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Interventions to improve functionality among paediatric patients with oncological diagnosis: a systematic review and meta-analysis protocol

Por: Holanda · K. M. · Vivas Costa · J. · Pereira · W. M. G. · Barbosa · A. S. · Martinez-Silveira · M. · Garcia-Hermoso · A. · Guerra · P. H. · Bezerra · I. N. · Barbosa Filho · V.
Introduction

Cancer is the leading cause of death and morbidity among children and adolescents worldwide. Functionality-based interventions are relevant among children and adolescents with an oncological diagnosis, whence studies summarising evidence on this topic are needed. This systematic review will summarise evidence on the effect of interventions to improve functionality indicators among paediatric patients diagnosed with cancer.

Methods and analysis

This protocol will follow Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA)-Protocols reporting guidelines. The systematic review will be conducted according to the Cochrane Handbook and PRISMA 2020. Studies will be searched in MEDLINE (PubMed), Embase, Web of Science, CENTRAL, LILACS and PEDro. Additional searches will include Google Scholar, reference lists of included studies, relevant reviews and trial registries. Studies will be included if they implement a functionality-based intervention. They must evaluate effects among paediatric patients with an oncological diagnosis. Secondary outcomes will include health-related quality of life. There will be no limits to language or year of publication, and articles published in peer-reviewed journals will be accepted. Only randomised controlled trials will be included. Risk of bias will be assessed using the Cochrane Risk of Bias Tool 2. Two independent reviewers will select studies, extract data and assess risk of bias. A narrative synthesis and meta-analysis will be conducted if studies are clinically and methodologically homogeneous. Statistical heterogeneity will be assessed using Higgins’ inconsistency test (I²). Meta-analysis may estimate combined effects using random-effects and the inverse variance method. The R statistical software will be used. The certainty of evidence will be evaluated for each outcome using the Grading of Recommendations Assessment, Development and Evaluation system.

Ethics and dissemination

This study used data from previously published studies, thus waiving submission to an Ethics Committee. Scientific dissemination strategies will include publication in peer-reviewed journals, conference presentations and workshops for the public.

PROSPERO registration number

CRD42024462833.

Volumetric MRI and FDG-PET hypometabolism biomarkers of frontotemporal dementia: protocol for a systematic review and meta-analysis

Por: Solomon · T. J. · Antonic-Baker · A. · Romero · L. · Sinclair · B. · OBrien · T. J. · Vivash · L.
Introduction

Frontotemporal dementia (FTD) remains challenging to diagnose owing to the marked clinical heterogeneity associated with the disease. This heterogeneity stems from the complex interplay of various clinical phenotypes, genetic mutations and underlying neuropathologies, such as TDP-43 and tau proteinopathies. Currently, there is no single confirmed biomarker that can reliably diagnose disease, specifically disease stage, disease subtype and underlying neuropathology. Recent research has indicated that neuroimaging techniques hold the most promise for the discovery of FTD biomarkers. We propose a protocol for a systematic review and meta-analysis to identify MRI and fluorodeoxyglucose positron emission tomography (FDG-PET) biomarkers associated with clinical, genetic and pathological subtypes of FTD. We aim to address the following research questions: can regional MRI volumetry and FDG-PET hypometabolism differentiate (1) FTD patients from healthy controls; (2) sporadic cases of FTD from healthy controls; (3) genetic cases of FTD (MAPT, GRN, and C9orf72 mutations); and (4) underlying neuropathology, specifically discriminating between tau- and TDP-43-based FTD?

Methods

Literature searches will be performed across three databases: Ovid Medline, Ovid Embase and Web of Science. Publications that have fewer than five participants, are non-human-based, not written in the English language or contain unpublished data will be excluded. Two independent investigators will screen and subsequently evaluate which publications to include. Should any disagreements arise, a third investigator will settle the discrepancy. After the random-effects meta-analysis has been used to extract and pool the data, I2 analysis will be used to quantify heterogeneity.

Ethics and dissemination

Ethics approval will not be required for this research. On completion, the systematic review and meta-analysis will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42024545302.

