Effect of Socioeconomic Disparities on Suicide Risk in Patients With Prostate Cancer During 2005 to 2020: A Population Study

PURPOSE

To determine whether socioeconomic disparities have an impact on the likelihood of suicide among prostate cancer patients.

METHODS

Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with malignant prostate cancer between 2005 and 2020. The socioeconomic disparities of the patients were evaluated by median household income (MHI) and ethnicity. Ethnicity included Spanish-Hispanic-Latino and non-Spanish-Hispanic-Latino. A Cox proportional risk model was utilized. Using the Kaplan-Meier approach, the cumulative incidence of suicide mortality was measured.

RESULTS

A total of 857,418 US population with prostate cancer were included. In the multivariate analysis, individuals with MHI over $75,000 had a lower risk of suicide mortality than those with MHI between $54,999 and $74,999 in all patients (aHRs: 0.693, 95 CI%: 0.603-0.797). Spanish-Hispanic-Latino displayed lower overall suicide mortality in all patients (aHRs: 0.426, 95% CI: 0.323-0.561). In the subgroup analysis of different ages, individuals with MHI over $75,000 had a lower risk of suicide than those with MHI between $54,999 and $74,999 in patients 60 to 79 years (aHRs: 0.668, 95% CI: 0.562-0.794) and individuals with MHI below $54,999 had higher suicide risk than those with MHI between $54,999 and $74,999 in patients 80+ years (aHRs: 1.786, 95% CI: 1.100-2.902). Hispanic-Latino individuals had lower overall suicide mortality in 00 to 59 years (aHRs: 0.420, 95% CI: 0.240-0.734), 60 to 79 years (aHRs: 0.445, 95% CI: 0.319-0.621), 80+ years (aHRs: 0.363, 95% CI: 0.133-0.988).

CONCLUSION

Socioeconomic disparities, including MHI and ethnicity, are important factors strongly related to suicide risk in prostate cancer patients. The lower MHI individuals and non-Spanish-Hispanic-Latino individuals were associated with higher suicide risk.

Mortality of children and adolescents co-infected with tuberculosis and HIV: a systematic review and meta-analysis

OBJECTIVE

Children and adolescents with HIV infection are well-known to face a heightened risk of tuberculosis. However, the exact mortality rates and temporal trends of those with HIV-TB co-infection remain unclear. We aimed to identify the overall mortality and temporal trends within this population.

METHODS

PubMed, Web of Science, and Embase were employed to search for publications reporting on the mortality rates of children and adolescents with HIV-TB co-infection from inception to March 2, 2024. The outcome is the mortality rate for children and adolescents with HIV-TB co-infection during the follow-up period. In addition, we evaluate the temporal trends of mortality.

RESULTS

During the follow-up period, the pooled mortality was 16% (95% CI 13-20). Single infection of either HIV or TB exhibit lower mortality rates (6% and 4%, respectively). We observed elevated mortality risks among individuals aged less than 12 months, those with EPTB, poor adherence to ART, and severe immunosuppression. In addition, we observed a decreasing trend in mortality before 2008 and an increasing trend after 2008, although the trends were not statistically significant (P = 0.08 and 0.2 respectively).

CONCLUSIONS

Children and adolescents with HIV-TB co-infection bear a significant burden of mortality. Timely screening, effective treatment, and a comprehensive follow-up system contribute to reducing the mortality burden in this population.

Non-pharmacological interventions for preventing suicide attempts: A systematic review and network meta-analysis

