Risultati per: Il dolore neuropatico: review

Objectives
Improving the quality of care requires specific, comprehensive and continuous attention from the administration of a health system. However, information on evaluations of national and subnational policies and strategies for quality is lacking. This study aims to map studies evaluating policies and strategies for quality in health systems around the world.

Design
This is a scoping review based on the guidelines of the Joanna Briggs Institute (JBI), guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR).

Data sources
The search for articles was carried out in the Embase, Medline/Pubmed, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature databases and in the grey literature in July 2024.

Eligibility criteria
Publications describing a tool for evaluating interventions for quality in the health system and studies containing at least one conceptual framework related to the evaluation of policies and strategies for quality in the health system, in any language, were included.

Data extraction and synthesis
Data selection was carried out independently by two reviewers, whose conflicts were resolved by consensus and the decision of a third reviewer. The findings were synthesised using a data extraction protocol adapted from two theoretical frameworks on National Quality Policies and Strategies proposed by the WHO.

Results
The data search resulted in 133 potentially eligible studies, of which 14 studies were included in the review. We found 27 countries that had evaluated their policies or strategies, most of them in Asia (11) and Africa (9). Six studies used instruments to evaluate interventions for quality at the health system level. An instrument used in Afghanistan, Armenia, Guatemala and Mexico proved to be potentially useful for dissemination in other countries. Among the elements recommended by the WHO for the implementation of strategic policies for quality, the most present were governance and organisational structure.

Conclusions
Although the evidence provides an indication of how countries have implemented their quality policies and strategies, we identified the need for tools to assess their impact on health systems.

Introduction
Appropriate use of pesticides minimises harm to human health and the environment. Despite regulations and restrictions on use, however, many farmers still use highly toxic pesticides in ways that endanger their health and the environment. Many pesticide users know little about the health effects of these chemicals or how to handle them safely. A systematic review will collate evidence of the effectiveness of educational interventions among farmers regarding health hazards and the safe handling of pesticides. The review aims to summarise the impact of educational interventions on knowledge and reported behaviour of pesticide users and to identify characteristics of more effective interventions.

Methods and analysis
We will search MEDLINE, LILACS, AGRICOLA, IMBIOMED, SciELO, Web of Science, Scopus, Embase databases and from the grey literature, Open Grey and WHO to identify potentially eligible studies. We will consider randomised and non-randomised controlled trials that evaluated the impact of educational interventions among farmers about the safe use of pesticides. We will include studies published between 2000 and 2024 in English, Spanish and Portuguese and consider outcomes of knowledge about pesticide health effects, knowledge about safe handling of pesticides and reported behaviour when handling pesticides. A meta-analysis of eligible studies, using a random-effects model, will estimate the impact of educational interventions on the outcomes as the difference between the intervention group and the control group at the last point of measurement. We will assess heterogeneity using the 2 test and I2 statistic, conduct a sensitivity analysis by removing each study from the meta-analysis and evaluate publication bias with a funnel plot and Begg and Egger tests. Subgroup analyses will examine the impact of different kinds of educational interventions.

Ethics and dissemination
Ethics approval is not required as no information from individuals are collected. The results will be published in a peer-reviewed journal or disseminated at relevant conferences.

PROSPERO registration number
CRD42023413028.

Introduction
Intensive care unit (ICU) delirium is an acute brain dysfunction that affects up to 7 out of 10 patients admitted to ICUs. Patients who develop ICU delirium cannot think clearly, have trouble paying attention, do not understand what is happening around them and may see or hear things that are not there. ICU delirium increases the time patients spend in ICUs and hospitals and therefore healthcare costs. ICU delirium is also associated with increased mortality and dementia in the longer term. ICU delirium prevention and management strategies are likely to include both pharmacological and non-pharmacological components as part of a complex intervention, but it is unclear which components should be included. The objective of this meta-review is to systematically map the quantity and certainty of the available evidence from reviews and meta-analyses of randomised controlled trials (RCTs) of pharmacological and non-pharmacological interventions, which will be used to design a multicomponent intervention to prevent and manage ICU delirium.

