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European Journal of Cancer Care Jan 2018Early cancer detection is fundamental to the promotion of better health in the community, but disparities remain in the likelihood of cancer being detected at an early... (Meta-Analysis)
Meta-Analysis Review
Early cancer detection is fundamental to the promotion of better health in the community, but disparities remain in the likelihood of cancer being detected at an early stage, some of which relate to socio-demographic factors such as marital status. The aim of this study was to conduct a systematic review of research on the association between marital status and stage at diagnosis of different types of cancer. A comprehensive systematic literature search was run in the Medline and Scopus databases (from January 1990 to June 2014), identifying 245 and 208 articles on PubMed and Scopus respectively. Of these 453 studies, 18 were judged eligible for this systematic review. A quality assessment was performed on the studies using the 22 items in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist. This review confirmed the important influence of being married on the earlier detection of cancer. None of the studies considered identified more cases of cancer in a later stage among married patients, and the majority of them reported a statically significant association between marital status and stage at diagnosis, with a positive effect of marriage on the likelihood of cancer being diagnosed at an early stage, for various types of malignancy. In particular, our meta-analysis showed that the unmarried have higher odds of having a later stage of breast cancer (OR = 1.287 95% CI: 1.025-1.617) or melanoma (OR = 1.350 95% CI: 1.161-1.570) at diagnosis. Specific interventions should be developed for the unmarried population to improve their chances of any neoplasms being diagnosed at an early stage, thereby reducing health disparities in the population at large.
Topics: Breast Neoplasms; Early Detection of Cancer; Female; Humans; Male; Marital Status; Melanoma; Neoplasm Staging; Neoplasms; Prostatic Neoplasms; Skin Neoplasms; Uterine Cervical Neoplasms
PubMed: 28850741
DOI: 10.1111/ecc.12755 -
Cancers Sep 2022To date, there are heterogeneous studies related to childhood cancer survivors' (CCS) employment rates. Given the importance of this topic, we aimed to perform a... (Review)
Review
To date, there are heterogeneous studies related to childhood cancer survivors' (CCS) employment rates. Given the importance of this topic, we aimed to perform a systematic review and meta-analysis to investigate the prevalence of employment among CCS and to examine its association with socio-demographic and clinical factors. We followed the PRISMA guidelines to search for pertinent articles in relevant electronic databases. Eighty-nine articles comprising 93 cohorts were included. The overall prevalence of employment was 66% (CI: 95% 0.63-0.69). Subgroup meta-analyses showed that lower rates were found for central nervous system tumor survivors (51%, CI: 95% 0.43-0.59), and for CCS treated with cranial-radiotherapy (53%, CI: 95% 0.42-0.64) or haematopoietic stem-cell transplantation (56%, CI: 95% 0.46-0.65). The studies conducted in Asia highlighted employment rates of 47% (CI: 95%, 0.34-0.60). Univariate meta-regressions identified the following socio-demographic factors associated with higher rates of employment: a female gender ( = 0.046), a higher mean age at the time of investigation ( = 0.00), a longer time since diagnosis ( = 0.00), a higher educational level ( = 0.03), and a married status ( = 0.00). In conclusion, this systematic review and meta-analysis provides evidence that two-thirds of CCS are employed worldwide. Identifying vulnerable groups of CCS may allow for the design of multidisciplinary support strategies and interventions to promote employment in this population.
PubMed: 36230516
DOI: 10.3390/cancers14194586 -
Campbell Systematic Reviews Sep 2022A growing body of research shows the promise and efficacy of technology-based or digital interventions in improving the health and well-being of survivors of intimate... (Review)
Review
BACKGROUND
A growing body of research shows the promise and efficacy of technology-based or digital interventions in improving the health and well-being of survivors of intimate partner violence (IPV). In addition, mental health comorbidities such as anxiety, post-traumatic stress disorder (PTSD), and depression occur three to five times more frequently in survivors of IPV than non-survivors, making these comorbidities prominent targets of technology-based interventions. Still, research on the long-term effectiveness of these interventions in reducing IPV victimization and adverse mental health effects is emergent. The significant increase in the number of trials studying technology-based therapies on IPV-related outcomes has allowed us to quantify the effectiveness of such interventions for mental health and victimization outcomes in survivors. This meta-analysis and systematic review provide critical insight from several randomized controlled trials (RCTs) on the overall short and long-term impact of technology-based interventions on the health and well-being of female IPV survivors.
