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The Journal of Hospital Infection Dec 2023Norovirus outbreaks in hospitals can potentially impair patient care and result in significant financial expenses. There is currently limited information on hospital... (Review)
Review
BACKGROUND
Norovirus outbreaks in hospitals can potentially impair patient care and result in significant financial expenses. There is currently limited information on hospital norovirus outbreaks in the Chinese mainland.
AIM
To systematically review the published literature to describe the characteristics of norovirus outbreaks in Chinese mainland hospitals to facilitate prompt identification and control of outbreaks.
METHODS
A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis standards. Databases including PubMed, Web of Science, and Chinese Journals Online databases (China National Knowledge Infrastructure (CNKI), Chinese Wan Fang digital database (WANFANG) were searched from inception to July 18, 2022.
FINDINGS
A total of 41 norovirus Chinese hospital outbreaks occurring before July 18, 2022 were reported in 32 articles. Most reported outbreaks were from Shanghai and Beijing, and occurred in December and January. Cases were mainly adults. The male:female ratio was 1.22:1. The majority of cases in norovirus outbreaks were hospitalized patients (56.82%); medical staff were affected in 15 outbreaks. Norovirus outbreaks occurred in both private and public hospitals, and in secondary and tertiary care centres, and occurred mainly in internal medicine and geriatric departments. Person-to-person transmission was the primary transmission mode and GII was more prevalent.
CONCLUSION
Norovirus outbreaks in hospitals can affect both patients and healthcare workers, sometimes causing serious financial losses. In order to have a more complete understanding of the disease burden caused by norovirus outbreaks, surveillance needs to be established in hospitals.
Topics: Adult; Aged; Female; Humans; Male; Caliciviridae Infections; China; Disease Outbreaks; Gastroenteritis; Genotype; Hospitals, Public; Norovirus
PubMed: 37805116
DOI: 10.1016/j.jhin.2023.09.016 -
JMIR Mental Health Jul 2023Telemedicine has played a vital role in providing psychiatric treatment to patients during the rapid transition of services during the COVID-19 pandemic. Furthermore,... (Review)
Review
Psychiatric Treatment Conducted via Telemedicine Versus In-Person Modality in Posttraumatic Stress Disorder, Mood Disorders, and Anxiety Disorders: Systematic Review and Meta-Analysis.
BACKGROUND
Telemedicine has played a vital role in providing psychiatric treatment to patients during the rapid transition of services during the COVID-19 pandemic. Furthermore, the use of telemedicine is expected to expand within the psychiatric field. The efficacy of telemedicine is well described in scientific literature. However, there is a need for a comprehensive quantitative review that analyzes and considers the different clinical outcomes and psychiatric diagnoses.
OBJECTIVE
This paper aimed to assess whether individual psychiatric outpatient treatment for posttraumatic stress disorder, mood disorders, and anxiety disorders in adults using telemedicine is equivalent to in-person treatment.
METHODS
A systematic search of randomized controlled trials was conducted using recognized databases for this review. Overall, 4 outcomes were assessed: treatment efficacy, levels of patient satisfaction, working alliance, and attrition rate. The inverse-variance method was used to summarize the effect size for each outcome.
RESULTS
A total of 7414 records were identified, and 20 trials were included in the systematic review and meta-analysis. The trials included posttraumatic stress disorder (9 trials), depressive disorder (6 trials), a mix of different disorders (4 trials), and general anxiety disorder (1 trial). Overall, the analyses yielded evidence that telemedicine is comparable with in-person treatment regarding treatment efficacy (standardized mean difference -0.01, 95% CI -0.12 to 0.09; P=.84; I=19%, 17 trials, n=1814), patient satisfaction mean difference (-0.66, 95% CI -1.60 to 0.28; P=.17; I=44%, 6 trials, n=591), and attrition rates (risk ratio 1.07, 95% CI 0.94-1.21; P=.32; I=0%, 20 trials, n=2804). The results also indicated that the working alliance between telemedicine and in-person modalities was comparable, but the heterogeneity was substantial to considerable (mean difference 0.95, 95% CI -0.47 to 2.38; P=.19; I=75%, 6 trials, n=539).
CONCLUSIONS
This meta-analysis provided new knowledge on individual telemedicine interventions that were considered equivalent to in-person treatment regarding efficacy, patient satisfaction, working alliance, and attrition rates across diagnoses. The certainty of the evidence regarding efficacy was rated as moderate. Furthermore, high-quality randomized controlled trials are needed to strengthen the evidence base for treatment provided via telemedicine in psychiatry, particularly for personality disorders and a range of anxiety disorders where there is a lack of studies. Individual patient data meta-analysis is suggested for future studies to personalize telemedicine.
