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Marsh SA, Parsafar S, Byrne MK. Should my child be given antibiotics? A systematic review of parental decision making in rural and remote locations. Antimicrob Resist Infect Control 2024; 13:105. [PMID: 39294826 PMCID: PMC11412025 DOI: 10.1186/s13756-024-01409-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 05/10/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND The emergence and growth in antibiotic resistant bacteria is a critical public health problem exacerbated by the misuse of antibiotics. Children frequently succumb to illness and are often treated with antibiotic medicines which may be used improperly by the parent. There is limited evidence of the factors influencing parental decision-making about the use of antibiotics in low-resource contexts. The aim of this systematic review was to understand and describe how parents living in rural and remote locations make choices about their children's antibiotic use. METHOD The CINAHL, Web of Science, Medline, Scopus and Academic Search Premier databases were systematically searched from 31 January until 28 June in 2023. No date restrictions were applied and additional search methods were utilised to identify further studies that met inclusion criteria. Eligibility criteria included studies which reported on factors contributing to parental decisions about their children's use of antibiotics in rural and remote settings. The Joanna Briggs Institute Critical Appraisal Checklists were employed to evaluate studies. Characteristics and findings were extracted from studies, and data was synthesised descriptively and presented in summary tables. RESULTS A total of 3827 articles were screened and 25 worldwide studies comprising of quantitative, qualitative and prospective designs were included in the review. Studies that reported the number of rural caregivers consisted of 12 143 participants. Data analysis produced six broad themes representing the mechanisms that influenced parents in their access and use of antibiotics: the child's symptoms; external advice and influences; parent-related determinants; barriers to healthcare; access to antibiotics; and socio-demographic characteristics. CONCLUSIONS A number of factors that influence parents' prudent use of antibiotics in rural contexts were identified. In seeking to enhance appropriate use of antibiotics by parents in rural and remote settings, these determinants can serve to inform interventions. However, the identified studies all relied upon parental self-reports and not all studies reviewed reported survey validation. Further research incorporating validated measures and intervention strategies is required. REGISTRATION DETAILS Should my child be given antibiotics? A systematic review of parental decision making in rural and remote locations; CRD42023382169; 29 January 2023 (date of registration). Available from PROSPERO.
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Affiliation(s)
- Stephanie A Marsh
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Sara Parsafar
- Discipline of Psychology, School of Arts and Sciences, The University of Notre Dame Australia, Sydney, NSW, Australia.
| | - Mitchell K Byrne
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
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Blanchard L, Ray S, Law C, Vega-Sala MJ, Bidonde J, Bridge G, Egan M, Petticrew M, Rutter H, Knai C. The effectiveness, cost-effectiveness and policy processes of regulatory, voluntary and partnership policies to improve food environments: an evidence synthesis. PUBLIC HEALTH RESEARCH 2024; 12:1-173. [PMID: 39323285 DOI: 10.3310/jywp4049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2024] Open
Abstract
Background Dietary factors are among the largest and costliest drivers of chronic diseases in England. As a response, the government implements a range of population interventions to promote healthy diets by targeting food environments. Objectives This study aimed to conduct a systematic review of the effectiveness, cost-effectiveness and policy process of real-world evaluations of national and state policies on improving food environments, with a focus on whether they were regulatory, voluntary or partnership approaches. Data sources Fourteen relevant English-language databases were searched in November 2020 for studies published between 2010 and 2020. Methods Six separate evidence reviews were conducted to assess the evidence of effectiveness, cost-effectiveness and policy processes of policies to improve food environments. Results A total of 483 primary research evaluations and 14 evidence syntheses were included. The study reveals considerable geographic, methodological and other imbalances across the literature, with, for example, 81% of publications focusing only on 12 countries. The systematic reviews also reveal the effectiveness and cost-effectiveness of reviewed regulatory approaches designed to improve health, consumer behaviour and food environment outcomes while public-private partnerships and voluntary approaches to improve diets via reformulation, advertising and promotion restrictions or other changes to the environment were limited in their effectiveness and cost-effectiveness. The study also revealed key enabling and impeding factors across regulatory, voluntary and public-private partnership approaches. Conclusion From the available evidence reviewed, this study finds that regulatory approaches appear most effective at improving the food environment, and voluntary agreements and partnerships have limited effectiveness. These findings should be carefully considered in future public health policy development, as should the findings of geographic imbalance in the evidence and inadequate representation of equity dimensions across the policy evaluations. We find that food policies are at times driven by factors other than the evidence and shaped by compromise and pragmatism. Food policy should be first and foremost designed and driven by the evidence of greatest effectiveness to improve food environments for healthier diets. Limitations This was a complex evidence synthesis due to its scope and some policy evaluations may have been missed as the literature searches did not include specific policy names. The literature was limited to studies published in English from 2010 to 2020, potentially missing studies of interest. Future work Priorities include the need for guidance for appraising risk of bias and quality of non-clinical studies, for reporting policy characteristics in evaluations, for supporting evaluations of real-world policies equitably across geographic regions, for capturing equity dimensions in policy evaluations, and for guideline development for quality and risk of bias of policy evaluations. Study registration This study is registered as PROSPERO CRD42020170963. Funding This award project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: NIHR128607) and is published in full in Public Health Research; Vol. 12, No. 8. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Laurence Blanchard
- London School of Hygiene & Tropical Medicine, Faculty of Public Health and Policy, London, UK
| | - Stephanie Ray
- London School of Hygiene & Tropical Medicine, Faculty of Public Health and Policy, London, UK
| | - Cherry Law
- University of Reading, School of Agriculture, Policy and Development, Reading, UK
| | | | - Julia Bidonde
- National Institute of Public Health, Department of Reviews and Health Technology Assessments, Oslo, Norway
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan University of Saskatchewan, Saskatoon, Canada
| | - Gemma Bridge
- University of Leeds, Leeds, UK
- York St John University, York Business School, York, UK
| | - Matt Egan
- London School of Hygiene & Tropical Medicine, Faculty of Public Health and Policy, London, UK
| | - Mark Petticrew
- London School of Hygiene & Tropical Medicine, Faculty of Public Health and Policy, London, UK
| | - Harry Rutter
- University of Bath, Department of Social and Policy Sciences, Bath, UK
| | - Cécile Knai
- London School of Hygiene & Tropical Medicine, Faculty of Public Health and Policy, London, UK
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Yuan L, Du L, Gao Y, Zhang Y, Shen Y. The challenges and benefits of public health in smart cities from a 4 M perspective. Front Public Health 2024; 12:1361205. [PMID: 38887254 PMCID: PMC11180731 DOI: 10.3389/fpubh.2024.1361205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 03/07/2024] [Indexed: 06/20/2024] Open
Abstract
Introduction With the acceleration of urbanization, public health issues have become increasingly prominent in smart city construction, especially in the face of sudden public health crises. A deep research method for public health management based on a 4M perspective (human, machine, materials, methods) is proposed to effectively address these challenges. Methods: The method involves studying the impact of human factors such as population age, gender, and occupation on public health from a human perspective. It incorporates a machine perspective by constructing a public health prediction model using deep neural networks. Additionally, it analyzes resource allocation and process optimization in public health management from the materials and methods perspectives. Results The experiments demonstrate that the public health prediction model based on deep neural networks achieved a prediction accuracy of 98.6% and a recall rate of 97.5% on the test dataset. In terms of resource allocation and process optimization, reasonable adjustments and optimizations increased the coverage of public health services by 20% and decreased the response time to public health events by 30%. Discussion This research method has significant benefits for addressing the challenges of public health in smart cities. It can improve the efficiency and effectiveness of public health services, helping smart cities respond more quickly and accurately to potential large-scale public health events in the future. This approach holds important theoretical and practical significance.