OBJECTIVES
To synthesize current evidence on the effects of technology-based or digital interventions on mental health outcomes (depression, anxiety, and PTSD) and victimization outcomes (physical, psychological, and sexual abuse) among IPV survivors.
SEARCH METHODS
We examined multiple traditional and grey databases for studies published from 2007 to 2021. Traditional databases (such as PubMed Central, Web of Science, CINAHL Plus, and PsychINFO) and grey databases were searched between April 2019 and February 2021. In addition, we searched clinical trial registries, government repositories, and reference lists. Authors were contacted where additional data was needed. We identified 3210 studies in traditional databases and 1257 from grey literature. Over 2198 studies were determined to be duplicates and eliminated, leaving 64 studies after screening titles and abstracts. Finally, 17 RCTs were retained for meta-analysis. A pre-registered protocol was developed and published before conducting this meta-analysis.
SELECTION CRITERIA
We included RCTs targeting depression, anxiety, PTSD outcomes, and victimization outcomes (physical, sexual, and psychological violence) among IPV survivors using a technology-based intervention. Eligible RCTs featured a well-defined control group. There were no study restrictions based on participant gender, study setting, or follow-up duration. Included studies additionally supplied outcome data for calculating effect sizes for our desired outcome. Studies were available in full text and published between 2007 and 2021 in English.
DATA COLLECTION AND ANALYSIS
We extracted relevant data and coded eligible studies. Using Cochrane's RevMan software, summary effect sizes () were assessed using an independent fixed-effects model. Standardized mean difference (SMD) effect sizes (or Cohen's ) were evaluated using a Type I error rate and an alpha of 0.05. The overall intervention effects were analyzed using the -statistic with a -value of 0.05. Cochran's test and Higgins' statistics were utilized to evaluate and confirm the heterogeneity of each cumulative effect size. The Cochrane risk of bias assessment for randomized trials (RoB 2) was used to assess the quality of the studies. Campbell Systematic Reviews registered and published this study's protocol in January 2021. No exploratory moderator analysis was conducted; however, we report our findings with and without outlier studies in each meta-analysis.
MAIN RESULTS
Pooled results from 17 RCTs yielded 18 individual effect size comparisons among 4590 survivors (all females). Survivors included college students, married couples, substance-using women in community prisons, pregnant women, and non-English speakers, and sample sizes ranged from 15 to 672. Survivors' ages ranged from 19 to 41.5 years. Twelve RCTs were conducted in the United States and one in Canada, New Zealand, China (People's Republic of), Kenya, and Australia. The results of this meta-analysis found that technology-based interventions significantly reduced among female IPV survivors at 0-3 months only (SMD = -0.08, 95% confidence interval [CI] = -0.17 to -0.00), among IPV survivors at 0-3 months (SMD = -0.27, 95% CI = -0.42 to -0.13, = 0.00, = 25%), and among IPV survivors at 0-6 months (SMD = -0.22, 95% CI = -0.38 to -0.05). We found significant reductions in psychological violence victimization at 0-6 months (SMD = -0.34, 95% CI = -0.47 to -0.20) and at >6 months (SMD = -0.29, 95% CI = -0.39 to -0.18); however, at both time points, there were outlier studies. At no time point did digital interventions significantly reduce (SMD = -0.04, 95% CI = -0.14 to 0.06, = .46, = 0%), or (SMD = -0.02, 95% CI = -0.14 to 0.11, = 21%) among female IPV survivors for all. With outlier studies removed from our analysis, all summary effect sizes were small, and this small number of comparisons prevented moderator analyses.
AUTHORS' CONCLUSIONS
The results of this meta-analysis are promising. Our findings highlight the effectiveness of IPV-mitigating digital intervention as an add-on (not a replacement) to traditional modalities using a coordinated response strategy. Our findings contribute to the current understanding of "what works" to promote survivors' mental health, safety, and well-being. Future research could advance the science by identifying active intervention ingredients, mapping out intervention principles/mechanisms of action, best modes of delivery, adequate dosage levels using the treatment intensity matching process, and guidelines to increase feasibility and acceptability.
