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BMC Primary Care Mar 2024Having a sufficient and well-functioning health workforce is crucial for reducing the burden of disease and premature death. Health workforce development, focusing on... (Review)
Review
BACKGROUND
Having a sufficient and well-functioning health workforce is crucial for reducing the burden of disease and premature death. Health workforce development, focusing on availability, recruitment, retention, and education, is inseparable from acceptability, motivation, burnout, role and responsibility, and performance. Each aspect of workforce development may face several challenges, requiring specific strategies. However, there was little evidence on barriers and strategies towards comprehensive health workforce development. Therefore, this review explored barriers and strategies for health workforce development at the primary health care level around the world.
METHODS
A scoping review of reviews was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews. The article search was performed in Google Scholar, PubMed, Web of Science, and EMBASE. We used EndNote x9 for managing the collected articles, screening processes, and citation purpose. The scoping review included any kind of review articles on the application of health workforce development concepts, such as availability, recruitment, retention, role and responsibility, education and training, motivation, and burnout, with primary health care and published in English anywhere in the world. Based on the concepts above, barriers and strategies for health workforce development were identified. The findings were synthesized qualitatively based on the building blocks of the health system framework. The analysis involved specific activities such as familiarization, construction of the thematic framework, indexing, charting, and interpretation. The results were presented in texts, tables, and figures.
RESULTS
The search strategies yielded 7,276 papers were found. Of which, 69 were included in the scoping review. The most frequently cited barriers were financial challenges and issues related to health care delivery, such as workloads. Barriers affecting healthcare providers directly, including lack of training and ineffective teamwork, were also prominent. Other health system and governance barriers include lack of support, unclear responsibility, and inequity. Another notable barrier was the shortage of health care technology, which pertains to both health care supplies and information technology. The most common cited effective strategies were ongoing support and supervision, engaging with communities, establishing appropriate primary care settings, financial incentives, fostering teamwork, and promoting autonomous health care practice.
CONCLUSIONS
Effective leadership/governance, a robust health financing system, integration of health information and technology, such as mobile health and ensuring a consistent supply of adequate resources are also vital components of primary health care workforce development. The findings highlight the importance of continuous professional development, which includes training new cadres, implementing effective recruitment and retention mechanisms, optimising the skill mix, and promoting workplace wellness. These elements are essential in fostering a well-trained and resilient primary health care workforce.
Topics: Humans; Health Personnel; Workforce; Delivery of Health Care; Health Workforce; Primary Health Care
PubMed: 38539068
DOI: 10.1186/s12875-024-02336-1 -
Journal of Clinical Medicine Nov 2023Until now, it is uncertain whether lifestyle interventions during pregnancy can prevent gestational diabetes mellites (GDM) in high-risk pregnant women. (Review)
Review
Effectiveness of Lifestyle Interventions during Pregnancy on Preventing Gestational Diabetes Mellitus in High-Risk Women: A Systematic Review and Meta-Analyses of Published RCTs.
BACKGROUND
Until now, it is uncertain whether lifestyle interventions during pregnancy can prevent gestational diabetes mellites (GDM) in high-risk pregnant women.
OBJECTIVE
This study aims at investigating the effectiveness of dietary interventions and/or exercise interventions during pregnancy for preventing GDM in high-risk pregnant women.
MATERIALS AND METHODS
Eligible randomized controlled trials (RCTs) were selected after a search in CENTRAL, Scopus, and PubMed. Synthesis was performed for the outcome of GDM in women with any identified GDM risk factor. Separate meta-analyses (MA) were performed to assess the efficacy of either nutrition or physical activity (PA) interventions or both combined compared with standard prenatal care for preventing GDM. Subgroup and sensitivity analyses, as well as meta-regressions against OR, were performed to assess potentional heterogeneity. Overall quality, the quality of RCTs, and publication bias were also evaluated.