Suicide attempts can cause serious physical harm or death. It would be crucial to gain a better understanding of the comparative efficacy of non-pharmacological interventions. We aimed to identify which non-pharmacological interventions are more effective in preventing suicide attempts. PubMed, Web of Science, and EMBASE databases were searched systematically from their inception until 3 April 2023. To be eligible for inclusion, randomized controlled trials (RCTs) had to meet the following criteria: Participants were individuals who had suicidal ideation or a history of severe self-harm or attempted suicide. A network meta-analysis was performed using a random effects model to estimate the treatment effect of various non-pharmacological interventions. (PROSPERO registration number: CRD42023411393). We obtained data from 54 studies involving 17,630 participants. Our primary analysis found that Cognitive therapy (CT) (OR=0.19, 95%CI =0.04-0.81), Dialectical Behavior Therapy (DBT) (OR=0.37, 95%CI =0.13-0.97), Cognitive-behavioral therapy (CBT) (OR=0.42, 95%CI =0.17-0.99), and Brief intervention and contact (BIC) (OR=0.65, 95%CI=0.44-0.94) were superior to TAU (within the longest available follow-up time) in preventing suicide attempts, while other intervention methods do not show significant advantages over TAU. Secondary analysis showed that the two intervention measures (CT and BIC) were effective when follow-up time did not exceed 6 months, but there was no effective intervention measure with longer follow-up times. CT, DBT, CBT, and BIC have a better effect in preventing suicide attempts than other non-pharmacological interventions. Additional research is necessary to validate which interventions, as well as which combinations of interventions, are the most effective.

Efficacy of recombinant human epidermal growth factor in pressure injury healing: evidence from Chinese randomized controlled trials

OBJECTIVE

To evaluate the efficacy of recombinant human epidermal growth factor (rhEGF) in healing pressure injuries (PIs).

METHODS

A meta-analysis was conducted of randomized controlled trials (RCTs) involving rhEGF in the treatment of PIs that were identified in PubMed, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure (CNKI). The population, intervention, comparison, outcomes, study design (PICOS) strategy was applied to determine analysis eligibility. The Cochrane risk of bias tool was used, and statistical analysis, including sensitivity analysis, was performed of 3 outcomes indicators: the primary outcome was total efficacy of rhEGF in treating PIs, and the secondary outcomes were the proportion of complete healing and the time to complete healing. Total efficacy refers to the proportion of cases that have been cured, obviously effective, or effective. Complete healing refers to cases where the wound has healed, scabbed, and the scab has sloughed off.

RESULTS

Sixteen RCTs were included, comprising a total of 1,206 patients. Study and control group size varied by outcomes. The total effective healing rate in rhEGF group was 97.18%, which was significantly higher than 83.38% in control group (OR: 5.69, [95% CI: 3.61, 8.97], z=7.49, P < .001). The proportion of complete healing in the rhEGF group was 73.30%, which was higher than 39.52% in control group (OR: 3.88, [95% CI: 3.01, 5.01], z=10.39, P < .001). Furthermore, the healing time using rhEGF was shorter (SMD: -2.14 days, [95% CI: -2.60, -1.67], z=9.07, P < .001). Sensitivity analyses indicated that the results were robust.

CONCLUSIONS

The meta-analysis indicated that rhEGF was effective in healing PIs with few negative effects. Further research beyond Chinese populations involving larger studies and studies that distinguish between results found in using rhEGF alone or in combination are recommended.

Suicide death, suicidal ideation and suicide attempt in patients with diabetes: A systematic review and meta-analysis

AIMS

Diabetes has been indicated to be a risk factor for suicide. We aim to estimate the prevalence of suicide in patients with diabetes.

DESIGN

A meta-analysis using PRISMA methodology was adopted to examine the incidence of suicide in diabetic patients.

DATA SOURCES

From inception to October 2022, three online databases (PubMed, China National Knowledge Infrastructure and Web of Science) were used to search studies.

REVIEW METHODS

We used random-effects model to analysis. And our primary outcome was the incidence of suicide death per 100 person-years, and other outcomes were prevalence of suicidal ideation and suicide attempt. To explore the sources of heterogeneity in our study, we performed subgroup and meta-regression analyses.

RESULTS

The suicide death rate in diabetic patients was 0.027 per 100 person-years, with a higher rate for Type 1 Diabetes Mellitus compared to Type 2 Diabetes Mellitus. The prevalence of suicidal ideation in diabetes patients was 0.175, with a higher prevalence in Type 1 Diabetes Mellitus compared to Type 2 Diabetes Mellitus. The prevalence of suicide attempts in diabetes patients was 0.033, indicating a higher rate for Type 2 Diabetes Mellitus compared to Type 1 Diabetes Mellitus.

