extract data, assess methodological quality (Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research) and rate the overall confidence in findings (JBI ConQual).

Ethics and dissemination
Findings will be published in a peer-reviewed journal, as well as presented at conferences and locally to physiotherapy teams. Ethical approval is not required for this systematic review.

PROSPERO registration number
CRD42024594621.

Introduction
Delirium is a common and serious condition that frequently affects patients in the intensive care unit (ICU). It is characterised by an acute disturbance in cognition, attention and awareness that develops over a short period of time and tends to fluctuate in severity. Patients with ICU delirium (ICUD) may experience confusion, disorientation, difficulty focusing and perceptual disturbances such as hallucinations or delusions. The prevalence of ICUD is high, with estimates suggesting that it can affect up to 70% of ICU patients. The development of ICUD is associated with several adverse outcomes, including prolonged ICU and hospital stays, increased healthcare costs, higher mortality rates and an increased risk of long-term cognitive impairment, including dementia. It is unclear which components should be included in a complex intervention to prevent and manage ICUD. Furthermore, we need to understand how the different components have been implemented and their impact on clinical practice.

Methods and analysis
The review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis Protocols (PRISMA-P) and the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) reporting recommendations. We will perform systematic searches to identify relevant interventions and implementation strategies for the prevention or management of ICUD. We will assess primary research, service evaluations and audits for the use of the Standards for QUality Improvement Reporting Excellence (SQUIRE) as a checklist for quality improvement in healthcare. We will extract both qualitative and quantitative data and assess study quality using the Critical Appraisal Skills Programme (CASP) tool. Our findings will be synthesised using a best-fit framework synthesis mapped against the Theoretical Domains Framework (TDF). Our Patient and Public Involvement (PPI) group will contribute to the development of review processes such as the research question and methodology and will help to evaluate which outcomes are most important.

Ethics and dissemination
No ethical approval is required for this study. The results of this systematic review of implementation strategies will be disseminated through peer-reviewed publications and conferences. They will also form part of an evidence map and logic model for factors that can improve the implementation of strategies for prevention, identification and management of ICUD.

PROSPERO registration number
CRD42024537313.

Introduction
Strengthening the safety climate in surgical centres is essential for ensuring care and patient safety, which directly impacts the reduction in the occurrence of adverse events and complications. In this sense, used to strengthen the safety climate in the operating room.

Methods and analysis
A scoping review will be carried out on the basis of the method proposed by the JBI and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) will be applied. The selection of studies, data extraction and synthesis will occur on the basis of the following inclusion criteria: Participants (leaders and health professionals), Concept (strategies for improving the safety climate) and Context (operating room) framework. This scoping review considers studies that address improvement strategies employed to strengthen the safety climate within the operating room. The review encompasses all studies published from 2009 to the present. The results will be presented in a narrative format with tables or diagrams.

Ethics and dissemination
No ethics committee approval is required for this study as it does not involve human participants. The results of the study will be disseminated through peer-reviewed publications, presentations at scientific congresses and targeted knowledge-sharing sessions with relevant stakeholders.