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Affiliation(s)
- Lirong Yuan
- Hebei University of Chinese Medicine, Shijiazhuang, China
- Traditional Chinese Medicine Health Care Research Key Laboratory Project of Hebei Province, Shijiazhuang, China
| | - Lihong Du
- Hebei University of Chinese Medicine, Shijiazhuang, China
- Traditional Chinese Medicine Health Care Research Key Laboratory Project of Hebei Province, Shijiazhuang, China
| | - Yonggang Gao
- Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Yujin Zhang
- Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Yongqing Shen
- Hebei University of Chinese Medicine, Shijiazhuang, China
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Shah M, Dansky Z, Nathavitharana R, Behm H, Brown S, Dov L, Fortune D, Gadon NL, Gardner Toren K, Graves S, Haley CA, Kates O, Sabuwala N, Wegener D, Yoo K, Burzynski J. NTCA Guidelines for Respiratory Isolation and Restrictions to Reduce Transmission of Pulmonary Tuberculosis in Community Settings. Clin Infect Dis 2024:ciae199. [PMID: 38632829 DOI: 10.1093/cid/ciae199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Affiliation(s)
- Maunank Shah
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Zoe Dansky
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Ruvandhi Nathavitharana
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, USA
| | - Heidi Behm
- TB Program, Oregon Health Authority, Portland, OR, USA
| | | | - Lana Dov
- Washington State Department of Health, WA, USA
| | - Diana Fortune
- National Tuberculosis Controllers Association, Smyrna, GA, USA
| | | | | | - Susannah Graves
- Department of Public Health, City and County of San Francisco, CA, USA
| | - Connie A Haley
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, TN, USA
| | - Olivia Kates
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | - Kathryn Yoo
- Society of Epidemiologists in Tuberculosis Control (SETC); Texas Department of State Health Services, Tuberculosis and Hansen's Disease Unit (TXDSHS), TX, USA
| | - Joseph Burzynski
- New York City Department of Health and Mental Hygiene, New York, NY, USA
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Michel SKF, Atmakuri A, von Ehrenstein OS. Systems for rating bodies of evidence used in systematic reviews of air pollution exposure and reproductive and children's health: a methodological survey. Environ Health 2024; 23:32. [PMID: 38539160 PMCID: PMC10976715 DOI: 10.1186/s12940-024-01069-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/05/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Translating findings from systematic reviews assessing associations between environmental exposures and reproductive and children's health into policy recommendations requires valid and transparent evidence grading. METHODS We aimed to evaluate systems for grading bodies of evidence used in systematic reviews of environmental exposures and reproductive/ children's health outcomes, by conducting a methodological survey of air pollution research, comprising a comprehensive search for and assessment of all relevant systematic reviews. To evaluate the frameworks used for rating the internal validity of primary studies and for grading bodies of evidence (multiple studies), we considered whether and how specific criteria or domains were operationalized to address reproductive/children's environmental health, e.g., whether the timing of exposure assessment was evaluated with regard to vulnerable developmental stages. RESULTS Eighteen out of 177 (9.8%) systematic reviews used formal systems for rating the body of evidence; 15 distinct internal validity assessment tools for primary studies, and nine different grading systems for bodies of evidence were used, with multiple modifications applied to the cited approaches. The Newcastle Ottawa Scale (NOS) and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, neither developed specifically for this field, were the most commonly used approaches for rating individual studies and bodies of evidence, respectively. Overall, the identified approaches were highly heterogeneous in both their comprehensiveness and their applicability to reproductive/children's environmental health research. CONCLUSION Establishing the wider use of more appropriate evidence grading methods is instrumental both for strengthening systematic review methodologies, and for the effective development and implementation of environmental public health policies, particularly for protecting pregnant persons and children.
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Affiliation(s)
- Sophie K F Michel
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.
| | - Aishwarya Atmakuri
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Ondine S von Ehrenstein
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
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SHIMONOVICH MICHAL, CAMPBELL MHAIRI, THOMSON RACHELM, BROADBENT PHILIP, WELLS VALERIE, KOPASKER DANIEL, McCARTNEY GERRY, THOMSON HILARY, PEARCE ANNA, KATIKIREDDI SVITTAL. Causal Assessment of Income Inequality on Self-Rated Health and All-Cause Mortality: A Systematic Review and Meta-Analysis. Milbank Q 2024; 102:141-182. [PMID: 38294094 PMCID: PMC10938942 DOI: 10.1111/1468-0009.12689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/18/2023] [Accepted: 11/13/2023] [Indexed: 02/01/2024] Open
Abstract
Policy Points Income is thought to impact a broad range of health outcomes. However, whether income inequality (how unequal the distribution of income is in a population) has an additional impact on health is extensively debated. Studies that use multilevel data, which have recently increased in popularity, are necessary to separate the contextual effects of income inequality on health from the effects of individual income on health. Our systematic review found only small associations between income inequality and poor self-rated health and all-cause mortality. The available evidence does not suggest causality, although it remains methodologically flawed and limited, with very few studies using natural experimental approaches or examining income inequality at the national level. CONTEXT Whether income inequality has a direct effect on health or is only associated because of the effect of individual income has long been debated. We aimed to understand the association between income inequality and self-rated health (SRH) and all-cause mortality (mortality) and assess if these relationships are likely to be causal. METHODS We searched Medline, ISI Web of Science, Embase, and EconLit (PROSPERO: CRD42021252791) for studies considering income inequality and SRH or mortality using multilevel data and adjusting for individual-level socioeconomic position. We calculated pooled odds ratios (ORs) for poor SRH and relative risk ratios (RRs) for mortality from random-effects meta-analyses. We critically appraised included studies using the Risk of Bias in Nonrandomized Studies - of Interventions tool. We assessed certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework and causality using Bradford Hill (BH) viewpoints. FINDINGS The primary meta-analyses included 2,916,576 participants in 38 cross-sectional studies assessing SRH and 10,727,470 participants in 14 cohort studies of mortality. Per 0.05-unit increase in the Gini coefficient, a measure of income inequality, the ORs and RRs (95% confidence intervals) for SRH and mortality were 1.06 (1.03-1.08) and 1.02 (1.00-1.04), respectively. A total of 63.2% of SRH and 50.0% of mortality studies were at serious risk of bias (RoB), resulting in very low and low certainty ratings, respectively. For SRH and mortality, we did not identify relevant evidence to assess the specificity or, for SRH only, the experiment BH viewpoints; evidence for strength of association and dose-response gradient was inconclusive because of the high RoB; we found evidence in support of temporality and plausibility. CONCLUSIONS Increased income inequality is only marginally associated with SRH and mortality, but the current evidence base is too methodologically limited to support a causal relationship. To address the gaps we identified, future research should focus on income inequality measured at the national level and addressing confounding with natural experiment approaches.
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Affiliation(s)
- MICHAL SHIMONOVICH
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - MHAIRI CAMPBELL
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - RACHEL M. THOMSON
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - PHILIP BROADBENT
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - VALERIE WELLS
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - DANIEL KOPASKER
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - GERRY McCARTNEY
- School of Social and Political SciencesUniversity of Glasgow
| | - HILARY THOMSON
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - ANNA PEARCE
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - S. VITTAL KATIKIREDDI
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
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Heller C, Haak M, Schmidt SM, Chiatti C, Ekstam L, Nilsson MH, Slaug B. The Relationship Between Physical Housing Characteristics, Housing Accessibility and Different Aspects of Health Among Community-Dwelling Older People: A Systematic Review. J Aging Health 2024; 36:120-132. [PMID: 37201208 PMCID: PMC10693737 DOI: 10.1177/08982643231175367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Objectives: To synthesize the evidence on the relationships between physical housing characteristics or housing accessibility and different aspects of health among community-dwelling people 60 years and older. Methods: A systematic review of recent evidence with a narrative synthesis was conducted. Results: We included 15 studies and found three themes covering physical housing characteristics or housing accessibility that are associated with aspects of health among community-dwelling older adults: (1) interventions by home modifications targeting housing features both at entrances and indoors; (2) non-interventions targeting indoor features; (3) non-interventions targeting entrance features, that is, the presence of an elevator or stairs at the entrance. The overall quality of evidence across studies was assessed as very low. Discussion: The findings highlight the need for studies with a stronger research design and higher methodological quality that address the physical housing environment in relation to health among older adults to strengthen the body of evidence.
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Affiliation(s)
| | - Maria Haak
- Department of Nursing Education and Integrated Health Sciences, Kristianstad University, Kristianstad, Sweden
| | | | | | - Lisa Ekstam
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Maria H. Nilsson
- Department of Health Sciences, Lund University, Lund, Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Björn Slaug
- Department of Health Sciences, Lund University, Lund, Sweden
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Ludwig-Walz H, Siemens W, Heinisch S, Dannheim I, Loss J, Bujard M. How the COVID-19 pandemic and related school closures reduce physical activity among children and adolescents in the WHO European Region: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2023; 20:149. [PMID: 38115056 PMCID: PMC10731871 DOI: 10.1186/s12966-023-01542-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/18/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Emerging research suggests that physical activity among children and adolescents decreased during the COVID-19 pandemic. However, a differentiated overview of European youth is lacking. In particular, no systematic analysis has been conducted to date on the impact of heterogeneous pandemic restrictions and school closures within European countries, and with regard to potentially vulnerable groups. METHODS We searched seven databases and included studies for children and adolescents (≤ 19 years) of the WHO European Region that compared physical activity during the COVID-19 pandemic with a pre-pandemic baseline using validated measurement instruments. We used the Oxford Stringency Index and School Closure Index as indicators of restriction stringency. Screening for eligibility, data extraction, assessment of the study risk of bias (using the 'Risk of Bias in Non-randomized Studies - of Exposure' [ROBINS-E]) and certainty grading of evidence (using the GRADE approach), were all done in duplicate. Unpublished data was requested from study authors. Data were pooled in random effects models. An a priori protocol was published, reporting is carried out in accordance with the 'Preferred Reporting Items for Systematic Review and Meta-Analyses' (PRISMA) statement. RESULTS Of 14,897 non-duplicate records, 26 publications (n = 15,038 pre-pandemic, n = 13,041 during pandemic) met full inclusion criteria. Comparison before and during the COVID-19 pandemic revealed a significant reduction in total physical activity (standardized mean difference [SMD], -0.57 [95%CI, -0.95; -0.20]) and moderate-to-vigorous physical activity (SMD, -0.43 [95% CI, -0.75; -0.10]), corresponding to a decrease of 12 min per day (a 20% reduction of the WHO recommendation). A decrease in sporting activity was also recorded. Subgroup analyses suggested that middle childhood (aged 8-12) and adolescents were particularly affected by the decline. School closures were associated with a reduction in physical activity. The certainty of evidence for all outcomes was low. CONCLUSIONS A sharp decline in all forms of physical activity was recorded among European children and adolescents during the COVID-19 pandemic. This decline was higher during periods of school closure and mainly affected younger schoolchildren and adolescents. Immediate action by policy-makers and practitioners, as well as evidence-based public health strategies, are imperative in reversing this trend. TRIAL REGISTRATION PROSPERO: CRD42023395871.