CONCLUSIONS

The results indicate a high rate of suicide among people with diabetes, and this study identifies populations and regions at high risk for suicide. Our review emphasizes interventions in mental health and the improvement of suicide prevention programmes.

IMPACT

The study investigated suicide death, suicidal ideation and suicide attempt in diabetic individuals. Suicide rates are elevated among diabetic patients, and various patient groups face distinct suicide risks. It is important to prioritize the mental well-being of diabetic individuals and enhance interventions, including personalized approaches, to inform public health efforts aimed at preventing and addressing suicide among diabetic patients.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public involvement.

Impact of the National Nursing Development Plan on nursing human resources in China: An interrupted time series analysis for 1978-2021

BACKGROUND

Shortages of nurses and unequal distribution of nursing staff have been huge challenges for global health services.

OBJECTIVES

The aim of our study was to evaluate the impact of the National Nursing Development Plan on nursing human resources in China.

METHODS

An interrupted time series design was used in this study. The data for this study were extracted from the National Health Statistics Yearbook from 1978 to 2021. The Ministry of Health issued the National Nursing Development Plan (2005-2010) in July 2005. Subsequently, the strategic plan was issued every 5 years: the National Nursing Development Plan (2011-2015), the National Nursing Development Plan (2016-2020), and the National Nursing Development Plan (2021-2025). This study used five indicators including 1) the number of registered nurses (RNs) in China, 2) the number of RNs per 1000 population in China, 3) the proportion of RNs in health technical personnel in China, 4) the doctor-nurse ratio and 5) the number of nurses working in primary medical institutions to evaluate the changing trend of nursing human resources in China from 1978 to 2021.

RESULTS

Interrupted time series analysis showed that after the implementation of the National Nursing Development Plan (2005-2010), the building of nurses in China was gradually strengthening, and the number of RNs in China increased by 0.198 million per year (95%CI 0.174-0.223; P < 0.001); the number of RNs per 1000 population (Coefficient = 0.139; 95%CI 0.123-0.154; P < 0.001); the proportion of RNs in the total number of health professionals in China has increased from 29.6 % to 44.6 % (Coefficient = 0.010; 95%CI 0.009-0.010; P < 0.001); in China, the doctor-nurse ratio increased by 0.024 (95%CI 0.019-0.029; P < 0.001). In 2021, the number of RNs working in primary medical institutions increased by approximately 0.86 million compared with that in 2005, and the proportion of RNs in the country increased by 1.4 %. The development of nurses is especially tilted to the primary level to meet the health and nursing needs of the primary level.

CONCLUSIONS

The implementation of the National Nursing Development Plan has greatly expanded the scale of nursing human resources in China and significantly optimized the efficiency of allocation. The implementation of the National Nursing Development Plan (2011-2015) and the National Nursing Development Plan (2016-2020) well continued the strategic plan from 2005 to 2010, further expanded the nursing workforce and further optimized the allocation efficiency.

TWEETABLE ABSTRACT

The implementation of the National Nursing Development Plan has greatly expanded the scale of nursing human resources in China and significantly optimized the efficiency of allocation.

Socioeconomic status on survival outcomes in patients with colorectal cancer: a cross-sectional study

BACKGROUND

Colorectal cancer (CRC) is widely acknowledged as a prevalent malignancy and the second most common cause of cancer-related mortality worldwide. The aim of this study was to examine the independent impact of Median Household Income (MHI) on prognosis and survival outcomes in patients with CRC.

METHODS

Data from 17 cancer registries of the United States Surveillance, Epidemiology, and End Results program, with follow-up extended until November 2022 was analyzed. A Cox proportional hazards regression analysis was conducted to evaluate the influence of different levels of MHI on survival outcomes among patients with CRC. A total of 761,697 CRC patient records were retrieved from the SEER database.

