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Sleep Medicine Reviews Jun 2023Lower urinary tract symptoms represent a significant public health problem worldwide, impairing patients' quality of life, especially in elderly people. Among LUTS,... (Review)
Review
Lower urinary tract symptoms represent a significant public health problem worldwide, impairing patients' quality of life, especially in elderly people. Among LUTS, nocturia is assessed as the most experienced entity related to several disorders such as sleep disorders and/or obstructive sleep apnea syndrome (OSAS). Among OSAS patients, nocturia stands as a bothersome symptom that increases alongside with the OSAS severity. However, despite the nocturia and OSAS shared a long-acknowledged link, the causes, and the pathophysiology for development of nocturia in OSAS have remained largely unexamined. Generally, the patients with OSAS experienced nocturia due to easy waking or increased bladder filling. However, nor the effect of treatment on management of nocturia in OSAS patients are well-established.
Topics: Humans; Aged; Nocturia; Quality of Life; Sleep Apnea, Obstructive; Continuous Positive Airway Pressure
PubMed: 37167825
DOI: 10.1016/j.smrv.2023.101787 -
BMJ (Clinical Research Ed.) Jul 2023To review the evidence on trends and impacts of private equity (PE) ownership of healthcare operators.
OBJECTIVE
To review the evidence on trends and impacts of private equity (PE) ownership of healthcare operators.
DESIGN
Systematic review.
DATA SOURCES
PubMed, Web of Science, Embase, Scopus, and SSRN.
ELIGIBILITY CRITERIA FOR STUDY SELECTION
Empirical research studies of any design that evaluated PE owned healthcare operators.
MAIN OUTCOME MEASURES
The main outcome measures were impact of PE ownership on health outcomes, costs to patients or payers, costs to operators, and quality. The secondary outcome measures were trends and prevalence of PE ownership of healthcare operators.
DATA SYNTHESIS
Studies were classified as finding either beneficial, harmful, mixed, or neutral impacts of PE ownership on main outcome measures. Results across studies were narratively synthesized and reported. Risk of bias was evaluated using ROBINS-I (Risk Of Bias In Non-randomised Studies of Interventions).
RESULTS
The electronic search identified 1778 studies, with 55 meeting the inclusion criteria. Studies spanned eight countries, with most (n=47) analyzing PE ownership of healthcare operators in the US. Nursing homes were the most commonly studied healthcare setting (n=17), followed by hospitals and dermatology settings (n=9 each); ophthalmology (n=7); multiple specialties or general physician groups (n=5); urology (n=4); gastroenterology and orthopedics (n=3 each); surgical centers, fertility, and obstetrics and gynecology (n=2 each); and anesthesia, hospice care, oral or maxillofacial surgery, otolaryngology, and plastics (n=1 each). Across the outcome measures, PE ownership was most consistently associated with increases in costs to patients or payers. Additionally, PE ownership was associated with mixed to harmful impacts on quality. These outcomes held in sensitivity analyses in which only studies with moderate risk of bias were included. Health outcomes showed both beneficial and harmful results, as did costs to operators, but the volume of studies for these outcomes was too low for conclusive interpretation. In some instances, PE ownership was associated with reduced nurse staffing levels or a shift towards lower nursing skill mix. No consistently beneficial impacts of PE ownership were identified.
CONCLUSIONS
Trends in PE ownership rapidly increased across almost all healthcare settings studied. Such ownership is often associated with harmful impacts on costs to patients or payers and mixed to harmful impacts on quality. Owing to risk of bias and frequent geographic focus on the US, conclusions might not be generalizable internationally.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42022329857.
Topics: Humans; Ownership; Hospitals; Nursing Homes; Health Services; Outcome Assessment, Health Care
PubMed: 37468157
DOI: 10.1136/bmj-2023-075244 -
BMJ Open Aug 2017Financial incentives associated with private insurance may encourage healthcare providers to perform more caesarean sections. We therefore sought to determine the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Financial incentives associated with private insurance may encourage healthcare providers to perform more caesarean sections. We therefore sought to determine the association of private insurance and odds of caesarean section.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
MEDLINE, Embase and The Cochrane Library from the first year of records through August 2016.