Methods and analysis
A systematic search strategy was performed in MEDLINE (Ovid), Embase (Elsevier), Cochrane Database of Systematic Reviews, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and Web of Science (from inception to 26 September 2023), as well as Epistemonikos (from inception to 19 July 2023). We will include all critically ill adults (aged≥18 years) and any ICU delirium prevention or management intervention (pharmacological or non-pharmacological). For pharmacological interventions, we will include reviews of RCTs. For non-pharmacological interventions, we will consider reviews of RCTs, quasi-experimental and cohort studies. We will use the International Consensus Study (Del-COrS) core outcome set for research evaluating interventions to prevent or manage ICU delirium and synthesise our findings using quantitative data description methods. We will involve our Patient and Public Involvement group of people who experienced ICU delirium to develop and comment on such aspects as the research question, methodology and which outcomes are most important.

Ethics and dissemination
No ethical approval is required for this study. The results of this meta-review will be disseminated through peer-reviewed publications and conferences. They will also form part of an evidence map and logic model for the prevention and management of ICU delirium.

PROSPERO registration number
CRD42023473260

Objectives
Providing adequate access to mental health services is a global challenge. Smartphone apps offer a potentially cost-effective, available and accessible solution for monitoring, supporting and treating mental health conditions. This systematic review describes and evaluates the usage of smartphone apps across a wide range of mental health disorders in terms of clinical effectiveness, feasibility and acceptability.

Design
This is a systematic review of studies examining treatment, self-monitoring and multipurpose smartphone apps for mental health disorders.

Data sources
Studies were identified through a comprehensive search of the Ovid and PubMed databases. Articles published up to 14 January 2024 were included based on predefined criteria.

Eligibility criteria
We included randomised controlled trials that compared mental health apps (single- or multipurpose) with treatment-as-usual or no treatment for clinical populations with mental health disorders. Studies were excluded if they focused on web-based interventions, combined apps with non-TAU treatments or targeted physical health apps.

Data extraction and synthesis
Two independent reviewers screened and selected studies, with a third reviewer resolving inconsistencies. Extracted data included study details, participant characteristics, app information and outcome measures related to effectiveness, feasibility and acceptability. A risk-of-bias assessment for each study was conducted.

Results
Out of 4153 non-duplicate articles screened, 31 studies met full-text eligibility criteria. These included 6 studies on treatment apps, 4 on self-monitoring apps and 21 on multipurpose apps for a range of mental health disorders. Fifteen were identified as having between some and high concern on the risk-of-bias assessment. While smartphone apps were generally effective and acceptable, their feasibility appeared to decline over time.

Conclusions
Smartphone apps are promising tools for mental healthcare, demonstrating effectiveness and acceptability. However, challenges such as reduced feasibility over time, potential biases and underrepresented demographics require further research. This review proposes five recommendations for improving clinical translation in future studies.

Objectives
People living with HIV (PLWH) were previously shown to have a higher prevalence of non-calcified coronary plaque with discrepant results for coronary stenosis and any plaque prevalence. This systematic review and meta-analysis summarise and estimate pooled effect sizes for observational studies among PLWH using comprehensive coronary CT angiography (CTA).

Design
Preferred Reporting Items for Systematic Review and Meta-analysis reporting guidelines were used.

Data sources
PubMed, Embase, Web of Science, CINAHL, Cochrane Clinical Trials and EBM were searched from inception to 23 February 2024.

Eligibility criteria
We included studies evaluating coronary atherosclerosis in adult PLWH with controls and CTA results for plaque prevalence, extent, severity and high-degree stenosis.

Data extraction and synthesis
Two independent reviewers used standardised methods to screen for relevance by title, abstract and full-text review. Two unblinded independent reviewers manually extracted data and rated study quality using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models. A sensitivity analysis was performed with a fixed effects model. Publication bias was assessed by visual inspection of funnel plots and formal testing by Egger’s and Begg’s tests. Segment scores were evaluated using the difference of medians.

Results
PLWH showed a significantly higher prevalence of non-calcified plaque (34% (95% CI: 15% to 53%)) compared with controls (22% (95% CI: 6% to 38%)) with an OR of 1.61 (1.13–2.30, p=0.009). There was no significant difference in partially calcified plaque prevalence (OR=1.20, 0.96–1.49), stenosis prevalence (OR=1.34, 0.92–1.96) and median difference in Segment Involvement Score (SIS; 0.39, –0.01 to 0.79) in PLWH compared with controls who have a non-significant difference in calcified plaque (OR=0.80, 0.61–1.04). The prevalence of any plaque (OR=1.22, 0.93–1.61) and difference in median Segment Stenosis Score (–0.12, –0.60 to 0.35) did not differ between groups.

