scholarly journals Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review

2020 ◽  
Vol 42 (1) ◽  
pp. 75-83 ◽  
Author(s):  
Elaine C. Toomey ◽  
Yvonne Conway ◽  
Chris Burton ◽  
Simon Smith ◽  
Michael Smalle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Evidence Base ◽  
World Health ◽  
Healthcare Organizations ◽  
Surgical Masks ◽  
Single Use ◽  
Current Guidance ◽  
The Impact

AbstractBackground:Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination.Objectives:To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators.Data sources:We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews.Methods:Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized.Results:In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale.Conclusions:Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.

scholarly journals Extended use or re-use of single-use surgical masks and filtering facepiece respirators: A rapid evidence review

2020 ◽  
Author(s):  
Elaine Toomey ◽  
Yvonne Conway ◽  
Christopher Burton ◽  
Simon Smith ◽  
Michael Smalle ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Data Extraction ◽  
Evidence Base ◽  
Open Science ◽  
World Health ◽  
Limited Evidence ◽  
Surgical Masks ◽  
Guidance Documents ◽  
Single Use ◽  
The Impact

Background The COVID-19 pandemic has led to unprecedented demand for personal protective equipment. Shortages of surgical masks and filtering facepiece respirators has led to the extended use or re-use of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices has been questioned. Objectives To summarise guidance and synthesise systematic review evidence on extended use, re-use or reprocessing of single-use surgical masks or filtering facepiece respirators. Methods A targeted search of the World Health Organization, European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites was conducted to identify guidance. Four databases (Medline, Pubmed, Epistemonikos, Cochrane Database of Systematic Reviews) and three preprint repositories (Litcovid, MedRxiv and Open Science Framework) were searched for relevant systematic reviews. Record screening and data extraction was conducted by two reviewers. Quality of included systematic reviews was appraised using the AMSTAR-2 checklist. Findings were integrated and narratively synthesised to highlight the extent to which key claims in guidance documents were supported by research evidence. Results Six guidance documents were identified. All note that extended use or re-use of single-use surgical masks and respirators (with or without reprocessing) should be considered only in situations of critical shortage. Extended use was generally favoured over re-use because of reduced risk of contact transmission. Four high-quality systematic reviews were included: three focused on reprocessing (decontamination) of N95 respirators and one focused on reprocessing of surgical masks. There was limited evidence on the impact of extended use on masks and respirators. Vaporised hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale. Conclusions: There is limited evidence on the impact of extended use and re-use of surgical masks and respirators. Where extended use or re-use is being practiced, healthcare organisations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.

Preventive Interventions for the Second Half of Life: A Systematic Review

2017 ◽  
Vol 32 (4) ◽  
pp. 1122-1139 ◽  
Author(s):  
Cother Hajat ◽  
Adriana Selwyn ◽  
Mark Harris ◽  
Derek Yach
Keyword(s):  
Systematic Review ◽  
Healthy Aging ◽  
Data Extraction ◽  
Evidence Base ◽  
Noncommunicable Diseases ◽  
Level Of Evidence ◽  
Summary Table ◽  
Age Related ◽  
Meta Analyses ◽  
The Impact

Objective: Recent improvements in life expectancy globally require intensified focus on noncommunicable diseases and age-related conditions. The purpose of this article is to inform the development of age-specific prevention guidelines for adults aged 50 and above, which are currently lacking. Data Source: PubMed, Cochrane database, and Google Scholar and explicit outreach to experts in the field. Study Inclusion and Exclusion Criteria: Meta-analyses, intervention-based, and prospective cohort studies that reported all-cause mortality, disease-specific mortality, or morbidity in adults were included. Data Extraction: A systematic review was undertaken in 2015 using search terms of a combination of <risk factor> and “intervention,” “mortality,” “reduction,” “improvement,” “death,” and “morbidity.” Data Synthesis: Interventions were categorized according to the Center for Evidence-Based Medicine Level of Evidence framework. Results: A summary table reports for each intervention the impact, strength of evidence, initiation, duration, and details of the intervention. Age-decade-specific preventive recommendations have been proposed relating to physical activity, diet, tobacco and alcohol use, medication adherence, screening and vaccination, and mental and cognitive health. Conclusion: Clear recommendations have been made according to the existing evidence base, but further research investment is needed to fill the many gaps. Further, personalized approaches to healthy aging complemented by population-wide approaches and broader cross-sector partnerships will help to ensure greater longevity is an opportunity, rather than a burden, for society.