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Affiliation(s)
| | - Waldemar Siemens
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Sarah Heinisch
- Institute for Physical Education and Sport, University of Education, Karlsruhe, Germany
| | - Indra Dannheim
- Regional Innovation Center for Health and Quality of Life in Fulda (RIGL), Fulda University of Applied Sciences, Fulda, Germany
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | | | - Martin Bujard
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
- Institute of Medical Psychology, Medical Faculty, University Heidelberg, Heidelberg, Germany
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Bandara TN, Higgs C, Zapata-Diomedi B, Gunn L, Turrell G, De Livera A. The longitudinal effects of the built environment on transportation and recreational walking, and differences by age and sex: systematic review protocol. Arch Public Health 2023; 81:184. [PMID: 37848953 PMCID: PMC10583415 DOI: 10.1186/s13690-023-01194-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND In high-income countries, the prevalence of physical inactivity and non-communicable diseases is high, and it is now well-established that insufficient physical activity is a risk factor for non-communicable diseases. Walking for recreation and transportation are effective means of improving population levels of physical activity. Research finds that the built environment (BE) can encourage or discourage walking behaviour, and this association varies for different age groups and sexes. This systematic review aims to synthesise longitudinal evidence to better understand how the BE affects recreational and transportation walking for different age groups (above 64 years and 18-64 years) and sexes in high-income countries. METHOD We will use Scopus, PubMed, SPORTDiscus with Full Text (EBSCO), Business Source Complete (EBSCO), Art and Architecture Archive (Proquest), Avery Index to Architectural Periodicals (ProQuest), and Art, Design & Architecture Collection (ProQuest) databases to search for relevant studies. Reviewers will screen the search results according to pre-specified eligibility criteria for study inclusion in the review. Required data for the synthesis will be extracted from the included studies to answer the research questions. Further, the methodological quality of the studies included in this systematic review will be evaluated using an established instrument, and the resulting quality scores will be utilized in sensitivity analysis. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist will be followed when reporting the findings. DISCUSSION This review will identify BE attributes that are likely to influence transportation and recreational walking for younger and older adults and different sexes in high-income countries. The findings will help policymakers with making decisions around walkable built environments for older and younger adults and different sexes to keep them healthy. TRIAL REGISTRATION This protocol of the prospective systematic review is developed following PRISMA-P guidelines and is registered on the Prospective Register of Systematic Reviews (PROSPERO) (registration ID CRD42022351919).
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Affiliation(s)
| | | | | | - Lucy Gunn
- RMIT University, Melbourne, Australia
| | | | - Alysha De Livera
- Melbourne School of Population Health, The University of Melbourne, Melbourne, Australia
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
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Ferguson M, Rittenbach K, Leece P, Adams A, Ali F, Elton-Marshall T, Burmeister C, Brothers TD, Medley A, Choisil P, Strike C, Ng J, Lorenzetti DL, Gallant K, Buxton JA. Document d’orientation sur la distribution et l’utilisation de trousses de naloxone à emporter par les intervenants et intervenantes communautaires en cas de surdose au Canada. CMAJ 2023; 195:E1312-E1325. [PMID: 37788838 PMCID: PMC10637331 DOI: 10.1503/cmaj.230128-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Affiliation(s)
- Max Ferguson
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Katherine Rittenbach
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Pamela Leece
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Alison Adams
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Farihah Ali
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Tara Elton-Marshall
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Charlene Burmeister
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Thomas D Brothers
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Andrea Medley
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Paul Choisil
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Carol Strike
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Justin Ng
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Diane L Lorenzetti
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Kat Gallant
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Jane A Buxton
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B.
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Xie K, Guan S, Jing H, Ji W, Kong X, Du S, Jia M, Wang H. Efficacy and safety of traditional Chinese medicine adjuvant therapy for severe pneumonia: evidence mapping of the randomized controlled trials, systematic reviews, and meta-analyses. Front Pharmacol 2023; 14:1227436. [PMID: 37841930 PMCID: PMC10570726 DOI: 10.3389/fphar.2023.1227436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
Background and Objective: Severe pneumonia is a critical respiratory disease with high mortality. There is insufficient evidence on the efficacy and safety of traditional Chinese medicine (TCM) adjuvant therapy for severe pneumonia. This study aims to identify, describe, assess, and summarize the currently available high-quality design evidence on TCM adjuvant therapy for severe pneumonia to identify evidence gaps using the evidence mapping approach. Methods: Systematic searches were performed on English and Chinese online databases (PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, WanFang Data, CQVIP, and SinoMed) to identify papers from inception until August 2023 for inclusion into the review. Randomized controlled trials (RCTs), systematic reviews (SRs), and meta-analyses concerning TCM adjuvant therapy for severe pneumonia or its complications in adults were included. The risk of bias in RCTs was evaluated by using the Cochrane Handbook ROB tool. The Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic Review (ROBIS) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were used to assess the methodological quality, risk of bias, and evidence quality of SRs or meta-analyses, respectively. Then, a bubble plot was designed to visually display information in four dimensions. Results: A total of 354 RCTs and 17 SRs or meta-analyses met the inclusion criteria. The published RCTs had several flaws, such as unreasonable design, limited sample size, insufficient attention to non-drug therapy studies and syndrome differentiation, improper selection or use of outcome indicators, and failure to provide high-quality evidence. Sixteen SRs or meta-analyses of methodological quality scored "Critically Low" confidence. Twelve SRs or meta-analyses were rated as "High Risk." Most outcomes were rated as "Low" evidence quality. We found that TCM combined with conventional treatment could improve the clinical total effective rate and the TCM syndromes efficacy. The combined approach could also shorten mechanical ventilation time, infection control time, and length of hospital and ICU stay; significantly reduce temperature, respiratory rate, heart rate, white blood cell counts, levels of C-reactive protein, procalcitonin, blood inflammatory factors, bacteriological response, and D-dimer; decrease CPIS, APACHE II score, and PSI score; improve pulmonary imaging features, arterial blood gas indicators (including arterial oxygen pressure, arterial oxygen saturation, and oxygen index), and lung function (including forced vital capacity and forced expiratory volume in the first second) for severe pneumonia compared with conventional treatment only (p < 0.05). There was no significant difference in adverse reactions and incidence of adverse events (p > 0.05). In addition, compared with conventional treatment only, most SRs or meta-analyses concluded that TCM combined with conventional treatment was "Beneficial" or "Probably beneficial." Conclusion: TCM combined with conventional treatment had advantages in efficacy, clinical signs, laboratory results, and life quality outcomes of severe pneumonia, with no difference in safety outcomes compared with conventional treatment only. QingJin Huatan decoction is the most promising target, and Xuanbai Chengqi decoction has a "Probably beneficial" conclusion. XueBiJing injection and TanReQing injection are two commonly used Chinese herbal injections for treating severe pneumonia, and both are "Probably beneficial." However, there was a need for multicenter RCTs with large sample sizes and high methodological quality in the future. In addition, the methodological design and quality of SRs or meta-analyses should be improved to form high-quality, evidence-based medical evidence and provide evidence for the effectiveness and safety of TCM adjuvant therapy for severe pneumonia.