Conclusion
This study demonstrates a greater prevalence of non-calcified plaque in PLWH than controls. Additional research is needed to assess quantitative CTA measurements. Increased power may reveal a difference in the prevalence of high-degree stenosis and median SIS score in PWLH, while controls may have a greater prevalence of calcified plaque.

This systematic review to support a 2025 US Preventive Services Task Force Recommendation Statement summarizes published evidence on the benefits and harms of screening for, and treatment of, osteoporosis to prevent fractures in adults.

In Reply We appreciate the questions raised by Dr Di Bella and colleagues in their Letter to the Editor regarding the use of lung ultrasonography for diagnosing CAP.

To the Editor We read with great interest the recent review on community-acquired pneumonia (CAP) by Dr Vaughn and colleagues. Although the thoroughness of the article is commendable, it is necessary to address the brief and somewhat dismissive mention of lung ultrasonography in diagnosing CAP. The assertion that “the utility of ultrasonography for diagnosing CAP is unclear” does not adequately reflect the advancements and growing body of evidence supporting the clinical value of this tool.

Objectives
Incontrovertible evidence surrounds the need to support healthcare professionals after patient safety incidents (PSIs). However, what characterises effective organisational support is less clearly understood and defined. This review aims to determine what support healthcare professionals want for coping with PSIs, what support interventions/approaches are currently available and which have evidence for effectiveness.

Design
Systematic research review with narrative synthesis.

Data sources
Medline, Scopus, PubMed and Web of Science databases (from 2010 to mid-2021; updated December 2022), reference lists of eligible articles and Connected Papers software.

Eligibility criteria for selecting studies
Empirical studies (1) containing information about support frontline healthcare staff want before/after a PSI, OR addressing (2) support currently available, OR (3) the effectiveness of support to help prevent/alleviate consequences of a PSI. Study quality was appraised using the Quality Assessment for Diverse Studies tool.

Results
Ninety-nine studies were identified. Staff most wanted: peer support (n=28), practical support and guidance (n=27) and professional mental health support (n=21). They mostly received: peer support (n=46), managerial support (n=23) and some form of debrief (n=15). Reports of poor PSI support were common. Eleven studies examined intervention effectiveness. Evidence was positive for the effectiveness of preventive/preparatory interventions (n=3), but mixed for peer support programmes designed to alleviate harmful consequences after PSIs (n=8). Study quality varied.

Conclusions
Beyond peer support, organisational support for PSIs appears to be misaligned with staff desires. Gaps exist in providing preparatory/preventive interventions and practical support and guidance. Reliable effectiveness data are lacking. Very few studies incorporated comparison groups or randomisation; most used self-report measures. Despite inconclusive evidence, formal peer support programmes dominate. This review illustrates a critical need to fund robust PSI-related intervention effectiveness studies to provide organisations with the evidence they need to make informed decisions when building PSI support programmes.

PROSPERO registration number
CRD42022325796.

Introduction
Sub-Saharan Africa bears a disproportionate burden of cancer-related morbidity and mortality compared with high-resource settings. Although pathology services are essential to providing optimal oncological care, diagnostic capacity in sub-Saharan Africa is insufficient for the cancer burden. This scoping review will be conducted to summarise the current state of practices and evidence for interventions and implementation strategies to improve anatomic pathology services for cancer in the region. The objective of this scoping review is to describe efforts to strengthen capacity for anatomic pathology services in sub-Saharan Africa. The information gathered will be used to inform the design of future pathology capacity-building interventions. The primary aim of the scoping review is to comprehensively map the existing evidence on initiatives aimed at enhancing the capacity for pathology services.

Methods and analysis
This study will follow Joanna Briggs Institute methodology for scoping reviews. MEDLINE, Embase, Cochrane Central and African Index Medicus will be searched for articles published in English and Portuguese with no limitations placed on date or publication type. A limited search for grey literature will be conducted using the WHO Institutional Repository for Information Sharing. Two independent reviewers will screen all articles, extract data and complete the descriptive analysis. All discrepancies will be resolved using a third reviewer. The results will be reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This review will consider scientific literature from published primary studies as well as scoping and systematic reviews related to capacity-building efforts to strengthen anatomic pathology services in any sub-Saharan African country. All study designs will be considered, including quantitative, qualitative and/or mixed-methods studies.

