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Healthcare (Basel, Switzerland) Apr 2024This study aimed to identify the individual, organizational, and environmental factors which contributed to COVID-19-related outcomes in long-term care facilities... (Review)
Review
This study aimed to identify the individual, organizational, and environmental factors which contributed to COVID-19-related outcomes in long-term care facilities (LTCFs). A systematic review was conducted to summarize and synthesize empirical studies using a multi-level analysis approach to address the identified influential factors. Five databases were searched on 23 May 2023. To be included in the review, studies had to be published in peer-reviewed journals or as grey literature containing relevant statistical data. The Joanna Briggs Institute critical appraisal tool was employed to assess the methodological quality of each article included in this study. Of 2137 citations identified after exclusions, 99 records met the inclusion criteria. The predominant individual, organizational, and environmental factors that were most frequently found associated with the COVID-19 outbreak comprised older age, higher dependency level; lower staffing levels and lower star and subset domain ratings for the facility; and occupancy metrics and co-occurrences of outbreaks in counties and communities where the LTCFs were located, respectively. The primary individual, organizational, and environmental factors frequently linked to COVID-19-related deaths comprised age, and male sex; higher percentages of racial and ethnic minorities in LTCFs, as well as ownership types (including private, for-profit, and chain membership); and higher occupancy metrics and LTCF's size and bed capacity, respectively. Unfolding the risk factors collectively may mitigate the risk of outbreaks and pandemic-related mortality in LTCFs during future endemic and pandemics through developing and improving interventions that address those significant factors.
PubMed: 38610229
DOI: 10.3390/healthcare12070807 -
Breast Disease 2024We reviewed the literature on breast cancer patients' physical activity and quality of life. This paper should urge health services and breast cancer survivors to...
OBJECTIVES
We reviewed the literature on breast cancer patients' physical activity and quality of life. This paper should urge health services and breast cancer survivors to continue appropriate physical activity and assess its advantages.
DESIGN
A systematic review was conducted.
DATA SOURCES
This systematic review used online databases: PubMed, Web of Science, Scopus, and Google Scholar. A search from the beginning of 2018-2024 was conducted.
REVIEW METHOD
Medical Subject Headings (MESH) were used for keyword selection along with other target keywords, such as "Quality of life", "Breast cancer", "Chemotherapy", "Treatment side effects", "Patient experience", "Psychosocial well-being", "Physical functioning", "Emotional distress", and "Supportive care". We reviewed and included all English-language publications. A narrative synthesis was conducted to present the results of the studies.
RESULTS
The search using the keywords yielded a total of 135 studies. Each result was filtered again according to the inclusion and exclusion criteria, resulting in a final total of 15 studies to be included in the systematic review.
CONCLUSION
The evidence supports the benefits of physical activity in enhancing the quality of life for breast cancer survivors, indicating that further prospective and intervention studies are needed.
Topics: Humans; Quality of Life; Breast Neoplasms; Female; Cancer Survivors; Exercise
PubMed: 38875025
DOI: 10.3233/BD-249005 -
Acta Bio-medica : Atenei Parmensis Dec 2023Simultaneous medial and lateral tibiofemoral osteoarthritis (OA) could be treated with bi-unicompartmental knee arthroplasty (Bi-UKA) as an alternative to total knee...
BACKGROUND AND AIM
Simultaneous medial and lateral tibiofemoral osteoarthritis (OA) could be treated with bi-unicompartmental knee arthroplasty (Bi-UKA) as an alternative to total knee arthroplasty (TKA). The present systematic review aims to assess if simultaneous Bi-UKA is a feasible option for treating medial and lateral tibiofemoral OA.
MATERIALS AND METHODS
A comprehensive search of PubMed, MEDLINE, Cochrane Library, and Google Scholar was performed to find studies that reported on the outcome of simultaneous Bi-UKA for both medial and lateral tibiofemoral OA.
RESULTS
Seven studies were considered eligible for inclusion in the present systematic review. Intraoperative fractures occurred 8 times. Overall, there were 22 revisions of the prosthetic components for any reason with a survival rate that ranged from 83 to 100%. Of these, 16 revisions were for the aseptic loosening of the prosthetic components. Out of 302 surgeries, three were revised due to symptomatic OA progression in the patello-femoral joint. All clinical scores improved at the latest follow-up compared to preoperative values. Moreover, there were no differences in clinical scores of Bi-UKA compared to unicompartmental knee arthroplasty (UKA), or medial UKA plus patello-femoral prosthesis. Whereas, compared to TKA, Bi-UKA patients had comparable or superior scores. Finally, the Bi-UKA group had a significantly shorter hospital stay compared to the TKA group.