PubMed: 36909881
DOI: 10.1002/cl2.1271 -
Global Heart 2023Bystander cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED) can improve out-of-hospital cardiac arrest survival. However, bystander...
Factors and Barriers on Cardiopulmonary Resuscitation and Automated External Defibrillator Willingness to Use among the Community: A 2016-2021 Systematic Review and Data Synthesis.
BACKGROUND
Bystander cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED) can improve out-of-hospital cardiac arrest survival. However, bystander CPR and AED rates remained consistently low. The goal of this systematic review was to assess factors influencing community willingness to perform CPR and use an AED for out-of-hospital cardiac arrest survival (OHCA) victims, as well as its barriers.
METHODS
The review processes (PROSPERO: CRD42021257851) were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) review protocol; formulation of review questions; systematic search strategy based on identification, screening, and eligibility using established databases including Scopus, Web of Science, and Medline Complete via EBSCOhost; quality appraisal; and data extraction and analysis. There is identification of full-text journal articles that were published between 2016 and 2021 and written in English.
RESULTS
Of the final 13 articles, there are six identified factors associated with willingness to perform CPR and use an AED, including socio-demographics, training, attitudes, perceived norms, self-efficacy, and legal obligation. Younger age, men, higher level of education, employed, married, having trained in CPR and AED in the previous 5 years, having received CPR education on four or more occasions, having a positive attitude and perception toward CPR and AED, having confidence to perform CPR and to apply an AED, and legal liability protection under emergency medical service law were reasons why one would be more likely to indicate a willingness to perform CPR and use an AED. The most reported barriers were fear of litigation and injuring a victim.
CONCLUSIONS
There is a need to empower all the contributing factors and reduce the barrier by emphasizing the importance of CPR and AEDs. The role played by all stakeholders should be strengthened to ensure the success of intervention programs, and indirectly, that can reduce morbidity and mortality among the community from OHCA.
Topics: Child, Preschool; Humans; Male; Cardiopulmonary Resuscitation; Databases, Factual; Educational Status; Emergency Medical Services; Out-of-Hospital Cardiac Arrest
PubMed: 37649652
DOI: 10.5334/gh.1255 -
Ageing Research Reviews Nov 2021While widowhood is known to be associated with poorer physical and mental health outcomes, studies examining the association of widowhood with cognition have yielded... (Meta-Analysis)
Meta-Analysis Review
While widowhood is known to be associated with poorer physical and mental health outcomes, studies examining the association of widowhood with cognition have yielded mixed results. This review aimed to elucidate the link between widowhood and cognitive decline. A systematic search of Medline, Embase, PsycInfo, CINAHL and Scopus (until December 2020) was conducted to identify studies on the association between widowhood (vs. being married) and cognition in cognitively healthy adults aged 50 +. A cross-sectional meta-analysis (of 10 studies; n = 24,668) found a significant association of widowhood with cognition (g = - 0.36, 95% CI [- 0.47, - 0.25], p = < 0.001). Meta-regressions suggested that study design, cognitive domain measured, sample age, difference in mean age between widowed and married groups, and study continent did not account for observed heterogeneity. A longitudinal meta-analysis (of 3 studies; n = 10,378) found that the "continually widowed" group (from baseline to follow-up) showed significantly steeper declines in cognition compared to the "continually married" group (g = - 0.15, 95%CI [- 0.19, - 0.10], p = < 0.001). Findings indicate that widowhood may be a risk factor for cognitive decline. As there are no effective treatments for cognitive impairment, studying mechanisms by which widowhood might be associated with poorer cognition could inform prevention programs for those who have experienced spousal bereavement.