Ethics and dissemination
Ethical approval is not required for this study. Dissemination of findings from this work will include the publication of the results in a peer-reviewed journal and presentations at conferences.

Protocol registration number
Open Science Framework, https://osf.io/6cmhg.

Introduction
Low back pain (LBP) is a global health concern. Approximately two-thirds of those who recover from LBP experience a relapse within a year, with many chronic cases encountering acute flare-ups (exacerbation). This systematic review will synthesise and analyse whether physical and/or psychological features can predict recurrent episodes of LBP or exacerbation of pain.

Methods and analysis
This systematic review protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Comprehensive literature searches will be conducted in MEDLINE, EMBASE, APA PsycInfo, PubMed, CINAHL Plus, Web of Science, Scopus and ZETOC, spanning from each database’s inception through to January 2025. Google Scholar and grey literature sources, including OpenGrey, will also be searched to ensure comprehensive coverage. Two independent reviewers will screen titles, abstracts and full texts, assessing the risk of bias with a modified Quality in Prognosis Studies tool. The overall certainty of evidence will be evaluated using an adapted Grading of Recommendations Assessment, Development and Evaluation approach. If sufficient data homogeneity is present, a meta-analysis will be performed; otherwise, findings will be synthesised narratively. The results will identify the ability of physical and/or psychological factors to predict pain recurrence or acute exacerbation in case of persistent non-specific LBP.

Ethics and dissemination
This study protocol does not present any ethical concerns. The findings from the systematic review will be submitted for publication in a peer-reviewed journal and will also be presented at relevant conferences.

PROSPERO registration number
CRD42024599514.

Introduction
Research indicates that older hospitalised individuals are more susceptible to hospital adverse events (AEs). Frailty is a syndrome marked by increased vulnerability, sudden and severe health changes and the risk of adverse outcomes. The majority of the available research puts a limited emphasis on those who live with frailty and examines the relationship between age alone and the occurrence of AEs. This review investigates the association between frailty and the likelihood of hospital AE occurrences in hospitalised older patients.

Methods and analysis
The proposed systematic review will search Ovid MEDLINE, CINAHL, Scopus and Web of Science databases. Studies that published original data in English using any methodology will be included. A manual search of the final included studies reference list will be made to identify studies that meet the inclusion criteria. If feasible, a meta-analysis will be conducted using the R statistical programme, and results will be visually presented using a forest plot. If there is high heterogeneity and a meta-analysis is not feasible, a narrative synthesis and analysis guided by Cochrane criteria will be conducted, and results will be presented in appropriate tables and figures.

Ethics and dissemination
No ethical approval will be obtained for this review since it will use secondary published data. The systematic review’s results will be published in a peer-reviewed frailty and geriatrics care-related journal and disseminated in conferences, congresses and scientific meetings.

Objective
To investigate the antecedents to episodes of aggression and the use of coercive measures in inpatient mental health settings, organize and explore their relationships and patterns through thematic analysis, identify gaps in the literature and provide insights for future research.

Introduction
The use of coercive measures in inpatient mental health settings remains controversial and ethically challenging. Despite an international consensus on the need to reduce their use, the antecedents to aggression and episodes involving coercive measures remain insufficiently explored. This review seeks to address this gap by systematically mapping the evidence of these antecedents and exploring their relationship, providing a foundation for future research.

Inclusion criteria
Studies included were those published from 2014 to the present in the English language, focusing on either adult mental health inpatients or mental healthcare professionals aged 18 years or older involved in episodes of aggression or exposure to coercive measures in both acute and long-term inpatient mental health settings. Included studies must address antecedents to aggression or the use of coercive measures. Exclusions apply to studies focusing exclusively on behaviours unrelated to aggression or coercive measures, studies conducted in non-inpatient settings and those involving child, adolescent, geriatric or forensic populations.

Methods
The review will follow the Joanna Briggs Institute methodology for scoping reviews. The search strategy will cover key databases, including Ovid Medline, APA PsycINFO and Scopus, with reference list screening to ensure comprehensive coverage. Initial exploratory searches were conducted in June 2024, with the formal searches updated in January 2025. Studies will be screened against the inclusion criteria, and data will be extracted using a standardised form adapted to the review objectives. Grey literature will be excluded, focusing on peer-reviewed evidence. The analysis will include descriptive mapping of the antecedents to aggression and the use of coercive measures, supplemented by thematic analysis to organize and explore patterns and relationships between them. Results will be presented in a descriptive summary, supported by thematic analysis and descriptive statistics.

