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Current Oncology (Toronto, Ont.) May 2022Advances in scientific understanding have led to novel therapies and improved supportive care for many patients with haematological malignancies. However, these new... (Review)
Review
UNLABELLED
Advances in scientific understanding have led to novel therapies and improved supportive care for many patients with haematological malignancies. However, these new drugs are often costly, only available at centralised health care facilities, require regular specialist reviews and lengthy treatment regimens. This leads to a significant financial burden. Understanding the impact of financial burden on haematological patients is important to appreciate the urgency of alleviating this systemic issue.
METHOD
Eligible studies were identified by systematically searching Medline, PsycINFO, CINAHL and Embase. Self-reported data reported in both quantitative and qualitative studies that described the financial burden for patients with haematological malignancies were included. Quality appraisal of the included studies was undertaken using the Joanna Briggs Institute tools. A narrative synthesis was employed. For quantitative studies, outcomes were extracted, tabulated and categorised to find similarities and differences between the studies. For qualitative studies, quotations, codes and themes were extracted and then clustered. An inductive approach derived qualitative themes.
RESULTS
Twenty studies were identified for inclusion. Of the quantitative studies most (83%) employed un-validated researcher-generated measures to assess financial burden. Between 15-59% of patients experienced a financial burden. Out-of-pocket expenditure was frequent for clinical appointments, prescription and non-prescription medication, and travel. Financial burden was associated with a worsening quality of life and living in metropolitan areas, but there was no evidence for impact on survival. Patient-centred experiences from the qualitative inquiry complemented the quantitative findings and five themes were determined: familial or household impact; reliance on others; barriers to care due to cost; and barriers to accessing financial assistance and sources of out-of-pocket expenses.
CONCLUSION
The impacts of financial burden are yet to be fully appreciated in haematological malignancies, exacerbated by the heterogeneous methods employed by researchers. Future work should focus on identifying the long-term ramifications of financial burden for patients and should trial interventions to reduce its prevalence and patient impacts.
Topics: Financial Stress; Hematologic Neoplasms; Humans; Qualitative Research; Quality of Life
PubMed: 35735414
DOI: 10.3390/curroncol29060305 -
Translational Behavioral Medicine Feb 2022It is widely acknowledged that vaccine hesitancy is a multifaceted problem that cannot be addressed by a single strategy. Behavior change theories and social media tools...
It is widely acknowledged that vaccine hesitancy is a multifaceted problem that cannot be addressed by a single strategy. Behavior change theories and social media tools may together help to guide the design of interventions aimed at improving vaccination uptake. This systematic review aims to identify the breadth and effectiveness of such theories and tools. The systematic review search was performed in PubMed, Scopus, ACM, Cochrane Library, ProQuest, and Web of Science databases for studies between January 2011 and January 2021 that applied social media tools to increase vaccine confidence or improve vaccination uptake. The literature search yielded a total of 3,065 publications. Twenty articles met the eligibility criteria, 12 of which were theory-based interventions. The result shows that the Health Belief Model was the most frequently deployed theory, and the most common social media tool was educational posts, followed by dialogue-based groups, interactive websites, and personal reminders. Theory-based interventions were generally more measurable and comparable and had more evidence to trigger the positive behavior change. Fifteen studies reported the effectiveness in knowledge gain, intention increase, or behavior change. Educational messages were proved to be effective in increasing knowledge but less helpful in triggering behavior change. Dialogue-based social media intervention performed well in improving people's intention to vaccinate. Interventions informed by behavior change theory and delivered via social media platforms offer an important opportunity for addressing vaccine hesitancy. This review highlights the need to use a multitheory framework and tailoring social media interventions to the specific circumstances and needs of the target audience in future interventions. The results and insights gained from this review will be of assistance to future studies.
