Guia clínica per a la prevenció de l'ictus

Les persones que es troben en situació de risc vascular elevat són més propenses a patir un ictus, la qual cosa pot provocar una discapacitat permanent o, fins i tot, la mort. Poder incidir en la prevenció precoç en aquelles persones que no l'han patit, i actuar de manera intensa en les que ja han sofert un ictus, és un dels objectius estratègics del Ministeri de Sanitat i Política Social en redactar una guia per a la promoció de la salut i la prevenció de malalties prevalents. Investigadors de la Universitat Autònoma de Barcelona han participat en la elaboració d'una versió breu sobre aquesta guia, publicada a Medicina Clínica.Las personas que se encuentran en situación de riesgo vascular elevado son más propensas a sufrir un ictus, lo cual puede provocar una discapacidad permanente o, incluso, la muerte. Poder incidir en la prevención precoz en aquellas personas que no lo han sufrido, y actuar de manera intensa en las que ya han sufrido un ictus, es uno de los objetivos estratégicos del Ministerio de Sanidad y Política Social al redactar una guía para la promoción de la salud y la prevención de enfermedades prevalentes. Investigadores de la Universitat Autònoma de Barcelona han participado en la elaboración de una versión breve sobre esta guía, publicada en Medicina Clínica

Frameworks to support evidence-informed decision-making from a public health perspective

Background Evidence-to-Decision (EtD) frameworks enable to consider critical criteria for decision-making. EtD frameworks with a public health perspective have not been systematically evaluated, and their application in the infectious diseases field remains unclear. Objective To identify and describe the existing EtD frameworks from a public health perspective, and to describe examples and experiences of their current application in the infectious diseases field. Methods: We will conduct a scoping review adhering to Joanna Briggs Institute methodological guidance, and PRISMA-ScR reporting guidance. We will include documents describing EtD frameworks (a structured process supporting panels to move from the evidence to a decision) from a public health perspective (aiming to make decisions at a health system or public health level on behalf of a population). We will also include representative examples and experiences of use of these frameworks in the infectious diseases field. We will search for documents in MEDLINE and Health System Evidence (2013-2023). We will also conduct manual searches in 60 key institutions’ websites, forward and backward citation search from the included frameworks, and surveys/interviews with key stakeholders. Two reviewers will conduct the selection and data extraction process. We will describe the scope of the frameworks, target audience and setting, categories of decisions, methods for development, definition of ‘evidence’, and decision making criteria

Whole‐body vibration training for patients with neurodegenerative disease

Background Whole‐body vibration (WBV) may be a complementary training to standard physical rehabilitation programmes and appears to have potential benefits in the sensorimotor system performance of patients with neurodegenerative diseases. Objectives The aim of this review was to examine the efficacy of WBV to improve functional performance according to basic activities of daily living (ADL) in neurodegenerative diseases. Additionally, we wanted to assess the possible effect on signs and symptoms of the disease, body balance, gait, muscle performance, quality of life and adverse events. Search methods We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2011 Issue 4), MEDLINE (1964 to 6 May 2011; via PubMed), EMBASE (1980 to 6 May 2011; via Ovid), PeDro (1929 to May 2011; via website), CINAHL (to September 2011; via Ovid) and PsycINFO (1806 to 6 May 2011; via Ovid). Selection criteria We included randomised controlled trials comparing single or multiple sessions of WBV to a passive intervention, any other active physical therapy or WBV with different vibration parameters. Data collection and analysis Two review authors independently selected trials for inclusion, assessed trial quality and extracted data. Disagreement was resolved by discussion or, if necessary, referred to a third review author. Main results We included 10 trials, of which six focused on Parkinson's disease and four on multiple sclerosis. None of the studies reported data on the primary outcome (functional performance). In Parkinson's disease, after pooling two studies, a single session of WBV caused a significant improvement of gait measured using the Timed Up and Go test (TUG) in comparison to standing exercises (mean difference ‐3.09, 95% confidence interval ‐5.60 to ‐0.59; P = 0.02; I2 = 0%). Nevertheless, longer duration of WBV did not show significant results in comparison with physical therapy in body balance or signs and symptoms measured with the Unified Parkinson's Disease Rating Scale (UPDRS). In multiple sclerosis there was no evidence of a short‐term or long‐term effect of WBV on body balance, gait, muscle performance or quality of life. Adverse events were reported in few trials. In those trials that reported them, the intervention appeared to be safe. Authors' conclusions There is insufficient evidence of the effect of WBV training on functional performance of neurodegenerative disease patients. Also, there is insufficient evidence regarding its beneficial effects on signs and symptoms of the disease, body balance, gait, muscle strength and quality of life compared to other active physical therapy or passive interventions in Parkinson's disease or multiple sclerosis. More studies assessing other functional tests and accurately assessing safety are needed before a definitive recommendation is established

LIVING EVIDENCE TO INFORM HEALTH DECISIONS

“Living Evidence to inform health decisions” is a knowledge transfer and capacity building research project involving the design and evaluation of the living model strategy to generate, use, and apply innovative methods and tools to support health decisions to be based on the most recent evidence. This project has received funding by the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 894990 Contact address: Maria Ximena Rojas . E-mail: [email protected] Website: https://livingevidenceframework.com/en