Topics: Aged; Bereavement; Cognitive Dysfunction; Cross-Sectional Studies; Female; Humans; Longitudinal Studies; Middle Aged; Widowhood
PubMed: 34534681
DOI: 10.1016/j.arr.2021.101461 -
Trauma, Violence & Abuse Dec 2023Attacks perpetrated using acid are a particular form of interpersonal violence, possibly one of the most heinous manifestations of Intimate Partner Violence (IPV). Acid... (Review)
Review
Attacks perpetrated using acid are a particular form of interpersonal violence, possibly one of the most heinous manifestations of Intimate Partner Violence (IPV). Acid attacks are mainly motivated by extramarital cheating, marital conflicts, women's rejection of marriage proposals, and sexual advances. As these attacks are not well understood from a psychological perspective, we conducted a systematic review, following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, of 284 articles identified, 13 were eligible for inclusion. Three main focuses were identified: "Risk and vulnerability factors," "Consequences and implications," and "Interventions and treatments." Acid attacks seem to be more frequent in countries where social and economic development leads to greater tensions over traditional gender roles like Bangladesh, Pakistan, and India. Identified risk factors were young age, low socioeconomic status, low educational attainment, ethnicity, unemployment status of the victim, alcohol, and drug use of the perpetrator. Among the main psychosocial consequences of acid attacks, isolation and social exclusion emerged. Additionally, the paper will discuss the role of mental health consequences and specific treatments from psychological, clinical, and medical-legal points of view.
Topics: Female; Humans; Family Conflict; Gender-Based Violence; Intimate Partner Violence; Risk Factors; Sexual Behavior
PubMed: 36062902
DOI: 10.1177/15248380221121288 -
Journal of Neurology, Neurosurgery, and... Mar 2018Being married is associated with healthier lifestyle behaviours and lower mortality and may reduce risk for dementia due to life-course factors. We conducted a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Being married is associated with healthier lifestyle behaviours and lower mortality and may reduce risk for dementia due to life-course factors. We conducted a systematic review and meta-analysis of studies of the association between marital status and the risk of developing dementia.
METHODS
We searched medical databases and contacted experts in the field for relevant studies reporting the relationship, adjusted for age and sex, between marital status and dementia. We rated methodological quality and conducted random-effects meta-analyses to summarise relative risks of being widowed, divorced or lifelong single, compared with being married. Secondary stratified analyses with meta-regression examined the impact of clinical and social context and study methodology on findings.
RESULTS
We included 15 studies with 812 047 participants. Compared with those who are married, lifelong single (relative risk=1.42 (95% CI 1.07 to 1.90)) and widowed (1.20 (1.02 to 1.41)) people have elevated risk of dementia. We did not find an association in divorced people.Further analyses showed that less education partially confounds the risk in widowhood and worse physical health the elevated risk in lifelong single people. Compared with studies that used clinical registers for ascertaining dementia diagnoses, those which clinically examined all participants found higher risk for being unmarried.
CONCLUSIONS
Being married is associated with reduced risk of dementia than widowed and lifelong single people, who are also underdiagnosed in routine clinical practice. Dementia prevention in unmarried people should focus on education and physical health and should consider the possible effect of social engagement as a modifiable risk factor.
Topics: Confounding Factors, Epidemiologic; Dementia; Divorce; Educational Status; Humans; Marital Status; Marriage; Observational Studies as Topic; Protective Factors; Risk Factors; Single Person; Widowhood
PubMed: 29183957
DOI: 10.1136/jnnp-2017-316274 -
The Lancet. Planetary Health Jun 2022The intensity and frequency of extreme weather and climate events are expected to increase due to anthropogenic climate change. This systematic review explores extreme... (Review)
Review
The intensity and frequency of extreme weather and climate events are expected to increase due to anthropogenic climate change. This systematic review explores extreme events and their effect on gender-based violence (GBV) experienced by women, girls, and sexual and gender minorities. We searched ten databases until February, 2022. Grey literature was searched using the websites of key organisations working on GBV and Google. Quantitative studies were described narratively, whereas qualitative studies underwent thematic analysis. We identified 26 381 manuscripts. 41 studies were included exploring several types of extreme events (ie, storms, floods, droughts, heatwaves, and wildfires) and GBV (eg, sexual violence and harassment, physical violence, witch killing, early or forced marriage, and emotional violence). Studies were predominantly cross-sectional. Although most qualitative studies were of reasonable quality, most quantitative studies were of poor quality. Only one study included sexual and gender minorities. Most studies showed an increase in one or several GBV forms during or after extreme events, often related to economic instability, food insecurity, mental stress, disrupted infrastructure, increased exposure to men, tradition, and exacerbated gender inequality. These findings could have important implications for sexual-transformative and gender-transformative interventions, policies, and implementation. High-quality evidence from large, ethnographically diverse cohorts is essential to explore the effects and driving factors of GBV during and after extreme events.