Topics: Humans; Intention; Social Media; Vaccination; Vaccination Hesitancy
PubMed: 34850217
DOI: 10.1093/tbm/ibab148 -
Nursing Open Mar 2023To summarize the use of machine learning (ML) for hospital-acquired pressure injury (HAPI) prediction and to systematically assess the performance and construction... (Review)
Review
AIMS AND OBJECTIVES
To summarize the use of machine learning (ML) for hospital-acquired pressure injury (HAPI) prediction and to systematically assess the performance and construction process of ML models to provide references for establishing high-quality ML predictive models.
BACKGROUND
As an adverse event, HAPI seriously affects patient prognosis and quality of life, and causes unnecessary medical investment. At present, the performance of various scales used to predict HAPIs is still unsatisfactory. As a new statistical tool, ML has been applied to predict HAPIs. However, its performance has varied in different studies; moreover, some deficiencies in the model construction process were observed in each study.
DESIGN
Systematic review.
METHODS
Relevant articles published between 2010-2021 were identified in the PubMed, Web of Science, Scopus, Embase and CINHAL databases. Study selection was performed in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines. The quality of the included articles was assessed using the prediction model risk of bias assessment tool.
RESULTS
Twenty-three studies out of 1793 articles were considered in this systematic review. The sample size of each study ranged from 149-75353; the prevalence of pressure injuries ranged from 0.5%-49.8%. ML showed good performance for HAPI prediction. However, some deficiencies were observed in terms of data management, data pre-processing and model validation.
CONCLUSIONS
ML, as a powerful decision-making assistance tool, is helpful for the prediction of HAPIs. However, existing studies have been insufficient in terms of data management, data pre-processing and model validation. Future studies should address these issues to establish ML models for HAPI prediction that can be widely used in clinical practice.
RELEVANCE TO CLINICAL PRACTICE
This review highlights that ML is helpful in predicting HAPI; however, in the process of data management, data pre-processing and model validation, some deficiencies still need to be addressed. The ultimate goal of integrating ML into HAPI prediction is to develop a practical clinical decision-making tool. A complete and rigorous model construction process should be followed in future studies to develop high-quality ML models that can be applied in clinical practice.
Topics: Humans; Pressure Ulcer; Quality of Life; Prognosis; Machine Learning; Hospitals
PubMed: 36310417
DOI: 10.1002/nop2.1429 -
International Journal of Environmental... Jul 2022Augmentative and alternative communication (AAC) consists of any method of communicating that supplements or completely substitutes oral and/or written language when it... (Review)
Review
Augmentative and alternative communication (AAC) consists of any method of communicating that supplements or completely substitutes oral and/or written language when it is impaired. Therefore, it enables children with complex communication needs to develop their full communicative potential. However, despite the many benefits of AAC and its widespread use, several review studies have underscored the problems faced by parents and children who use AAC in their daily lives. The general objective of this systematic review and qualitative meta-synthesis is to provide a complete overview of parents' experiences and perceptions with their children's use of AAC. Specifically, it aimed to identify common themes and subthemes of interest and to analyze the research quality of the selected studies. An exhaustive literature search was carried out using different electronic databases. Nineteen studies were included, involving 297 parents. A thematic synthesis was undertaken. Three main themes and nine subthemes were identified: service support (accessibility, providers and coordination); characteristics of AAC systems (usability and acceptability, features, cost and funding); and integration of AAC in daily life (family, school, social and community). Findings raise a need for more services that support children with complex communication deficits in different contexts, more functional use of AAC systems at school and in real-world situations, as well as service assistance over an extended time period.
Topics: Child; Communication; Communication Aids for Disabled; Communication Disorders; Humans; Palliative Care
PubMed: 35805750
DOI: 10.3390/ijerph19138091 -
Drug and Alcohol Dependence Nov 2016Methamphetamine use is associated with a range of poor health, social and justice outcomes. In many parts of the world increased methamphetamine use has been identified... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Methamphetamine use is associated with a range of poor health, social and justice outcomes. In many parts of the world increased methamphetamine use has been identified as a major public health concern. Methamphetamine treatment programmes have been effective in reducing and ceasing use, however a range of barriers have prevented these programmes being widely adopted by methamphetamine users. This review examines the barriers to accessing meth/amphetamine treatment identified in the literature.
