This integrative review synthesizes the scientific evidence on fertility preservation counseling prior to oncological treatment for women of reproductive age diagnosed with cancer. Bibliographic research was conducted on databases PubMed, CINAHL, LILACS, EMBASE, Scopus, and Web of Science. The structured search strategy for the review question was \"counseling AND antineoplastic agents AND fertility preservation\". The use of controlled descriptors and keywords was adapted for each database. Study selection through the Rayyan platform was independent and blinded. The final sample comprised seven studies emphasizing the importance of clarifying factors related to the risk of infertility due to oncological treatment and fertility preservation techniques, such as success rate, pregnancy rate, cost, available options, and side-effects, as well as discussing the possibilities of adoption and surrogacy. This review provided evidence reinforcing the importance of counseling for fertility preservation, promoting motherhood for women who face oncological treatment. Organized networks linking oncology and reproductive medicine units are crucial to facilitate patient referral between these services and interprofessional communication.

Older patients are regularly exposed to multiple medication changes during a hospital stay and are more likely to experience problems understanding these changes. Medication counselling is often proposed as an important component of seamless care to ensure appropriate medication use after hospital discharge.
The purpose of this systematic review was to describe the components of medication counselling in older patients (aged ≥ 65 years) prior to hospital discharge and to review the effectiveness of such counselling on reported clinical outcomes.
Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology (PROSPERO CRD42019116036), a systematic search of MEDLINE, EMBASE and CINAHL was conducted. The QualSyst Assessment Tool was used to assess bias. The impact of medication counselling on different outcomes was described and stratified by intervention content.
Twenty-nine studies were included. Fifteen different components of medication counselling were identified. Discussing the dose and dosage of patients\' medications (19/29; 65.5%), providing a paper-based medication list (19/29; 65.5%) and explaining the indications of the prescribed medications (17/29; 58.6%) were the most frequently encountered components during the counselling session. Twelve different clinical outcomes were investigated in the 29 studies. A positive effect of medication counselling on medication adherence and medication knowledge was found more frequently, compared to its impact on hard outcomes such as hospital readmissions and mortality. Yet, evidence remains inconclusive regarding clinical benefit, owing to study design heterogeneity and different intervention components. Statistically significant results were more frequently observed when counselling was provided as part of a comprehensive intervention before discharge.
Substantial heterogeneity between the included studies was found for the components of medication counselling and the reported outcomes. Study findings suggest that medication counselling should be part of multifaceted interventions, but the evidence concerning clinical outcomes remains inconclusive.

BACKGROUND: Physical activity and dietary change programmes play a central role in addressing public health priorities. Programme evaluation contributes to the evidence-base about these programmes; and helps justify and inform policy, programme and funding decisions. A range of evaluation frameworks have been published, but there is uncertainty about their usability and applicability to different programmes and evaluation objectives, and the extent to which they are appropriate for practitioner-led or researcher-led evaluation. This review appraises the frameworks that may be applicable to evaluation of physical activity and/or dietary change programmes, and develops a typology of the frameworks to help guide decision making by practitioners, commissioners and evaluators.
METHODS: A scoping review approach was used. This included a systematic search and consultation with evaluation experts to identify evaluation frameworks and to develop a set of evaluation components to appraise them. Data related to each framework\'s general characteristics and components were extracted. This was used to construct a typology of the frameworks based on their intended programme type, evaluation objective and format. Each framework was then mapped against the evaluation components to generate an overview of the guidance included within each framework.
RESULTS: The review identified 71 frameworks. These were described variously in terms of purpose, content, or applicability to different programme contexts. The mapping of frameworks highlighted areas of overlap and strengths and limitations in the available guidance. Gaps within the frameworks which may warrant further development included guidance on participatory approaches, non-health and unanticipated outcomes, wider contextual and implementation factors, and sustainability.
CONCLUSIONS: Our typology and mapping signpost to frameworks where guidance on specific components can be found, where there is overlap, and where there are gaps in the guidance. Practitioners and evaluators can use these to identify, agree upon and apply appropriate frameworks. Researchers can use them to identify evaluation components where there is already guidance available and where further development may be useful. This should help focus research efforts where it is most needed and promote the uptake and use of evaluation frameworks in practice to improve the quality of evaluation and reporting.