ELIGIBILITY CRITERIA
We included studies that reported data to allow the calculation of OR of caesarean section of privately insured as compared with publicly insured women.
OUTCOMES
The prespecified primary outcome was the adjusted OR of births delivered by caesarean section of women covered with private insurance as compared with women covered with public insurance. The prespecified secondary outcome was the crude OR of births delivered by caesarean section of women covered with private insurance as compared with women covered with public insurance.
RESULTS
Eighteen articles describing 21 separate studies in 12.9 million women were included in this study. In a meta-analysis of 13 studies, the adjusted odds of delivery by caesarean section was 1.13 higher among privately insured women as compared with women with public insurance coverage (95% CI 1.07 to 1.18) with no relevant heterogeneity between studies (τ=0.006). The meta-analysis of crude estimates from 12 studies revealed a somewhat more pronounced association (pooled OR 1.35, 95% CI 1.27 to 1.44) with no relevant heterogeneity between studies (τ=0.011).
CONCLUSIONS
Caesarean sections are more likely to be performed in privately insured women as compared with women using public health insurance coverage. Although this effect is small on average and variable in its magnitude, it is present in all analyses we performed.
Topics: Cesarean Section; Female; Humans; Insurance, Health; Pregnancy; Private Sector
PubMed: 28827257
DOI: 10.1136/bmjopen-2017-016600 -
The Orthopedic Clinics of North America Oct 2022This review article examines contemporary methods and assesses radiographic outcomes and postoperative complications following the modified Lapidus procedure. A... (Review)
Review
This review article examines contemporary methods and assesses radiographic outcomes and postoperative complications following the modified Lapidus procedure. A systematic review demonstrated significant improvements in intermetatarsal angle, hallux valgus angle, and tibial sesamoid position. We are updating a modified Lapidus technique for achieving triplanar correction of hallux valgus. Two cases of hallux valgus, one primary and one recurrent, are presented. As demonstrated in the systematic review, outcomes of Lapidus procedures create future opportunities. Surprisingly, only 78% of the studies assessed for this review reported on the hallux valgus angle and only 33% reported on tibial sesamoid position.
Topics: Arthrodesis; Hallux Valgus; Humans; Osteotomy; Radiography; Retrospective Studies; Treatment Outcome
PubMed: 36208892
DOI: 10.1016/j.ocl.2022.05.005 -
Ageing Research Reviews Aug 2021The association between socioeconomic position (SEP) and health is well-established. However, the association between SEP and healthy ageing as a multidimensional... (Review)
Review
BACKGROUND
The association between socioeconomic position (SEP) and health is well-established. However, the association between SEP and healthy ageing as a multidimensional construct is unclear.
METHODS
We conducted a systematic review of peer-reviewed cross-sectional and longitudinal studies on the associations between SEP and multidimensional healthy ageing measures. Studies were identified from a systematic search across major electronic databases from inception to February 2021.
RESULTS
Fourthy-five articles met inclusion criteria (26 cross-sectional and 19 longitudinal studies). There was no consistency in method of operationalizing healthy ageing across studies, domains included in the healthy ageing measures, or in the definition and number of levels of SEP indicators. Overall, regardless of heterogeneity between studies, a positive association between educational level (85.0 % of studies) and income/wealth (81.4 % of studies) and healthy ageing was evident. Regarding occupational position, evidence from 11 studies was inconclusive. The number of studies including home ownership, parenteral SEP, or composite SEP scores was insufficient to be able to draw a conclusion.
CONCLUSIONS
There is evidence that socioeconomic inequalities, as assessed by educational level and income/wealth, are associated with healthy ageing. These findings, and the broader evidence base on SEP and healthy ageing, highlight the importance of addressing inequality through integrated health and social policies and strategies.