TRIAL REGISTRATION
PROSPERO International Prospective Register of Systematic Reviews CRD42021256357; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=256357.
PubMed: 37277113
DOI: 10.2196/44790 -
Journal of Psychosomatic Research Dec 2023This systematic review sought to summarize comprehensively the research investigating the association between facets of neuroticism and mortality risk. (Review)
Review
OBJECTIVE
This systematic review sought to summarize comprehensively the research investigating the association between facets of neuroticism and mortality risk.
METHODS
A systematic review of prospective cohort studies utilizing rigorous reporting methods was conducted. Six electronic bibliographic databases, MEDLINE [Ovid], Embase, PsycINFO, CINAHL, Web of Science, and SCOPUS, were searched for eligible studies using keywords encompassing personality traits and mortality. Articles from inception to January 2023 were reviewed. The risk of bias was also assessed.
RESULTS
Six of the 2358 identified studies met the inclusion criteria for extraction. Included studies had 335,715 participants, of whom 3.23% died. Participants ages at baseline ranged from 20 to 102, and 54% were female. Five of the six studies reported statistically significant associations between facets of neuroticism and mortality risk. Several underlying facets were reported to be associated with an increased mortality risk, namely vulnerability, cynicism, pessimistic, anxious, and depressive facets. Inadequacy, and worried-vulnerable were reported as protective. One study reported protective effects for impulsiveness, but this was not observed in a further follow-up study.
CONCLUSIONS
Various facets related to neuroticism are associated with an increased or decreased mortality risk. Encompassing all facets in a broad trait likely masks very important personality-health relations, which later impact longevity. Based on these findings, recommendations and future considerations are discussed.
Topics: Humans; Female; Male; Neuroticism; Follow-Up Studies; Prospective Studies; Personality; Personality Disorders
PubMed: 37832272
DOI: 10.1016/j.jpsychores.2023.111500 -
Body Image Sep 2023Body dysmorphic disorder (BDD) is characterised by a preoccupation with a perceived defect in appearance. This preoccupation results in the completion of repetitive/time... (Meta-Analysis)
Meta-Analysis Review
Body dysmorphic disorder (BDD) is characterised by a preoccupation with a perceived defect in appearance. This preoccupation results in the completion of repetitive/time consuming behaviours to reduce distress. While the disorder results in considerable distress and impairment, the prevalence of the disorder is largely unknown, as BDD has not been examined in large epidemiological studies. The aim of the current study was to provide an estimate of BDD prevalence in a variety of settings using a meta-analytic approach using only studies that have made a diagnosis using a structured diagnostic interview. Twenty-two studies met criteria (n = 7159) and the pooled point-prevalence estimate for BDD was 11.3% across all studies with high levels of heterogeneity (I = 95.81). The pooled point-prevalence estimate was 20.0% in cosmetic/dermatology settings, 7.4% in mental health settings, and 6.7% in 'other' settings (including students and professional ballet dancers). The risk of bias assessment indicated questionable methodological quality in some of the included studies. While this study provides an important improvement on the existing literature there is a need to include BDD in epidemiological studies in order to have a more accurate understanding of the prevalence rate of this mental health condition in the community.
Topics: Humans; Body Dysmorphic Disorders; Prevalence; Body Image; Students
PubMed: 37352787
DOI: 10.1016/j.bodyim.2023.06.008 -
PloS One 2023Food insecurity is one of the main factors affecting multimorbidity. Previous studies have shown that food insecurity may lead to multimorbidity due to person's... (Meta-Analysis)
Meta-Analysis
Food insecurity is one of the main factors affecting multimorbidity. Previous studies have shown that food insecurity may lead to multimorbidity due to person's inability to consume nutritious diet. However, considering that multimorbidity may cause work-related disabilities and an unstable income, others support the possible effect that multimorbidity has on food insecurity. The purpose of this systematic review and meta-analysis is to examine the relationship between food insecurity and multimorbidity in adults. A systematic literature review of studies was performed using the PubMed, EBSCO and SCOPUS for all articles including adults ≥ 18-year-old with multimorbidity living in developed countries published from August 5th until December 7th 2022. Meta-analysis was performed considering results from the fully adjusted model. The methodological quality was assessed using the Newcastle-Ottawa Scale adapted for cross-sectional studies. This systematic review was not registered. This research received no specific grant from any funding agency. Four cross-sectional studies involving 45,404 participants were included in order to investigate the possible impact that food insecurity has on multimorbidity. The study findings showed an increased probability of multimorbidity 1.55 (95% CI:1.31-1.79, p<0.001, I2 = 44.1%) among people with food insecurity. Conversely, three of the included studies, involving 81,080 participants concluded that people with multimorbidity, have 2.58 (95% CI: 1.66-3.49, p<0.001, I2 = 89.7%) times higher odds to present food insecurity. This systematic review and meta-analysis provide evidence of a reverse association between food insecurity and multimorbidity. Further cross-sectional studies must be conducted in order to elucidate the association between multimorbidity and food insecurity across age groups and between the two genders.
