Risultati per: Progressi nel trattamento della psoriasi: review

Objective
Pneumonia is associated with four times higher odds of death among children with severe undernutrition. However, there is an equipoise for the mortality of children without severe undernutrition and the impact of macronutrient interventions. We collated evidence on mortality, anthropometric outcomes and the effect of macronutrient interventions in the management of non-severely undernourished children (28 days–17 years) with pneumonia globally.

Design
Systematic review and meta-analysis using a priori criteria developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.

Data sources
PubMed, Medline, EMBASE, Web of Science, Google Scholar, Scopus, Cochrane Central and bibliographies were searched between January 2000 and July 2024.

Eligibility criteria
We included articles conducted among children between 28 days and 17 years with pneumonia and non-severe malnutrition that reported on mortality and changes in anthropometric status or macronutrient supplementation. Studies conducted exclusively among adults, on micronutrient supplementation, case studies, commentaries and reviews were excluded.

Data extraction and synthesis
Two reviewers independently screened, abstracted the data and conducted risk of bias (RoB) using standard criteria including the RoB in non-randomised follow-up studies of exposure for observational studies and the revised Cochrane RoB assessment tool for randomised studies (RoB 2.0). Heterogeneity was assessed using the I2 statistic, and subgroup analysis was done. Data were analysed using both narrative and quantitative synthesis. Quantitative synthesis was done using the maximum likelihood random-effects model in STATA V.18.0, with the ‘meta_es’ command.

Results
A total of 15 articles were included (11 conducted in sub-Saharan Africa and four in Asia), with 169 901 participants overall. The mortality among non-severely undernourished children with pneumonia was 3.0% (95% CI 2% to 5%, I2=99.38%), with a range of 1–13% across studies. Children with moderate undernutrition had a higher overall mortality, 9.0% (95% CI 6% to 13%, I2=89.50%), than well-nourished children, with a range of 3–19% across studies. Only one of the 15 studies reported anthropometric outcomes during follow-up and compared mortality rates of those who did versus did not receive macronutrients. The study results were inconclusive.

Conclusions
Mortality among non-severely undernourished children with pneumonia ranges between 1–13% globally. There is inadequate follow-up nutritional assessment and management for non-severely undernourished children with pneumonia.

PROSPERO registration number
CRD42021257272.

Objectives
This study systematically characterises policies related to the prevention and control of non-communicable diseases (NCDs) at the provincial primary healthcare (PHC) level, identifying key characteristics and potential gaps compared with national policies.

Study design
Policy review and thematic content analysis.

Methods
Policy documents from Guangdong and Heilongjiang provinces (2009–2023) were analysed using the WHO’s six building blocks framework. A total of 135 eligible documents were included, with thematic analysis conducted to categorise policies as ‘extension’ or ‘reduction’ based on their alignment with national directives.

Results
12 major policy initiatives were identified, with most themes reflecting provincial adaptations (‘extension’) of national strategies. Leadership and governance, medicines and technologies and service delivery received robust policy support, while health information systems lagged. Provincial policies demonstrated significant multisectoral collaboration, though gaps in health financing and workforce capacity persisted.

Conclusions
To strengthen PHC-based NCD control, future reforms must prioritise multisectoral collaboration, interoperable digital health systems and tailored health education. Addressing regional disparities in policy implementation is critical for equitable outcomes.

Introduction
Dengue fever, the fastest-spreading mosquito-borne viral disease, poses a significant global public health challenge. Over the past two decades, its rapid spread has been driven by urbanisation, climate change and international travel, particularly affecting tropical and subtropical regions. Despite its considerable economic burden, effective antiviral treatments and vaccines remain unavailable. This study aims to bridge gaps in dengue fever management by systematically identifying and analysing strategies, challenges and solutions adopted within health systems worldwide.

Methods and analysis
This scoping review will adopt the methodological framework of Arksey and O’Malley. A comprehensive search will be conducted across databases including PubMed, Scopus, Web of Science, Embase and Cochrane Library, along with grey literature sources and manual reference list searches, covering the period from 2003 to 2024, limited to English-language publications. Search strategies will be developed using controlled vocabulary and key terms associated with various components of dengue fever management. Two independent reviewers will screen titles and abstracts based on predefined inclusion and exclusion criteria, followed by full text screening to determine final eligibility. A descriptive numerical analysis will summarise the characteristics of included studies, while a thematic analysis will provide an overview of the literature, encompassing strategies, challenges and solutions.