Right-restricting measures implemented by Public Health Surveillance services during the COVID-19 pandemic: a systematic review protocol

Por: Vivas · M. D. · Correia · T. · Bragagnolo · L. · da Silva · I. A. L. · Tureck · F. · Santos · R. · Kielmann · S. · do Carmo · D. · Avarca · C. · da Silva · F. · Paes · M. · Tofani · L. F. N. · Chioro · A.
Introduction

The COVID-19 pandemic’s unprecedented nature has exposed significant vulnerabilities in most public health systems and highlighted the importance of coordinated responses across various levels of government. A global debate emerged on the types of health measures necessary to curb the rapid spread of contagious and/or lethal diseases. However, some of these measures involved restricting individual rights, raising significant ethical, legal and public health questions. The protocol of this systematic review aims to address a critical gap in the literature by analysing how Public Health Surveillance services worldwide implemented compulsory right-restricting measures during the COVID-19 pandemic, and what impacts these measures had on public health outcomes and individual rights.

Methods and analysis

This protocol focuses on studies about right-restricting measures enacted by Public Health Surveillance services during the COVID-19 pandemic. It will be unrestrictive as to period (starting in 2019, when the outbreak was identified), language or publication status in a preliminary stage. It will include only peer-reviewed publications, discarding opinion articles, editorials, conference papers and non-peer-reviewed publications. Considering the PICo strategy, the research question of this systematic review can be formulated as follows: Problem—right-restricting measures enacted by Public Health Surveillance services; Interest—implementation modalities and impacts on individual rights and public health outcomes; Context—COVID-19 pandemic. This protocol will use the following databases: Pubmed, Cochrane/CENTRAL, Embase, Scopus and Web of Science. Considering the various measures that may have been adopted, the following categories of analysis will be used: (i) Public Health Surveillance as a field, (ii) the various specific areas of Health Surveillance, (iii) law enforcement, (iv) right-restricting measures and consent, (v) interactions between right-restricting measures and routine Public Health Surveillance functions, (vi) differences between countries and (vii) Health Surveillance lessons learnt from the COVID-19 pandemic. These categories are not strictly mutually exclusive; however, each study will be assigned to the category most aligned with its primary focus. To ensure the validity and reliability of findings, each study will have its risk of bias assessed at both the study and outcome levels.

Ethics and dissemination

Patients and the public were not involved in the design, conduct, reporting or dissemination plans of this systematic review. The results will be presented in one or more articles to be submitted to scientific journals and may also be presented at scientific conferences and to public policy makers.

PROSPERO registration number

This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 20 November 2024 (registration number CRD42024613039).

Prácticas ancestrales de lactancia materna en el territorio indígena nasa de juan tama- Huila, colombia.

Resumen

La lactancia materna es la alimentación recomendada desde el nacimiento de forma exclusiva hasta los 6 meses, sin embargo, su práctica varía con cada cultura. Los pueblos indígenas han sufrido efectos de la colonización en sus prácticas derivados de modelos de la salud occidental que generan consecuencias que resultan inapropiadas a estos contextos.

Objetivo: Identificar las prácticas ancestrales de lactancia materna de las mujeres en el territorio indígena de Juan Tama desde la cosmovisión Nasa.

Método: Investigación de enfoque cualitativo, cuya población fueron mujeres del Resguardo indígena Nasa de Juan Tama. Se conformó muestra por criterio de 8 participantes, con quienes se realizaron grupos focales. El análisis de datos fue mediante herramientas analíticas de la teoría fundamentada.

Resultados: Surgieron 180 códigos descriptivos agrupados en 5 categorías analíticas: prácticas de preparación, rituales, promoción, prevención y de cuidado de LM.

Conclusiones:  Las prácticas ancestrales han sufrido un debilitamiento en los territorios indígenas. En resistencia, se preservan prácticas a través de mayoras, parteras y abuelas. La coexistencia de prácticas son una oportunidad de aprendizaje mutuo de comunidades indígenas y agentes de salud, promoviendo enfoques de salud que respeten y valoren las tradiciones culturales.