RESULTS
A total of 13,524 participants comprising high-risk pregnant women in 41 eligible RCTs were analyzed for GDM. Women receiving only a nutrition intervention during pregnancy were less likely to experience GDM compared with women following standard prenatal care. Among 3109 high-risk pregnant women undergoing only dietary intervention for preventing GDM, 553 (17.8%) developed GDM; however, the result of the MA was marginally not significant (OR 0.73, 95%CI 0.51, 1.03; -value 0.07), (Q 21.29, -value 0.01; I 58% (95%CI 10, 78%)). Subgroup analyses demonstrated an effect for studies that were conducted in Great Britain (OR 0.65, 95%CI 0.49, 0.81; -value 0.003), and in Spain (OR 0.50, 95%CI 0.27, 0.94; -value 0.03), for studies with forms of the Mediterranean diet as the intervention's component (OR 0.61; 95%CI 0.46, 0.81; -value 0.0005), and for studies including a motivation arm in the intervention (OR 0.71, 95%CI 0.58, 0.87; -value 0.0008). Among 2742 high-risk pregnant women being analyzed for GDM outcome after receiving only an exercise intervention, 461 (16.8%) were diagnosed with GDM. Women after receiving PA intervention were less likely to develop GDM (OR 0.64, 95%CI 0.51, 0.80; -value < 0.0001), (Q 11.27, -value 0.51; I 0% (95%CI 0, 99%)). Finally, 1308 (17%) cases of GDM were diagnosed among 7673 high-risk pregnant women undergoing both diet and PA intervention. Women in the group of mixed lifestyle intervention had a significant reduction in incidence of GDM (OR 0.70, 95%CI 0.55, 0.90; -value 0.005), (Q 50.32, -value < 0.0001, I 66%, (95% CI 44, 79%)).
CONCLUSIONS
The results of this study support the efficacy of lifestyle interventions during pregnancy for preventing GDM in high-risk women if an exercise component is included in the intervention arm, either alone, or combined with diet. A combined lifestyle intervention including physical exercise and a Mediterranean diet accompanied by motivation support may be considered the most effective way to prevent GDM among high-risk women during pregnancy. Future research is needed to strengthen these findings.
PubMed: 38002654
DOI: 10.3390/jcm12227038 -
Globalization and Health Sep 2023Globally, COVID-19 vaccines have proven to be instrumental for promoting population health by reducing illness from SARS-CoV-2. Vaccine certificates emerged as a... (Review)
Review
BACKGROUND
Globally, COVID-19 vaccines have proven to be instrumental for promoting population health by reducing illness from SARS-CoV-2. Vaccine certificates emerged as a potentially promising solution for encouraging vaccination and facilitating the safe reopening of society, however, they were controversial due to criticisms of infringing upon individual rights. While there is extensive literature describing the ethical, legal, and public health implications of vaccine certificates, there is currently a gap in knowledge about the association of vaccine certificates on vaccine uptake during the COVID-19 pandemic and barriers and facilitators to their use.
OBJECTIVES
The objectives of this scoping review are to (i) describe the existing literature on the association of vaccine certificates on the rates of COVID-19 vaccine uptake across several countries and (ii) describe the intrinsic and extrinsic barriers or facilitators that moderate this relationship.
METHODS
We conducted a scoping review based on PRISMA Extension for Scoping Reviews (PRSIMA-ScR) guidelines. We searched three bibliographic databases (APA PsychInfo, Embase Classic + Embase, OVID-Medline) and preprint severs during the first week of July 2023. Three reviewers independently screened the studies based on pre-specified eligibility criteria and performed quality assessments of the primary literature and data extraction.
RESULTS
Sixteen studies met the inclusion criteria. 14 or these were surveys and 2 were modelling studies. The majority documented that vaccine certificates were significantly associated with increased rates of COVID-19 vaccine uptake (n = 12), motivated by factors such as travel/employer requirements, influence from the government/peers, and trust in the safety, efficacy, and science behind COVID-19 vaccines. Three studies had non-significant or mixed findings. Only one study found a significant decrease in COVID-19 vaccine uptake, motivated by pervasive distrust in the QR code-based system of digital vaccine certificates in Russia. Quality of survey studies was generally high.