METHODS
Databases were systematically searched using relevant terms for peer-reviewed articles describing original research exploring the barriers to accessing treatment for meth/amphetamine use. Reviews and grey literature were excluded. Eleven studies conducted in 5 countries were included in data synthesis; this involved a systematic review of all 11 studies, and meta-analysis of the prevalence of barriers reported in 6 studies that published sufficient quantitative data.
RESULTS
Psychosocial/internal barriers to accessing methamphetamine treatment were most prevalent across studies (10/11 studies). Meta-analysis confirmed the four most commonly endorsed barriers to treatment access across studies all psychosocial barriers were embarrassment or stigma (60%, 95% CI: 54-67%); belief that treatment was unnecessary (59%, 95% CI:54-65%); preferring to withdraw alone without assistance (55%, 95% CI:45-65); and privacy concerns (51%, 95% CI:44-59%).
CONCLUSIONS
The primary barriers to accessing methamphetamine treatment are psychosocial/internal. Services and treatment models that address these barriers are urgently required. There is a growing need for methamphetamine-appropriate treatment services. Further research evaluating treatment engagement and effectiveness for methamphetamine and polysubstance use, including the development of effective pharmacotherapies is warranted.
Topics: Amphetamine-Related Disorders; Culture; Humans; Methamphetamine; Social Stigma; Treatment Refusal
PubMed: 27736680
DOI: 10.1016/j.drugalcdep.2016.10.001 -
Duration of Breastfeeding and Maternal-Related Factors in Iran, Systematic Review and Meta-Analysis.Journal of Pediatric Nursing 2020Although the benefits of breastfeeding are commonly approved, there remains a significant discrepancy between maternal practices and World Health Organization (WHO)... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although the benefits of breastfeeding are commonly approved, there remains a significant discrepancy between maternal practices and World Health Organization (WHO) guidelines in some countries.
OBJECTIVES
We had two aims in this study; average duration of breastfeeding, and its maternal determinants.
DATA SOURCES
A web-based citation index was used for citing documents.
STUDY ELIGIBILITY CRITERIA AND PARTICIPANTS
We included observational studies evaluating breastfeeding duration among children who were at least two years old and not older than five were included in Iran.
SYNTHESIS METHODS
The pooled mean and mean differences were considered. Heterogeneity was evaluated with the I statistic.
RESULTS
The pooled mean of breastfeeding duration was calculated at 17.31 months. Children with younger mothers and lower birth orders had shorter durations of breastfeeding. Women with a high school and higher education level had early cessation of breastfeeding in comparison with less educated women.
LIMITATIONS
The main limitation of the current study was lack of librarian assistance.
CONCLUSIONS
The pooled mean of breastfeeding duration in Iranian children aged 2-5 was less than WHO recommendations. Accurate identification of the effect a mother's level of education has on duration of lactation requires standardized categorization.
IMPLICATIONS OF KEY FINDINGS
Raising awareness among women can be an effective strategy in increasing the duration of lactation.
Topics: Breast Feeding; Child; Child, Preschool; Female; Humans; Iran; Lactation; Mothers; Time Factors
PubMed: 32553476
DOI: 10.1016/j.pedn.2020.04.011 -
American Journal of Public Health Jul 2016Health disparities are aggravated when prevention and care initiatives fail to reach those they are intended to help. Groups can be classified as hardly reached... (Review)
Review
BACKGROUND
Health disparities are aggravated when prevention and care initiatives fail to reach those they are intended to help. Groups can be classified as hardly reached according to a variety of circumstances that fall into 3 domains: individual (e.g., psychological factors), demographic (e.g., socioeconomic status), and cultural-environmental (e.g., social network). Several reports have indicated that peer support is an effective means of reaching hardly reached individuals. However, no review has explored peer support effectiveness in relation to the circumstances associated with being hardly reached or across diverse health problems.
OBJECTIVES
To conduct a systematic review assessing the reach and effectiveness of peer support among hardly reached individuals, as well as peer support strategies used.
