Testosterone products comprise a multi-billion dollar industry; however, Health Canada and the United States Food and Drug Administration have issued statements of concern about their safety, and their benefits are unclear. In the first phase of this study, we performed a systematic review of the current evidence for the benefits of testosterone replacement therapy. In the second phase, we analyzed the evidence from randomized controlled trials for the benefits of testosterone replacement therapy (depression, quality of life, erectile function, libido, total testosterone level). In the third phase, we analyzed data for harms (cardiovascular death, myocardial infarction, stroke, newly diagnosed prostate cancer, coronary artery disease or diabetes, serious adverse events, withdrawals due to adverse events, erythrocytosis) from randomized controlled trials and non-randomized studies. In general, most included studies had a short duration and were poorly reported. Additional high-quality research into the long-term safety of testosterone products is needed.

Objective. To conduct a systematic review of reports of pharmacy student research programs that describes the programs and resulting publications or presentations. Methods. To be eligible for the review, reports had to be in English and indicate that students were required to collect, analyze data, and report or present findings. The outcome variables were extramural posters/presentations and publications. Results. Database searches resulted in identification of 13 reports for 12 programs. Two-thirds were reports of projects required for a course or for graduation, and the remaining third were elective (participation was optional). Extramural posters resulted from 75% of the programs and publications from 67%. Conclusion. Although reporting on the outcomes of student research programs is limited, three-quarters of the programs indicated that extramural presentations, publications, or both resulted from student research. Additional research is needed to identify relevant outcomes of student research programs in pharmacy.

Orientador: Edison Iglesias de Oliveira Vidal / Resumo: A síndrome de fragilidade é definida como uma síndrome clínica de origem multicausal caracterizada por redução de reservas fisiológicas que aumentam a vulnerabilidade de um indivíduo a desfechos adversos como quedas, hospitalização, desenvolvimento de dependência funcional e morte. Acredita-se que a síndrome da fragilidade pode ser potencialmente modificável ou reversível mediante intervenções apropriadas. Esta é a primeira revisão sistemática com metanálise de ensaios clínicos randomizados para avaliar a eficácia de intervenções nutricionais para o tratamento da síndrome da fragilidade em idosos. Foram incluídos 11 ensaios clínicos randomizados com idosos de 60 anos ou mais com diagnóstico de síndrome da fragilidade ou pré-fragilidade. Metanálises bayesianas de efeitos randômicos não revelaram diferenças estatisticamente significativas ao comparar a suplementação nutricional isolada com grupos controle que receberam placebo ou nenhum tratamento em relação ao escore de síndrome da fragilidade (MD: 0,09 pontos, IC 95%: -0,45 a 0,62), Bateria de Desempenho Físico Breve (SMD: 0,29, IC 95%: -0,55 a 1,40), força muscular (SMD: -0,14, IC 95%: -0,38 a 0,09), velocidade da marcha (SMD: 0,06, IC 95%: -0,04 a 0,17), massa magra apendicular (MD: 0,60kg, IC 95%: -0,82 a 2,01), massa gorda (MD: 1,67kg, IC 95%: -0,63 a 3,96), memória declarativa (SMD: 0,11, IC 95%: -0,31 a 0,53), linguagem e função executiva (MD: 0,21 pontos, IC 95%: -0,99 a 1,42) e outros resultados. Estudo único de inter... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Frailty is a clinical syndrome of multicausal origin characterized by a reduction of physiological reserves that increase the vulnerability of an individual to adverse outcomes such as falls, hospital admission, disability and death. It has been suggested that frailty can be potentially modifiable or even reversible with appropriate interventions. This is the first systematic review with meta-analysis or Randomized Clinical Trials (RCTs) to appraise the effectiveness of nutritional interventions for the treatment of frailty in older adults. We included 11 RCTs of people aged 60 years and older with a diagnosis of frailty or pre-frailty. Bayesian random effects meta-analyses found no statistically significant differences when comparing nutritional supplementation alone with control groups receiving placebo or no treatment regarding frailty score (MD: 0.09 points, 95%CI: -0.45 to 0.62), Short Physical Performance Battery (SMD: 0.29, 95%CI: -0.55 to 1.40), muscle strength (SMD: -0.14, 95%CI: -0.38 to 0.09), gait speed (SMD: 0.06, 95%CI: -0.04 to 0.17), appendicular lean mass (MD: 0.60kg, 95%CI: -0.82 to 2.01), fat mass (MD: 1.67kg, 95%CI: -0.63 to 3.96), declarative memory (SMD: 0.11, 95%CI: -0.31 to 0.53), language & executive function (MD: 0.21 points, 95%CI: -0.99 to 1.42) and other outcomes. Single study of nutritional education interventions also did not show any significant improvements in comparison with general health advice. The overall quality of evidence assessed usin... (Complete abstract click electronic access below) / Mestre

