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Archives of Physical Medicine and... Oct 2023This review aims to evaluate the effectiveness of solely overground robotic exoskeleton (RE) training or overground RE training with conventional rehabilitation in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This review aims to evaluate the effectiveness of solely overground robotic exoskeleton (RE) training or overground RE training with conventional rehabilitation in improving walking ability, speed, and endurance among patients with stroke.
DATA SOURCES
Nine databases, 5 trial registries, gray literature, specified journals, and reference lists from inception until December 27, 2021.
STUDY SELECTION
Randomized controlled trials adopting overground robotic exoskeleton training for patients with any phases of stroke on walking-related outcomes were included.
DATA EXTRACTION
Two independent reviewers extracted items and performed risk of bias using the Cochrane Risk of Bias tool 1 and certainty of evidence using the Grades of Recommendation Assessment, Development, and Evaluation.
DATA SYNTHESIS
Twenty trials involving 758 participants across 11 countries were included in this review. The overall effect of overground robotic exoskeletons on walking ability at postintervention (d=0.21; 95% confidence interval [CI], 0.01, 0.42; Z=2.02; P=.04) and follow-up (d=0.37; 95% CI, 0.03, 0.71; Z=2.12; P=.03) and walking speed at postintervention (d=0.23; 95% CI, 0.01, 0.46; Z=2.01; P=.04) showed significant improvement compared with conventional rehabilitation. Subgroup analyses suggested that RE training should combine with conventional rehabilitation. A preferable gait training regime is <4 times per week over ≥6 weeks for ≤30 minutes per session among patients with chronic stroke and ambulatory status of independent walkers before training. Meta-regression did not identify any effect of the covariates on the treatment effect. The majority of randomized controlled trials had small sample sizes, and the certainty of the evidence was very low.
CONCLUSION
Overground RE training may have a beneficial effect on walking ability and walking speed to complement conventional rehabilitation. Further large-scale and long-term, high-quality trials are recommended to enhance the quality of overground RE training and confirm its sustainability.
Topics: Humans; Exoskeleton Device; Stroke Rehabilitation; Randomized Controlled Trials as Topic; Walking; Stroke; Gait
PubMed: 36972746
DOI: 10.1016/j.apmr.2023.03.006 -
International Journal of Hygiene and... Sep 2023To date, there is scarce evidence on the association between sleep disorders and noise generated by wind turbines. We searched six relevant electronic databases from the... (Meta-Analysis)
Meta-Analysis Review
To date, there is scarce evidence on the association between sleep disorders and noise generated by wind turbines. We searched six relevant electronic databases from the inception to May 2023 for relevant articles. The methodological quality of the included articles was evaluated using the US National Institutes of Health tool. Fifteen articles met the inclusion criteria. The overall prevalence of sleep disorders among residents close to wind turbines was 34% (95% Confidence Interval, 0.22-0.47). Univariate meta-regressions for distance and sound power level showed that at higher distance the prevalence of sleep disorders decreases (p = 0.010) and with a higher sound power level the prevalence increases (p = 0.037). Furthermore, this systematic review and meta-analysis highlighted that the overall quality of current research on this topic is poor, and the methods to measure the results are often based on subjective assessments and not validated questionnaires. In conclusion, our preliminary findings suggest that there may be a possible relation between exposure to wind turbines and sleep disorders, although no conclusions can be drawn in terms of causality due to the nature of the retrieved data and the poor quality of current evidence. Future studies should adopt a longitudinal design and focus on objective measurements, supported by validated subjective methods such as questionnaires.
Topics: Humans; Power Plants; Noise; Sound; Surveys and Questionnaires; Sleep Wake Disorders
PubMed: 37844409
DOI: 10.1016/j.ijheh.2023.114273 -
Journal of Exercise Science and Fitness Jan 2024This study aims to compare, through quantitative analysis, the effectiveness of different endurance training types on increasing lower limb strength and muscle... (Review)
Review
OBJECTIVE
This study aims to compare, through quantitative analysis, the effectiveness of different endurance training types on increasing lower limb strength and muscle cross-sectional area (MCSA) in concurrent training.