Ethics and dissemination
This study, approved by the Medical Ethics Committee of Mashhad University of Medical Sciences (IR.MUMS.REC.1403.142), adheres to ethical guidelines for handling publicly available data. All findings will be transparently reported and disseminated through peer-reviewed journals, relevant conferences and stakeholder engagement.

Objectives
Considerable resources are invested in health system innovation and strengthening. This calls for efforts to ensure the sustainability of such interventions. We conducted a scoping review to identify factors influencing the sustainability of externally funded health system strengthening interventions targeting primary healthcare, the sustainability outcomes observed in such interventions and the methods used to measure sustainability.

Design
Scoping review following the Joanna Briggs Institute scoping review guidelines.

Data sources
Web of Science, Ovid Medline and Embase databases were searched through 11 March 2024.

Eligibility criteria
Studies in English with no restriction on study type or country. Externally funded health system strengthening interventions targeting primary health systems and measuring sustainability.

Data extraction and synthesis
One reviewer screened all titles and abstracts, and two independent pairs of reviewers read full texts. Relevant study data were extracted from the articles and descriptively analysed.

Results
From the 6439 titles retrieved, eight eligible studies were identified and included in the final analysis. Only four studies presented a sustainability definition. Institutionalisation and continued programme activities were described four times as sustainability outcomes, followed by capacity building twice and continued health impact and benefits once. Sustainability was assessed in five studies after intervention completion and in three studies during the implementation period. The sustainability factors were mostly related to processes (n=19), inner context (n=18), intervention characteristics (n=12) and outer context (n=11), with stakeholder engagement and partnership (n=6) as well as funding (n=3) being the most reported factors.

Conclusion
This review highlights the limited documentation on the sustainability of externally funded health system strengthening interventions. Sustainability was mainly assessed retrospectively. Influencing factors spanned over all categories of the integrated sustainability framework, with stakeholder engagement and funding playing key roles. Planning for sustainability assessments with clear definitions, methods and timeframes can enhance evidence on achieving lasting impacts of health system strengthening interventions.

Registration
Open Science Framework, https://osf.io/hazqp/?view_only=d53472afbba447e790049d81ca60aa29.

SSA has a high, geographically varied STI burden, with increasing prevalence of chlamydia. Region-specific sex-prevalence ratios differed from existing global ratios and should be considered in future burden estimates. Enhanced sex-stratified surveillance is crucial to guide national programmes and reduce STI prevalence in SSA.

Background
Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related mortality worldwide, with conventional treatments often limited by radiation resistance, systemic toxicity and poor outcomes in advanced stages. Iodine-125 (I-125) seed implantation, combined with chemotherapy and immunotherapy, has emerged as a promising therapeutic strategy, but its efficacy and safety compared with conventional external beam radiotherapy combined with systemic therapies remain unclear. This systematic review and meta-analysis aims to synthesise the available evidence to evaluate the comparative benefits and risks of these treatment modalities.

Methods and analysis
Two reviewers will independently search seven databases—PubMed, Embase, Web of Science and the Cochrane Library—for randomised controlled trials (RCTs). These RCTs should compare the efficacy and safety of I-125 seed implantations combined with chemotherapy and immunotherapy against chemoradiotherapy combined with immunotherapy in patients with NSCLC. The risk of bias in the included studies will be evaluated using the Revised Cochrane risk-of-bias tool V.2. Data synthesis will be conducted using RevMan software. Trial sequential analysis will be applied to the primary outcomes. Additionally, subgroup and sensitivity analyses will be performed to assess the robustness of the findings.

Ethics and dissemination
Ethical approval is not required because this study is a secondary analysis of existing data. We will disseminate the findings through peer-reviewed publications.

PROSPERO registration number
CRD42024591684.

Introduction
Falls have financial, emotional and physical implications for ageing individuals and the healthcare system. Evidence-based exercise programmes have been one of the most effective ways of preventing falls in community dwellings for older adults. However, more research is needed to understand how to sustain these programmes. This scoping review protocol describes our plan to investigate the factors influencing the sustainability of community-based fall prevention exercise programmes.