RESULTS

The Cox regression analysis results indicated that patients with higher MHI exhibited improved overall survival outcomes when compared to those with lower MHI (MMHI: P < 0.001; HMHI: P < 0.001). Regardless of the specific tumor location, gender, stage of CRC, or treatment method, higher MHI is consistently linked to improved survival outcomes. However, this association was not found to be statistically significant among American Indian/Alaska Native (MMHI: P = 0.017; HMHI: P = 0.081), Asian or Pacific Islander (MMHI: P = 0.223; HMHI: P = 0.002) and unmarried or domestic partner patients (MMHI: P = 0.311; HMHI: P = 0.011).

CONCLUSION

These results emphasize the importance of considering socioeconomic factors, such as income level, in understanding and addressing disparities in survival outcomes of CRC patients.

Gender differences in suicide among patients with bipolar disorder: A systematic review and meta-analysis

OBJECTIVE

To examine gender differences in suicidal ideation, suicide attempts, and suicide deaths in patients with bipolar disorder.

METHODS

PubMed, Web of Science, and Embase were systematic searched from inception to March 7, 2023. Two reviewers extract data independently. Demographic data, the number of males and females with bipolar disorder, and the number of individuals with suicidal ideation, suicide attempts, and suicide deaths among participants were extracted.

RESULTS

The pooled prevalence of suicidal ideation in males and females was 48.0 % and 44.0 %, respectively, and the overall male-to-female ratios present a statistically insignificant result (OR = 0.95, 95%CI = 0.75-1.21) among patients with bipolar disorder. The pooled prevalence of suicide attempts in males and females was 6.7 % and 9.3 %, respectively, and there was a statistically significant lower prevalence among male patients with bipolar disorder (OR = 0.71, 95%CI = 0.67-0.75). However, the pooled prevalence of suicide deaths in males and females was 0.7 % and 0.3 % respectively, and there was a statistically significant higher prevalence among male patients with bipolar disorder (OR = 1.86, 95%CI = 1.63-2.13).

LIMITATIONS

The included studies were from mainly middle- and high-income countries and used inconsistent measurement tools. Thus, there is a potential for bias in our results.

CONCLUSIONS

Among patients with bipolar disorder, females were found to have a higher prevalence of suicide attempts, while males have a higher prevalence of suicide deaths. However, there is no significant gender difference in suicidal ideation. Efforts to optimize recognition, treatment, and administration in males and females may reduce gender differences.

The connection between six common air pollution particles and adult brain tumors: a meta-analysis of 26,217,930 individuals

Environmental air pollutants (black carbon (BC), nitrogen oxides (NOx), particulate matter with diameter < 2.5 μm (PM2.5), nitrogen dioxide (NO2), particulate matter with diameter <10 μm (PM10), and ozone (O3)) are one of the major menaces to mankind's health globally. This analysis reviews the association between exposure to these air pollutants and the chance of developing brain tumors in adults (total brain tumors, malignant brain tumors, and benign brain tumors). Studies published by April 2022 were searched. Raw effect sizes were converted to standardized effect sizes per 10 μg/m3 increase. Random effect models were applied to calculate combined effect size and 95% confidence intervals (CIs) were computed. A total of 8 articles were included for meta-analysis. The pooled effect size (ES) for per 10 μg/m3 BC intake was 1.67 (95% CI: 1.25, 2.22), P = 0.449. For every 10 μg/m3 rise in NO2 concentration, ES was 1.03 (95% CI: 1.01, 1.05), P = 0.319. Meanwhile, there was a boundary association between NOx and adult brain tumors (ES and 95% CI: 1.01; 1.00, 1.01/10 μg/m3; P = 0.716). While there was no conjunction between PM2.5, PM10, O3 (PM2.5: ES and 95% CI: 1.04; 0.99, 1.08/10 μg/m3; P = 0.834; PM10: ES and 95% CI: 1.01; 0.97, 1.04/10 μg/m3; P = 0.627; O3: ES and 95% CI: 0.97; 0.94, 1.00/10 μg/m3; P = 0.253). This research shows testimony of a significant link between air pollutants and brain tumors in adults, especially when exposed to BC, NO2, and NOx. This evidence emphasizes the importance of improving air quality as part of a comprehensive approach to prevent the occurrence and deterioration of brain tumors.

