Risultati per: Il dolore neuropatico: review

Background
Gastrointestinal (GI) cancers are among the most significant contributors to the global cancer burden, causing substantial physical and emotional distress. Effective management of patient-reported outcomes (PROs) is essential for enhancing quality of life and overall survival in cancer care. Despite significant advances in cancer care, understanding PROs and their integration into clinical practice remains limited. Prediction models for PROs have the potential to support patient-centred care by improving shared decision-making and informing care plans. However, the development and application of clinical tools that predict PROs in patients with GI cancer have not been systematically explored. This scoping review aims to explore clinical prediction tools for PROs and the quality of life in patients with GI cancer, identifying current tools, predictors and outcomes, as well as evaluating their clinical usability and equity considerations.

Methods and analysis
A scoping review methodology, guided by the JBI Manual for Evidence Synthesis and the Arksey and O’Malley framework, will be used. The review will include studies of adult patients with primary GI cancer that developed or validated clinical prediction tools for PROs or quality of life. Inclusion criteria require the use of self-reported PRO measures. A systematic search of Ovid Medline, Embase and CINAHL will be conducted from 1946 to 2024. The search strategy will be updated periodically to incorporate the most recent literature and complemented by hand-searching references. Data extraction will focus on tool characteristics, predictors, statistical methods and equity considerations. The findings will be synthesised descriptively, mapping trends, identifying gaps and highlighting areas for future research.

Ethics and dissemination
Ethical approval is not required for this literature-based study. Results will be disseminated through peer-reviewed publications, conferences and patient advocacy networks to maximise the impact on research, policy and clinical practice.

Objectives
Vitamin D deficiency is prevalent among the population. Previous studies have shown that vitamin D supplementation might be useful for treating COVID-19 infection. Therefore, we performed a meta-analysis to explore vitamin D supplementation efficacy in treating COVID-19 patients with vitamin D deficiency.

Design
Systematic review and meta-analysis

Data sources
PubMed, Cochrane Library, Embase and Web of Science.

Eligibility criteria
Randomised controlled trials exploring vitamin D supplementation for patients with COVID-19 and vitamin D deficiency.

Data extraction and synthesis
Two independent reviewers employed standardised methods to search, screen and code the included studies. The primary outcomes included mortality during follow-up, 28-day mortality, need for mechanical ventilation and intensive care unit (ICU). The secondary outcome included length of stay in hospital and ICU. The risk of bias was assessed using the Risk of Bias 2 tool. Depending on the level of heterogeneity, either a random-effects model or a fixed-effects model was applied. The findings were summarised using Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence profiles and synthesised qualitatively.

Results
A total of nine studies, comprising 870 participants, were included in the analysis. The pooled results indicated that vitamin D supplementation was associated with a lower risk of mortality (risk ratio 0.76; 95% CI 0.60 to 0.97). However, this apparent benefit was not robust when examined through the leave-one-out method and trial sequential analysis. Regarding other outcomes, there was no statistically significant difference between vitamin D supplementation and no supplementation in terms of 28-day mortality, the need for mechanical ventilation and ICU admission. Vitamin D supplementation was associated with a 0.41 day shorter length of stay in the ICU (mean difference –0.41; 95% CI –1.09 to 0.28) and a 0.07 day shorter length of stay in the hospital (mean difference –0.07; 95% CI –0.61 to 0.46) compared with no supplementation; however, neither difference was statistically significant.

Conclusion
Based on evidence of low to moderate quality, vitamin D supplementation reduced the mortality rate during follow-up in COVID-19 patients with vitamin D deficiency. However, it did not improve 28-day mortality, nor did it reduce the need for mechanical ventilation and ICU admission, or the length of stay in the ICU and hospital.

PROSPERO registration number
CRD42024573791.

Introduction
The immunological composition of breastmilk has gained research interest as breastfeeding has been persistently correlated with improved health outcomes in children. Immune cells, also known as leucocytes, are key components of the body’s immune system, but they remain understudied in breastmilk. The relevance of breastmilk leucocytes for breastfeeding-mediated immune benefits remains controversial. To identify the current state-of-the-art on breastmilk leucocyte research, unearth knowledge gaps and propose research priorities, a scoping review is necessary.