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Affiliation(s)
- Kai Xie
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Shengnan Guan
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Hui Jing
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Wenshuai Ji
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xinxin Kong
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Shen Du
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Mingyan Jia
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Haifeng Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
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Ghorbani Z, Kazemi A, Shoaibinobarian N, Taylor K, Noormohammadi M. Overall, plant-based, or animal-based low carbohydrate diets and all-cause and cause-specific mortality: A systematic review and dose-response meta-analysis of prospective cohort studies. Ageing Res Rev 2023; 90:101997. [PMID: 37419282 DOI: 10.1016/j.arr.2023.101997] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/03/2023] [Accepted: 07/02/2023] [Indexed: 07/09/2023]
Abstract
INTRODUCTION In this study, we sought to summarize the associations between overall, plant-, and animal-based low carbohydrate diet (LCD) scores and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality from prospective cohort studies. METHODS We searched PubMed, Scopus, and Web of Science up to January 2022. We included prospective cohort studies that investigated the relationship between LCD-score and risk of overall, CVD, or cancer mortality. Two investigators assessed the studies for eligibility and extracted the data. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a random-effects model. RESULTS Ten studies, with 421022 participants, were included in the analysis. In the high-versus-low meta-analysis, overall (HR:1.05,95%CI:0.97, 1.13, I2 =72.0%) and animal-based LCD-scores (HR: 1.08, 95% CI: 0.97-1.21; I2 = 88.0%) were not associated with all-cause mortality, but plant-based LCD-score was associated with a risk reduction (HR:0.87, 95%CI:0.78,0.97; I2 = 88.4%). CVD mortality was not associated with overall, plant-, or animal-based LCD-scores. Overall (HR:1.14, 95%CI:1.05,1.24; I2 = 37.4%) and animal-based LCD scores (HR:1.16,95%CI:1.02,1.31; I2 = 73.7%) were associated with a higher risk of cancer mortality, while plant-based LCD-score was not. A U-shaped relationship was revealed between overall LCD-score and all-cause and CVD mortality. The shape of relationship between LCD and cancer mortality was a linear dose-response. CONCLUSION In conclusion, diets with a moderate carbohydrate content were associated with the lowest risk of all-cause and CVD mortality. If the sources of macronutrients that replaced carbohydrates were plant-based, the risk of all-cause mortality was reduced linearly with lower carbohydrate content. The risk of cancer mortality increased linearly with the increase in carbohydrate content. Considering the low certainty of evidence, more robust prospective cohort studies are suggested.
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Affiliation(s)
- Zeinab Ghorbani
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Asma Kazemi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Nargeskhatoon Shoaibinobarian
- Department of Nutrition, School of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch, Tehran, Iran
| | - Kate Taylor
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - Morvarid Noormohammadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Ferguson M, Rittenbach K, Leece P, Adams A, Ali F, Elton-Marshall T, Burmeister C, Brothers TD, Medley A, Choisil P, Strike C, Ng J, Lorenzetti DL, Gallant K, Buxton JA. Guidance on take-home naloxone distribution and use by community overdose responders in Canada. CMAJ 2023; 195:E1112-E1123. [PMID: 37640401 PMCID: PMC10462409 DOI: 10.1503/cmaj.230128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The increasing toxicity of opioids in the unregulated drug market has led to escalating numbers of overdoses in Canada and worldwide; takehome naloxone (THN) is an evidence-based intervention that distributes kits containing naloxone to people in the community who may witness an overdose. The purpose of this guidance is to provide policy recommendations for territorial, provincial and federal THN programs, using evidence from scientific and grey literature and community evidence that reflects 11 years of THN distribution in Canada. METHODS The Naloxone Guidance Development Group - a multidisciplinary team including people with lived and living experience and expertise of drug use - used the Appraisal of Guidelines for Research & Evaluation (AGREE II) instrument to inform development of this guidance. We considered published evidence identified through systematic reviews of all literature types, along with community evidence and expertise, to generate recommendations between December 2021 and September 2022. We solicited feedback on preliminary recommendations through an External Review Committee and a public input process. The project was funded by the Canadian Institutes of Health Research through the Canadian Research Initiative in Substance Misuse. We used the Guideline International Network principles for managing competing interests. RECOMMENDATIONS Existing evidence from the literature on THN was of low quality. We incorporated evidence from scientific and grey literature, and community expertise to develop our recommendations. These were in 3 areas: routes of naloxone administration, THN kit contents and overdose response. Take-home naloxone programs should offer the choice of both intramuscular and intranasal formulations of naloxone in THN kits. Recommended kit contents include naloxone, a naloxone delivery device, personal protective equipment, instructions and a carrying case. Trained community overdose responders should prioritize rescue breathing in the case of respiratory depression, and conventional cardiopulmonary resuscitation in the case of cardiac arrest, among other interventions. INTERPRETATION This guidance development project provides direction for THN programs in Canada in the context of limited published evidence, with recommendations developed in collaboration with diverse stakeholders.
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Affiliation(s)
- Max Ferguson
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Katherine Rittenbach
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Pamela Leece
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Alison Adams
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Farihah Ali
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Tara Elton-Marshall
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Charlene Burmeister
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Thomas D Brothers
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Andrea Medley
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Paul Choisil
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Carol Strike
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Justin Ng
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Diane L Lorenzetti
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Kat Gallant
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Jane A Buxton
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
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14
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Chew MT, Chan C, Kobayashi S, Cheng HY, Wong TM, Nicholson LL. Online pain management programs for chronic, widespread musculoskeletal conditions: A systematic review with meta-analysis. Pain Pract 2023. [PMID: 37051894 DOI: 10.1111/papr.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/09/2023] [Accepted: 03/24/2023] [Indexed: 04/14/2023]
Abstract
Face-to-face pain management programs demonstrate positive clinical outcomes in the chronic pain population by improving pain intensity and attitudes, depression, and functional disability scores. The effects of this modality carried out online is less known, particularly in subgroups of chronic pain. This systematic review assessed the effects of online pain management programs in chronic, widespread musculoskeletal conditions on pain measurements (intensity, interference, coping, and catastrophizing), health-related quality of life, depression, and anxiety scores immediately post-intervention. Five electronic databases (Embase, Medline, CINAHL, Scopus, and PEDro) were searched with 3546 studies identified. Eighteen randomized controlled trials fulfilled the inclusion criteria. Included studies had moderate methodological quality (using the Effective Public Health Practice Project (EPHPP) quality assessment tool) but high risk of bias (using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2)). There were significant improvements in pain intensity (11 studies, 1397 participants, SMD -0.30, 95% CI -0.50 to -0.10, p = 0.004), health-related quality of life (eight studies, 1054 participants, SMD 0.41, 95% CI 0.08 to 0.75, p = 0.02), and depression (nine studies, 1283 participants, SMD -0.32, 95% CI -0.55 to -0.08, p = 0.008). However, effect sizes were small and did not meet their respective measure's minimal clinically important change score. Guided interventions (regular interaction with an instructor) appeared to be superior to self-completed interventions. Future research should standardize outcome measures for assessing pain, use active control groups, and analyze other outcome measures such as cost and long-term effects. This study was registered with Prospero on August 15, 2021 (CRD42021267565).
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Affiliation(s)
- Min Tze Chew
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Cliffton Chan
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Sarah Kobayashi
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- School of Allied Health, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Hoi Yan Cheng
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Tsz Ming Wong
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Leslie L Nicholson
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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15
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Ludwig-Walz H, Dannheim I, Pfadenhauer LM, Fegert JM, Bujard M. Anxiety among children and adolescents during the COVID-19 pandemic in Europe: a systematic review protocol. Syst Rev 2023; 12:64. [PMID: 37038242 PMCID: PMC10088269 DOI: 10.1186/s13643-023-02225-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/24/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND A growing number of studies point to a high mental health burden among children and adolescents during the COVID-19 pandemic, particularly concerning anxiety. However, the study quality and effect direction are heterogeneous in the existing primary studies with a lacking overview for the European continent. Therefore, this systematic review aims to critically synthesise the evidence regarding the impact of the COVID-19 pandemic on anxiety among children and adolescents in Europe compared to a pre-pandemic baseline. METHODS A systematic literature search will be performed in six databases (MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, and WHO COVID-19 database) with a peer reviewed search strategy according to the evidence-based checklist Peer Review of Electronic Search Strategies (PRESS). Inclusion criteria are children and adolescents ≤ 19 years living in Europe and data report during the COVID-19 pandemic with an appropriate pre-pandemic baseline. Primary outcomes are general anxiety symptoms and clinically relevant anxiety rates. Risk of bias will be assessed using the 'Risk of Bias in Non-randomised Studies of Exposure' (ROBINS-E). Data extraction will systematically include information on study design, population characteristics, COVID-19 determinants, pre-pandemic baseline, diagnostic instruments and outcome. The certainty of evidence for each outcome will be evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach adapted to the use of non-randomised studies. All process steps will be performed independently by two reviewers; any discrepancies will be discussed and, if necessary, resolved by a third author. Also, subgroup analysis, sensitivity analysis, publication bias analysis, and meta-regression analysis, if applicable, will be performed. The systematic review was registered in the Prospective Register of Systematic Reviews (PROSPERO) and the protocol was prepared in accordance to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. DISCUSSION This systematic review will address the lack of a critical and comprehensive summary of findings on the COVID-19 pandemic impact on anxiety among children and adolescents in Europe. In addition, it aims to identify pandemic-policy differences, such as the effect of school-closures, and identify particularly vulnerable risk groups. SYSTEMATIC REVIEW REGISTRATION CRD42022303714 (PROSPERO).