METHODS
This systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) [PROSPERO ID: CRD42023396886]. Web of Science, SportDiscuss, Pubmed, Cochrane, and Scopus were systematically searched from their inception date to October 20, 2023.
RESULTS
A total of 40 studies (841 participants) were included in this meta-analysis. MCSA analysis showed that, compared to resistance training alone, concurrent high-intensity interval running training and resistance training and concurrent moderate-intensity continuous cycling training and resistance training were more effective (SMD = 0.15, 95% CI = -0.46 to 0.76, and SMD = 0.07, 95% CI = -0.24 to 0.38 respectively), while other modalities of concurrent training not. Lower body maximal strength analysis showed that all modalities of concurrent training were inferior to resistance training alone, but concurrent high-intensity interval training and resistance training showed an advantage in four different concurrent training modalities (SMD = -0.08, 95% CI = -0.25 to 0.08). For explosive strength, only concurrent high-intensity interval training and resistance training was superior to resistance training (SMD = 0.06, 95% CI = -0.21 to 0.33).
CONCLUSION
Different endurance training types have an impact on the effectiveness of concurrent training, particularly on lower limb strength. Adopting high-intensity interval running as the endurance training type in concurrent training can effectively minimize the adverse effects on lower limb strength and MCSA.
PubMed: 38187085
DOI: 10.1016/j.jesf.2023.12.005 -
Journal of Cancer Education : the... Aug 2023Cholangiocarcinoma (CCA), caused mainly by Opisthorchis viverrini (OV) infection, is a public health issue. Health literacy can play a significant role in preventing OV... (Meta-Analysis)
Meta-Analysis Review
Cholangiocarcinoma (CCA), caused mainly by Opisthorchis viverrini (OV) infection, is a public health issue. Health literacy can play a significant role in preventing OV and CCA and adopting preventive behaviors. Therefore, this study aimed to evaluate, summarize, and synthesize the current evidence on health literacy programs for preventing OV and CCA.A systematic literature search, with Thai and English languages, was performed using electronic databases through PubMed, Google Scholar, ThaiJo, ThaiLis, and Embase to identify studies examining health literacy programs to prevent OV and CCA. We followed PRISMA 2020 guidelines. In addition, we used the RevMan software to perform a meta-analysis to analyze effect sizes using a fixed-effects model and measures of heterogeneity using Cochran's Q and I. This meta-analysis included seven studies that met the criteria. The results showed that the people who received a program had an increased health literacy overall and in each aspect with a statistically significant (p < 0.001). So, health literacy programs can assist people in understanding their health and gaining access to health information and services. Additionally, the effect of programs (communication abilities, self-management, media and information literacy, and decision-making in practice) can help prevent OV and CCA. As a result, multi-disciplinary healthcare teams are crucial to developing preventive programs to prevent OV and CCA. Further studies need to be done and applied to these programs to modify behavior to avoid other diseases.
Topics: Animals; Humans; Opisthorchiasis; Opisthorchis; Health Literacy; Cholangiocarcinoma; Bile Duct Neoplasms; Bile Ducts, Intrahepatic
PubMed: 36637714
DOI: 10.1007/s13187-023-02265-0 -
Journal of Pediatric Surgery Dec 2023Learning health networks (LHN) are consortia of institutions that collaborate and embrace the elements of the learning health system (LHS), including quality... (Review)
Review
BACKGROUND
Learning health networks (LHN) are consortia of institutions that collaborate and embrace the elements of the learning health system (LHS), including quality improvement, education, research, and stakeholder involvement. Their ultimate goal is rapid information dissemination in clinical care. Pediatric surgical specialties perform unique yet high-impact procedures that could benefit from LHN, thereby improving surgical outcomes and care through LHS approaches. Consequently, health system leaders should be aware of LHN and their importance in enhancing surgical care and improving outcomes. This scoping review aims to map and characterize the existing LHN applied in pediatric surgical specialties.