Methods and analysis
This scoping review will address the general question of what is known about leucocytes in human breastmilk. The development of this scoping review protocol adhered to the recommendations set forth by the Joanna Briggs Institute guidelines. Peer-reviewed research articles published in English, French or Spanish will be eligible for inclusion in the scoping review. The initial literature search was conducted in January 2024 within the Medline, Embase, Cochrane Central and BVS databases.

Ethics and dissemination
This review does not require ethics approval. Our dissemination strategy includes peer-review publication and presentations at conferences and to relevant stakeholders.

Registration details
This protocol was registered in Open Science Framework (available at: https://osf.io/kwfsy) on 19 February 2024.

Introduction
As people get older, they tend to take more preventive medication such as statins, beta-blockers and anti-coagulants to help prolong their lives. The risks of taking medication can start to outweigh the benefits in older people, and whether those with comorbidities want to extend these years of poor health is another consideration. One-third of older people will develop dementia, and they may not have the mental capacity to decide whether to continue or withdraw preventive medication. In these cases, deprescribing is left to advocates, such as healthcare professionals and family members. This systematic review will look at the views of stakeholders, including advocates, people living with dementia and any other people involved in the decision-making process for deprescribing preventive medication in dementia.

Methods and analysis
A systematic review of qualitative evidence using thematic synthesis and an inductive approach will be conducted. The following databases and platforms will be searched: Embase, HMIC, MEDLINE, PsycINFO, CINAHL, PubMed, Cochrane Central Library, OATD, ProQuest, Scopus and the Web of Science, along with manual searches through citation mining and grey literature. Only primary qualitative studies (or the qualitative elements of mixed method studies) will be used. There will be no date limit, and the search will be completed by April 2025. Only English-language articles will be used. The included studies will present views and experiences about deprescribing specifically preventive medication in dementia cases. Principles identified by Cochrane for qualitative studies will be used as guidance. Covidence will facilitate two independent reviewers to identify relevant studies, and the Critical Appraisal Skills Programme and Mixed Methods Appraisal Tool will be used to assess quality. NVivo will be used to manage the extracted findings from the included studies.

Ethics and dissemination
Ethical approval is not applicable for this study as no original data is going to be collected as it is a systematic review. The findings will be disseminated in a peer-reviewed open-access publication and at conference presentations.

PROSPERO registration number
CRD42023476394. Any changes made to the protocol will be reported on PROSPERO.

Introduction
Women with disabilities in low- and middle-income countries (LMICs) face heightened risks of experiencing gender-based violence (GBV). The rapid growth of digital technologies has introduced new forms of violence, such as technology-facilitated gender-based violence (TFGBV), which disproportionately affects marginalised groups. Despite growing awareness, the intersection of disability, gender and TFGBV is under-researched. This scoping review aims to map and synthesise the evidence on TFGBV against women with disabilities in LMICs, exploring the manifestations of violence, its key vulnerabilities and protective factors within these settings.

Methods and analysis
This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines. A systematic search of peer-reviewed and grey literature will be performed in six databases, including CINAHL, Scopus, Web of Science, Social Sciences Citation Index, PubMed and PsycINFO. Studies published from 2010 onwards, focusing on women with disabilities in LMICs and involving any form of TFGBV, will be included. The search strategy includes broad query terms to capture diverse experiences of TFGBV. The identified literature will be screened and double-checked for relevance by independent reviewers. Data extraction will focus on key themes such as study design, forms of TFGBV and the risks and protective factors reported. We will conduct basic content analysis, and results will be presented in tables and narratives, providing a descriptive map of the evidence.

Ethics and dissemination
This review will synthesise previously published studies and publicly available grey literature; therefore, ethical approval is not required. The findings will be disseminated through a peer-reviewed publication, presentations at relevant conferences and knowledge-sharing sessions with stakeholders working in the field of disability and GBV prevention. The review will inform future research and interventions aimed at addressing TFGBV in LMICs.