Topics: Cross-Sectional Studies; Educational Status; Healthy Aging; Humans; Longitudinal Studies; Socioeconomic Factors
PubMed: 34004378
DOI: 10.1016/j.arr.2021.101365 -
Psychonomic Bulletin & Review Mar 2024We conducted a systematic review investigating the influence of visual perspective and body ownership (BO) on vicarious brain resonance and vicarious sensations during... (Review)
Review
We conducted a systematic review investigating the influence of visual perspective and body ownership (BO) on vicarious brain resonance and vicarious sensations during the observation of pain and touch. Indeed, the way in which brain reactivity and the phenomenological experience can be modulated by blurring the bodily boundaries of self-other distinction is still unclear. We screened Scopus and WebOfScience, and identified 31 articles, published from 2000 to 2022. Results show that assuming an egocentric perspective enhances vicarious resonance and vicarious sensations. Studies on synaesthetes suggest that vicarious conscious experiences are associated with an increased tendency to embody fake body parts, even in the absence of congruent multisensory stimulation. Moreover, immersive virtual reality studies show that the type of embodied virtual body can affect high-order sensations such as appropriateness, unpleasantness, and erogeneity, associated with the touched body part and the toucher's social identity. We conclude that perspective plays a key role in the resonance with others' pain and touch, and full-BO over virtual avatars allows investigation of complex aspects of pain and touch perception which would not be possible in reality.
PubMed: 38429591
DOI: 10.3758/s13423-024-02477-5 -
Neuroscience and Biobehavioral Reviews Dec 2022In recent years, an increasing number of studies employed the full body illusion paradigm (i.e., the experimentally induced illusory ownership over a fake/virtual body)... (Review)
Review
In recent years, an increasing number of studies employed the full body illusion paradigm (i.e., the experimentally induced illusory ownership over a fake/virtual body) to investigate the role of body ownership in higher-level cognition. However, to date, no systematic review of this topic is present. To fill this gap, here we identified 102 papers classifiable in 4 cognitive domains and 12 subdomains. Overall, they manipulated the identity of the fake body, and/or its spatial perspective, and/or the kind of multisensory stimulation, and/or its spatiotemporal congruency. The effects were measured through implicit and/or explicit indices. In summary, results showed that participants' behavior shifted away from the self and/or towards that of the embodied fake/virtual body. The findings have been interpreted within various exploratory frameworks, with the most common being the Proteus effect, the cortical body matrix and the inverse model of motor control. Future studies should focus on building a unitary theoretical explanation of the effects, gaining solid neural evidence, creating standard experimental procedures, and exploring the practical applications.
Topics: Humans; Illusions; Cognition; Body Image; Visual Perception; Touch Perception
PubMed: 36341941
DOI: 10.1016/j.neubiorev.2022.104926 -
International Journal of Environmental... Feb 2017Childhood and adolescence are important developmental phases which influence health and well-being across the life span. Social relationships are fundamental to child... (Review)
Review
Childhood and adolescence are important developmental phases which influence health and well-being across the life span. Social relationships are fundamental to child and adolescent development; yet studies have been limited to children's relationships with other humans. This paper provides an evidence review for the potential associations between pet ownership and emotional; behavioural; cognitive; educational and social developmental outcomes. As the field is in the early stages; a broad set of inclusion criteria was applied. A systematic search of databases and grey literature sources found twenty-two studies meeting selection criteria. The review found evidence for an association between pet ownership and a wide range of emotional health benefits from childhood pet ownership; particularly for self-esteem and loneliness. The findings regarding childhood anxiety and depression were inconclusive. Studies also showed evidence of an association between pet ownership and educational and cognitive benefits; for example, in perspective-taking abilities and intellectual development. Evidence on behavioural development was unclear due to a lack of high quality research. Studies on pet ownership and social development provided evidence for an association with increased social competence; social networks; social interaction and social play behaviour. Overall, pet ownership and the significance of children's bonds with companion animals have been underexplored; there is a shortage of high quality and longitudinal studies in all outcomes. Prospective studies that control for a wide range of confounders are required.