scholarly journals Promoting men’s awareness, self-examination, and help-seeking for testicular disorders: a systematic review of interventions

2018 ◽  
Vol 1 ◽  
pp. 16 ◽  
Author(s):  
Mohamad M. Saab ◽  
Martin Davoren ◽  
Aileen Murphy ◽  
David Murphy ◽  
Eoghan Cooke ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Help Seeking ◽  
Grey Literature ◽  
World Health ◽  
Cochrane Library ◽  
Medical Attention ◽  
Younger Men ◽  
Self Examination ◽  
The Impact

Background: Testicular cancer (TC) is commonly diagnosed among men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders such as testicular torsion and epididymitis can lead to testicular ischemia, sepsis, and infertility if left untreated. This systematic review aims to evaluate the effectiveness of studies promoting men’s knowledge and awareness of testicular disorders and/or self-examination, behaviours and/or intentions to examine their testes, and help-seeking behaviours and/or intentions for testicular symptoms. Methods: Academic Search Complete, Medline, CINAHL, PsychINFO, ERIC, the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, Clinicaltrials.gov, Grey Literature Report, and Open Grey were searched for studies published between November 2014 and April 2018. The methodological quality and level of evidence per outcome were assessed.  Results: There were five papers included: two were experimental studies, two were systematic reviews, and one was an integrative review. The majority of the reviewed interventions were successful in increasing men’s awareness of TC and self-examination. Examples include a television show featuring a celebrity with TC, a university campaign, and interactive educational sessions. The impact of the reviewed interventions on health beliefs (i.e. perceived susceptibility, severity, benefits, barriers, and self-efficacy) varied across the reviewed literature. Studies promoting help-seeking for testicular symptoms and awareness of benign testicular disorders were lacking. Conclusions: This review highlights the importance of evaluating educational interventions aimed at younger men, whilst raising their awareness of testicular disorders and increasing their help-seeking intentions for testicular symptoms. Given the lack of consensus around scheduled testicular self-examination among younger men, clinicians are encouraged to instruct men to familiarise themselves with the look and feel of their own testes and to seek timely medical attention for abnormalities. Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42018093671.

scholarly journals Risks of and From SARS-CoV-2 Infection and COVID-19 in People With Diabetes: a Systematic Review of Reviews

2021 ◽  
Author(s):  
Jamie Hartmann-Boyce ◽  
Karen Rees ◽  
James C Perring ◽  
Sven A Kerneis ◽  
Elizabeth M. Morris ◽  
...  
Keyword(s):  
Risk Factor ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Severe Disease ◽  
World Health ◽  
Glucose Levels ◽  
Study Selection ◽  
Increased Risk ◽  
Health Organization ◽  
The Impact

Background <p>This review was commissioned by the World Health Organization and presents a summary of the latest research evidence on the impact of COVID-19 in people with diabetes (PWD).</p> <p>Purpose </p> <p>To review the evidence regarding the extent to which PWD are at increased risk of SARS-CoV-2 infection, and/or of suffering its complications including associated mortality.</p> <p>Data sources</p> <p>We searched the Cochrane COVID-19 study register, Embase, MEDLINE, and LitCOVID on 3 December 2020.</p> <p>Study selection</p> <p>Systematic reviews synthesising data on PWD exposed to SARS-CoV-2 infection, reporting data on confirmed SARS-CoV-2 infection, admission to hospital and/or to ICU with COVID-19, death with COVID-19.</p> <p>Data extraction</p> <p>One reviewer appraised and extracted data; data were checked by a second.</p> <p>Data synthesis</p> <p>Data from 112 systematic reviews were narratively synthesised and displayed using effect direction plots. Reviews provided consistent evidence that diabetes is a risk factor for severe disease and death from COVID-19. There was less data available on ICU admission, but where available this data also signalled increased risk. Within PWD, higher blood glucose levels both prior to COVID-19 illness and during COVID-19 illness were associated with worse COVID-19 outcomes. Type 1 diabetes was associated with worse outcomes compared to type 2 diabetes. There was no appropriate data for discerning whether diabetes was a risk factor for acquiring SARS-CoV-2 infection.</p> <p>Limitations</p> <p>Due to the nature of the review questions, the majority of data contributing to included reviews come from retrospective observational studies. Reviews varied in the extent to which they assessed risk of bias.</p> <p>Conclusions</p> <p>There are no data on whether diabetes predisposes to infection with SARS-CoV-2. Data consistently show that diabetes increases risk of severe COVID-19. As both diabetes and worse COVID-19 outcomes are associated with socioeconomic disadvantage, their intersection warrants particular attention.</p>

