A Review published in BMCPregnancyChildbirth highlights the significant psychosocial impact of medicalised conception impacting antenatal and early parenting experiences, aggravated by the sociocultural context.
for details) were conducted in five databases: CINAHL , MEDLINE , PsycINFO and EMBASE and all editions of Web of Science . Due to the multi-disciplinary nature of MAC, this database selection ensured study detection from psychological, medical and nursing literature. The databases were searched from inception to March 2023, with no restriction on publication date.
Search terms were informed by the titles and abstracts of key papers and a list of keywords and synonyms were generated. Keywords and synonyms were associated with parents, assisted reproductive treatments, qualitative research, and the antenatal and postnatal period . The controlled vocabulary thesaurus of each database was used when appropriate to further identify relevant papers. Truncation and Boolean operators were utilised to combine searches for individual databases.
References were exported to Endnote Reference Managing software and duplicates removed using the ‘remove duplicates’ function. Database searches were supplemented by forward and backward searching the reference lists of included studies. The titles and abstracts of all obtained articles were screened independently against the inclusion criteria by the first author and another reviewer , who was not part of the author team.
To minimise the inclusion of studies lacking peer review and potentially conducted with less standardised scientific rigour, grey literature was excluded. Studies were also excluded when they deviated from the experience of MAC itself and focused on specific topics, such as fertility, use of donor gametes or surrogacy and when they did not focus on the parents’ perspective or lived experiences, for example, only reporting professional views.
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Temporal and spatial distribution trends of polio vaccine coverage in less than one-year old children in Brazil, 2011–2021 - BMC Public HealthBackground Low polio vaccine coverage can result in the spread of Poliovirus to areas free from viral circulation. This study analyzed the temporal trends and spatial distribution of polio vaccine coverage in one year-old children in Brazil, between 2011 and 2021. Methods: This was an ecological, time-series study (2011 to 2021) with annual vaccine coverages against poliomyelitis, extracted from the Information System of the National Immunization Program from the 26 States and the Distrito Federal (DF). The percentage reductions in vaccination coverage in Brazil and in the Regions were calculated. Prais-Winsten regression models were used to analyze time series for the Regions and States, and spatial analysis identified the distribution of clusters (high-high; low-low; high-low and low-high) of vaccination coverages across Brazilian municipalities, using a 5% significance level. Results: From 2011 to 2021, the coverage of polio vaccines decreased by 29,9%. There was a progressive increase observed in clusters resulting in low vaccination coverages (140 low-low Brazilian municipalities in 2011 vs. 403 in 2021), mostly reported in the North and Northeast regions of the country. There was a downward trend in vaccination coverages in 24 of the 26 States and DF (p ≤ 0.05). Conclusions: The reduction in polio vaccine coverage, as observed in the North and Northeast regions of Brazil, may favor the spread of Poliovirus. Therefore, vaccination strategies should be prioritized for children residing in areas with sharp and recurrent declines in vaccination coverages, including travelers, migrants, and refugees.
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Analgesic effectiveness of serratus anterior plane block in patients undergoing video-assisted thoracoscopic surgery: a systematic review and updated meta-analysis of randomized controlled trials - BMC AnesthesiologyBackground Serratus anterior plane block (SAPB) is a promising regional technique for analgesia in thoracic surgery. Till now, several randomized controlled trials (RCTs) have explored the effectiveness of SAPB for postoperative pain control in patients undergoing video-assisted thoracoscopic surgery (VATS), but the sample sizes were small and conclusions remained in controversy. Therefore, we conducted the present systematic review and meta-analysis. Methods RCTs evaluating the analgesic performance of SAPB, comparing to control methods (no block, placebo or local infiltration anesthesia), in patients undergoing VATS were searched in PubMed, EMBASE, Web of Science and Cochrane Library from inception to December 31, 2022. Mean difference (MD) and corresponding 95% confidence interval (95%CI) were calculated for postoperative pain scores at various time points, postoperative opioid consumption and length of hospital stay. Pooled relative risk (RR) with 95%CI were calculated for the risk of postoperative nausea and vomiting (PONV) and dizziness. A random-effect model was applied. Results A total of 12 RCTs (837 participants) were finally included. Compared to control group, SAPB had significant reductions of postoperative pain scores at 2 h (MD = -1.58, 95%CI: -1.86 to -1.31, P | 0.001), 6 h (MD = -2.06, 95%CI: -2.74 to -1.38, P | 0.001), 12 h (MD = -1.72, 95%CI: -2.30 to -1.14, P | 0.001) and 24 h (MD = -1.03, 95%CI: -1.55 to -0.52, P | 0.001), respectively. Moreover, SAPB conferred a fewer postoperative opioid consumption (MD = -7.3 mg of intravenous morphine equivalent, 95%CI: -10.16 to -4.44, P | 0.001) and lower incidence of PONV (RR = 0.56, 95%CI: 0.41 to 0.77, P | 0.001). There was no difference between both groups regarding length of hospital stay and risk of dizziness. Conclusion SAPB shows an excellent performance in postoperative pain management in patients undergoing VATS by reducing pains scores, postoperative opioid consumption and incidence of PONV. How
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