Topics: Adolescent; Adolescent Development; Animals; Anxiety; Child; Child Development; Depression; Humans; Loneliness; Mental Health; Pets; Self Concept
PubMed: 28264460
DOI: 10.3390/ijerph14030234 -
Obesity Reviews : An Official Journal... Aug 2017The objective of this study was to systematically review evidence to identify intrapersonal, social environmental, physical environmental and policy correlates of... (Review)
Review
OBJECTIVE
The objective of this study was to systematically review evidence to identify intrapersonal, social environmental, physical environmental and policy correlates of sedentary behaviour (SB) among adults.
METHODS
Six databases were searched to identify studies that reported on intrapersonal, social, physical environmental and/or policy correlates of SB across domains (i.e. occupational, leisure and transportation) in adults (mean ≥ 18 years old). Subgroup differences (sex, age, disease status, publication status and date, weekdays vs. weekend) were examined. Risk of bias was assessed, and a qualitative synthesis completed.
PROSPERO
CRD42014009814 RESULTS: Searching identified 22,779 articles; 257 were used in the analysis. Most studies used self-reported SB and were cross-sectional. The most studied domain of SB and correlate was leisure and intrapersonal, respectively. Consistent evidence found positive relationships between full-time employment and higher transportation and lower leisure SB; higher income/socioeconomic status and greater transportation and occupation SB; living in more urban areas and greater sitting time and total SB; ownership of televisions and greater leisure SB; and, active workstations and lower occupational SB.
CONCLUSIONS
The review identifies the need for longitudinal studies, as well as further research on factors in the physical, social and policy environments. The review also recognizes the need to standardize methodology for collecting, defining and reporting SB and correlates.
Topics: Adult; Humans; Leisure Activities; Sedentary Behavior; Social Class; Social Environment
PubMed: 28524615
DOI: 10.1111/obr.12529 -
JCO Precision Oncology Aug 2022Non-V600 mutations comprise approximately 35% of all BRAF mutations in cancer. Many of these mutations have been identified as oncogenic drivers and can be classified... (Meta-Analysis)
Meta-Analysis
PURPOSE
Non-V600 mutations comprise approximately 35% of all BRAF mutations in cancer. Many of these mutations have been identified as oncogenic drivers and can be classified into three classes according to molecular characteristics. Consensus treatment strategies for class 2 and 3 BRAF mutations have not yet been established.
METHODS
We performed a systematic review and meta-analysis with published reports of individual patients with cancer harboring class 2 or 3 BRAF mutations from 2010 to 2021, to assess treatment outcomes with US Food and Drug Administration-approved mitogen-activated protein kinase (MAPK) pathway targeted therapy (MAPK TT) according to BRAF class, cancer type, and MAPK TT type. Coprimary outcomes were response rate and progression-free survival.
RESULTS
A total of 18,167 studies were screened, identifying 80 studies with 238 patients who met inclusion criteria. This included 167 patients with class 2 and 71 patients with class 3 BRAF mutations. Overall, 77 patients achieved a treatment response. In both univariate and multivariable analyses, response rate and progression-free survival were higher among patients with class 2 compared with class 3 mutations, findings that remain when analyses are restricted to patients with melanoma or lung primary cancers. MEK ± BRAF inhibitors demonstrated greater clinical activity in class 2 compared with class 3 BRAF-mutant tumors than BRAF or EGFR inhibitors.
CONCLUSION
This meta-analysis suggests that MAPK TTs have clinical activity in some class 2 and 3 BRAF-mutant cancers. BRAF class may dictate responsiveness to current and emerging treatment strategies, particularly in melanoma and lung cancers. Together, this analysis provides clinical validation of predictions made on the basis of a mutation classification system established in the preclinical literature. Further evaluation with prospective clinical trials is needed for this population.
Topics: Humans; Lung Neoplasms; Melanoma; Mitogen-Activated Protein Kinases; Prospective Studies; Protein Kinase Inhibitors; Proto-Oncogene Proteins B-raf; United States
PubMed: 35977349
DOI: 10.1200/PO.22.00107