CONCLUSION
Our findings provide insights into the existing literature on vaccine certificates association with vaccine uptake in several different jurisdictions and barriers and facilitators to their uptake. This information can be used to guide future examinations of the implementation of vaccine certificates and more effective implementations.
Topics: Humans; COVID-19 Vaccines; Pandemics; COVID-19; SARS-CoV-2; Vaccines
PubMed: 37759306
DOI: 10.1186/s12992-023-00969-y -
Human Vaccines & Immunotherapeutics Aug 2023The introduction of the COVID-19 vaccine amidst the pandemic has heralded a paradigm shift. Healthcare students in nursing, medicine, and dentistry must have positive... (Review)
Review
The introduction of the COVID-19 vaccine amidst the pandemic has heralded a paradigm shift. Healthcare students in nursing, medicine, and dentistry must have positive attitudes owing to their future role in vaccine recommendations to the public and patients. This meta-regression analysis assessed the differences in COVID-19 vaccination intention (VI) of nursing, medical, and dental students. Medline/PubMed, EMBASE, CINAHL, Cochrane Library, and Korean MBASE were searched for eligible studies. Quality was assessed by the Joanna Briggs Institute's quality appraisal. Forty-one studies were included in the final analysis, and the estimation of pooled prevalence (68%) and relevant factors were assessed. Dental students were found to have the lowest VI (57%), which significantly ( = .018) differed from that of nursing students (64%). Countries in South-East Asia and those with high income levels were found to have high VI. Therefore, global vaccine programs for healthcare students should be prepared considering their geographical and economic status.
Topics: Humans; COVID-19 Vaccines; Intention; Students, Dental; COVID-19; Vaccination
PubMed: 37732552
DOI: 10.1080/21645515.2023.2253600 -
Addiction Biology Mar 2024A network meta-analysis (NMA) including randomized controlled trials (RCTs) was conducted to evaluate the effects of different interventions on smoking cessation.... (Meta-Analysis)
Meta-Analysis
A network meta-analysis (NMA) including randomized controlled trials (RCTs) was conducted to evaluate the effects of different interventions on smoking cessation. Studies were collected from online databases including PubMed, EMBASE, Cochrane Library, and Web of Science based on inclusion and exclusion criteria. Eligible studies were further examined in the NMA to compare the effect of 14 interventions on smoking cessation. Thirty-four studies were examined in the NMA, including a total of 14 interventions and 28 733 participants. The results showed that health education (HE; odds ratio ([OR] = 200.29, 95% CI [1.62, 24 794.61])), other interventions (OI; OR = 29.79, 95% CI [1.07, 882.17]) and multimodal interventions (MUIs; OR = 100.16, 95% CI [2.06, 4867.24]) were better than self-help material (SHM). HE (OR = 243.31, 95% CI [1.39, 42531.33]), MUI (OR = 121.67, 95% CI [1.64, 9004.86]) and financial incentive (FI; OR = 14.09, 95% CI [1.21, 164.31]) had positive effects on smoking cessation rate than smoking cessation or quitting APP (QA). Ranking results showed that HE (83.6%) and motivation interviewing (MI; 69.6%) had better short-term effects on smoking cessation. HE and MUI provided more smoking cessation benefits than SHM and QA. FI was more effective at quitting smoking than QA. Also, HE and MI were more likely to be optimal smoking cessation interventions.