Methods and analysis
Our scoping review will use the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews framework. The studies will have no restrictions, including publication date, language or geographic location. Key search terms concerning programme sustainability and exercise falls prevention will be conducted in Medline, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Premier, APA PsycINFO and SPORTDiscus in consultation with an experienced librarian. Once duplicates have been removed, two independent reviewers will conduct title and abstract screening, full-text screening and data extraction. Data from eligible articles will be collated and charted to summarise data into three categories: (1) study description, including publication date, author(s), study location, paper’s aim/purpose, study participants, study design and conclusion; (2) data regarding the type of exercise programme will be used using the 16-point checklist Consensus on Exercise Reporting Template; and (3) data regarding sustainability will be organised using domains from the Program Sustainability Assessment Tool. Our results will be charted through the use of Covidence to identify patterns across the studies. Additionally, narrative synthesis will be employed to articulate the study findings.

Ethics and dissemination
As this is a scoping review, we do not require ethics approval. We intend to share our report findings with scientists, healthcare professionals and decision-makers. We will publish our results in reputable scientific journals and present them at relevant conferences.

Introduction
Dengue fever is a major global public health challenge caused by the Arbovirus and transmitted by Aedes mosquitoes. The increasing incidence of dengue, particularly in the Southeast Asia (SEA) region, including Malaysia, highlights the urgent need for a comprehensive understanding of dengue molecular epidemiology. This study aims to systematically review various aspects of dengue molecular epidemiology to gain insights into the disease’s dynamics, transmission and circulation. Providing evidence-based insights is crucial for the prevention and control of dengue.

Methods and analysis
A systematic review and meta-analysis will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Eligible studies will include observational designs from the inception of time to 31 December 2024, in the SEA region. The review will encompass various molecular epidemiology domains as the exposures and assess the outcomes, such as confirmed dengue cases and severity. Descriptive and meta-analytical methods will determine prevalence, genetic changes and associations. Grading of Recommendations Assessment, Development, and Evaluation methodology will evaluate the quality of evidence, and reporting biases will be addressed. This review aims to bridge the gap in dengue molecular epidemiology in the SEA region by providing comprehensive insights crucial for effective dengue prevention and control.

Ethics and dissemination
No primary data will be collected; thus, the ethical exemption was obtained from Medical Research Ethics Committee with reference number 23-03212-AE6 and ethics approval from the IMU University Joint Committee. The results will be disseminated through a peer-reviewed publication and conference presentation.

PROSPERO registration number
CRD42023480417.

Introduction
Adolescents diagnosed with cancer face unique challenges that can significantly impact their physical, emotional and social well-being. Educational interventions are essential in providing these young patients with the knowledge and skills necessary to navigate their cancer journey effectively. This scoping review aims to map the existing evidence on educational interventions tailored for adolescents with cancer, identifying gaps in the literature and informing future research and practice.

Methods and analysis
The review will follow a systematic scoping review as outlined by the Joanna Briggs Institute. A preliminary search was conducted in June 2024 with the PubMed database. This will be followed by a comprehensive search strategy across multiple databases, including PubMed, SCOPUS, WoS, PsycINFO, GIM and CINAHL, to identify relevant literature published in English. All types of educational interventions targeting adolescents with cancer will be included, while studies focusing on non-cancer populations or published in non-English languages will be excluded. Data extraction will be conducted by two independent reviewers using a standardised tool, and qualitative content analysis will be performed to summarise the findings. The results will be presented in tables and figures, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: Extension for Scoping Reviews guidelines. This scoping review has been registered with Open Science Framework (https://osf.io/7p93v).

Ethics and dissemination
As this scoping review will use secondary data from published literature, ethical approval is not required. The findings will be disseminated through peer-reviewed publications, conference presentations and stakeholder engagement.

Introduction
There is growing public concern and emphasis on the potential negative implications of social media on adolescent mental health and the implementation of social media restrictions, despite limited and mixed evidence that predominantly originates from the Global North. In sub-Saharan Africa (SSA), where adolescent populations are rapidly expanding and adopting technology, research on social media and mental health is limited. This scoping review aims to map and describe the available evidence on social media use and mental health among adolescents in SSA.