Trial registration details
Open Science Framework (https://doi.org/10.17605/OSF.IO/GZ2UR).

Objectives
Cross-sector collaboration has been encouraged to improve population health. Both local authorities and civil society organisations impact population health, but less is known about how the actual process of collaboration is done. This scoping review aims to explore how local authorities and civil society organisations collaborate with the ambition to improve population health.

Design
This scoping review was informed by the guidance of the Joanna Briggs Institute, and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.

Data sources
Medline, Web of Science, CINAHL and Sociological Abstracts were searched from inception to September 2022.

Eligibility criteria
We included peer-reviewed empirical studies that describe the initiation, execution or sustainment of collaboration for health between local authorities and civil society organisations.

Data extraction and synthesis
Two independent reviewers extracted data, which was summarised and analysed using inductive content analysis.

Results
In the 79 included articles, collaborations between local authorities and civil society organisations entailed many different aspects, from exchanging knowledge, allocating resources, providing different types of support or human resources, training, forming different working groups, agreements and working plans to gathering data for needs analysis or evaluation. Few articles described how the collaboration had been initiated or sustained. Initiation was done through advocacy, needs assessments, making a request, creating a workgroup and conducting a pilot study. Sustainment efforts were continuous meetings, documents and tools, funding, and different plans and work structures. There were often additional actors involved in the collaborations. Information about study design was often not described in a clear and comparative manner.

Conclusions
There is a need for more research on the details of initiating, executing and sustaining collaborations for health between local authorities and civil society organisations. Knowledge from this scoping review can be used to inform the planning of future collaborations between local authorities and civil society organisations.

Objective
Adolescence is a period characterised by profound changes that warrant special attention, particularly for adolescents living in conflict-stricken regions. The dearth of available information regarding observational health research and interventions in the occupied Palestinian territory emphasises the need for a comprehensive examination of all accessible data. The aim of this review is to conduct a thorough analysis of the existing literature and initiatives focusing on adolescent health in the occupied Palestinian territory.

Design
Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) framework.

Data sources
PubMed, Embase, Web of Science, Scopus, CINAHL and PsycINFO, along with grey literature, were searched for the period between 2012 and 2023.

Eligibility criteria for selecting studies
Research studies, programmes or interventions targeting adolescents aged 10–19 years, conducted in the occupied Palestinian territory, and published between 2012 and 2023 were considered. Both peer-reviewed articles and grey literature were included.

Data extraction and synthesis
Two independent reviewers conducted abstract and full-text screening of the selected articles. Discrepancies were resolved through discussion, with a third reviewer consulted when necessary. Data extraction was performed using Excel software by two independent reviewers. Extracted data were categorised as either intervention or observational research. For analysis, the extracted data underwent an explanatory frequency analysis using SPSS software.

Results
Our search yielded 114 research projects and 19 interventions from peer-reviewed and grey literature searches. The most frequently addressed topic was non-communicable diseases, with health awareness being the most common method employed in interventions. The studies targeted both male and female participants, with a particular focus on adolescents aged 10–19 years. The majority of the included studies received funding from international sources and were conducted by foreign and local researchers.

Conclusion
This review sheds light on the current framework of adolescent health interventions, identifies areas where research is lacking and advocates for evidence-based practices to enhance the well-being of Palestinian adolescents. Future interventions should encompass the younger age group, and research should strive to provide precise information for each age group independently.

Introduction
A health-promoting lifestyle is essential for improving quality of life and reducing the risk of chronic diseases. However, despite their high health literacy, medical personnel often show low adherence to such lifestyles. Identifying the factors influencing these behaviours in medical professionals is critical for developing effective interventions. This review aims to identify the factors that influence the health-promoting lifestyle among medical personnel.