Topics: Humans; Male; Adult; Female; Adolescent; Multimorbidity; Cross-Sectional Studies; Food Insecurity; Diet; Income; Food Supply
PubMed: 37410753
DOI: 10.1371/journal.pone.0288063 -
Appetite Aug 2023There is a consistent link between perfectionism and eating disorders, however no meta-analysis to date has synthesized this literature in children and adolescents. We... (Meta-Analysis)
Meta-Analysis Review
There is a consistent link between perfectionism and eating disorders, however no meta-analysis to date has synthesized this literature in children and adolescents. We hypothesized that there would be significant, small pooled correlations between perfectionism dimensions and eating disorder symptoms in children and adolescents. Published, peer-reviewed articles with standardised measures of perfectionism and eating disorder symptoms were included. Articles were excluded if the age range was over 18 years. Overall, 39 studies were included (N = 13,954 participants, M age = 13.7 years). Total perfectionism (r = 0.25), perfectionistic strivings (r = 0.21), and perfectionistic concerns (r = 0.31) had significant positive associations with eating disorder symptoms. Most studies were rated as fair or good quality. Limitations included high heterogeneity, insufficient studies to investigate age as a moderator, the inclusion of only English articles, and predominately cross-sectional studies which precluded causal inference. Higher perfectionism was associated with greater eating disorder symptoms in children and adolescents. Future research should focus on longitudinal studies of eating disorder symptoms in children and adolescents.
Topics: Humans; Adolescent; Child; Perfectionism; Cross-Sectional Studies; Feeding and Eating Disorders; Longitudinal Studies; Risk Factors
PubMed: 37196843
DOI: 10.1016/j.appet.2023.106586 -
Body Image Mar 2024Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing... (Review)
Review
Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing literature that has explored the relationship between weight stigma and disordered eating cognitions and behaviors. We specifically examined three dimensions of weight stigma - experienced, anticipated, and internalized - and adopted an inclusive conceptualization of outcomes related to disordered eating (including constructs such as binge eating, body dissatisfaction, and other cognitions and behaviors such as dietary restraint, unhealthy weight control behaviors, and drive for thinness). We searched PubMed, Embase, CINAHL, Web of Science, Sociological Abstracts, and PsycINFO for English-language, peer-reviewed articles and dissertations with quantitative methodology published through October 2023. The search resulted in 242 articles meeting inclusion criteria. A narrative review found a consistent relationship between greater weight stigma and more disordered eating cognitions and behaviors. Methodological and theoretical limitations are discussed, as are critical avenues for future research and potential clinical implications stemming from this body of research. Given the widespread nature and impact of weight stigma on disordered eating, it is imperative that we intervene to address weight stigma at all levels, from the structural to the intrapersonal.
Topics: Humans; Body Image; Weight Prejudice; Feeding and Eating Disorders; Thinness; Cognition
PubMed: 38278088
DOI: 10.1016/j.bodyim.2023.101678 -
Pediatric Pulmonology May 2024Given extensive pertinent disease factors and evolving medical treatments, this systematic review explores qualitative and quantitative cystic fibrosis (CF) research... (Review)
Review
Given extensive pertinent disease factors and evolving medical treatments, this systematic review explores qualitative and quantitative cystic fibrosis (CF) research surrounding self-concept, an overarching perception of self. Research methodologies, self-concept dimensions, prominent self-concept findings and clinical recommendations are identified. Preferred Reporting Items for Systematic Review and Meta-analyses guidelines were applied. PubMed, Scopus, Medline, Psycinfo, CINAHL (ebsco), and CENTRAL Cochrane electronic databases were searched from 2012 to 2022. Methodological quality was assessed using the critical appraisal skills program. Data-based convergent synthesis was applied to analyze and report on qualitative and quantitative studies in parallel. Thirty-seven publications met the inclusion criteria, most of which employed a cross-sectional, single-center design within an adolescent and adult population. Self-efficacy, self-esteem, and self-identity studies were dimensions of self-concept identified, with studies relating to self-efficacy surrounding physical health management most prevalent. All three dimensions were positively associated with improved treatment adherence and psychosocial health. Efficacy tested intervention programs to enhance self-concept are limited; however, an extensive range of clinical recommendations are offered, highlighting the importance of clinician self-concept awareness, quality clinician-patient conversations and online CF peer-support. Self-concept is an important mechanism to optimize patient outcomes. Further CF self-concept research is required, particularly multicenter, longitudinal, and interventional studies. Early childhood, post lung transplant and the older adult CF population in particular, lack research attention. Given the potential impact of rapidly evolving CF transmembrane conductance regulator modulator drugs on many aspects of self, future self-concept research beyond the dimension of self-efficacy may be beneficial.