Topics: Humans; Smoking Cessation; Network Meta-Analysis; Smoking; Tobacco Use Cessation Devices; Behavior Therapy
PubMed: 38488699
DOI: 10.1111/adb.13376 -
Psychology Research and Behavior... 2023In the past two decades, several scholars from different disciplines have conducted theoretical research and practical explorations on the issue of psychological capital... (Review)
Review
In the past two decades, several scholars from different disciplines have conducted theoretical research and practical explorations on the issue of psychological capital and achieved certain research results. Yet, few studies have synthesized the psychological capital related to academic outcomes among university students. Thus, the aim of this article is to explore how PsyCap is described in an academic context and how PsyCap and academic-related outcomes are related. A comprehensive systematic review was conducted on 43 studies between 2012 and 2022, sourced from six leading databases: Web of Science, Scopus, ERIC, PsyINFO (EBSCO), Springerlink, and ScienceDirect. Our selection criteria focused on empirical research that specifically discussed PsyCap's impact on university students' academic performance. This review identifies personal and social factors that influence the development of PsyCap in university students, such as self-esteem, motivation, gratitude, family support, and peer relationships. We found that PsyCap plays a key role in academic outcomes, including academic performance, engagement, burnout, adjustment, stress, and intrinsic motivation. Highlighting the significance of PsyCap in academic settings, our study underscores the need for further research on its relationship with student outcomes. Given the substantial influence of PsyCap on academic performance, institutions should consider incorporating psychological capital development programs into their curriculum. Such initiatives could optimize the academic achievements and holistic well-being of students.
PubMed: 37705849
DOI: 10.2147/PRBM.S421549 -
Brain & Spine 2024Clinicians encounter challenges in promptly diagnosing thoracolumbar injuries (TLIs) and fractures (VFs), motivating the exploration of Artificial Intelligence (AI) and... (Review)
Review
Sensitivity and specificity of machine learning and deep learning algorithms in the diagnosis of thoracolumbar injuries resulting in vertebral fractures: A systematic review and meta-analysis.
INTRODUCTION
Clinicians encounter challenges in promptly diagnosing thoracolumbar injuries (TLIs) and fractures (VFs), motivating the exploration of Artificial Intelligence (AI) and Machine Learning (ML) and Deep Learning (DL) technologies to enhance diagnostic capabilities. Despite varying evidence, the noteworthy transformative potential of AI in healthcare, leveraging insights from daily healthcare data, persists.
RESEARCH QUESTION
This review investigates the utilization of ML and DL in TLIs causing VFs.
MATERIALS AND METHODS
Employing Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) methodology, a systematic review was conducted in PubMed and Scopus databases, identifying 793 studies. Seventeen were included in the systematic review, and 11 in the meta-analysis. Variables considered encompassed publication years, geographical location, study design, total participants (14,524), gender distribution, ML or DL methods, specific pathology, diagnostic modality, test analysis variables, validation details, and key study conclusions. Meta-analysis assessed specificity, sensitivity, and conducted hierarchical summary receiver operating characteristic curve (HSROC) analysis.
RESULTS
Predominantly conducted in China (29.41%), the studies involved 14,524 participants. In the analysis, 11.76% (N = 2) focused on ML, while 88.24% (N = 15) were dedicated to deep DL. Meta-analysis revealed a sensitivity of 0.91 (95% CI = 0.86-0.95), consistent specificity of 0.90 (95% CI = 0.86-0.93), with a false positive rate of 0.097 (95% CI = 0.068-0.137).
CONCLUSION
The study underscores consistent specificity and sensitivity estimates, affirming the diagnostic test's robustness. However, the broader context of ML applications in TLIs emphasizes the critical need for standardization in methodologies to enhance clinical utility.
PubMed: 38681175
DOI: 10.1016/j.bas.2024.102809 -
Primary Health Care Research &... Jan 2024This qualitative systematic review aimed to synthesise existing qualitative research on HCPs' perceptions and experiences of obesity and its management in primary care... (Review)
Review
AIM
This qualitative systematic review aimed to synthesise existing qualitative research on HCPs' perceptions and experiences of obesity and its management in primary care settings.
BACKGROUND
Healthcare professionals (HCPs), particularly those in primary care, play a key role in policy implementation around weight management. Overweight and obese individuals are subject to weight stigma which has negative health consequences and reduces the likelihood of healthcare service usage. An understanding of HCPs' perceptions of obesity and weight management in primary care is necessary for the development and delivery of effective initiatives.