Topics: Cross-Sectional Studies; Female; Gender-Based Violence; Humans; Male; Violence
PubMed: 35709808
DOI: 10.1016/S2542-5196(22)00088-2 -
Breastfeeding Medicine : the Official... Feb 2023Breastfeeding as an important key to sustainable development strategies is the best nutrition for ensuring healthy growth and development in the first 1,000 days of... (Meta-Analysis)
Meta-Analysis Review
Breastfeeding as an important key to sustainable development strategies is the best nutrition for ensuring healthy growth and development in the first 1,000 days of life. The current systematic review and meta-analysis were conducted to evaluate the correlation between marital relationship satisfaction and breastfeeding self-efficacy and duration of breastfeeding. A systematical search was carried out in main electronic databases (PubMed, Scopus, Embase, ProQuest, and Web of Science) and gray literature until June 2022. The study's risk of bias was assessed using the Newcastle-Ottawa risk-of-bias tool. Publication bias was evaluated using a funnel plot, and Begg's and Egger's tests. The degree of heterogeneity was assessed using the test. To estimate common effect size coefficient () and confidence intervals (95% CIs), random-effect models were fitted, and the results were presented using forest plots. In total, 13 studies with 5,843 subjects were included in the meta-analysis. Overall, the pool estimates show a positive correlation between marital relationship satisfaction, and breastfeeding self-efficacy ( = 0.27, 95% CI (0.09-0.50), = 0.024), but this relationship was not found in the term of breastfeeding duration ( = 0.11, 95% CI [-0.01 to 0.23], = 0.079). The heterogeneity of studies was high ( = 95.2%) Our finding confirms a positive and moderate level of correlation between marital relationship satisfaction and breastfeeding self-efficacy. It is suggested to conduct more studies to reach appropriate conclusions regarding marital relationship satisfaction and breastfeeding duration.
Topics: Female; Humans; Breast Feeding; Marriage; Self Efficacy
PubMed: 36800333
DOI: 10.1089/bfm.2022.0210 -
Archives of Rehabilitation Research and... Jun 2021To estimate the pooled national burden of occupational stress, burnout, and contributing factors among health care workers in Ethiopia. (Review)
Review
OBJECTIVE
To estimate the pooled national burden of occupational stress, burnout, and contributing factors among health care workers in Ethiopia.
DATA SOURCES
Both published and unpublished observational studies conducted on the burden of occupational stress and burnout among health workers in Ethiopia were included.
STUDY SELECTION
This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered on PROSPERO (CRD42020166585). The eligibility of the studies was evaluated based on predetermined inclusion and exclusion criteria.
DATA EXTRACTION
Data extraction was conducted using major databases; PubMed, Google Scholar, Cumulative Index to Nursing and Allied Health, Scopes, Cochrane Library, the Web of Science, and African Journals Online were involved in the review. Two reviewers extracted data independently using a standardized data extraction checklist on Microsoft Excel. Any discrepancy was resolved by including the third reviewer for a possible consensus.
DATA SYNTHESIS
Fourteen studies, with a total of 4066 health care workers, were included in the meta-analysis. The pooled burdens of occupational stress and burnout were 52.9% (95% confidence interval [CI], 46.259.7) and 39.1% (95% CI, 23.952.3), respectively. Major determinants of occupational stress were being female (odds ratio [OR], 1.9; 95% CI, 1.1-3.3), being younger (OR, 1.4; 95% CI, 1.03-1.9), having a lower educational level (OR, 2.7; 95% CI, 1.05-7.2), and being satisfied with a job (OR, 0.3; 95% CI, 0.2-0.5). Being married (OR, 0.7; 95% CI, 0.5-0.9), having a lower educational level (OR, 0.5; 95% CI, 0.4-0.8), and working in shifts (OR, 0.7; 95% CI, 0.5-0.9) were significant predictors of burnout.
CONCLUSIONS
More than half and more than one-third of health care workers were affected by occupational stress and burnout, respectively, in Ethiopia, and sociodemographic and occupation-related factors were significant factors. Measures that improve job satisfaction, career development, and educational opportunities should be strengthened.
PubMed: 34179761
DOI: 10.1016/j.arrct.2021.100125