scholarly journals Predicting the time needed to conduct an environmental systematic review or systematic map: analysis and decision support tool

2018 ◽  
Author(s):  
Neal R Haddaway ◽  
Martin J Westgate
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Decision Support Tool ◽  
Evidence Base ◽  
Systematic Map ◽  
Support Tool ◽  
Starting Point ◽  
Resource Requirements ◽  
Time Requirements

AbstractSystematic reviews aim to maximise transparency and comprehensiveness, whilst also minimising subjectivity and sources of bias. Because of these time-consuming and complex tasks, systematic reviews are perceived as being resource-intensive. To date, published estimates of systematic review resource requirements have been largely anecdotal, being imprecise and not based on evidence. However, it is valuable to provide reliable means of estimating the resource and time requirements of systematic reviews and maps. We analysed all CEE systematic reviews (n=66) and maps (n=20) published or registered between 2012 and 2017 to estimate the average time needed to complete a systematic review and map. We then surveyed 33 experienced systematic reviewers to collate information on time needed for each stage of the review process. Our results show that the average CEE systematic review takes 157 days (SD; ±22), whilst the average CEE systematic map takes 209 days (SD; ±53). While screening of titles and abstracts is widely accepted to be time-consuming, in practice meta-data extraction and critical appraisal can take as long (or even longer) to complete, especially when producing systematic maps. Finally, we present a tool that allows the user to predict the time requirements of a review or map given information known about the planned methods and evidence base likely to be identified. Our tool uses evidence-based defaults as a useful starting point for those wishing to predict the time requirements for a particular review. Our analyses shed light on the most time-consuming stages of the systematic review and map process, and highlight key bottlenecks from the perspective of time requirements, helping future reviewers to plan their time accordingly. Future predictions of effort required to complete systematic reviews and maps could be improved if CEE and CEE review authors provided more detailed reporting of the methods and results of their reviewing processes.

scholarly journals Promoting men’s awareness, self-examination, and help-seeking for testicular disorders: a systematic review of interventions

2018 ◽  
Vol 1 ◽  
pp. 16
Author(s):  
Mohamad M. Saab ◽  
Martin Davoren ◽  
Aileen Murphy ◽  
David Murphy ◽  
Eoghan Cooke ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Help Seeking ◽  
Grey Literature ◽  
World Health ◽  
Cochrane Library ◽  
Medical Attention ◽  
Younger Men ◽  
Self Examination ◽  
The Impact

Background: Testicular cancer (TC) is commonly diagnosed among men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders such as testicular torsion and epididymitis can lead to testicular ischemia, sepsis, and infertility if left untreated. This systematic review aims to evaluate the effectiveness of studies promoting men’s knowledge and awareness of testicular disorders and/or self-examination, behaviours and/or intentions to examine their testes, and help-seeking behaviours and/or intentions for testicular symptoms. Methods: Academic Search Complete, Medline, CINAHL, PsychINFO, ERIC, the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, Clinicaltrials.gov, Grey Literature Report, and Open Grey were searched for studies published between November 2014 and April 2018. The methodological quality and level of evidence per outcome were assessed.  Results: There were five papers included: two were experimental studies, two were systematic reviews, and one was an integrative review. The majority of the reviewed interventions were successful in increasing men’s awareness of TC and self-examination. Examples include a television show featuring a celebrity with TC, a university campaign, and interactive educational sessions. The impact of the reviewed interventions on health beliefs (i.e. perceived susceptibility, severity, benefits, barriers, and self-efficacy) varied across the reviewed literature. Studies promoting help-seeking for testicular symptoms and awareness of benign testicular disorders were lacking. Conclusions: This review highlights the importance of evaluating educational interventions aimed at younger men, whilst raising their awareness of testicular disorders and increasing their help-seeking intentions for testicular symptoms. Given the lack of consensus around scheduled testicular self-examination among younger men, clinicians are encouraged to instruct men to familiarise themselves with the look and feel of their own testes and to seek timely medical attention for abnormalities. Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42018093671.