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Affiliation(s)
| | - Indra Dannheim
- Regional Innovative Centre of Health and Quality of Live Fulda (RIGL), Department of Nutrition, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology-IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Jörg M Fegert
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Competence Domain Mental Health Prevention, Ulm, Germany
| | - Martin Bujard
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
- Institute for Medical Psychology, Medical Faculty, University Heidelberg, Heidelberg, Germany
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16
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Xun Y, Guo Q, Ren M, Liu Y, Sun Y, Wu S, Lan H, Zhang J, Liu H, Wang J, Shi Q, Wang Q, Wang P, Chen Y, Shao R, Xu DR. Characteristics of the sources, evaluation, and grading of the certainty of evidence in systematic reviews in public health: A methodological study. Front Public Health 2023; 11:998588. [PMID: 37064677 PMCID: PMC10097925 DOI: 10.3389/fpubh.2023.998588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
Objectives To systematically explore how the sources of evidence, types of primary studies, and tools used to assess the quality of the primary studies vary across systematic reviews (SRs) in public health. Methods We conducted a methodological survey of SRs in public health by searching the of literature in selected journals from electronic bibliographic databases. We selected a 10% random sample of the SRs that met the explicit inclusion criteria. Two researchers independently extracted data for analysis. Results We selected 301 SRs for analysis: 94 (31.2%) of these were pre-registered, and 211 (70.1%) declared to have followed published reporting standard. All SRs searched for evidence in electronic bibliographic databases, and more than half (n = 180, 60.0%) searched also the references of the included studies. The common types of primary studies included in the SRs were primarily cross-sectional studies (n = 132, 43.8%), cohort studies (n = 126, 41.9%), randomized controlled trials (RCTs, n = 89, 29.6%), quasi-experimental studies (n = 83, 27.6%), case-control studies (n = 58, 19.3%) qualitative studies (n = 38, 12.6%) and mixed-methods studies (n = 32, 10.6%). The most frequently used quality assessment tools were the Newcastle-Ottawa Scale (used for 50.0% of cohort studies and 55.6% of case-control studies), Cochrane Collaboration's Risk of Bias tool (50.7% of RCTs) and Critical Appraisal Skills Program (38.5% of qualitative studies). Only 20 (6.6%) of the SRs assessed the certainty of the body of evidence, of which 19 (95.0%) used the GRADE approach. More than 65% of the evidence in the SRs using GRADE was of low or very low certainty. Conclusions SRs should always assess the quality both at the individual study level and the body of evidence for outcomes, which will benefit patients, health care practitioners, and policymakers.
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Affiliation(s)
- Yangqin Xun
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qiangqiang Guo
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Mengjuan Ren
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yunlan Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yajia Sun
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Shouyuan Wu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Hui Lan
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Juanjuan Zhang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Hui Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Jianjian Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Qi Wang
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
| | - Ping Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- School of Public Health, Lanzhou University, Lanzhou, China
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Lanzhou University, An Affiliate of the Cochrane China Network, Lanzhou, China
- World Health Organization (WHO) Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Ruitai Shao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Non-communicable Diseases, World Health Organization (WHO), Geneva, Switzerland
| | - Dong Roman Xu
- SMU Institute for Global Health (SIGHT), School of Health Management and Dermatology Hospital, Southern Medical University (SMU), Guangzhou, China
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Sehmbi H, Retter S, Shah UJ, Nguyen D, Martin J, Uppal V. Epidemiological, methodological, and statistical characteristics of network meta-analysis in anaesthesia: a systematic review. Br J Anaesth 2023; 130:272-286. [PMID: 36404140 DOI: 10.1016/j.bja.2022.08.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 06/29/2022] [Accepted: 08/15/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Network meta-analyses (NMAs) combine direct and indirect estimates to provide mixed (or network) estimates of effect sizes. The scientific rigour of the conduct and reporting of anaesthesia NMAs is unknown. This review assessed the epidemiological, methodological, and statistical characteristics of anaesthesia NMAs. METHODS We searched four databases for anaesthesia NMAs and developed a 64-item checklist to evaluate NMAs. For 29 binary items, we defined compliance as 'the ratio of NMAs that was awarded a 'yes' for that item, divided by the total number of NMAs. The compliance of such binary items was reclassified as very low (≤25%), low (26-50%), fair (51-75%), and high (>75%). We amalgamated findings from 29 key items to provide specific recommendations (post hoc). We compared the compliance of NMAs in anaesthesia across 26 items, with that of cancer NMAs and Cochrane NMAs, and analysed improvement over time (post hoc). RESULTS Among 62 included NMAs, compliance was low (26-50%) for protocol registration, use of PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for NMA), publication bias assessment, evidence appraisal, reporting of Bayesian methodology and consistency evaluation. Compliance was very low (≤25%) for bias assessment, biostatistician involvement, search specialist, and use of predefined important differences. CONCLUSIONS Anaesthesia NMAs need improvement in their conduct and reporting. Anaesthesia journals should mandate the registration of protocols and reporting of NMAs using PRISMA-NMA. Authors should carefully assess publication bias, and use updated bias assessment tools, and evidence appraisal methods designed for NMAs. SYSTEMATIC REVIEW PROTOCOL PROSPERO CRD42021227608.
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Affiliation(s)
- Herman Sehmbi
- Department of Anesthesia & Perioperative Medicine, London Health Sciences Centre, University of Western Ontario, London, ON, Canada.
| | - Susanne Retter
- Department of Anesthesia, Perioperative Medicine and Pain Management, Dalhousie University, Nova Scotia Health Authority and IWK Health Centre, Halifax, NS, Canada
| | - Ushma J Shah
- Department of Anesthesia & Perioperative Medicine, London Health Sciences Centre, University of Western Ontario, London, ON, Canada
| | - Derek Nguyen
- Schulich School of Medicine & Dentistry, London, ON, Canada
| | - Janet Martin
- Department of Anesthesia & Perioperative Medicine, London Health Sciences Centre, University of Western Ontario, London, ON, Canada; Department of Epidemiology & Biostatistics, London Health Sciences Centre, University of Western Ontario, London, ON, Canada
| | - Vishal Uppal
- Department of Anesthesia, Perioperative Medicine and Pain Management, Dalhousie University, Nova Scotia Health Authority and IWK Health Centre, Halifax, NS, Canada
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18
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Eshun-Wilson I, Ford N, Mody A, Beres L, Schwartz S, Baral S, Geng EH. Strengthening implementation guidelines for HIV service delivery: Considerations for future evidence generation and synthesis. PLoS Med 2023; 20:e1004168. [PMID: 36877738 PMCID: PMC10027212 DOI: 10.1371/journal.pmed.1004168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 03/20/2023] [Indexed: 03/07/2023] Open
Abstract
Ingrid Eshun-Wilson and colleagues summarize gaps in primary HIV implementation research methods and reporting, and propose areas for future methodological development.
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Affiliation(s)
- Ingrid Eshun-Wilson
- Division of Infectious Diseases, School of Medicine, Washington University in Saint Louis, Saint Louis, Missouri, United States of America
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Nathan Ford
- Department of HIV, Viral Hepatitis and Sexually Transmitted Infectionss, World Health Organization, Geneva, Switzerland
| | - Aaloke Mody
- Division of Infectious Diseases, School of Medicine, Washington University in Saint Louis, Saint Louis, Missouri, United States of America
| | - Laura Beres
- Department of International Health, John Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Sheree Schwartz
- Department of Epidemiology, John Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Stefan Baral
- Department of Epidemiology, John Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Elvin H. Geng
- Division of Infectious Diseases, School of Medicine, Washington University in Saint Louis, Saint Louis, Missouri, United States of America
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Medicines for Obesity: Appraisal of Clinical Studies with Grading of Recommendations, Assessment, Development, and Evaluation Tool. Nutrients 2023; 15:nu15030606. [PMID: 36771314 PMCID: PMC9919203 DOI: 10.3390/nu15030606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 01/27/2023] Open
Abstract
We evaluated the quality of evidence from phase III/IV clinical trials of drugs against obesity using the principles of Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Our systematic review evaluates the quality of clinical evidence from existing clinical trials and not the pharmacological efficacy of anti-obesity therapies. A literature search using select keywords in separate was performed in PubMed and ClinicalTrials.gov databases for phase III/IV clinical trials during the last ten years. Our findings indicate that the quality of existing clinical evidence from anti-obesity trials generally ranges from low to moderate. Most trials suffered from publication bias. Less frequently, trials suffered from the risk of bias mainly due to lack of blindness in the treatment. Our work indicates that additional higher-quality clinical trials are needed to gain more confidence in the estimate of the effect of currently used anti-obesity medicines, to allow more informed clinical decisions, thus reducing the risk of implementing potentially ineffective or even harmful therapeutic strategies.