Ethics and dissemination
Ethical approval is not required since this study uses existing published literature. The results will be disseminated through a peer-reviewed journal and presented at relevant international conferences.

Objective
The objective of this review was to map the available evidence on oral health surveys of traditional peoples and communities (TPC) in Brazil, addressing the question, ‘What evidence is available on oral health surveys of traditional peoples and communities in Brazil?’.

Design
Scoping review according to the Scoping Review extension for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Data sources
MEDLINE/PubMed, Scopus, Web of Science, Embase and Latin American and Caribbean Literature in Health Sciences were searched up until June 2023.

Eligibility criteria
Studies involving individuals from indigenous groups, quilombolas, riverside communities and Romani communities, all included in TPC in Brazil, were included without any age restrictions.

Data extraction and synthesis
Data were extracted by two independent reviewers, and studies were categorised considering the author and year of publication, the traditional group, study type, geographical location, age group, sample size, data collection method and the main oral health condition assessed.

Results
After the searches, 39 studies were included in the review, and 2 studies were manually added. The studies included in the review were published between the years 1968 and 2023. Of the total, 31 studies investigated the oral health condition of indigenous peoples, 7 were studies on quilombola communities and 3 studies focused on riverside communities. No studies on Romani people were found in the search. The majority of studies were located in the Northeast region (n=12) of the country, with dental caries being the main oral health issue assessed (n=13) through clinical examinations (n=25), with a high prevalence observed among TPC (n=11).

Conclusion
This review reveals that in Brazil, studies on the oral health of TPC are ongoing, although they occur in an isolated and independent manner, indicating a considerably high prevalence of oral health problems in these communities.

Thomas B, Pattinson R, Edwards D, et al. Defining and measuring long COVID fatigue: a scoping review. BMJ Open 2024;14:e088530. doi: 10.1136/bmjopen-2024–0 88 530 The authors have identified several copyediting errors in their paper since it was published online. Results In the third paragraph, the eligibility criteria were met by 57 studies; however, the country-wise breakdown was not clearly provided. Additionally, the count for Italy was previously incorrect and has been revised from 8 to 7. The corrected text now reads: ‘Studies spanned 22 countries: Italy (n=7),27 44 54 60 67 71 72 Spain (n=6),30 39 43 57 59 65 UK (n=7),31 48 53 56 61 73 74 USA (n=6),32 35 36 52 75 76 Germany (n=5),28 38 50 63 77 Ireland (n=3),8 47 62 the Netherlands (n=3),51 68 78 Denmark (n=2),26 41 Egypt (n=2),66 79 Brazil (n=2),45 55 Hungary (n=2),40 80 France (n=1),64 India (n=2),37 81 Canada (n=1),9 Poland…

Introduction
Microsimulation models are computer-based models, which can be employed to simulate the behaviour of microagents, such as children and adolescents, to understand the potential behavioural and economic effects of health interventions or policies. As a result, these models can be useful tools to help guide decision-making. A comprehensive review of the literature on child and adolescent microsimulation models has yet to be undertaken. Moreover, an evaluation of the quality of the existing models can be useful to understand their strengths and limitations and thus inform the development of future models. The aim of this scoping review will be to retrieve, synthesise and critically appraise the literature on existing microsimulation models focused on child and adolescent health.

Methods and analysis
We will conduct a scoping review using established methods. We will search PubMed (until 23 September 2024), Embase (until 18 September 2024), CINAHL (until 9 September 2024), PsyclNFO (11 September 2024), EconLit (until 9 September 2024) and Scopus (until 10 September 2024), with an update closer to the time of manuscript submission. We will also undertake snowballing, Google searches and searches on specific journal (eg, International Journal of Microsimulation) and websites (eg, https://www.microsimulation.ac.uk/) to complement database searches. We will extract relevant data on all studies retrieved and use the Quality Assessment Reporting for Microsimulation Models checklist to assess the reporting quality of each model. We will use a narrative synthesis with summary tables to describe our findings. Findings will be synthesised by type of health condition, if/where possible.

Ethics and dissemination
Given that primary data will not be collected in this study, research ethics approval is not required. We will present our findings at relevant conferences and publish our results in an appropriate peer-reviewed academic journal. In addition, we will use this information to guide the development of a microsimulation model on child and adolescent health for use in the Swedish context.

Registration details
https://osf.io/a8txn/