CONCLUSIONS
The use of simultaneous Bi-UKA is a valid option to address bicompartmental knee OA in selected patients with low intraoperative fracture rate, low revision rate, satisfactory clinical outcome, and fast recovery.
Topics: Humans; Arthroplasty, Replacement, Knee; Treatment Outcome; Reoperation; Osteoarthritis, Knee; Knee Prosthesis; Intraoperative Complications; Retrospective Studies
PubMed: 38054676
DOI: 10.23750/abm.v94i6.15006 -
BMC Public Health Apr 2024Rising housing prices are becoming a top public health priority and are an emerging concern for policy makers and community leaders. This report reviews and synthesizes...
BACKGROUND
Rising housing prices are becoming a top public health priority and are an emerging concern for policy makers and community leaders. This report reviews and synthesizes evidence examining the association between changes in housing price and health outcomes.
METHODS
We conducted a systematic literature review by searching the SCOPUS and PubMed databases for keywords related to housing price and health. Articles were screened by two reviewers for eligibility, which restricted inclusion to original research articles measuring changes in housing prices and health outcomes, published prior to June 31st, 2022.
RESULTS
Among 23 eligible studies, we found that changes in housing prices were heterogeneously associated with physical and mental health outcomes, with multiple mechanisms contributing to both positive and negative health outcomes. Income-level and home-ownership status were identified as key moderators, with lower-income individuals and renters experience negative health consequences from rising housing prices. This may have resulted from increased stress and financial strain among these groups. Meanwhile, the economic benefits of rising housing prices were seen to support health for higher-income individuals and homeowners - potentially due to increased wealth or perception of wealth.
CONCLUSIONS
Based on the associations identified in this review, it appears that potential gains to health associated with rising housing prices are inequitably distributed. Housing policies should consider the health inequities born by renters and low-income individuals. Further research should explore mechanisms and interventions to reduce uneven economic impacts on health.
Topics: Humans; Housing
PubMed: 38561729
DOI: 10.1186/s12889-024-18360-w -
BMC Health Services Research Jan 2024Globally, non-communicable diseases (NCDs) are the leading cause of mortality and morbidity placing a huge burden on individuals, families and health systems, especially...
BACKGROUND
Globally, non-communicable diseases (NCDs) are the leading cause of mortality and morbidity placing a huge burden on individuals, families and health systems, especially in low- and middle-income countries (LMICs). This rising disease burden calls for policy responses that engage the entire health care system. This study aims to synthesize evidence on how people with NCDs choose their healthcare providers in LMICs, and the outcomes of these choices, with a focus on private sector delivery.
METHODS
A systematic search for literature following PRISMA guidelines was conducted. We extracted and synthesised data on the determinants and outcomes of private health care utilisation for NCDs in LMICs. A quality and risk of bias assessment was performed using the Mixed Methods Appraisal Tool (MMAT).
RESULTS
We identified 115 studies for inclusion. Findings on determinants and outcomes were heterogenous, often based on a particular country context, disease, and provider. The most reported determinants of seeking private NCD care were patients having a higher socioeconomic status; greater availability of services, staff and medicines; convenience including proximity and opening hours; shorter waiting times and perceived quality. Transitioning between public and private facilities is common. Costs to patients were usually far higher in the private sector for both inpatient and outpatient settings. The quality of NCD care seems mixed depending on the disease, facility size and location, as well as the aspect of quality assessed.
CONCLUSION
Given the limited, mixed and context specific evidence currently available, adapting health service delivery models to respond to NCDs remains a challenge in LMICs. More robust research on health seeking behaviours and outcomes, especially through large multi-country surveys, is needed to inform the effective design of mixed health care systems that effectively engage both public and private providers.
TRIAL REGISTRATION
PROSPERO registration number CRD42022340059 .
Topics: Humans; Noncommunicable Diseases; Developing Countries; Private Sector; Health Behavior; Patient Acceptance of Health Care
PubMed: 38263128
DOI: 10.1186/s12913-023-10464-0 -
PloS One 2023To provide a summary of the economic and methodological evidence on capturing antimicrobial resistance (AMR) associated costs for curable sexually transmitted infections...
OBJECTIVE
To provide a summary of the economic and methodological evidence on capturing antimicrobial resistance (AMR) associated costs for curable sexually transmitted infections (STIs). To explore approaches for incorporating the cost of AMR within an economic model evaluating different treatment strategies for gonorrhoea, as a case study.