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20
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Wensing M, Sales A, Aarons GA, Xu D(R, Wilson P. Evidence for objects of implementation in healthcare: considerations for Implementation Science and Implementation Science Communications. Implement Sci 2022; 17:83. [PMID: 36527104 PMCID: PMC9758917 DOI: 10.1186/s13012-022-01249-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The journals Implementation Science and Implementation Science Communications are focused on the implementation of evidence into healthcare practice and policy. This editorial offers reflections on how we handle this as editors. Studies that focus on the simultaneous implementation of implementation objects and (technological or other) structures to enable their implementation are considered on a case-by-case basis regarding their contribution to implementation science. Studies on implementation objects with limited, mixed, or of out-of-context evidence are considered if the evidence for key components of the object of interest is sufficiently robust. We follow GRADE principles in our assessment of the certainty of research findings for health-related interventions in individuals. Adapted thresholds apply to evidence for population health interventions, organizational changes, health reforms, health policy innovations, and medical devices. The added value of a study to the field of implementation science remains of central interest for our journals.
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Affiliation(s)
- Michel Wensing
- grid.5253.10000 0001 0328 4908Heidelberg University Hospital, Heidelberg, Germany
| | - Anne Sales
- grid.134936.a0000 0001 2162 3504Sinclair School of Nursing and Department of Family and Community Medicine, University of Missouri, Columbia, MO USA ,grid.413800.e0000 0004 0419 7525Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI USA
| | - Gregory A. Aarons
- grid.266100.30000 0001 2107 4242Department of Psychiatry and ACTRI Dissemination and Implementation Science Center, University of California San Diego, La Jolla, San Diego, CA USA
| | - Dong (Roman) Xu
- grid.284723.80000 0000 8877 7471SMU Institute for Global Health (SIGHT), School of Health Management and Dermatology Hospital , Southern Medical University (SMU), Guangzhou, China
| | - Paul Wilson
- grid.5379.80000000121662407Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK ,NIHR Applied Research Collaboration Greater Manchester, Manchester, UK
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21
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Barnes B, Buchmann M, Mumm R, Nowossadeck E, Peitz D, Prütz F, Wachtler B, Wienecke A. [Evidence syntheses in public health: An overview]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 175:17-28. [PMID: 36335008 PMCID: PMC9630138 DOI: 10.1016/j.zefq.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/11/2022] [Accepted: 09/07/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Since the beginning of the COVID-19 pandemic, there has been a high demand for rapid evidence syntheses to answer urgent public health questions. This article provides an overview of different types of reviews for public health questions and a synthesis of existing recommendations for the preparation of reviews. The aim is to support the planning of one's own review and the critical evaluation of published reviews. METHODS The basis of this summary is an extensive search for guidelines and recommendations for different review types. Furthermore, internal journal clubs were held to determine knowledge needs and to critically discuss the various review types. Relating to the dissemination of results, fact sheets were developed for the individual review types including the most important information, prerequisites and work steps, as well as a decision tree for identifying the appropriate review type for the respective question. RESULTS Of the review types identified, Systematic, Rapid, Scoping, Umbrella, and Narrative Reviews were considered in more detail because they are particularly relevant to public health issues. Together with scoping and umbrella reviews, systematic reviews have the highest resource requirements due to the demands for extensive, systematic evidence synthesis and reproducibility. Rapid methods can accelerate the review process, for example by a very narrowly formulated question, a limited literature search, or the execution of certain steps by one instead of two persons. DISCUSSION Systematic Reviews may be considered as the gold standard, but they were developed primarily for clinical questions relating to interventions. This article, however, focusses on review types that consider the diversity of questions as well as the predominant use of quantitative methods in the field of public health. The fact sheets developed and the decision tree should enable low-threshold access to reviews while linking the perspectives of research and resource planning. They complement existing guidelines and recommendations. CONCLUSION To answer the diverse spectrum of public health questions, various types of reviews with various requirements and approaches are available. Given this diversity, a systematic introduction can be helpful for researchers planning or assessing a review.
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Affiliation(s)
- Benjamin Barnes
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland.
| | - Maike Buchmann
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - Rebekka Mumm
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - Enno Nowossadeck
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - Diana Peitz
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - Franziska Prütz
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - Benjamin Wachtler
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - Antje Wienecke
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
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22
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Mathieu S, Ross V, Wardhani R, Brough P, Wishart D, Chan XW, Kõlves K. Suicide among transport industry workers: A systematic review and meta-analysis. Scand J Work Environ Health 2022; 48:598-610. [PMID: 36153776 PMCID: PMC10546617 DOI: 10.5271/sjweh.4059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Indexed: 10/08/2023] Open
Abstract
OBJECTIVES Working in high-stress and male-dominated occupations is associated with an elevated risk of suicide. The current study sought to conduct the first systematic literature review and meta-analysis aimed at determining suicide risk across the diverse, high pressure and male-dominated transport industry (commercial aviation, merchant seafaring, transit/driving) as compared to the general/employed population. METHODS Searches of PubMed/Medline, Scopus and PsycINFO databases were conducted without date restriction until March 2021. Studies were included if they were written in English, were peer reviewed, and presented primary observational research data. Studies referring exclusively to suicidal ideation, suicide attempts, self-harm, and/or accidents were excluded. RESULTS Following deletion of duplicates and non-English titles, a total of 4201 titles/abstracts were screened and 92 full-texts were read against inclusion/exclusion criteria. The final included sample consisted of 23 articles (16 used for meta-analysis). Results from the meta-analysis indicated that transport workers had a significantly elevated risk for suicide as compared to the general/employed population. Results were consistent across sensitivity analyses, and there was some variation across subgroup analyses. CONCLUSIONS Overall, we found transport workers had a significantly higher risk for suicide than the general/employed population, and this appeared to be driven by the association for those working in merchant seafaring/maritime occupations. The findings are discussed in relation to an identified need for the development, implementation, and evaluation of tailored workplace suicide prevention strategies for transport industry workers.
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Affiliation(s)
- Sharna Mathieu
- Australian Institute for Suicide Research and Prevention & World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention & World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
- Centre for Work, Organisation, and Wellbeing, Griffith University, Brisbane, Australia
| | - Rachmania Wardhani
- Australian Institute for Suicide Research and Prevention & World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Paula Brough
- Centre for Work, Organisation, and Wellbeing, Griffith University, Brisbane, Australia
| | - Darren Wishart
- Centre for Work, Organisation, and Wellbeing, Griffith University, Brisbane, Australia
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Xi Wen Chan
- Centre for Work, Organisation, and Wellbeing, Griffith University, Brisbane, Australia
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention & World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
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Ruszkowski J, Majkutewicz K, Heleniak Z, Witkowski JM, Dębska-Ślizień A. Prevalence and Severity of Lower Gastrointestinal Symptoms amongst Non-Dialysis Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:6363. [PMID: 36362591 PMCID: PMC9656905 DOI: 10.3390/jcm11216363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 12/27/2023] Open
Abstract
Chronic kidney disease (CKD) patients experience a wide range of symptoms that deteriorate their health-related quality of life (HRQoL). We aimed to estimate the prevalence and severity of lower gastrointestinal (GI) symptoms in non-dialysis CKD adult outpatients, and to summarize the relationships between these symptoms and HRQoL, laboratory test results, and clinical data. The protocol of the study was preregistered (PROSPERO CRD42021255122). We searched MEDLINE, Scopus, Web of Science, and grey literature sources from the databases' inception up until 27 November 2021. Wide citation chasing was conducted. Single proportions (prevalence of functional constipation, self-reported constipation, diarrhea, abdominal bloating, fecal incontinence, and abdominal/rectal pain) were pooled using generalized linear mixed models. A total of 37 studies with 12,074 patients were included. We found that lower GI symptoms, especially self-reported abdominal bloating [CKD G1-2: 48.45% (95% CI: 43.5-53.4%; 2 studies); G3: 46.95% (95% CI: 45.0-48.9%; 2 studies), G4-5: 36.1% (95% CI: 25.4-48.5%; 8 studies)] and constipation [CKD G1-2: 31.8% (95% CI: 13.9-54.9%); G3: 29.8% (95% CI: 21.2-40.1%; 4 studies); G4-5: 38.8% (95% CI: 30.9-47.4%); 22 studies)], were common in non-dialysis CKD patients. The severity of the symptoms was limited. Self-reported constipation was most consistently associated with worse HRQoL, whereas hard stool consistency was associated with higher uremic toxins levels. To conclude, since lower GI symptoms are common in CKD, using symptom questionnaires that do not take them into account cannot provide full insight into the patient's experience. Further studies are needed to cover identified knowledge gaps, including the exploration of the pathophysiology of GI symptoms in CKD with multi-omics data.