METHODS
A systematic literature search was performed on Medline, EMBASE, and Scopus up to June 2022, with an update search conducted in May 2023. Additionally, Google Scholar, ProQuest and inquiry from topic experts were used for cross-referencing relevant review articles to identify grey literature. This scoping review was conducted and reported according to the PRISMA-scoping review extension.
RESULTS
A total of 56 publications for 19 LHN were identified and included in this scoping review. Out of 19 identified LHN in pediatric surgical specialties, 18 were organized in North America. Eight of the networks are related to pediatric general surgery and another eight were related to pediatric transplantation. The 16 out of 19 LHN were initiated after 2001. To date, only eight of the LHNs generated reports of comparative improved outcomes.
CONCLUSION
This scoping review provides an overview of the available LHNs in pediatric surgical specialties. Over the past decade, several pediatric surgical specialties have embraced the principles of learning health systems, forming inter-institutional collaborations that utilize information technology to generate big data on patient-level clinical information, engage in quality improvement cycles, adopt evidence-based practices, and actively involve patients and stakeholders.
LEVEL OF EVIDENCE
IV.
Topics: Humans; Child; North America; Learning Health System; Awareness; Educational Status; Altruism
PubMed: 37544802
DOI: 10.1016/j.jpedsurg.2023.07.006 -
Medical Decision Making : An... 2023Medically assisted reproduction (MAR) is a challenging application area for health economic evaluations, entailing a broad range of costs and outcomes, stretching out... (Review)
Review
BACKGROUND
Medically assisted reproduction (MAR) is a challenging application area for health economic evaluations, entailing a broad range of costs and outcomes, stretching out long-term and accruing to several parties.
PURPOSE
To systematically review which costs and outcomes are included in published economic evaluations of MAR and to compare these with health technology assessment (HTA) prescriptions about which cost and outcomes should be considered for different evaluation objectives.
DATA SOURCES
HTA guidelines and systematic searches of PubMed Central, Embase, WOS CC, CINAHL, Cochrane (CENTRAL), HTA, and NHS EED.
STUDY SELECTION
All economic evaluations of MAR published from 2010 to 2022.
DATA EXTRACTION
A predetermined data collection form summarized study characteristics. Essential costs and outcomes of MAR were listed based on HTA and treatment guidelines for different evaluation objectives. For each study, included costs and outcomes were reviewed.
DATA SYNTHESIS
The review identified 93 cost-effectiveness estimates, of which 57% were expressed as cost-per-(healthy)-live-birth, 19% as cost-per-pregnancy, and 47% adopted a clinic perspective. Few adopted societal perspectives and only 2% used quality-adjusted life-years (QALYs). Broader evaluations omitted various relevant costs and outcomes related to MAR. There are several cost and outcome categories for which available HTA guidelines do not provide conclusive directions regarding inclusion or exclusion.
LIMITATIONS
Studies published before 2010 and of interventions not clearly labeled as MAR were excluded. We focus on methods rather than which MAR treatments are cost-effective.
CONCLUSIONS
Economic evaluations of MAR typically calculate a short-term cost-per-live-birth from a clinic perspective. Broader analyses, using cost-per-QALY or BCRs from societal perspectives, considering the full scope of reproduction-related costs and outcomes, are scarce and often incomplete. We provide a summary of costs and outcomes for future research guidance and identify areas requiring HTA methodological development.
