Alternate day fasting on subjective feelings of appetite and body weight for adults with overweight or obesity: a systematic review

Alternate day fasting (ADF) with consumption of calories up to 25 % of the daily energy intake on fast days is one of the most used intermittent fasting regimens and promoted as a promising, alternative approach for treating obesity. Feelings of appetite are critical for adherence to dietary approaches, and therefore the success of dietary interventions. This systematic review aimed to assess the effects of a minimum of 8 weeks of ADF on subjective feelings of appetite and body weight for adults with overweight and obesity. We conducted the review in accordance with the Cochrane guidelines, including systematic searches in four databases. Because of the high level of clinical and methodological heterogeneity, a narrative approach was used to synthesise the results. Eight studies with a total of 456 participants met the eligibility criteria: three randomised controlled trials and five uncontrolled before-after studies. Seven of the studies had high risk of bias. Feelings of appetite were assessed by hunger in eight studies, fullness in seven studies, satisfaction in four studies and desire to eat in one study. All the studies assessed weight loss. The certainty of the evidence was rated low or very low for all outcomes, thus no firm conclusions can be drawn about the potential benefits of ADF on subjective feelings of appetite and body weight. Despite the high interest in ADF, good quality evidence is still needed to determine its effectiveness and if offered in clinical practice, ADF should be offered cautiously while concomitantly evaluated

Realist Review: Current Practice and Future Prospects

Realist review has emerged as a specific literature review approach that is concerned with explaining the outcomes of complex intervention programs. We undertook a systematic scoping review to examine the current practice of realist review. A systematic scoping review is a process of mapping the existing evidence base on a particular topic. We identified a growing body of literature using the realist review approach. We selected 54 reviews for our study. These reviews covered a range of topics, including health care, education, management, and public safety. We found that the initial process of exploratory scoping of the literature was described in only 58 per cent of the reviews. The approaches regarding appraisal, analysis, and synthesis of the selected studies were poorly described in most reviews. Overall, there was little uniformity and transparency regarding many methodological issues. Specific methodological guidance may need to be developed if realist reviews are to have a more uniform and transparent approach

The Obstetric Consequences of Female Genital Mutilation/Cutting: A Systematic Review and Meta-Analysis

Various forms of female genital mutilation/cutting (FGM/C) have been performed for millennia and continue to be prevalent in parts of Africa. Although the health consequences following FGM/C have been broadly investigated, divergent study results have called into question whether FGM/C is associated with obstetric consequences. To clarify the present state of empirical research, we conducted a systematic review of the scientific literature and quantitative meta-analyses of the obstetric consequences of FGM/C. We included 44 primary studies, of which 28 were comparative, involving almost 3 million participants. The methodological study quality was generally low, but several studies reported the same outcome and were sufficiently similar to warrant pooling of effect sizes in meta-analyses. The meta-analyses results showed that prolonged labor, obstetric lacerations, instrumental delivery, obstetric hemorrhage, and difficult delivery are markedly associated with FGM/C, indicating that FGM/C is a factor in their occurrence and significantly increases the risk of delivery complications. There was no significant difference in risk with respect to cesarean section and episiotomy. These results can make up the background documentation for health promotion and health care decisions that inform work to reduce the prevalence of FGM/C and improve the quality of services related to the consequences of FGM/C

Effectiveness of psychotherapy for adults with depression: a systematic review of the best available evidence

AbstractThe present systematic review assessed the effectiveness of psychotherapy for adults with depression. Studies were considered in scope if they examined a recognized form of psychotherapy compared with no or minimal care, pharmacological treatment, treatment as usual, or other forms of psychotherapy. We included and summarised results from nine studies of high methodological quality. Findings from the best available evidence suggest that the depression experienced by adults of either sex can be affectively ameliorated by psychotherapeutic intervention, but no more so than by antidepressants, and no variant of psychological treatment appears to be superior to another. Additional research is warranted

Peer Support for People Living With HIV: A Scoping Review

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The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis

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Effect of remote patient monitoring for patients with chronic kidney disease who perform dialysis at home: a systematic review