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Affiliation(s)
- Jakub Ruszkowski
- Department of Pathophysiology, Faculty of Medicine, Medical University of Gdańsk, 80-211 Gdańsk, Poland
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Katarzyna Majkutewicz
- Student Scientific Circle, Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Zbigniew Heleniak
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Jacek M. Witkowski
- Department of Pathophysiology, Faculty of Medicine, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
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Adams A, Ferguson M, Greer AM, Burmeister C, Lock K, McDougall J, Scow M, Buxton JA. Guideline development in harm reduction: Considerations around the meaningful involvement of people who access services. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 4:100086. [PMID: 36846576 PMCID: PMC9948926 DOI: 10.1016/j.dadr.2022.100086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/13/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
Background Harm reduction seeks to minimizes the negative effects of drug use while respecting the rights of people with lived and living experience of substance use (PWLLE). Guideline standards ("guidelines for guidelines") provide direction on developing healthcare guidelines. To identify essential considerations for guideline development within harm reduction, we examined whether guideline standards are consistent with a harm reduction approach in their recommendations on involving people who access services. Methods We searched the literature from 2011-2021 to identify guideline standards used in harm reduction and publications on involving PWLLE in developing harm reduction services. We used thematic analysis to compare their guidance on involving people who access services. Findings were validated with two organizations of PWLLE. Results Six guideline standards and 18 publications met inclusion criteria. We identified three themes related to involving people who access services: Reasons for Involvement, Methods of Involvement, and Factors in Success. Subthemes varied across the literature. We identified five essential considerations for guideline development in harm reduction: establishing a shared understanding of reasons for involving PWLLE; respecting their expertise; partnering with PWLLE to ensure appropriate engagement; incorporating perspectives of populations disproportionately affected by substance use; and securing resources. Conclusion Guideline standards and the harm reduction literature approach the involvement of people who access services from different perspectives. Thoughtful integration of the two paradigms can improve guidelines while empowering PWLLE. Our findings can support the development of high-quality guidelines that align with the fundamental principles of harm reduction in their involvement of PWLLE.
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Affiliation(s)
- Alison Adams
- British Columbia Center for Disease Control, 655W 12th Avenue, Vancouver, BC V5Z 4R4, Canada,School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC V6T 1Z8, Canada
| | - Max Ferguson
- British Columbia Center for Disease Control, 655W 12th Avenue, Vancouver, BC V5Z 4R4, Canada
| | - Alissa M. Greer
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Charlene Burmeister
- British Columbia Center for Disease Control, 655W 12th Avenue, Vancouver, BC V5Z 4R4, Canada
| | - Kurt Lock
- British Columbia Center for Disease Control, 655W 12th Avenue, Vancouver, BC V5Z 4R4, Canada
| | - Jenny McDougall
- British Columbia Center for Disease Control, 655W 12th Avenue, Vancouver, BC V5Z 4R4, Canada
| | - Marnie Scow
- British Columbia Center for Disease Control, 655W 12th Avenue, Vancouver, BC V5Z 4R4, Canada,School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC V6T 1Z8, Canada
| | - Jane A. Buxton
- British Columbia Center for Disease Control, 655W 12th Avenue, Vancouver, BC V5Z 4R4, Canada,School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC V6T 1Z8, Canada,Corresponding author at: BC Centre for Disease Control, 655 West 12th Ave., Vancouver, BC V5Z 4R4, Canada.
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25
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Johnstone A, McCrorie P, Cordovil R, Fjørtoft I, Iivonen S, Jidovtseff B, Lopes F, Reilly JJ, Thomson H, Wells V, Martin A. Nature-Based Early Childhood Education and Children's Physical Activity, Sedentary Behavior, Motor Competence, and Other Physical Health Outcomes: A Mixed-Methods Systematic Review. J Phys Act Health 2022; 19:456-472. [PMID: 35537707 PMCID: PMC7613039 DOI: 10.1123/jpah.2021-0760] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/04/2022] [Accepted: 04/03/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose was to synthesize evidence on the association between nature-based Early Childhood Education (ECE) and children's physical activity (PA) and motor competence (MC). METHODS A literature search of 9 databases was concluded in August 2020. Studies were eligible if (1) children were aged 2-7 years old and attending ECE, (2) ECE settings integrated nature, and (3) assessed physical outcomes. Two reviewers independently screened full-text articles and assessed study quality. Synthesis was conducted using effect direction (quantitative), thematic analysis (qualitative), and combined using a results-based convergent synthesis. RESULTS 1370 full-text articles were screened and 39 (31 quantitative and 8 qualitative) studies were eligible; 20 quantitative studies assessed PA and 6 assessed MC. Findings indicated inconsistent associations between nature-based ECE and increased moderate to vigorous PA, and improved speed/agility and object control skills. There were positive associations between nature-based ECE and reduced sedentary time and improved balance. From the qualitative analysis, nature-based ECE affords higher intensity PA and risky play, which could improve some MC domains. The quality of 28/31 studies was weak. CONCLUSIONS More controlled experimental designs that describe the dose and quality of nature are needed to better inform the effectiveness of nature-based ECE on PA and MC.
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Affiliation(s)
- A Johnstone
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK
| | - P McCrorie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK
| | - R Cordovil
- CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1499-002 Cruz Quebrada, Lisboa, Portugal
| | - I Fjørtoft
- Faculty of Humanities, Sports and Education Sciences, University of South-Eastern Norway, Lærerskoleveien 40, 3679 Notodden, Norway
| | - S Iivonen
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Yliopistokatu 2, FI-80100 Joensuu, Finland
| | - B Jidovtseff
- Research Unit on Childhood, Department of Sport and Rehabilitation Sciences, University of Liege, 2 Allee des sports, 4000 Liege, Belgium
| | - F Lopes
- Laboratory of Motor Behavior, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz-Quebrada, 1499-002 Portugal
| | - JJ Reilly
- School of Psychological Sciences and Health, University of Strathclyde, 50 George Street, Glasgow G1 1QE, UK
| | - H Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK
| | - V Wells
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK
| | - A Martin
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK
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26
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Johnstone A, Martin A, Cordovil R, Fjørtoft I, Iivonen S, Jidovtseff B, Lopes F, Reilly JJ, Thomson H, Wells V, McCrorie P. Nature-Based Early Childhood Education and Children's Social, Emotional and Cognitive Development: A Mixed-Methods Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105967. [PMID: 35627504 PMCID: PMC9142068 DOI: 10.3390/ijerph19105967] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 01/17/2023]
Abstract
This systematic review synthesised evidence on associations between nature-based early childhood education (ECE) and children's social, emotional, and cognitive development. A search of nine databases was concluded in August 2020. Studies were eligible if: (a) children (2-7 years) attended ECE, (b) ECE integrated nature, and (c) assessed child-level outcomes. Two reviewers independently screened full-text articles and assessed study quality. Synthesis included effect direction, thematic analysis, and results-based convergent synthesis. One thousand three hundred and seventy full-text articles were screened, and 36 (26 quantitative; 9 qualitative; 1 mixed-methods) studies were eligible. Quantitative outcomes were cognitive (n = 11), social and emotional (n = 13), nature connectedness (n = 9), and play (n = 10). Studies included controlled (n = 6)/uncontrolled (n = 6) before-after, and cross-sectional (n = 15) designs. Based on very low certainty of the evidence, there were positive associations between nature-based ECE and self-regulation, social skills, social and emotional development, nature relatedness, awareness of nature, and play interaction. Inconsistent associations were found for attention, attachment, initiative, environmentally responsible behaviour, and play disruption/disconnection. Qualitative studies (n = 10) noted that nature-based ECE afforded opportunities for play, socialising, and creativity. Nature-based ECE may improve some childhood development outcomes, however, high-quality experimental designs describing the dose and quality of nature are needed to explore the hypothesised pathways connecting nature-based ECE to childhood development (Systematic Review Registration: CRD42019152582).
