Title: Journal of Family Planning and Reproductive Health Care

Title: Journal of Family Planning and Reproductive Health Care

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? Henderson, H.J. (2009), Why lesbians should be encouraged to have regular cervical screening. Journal of Family Planning and Reproductive Health Care, 35 (1), 49-52.

Abstract: Introduction The UK National Health Service Cervical Screening Programme (NHSCSP) advice on cervical cytology screening states that women who have never had sex with men are at very low risk of developing cervical cancer, and advice regarding need for screening in lesbians is inconsistent. Methods Literature review searching PUBMED, Web of Science and the Internet for articles on lesbians, cervical cancer and cervical cancer risk factors focusing on human papillomavirus (HPV) and screening behaviours. Results Case reports and prevalence studies show that HPV can be transmitted sexually between women. It is not known whether prevalence of HPV or cervical cancer differs between lesbians and heterosexual women. The evidence consistently shows that prevalence of non-attendance for cervical screening is much higher in lesbian than heterosexual women, which is linked to a belief that lesbians are less susceptible to cervical cancer and have less need for screening. Despite sharing most of the same risk factors as heterosexual women, lesbians are much less likely to undergo regular screening. Conclusions The NHSCSP should take a clear and consistent stance on the need for cervical screening in lesbians. Both the health care and the lesbian communities must be made aware of the fact that regular cervical screening is as important in this group as it is in the heterosexual female population.

Keywords: Behaviors, Bisexual Women, Cancer, Care, Case Reports, Cervical Cancer, Cervical Screening, Genital Human-Papillomavirus, Health, Health Care, HPV, Human, Human Papillomavirus, Internet, Lesbian, Literature Review, Methods, Neoplasia, Prevalence, Pubmed, Review, Risk, Risk Factors, Sample, Science, Screening, Screening Policy, Sexual Orientation, UK, Web of Science, Women

Title: Journal of Family Practice

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ISSN: 0094-3509

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? Geyman, J.P. (1983), Citation analysis of the Journal of Family Practice. Journal of Family Practice, 16 (4), 812-??.

? Flynn, C.A., D’Amico, F. and Smith, G. (1998), Should we patch corneal abrasions? A meta-analysis. Journal of Family Practice, 47 (4), 264-270.

Abstract: BACKGROUND. Eye patching is commonly recommended for treating corneal abrasions. This advice seems based more on anecdotes or disease-oriented evidence theorizing that there is faster healing or less pain when the eye is patched. This meta-analysis was performed to determine if eye patching is a useful treatment for corneal abrasions.

METHODS. We conducted a comprehensive search of both MEDLINE (1966 to 1997) and Science Citation Index to locate relevant articles. We reviewed the bibliographies of included studies, and ophthalmology and primary care texts. Local ophthalmologists and authors were contacted to identify any unpublished data. Controlled trials that evaluated eye patching compared with no patching in patients older than 6 years with uncomplicated corneal abrasions were considered. The outcomes of interest were healing rates and degree of pain.

RESULTS. Seven trials were identified for inclusion, of which five could be statistically combined. Healing rates were similar in the two groups. The summary ratios (95% confidence interval) of healing rates in the patch group as compared with the no-patch group were 0.87 (0.68 to 1.13) and 0.90 (0.75 to 1.10) at days 1 and 2, respectively. Six studies evaluated pain: four found no difference and two favored not patching. No differences in complication rates were noted between the patched and non-patched groups.

CONCLUSIONS, Eye patching was not found to improve healing rates or reduce pain in patients with corneal abrasions. Given the theoretical harm of loss of binocular vision and possible increased pain, we recommend the route of harmless nonintervention in treating corneal abrasions.

Keywords: Corneal Diseases, Meta-Analysis, Treatment, Eye, Foreign-Body Removal, Soft Contact-Lenses, Collagen Shields, Efficacy, Therapy, Trauma

? Berman, B.M., Ezzo, J., Hadhazy, V. and Swyers, J.P. (1999), Is acupuncture effective in the treatment of fibromyalgia? Journal of Family Practice, 48 (3), 213-218.

Abstract: BACKGROUND. We conducted this study to assess the effectiveness of acupuncture in the treatment of fibromyalgia syndrome (FMS), report any adverse effects, and generate hypotheses for future investigation.