QTc prolongation in patients with schizophrenia taking antipsychotics: Prevalence and risk factors

BACKGROUND

QTc prolongation is one of the possible complications in patients with schizophrenia taking antipsychotics, which leads to malignant cardiac arrhythmia. No meta-analysis has been reported assessing the prevalence and correlated risk factors for QTc prolongation.

METHODS

This meta-analysis aimed to assess the evidence for the prevalence of QTc prolongation and correlated risk factors in patients with schizophrenia taking antipsychotics. Web of Science and PubMed were searched according to preset strategy. The quality of research was assessed by the Newcastle-Ottawa Scale (NOS).

RESULTS

In all, 15 studies covering 15,540 patients with schizophrenia taking antipsychotics were included. Meta-analysis showed that the prevalence of QTc prolongation in patients with schizophrenia taking antipsychotics was about 4.0% (95% confidence interval (CI): 3.0%-5.0%, p < 0.001). The prevalence was about 4.0% in Asia (95%CI: 3.0%-6.0%, p < 0.001), about 5.0% in Europe (95%CI: 2.0%-7.0%, p < 0.001), and about 2.0% in America (95%CI: 1.0%-3.0%, p < 0.001). Sensitivity analyses indicated the robustness of the result. Publication bias analysis reported a certain publication bias (t = 3.37, p = 0.012). Meta-regression suggested that female and elderly patients were clinically associated with a higher prevalence of QTc prolongation. According to included studies, smoking, comorbidity of cardiovascular disease, and abnormal levels of high-density lipoprotein/low-density lipoprotein might be related to QTc prolongation in patients with schizophrenia taking antipsychotics.

CONCLUSIONS

The prevalence of QTc prolongation in patients with schizophrenia taking antipsychotics was about 4.0%. Female and elderly patients were more likely to experience QTc prolongation. Close electrocardiogram monitoring was suggested in these at-risk populations.

Incidence, prevalence and risk factors of device-related pressure injuries in adult intensive care unit: A meta-analysis of 10,084 patients from 11 countries

Device-related pressure injuries (DRPIs) prevail in the intensive care unit (ICU) and have much to do with medical devices and patients' conditions. This meta-analysis aims to systematically assess the incidence, prevalence and risk factors related to DRPIs among adults in ICU. Web of Science, Cochrane Library, MEDLINE, PubMed and CINAHL were searched from inception to March 2023. Observational studies were included, and the Newcastle-Ottawa scale (NOS) was used to assess literature quality. The primary outcomes were the incidence, prevalence and risk factors regarding DRPIs among adults in ICU. The 19 studies conformed to the criteria for inclusion in the review. The estimated pooled incidence of DRPIs was 14.7% (95% CI: 9.7%-19.6%) in 10 studies (4866 participants). The estimated pooled prevalence of DRPIs was 19.0% (95% CI: 13.6%-24.3%) in 9 studies (5218 participants). The most significant risk factor for DRPIs was using mechanical ventilation. The pooled analysis of the four studies showed that DRPIs were more likely to occur in patients who required mechanical ventilation compared with patients who did not use mechanical ventilation (OR: 9.67, 95% CI: 5.03-18.61, p < 0.001) and using vasopressors, age, length of ICU stays, APACHE II score, Braden score, fever, sex, oedema, diabetes and number of medical devices, SOFA score was also related to pressure injuries risk. The incidence and prevalence of DRPIs in adult ICU were high, and the most significant risk factor for DRPIs was using mechanical ventilation. It is imminent to identify patients of increased risk with DRPIs early.

Global prevalence of nursing burnout syndrome and temporal trends for the last 10 years: A meta-analysis of 94 studies covering over 30 countries

AIMS AND OBJECTIVES

To determine the global prevalence of nursing burnout syndrome and time trends for the last 10 years.

BACKGROUND

The prevalence of burnout syndrome varied greatly in different regions in the last 10 years, so the average prevalence and time trends of nursing burnout syndrome for the last 10 years were not completely clear.

DESIGN

A meta-analysis conducted in the PRISMA guidelines.