SEARCH METHODS
Three systematic searches conducted in PubMed identified studies that evaluated peer support programs among hardly reached individuals. In aggregate, the searches covered articles published from 2000 to 2015.
SELECTION CRITERIA
Eligible interventions provided ongoing support for complex health behaviors, including prioritization of hardly reached populations, assistance in applying behavior change plans, and social-emotional support directed toward disease management or quality of life. Studies were excluded if they addressed temporally isolated behaviors, were limited to protocol group classes, included peer support as the dependent variable, did not include statistical tests of significance, or incorporated comparison conditions that provided appreciable social support.
DATA COLLECTION AND ANALYSIS
We abstracted data regarding the primary health topic, categorizations of hardly reached groups, program reach, outcomes, and strategies employed. We conducted a 2-sample t test to determine whether reported strategies were related to reach.
RESULTS
Forty-seven studies met our inclusion criteria, and these studies represented each of the 3 domains of circumstances assessed (individual, demographic, and cultural-environmental). Interventions addressed 8 health areas, most commonly maternal and child health (25.5%), diabetes (17.0%), and other chronic diseases (14.9%). Thirty-six studies (76.6%) assessed program reach, which ranged from 24% to 79% of the study population. Forty-four studies (94%) reported significant changes favoring peer support. Eleven strategies emerged for engaging and retaining hardly reached individuals. Among them, programs that reported a strategy of trust and respect had higher participant retention (82.8%) than did programs not reporting such a strategy (48.1%; P = .003). In 5 of the 6 studies examining moderators of the effects of peer support, peer support benefits were greater among individuals characterized by disadvantage (e.g., low health literacy).
CONCLUSIONS
Peer support is a broad and robust strategy for reaching groups that health services too often fail to engage. The wide range of audiences and health concerns among which peer support is successful suggests that a basis for its success may be its flexible response to different contexts, including the intended audience, health problems, and setting.
PUBLIC HEALTH IMPLICATIONS
The general benefits of peer support and findings suggesting that it may be more effective among those at heightened disadvantage indicate that peer support should be considered in programs intended to reach and benefit those too often hardly reached. Because engendering trust and respect was significantly associated with participant retention, programs should emphasize this strategy.
Topics: Culture; Environment; Health Behavior; Health Education; Humans; Mental Disorders; Peer Group; Social Support; Socioeconomic Factors; Vulnerable Populations
PubMed: 27196645
DOI: 10.2105/AJPH.2016.303180 -
Implementation Science Communications Mar 2023Research centers and programs focused on dissemination and implementation science (DIS) training, mentorship, and capacity building have proliferated in recent years.... (Review)
Review
BACKGROUND
Research centers and programs focused on dissemination and implementation science (DIS) training, mentorship, and capacity building have proliferated in recent years. There has yet to be a comprehensive inventory of DIS capacity building program (CBP) cataloging information about activities, infrastructure, and priorities as well as opportunities for shared resources, collaboration, and growth. The purpose of this systematic review is to provide the first inventory of DIS CBPs and describe their key features and offerings.
METHODS
We defined DIS CBPs as organizations or groups with an explicit focus on building practical knowledge and skills to conduct DIS for health promotion. CBPs were included if they had at least one capacity building activity other than educational coursework or training alone. A multi-method strategy was used to identify DIS CBPs. Data about the characteristics of DIS CBPs were abstracted from each program's website. In addition, a survey instrument was developed and fielded to gather in-depth information about the structure, activities, and resources of each CBP.
RESULTS
In total, 165 DIS CBPs met our inclusion criteria and were included in the final CBP inventory. Of these, 68% are affiliated with a United States (US) institution and 32% are internationally based. There was one CBP identified in a low- and middle-income country (LMIC). Of the US-affiliated CBPs, 55% are embedded within a Clinical and Translational Science Award program. Eighty-seven CBPs (53%) responded to a follow-up survey. Of those who completed a survey, the majority used multiple DIS capacity building activities with the most popular being Training and Education (n=69, 79%) followed by Mentorship (n=58, 67%), provision of DIS Resources and Tools (n=57, 66%), Consultation (n=58, 67%), Professional Networking (n=54, 62%), Technical Assistance (n=46, 52%), and Grant Development Support (n=45, 52%).