Methods and analysis
This study employs the scoping review methodology from the Joanna Briggs Institute, following a five-stage process: (1) determining the research question, (2) creating a search strategy, (3) defining inclusion criteria, (4) extracting data, (5) conducting analysis, presentation, and (6) consultations. The search strategy will be applied to databases such as PsycINFO, PubMed (Medline and OVID), Web of Science, LILACS, Scopus, Google Scholar, ProQuest Dissertations and PsycINFO Extra, covering both empirical and grey literature. Articles will be independently assessed for eligibility with data extraction and charting performed using a standardised form. Visualisation tools, such as a heatmap for the prevalence of studies in SSA and a network diagram depicting relationships, will be used.

Ethics and dissemination
Ethics approval was not required for this review. Dissemination will occur through a peer-reviewed journal article, academic presentations and online news media in the form of a commentary which will be publicly available.

Introduction
People with multiple sclerosis (MS) live with a progressive condition that can result in complex disability support needs. Consequently, they may require specialised care and assistive technology to maintain independence at home. It is essential to develop an understanding of the support needs and preferences of people with MS to maintain independence and enhance their quality of life.

Methods and analysis
The principles of a systematic review framework are incorporated into our rapid review. As such, a reference group was recruited at the project’s outset, shaping the research question and study design, followed by developing a thorough listing of search terms. We then adapted the methodology in line with recommendations for conducting a rapid review whereby only three databases were included: MEDLINE (Ovid), Embase (Ovid) and PsycINFO (Ovid). Data from qualitative and mixed-method studies will be extracted, coded and classified using content analysis. In addition to including peer-reviewed articles, we will examine grey literature sourced from MS-specific organisations and research centres. Grey literature content that has the potential to inform practice will be extracted and categorised. Collectively, themes will be identified from the analysed literature, with a subsequent evaluation conducted by our reference group. The inclusion criteria assert that all documentation must be published in English from 2010 onwards, specifically focusing on people with MS.

Ethics and dissemination
This rapid review does not require ethics approval. Findings will be circulated to our reference group and then published in peer-reviewed journals or presented at conferences.

Introduction
A quarter of women experience heavy periods in their lifetime, often significantly impairing their well-being, productivity and quality of life.
Several treatment options are offered for heavy menstrual bleeding; however, there is limited evidence on the effectiveness, safety and cost of available treatments. We aim to conduct a comprehensive systematic review, network meta-analyses and health economic evaluation to compare all available treatment options while considering the views and treatment preferences of women with heavy menstrual bleeding.

Methods and analysis
We will systematically search electronic databases (MEDLINE, EMBASE, CENTRAL) as well as the grey literature, conference proceedings and trial registries to identify all relevant randomised trials that evaluated any medical or surgical treatment for women with heavy menstrual bleeding regardless of their cause compared with placebo or other active treatments.
We will perform pairwise and network meta-analyses using standard methods. We will report primarily on changes in menstrual blood loss (using Pictorial blood loss assessment chart scores or the Alkaline-Haematin method), quality-of-life measures, safety in addition to other important clinical outcomes.
We will develop a health economic model to evaluate the cost-effectiveness of available treatments within a healthcare perspective using data inputs from the planned meta-analyses. We will calculate the incremental cost per change in alternative outcomes and present the net monetary benefit for a range of cost-effectiveness thresholds for quality-adjusted life-year gained. We will conduct consultations and a discrete choice experiment involving patient representatives to capture the factors influencing women’s decision-making and treatment preferences in real life.

Ethics and dissemination
The project was approved by the UCL Institute for Women’s Health Low-Risk Research Ethics Committee (reference: 004_2023_24) and UCL Research Ethics Committee (ID 16351/003) for the planned patient involvement and qualitative research. We will produce an evidence-based decision aid toolkit and will publish the findings in peer-reviewed journals, as well as lay media outputs to inform health professionals, policymakers and the patient community.

PROSPERO registration numbers
https://doi.org/10.17605/OSF.IO/4MUSF, CRD42023468055, CRD42024519622, CRD42024520558 and CRD42024520634.

This narrative review summarizes current evidence regarding the epidemiology, diagnosis, and management of localized and metastatic prostate cancer.

Objective
The UK government’s response to the COVID-19 pandemic included a ‘test, trace and isolate’ strategy. Testing services for healthcare workers, care homes and schools accounted for the greatest spend and volume of tests. We reviewed relevant literature to identify common and unique barriers and facilitators to engaging with each of these testing services.