HIGHLIGHTS
The cost-effectiveness of MAR procedures can be exceptionally complex to estimate as there is a broad range of costs and outcomes involved, in principle stretching out over multiple generations and over many stakeholders.We list 21 key areas of costs and outcomes of MAR. Which of these needs to be accounted for alters for different evaluation objectives (determined by the type of economic evaluation, time horizon considered, and perspective).Published studies mostly investigate cost-effectiveness in the very short-term, from a clinic perspective, expressed as cost-per-live-birth. There is a lack of comprehensive economic evaluations that adopt a broader perspective with a longer time horizon. The broader the evaluation objective, the more relevant costs and outcomes were excluded.For several costs and outcomes, particularly those relevant for broader, societal evaluations of MAR, the inclusion or exclusion is theoretically ambiguous, and HTA guidelines do not offer sufficient guidance.
Topics: Female; Humans; Pregnancy; Cost-Benefit Analysis; Pregnancy, Multiple
PubMed: 37621143
DOI: 10.1177/0272989X231188129 -
Vector Borne and Zoonotic Diseases... May 2024The burden of zoonotic diseases in developing countries is significantly underestimated, influenced by various factors such as misdiagnosis, underreporting, natural... (Review)
Review
The burden of zoonotic diseases in developing countries is significantly underestimated, influenced by various factors such as misdiagnosis, underreporting, natural disasters, climate change, resource limitations, rapid unplanned urbanization, poverty, animal migration, travel, ecotourism, and the tropical environmental conditions prevalent in the region. Despite Sri Lanka's provision of a publicly funded free health care system, zoonoses still contribute significantly to the burden of communicable diseases in the country. This study serves as a timely and exhaustive systematic review of zoonoses reported over the past 22 years in Sri Lanka. This systematic review adhered to the guidelines provided by the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) statement. A systematic literature search was conducted between July and September 2022, utilizing the following databases and sources: Google Scholar, PubMed, Cochrane Library, Weekly Epidemiological Reports, and Rabies Statistical Bulletins published by the Ministry of Health, Sri Lanka. From the initial database search, 1,710 articles were identified. After excluding nonzoonotic diseases, duplicated reports, inaccessible articles, and those not meeting the inclusion criteria, 570 reports were evaluated for eligibility. Of these, 91 reports were selected for data extraction, comprising 58 original research articles, 10 case reports, 16 weekly epidemiological reports, and 7 rabies statistical bulletins. Over the study period (2000-2022), 14 parasitic, 7 bacterial, and 7 viral zoonoses have been reported in Sri Lanka. Notably, leptospirosis emerged as the most reported zoonotic disease in the country. In response to these findings, we strongly recommend the implementation of a tailored, country-specific prevention and control program. To achieve this goal effectively, we emphasize the importance of adopting a country-specific "One Health" approach as a comprehensive framework for managing and controlling zoonotic diseases in Sri Lanka.
PubMed: 38775108
DOI: 10.1089/vbz.2023.0141 -
Journal of Endourology Feb 2024The journey of minimally invasive (MI) urology is one of quality improvement (QI) and patient safety. New techniques have been progressively studied for adoption and... (Review)
Review
The journey of minimally invasive (MI) urology is one of quality improvement (QI) and patient safety. New techniques have been progressively studied for adoption and growth. As more advanced methods of data collection and analysis are developed, a review of the patterns and history of these principles in the development of MI urology can inform future urologic QI and patient safety initiatives. To perform a scoping review identifying patterns of QI and patient safety in MI urology. PubMed and the American Urological Association (AUA) journal search page were screened on December 2022 for publications using the search parameters "quality improvement" and "minimally invasive." Articles were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR). The initial literature search identified 471 articles from PubMed and 57 from the AUA journal search page. After screening, 528 articles were relevant to the topic and reviewed. Four hundred eighty-two articles were duplicates or did not meet inclusion criteria. Forty-six are included in this review. Urology has developed a pattern of assessing MI surgery the open counterpart. This includes analyzing the newest approach to understand complications, examining the factors contributing to complications, and lastly designing projects to mitigate future risk. This information, as well as advanced methods of data collection, has identified areas of improvement for new QI projects. The stage is set for a promising future with the adoption of advanced QI in daily urologic practice to improve patient safety and minimize errors.