METHODS

CINAHL, Web of Science, and PubMed were searched for trials on the prevalence of nursing burnout syndrome from 2012 to 2022 systematically. Hoy's quality assessment tool was used to evaluate the risk of bias. The global prevalence of nursing burnout syndrome was estimated, and subgroup analysis was used to explore what caused heterogeneity. Time trends for the last 10 years were evaluated by meta-regression using Stata 11.0.

RESULTS

Ninety-four studies reporting the prevalence of nursing burnout were included. The global prevalence of nursing burnout was 30.0% [95% CI: 26.0%-34.0%]. Subgroup analysis indicated that the specialty (p < .001) and the region (p < .001) and the year (p < .001) were sources of the high heterogeneity. Meta-regression indicated that it tended to increase gradually for the last 10 years (t = 3.71, p = .006). The trends increased in Europe (t = 4.23, p = .006), Africa (t = 3.75, p = .006) and obstetrics (t = 3.66, p = .015). However, no statistical significance was found in ICU (t = -.14, p = .893), oncology (t = -0.44, p = .691) and emergency department (t = -0.30, p = .783).

CONCLUSIONS

A significant number of nurses were found to have moderate-high levels of burnout syndrome for the last 10 years. The meta-analysis also indicated an increased trend over time. Therefore, more attention to the prevalence of nursing burnout syndrome is urgently required.

RELEVANCE TO CLINICAL PRACTICE

High prevalence of nursing burnout may attract more attention from the public. This analysis may serve as an impetus for relevant policy to change nurses' working conditions and reduce the occurrence of burnout.

The Relationship Between Loneliness and Internet or Smartphone Addiction Among Adolescents: A Systematic Review and meta-Analysis

Background: Loneliness is a common public health problem that influences people's physical and mental health. There is a high incidence of loneliness in adolescents. Some research suggested that smartphone or Internet addiction (SA or IA) may be a factor. But the relationship between loneliness and SA or IA is not completely clear among adolescents. We aim to estimate the correlation coefficient r between them. Methods: Databases, consisting of PubMed and Web of Science, were retrieved systematically for studies of the association between adolescents' loneliness and SA or IA. The Newcastle-Ottawa Scale was chosen as an assessment tool in this analysis. We estimated the correlation coefficient r between loneliness and SA or IA and drew a forest plot. Moreover, moderator analyses were also conducted to explore what leads to heterogeneity in our study. Results: 21 studies were finally included in our analysis with 27,843 samples. The pooled correlation coefficient r was 0.252 (95% confidence interval: [0.173, 0.329]; p < 0.001) with low heterogeneity (I² = 0.000%; Q = 23.616; p < 0.001), indicating a moderate positive association. The funnel plot indicated small publication bias. A one-study removal sensitivity analysis indicated there was no significant difference between these studies. Meta-regression indicated no significant difference between the results and age (Q = 11.94, df = 18, p = 0.8504). Conclusions: Our analysis indicated a moderate positive association between loneliness and SA or IA. The results may attract the attention of some experts who study adolescent psychological problems and behavioral problems and may provide ideas for their research in the future.

COVID-19 pandemic increases the occurrence of nursing burnout syndrome: an interrupted time-series analysis of preliminary data from 38 countries

AIM

To evaluate the trends in nursing burnout rates before and during the coronavirus 2019 restrictions.

METHOD

Meta-analysis was used to extract the data on global nursing burnout from 1 Jan. 2010-15 Dec. 2022. An interrupted time-series analysis using segmented ordinary least squares (OLS) regression models was used to explore if the nursing burnout were affected by the epidemic. Newey-West standard error was used to adjust for autocorrelation and heteroskedasticity.

RESULTS

Before the epidemic (April 2020), the nursing burnout rate rose with 0.0007497 (95% CI: 0.0000316, 0.0014677, t = 2.07, P = 0.041) per month. The trend of nursing burnout rate has increased by 0.0231042 (95 CI%:0.0086818, 0.0375266, t = 3.18, P = 0.002). The increasing trend of nursing burnout rate after the COVID-19 restrictions is 0.0007497 + 0.0231042 = 0.0238539 per month.

CONCLUSION

The study indicated that the Covid-19 restrictions had an impact on nursing burnout, increasing the occurrence of nursing burnout syndrome.