scholarly journals Risks of and From SARS-CoV-2 Infection and COVID-19 in People With Diabetes: a Systematic Review of Reviews

2021 ◽  
Author(s):  
Jamie Hartmann-Boyce ◽  
Karen Rees ◽  
James C Perring ◽  
Sven A Kerneis ◽  
Elizabeth M. Morris ◽  
...  
Keyword(s):  
Risk Factor ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Severe Disease ◽  
World Health ◽  
Glucose Levels ◽  
Study Selection ◽  
Increased Risk ◽  
Health Organization ◽  
The Impact

Background <p>This review was commissioned by the World Health Organization and presents a summary of the latest research evidence on the impact of COVID-19 in people with diabetes (PWD).</p> <p>Purpose </p> <p>To review the evidence regarding the extent to which PWD are at increased risk of SARS-CoV-2 infection, and/or of suffering its complications including associated mortality.</p> <p>Data sources</p> <p>We searched the Cochrane COVID-19 study register, Embase, MEDLINE, and LitCOVID on 3 December 2020.</p> <p>Study selection</p> <p>Systematic reviews synthesising data on PWD exposed to SARS-CoV-2 infection, reporting data on confirmed SARS-CoV-2 infection, admission to hospital and/or to ICU with COVID-19, death with COVID-19.</p> <p>Data extraction</p> <p>One reviewer appraised and extracted data; data were checked by a second.</p> <p>Data synthesis</p> <p>Data from 112 systematic reviews were narratively synthesised and displayed using effect direction plots. Reviews provided consistent evidence that diabetes is a risk factor for severe disease and death from COVID-19. There was less data available on ICU admission, but where available this data also signalled increased risk. Within PWD, higher blood glucose levels both prior to COVID-19 illness and during COVID-19 illness were associated with worse COVID-19 outcomes. Type 1 diabetes was associated with worse outcomes compared to type 2 diabetes. There was no appropriate data for discerning whether diabetes was a risk factor for acquiring SARS-CoV-2 infection.</p> <p>Limitations</p> <p>Due to the nature of the review questions, the majority of data contributing to included reviews come from retrospective observational studies. Reviews varied in the extent to which they assessed risk of bias.</p> <p>Conclusions</p> <p>There are no data on whether diabetes predisposes to infection with SARS-CoV-2. Data consistently show that diabetes increases risk of severe COVID-19. As both diabetes and worse COVID-19 outcomes are associated with socioeconomic disadvantage, their intersection warrants particular attention.</p>

scholarly journals Misuse of medication in adult substance misuse services: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047283
Author(s):  
Rosalind Gittins ◽  
Louise Missen ◽  
Ian Maidment
Keyword(s):  
Systematic Review ◽  
Substance Misuse ◽  
Data Extraction ◽  
Meta Analysis ◽  
Grey Literature ◽  
Opioid Analgesics ◽  
Physical And Mental Health ◽  
Qualitative Synthesis ◽  
Treatment Services ◽  
The Impact

