Alternative medicine and herbal remedies in the treatment of erectile dysfunction: A systematic review

Objectives: To systematically review and discuss the current evidence from placebo-controlled clinical trials that investigated the use of alternative medicines and herbal remedies in the management of erectile dysfunction (ED). Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)- based systematic review using specific keyword combinations was conducted on the PubMed and Scopus databases. Randomised controlled trials investigating herbal medicine in at least one group and using the International Index of Erectile Function (IIEF) as an outcome in patients primarily diagnosed with ED were included for review. Results: Following the literature search, screening and eligibility analysis, a total of 42 articles were included. The 42 articles were categorised as single herb extractions (n = 14), combination herbal formula (n = 5), combination of herbal formula and non-herbal nutraceuticals (n = 7), non-herbal nutraceuticals (n = 5), acupuncture and moxibustion (n = 2), diet and nutrition (n = 3), exercise (n = 5), and topical treatments (n = 1). Based on the results, Korean ginseng, Pygnogenol and Prelox, Tribulus terrestris, Lepidium meyenii, L-arginine, acupuncture and lifestyle interventions were the more predominantly investigated treatments interventions for ED. Conclusions: Panax ginseng, Pygnogenol, Prelox and Tribulus terrestris have promising evidence as herbal products, alongside L-arginine as a nutritional supplement, for ED based on IIEF outcomes, and warrant further clinical investigation. The mechanisms of action remain unclear, but each of these appears to in part increase nitric oxide synthesis. Importantly, improved diet and exercise should be considered, particularly in patients with obesity or diabetes mellitus

Caregiver involvement in interventions for improving children’s dietary intake and physical activity behaviors

CITATION: Morgan, E. H., et al. 2017. Caregiver involvement in interventions for improving children’s dietary intake and physical activity behaviors. Cochrane Database of Systematic Reviews, 2:1-19, Art. CD012547, doi:10.1002/14651858.CD012547.The original publication is available at https://www.cochranelibrary.comThis is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of caregiver involvement in interventions for improving children's dietary intake and physical activity behavior, including those intended to prevent overweight and obesity. We will also describe the intervention content and the behavior change techniques employed, drawing from behavior change technique taxonomy developed and advanced by Abraham, Michie, and colleagues (Abraham 2008; Michie 2011; Michie 2013; Michie 2015). We will identify content and techniques related to the reported outcomes, where such information has been reported in included studies.https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012547Publisher's versio

Hard Structures for Coastal Protection, Towards Greener Designs

Over recent years, many coastal engineering projects have employed the use of soft solutions as these are generally less environmentally damaging than hard solutions. However, in some cases, local conditions hinder the use of soft solutions, meaning that hard solutions have to be adopted or, sometimes, a combination of hard and soft measures is seen as optimal. This research reviews the use of hard coastal structures on the foreshore (groynes, breakwaters and jetties) and onshore (seawalls and dikes). The purpose, functioning and local conditions for which these structures are most suitable are outlined. A description is provided on the negative effects that these structures may have on morphological, hydrodynamic and ecological conditions. To reduce or mitigate these negative impacts, or to create new ecosystem services, the following nature-based adaptations are proposed and discussed: (1) applying soft solutions complementary to hard solutions, (2) mitigating morphological and hydrodynamic changes and (3) ecologically enhancing hard coastal structures. The selection and also the success of these potential adaptations are highly dependent on local conditions, such as hydrodynamic forcing, spatial requirements and socioeconomic factors. The overview provided in this paper aims to offer an interdisciplinary understanding, by giving general guidance on which type of solution is suitable for given characteristics, taking into consideration all aspects that are key for environmentally sensitive coastal designs. Overall, this study aims to provide guidance at the interdisciplinary design stage of nature-based coastal defence structures

Hard Structures for Coastal Protection, Towards Greener Designs

Over recent years, many coastal engineering projects have employed the use of soft solutions as these are generally less environmentally damaging than hard solutions. However, in some cases, local conditions hinder the use of soft solutions, meaning that hard solutions have to be adopted or, sometimes, a combination of hard and soft measures is seen as optimal. This research reviews the use of hard coastal structures on the foreshore (groynes, breakwaters and jetties) and onshore (seawalls and dikes). The purpose, functioning and local conditions for which these structures are most suitable are outlined. A description is provided on the negative effects that these structures may have on morphological, hydrodynamic and ecological conditions. To reduce or mitigate these negative impacts, or to create new ecosystem services, the following nature-based adaptations are proposed and discussed: (1) applying soft solutions complementary to hard solutions, (2) mitigating morphological and hydrodynamic changes and (3) ecologically enhancing hard coastal structures. The selection and also the success of these potential adaptations are highly dependent on local conditions, such as hydrodynamic forcing, spatial requirements and socioeconomic factors. The overview provided in this paper aims to offer an interdisciplinary understanding, by giving general guidance on which type of solution is suitable for given characteristics, taking into consideration all aspects that are key for environmentally sensitive coastal designs. Overall, this study aims to provide guidance at the interdisciplinary design stage of nature-based coastal defence structures