Three-dimensional (3D) printing has profoundly impacted biomedicine. It has been used to pattern cells; replicate tissues or full organs; create surgical replicas for planning, counseling, and training; and build medical device prototypes and prosthetics, and in numerous other applications.
To assess the impact of 3D printing for surgical planning, training and education, patient counseling, and costs in urology.
A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
After screening, 4026 publications were identified for detailed review, of which 52 were included in the present systematic review: two papers reported the use of 3D-printing modeling for adrenal cancer, two papers for urethrovesical anastomosis, 24 papers for kidney transplantation and renal cancer, 13 papers for prostate cancer, seven papers for pelvicalyceal system procedures, and three papers for ureteral stents, and three papers reported 3D-printed biological scaffold development.
Three-dimensional printing shows revolutionary potentials for patient counseling, pre- and intraoperative surgical planning, and education in urology. Together with the \"patient-tailored\" presurgical planning, it puts the basis for 3D-bioprinting technology. Although costs and \"production times\" remain the major concerns, this kind of technology may represent a step forward to meet patients\' and surgeons\' expectations.
Three-dimensional printing has been used for several purposes to help the surgeon better understand anatomy, sharpen his/her skills, and guide the identification of lesions and their relationship with surrounding structures. It can be used for surgical planning, education, and patient counseling to improve the decision-making process.

The incidence of colorectal cancer among reproductive-aged women is increasing. Concerns regarding future fertility are secondary only to concerns regarding survival and may significantly impact quality of life among reproductive-aged female cancer survivors. Fertility preservation counseling reduces long-term regret and dissatisfaction among cancer survivors. Health care providers counseling patients with colorectal cancer must understand the impact of cancer treatment on future reproductive potential.
This review aims to examine the effects that colorectal cancer treatments have on female fertility and summarize existing and emerging options for fertility preservation.
EMBASE, National Library of Medicine (MEDLINE)/PubMed, Cochrane Review Library were the data sources for this review.
A systematic literature review was performed using exploded MeSH terms to identify articles examining the effect of surgery, chemotherapy, and radiation, as well as fertility preservation options for colorectal cancer on female fertility. Relevant studies were included.
The primary outcome was the effect of colorectal cancer treatment on fertility.
There are limited data regarding the impact of colorectal surgery on fertility. The gonadotoxic effects of chemotherapy on reproductive capacity depend on age at the time of chemotherapy administration, cumulative chemotherapy, radiation dose, type of agent, and baseline fertility status. Chemotherapy-induced risks for colorectal cancers are considered low to moderate, whereas pelvic radiation with a dose of 45 to 50 Gray induces premature menopause in greater than 90% of patients. Ovarian transposition may reduce but not eliminate the damaging effect of radiation on the ovaries. Embryo and oocyte cryopreservation are considered standard of care for women desiring fertility preservation, with oocyte cryopreservation no longer being considered experimental. Ovarian tissue cryopreservation remains experimental but may be an option for select patients. The use of gonadotropin-releasing hormone agonists remains controversial and has not been definitively shown to preserve fertility.
The limitations of this review are the lack of randomized controlled trials and high-quality studies, as well as the small sample sizes and the use of surrogate fertility markers.
Reproductive-aged women with colorectal cancer benefit from fertility preservation counseling before the initiation of cancer treatment.