The dissertation, of limited scope, reviewed existing research on multilingualism in challenging educational contexts. The aim was to explore and determine the state of research in the area of multilingualism in educational contexts that are considered challenging, over the time period 2010 to 2020. In addition, the dissertation of limited scope also explored the benefits of multilingualism and how the current state of research influences future research through the identification of trends and gaps. The research was collected and identified through a rigorous process whereby specific search strategies were used with particular keywords. Distinct databases such as JSTOR PsycARTICLES, Academic Search Complete, and Linguistic Collection as well as other journal and Internet resources were used to obtain 34 studies relevant to the research questions of the dissertation of limited scope. The results showed that 1) research related for multilingualism in challenging contexts of education is centred around the trends of pedagogical practices of learning, first language as the language of instruction, academic achievement and the resourcefulness of multilingualism, 2) multilingualism in 3) there is great opportunity for future research in this linguistic and academic area due to the lack of research and visible gaps in the literature over the last ten years. As there has been no previous overview, the findings provide a theoretical contribution to research on multilingualism in challenging contexts. They both encourage future research in a South African context and also indicate that research in other similar global contexts should be conducted. The findings provide an overview of relevant information for any parties that may be interested in this area of multilingualism and serve as a reference point for further research. / Dissertation (MEd)--University of Pretoria, 2020. / Educational Psychology / MEd / Unrestricted

Background Pulmonary diseases are the leading causes of mortality globally amongst children under five years of age. Economic evaluations (EEs) guide decision-makers on which health care intervention to adopt to reduce paediatric pulmonary disease burden. Methods We systematically reviewed EEs for paediatric pulmonary diseases published globally between 2010 and 2020. We searched PubMed, Web of Science, MEDLINE, Paediatric Economic Database Evaluation (PEDE), and the Cochrane library. EEs included were specific to paediatric pulmonary diseases in a hospital setting and of children aged from zero to six years old. We extracted data items guided by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. We collected qualitative and quantitative data which we analysed in Microsoft Excel and R Software. Results 22 studies met the inclusion criteria. Seven of the articles were cost-effectiveness analyses, five cost-utility analyses, two cost-minimisation analyses, and eight cost analyses. Fourteen studies were conducted in high-income countries, eight in low-middle-income countries (LMICs). Ten studies were on asthma, nine on pneumonia, two on asthma and pneumonia, and one on tuberculosis. Quality assessment of the articles revealed some methodological inconsistencies across the articles. Conclusion Fewer EEs were conducted in LMICs, yet children from these countries are disproportionately affected by pulmonary diseases. Developing standardised methods for EEs and conducting more EEs and for paediatric pulmonary diseases in LMICs could allow for more evidence-based decision-making.

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Public and scholarly interest in the intergenerational effects of maternal adverse childhood experiences (ACEs) on children’s internalizing or externalizing behaviors continues to grow. ACEs are defined as traumatic events that occur prior to the age of eighteen, such as emotional, physical, or sexual abuse, neglect, and household dysfunction. The existing research has helped explicate the potential intergenerational consequences of these events on a child’s behavior, which provides useful information on who is the most at-risk. A systematic review was conducted to determine these effects. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases CIANHL, PubMed, PsycINFO, PsycARTICLES, Sociological Abstracts, and Web of Science were used to search for articles measuring maternal ACEs and child internalizing or externalizing behaviors. Other inclusion criteria were that the journal articles presented results from empirical studies, and the articles were published between 1995 and January 2022. The initial search yielded 1601 possible articles. Two independent reviewers reviewed all abstracts to determine whether the study met inclusion criteria; 22 articles were retained for data extraction. Across studies, children were assessed across a range of ages from 6 weeks to 16-17 years old. Participants were primarily recruited from medical clinics, followed by schools, although there was diversity of recruitment site, with some studies recruiting from Head Start programs, domestic violence shelters, WIC clinics, CPS reports, and an online platform. The majority of studies included used retrospective reporting of the original 10-item ACEs questionnaire to assess maternal ACEs, and the Child Behaviors Checklist was commonly used to assess child internalizing and externalizing behaviors. The outcomes most commonly predicted by maternal ACEs included child externalizing behaviors, depression, behavioral and social-emotional problems, anxiety, and negative temperament characteristics. Other outcomes less commonly assessed, but found to be associated with maternal ACEs, were lower academic performance, developmental delays, attention problems, trauma symptoms, and likelihood of psychiatrics diagnosis overall. Inconsistent results were found for internalizing behaviors, as some studies found these to be significantly associated with maternal ACEs, while this relationship was not significant in other studies. Mediators and moderators explored in the studies were also extracted and will be presented as well. Results of this systematic review highlight what is currently known in this field, and identify opportunities for future research. For example, examining internalizing behaviors as a unitary construct may be less helpful than examining specific internalizing behaviors individually, given the conflicting findings in this area.