Topics: Adolescent; Adult; Humans; Cystic Fibrosis; Self Concept; Self Efficacy
PubMed: 38376009
DOI: 10.1002/ppul.26916 -
Health Policy (Amsterdam, Netherlands) Nov 2023Human behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative reviews... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Human behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative reviews indexed in Medline on behavioral interventions to increase vaccine uptake, to our knowledge, none have been systematic reviews and meta-analyses covering not just high but also low-and-middle income countries.
METHODS
We included 613 studies from the Medline database in our systematic review and meta-analysis categorizing different behavioral interventions in 9 domains: education campaigns, on-site vaccination, incentives, free vaccination, institutional recommendation, provider recommendation, reminder and recall, message framing, and vaccine champion. Additionally, considering that there is variability in the acceptance of vaccines among different populations, we assessed studies from both high-income countries (HICs) and low- to middle-income countries (LMICs), separately.
FINDINGS
Our results showed that behavioral interventions can considerably improve vaccine uptake in most settings. All domains that we examined improved vaccine uptake with the highest effect size associated with provider recommendation (OR: 3.4 (95%CI: 2.5-4.6); Domain: motivation) and on-site vaccination (OR: 2.9 (95%CI: 2.3-3.7); Domain: practical issues). While the number of studies conducted in LMICs was smaller, the quality of studies was similar with those conducted in HICs. Nevertheless, there were variations in the observed effect sizes.
INTERPRETATION
Our findings indicate that "provider recommendation" and "on-site vaccination" along with other behavioral interventions can be employed to increase vaccination rates globally.
Topics: Humans; Vaccination; Vaccines; Motivation; Health Facilities; Databases, Factual
PubMed: 37714082
DOI: 10.1016/j.healthpol.2023.104894 -
Nutrients Aug 2023In phenylketonuria (PKU), natural protein tolerance is defined as the maximum natural protein intake maintaining a blood phenylalanine (Phe) concentration within a... (Meta-Analysis)
Meta-Analysis Review
In phenylketonuria (PKU), natural protein tolerance is defined as the maximum natural protein intake maintaining a blood phenylalanine (Phe) concentration within a target therapeutic range. Tolerance is affected by several factors, and it may differ throughout a person's lifespan. Data on lifelong Phe/natural protein tolerance are limited and mostly reported in studies with low subject numbers. This systematic review aimed to investigate how Phe/natural protein tolerance changes from birth to adulthood in well-controlled patients with PKU on a Phe-restricted diet. Five electronic databases were searched for articles published until July 2020. From a total of 1334 results, 37 articles met the eligibility criteria ( = 2464 patients), and 18 were included in the meta-analysis. The mean Phe (mg/day) and natural protein (g/day) intake gradually increased from birth until 6 y (at the age of 6 months, the mean Phe intake was 267 mg/day, and natural protein intake was 5.4 g/day; at the age of 5 y, the mean Phe intake was 377 mg/day, and the natural protein intake was 8.9 g/day). However, an increase in Phe/natural protein tolerance was more apparent at the beginning of late childhood and was >1.5-fold that of the Phe tolerance in early childhood. During the pubertal growth spurt, the mean natural protein/Phe tolerance was approximately three times higher than in the first year of life, reaching a mean Phe intake of 709 mg/day and a mean natural protein intake of 18 g/day. Post adolescence, a pooled analysis could only be performed for natural protein intake. The mean natural protein tolerance reached its highest (32.4 g/day) point at the age of 17 y and remained consistent (31.6 g/day) in adulthood, but limited data were available. The results of the meta-analysis showed that Phe/natural protein tolerance (expressed as mg or g per day) increases with age, particularly at the beginning of puberty, and reaches its highest level at the end of adolescence. This needs to be interpreted with caution as limited data were available in adult patients. There was also a high degree of heterogeneity between studies due to differences in sample size, the severity of PKU, and target therapeutic levels for blood Phe control.
Topics: Child; Child, Preschool; Adolescent; Adult; Humans; Infant; Phenylalanine; Phenylketonurias; Databases, Factual; Immune Tolerance; Longevity
PubMed: 37630696
DOI: 10.3390/nu15163506