The development and maintenance of healthy lifestyle behaviours are among the most promising strategies for reducing complications and premature death among women living with type 2 diabetes mellitus (T2DM). However, despite the potential benefits of these interventions, they have had varying success and the sustained uptake of the recommended lifestyle modifications is limited. This paper reviews research on the impact of lifestyle interventions aimed at improving health and health behaviours in women with T2DM. In a systematic review of the literature, empirical literature from 2011 to 2017 is examined to explore the effects of various lifestyle interventions on a number of objective and subjective health indicators in women with T2DM. A total of 18 intervention studies in women aged between 21 and 75 years were included in this narrative review. Interventions included education/counselling, exercise, diet, or combined components of varying duration. The included studies used a variety of objective indicators, including glycaemic control, lipid profile and anthropometric indices, as well as a number of diabetes-specific and generic subjective scales (for example, the Diabetes Problem Solving Inventory and the Short Form 36). Significant heterogeneity was noted in the interventions and also the study findings, although exercise interventions tended to yield the most consistent benefit in relation to glycaemic control, while exercise/dietary interventions generally improved anthropometric indices. The findings from this review did not consistently suggest the greater value of any one type of intervention. Future research should consider interventions that target multiple health behaviours and emphasize health literacy, self-efficacy, and problem-solving skills.

BACKGROUND: Alcohol is a leading risk factor contributing to the global burden of disease. National and international agencies recommend evidence-based screening and brief interventions in primary care settings in order to reduce alcohol consumption. However, the majority of primary care professionals do not routinely deliver such interventions.
OBJECTIVE: To identify factors influencing general practitioners/family physicians\' and primary care nurses\' routine delivery of alcohol screening and brief intervention in adults.
METHODS: A systematic literature search will be carried out in the following electronic databases: Medline, CINAHL, CENTRAL, and PsycINFO. Two authors will independently abstract data and assess study quality using the NIH National Heart, Lung, and Blood Institute quality assessment tools for quantitative studies, and the CASP checklist for qualitative studies. A narrative synthesis of the findings will be provided, structured around the barriers and facilitators identified. Identified barriers and facilitators will be further analysed using the Behavioural Change Wheel/Theoretical Domains Framework.
CONCLUSIONS: This review will describe the barriers to, and facilitators for, the implementation of alcohol screening and brief interventions by general practitioners/family physicians and nurses at primary care practices. By mapping the barriers and facilitators to the domains of the Behavioural Change Wheel/Theoretical Domains Framework, this review will also provide implementation researchers with a useful tool for selecting promising practitioner-oriented behavioural interventions for improving alcohol screening and brief intervention delivery in primary care.
CONCLUSIONS: This review will provide important information for implementing alcohol screening and brief intervention in primary health care.Systematic Review Registration: PROSPERO CRD42016052681.
Introdução: O consumo de álcool é um importante fator de risco a nível mundial. Apesar de serem recomendadas por muitas instâncias nacionais e internacionais, a deteção e intervenção breve no consumo de álcool ainda não está integrada na prática da maioria dos profissionais de saúde dos Cuidados de Saúde Primários. Objetivo: Identificar as barreiras e os facilitadores à implementação da deteção e intervenção breve nos consumos de álcool nos Cuidados de Saúde Primários por parte dos Médicos e Enfermeiros de Família. Material e Métodos: Será realizada uma revisão sistemática da literatura nas seguintes bases de dados: Medline, CINAHL, CENTRAL, e PsycINFO. Dois autores irão, de forma independente, extrair os dados, e avaliar a qualidade dos estudos selecionados. A qualidade dos estudos quantitativos será avaliada através das checklists do NIH National Heart, Lung, and Blood Institute, enquanto a dos estudos qualitativos será avaliada através da checklist CASP. Os resultados serão apresentados numa síntese narrativa, estruturada em torno das barreiras e facilitadores identificados, e analisados à luz dos domínios teóricos da Behavioural Change Wheel/Theoretical Domains Framework. Discussão: Esta revisão sistemática descreverá as barreiras e os facilitadores à implementação da deteção e intervenção breve nos consumos de álcool nos Cuidados de Saúde Primários. Ao estabelecer a ligação entre estes fatores e os diferentes domínios teóricos da Behavioural Change Wheel/Theoretical Domains Framework, esta revisão sistemática vai facilitar o desenho de programas que visem a implementação destas boas práticas neste nível de cuidados. Conclusão: Esta revisão contribuirá com informação importante para a implementação da deteção e intervenção breve nos consumos de álcool nos Cuidados de Saúde Primários. Registo: PROSPERO CRD42016052681.