METHODS. We searched MEDLINE, EMBASE, Manual Therapy Information System, the Cochrane registry, the University of Maryland Complementary and Alternative Medicine in Pain, the Centralized Information Service for Complementary Medicine, and the National Institutes of Health Office of Alternative Medicine databases for the key words “acupuncture” and “fibromyalgia.” Conference abstracts, citation lists, and letters supplemented the search. We selected all randomized or quasi-randomized controlled trials, or cohort studies of patients with FMS who were treated with acupuncture. Methodologic quality, sample characteristics, type of acupuncture treatment, and outcomes were extracted. Statistical pooling was not performed because of the differences in control groups.

RESULTS. Seven studies (3 randomized controlled trials and 4 cohort studies) were included; only one was of high methodologic quality. The high-quality study suggests that real acupuncture is more effective than sham acupuncture for relieving pain, increasing pain thresholds, improving global ratings, and reducing morning stiffness of FMS, but the duration of benefit following the acupuncture treatment series is not known. Some patients report no benefit, and a few report an exacerbation of FMS-related pain. Lower-quality studies were consistent with these findings. Booster doses of acupuncture to maintain benefit once regular treatments have stopped have been described anecdotally but not investigated in controlled trials.

CONCLUSIONS. The limited amount of high-quality evidence suggests that real acupuncture is more effective than sham acupuncture for improving symptoms of patients with FMS. However, because this conclusion is based on a single high-quality study, further high-quality randomized trials are needed to provide more robust data on effectiveness.

Keywords: Acupuncture, Fibromyalgia, Pain, Trigger Points, Systematic Review, Alternative Medicine Use, Electroacupuncture, Trials

? Smucny, J.J., Flynn, C.A., Becker, L.A. and Glazier, R.H. (2001), Are beta(2)-agonists effective treatment for acute bronchitis or acute cough in patients without underlying pulmonary disease? A systematic review. Journal of Family Practice, 50 (11), 945-951.

Abstract: OBJECTIVE our goal was to determine whether beta (2)-agonists improve the symptoms of acute bronchitis or acute cough in patients who do not have underlying pulmonary disease.

STUDY DESIGN We performed a systematic review including meta-analysis.

DATA SOURCES We included randomized controlled trials comparing beta (2)-agonists with placebo or alternative therapies identified from the Cochrane Library, MEDLINE, EMBASE, conference proceedings, Science Citation Index, the System for Information on Grey literature in Europe, and letters to manufacturers of beta (2)-agonists.

OUTCOME MEASURED We measured duration, persistence, severity or frequency of cough, productive cough, and night cough; duration of activity limitations; and adverse effects.

RESULTS Two trials in children with cough and no obvious airway obstruction did not find any benefits from beta (2)-agonists. Five trials in adults with cough and with or without airway obstruction had mixed results, but summary statistics did not reveal any significant benefits from beta (2)-agonists. Studies that enrolled more wheezing patients were more likely to show benefits from beta (2)-agonists, and in one study only patients with evidence of airflow limitation were more likely to benefit, Patients given beta (2)-agonists were more likely to report tremor, shakiness, or nervousness than those in the control groups.

CONCLUSIONS There is no evidence to support using beta (2)-agonists in children with acute cough and no evidence of airflow obstruction. There is little evidence that the routine use of beta (2)-agonists for adults with acute cough is helpful. These agents may reduce symptoms, including cough, in patients with evidence of airflow obstruction, but this potential benefit is not well-supported by the available data and must be weighed against the adverse effects associated with beta (2)-agonists.

Keywords: Bronchitis, Cough, Adrenergic Beta-Agonists, Meta-Analysis, Acute Transient Cough, Air-Flow Limitation, Family Physicians, Controlled Trial, Ambulatory Care, National Survey, Oral Albuterol, Adults, Metaanalysis, Antibiotics

? Rastegar, D.A. and Wolfe, L. (2002), Experience, expertise, or specialty? Uses and misuses of a reference. Journal of Family Practice, 51 (2), 168-U12.

Abstract: OBJECTIVE To analyze systematically the manner in which the results of a published study are presented in subsequent publications that refer to it. STUDY DESIGN We identified a convenience sample of 121 scientific papers that referred to an often-cited 1996 study by Kitahata and colleagues. This study reported that greater primary care physician experience with AIDS was associated with lower mortality among their patients with AIDS. OUTCOMES MEASURED We determined the manner in which the results of the Kitahata and coworkers study were presented, the type of article, and whether its focus was on HIV care. RESULTS Most of the articles reviewed (78%) appropriately referred to the study as evidence of improved outcomes with increasing provider experience. However, 8% of the articles reviewed referred to the study as evidence of improved outcomes with specialty care and 3% referred to it as evidence of the benefits of expert care. Articles that referred to the study as evidence of improved outcomes with specialty care were more likely to be review articles and articles with a non-HIV focus. CONCLUSIONS This study demonstrates that misrepresentation of the findings of published studies is not uncommon. More needs to be done to ensure the accuracy of references in scientific publications.