Methods and analysis
We will conduct a systematic search across three electronic databases: Web of Science, Scopus and PubMed. To ensure comprehensive literature coverage, we will also examine the reference lists of included studies and relevant reviews identified during the search. Eligible studies will include quantitative, qualitative and mixed-methods research articles that investigate factors influencing health-promoting lifestyles among medical personnel. No restrictions will be applied regarding geographical location or publication year. Only original, peer-reviewed journal articles published in English will be considered. The search strategy will incorporate key terms and their synonyms, including Medical Subject Headings terms such as ‘factor’, ‘barrier’, ‘enabler’, ‘health-promoting lifestyle’, ‘medical personnel’, ‘doctor’, ‘nurse’, ‘medical technician’, ‘pharmacist’ and ‘hospital administrative staff.’ All retrieved studies will be imported into Rayyan software for duplicate removal. Two independent reviewers will conduct the screening process based on predefined inclusion and exclusion criteria. The risk of bias in individual studies will be assessed using the Mixed Methods Appraisal Tool. A narrative synthesis approach will be employed to synthesise findings, categorising identified influencing factors into five levels of the Ecological Model of Health Behavior: intrapersonal, interpersonal, organisational, community and public policy levels.

Ethics and dissemination
Ethical approval is not required as no original data collection is involved. Findings will be disseminated via peer-reviewed journals, conferences and the primary author’s PhD thesis.

PROSPERO registration number
CRD42024579746.

In HIV and ID Observations, read Dr. Paul Sax’s roundup on CROI.

Introduction
Multidisciplinary advanced kidney care (AKC) services provide care to patients with advanced chronic kidney disease (CKD) (typically estimated glomerular filtration rate (eGFR) ≤20 mls/min/1.73m2), as symptoms and complications become more common, also in preparation for kidney failure treatments. Despite their prominence in UK renal services, there is no consensus around the best practice for AKC services in terms of care delivery models or interventions to optimise patient care, and there is widespread geographical variation in practice. The UK Kidney Association Kidney Quality Improvement Partnership has launched a 3-year ‘Transform AKC’ quality improvement project to address unmet needs in AKC services and work towards improvement. This scoping review is part of the Transform AKC project and aims to identify existing evidence for the current and best practice in AKC. The aim of this review is to establish any evidence that demonstrates best practice models of care and interventions to optimise care for adult patients with advanced CKD.

Methods and analysis
We will undertake a scoping review seeking to identify and evaluate evidence that demonstrated best practice for care of adults with advanced CKD. Databases (Medline and Embase) will be searched systematically (search dates from 1 January 2014 to 8 August 2024), and a final list of included studies will be analysed and synthesised.

Ethics and dissemination
We will use robust methodology to identify the existing literature describing the best practices in care of adults with advanced CKD. These findings will directly inform the ‘Transform AKC’ national quality improvement project, in which this scoping review is embedded. Findings will also be disseminated through national conferences and will be published in a relevant journal.

Introduction
Cardiovascular disease (CVD) remains a major public health issue in the United Kingdom (UK) and disproportionately affects minority ethnic groups who face higher rates of CVD, necessitating targeted interventions to address their specific health needs. Community pharmacies are accessible healthcare hubs that could address CVD and associated health inequalities. However, more promotion and research are needed to effectively reach deprived and hard-to-reach groups. Understanding the role of community pharmacies in preventing CVD in minority ethnic groups, including barriers and facilitators, is essential to improve their use in meeting this inequity. The objective of this review is to review the published literature to understand the potential role of community pharmacy in the prevention of CVD in minority ethnic groups, including barriers and facilitators.

Methods and analysis
A comprehensive literature search of Medline, EMBASE, PubMed, Scopus, Web Of Science and The Cumulative Index to Nursing and Allied Health Literature to identify published primary studies reporting on the role of community pharmacy in the prevention of CVD in minority ethnic groups including barriers and facilitators will be conducted (conducted 30 September 2024–2 October 2024). Backward and forward citation tracking will be conducted to identify further studies of relevance. Additionally, OpenGrey and Google Scholar searches will be conducted to identify unpublished studies. The mixed methods appraisal tool will be employed to assess study quality. Data will be extracted using a piloted data extraction form, adapted from the National Institute for Health and Care Excellence evidence table for qualitative studies. Reporting will be in line with enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) guidelines.