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Affiliation(s)
- Avril Johnstone
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK; (A.J.); (A.M.); (H.T.); (V.W.)
| | - Anne Martin
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK; (A.J.); (A.M.); (H.T.); (V.W.)
| | - Rita Cordovil
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002 Lisboa, Portugal;
| | - Ingunn Fjørtoft
- Faculty of Humanities, Sports and Educational Sciences, University of South-Eastern Norway, 3672 Notodden, Norway;
| | - Susanna Iivonen
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, 80101 Joensuu, Finland;
| | - Boris Jidovtseff
- Research Unit for a Life-Course Perspective on Health and Education, Department of Sport and Rehabilitation Sciences, University of Liege, 2 Allee des Sports, 4000 Liege, Belgium;
| | - Frederico Lopes
- Laboratory of Motor Behavior, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002 Lisbon, Portugal;
| | - John J. Reilly
- School of Psychological Sciences and Health, University of Strathclyde, 50 George Street, Glasgow G1 1QE, UK;
| | - Hilary Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK; (A.J.); (A.M.); (H.T.); (V.W.)
| | - Valerie Wells
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK; (A.J.); (A.M.); (H.T.); (V.W.)
| | - Paul McCrorie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK; (A.J.); (A.M.); (H.T.); (V.W.)
- Correspondence:
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27
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Hilton Boon M, Burns J, Craig P, Griebler U, Heise TL, Vittal Katikireddi S, Rehfuess E, Shepperd S, Thomson H, Bero L. Value and Challenges of Using Observational Studies in Systematic Reviews of Public Health Interventions. Am J Public Health 2022; 112:548-552. [PMID: 35319925 PMCID: PMC8961824 DOI: 10.2105/ajph.2021.306658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Michele Hilton Boon
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jacob Burns
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Peter Craig
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Ursula Griebler
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Thomas L Heise
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - S Vittal Katikireddi
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Eva Rehfuess
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Sasha Shepperd
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Hilary Thomson
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Lisa Bero
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
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28
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Abstract
WHO has a pivotal role in reducing health inequities but faces five fundamental constraints to progress, argue Unni Gopinathan and Kent Buse
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Affiliation(s)
- Unni Gopinathan
- Cluster for Global Health, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Kent Buse
- Healthier Societies Programme, George Institute for Global Health, Imperial College London, London, UK
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29
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Kantorová L, Friessová T, Slezáková S, Langaufová A, Kantor J, Munn Z, Barker TH, Katikireddi SV, Mustafa RA, Žuljević MF, Lukežić M, Klugarová J, Riad A, Vrbová T, Pokorná A, Búřilová P, Búřil J, Kirkovski A, Ćaćić N, Delač L, Tokalić R, Poklepović Peričić T, Klugar M. Addressing Challenges When Applying GRADE to Public Health Guidelines: A Scoping Review Protocol and Pilot Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020992. [PMID: 35055814 PMCID: PMC8775462 DOI: 10.3390/ijerph19020992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 02/05/2023]
Abstract
This is a protocol for a scoping review that aims to determine how guideline authors using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach have addressed previously identified challenges related to public health. The Joanna Briggs Institute (JBI) methodology for scoping reviews will be followed. We will search and screen titles of guidelines for all languages published in 2013–2021 in: the GIN library, BIGG database, Epistemonikos GRADE guidelines repository, GRADEpro Database, MAGICapp, NICE and WHO websites. Two reviewers will independently screen full texts of the documents identified. The following information will be extracted: methods used for identifying different stakeholders and incorporating their perspectives; methods for identification and prioritization of non-health outcomes; methods for determining thresholds for decision-making; methods for incorporating and grading evidence from non-randomized studies; methods for addressing concerns with conditional recommendations in public health; methods for reaching consensus; additional methodological concerns; and any modifications made to GRADE. A combination of directed content analysis and descriptive statistics will be used for data analysis, and the findings presented narratively in a tabular and graphical form. In this protocol, we present the pilot results from 13 identified eligible guidelines issued between January and August 2021. We will publish the full review results when they become available.
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Affiliation(s)
- Lucia Kantorová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
- Department of Public Health, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Tereza Friessová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
| | - Simona Slezáková
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
| | - Alena Langaufová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
| | - Jiří Kantor
- Center of Evidence-Based Education & Arts Therapies: A JBI Affiliated Group, Faculty of Education, Palacky University, Žižkovo nám. 5, 779 00 Olomouc, Czech Republic;
- Institute of Special Education Studies, Faculty of Education, Palacky University, Žižkovo nám. 5, 779 00 Olomouc, Czech Republic
| | - Zachary Munn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia; (Z.M.); (T.H.B.)
| | - Timothy Hugh Barker
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia; (Z.M.); (T.H.B.)
| | - Srinivasa Vittal Katikireddi
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK;
| | - Reem A. Mustafa
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 3L8, Canada;
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Marija Franka Žuljević
- Department of Medical Humanities, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia;
| | - Marina Lukežić
- Department of Public Health, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia;
| | - Jitka Klugarová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
| | - Abanoub Riad
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
| | - Tereza Vrbová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
| | - Andrea Pokorná
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Petra Búřilová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Jiří Búřil
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
- Ist Department of Neurology, St. Anne´s Faculty Hospital, Faculty of Medicine, Masaryk University, Pekařská 664/53, 656 91 Brno, Czech Republic
| | | | - Nensi Ćaćić
- Department of Research in Biomedicine and Health, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia; (N.Ć.); (R.T.); (T.P.P.)
| | - Ljerka Delač
- Department of Basic and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia;
| | - Ružica Tokalić
- Department of Research in Biomedicine and Health, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia; (N.Ć.); (R.T.); (T.P.P.)
| | - Tina Poklepović Peričić
- Department of Research in Biomedicine and Health, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia; (N.Ć.); (R.T.); (T.P.P.)
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; (L.K.); (T.F.); (S.S.); (A.L.); (J.K.); (A.R.); (T.V.); (A.P.); (P.B.); (J.B.)
- Correspondence:
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Lu C, Ke L, Li J, Zhao H, Lu T, Mentis AFA, Wang Y, Wang Z, Polissiou MG, Tang L, Tang H, Yang K. Saffron (Crocus sativus L.) and health outcomes: a meta-research review of meta-analyses and an evidence mapping study. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 91:153699. [PMID: 34419735 DOI: 10.1016/j.phymed.2021.153699] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/31/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Although a number of systematic reviews and meta-analyses of saffron (Crocus sativus L.) have been published, no study has comprehensively summarized the clinical evidence from meta-analyses, or assessed the reporting or methodological quality of these reviews. PURPOSE The present meta-research study was designed to fill the gaps in knowledge to inform future studies and allow enhanced clinical decision-making on saffron. METHODS The PubMed, Cochrane Library, Embase, and CNKI databases were systematically searched from inception to April 3 rd, 2021, for meta-analyses of clinical trials that assessed the efficacy and safety of saffron. PRISMA 2009 and AMSTAR-2 were employed to assess the reporting and methodological quality of meta-analyses identified in the search, respectively. The present study was registered on PROSPERO with registration number CRD42020220274. RESULTS Nineteen eligible systematic reviews with meta-analyses published in English were identified from 235 records. These meta-analyses were published in 12 peer-reviewed journals from 2013 to 2021. The heterogeneous results indicated that saffron significantly reduced fasting blood glucose, waist circumference, diastolic blood pressure, concentrations of total cholesterol and low-density lipoprotein cholesterol, and improved symptoms of depression, cognitive function and sexual dysfunction compared with controls (mainly placebos). Common side effects of saffron consumption included nausea, dry mouth, poor appetite, and headache, but no serious adverse reactions were reported. Primary analysis and sensitivity analysis confirmed that the reporting and methodological quality of reviews included in the study were highly correlated (p < 0.001). The quality of meta-analyses of saffron requires improvement by including a structured abstract, a prospective protocol and registration, explanation of the study designs within each study that is reviewed, the searches, risk of bias assessment, literature selection, and reporting of funding sources. CONCLUSION The available evidence indicates that saffron is a safe plant for administration as a medicine and can improve diverse clinical outcomes, but the scientific quality of the published systematic reviews needs to be improved. Moreover, the clinical effects of saffron need to be confirmed through high-quality randomized trials in multiple countries with large sample sizes.
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Affiliation(s)
- Cuncun Lu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China; Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
| | - Lixin Ke
- Hepatobiliary and pancreatic center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Jieyun Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Haitong Zhao
- Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Tingting Lu
- Institute of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
| | - Alexios Fotios A Mentis
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens 10183, Greece
| | - Youyou Wang
- National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Zhifei Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Moschos G Polissiou
- Laboratory of Chemistry, Department of Science, Agricultural University of Athens, Athens 10183, Greece
| | - Liyao Tang
- Clinical College of Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Hao Tang
- Clinical College of Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China; Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China.
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31
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Tobias DK, Wittenbecher C, Hu FB. Grading nutrition evidence: where to go from here? Am J Clin Nutr 2021; 113:1385-1387. [PMID: 33963733 PMCID: PMC8168365 DOI: 10.1093/ajcn/nqab124] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Deirdre K Tobias
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Clemens Wittenbecher
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Frank B Hu
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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