Care of pregnant woman, including fertility and procreation counseling, has become a significant part of the nephrological practice in the last years. In this context, the management of immunosuppression assumes a primary role both for autoimmune diseases and for post-transplant follow up. The present review analyzes the latest evidence on immunosuppressive drugs of current use in nephrology and kidney transplantation. Although the placenta inactivates prednisone and prednisolone, it is advisable to limit the dose to the minimal effective one, to prevent side effects. Azathioprine is generally the immunosuppressive of choice in many high-risk pregnancies in autoimmune diseases because of the safety profile and its steroid-sparing property. In lupus nephropathy, hydroxychloroquine is a current indication in the prevention of flares. Cyclosporine and tacrolimus can also be used as steroid-sparing agents as well as in post-transplant maintenance therapy. Experience on mammalian target of rapamycin inhibitors is limited and its use during pregnancy is still controversial even if initial positive data are emerging. Intravenous immunoglobulins are safe and represent an important option for relapses of lupus and vasculitis. Mycophenolate mofetil and cyclophosphamide are to avoid. An important part is reserved to biologic agents, which are having a huge impact on therapy protocols for several pathologies. Data on the utilization of these molecules during pregnancy, however, are still scant and therefore they do not yet allow a definitive evaluation of their safety profile.

BACKGROUND: There is currently no specific guidance on the role of exercise in managing postpartum depression in the UK and US, and international guidance is inconsistent.
OBJECTIVE: To assess the effectiveness of aerobic exercise on postpartum depressive symptoms.
METHODS: Systematic review and meta-analysis. There was no restriction to study site or setting.
METHODS: The databases MEDLINE, EMBASE, Cochrane Library, PsycINFO, SportDiscus, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform were searched. Titles and abstracts, then full-text articles, were screened against inclusion criteria: RCTs measuring depressive symptoms in mothers ≤1 year postpartum; and interventions designed to increase aerobic exercise compared with usual care or other comparators. Included studies were assessed using the Cochrane Collaboration\'s risk of bias tool. Meta-analysis was conducted. Pre-planned subgroup analyses explored heterogeneity.
RESULTS: Thirteen RCTs were included, with 1734 eligible participants. Exercise significantly reduced depressive symptoms when all trials were combined (standardised mean difference -0.44; 95% confidence interval = -0.75 to -0.12). Exploration of heterogeneity did not find significant differences in effect size between women with possible depression and in general postpartum populations; exercise only and exercise with co-interventions; and group exercise and exercise counselling.
CONCLUSIONS: This systematic review provides support for the effectiveness of exercise in reducing postpartum depressive symptoms. Group exercise, participant-chosen exercise, and exercise with co-interventions all may be effective interventions. These results should be interpreted with caution because of substantial heterogeneity and risk of bias.

OBJECTIVE: Physical activity, sedentary and sleep behaviours have strong associations with health. This systematic review aimed to identify how clinical practice guidelines (CPGs) for the management of chronic obstructive pulmonary disease (COPD) report specific recommendations and strategies for these movement behaviours.
METHODS: A systematic search of databases (Medline, Scopus, CiNAHL, EMbase, Clinical Guideline), reference lists and websites identified current versions of CPGs published since 2005. Specific recommendations and strategies concerning physical activity, sedentary behaviour and sleep were extracted verbatim. The proportions of CPGs providing specific recommendations and strategies were reported.
RESULTS: From 2370 citations identified, 35 CPGs were eligible for inclusion. Of these, 21 (60%) provided specific recommendations for physical activity, while none provided specific recommendations for sedentary behaviour or sleep. The most commonly suggested strategies to improve movement behaviours were encouragement from a healthcare provider (physical activity n = 20; sedentary behaviour n = 2) and referral for a diagnostic sleep study (sleep n = 4).
CONCLUSIONS: Since optimal physical activity, sedentary behaviour and sleep durations and patterns are likely to be associated with mitigating the effects of COPD, as well as with general health and well-being, there is a need for further COPD-specific research, consensus and incorporation of recommendations and strategies into CPGs.