IntroductionThere is a growing concern about the misuse of over the counter (OTC) and prescription only medication (POM) because of the impact on physical and mental health, drug interactions, overdoses and drug-related deaths. These medicines include opioid analgesics, anxiolytics such as pregabalin and diazepam and antidepressants. This protocol outlines how a systematic review will be undertaken (during June 2021), which aims to examine the literature on the pattern of OTC and POM misuse among adults who are accessing substance misuse treatment services. It will include the types of medication being taken, prevalence and demographic characteristics of people who access treatment services.Methods and analysisAn electronic search will be conducted on the Cochrane, OVID Medline, Pubmed, Scopus and Web of Science databases as well as grey literature. Two independent reviewers will conduct the initial title and abstract screenings, using predetermined criteria for inclusion and exclusion. If selected for inclusion, full-text data extraction will be conducted using a pilot-tested data extraction form. A third reviewer will resolve disagreements if consensus cannot be reached. Quality and risk of bias assessment will be conducted for all included studies. A qualitative synthesis and summary of the data will be provided. If possible, a meta-analysis with heterogeneity calculation will be conducted; otherwise, Synthesis Without Meta-analysis will be undertaken for quantitative data. The reporting of this protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationEthical approval is not required. Findings will be peer reviewed, published and shared verbally, electronically and in print, with interested clinicians and policymakers.PROSPERO registration numberCRD42020135216.

scholarly journals Consequences of the COVID-19 Syndemic for Nutritional Health: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1168
Author(s):  
Cristian Neira ◽  
Rejane Godinho ◽  
Fabio Rincón ◽  
Rodrigo Mardones ◽  
Janari Pedroso
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Preventive Measures ◽  
Physical Contact ◽  
Current Evidence ◽  
Study Objective ◽  
Eating Style ◽  
Healthy Nutrition ◽  
Meta Analyses ◽  
The Impact

Confinement at home, quarantine, and social distancing are some measures adopted worldwide to prevent the spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2), which has been generating an important alteration in the routines and qualities of life of people. The impact on health is still being evaluated, and consequences in the nutritional field are not entirely clear. The study objective was to evaluate the current evidence about the impact that preventive measures of physical contact restriction causes in healthy nutrition. A systematic review was carried out according to the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” PRISMA Group and Cochrane method for rapid systematic reviews. Searching was performed in six electronic databases and evaluated articles published between 2010 and 2020, including among their participants adult subjects who had been exposed to the preventive measures of physical contact restriction. Seven studies met the selection criteria and reported an overall increase in food consumption, weight, Body Mass Index (BMI), and a change in eating style. Findings suggest that healthy nutrition is affected by preventive measures to restrict physical contact as a result of the COVID-19 syndemic.

scholarly journals Polyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses

2020 ◽  
pp. 1-15
Author(s):  
Daniel Joseph Lamport ◽  
Claire Michelle Williams
Keyword(s):  
Systematic Reviews ◽  
Evidence Base ◽  
Epidemiological Studies ◽  
Cognitive Outcome ◽  
Current Evidence ◽  
Duration Of Treatment ◽  
Current Evidence Base ◽  
Cognitive Benefits ◽  
Meta Analyses ◽  
The Impact

There is increasing interest in the impact of dietary influences on the brain throughout the lifespan, ranging from improving cognitive development in children through to attenuating ageing related cognitive decline and reducing risk of neurodegenerative diseases. Polyphenols, phytochemicals naturally present in a host of fruits, vegetables, tea, cocoa and other foods, have received particular attention in this regard, and there is now a substantial body of evidence from experimental and epidemiological studies examining whether their consumption is associated with cognitive benefits. The purpose of this overview is to synthesise and evaluate the best available evidence from two sources, namely meta-analyses and systematic reviews, in order to give an accurate reflection of the current evidence base for an association between polyphenols and cognitive benefits. Four meta-analyses and thirteen systematic reviews published between 2017–2020 were included, and were categorised according to whether they reviewed specific polyphenol-rich foods and classes or all polyphenols. A requirement for inclusion was assessment of a behavioural cognitive outcome in humans. A clear and consistent theme emerged that whilst there is support for an association between polyphenol consumption and cognitive benefits, this conclusion is tentative, and by no means definitive. Considerable methodological heterogeneity was repeatedly highlighted as problematic such that the current evidence base does not support reliable conclusions relating to efficacy of specific doses, duration of treatment, or sensitivity in specific populations or certain cognitive domains. The complexity of multiple interactions between a range of direct and indirect mechanisms of action is discussed. Further research is required to strengthen the reliability of the evidence base.

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