METHODS
A search strategy developed using the SPIDER framework was applied to Medline and CINAHL databases. Inclusion criteria were applied, and quality assessment was undertaken using the CASP framework. Fifteen papers meeting the inclusion criteria were analysed thematically.
FINDINGS
Four themes were identified: conflicting discourses surrounding obesity, medicalisation of obesity, organisational factors, and lack of patient knowledge and motivation. Conflicting discourses around obesity refers to the differing views of HCPs regarding what it means to have and treat obesity. Medicalisation of obesity considers whether obesity should be treated as a medical condition. Organisational factors were identified as knowledge, resources and time that affected HCPs' ability to provide care to overweight or obese. Finally, the review discovered that patients required their own knowledge and motivation to lose weight. This review has highlighted the need to provide safe, non-judgemental spaces for HCPs and patients to discuss weight and weight loss. This is essential to the therapeutic relationship and the provision of effective obesity management.
Topics: Humans; Overweight; Obesity; Weight Loss; Health Personnel; Qualitative Research; Delivery of Health Care; Primary Health Care
PubMed: 38229563
DOI: 10.1017/S1463423623000683 -
Journal of the Saudi Heart Association 2023The clinical outcome and quality of life of CHD patients are greatly influenced by medication adherence. Non-adherence of CHD patients to treatment results in... (Review)
Review
OBJECTIVE
The clinical outcome and quality of life of CHD patients are greatly influenced by medication adherence. Non-adherence of CHD patients to treatment results in sub-optimal clinical outcomes and increasing costs. This study aims to describe effectiveness of the intervention to improve the medication adherence in CHD patients.
METHODS
Systematic review methodology was used in this study. Scopus and PubMed were used to search the relevant article systematically. The outcome measured was medication adherence in coronary heart disease patients.
RESULTS
Final screening was 31 articles that met the inclusion criteria in this study of 788 articles. Selection processes the article used the PRISMA guideline. Most of the articles (15 articles) use interventions that utilize information technology (IT) as known with m-health in the form of text messages, website, and smartphone-based applications in increasing medication adherence in CHD patients. The non m-health interventions developed are in the form of self-efficacy programs, monitoring and education by health workers or care workers, pharmacy care by clinical pharmacists, and the use of drugs in the form of multi-capsules. The results of most intervention with m-health can improve the medication adherence in CHD patient effectively. Education and motivation program by professional health care and multi-capsules also increasing the medication adherence in the intervention control. There was a decrease of medication adherence in some articles with long time follow-up that can be attention for the professional health care to manage the patient adherent.
CONCLUSION
The medication adherence in CHD patient can be improve by various program. Modification of m-health and non m-health intervention can be resolved to increase the communication, motivation, and knowledge about medication adherence in CHD patients.
PubMed: 38116401
DOI: 10.37616/2212-5043.1356 -
Heliyon Mar 2024Female tourism is gaining momentum in the world. Thus, a review of female tourism is essential to explore future research directions. The paper discusses the evolution... (Review)
Review
Female tourism is gaining momentum in the world. Thus, a review of female tourism is essential to explore future research directions. The paper discusses the evolution of female tourism research from the early 1980s to 2022 through different analytical methods. The 116 articles published in the list of Social Science Citation Index (SSCI) journals were collected. A systematic quantitative assessment of 116 articles was conducted using HistCite, and research themes were identified using VOSviewer. Qualitative content analysis was conducted to trace the growth of research, understand the past research development of each research theme, and identify research gaps for further research. The results show that current female tourism research can be divided into three research themes: motivation, risk, and sexuality. The motivations for young female travellers, solo female travellers, and middle-aged female travellers are discussed. In the atmosphere of gender equality, current female tourism research in risk and sexuality contains contradictory viewpoints with past studies as a result of changing times. A research agenda in four potential research areas is recommended. This review contributes to female tourism research by providing researchers with literature to guide and support further research.
PubMed: 38463852
DOI: 10.1016/j.heliyon.2024.e27256