Ethics and dissemination
Ethics approval is not required for systematic reviews of published literature. The review will be published in a peer-reviewed journal. The findings of this review will be combined with those of the future research and will be disseminated as guidance for members of ethnic minority groups and as recommendations for healthcare professionals and policy makers.

PROSPERO registration number
CRD42024579766.

Background
Approximately 2% of the global population has survived tuberculosis (TB). Increasing evidence indicates that a significant proportion of pulmonary TB survivors develop TB-associated respiratory impairment and disability—commonly referred to as post-TB lung disease—marked by impaired respiratory function, persistent symptoms and activity limitations. However, the prevalence, risk factors and progression of TB-associated respiratory disability throughout the life course are not well understood. To address these gaps, we will undertake a systematic review and individual participant-level data meta-analysis (IPD-MA) focusing on TB-associated respiratory impairment and disability in children, adolescents and adults successfully treated for pulmonary TB.

Methods and analysis
We will systematically search MEDLINE, Embase, CENTRAL, Global Index Medicus and medRxiv for original studies investigating TB-associated respiratory impairment and disability in people of all ages who have completed treatment for microbiologically confirmed or clinically diagnosed pulmonary TB. Authors of eligible studies will be invited to contribute deidentified data and form a collaborative group. Primary outcomes will be (1) abnormal lung function based on spirometry parameters and (2) chronic respiratory symptoms. We will estimate the overall and subgroup-specific prevalence of each outcome through IPD-MA. Next, we will develop clinical prediction tools assessing the risk of future TB-associated respiratory impairment and disability. Finally, we will use stepwise hierarchical modelling to identify epidemiological determinants of respiratory impairment and disability.

Ethics and dissemination
This study has been approved by the ethics review boards at the Rhode Island Hospital (2138217-2) and the Research Institute of the McGill University Health Centre (2024-10345). Individual study authors will be required to obtain institutional approval prior to sharing data. Results will be disseminated through open-access, peer-reviewed publications and conference presentations.

PROSPERO registration number
CRD42024529906.

Introduction
People with intellectual disability suffer from poorer health outcomes compared with the general population. Some of these inequalities are driven by systematic neglect of the healthcare system in responding to the needs of these people. This paper is a protocol for a mapping review that aims to systematically map the evidence base for the quality of healthcare for people with intellectual disability in Australia and similar universal health systems. It will use the Australian Health Performance Framework quality domains as a guide to define quality (effective, safe, appropriate, accessible, efficient/sustainable and continuity of care). The review aims to provide an overview of the existing evidence for quality in healthcare for people with intellectual disability, helping to steer future investments in improving the health and quality of life for people with intellectual disability.

Methods and analysis
A mapping review design has been chosen to address the broad aim and will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Scoping Reviews extension guidelines. Systematic searches of scientific databases and grey literature sources will be undertaken based on a search strategy developed in collaboration with academic librarians. Two reviewers will independently screen references against the inclusion/exclusion criteria. Visual/tabular summaries will then be produced alongside a descriptive overview. The mapping review has been registered with Open Science Framework (osf.io/7f8cy).

Ethics and dissemination
Formal ethical approval is not required as primary data will not be collected. This work is considered part of a larger stream of work by the National Centre of Excellence in Intellectual Disability and Health (NCoE) consisting of a consortium of expert organisations in intellectual disability and health. The NCoE will be engaged throughout the entirety of this review, including dissemination activities (presentations, reports, workshops and social media content).

Introduction
Transition shock is a very common negative clinical practice experience for nursing students, which not only makes the adaptation to clinical practice difficult but also influences the smooth transition from nursing students to registered nurses and eventually could lead them to leave the nursing field. Therefore, transition shock of nursing students deserves attention. Recently, there has been a notable increase in research dedicated to transition shock experienced by nursing students. However, the overview of research done on this topic remains unclear. Therefore, we will conduct a scoping review to summarise assessment tools, influencing factors, the impacts and intervention strategies of transition shock among nursing students and identify knowledge gaps in this field to guide further research.