Palabras clave: Lactancia materna; mujeres; pueblos indígenas; creencias; cultura indígena

Impacto en la calidad de vida percibida en pacientes COVID-19 en función del sexo

Objetivo. Comparar la percepción de la calidad de vida relacionada con la salud (CVRS) tras la COVID-19 en función del sexo. Metodología. Estudio observacional descriptivo y transversal en pacientes post-COVID de neumología-medicina interna del Complejo asistencial de Zamora, diagnosticados de COVID-19 al menos 3 meses antes. La CVRS se valoró mediante el cuestionario EQ-5D-5L. Resultados. Se incluyeron 192 pacientes, 91 mujeres (47,4 %), edad 57±13 años. 127 pacientes (66,0%) reflejaron un EQ-5D Index < 1, lo que supone una merma en su CVRS. En el análisis comparativo en función del sexo, las mujeres manifestaron mayor dificultad para las actividades cotidianas (38 [41,3%] vs. 22 [21,6%]; p=0,003), dolor/malestar de forma habitual (50 [54,3%] vs. 35 [34,3%]; p=0,005) y ansiedad/depresión (48 [52,2%] vs. 38 [37,3%]; p=0,037). La Escala Visual Analógica (EVA) fue mayor en hombres (69,8±18,7 vs. 63,1±19,5; p=0,016), así como el EQ-5D Index (0,84±0,22 vs. 0,76±0,25; p=0,023). La regresión lineal multivariante confirmó que las mujeres tenían una peor autopercepción de la CVRS independientemente del resto de factores analizados, tanto en el EQ-5D Index [b (IC95%): -0,090 (-0,153 a -0,026)] como en la EVA [b (IC95%): -6,858 (-12,083 a -1,633)]. Discusión. El sexo femenino es un factor de riesgo significativo para una peor calidad de vida auto percibida en pacientes que han pasado la COVID-19, con mayor incidencia de ansiedad, depresión, dolor y limitaciones en actividades cotidianas. Estos problemas fueron más prevalentes en mujeres, quienes mostraron diferencias significativamente menores en el índice EQ-5D y la escala EVA en comparación con los hombres.

ABSTRACT

Objective. To compare the health-related quality of life perception (HRQoL) after COVID-19 according to sex. Methodology. Cross-sectional study in post-COVID patients attending neumology and internal medicine consultation rooms at Complejo Asistencial de Zamora, diagnosed from COVID-19, at least 3 months before. HRQoL was evaluated using the EQ-5D-5L questionnaire. Results: 192 patients were included, 91 women (47,4 %), aged 57±13. 127 patients (66,0%) obtained EQ-5D Index < 1, what means a decrease in their HRQoL. Comparative analysis according to sex showed women had higher difficulties for daily activities (38 [41,3%] vs. 22 [21,6%]; p=0,003), usual pain/discomfort (50 [54,3%] vs. 35 [34,3%]; p=0,005), anxiety/depression (48 [52,2%] vs. 38 [37,3%]; p=0,037). Visual Analogue Scale (VAS) was higher among men (69,8±18,7 vs. 63,1±19,5; p=0,016), as well as EQ-5D Index (0,84±0,22 vs. 0,76±0,25; p=0,023). Multivariate linear regression confirmed women had a worse HRQoL perception with independence of the rest of the analyzed factors, in EQ-5D Index [b (IC95%): -0,090 (-0,153 a -0,026)] as well as VAS [b (IC95%): -6,858 (-12,083 a -1,633)]. Discussion: Female sex is a significative risk factor for a worse self-perceived quality of life in patients who had suffered from COVID-19, with a high incidence of anxiety, depression, pain, and limitations for daily activities. These problems were more prevalent in women, who showed significant lower differences in the EQ-5D index and the VAS scale compared to men.

Evaluación del manejo del inhalador presurizado de dosis media en el paciente pediátrico

Objetivo principal: Evaluar el manejo del inhalador presurizado de dosis media en el paciente pediátrico. Metodología: Estudio exploratorio transversal y evaluativo a través de un cuestionario con preguntas cerradas. Se creó un índice (Ic; escala de 0 a 1) para valorar el uso correcto de los inhaladores. Resultados principales: La puntuación media obtenida del uso correcto fue de Ic=0,64 (d.e. +/- 0,176). Aun-que este índice es superior en los casos en los que se declara haber recibido una explicación (Ic=0,65) con relación a los que indican que no (Ic=0,53), no se encontró significación estadística entre dicha diferencia (p=0,331). Asimismo, se apreció que cuando es el personal de enfermería es quién realiza la explicación el índice es mayor comparado con otros profesionales (Ic=0,7; p=0,23). Conclusión principal: No se encontró ningún niño que no cometiera al menos un error. Observamos un índice de uso correcto más elevado cuando la explicación parte de enfermería.

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