METHODS
A systematic review protocol was registered on PROSPERO (CRD42022298232). MEDLINE, EMBASE, CINAHL, Cochrane Library, International Health Technology Assessment Database, National Health Service Economic Evaluation Database, and EconLit databases were searched up to August 2022. Included studies were analysed, quality assessed and findings synthesised narratively. Additionally, an economic evaluation which incorporated AMR was undertaken using a decision tree model and primary data from a randomised clinical trial comparing gentamicin therapy with standard treatment (ceftriaxone). AMR was incorporated into the evaluation using three approaches-integrating the additional costs of treating resistant infections, conducting a threshold analysis, and accounting for the societal cost of resistance for the antibiotic consumed.
RESULTS
Twelve studies were included in the systematic review with the majority focussed on AMR in gonorrhoea. The cost of ceftriaxone resistant gonorrhoea and the cost of ceftriaxone sparing strategies were significant and related to the direct medical costs from persistent gonorrhoea infections, sequelae of untreated infections, gonorrhoea attributable-HIV transmission and AMR testing. However, AMR definition, the collection and incorporation of AMR associated costs, and the perspectives adopted were inconsistent or limited. Using the review findings, different approaches were explored for incorporating AMR into an economic evaluation comparing gentamicin to ceftriaxone for gonorrhoea treatment. Although the initial analysis showed that ceftriaxone was the cheaper treatment, gentamicin became cost-neutral if the clinical efficacy of ceftriaxone reduced from 98% to 92%. By incorporating societal costs of antibiotic use, gentamicin became cost-neutral if the cost of ceftriaxone treatment increased from £4.60 to £8.44 per patient.
CONCLUSIONS
Inclusion of AMR into economic evaluations may substantially influence estimates of cost-effectiveness and affect subsequent treatment recommendations for gonorrhoea and other STIs. However, robust data on the cost of AMR and a standardised approach for conducting economic evaluations for STI treatment which incorporate AMR are lacking, and requires further developmental research.
Topics: Humans; Anti-Bacterial Agents; Ceftriaxone; Cost-Benefit Analysis; Drug Resistance, Bacterial; Gentamicins; Gonorrhea; Sexually Transmitted Diseases; State Medicine
PubMed: 37856496
DOI: 10.1371/journal.pone.0292273 -
Primary Care Diabetes Jun 2024This study will explore the effectiveness of fish skin grafts (FSG) in ulcer healing in diabetic foot disease compared to standard of care (SOC). (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
This study will explore the effectiveness of fish skin grafts (FSG) in ulcer healing in diabetic foot disease compared to standard of care (SOC).
METHODS
The systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. The electronic databases of PubMed, EMBASE, and Web of Science (WoS) internet were searched for the outcome rate of complete ulcer healing. The risk of bias assessment was conducted using the tool recommended by the Cochrane Collaboration. Statistical analysis included the individual and combined result of the studies, heterogeneity test, the effect size, sensitivity analysis, and publication bias tests.
RESULTS
Five randomised controlled trials (RCTs) with a total of 411 patients were included in this study. This meta-analysis showed a higher rate of complete ulcer healing in groups receiving fish skin grafts (OR = 3.34, 95% CI 2.14-5.20, p < 0.01, I = 0%) compared to control groups.
CONCLUSION
Fish skin grafts have been shown to be more effective for achieving complete ulcer healing compared to current conventional treatments in diabetic foot disease.
Topics: Adult; Aged; Animals; Female; Humans; Male; Middle Aged; Chronic Disease; Diabetic Foot; Fishes; Randomized Controlled Trials as Topic; Risk Factors; Skin Transplantation; Standard of Care; Time Factors; Treatment Outcome; Wound Healing
PubMed: 38644082
DOI: 10.1016/j.pcd.2024.03.008 -
Journal of Orthopaedic Surgery and... Feb 2024The treatment of unstable atlas fractures remains a controversial topic. The study aims at assessing the prognosis and efficacy of osteosynthesis for unstable atlas...
PURPOSE
The treatment of unstable atlas fractures remains a controversial topic. The study aims at assessing the prognosis and efficacy of osteosynthesis for unstable atlas fractures through a review of the current literature and additionally aims to compare outcomes between the transoral and posterior approaches.
METHODS
A systematic review of databases including PubMed, EMBASE, Cochrane, Web of Science, CNKI, and Wanfang was conducted. Titles and abstracts were screened by two reviewers to identify studies meeting pre-defined inclusion criteria for comprehensive analysis.
RESULTS
The systematic review included 28 articles, 19 employing the posterior approach and 9 utilizing the transoral approach. It covered osteosynthesis in 297 patients with unstable atlas fractures, comprising 169 treated via the posterior approach and 128 via the transoral approach. Analysis revealed high healing rates and clinical improvement in both approaches, evidenced by improvements in the visual analog scale, range of motion, atlantodens interval, and lateral displacement distance post-surgery.