Topics: Humans; Quality Improvement; Patient Safety; Urology; Minimally Invasive Surgical Procedures
PubMed: 37950717
DOI: 10.1089/end.2022.0733 -
Discover Mental Health Nov 2023Muslims experience the lowest recovery rate from mental health difficulties across all religious groups. The aim of this research is to understand the barriers that... (Review)
Review
Understanding the beliefs and attitudes towards mental health problems held by Muslim communities and acceptability of Cognitive Behavioral Therapy as a treatment: systematic review and thematic synthesis.
BACKGROUND
Muslims experience the lowest recovery rate from mental health difficulties across all religious groups. The aim of this research is to understand the barriers that prevent Muslims from accessing Cognitive Behavioral Therapy (CBT) and the extent to which these may vary across country of residence.
METHODS
Systematic review and thematic synthesis for quantitative, qualitative, and mixed methods studies published in English and Arabic informed by the SPIDER search tool. Methodological quality and risk of bias of included papers were critically appraised independently according to the Mixed Methods Appraisal Tool.
RESULTS
A search of seven databases in the Arabic and English language yielded 3836 studies with 210 studies assessed for eligibility. Employing the Mixed Methods Appraisal Tool resulted in 14 studies included in the thematic synthesis. Seven studies adopted a qualitative methodology employing semi-structured interviews and seven were quantitative descriptive studies.
CONCLUSIONS
Muslim communities experience barriers accessing Cognitive Behavioral Therapy at the level of the individual, culture, provider and management. The main barriers were experienced at the individual level which was dominated by the influence of Islam regarding the cause of mental health difficulties, which also influenced the way in which difficulties were managed.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO and registration number: CRD42020192854.
PubMed: 37995058
DOI: 10.1007/s44192-023-00053-2 -
Frontiers in Public Health 2023As a primary source of added sugars in the US diet, sugar-sweetened beverage (SSB) consumption is presumed to contribute to obesity prevalence and poor oral health. We... (Meta-Analysis)
Meta-Analysis
BACKGROUND
As a primary source of added sugars in the US diet, sugar-sweetened beverage (SSB) consumption is presumed to contribute to obesity prevalence and poor oral health. We systematically synthesized and quantified evidence from US-based natural experiments concerning the impact of SSB taxes on beverage prices, sales, purchases, and consumption.
METHODS
A keyword and reference search was performed in PubMed, Web of Science, Cochrane Library, Scopus, and EconLit from the inception of an electronic bibliographic database to Oct 31, 2022. Meta-analysis was conducted to estimate the pooled effect of soda taxes on SSB consumption, prices, passthrough rate, and purchases.
RESULTS
Twenty-six natural experiments, all adopting a difference-in-differences approach, were included. Studies assessed soda taxes in Berkeley, Oakland, and San Francisco in California, Philadelphia in Pennsylvania, Boulder in Colorado, Seattle in Washington, and Cook County in Illinois. Tax rates ranged from 1 to 2 ¢/oz. The imposition of the soda tax was associated with a 1.06 ¢/oz. (95% confidence interval [CI] = 0.90, 1.22) increase in SSB prices and a 27.3% (95% CI = 19.3, 35.4%) decrease in SSB purchases. The soda tax passthrough rate was 79.7% (95% CI = 65.8, 93.6%). A 1 ¢/oz. increase in soda tax rate was associated with increased prices of SSBs by 0.84 ¢/oz (95% CI = 0.33, 1.35).
CONCLUSION
Soda taxes could be effective policy leverage to nudge people toward purchasing and consuming fewer SSBs. Future research should examine evidence-based classifications of SSBs, targeted use of revenues generated by taxes to reduce health and income disparities, and the feasibility of redesigning the soda tax to improve efficiency.
Topics: Humans; Taxes; Carbonated Beverages; Consumer Behavior; Beverages; Diet
PubMed: 37808982
DOI: 10.3389/fpubh.2023.1126569