Yes / Purpose: The aim of this study was to systematically review the literature to investigate the link (if any) between vision and dizziness. Methods: Medline, CINAHL, AMED, Web of Science and The Cochrane Library were searched with keywords chosen to find articles which investigated the causes of dizziness and considered vision as a possible trigger. Citation chaining of all included papers was performed in addition to the hand searching of all reference lists. Unpublished literature was identified using www.opengrey.eu. The review considered studies involving adults which link, measure or attempt to improve any aspect of vision in relation to dizziness. Results: Nine thousand six hundred and eighty one possible references were found, and the abstracts were screened independently by two reviewers to determine if they should be included in the study. Thirteen papers were found which investigated whether dizziness was linked to an assessment of vision. Visual impairment measures were crude and typically self-report, or Snellen visual acuity with little or no measurement details. Five studies found an independent link between dizziness and vision, five found a weak association (typically finding a link when univariate analyses were used, but not when multivariate analyses were used), and three found no association. Studies finding a strong link were usually cross-sectional with a large study population whereas those finding a weak association had relatively small numbers of participants. Studies which did not find an association used a broad definition of dizziness that included the term light-headedness, an unreliable Rosenbaum near visual acuity chart or an unusual categorisation of visual acuity. Conclusions: This review suggests that dizziness (although likely not ‘light-headedness’) is linked with poor vision although further studies using more appropriate measures of vision are recommended. / Deborah Armstrong was funded by a College of Optometrists Research Scholarship and Emily Charlesworth by a College of Optometrists summer studentship.

Modern Autism Spectrum Disorder (ASD) research has shifted in focus from explaining a debilitating childhood illness to helping individuals of all ages, cultures, and intelligence navigate their social problems. Understanding of the adult perspective has also grown massively since the autism diagnosis changed in the Diagnostic Statistical Manual, Fifth Edition (DSM-5) in 2013 and has brought into question how the neurodevelopmental disorder affects the individual. Anxiety symptoms in ASD, like the existence of camouflaging, have proven unique only to ASD, and recent findings suggests that the cause of anxiety in autistic individuals may be due to fundamental differences in communication that affect both the level of care received by the individual as well as the effectiveness of social interaction with neurotypical peers. This systematic review consolidates recent findings in research on the characteristics of anxiety disorders in autism spectrum disorder, from presentation to treatment options and quality of life surrounding an individual with both comorbidities. Results show not only an atypical anxiety presentation, but a concerning look at the state of autistic research as a whole.

No / Fatigue is common in people with multiple sclerosis (MS) and symptoms of fatigue are often reported as the most debilitating symptoms of the disease. However, there are few reports of interventions for fatigue in MS. A systematic review of published literature examining pharmacological and psychosocial/psychological interventions for fatigue in MS was conducted. The search and review strategy undertaken used the Centre for Reviews and Dissemination guidelines. Papers were reviewed by two independent reviewers. Of 81 studies short-listed for inclusion, 15 studies were included, of which 10 were studies of pharmacological therapy and five were studies of psychosocial/psychological interventions. Of the pharmacological studies, two were rated as of moderate-to-high quality, three of moderate quality, two of moderate-to-low quality and three of low quality. Of the psychosocial/psychological studies, three were rated as of moderate quality and two of moderate-to-low quality. None of the studies reviewed reached the highest level of quality according to pre-agreed criteria. Regardless of level of quality, effectiveness of both pharmacological and psychosocial/psychological interventions was modest at best and often absent. Accordingly, there is little evidence-based advice that can be offered to people with MS to help manage their fatigue.