CONCLUSION
Osteosynthesis offers effective treatment for unstable atlas fractures. Both transoral and posterior approaches can achieve good clinical outcomes for fracture, and biomechanical studies have confirmed that osteosynthesis can maintain the stability of the occipitocervical region, preserve the motor function of the atlantoaxial and occipito-atlantoaxial joints, and greatly improve the quality of life of patients. However, variations exist in the indications and surgical risks associated with each method, necessitating their selection based on a thorough clinical evaluation of the patient's condition.
Topics: Humans; Cervical Atlas; Quality of Life; Spinal Fractures; Treatment Outcome; Fracture Fixation, Internal; Fractures, Comminuted
PubMed: 38331873
DOI: 10.1186/s13018-024-04571-9 -
Inflammatory Bowel Diseases Nov 2023Total proctocolectomy with ileal pouch anal anastomosis (IPAA) for medically refractory ulcerative colitis or dysplasia may be associated with structural and...
BACKGROUND
Total proctocolectomy with ileal pouch anal anastomosis (IPAA) for medically refractory ulcerative colitis or dysplasia may be associated with structural and inflammatory complications. However, even in their absence, defecatory symptoms secondary to dyssynergic defecation or fecal incontinence may occur. Although anorectal manometry is well established as the diagnostic test of choice for defecatory symptoms, its utility in the assessment of patients with IPAA is less established. In this systematic review, we critically evaluate the existing evidence for anopouch manometry (APM).
METHODS
A total of 393 studies were identified, of which 6 studies met all inclusion criteria. Studies were not pooled given different modalities of testing with varying outcome measures.
RESULTS
Overall, less than 10% of symptomatic patients post-IPAA were referred to APM. The prevalence of dyssynergic defecation as defined by the Rome IV criteria in symptomatic patients with IPAA ranged from 47.0% to 100%. Fecal incontinence in patients with IPAA was characterized by decreased mean and maximal resting anal pressure on APM, as well as pouch hyposensitivity. The recto-anal inhibitory reflex was absent in most patients with and without incontinence.
CONCLUSION
Manometry alone is an imperfect assessment of pouch function in patients with defecatory symptoms, and confirmatory testing may need to be performed with dynamic imaging.
Topics: Humans; Fecal Incontinence; Proctocolectomy, Restorative; Anastomosis, Surgical; Rectum; Colitis, Ulcerative; Anal Canal; Colonic Pouches
PubMed: 36351035
DOI: 10.1093/ibd/izac234 -
Acta Bio-medica : Atenei Parmensis Aug 2023To investigate the association between CYP17A1 (rs74357) polymorphism and the risk of Polycystic Ovary Syndrome (PCOS). (Meta-Analysis)
Meta-Analysis
BACKGROUND AND AIM
To investigate the association between CYP17A1 (rs74357) polymorphism and the risk of Polycystic Ovary Syndrome (PCOS).
METHODS
Literature on the association of CYP17rs74357 gene polymorphism and susceptibility to PCOS was retrieved by searching databases such as PubMed, Science Direct, Google Scholar and Embase from. The association measure was analyzed using an Odds Ratio (OR) and 95% Confidence Interval (CI). All the statistical analyses were executed using CMA 3.0 Software.
RESULTS
In the present meta-analysis,24 studies including 3462 PCOS and 2898 controls were analyzed. The overall results validated that the 17 CYP17 T/C (rs74357) gene polymorphism was significantly associated with PCOS risk in 5 genetic models: recessive model (fixed and random effect), dominant model (random effect), CC vs. TT (fixed effect), CT vs. TT (fixed effect), and allele contrast (random effect). Stratified analyses by ethnicity/country also detected significant association between Asian and Caucasian under the recessive, dominant, CC vs. TT, CC vs. CT, and the allele contrast models.
CONCLUSIONS
In the present study, CYP17 T/C (rs74357) gene polymorphism increase the susceptibility of PCOS, and the recessive C allele, can be proposed as a predictive factor for the risk of PCOS or an important pathway in PCOS associated metabolic and hormonal dysregulation especially insulin resistance.However, larger sample size andmultiracial studies are needed in the future to confirm the findings.
Topics: Female; Humans; Genetic Predisposition to Disease; Polycystic Ovary Syndrome; Polymorphism, Genetic; Steroid 17-alpha-Hydroxylase
PubMed: 37539608
DOI: 10.23750/abm.v94i4.14229