Objective - The purpose of the systematic review was to assess the effectiveness of remote patient monitoring (RPM) follow-up compared with standard care, for patients with chronic kidney disease (CKD) who perform dialysis at home. Methods - We conducted a systematic review in accordance with international guidelines. We performed systematic searches for publications from 2015 to 2021 in five databases (eg, Medline, Cinahl, Embase) and a search for grey literature in reference lists. Included effect measures were quality of life, hospitalisation, technical failure as the cause for transfer to a different dialysis modality, infections and time patients use for travel. Screening of literature, data extraction, risk-of-bias assessment and certainty of evidence assessment (using the Grading of Recommendations Assessment, Development and Evaluation approach) were done by two researchers. We conducted meta-analyses when possible. Results - Seven studies met the inclusion criteria, of which two were randomised controlled trials and five were retrospective cohort studies with control groups. The studies included 9975 participants from 5 countries, who were a good representation of dialysis patients in high-income and upper-middle-income countries. The patients were on peritoneal dialysis (six studies) or home haemodialysis (one study). There was very low certainty of evidence for the outcomes, except for hospitalisations: there was low certainty evidence from three cohort studies for fewer hospitalisation days in the RPM group. No studies included data for time patients used for travel. Conclusion - We found low to very low certainty evidence that indicate there may be positive effects of RPM follow-up, in comparison to standard care only, for adult patients with CKD who perform dialysis at home. Offering RPM follow-up for home dialysis patients as an alternative or supplement to standard care appears to be safe and provide health benefits such as fewer hospitalisation days. Future implementation should be coupled with robust, high-quality evaluations

Health characteristics associated with chemsex among men who have sex with men: Results from a cross-sectional clinic survey in Norway

Background Chemsex typically involves drugs such as GHB/GBL, crystal meth and mephedrone, and is increasingly common among MSM. The behaviour has been found to be associated with sexually transmitted infections (STIs) and mental health problems. We aimed to assess the extent of chemsex engagement and associations with different aspects of health, among MSM attending a free specialist walk-in clinic for STIs in Oslo, Norway. Methods Anonymous cross-sectional survey data was collected from June to October 2016. Differences in STI health (chlamydia, gonorrhoea, syphilis, HIV diagnoses), mental health (depression/anxiety) and internalised homonegativity between MSM using and not using GHB/GBL, crystal meth, mephedrone, cocaine or ketamine with sex in the last year were assessed descriptively and in a multivariate logistic regression model. The predictors were number of self-reported chlamydia, gonorrhoea or syphilis diagnoses, HIV diagnosis, depression/anxiety, and degree of internalised homonegativity. We adjusted for age, education level and having lived abroad. Results Of the 518 MSM respondents, 17% reported sexualised use of either GHB/GBL, crystal meth, mephedrone, cocaine or ketamine in the last year (chemsex). We found significant positive associations between chemsex and self-reported HIV diagnoses (adjusted odds ratio [aOR] = 3.26, 95%CI = 1.37–7.76), number of reported chlamydia, gonorrhoea or syphilis diagnoses in the last year (aOR = 1.63, 95%CI = 1.18–2.12), having lived more than one year abroad (aOR = 2.10, 95%CI = 1.20–3.65), but no significant association with depression/anxiety (aOR = 1.02, 95%CI = 0.53–1.93), nor internalised homonegativity (aOR = 0.62, 95%CI = 0.33–1.19). Conclusion Chemsex engagement in Norway is relatively low compared to findings from STI clinics in other European countries, and GHB/GBL and cocaine the two most commonly used drugs with sex. Chemsex was more common among MSM having lived more than one year abroad, reporting HIV diagnoses and a higher number of either chlamydia, gonorrhoea or syphilis diagnoses in the last year. Health care providers need to be made aware of chemsex as a behavioural phenomenon among MSM, and special care should be afforded to MSM living with HIV and being diagnosed with STIs

Instruments to Identify Symptoms of Paternal Depression During Pregnancy and the First Postpartum Year: A Systematic Scoping Review

Men often experience depressive symptoms during the transition to parenthood, but there is a lack of synthesized knowledge of instruments used to identify such symptoms. The aim of this scoping review was to identify instruments used to measure symptoms of depressive symptoms among fathers in pregnancy and the postpartum period, and to describe the instruments’ characteristics and measurement properties. We identified studies published since 1990 through searches in databases such as MEDLINE, EMBASE, and PsycINFO and in gray literature. Pairs of reviewers selected relevant studies based on predetermined inclusion criteria. For each included study, we collected information relevant to the review question, guided by the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN). We included 13 instruments, described in 59 studies with about 29,000 participants across 25 countries. There were 12 validation studies. None of the instruments were uniquely developed for assessing paternal depressive symptoms related to fatherhood. The three most extensively examined instruments were the Edinburgh Postnatal Depression Scale (EPDS), Center for Epidemiologic Studies Depression Scale, and Beck Depression Inventory. For seven of the 13 instruments, there was no information reported about the instruments’ properties beyond internal consistency, but for the other six instruments the 12 validation studies reported on both reliability and validity. No studies reported on measurement error or responsiveness. EPDS was both the most extensively assessed instrument and reported to be the most reliable and valid. Further research on instruments for identifying men with depression in pregnancy and the postpartum period is warranted