Methods and analysis
We will follow the Joanna Briggs Institute scoping review guidelines to conduct this scoping review. A comprehensive literature search will be conducted through 12 databases and grey literature sources. The search period will be restricted from May 2009 to December 2024, and this review will only incorporate publications in Chinese or English. Two researchers will independently screen the literature according to inclusion criteria, and then conduct data extraction. Any differences arising between the two researchers will be addressed by engaging in discussion with a third researcher. We will collate, summarise and analyse the extracted data and subsequently present the results by means of figures, tables and descriptive narratives. This review will be reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews reporting checklist.

Ethics and dissemination
As this review does not involve patients or the public, there is no need for ethical approval. The results of this scoping review will be disseminated by means of conference presentations and publication in a peer-reviewed academic journal.

Registration
Open Science Framework (https://osf.io/2r6jn/).

Introduction
Musculoskeletal disorders (MSDs) represent a significant global health burden that leads to substantial disability with socioeconomic impact. With the rise of artificial intelligence (AI), particularly large language model-driven conversational agents (chatbots), there is potential to enhance the management of MSDs. However, the application of AI-powered chatbots in this population has not been comprehensively synthesised. Therefore, this scoping review aims to explore the current and potential use of AI-powered chatbots in managing MSDs. The review will map out the targeted diseases, the purposes of chatbot interventions, the clinical tools or frameworks used in training these systems and the evaluated outcomes in clinical settings.

Methods and analysis
This scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, with a comprehensive search across multiple databases, including Medline (Ovid Medline), Embase (Ovid), ISI Web of Science (Clarivate) and ClinicalTrials.gov. We will include studies involving adults with MSDs, regardless of publication status, language or year. The scoping review will exclude studies using non-AI chatbots or human health coaches. Data extraction and synthesis will focus on demographic characteristics, chatbot methods, outcomes and thematic analysis.

Ethics and dissemination
Formal ethical approval is not required as this study involves neither human participants nor unpublished secondary data. The findings of this scoping review will be disseminated through professional networks, conference presentations and publication in a scientific journal.

Objectives
Changes in poststroke heart rate variability (HRV) might be helpful for early identification of patients with neurological impairment and poor prognosis, which could allow for early intervention to reduce adverse outcomes. The aim of this study is to perform a scoping review to identify the influence of poststroke HRV on the neurological impairment severity and the prognosis among patients with ischaemic stroke (IS).

Design
The study design allows us to examine existing research, identify the research gaps and target the important areas for future research. In the search and report process, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines and checklist were used.

Data sources
Three databases (PubMed, Web of Science and Ovid MEDLINE (Ovid)) were searched before December 2023.

Eligibility criteria for selecting studies
The literature related to the topic of this study was mainly included, and the articles were excluded if they only focused on cerebral haemorrhage or were reviews, guidelines, books, etc.

Data extraction and synthesis
Descriptive analysis was used to display the distribution of the included studies and then the summary method was adopted for further analysing.

Results
3251 articles that may be related to the scoping review topic were screened. After title and abstract screening and full-text reading, 21 records were finally included. Whether at discharge (n=6) or after follow-up (n=11), it was found that when the SD of all normal-to-normal intervals (SDNN) or the SD of the averages of normal-to-normal intervals decreased, the neurological impairment severity would be increased, including dysarthria, aphasia and hemiplegia. The root mean square of successive differences, the ratio of low frequency to high frequency and the high frequency were valuable predictors for the occurrence of adverse cardiocerebrovascular events. And the poor prognosis among patients with IS might be influenced by SDNN.

Conclusion
This scoping review confirmed that post-IS HRV indicators can predict neurological impairment and prognosis of patients with stroke, highlighting a potential direction for early intervention. Large independent cohorts should be used to evaluate the predictive performance, reliability and potential limitations of these indicators in the future, and it will be important to explore interventions that make HRV change.