Design
Scoping review.

Search strategy
PubMed, Scopus and the WHO COVID-19 Research Database were searched for evidence published between 1 January 2020 and 7 November 2022. This was supplemented by evidence identified via free-text searches on Google Scholar and provided by the UK Health Security Agency (UKHSA).

Data extraction and synthesis
Data were extracted by a team of reviewers and synthesised thematically under the broad headings of perceptions, experiences, barriers and facilitators to engaging with the COVID-19 testing programme.

Results
This study included 40 sources, including 17 from projects that informed UKHSA’s decisions during the pandemic. Eight themes emerged and were used to categorise barriers and facilitators to engaging with the testing services for healthcare workers, care homes and schools: (1) perceived value, (2) trust in the tests and public bodies, (3) importance of infrastructure, (4) impact of media and social networks, (5) physical burden of the test, (6) perceived capability to undertake testing, (7) importance of relevant information and 8) consequences of testing.

Conclusions
Universal barriers and facilitators to engagement with the testing programme related to the core elements of each testing service, such as uncomfortable specimen collection and the influence of media and peers; these could be mitigated or leveraged to increase engagement across settings. However, the individuals involved, perceptions of value and available resources differed across services, leading to unique experiences between settings. Thus, consideration of context is crucial when designing and implementing a testing programme in response to a pandemic.

Objective
This systematic review aims to summarise and assess the measurement properties of existing instruments for measuring child well-being.

Design
A systematic review of measurement properties following the COnsensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guideline and the Joanna Briggs Institute methodology was performed.

Data sources
A search was performed in PubMed, Medline Complete, CINAHL Plus, Psychology & Behavioral Sciences (via EBSCOHost) and GoogleScholar (last search August 2024).

Eligibility criteria
This review focused on studies that evaluated the measurement properties of instruments to measure the well-being of children ages 2–7 years, published between 2000 and 2023. We excluded studies that used the child well-being instrument as an outcome measure or to validate another instrument.

Risk of bias and data synthesis
The methodological quality of eligible studies was evaluated using the COSMIN Risk of Bias checklist, the measurement properties of the instruments per study were assessed using the updated criteria for good measurement properties and an overall rating for the measurement property of each instrument is determined and compared against the criteria for good measurement properties. The quality of evidence was evaluated using the modified Grading of Recommendations Assessment, Development and Evaluation approach, and measurement recommendations were formulated. Results were presented using a narrative synthesis and tables.

Results
Three measures from three studies were included, and they presented moderate to high quality evidence for structural validity, internal consistency and construct validity. However, limited evidence was available for content validity.

Conclusion
Few instruments to measure the well-being of children aged 2–7 years are available, and only three measurement properties were fully evaluated in these studies. This review was conducted even if there was incomplete or unavailable information regarding their content validity. Further research is recommended before these measures may be recommended for use.

Prospero registration number
CRD42023428953.

Introduction
Many systematic reviews and meta-analyses (SRs/MAs) have evaluated the efficacy of biologic therapies for severe asthma. However, the overall quality of these SRs/MAs is unclear, which may influence the selection of biologics and lead to misleading clinical decisions. This umbrella review aims to objectively evaluate the overall quality of these SRs/MAs and reassess the efficacy of biologic therapies for severe asthma. Thus, this study will provide reliable evidence for clinical practice.

Methods and analysis
A systematic search will be performed in PubMed, Embase, Cochrane Library, Web of Science, Scopus and conference abstracts up to 1 March 2025. Literature screening and data extraction will be conducted according to predefined inclusion and exclusion criteria. We will evaluate the reporting quality, methodological quality and evidence quality of these SRs/MAs using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, PRISMA for Network Meta-Analysis 2015 checklist, A MeaSurement Tool to Assess Systematic Reviews 2, Cochrane Risk of Bias 1.0 and Grading of Recommendations Assessment, Development and Evaluation system. Additionally, the re-analysis of outcomes will be performed using R software (V.4.3.3).

Ethics and dissemination
Since this umbrella review will use publicly available data, ethics approval is not required. The results of this study will be disseminated through publication in a peer-reviewed journal.

PROSPERO registration number
CRD42024607393.