CONCLUSIONS
To our knowledge, this is the first study to catalog DIS programs and synthesize learnings into a set of priorities and sustainment strategies to support DIS capacity building efforts. There is a need for formal certification, accessible options for learners in LMICs, opportunities for practitioners, and opportunities for mid/later stage researchers. Similarly, harmonized measures of reporting and evaluation would facilitate targeted cross-program comparison and collaboration.
PubMed: 36973832
DOI: 10.1186/s43058-023-00405-7 -
The Science of the Total Environment Jan 2023The presence of heavy metals (HMs) in the soil can pose risks to human health via ingestion and dermal absorption. This systematic review and meta-analysis study focused... (Meta-Analysis)
Meta-Analysis Review
The presence of heavy metals (HMs) in the soil can pose risks to human health via ingestion and dermal absorption. This systematic review and meta-analysis study focused on both of health and ecological risks attributed to the six HMs (As, Cd, Cr, Cu, Pb, Zn) in the soil of different Provinces of Iran. Articles were selected in the Web of Science and Scopus from 2000 to August 2021. The study was carried out according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. Based on the inclusion and exclusion criteria, finally 32 studies were reviewed which the ranking of mean concentrations of the studied metals followed as: As > Zn > Cr > Pb > Cu > Cd. Mean concentration of Cd and As calculated via meta-analysis in the studied Provinces was found to be more than Iran's environment protection agency (EPA) guideline values. Other HMs met guideline values. A significant non-carcinogenic risk attributed to the As found in Kurdistan Province (hazard index, HI > 1). Furthermore, a significant carcinogenic health risk was found in Kurdistan and West Azerbaijan associated to As and in Fars, Khozestan and Khorasan-e-Razavi Provinces associated to Cd (ELCR >10). Concerning the impact on the ecosystem, Cd, As and Pb caused ecological risks in some areas of Iran (ecological risk, ER > 40 and potential ecological risk, PER >150). Hence, we can conclude that Cd and As are important heavy metals from the health aspect. Moreover, Cd, As and Pb must be considered from an ecological point of view. Therefore, control of the Cd, As and Pb release in the environment and remediation of polluted sites through novel approaches is recommended.
Topics: Humans; Soil; Soil Pollutants; Ecosystem; Iran; Cadmium; Lead; Environmental Monitoring; Risk Assessment; Metals, Heavy; China
PubMed: 36174699
DOI: 10.1016/j.scitotenv.2022.158925 -
Pathogens (Basel, Switzerland) Feb 2023The COVID-19 pandemic due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been plaguing the world since late 2019/early 2020 and has changed the... (Review)
Review
The COVID-19 pandemic due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been plaguing the world since late 2019/early 2020 and has changed the way we function as a society, halting both economic and social activities worldwide. Classrooms, offices, restaurants, public transport, and other enclosed spaces that typically gather large groups of people indoors, and are considered focal points for the spread of the virus. For society to be able to go "back to normal", it is crucial to keep these places open and functioning. An understanding of the transmission modes occurring in these contexts is essential to set up effective infection control strategies. This understanding was made using a systematic review, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PRISMA) 2020 guidelines. We analyze the different parameters influencing airborne transmission indoors, the mathematical models proposed to understand it, and discuss how we can act on these parameters. Methods to judge infection risks through the analysis of the indoor air quality are described. Various mitigation measures are listed, and their efficiency, feasibility, and acceptability are ranked by a panel of experts in the field. Thus, effective ventilation procedures controlled by CO-monitoring, continued mask wearing, and a strategic control of room occupancy, among other measures, are put forth to enable a safe return to these essential places.
PubMed: 36986304
DOI: 10.3390/pathogens12030382