Non-pharmacological pain interventions for sickle cell crisis in pediatrics: A scoping review.

PROBLEM: Sickle cell crises (SCC) are recurrent, severe pain episodes experienced by people living with sickle cell disease (SCD). Non-pharmacological interventions have been recommended for SCC pain management however, little is known about the impact of these interventions on SCC pain. This scoping review aims to systematically identify evidence on the use and effectiveness of non-pharmacological interventions for pain management during SCC in the pediatric population. ELIGIBILITY CRITERIA: Studies were eligible if they are published in English and focusing on the use of any non-pharmacological interventions on pain during SCC in pediatric patients. Nine databases were searched including Medline, CINAHL and PsychInfo. Also, the reference lists of relevant studies were searched. SAMPLE: The database searching yielded 1517 studies. After the title and abstract screening, 1348 studies were excluded, and 169 full texts were retrieved and screened. One study was identified through handsearching. Finally, 27 articles were included in this scoping review. RESULTS: Across all studies, 27 different non-pharmacological interventions were identified. There were inconsistent results regarding the effectiveness of virtual reality, guided imagery, and cognitive-behavioral interventions in experimental studies. The most common interventions used at home were prayer, massage, and distraction. The main interventions used in hospitals were prayer and fluid intake, but this was explored by a few studies. CONCLUSION: Pediatric SCD patients use numerous non-pharmacological interventions to manage pain during SCC. However, the impact of many interventions on SCC pain has not been empirically investigated. IMPLICATIONS: Further research is necessary to establish the effectiveness of non-pharmacological interventions on SCC pain.

Conducting Patient-Oriented Research in Low-Income and Middle-Income Countries: A Scoping Review.

BACKGROUND: Patient-oriented research involves extensive collaboration with patients, their families, caregivers, clinicians and other relevant stakeholders to identify and investigate problems and outcomes relevant to patients. Patient-oriented research can help develop effective patient-centred interventions. Patient-oriented research is an increasingly used approach in high-income countries, but it is unclear how patients are engaged in research in low-income and middle-income countries (LMICs). OBJECTIVES: The aim of this scoping review was to explore how patient-oriented research is conducted in LMICs. The objectives were to determine the levels of involvement of patients in the research, how studies have impacted healthcare and patient outcomes in these countries, the reported benefits of patient-oriented research on the research process and the reported challenges of conducting patient-oriented research in LMICs. METHODS: A scoping review was conducted using the methodological framework suggested by Arksey and O'Malley and the Joanna Briggs Institute guidelines for conducting scoping reviews. The eligibility criteria were any healthcare research using any research design that involved patients of any age group in the research process. Six databases were searched from their inception till January 4, 2022: MEDLINE, Embase, Cumulated Index to Nursing and Allied Health Literature, PsychInfo, Cochrane Central Register of Controlled Trials and EBM Reviews. The reference lists of relevant articles and Google Scholar were combed as well. Data extraction was performed with a self-developed data extraction guide. The findings were narratively summarised. RESULTS: Thirteen articles were included in this scoping review, representing eight LMICs in Africa and Asia. The majority of studies (38%, n = 5) focused on patients living with human immunodeficiency virus. More than half of the studies (n = 8, 62%) were conducted in the adult population, 31% (n = 4) of the studies involved children and/or adolescents. For most of the studies (92%, n = 12), the participants served as consultants; for one study, the authors identified the participants as co-researchers. Across the studies, information regarding patient-oriented research activities was not consistently reported in the same manner (i.e. different locations in the article), with very limited information in some cases. None of the studies used a patient-oriented research framework and the majority did not report on how patient-oriented research impacted healthcare and patient outcomes. Patient-oriented research was beneficial in identifying relevant patients' needs and improving collaboration among stakeholders, but it also led to extended research timelines and increased financial costs for the researchers and patients. CONCLUSIONS: Researchers in LMICs are incorporating patient-oriented research in their research; however, there is a need for improved reporting practices in published articles, and the use of frameworks to guide patient-oriented research in LMICs. In LMICs, patient-oriented research enhances collaboration across stakeholders and gives patients a sense of ownership over the interventions and research process. Future work should focus on developing contextually relevant conceptual frameworks and further studies should explore the impact of patient-oriented research on healthcare and patient outcomes in the LMIC context.

Impact of the COVID-19 pandemic on the HIV care continuum: a mixed methods systematic review protocol.