Keywords: Accuracy, AID, AIDS, Care, Design, Disease, Evidence, Experience, HIV, HIV-Infection, Hospitalist, Journals, Managed Care, Medicine, Model, Mortality, Needs, Outcome, Outcomes, Papers, Patients, Peer Review, Physician, Primary, Primary Care, Primary Health Care, Publication, Publications, Reference, References, Review, Scientific Publications, Specialty

? Blair, A.S., Lloyd-Williams, F. and Mair, F.S. (2002), What do we know about socioeconomic status and congestive heart failure? A review of the literature. Journal of Family Practice, 51 (2), 169-??.

Abstract: OBJECTIVE To examine and assess the available literature concerning the effects of socioeconomic status (SES) and congestive heart failure (CHT).

STUDY DESIGN We examined electronic databases, including: MEDLINE, EMBASE, Social Science Citation Index, Science citation index, the Cochrane Database, and Bandolier. W(hand searched recent copies of appropriate journals and scrutinized lists of identified papers. The search terms we used included “heart failure, “ “cardiac failure, “ “ventricular dysfunction, “ “social class, “ “socioeconomic, “ “poverty, “ and “deprivation.” Two reviewers independently examined and selected papers for inclusion. A standardized data collection form was used for data extraction.

OUTCOMES MEASURED We measured (1) prevalence; (2) differences in care (eg, use of diagnostic tests); (3) morbidity (eg, health care use); and (4) mortality.

DATA SOURCES We examined all English-language abstracts or papers concerning human research related to the subject of SES and CHF, including all clinical trials, reviews, discussion papers, and editorials.

RESULTS Only 8 clinical studies were identified that specifically examined aspects of the relationship, between socioeconomic status and CHF. Key themes included increased hospitalization rates with increasing social deprivation; lower income inversely associated with being placed on a waiting list for transplantation; and that those of lower socioeconomic status had a greater severity of illness on admission.

CONCLUSIONS There is a paucity of generalizable high-quality research in this subject area. Crucial issues not addressed include the effects, if any, of socioeconomic status on the behaviors of health care providers. Further investigation, with a more holistic approach, is necessary to inform future intervention strategies aimed at reducing excess mortality from CHF.

Keywords: Systematic Review [Non-Mesh], Congestive Heart Failure, Social Class, Depnivation, Risk-Factors, Cardiovascular-Disease, Racial-Differences, National Survey, Health, Care, Deprivation, Mortality, Inequalities, Prevalence

? Nash, C.E., Mickan, S.M., Del Mar, C.B. and Glasziou, P.R. (2004), Resting injured limbs delays recovery: A systematic review. Journal of Family Practice, 53 (9), 706-712.

Abstract: Objectives Rest is commonly used as primary treatment, rather than just palliation, for injured limbs. We searched the literature for evidence of benefit or harm from immobilization or mobilization of acute limb injury in adults. Data Sources We systematically searched for and retrieved randomized controlled trials (RCTs) of mobilization or rest for treatment of acute limb injuries, in MEDLINE (1966-2002), EMBASE, Web of Science, and the Cochrane library, in all languages. Review Methods We examined patient-centered outcomes (pain, swelling, and cost), functional outcomes (range of motion, days lost from work) and complications of treatment. Results Forty-nine trials of immobilization for soft. tissue injuries and fractures of both upper and lower limbs were identified (3366 patients). All studies reported either no difference between rest and early mobilization protocols, or found in favor of early mobilization. Reported benefits of mobilization included earlier return to work; decreased pain, swelling, and stiffness; and a greater preserved range of joint motion. Early mobilization caused no increased complications, deformity or residual symptoms. Conclusions We should not assume any benefit for immobilization after acute upper or lower limb injuries in adults. Rest appears to be overused as a treatment. More trials are needed to identify optimal programs for early mobilization.

Keywords: Achilles-Tendon Rupture, Adults, Cast Immobilization, Cochrane, Colles Fractures, Early Mobilization, Embase, Functional, Functional Treatment, Injury, Lateral Ankle Sprains, Literature, Malleolar Fractures, Metacarpal Fractures, Methods, Outcomes, Pain, Postoperative Immobilization, Primary, Randomized Clinical-Trial, Randomized Controlled Trials, Return To Work, Review, Science, Sources, Symptoms, Systematic, Systematic Review, Treatment, Web of Science