OBJECTIVE: The objective of this systematic review is to synthesize evidence on the impact of the COVID-19 pandemic on the HIV care continuum for persons living with or at risk of living with HIV. INTRODUCTION: The COVID-19 pandemic affected the self-management and care of people living with HIV. Self-regulation to acquire recurring treatment for HIV is essential for managing symptoms as well as viral suppression. Therefore, this review will systematically appraise and synthesize primary literature on the impact of the COVID-19 pandemic on all phases of the HCC for people living with, or at risk of acquiring, HIV. INCLUSION CRITERIA: This systematic review will include quantitative, qualitative, and mixed methods studies. The search will be limited to studies reporting findings from March 2020. Selected studies must focus on one or more steps of the HIV care continuum, which are diagnosis of HIV infection, linkage to care, retention in care, adherence to antiretroviral therapy, and viral suppression. There are no age, gender, or geographic location restrictions for this review. Studies that examined the impact on other diseases as well as HIV will be included only if the data for HIV can be extracted separately. METHODS: The JBI methodology for convergent integrated mixed methods systematic reviews will guide this review. The following databases will be searched: MEDLINE (Ovid), CINAHL (EBSCOhost), CAB Direct, and Embase. Articles will be screened by 2 independent reviewers. In the case of a disagreement between reviewers, a third independent reviewer will resolve the conflict. Articles will be appraised for methodological quality and their data extracted using an original extraction tool created for the study's purpose. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021285677.

The awareness and practice of testicular self-examination among male undergraduates in Nigeria: a descriptive cross-sectional study.

BACKGROUND: Testicular cancer is a relatively rare form of cancer but curable. In Nigeria, late presentation hinders treatment due to limited resources for diagnosis and treatment. Testicular self-examination enables men to identify the presence of lumps and any abnormality in their testes. This can facilitate early detection and presentation at hospitals. The purpose of this study was to examine the awareness and practice of testicular self-examination by students at a College of Health Sciences in a Nigerian university. METHODS: A cross-sectional study was conducted. The target population were second-sixth year students in the College of Health Sciences. The respondents were conveniently selected to complete a 38-item, self-administered questionnaire. The paper-based questionnaire was distributed to 280 respondents in classrooms and dormitories. Descriptive statistics (such as percentages and frequencies) were used to summarize the frequency of categorical data. RESULTS: Of the 277 respondents, only 53.4% (n = 148) have heard about testicular self-examination. The mean age was 20.6 (± 4.51) years. Out of the 148 respondents, only 11.6% practiced it regularly. For majority of the respondents, the barriers mitigating the practice of testicular self-examination are the fear of discovering a lump and lack of knowledge. CONCLUSION: It is necessary for the importance of testicular self-examination to be emphasized in the training of nurses, medical doctors, and other healthcare professionals and its practice should be encouraged among health science students. This will equip these students with the knowledge and skills for their health and to educate their patients and the society on the relevance of testicular self-examination.

The effectiveness of Janus kinase inhibitors in treating atopic dermatitis: A systematic review and meta-analysis.

Primary studies have presented conflicting results on the efficacy of Janus kinase (JAK) inhibitors in treating atopic dermatitis. Hence, it is important to determine the summary effect of JAK inhibitors in order to guide the clinical application of this potentially beneficial drug. To determine the efficacy of JAK inhibitors in treating atopic dermatitis in all age groups. A systematic review with meta-analyses of randomized controlled trials (RCTs) reporting on the effect of JAK inhibitors on the signs and symptoms of atopic dermatitis were conducted. Six electronic databases, registries, and search engines (PubMed, Cochrane Central Register of Controlled Trials [CENTRAL], Google Scholar, ScienceDirect, Clinical.gov, and WHO ICTRP) were searched from inception to September, 2019. The search terms include "atopic dermatitis," "eczema," and "Janus kinase inhibitor." The search was restricted to humans. A total of 413 studies were identified through the database search and hand-searching. After the selection process, five RCTs were included in this systematic review. A meta-analysis of three studies showed that JAK inhibitors were effective in reducing Eczema Area and Severity Index (P = .0001) and pruritus scores (P = .0001). JAK inhibitors appear to be effective in treating atopic dermatitis. Future studies should aim to evaluate its cost-effectiveness and availability to patients especially in developing countries.

The level of knowledge and associated socio-demographic factors on cervical cancer among women: a cross-sectional study at Kenyase Bosore community, Ghana.

INTRODUCTION: Cervical cancer is a major cause of death amongst women around the world. In Ghana, it accounts for over 2,119 female deaths and about 3,151 new diagnoses of the disease. It is usually diagnosed at an advanced stage, making it difficult to treat. This study aims at assessing the knowledge on risk factors, prevention and treatment of cervical cancer among women in Kenyase Bosore, Ghana. METHODS: This study was a cross-sectional descriptive study conducted among women in Bosore Kenyase, Ghana. A total of 200 women were selected for the studies using the convenience sampling technique. Structured questionnaires were used for data collection and statistical package for social sciences application was also used to analyse the data. Pearson chi-square test was used to find associations between knowledge and awareness level and socio-demographic characteristics of the participants. RESULTS: Overall, 9.7% of the respondents had high knowledge on cervical cancer, 20.6% had moderate knowledge and 69.7% had low knowledge on cervical cancer. There was a significant association between educational background (p=0.000) and awareness level of the respondents. There was also a significant association between the occupation (p=0.003), educational background (p=0.000) and knowledge level of the respondents. CONCLUSION: The knowledge level of the respondents was very low. Specifically, the respondents had inadequate knowledge on risk factors, signs and symptoms, prevention and treatment of cervical cancer. The authors recommend the intensification of cervical cancer education in Kenyase Bosore, and Ghana as a whole.