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Journal of Global Health Oct 2023Healthcare workers (HCWs) are at risk of acquiring blood-borne infections such as hepatitis B, hepatitis C, and human immunodeficiency virus through needlestick injuries... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Healthcare workers (HCWs) are at risk of acquiring blood-borne infections such as hepatitis B, hepatitis C, and human immunodeficiency virus through needlestick injuries (NSIs). We aimed to investigate the prevalence of needlestick injuries and other related indicators among HCWs in Iran through a systematic review and meta-analysis.
METHODS
We searched various databases until the end of May 2023 for studies reporting the prevalence of NSIs among healthcare workers in Iran. We used a random model with 95% confidence intervals (CIs) to analyse the data and the Joanna Briggs Institute (JBI) tool to evaluate the quality of included studies. We conducted and reported the study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
RESULTS
We included 87 studies in the analysis and found that 47% (95% CI = 42-52, I = 98.9%) of Iranian HCWs experienced NSI. NSIs were most frequently related to syringe needles (58%; 95% CI = 52-65, I = 96.8%) and most often caused by recapping (30%; 95% CI = 22-38, I = 98.5%). In this study, 56% (95% CI = 45-67, I = 98.6%) of HCWs with NSIs did not report their injury. Moreover, the prevalence of NSIs the highest in the morning shift (0.44; 95% CI = 0.36-0.53, I = 97.2%), emergency unit (0.20; 95% CI = 0.16-0.24, I = 93.7%), and intensive care unit (0.20; 95% CI = 0.16-0.24, I = 94.3%).
CONCLUSIONS
To reduce the high prevalence of NSIs, HCWs, especially those in emergency departments, should use safety equipment. Healthcare managers should provide a calm and stress-free environment for HCWs, educate them on safety principles and standards, and support experienced HCWs with NSIs.
Topics: Humans; Needlestick Injuries; Iran; Prevalence; Health Personnel; Protective Devices
PubMed: 37781996
DOI: 10.7189/jogh.13.04104 -
Frontiers in Psychology 2021This paper reports the results of a systematic review conducted on articles examining the effects of daytime electric light exposure on alertness and higher cognitive... (Review)
Review
This paper reports the results of a systematic review conducted on articles examining the effects of daytime electric light exposure on alertness and higher cognitive functions. For this, we selected 59 quantitative research articles from 11 online databases. The review protocol was registered with PROSPERO (CRD42020157603). The results showed that both short-wavelength dominant light exposure and higher intensity white light exposure induced alertness. However, those influences depended on factors like the participants' homeostatic sleep drive and the time of day the participants received the light exposure. The relationship between light exposure and higher cognitive functions was not as straightforward as the alerting effect. The optimal light property for higher cognitive functions was reported dependent on other factors, such as task complexity and properties of control light. Among the studies with short-wavelength dominant light exposure, ten studies (morning: 3; afternoon: 7) reported beneficial effects on simple task performances (reaction time), and four studies (morning: 3; afternoon: 1) on complex task performances. Four studies with higher intensity white light exposure (morning: 3; afternoon: 1) reported beneficial effects on simple task performance and nine studies (morning: 5; afternoon: 4) on complex task performance. Short-wavelength dominant light exposure with higher light intensity induced a beneficial effect on alertness and simple task performances. However, those effects did not hold for complex task performances. The results indicate the need for further studies to understand the influence of short-wavelength dominant light exposure with higher illuminance on alertness and higher cognitive functions.
PubMed: 35069337
DOI: 10.3389/fpsyg.2021.765750 -
Annals of Allergy, Asthma & Immunology... Aug 2020Inhaled corticosteroids (ICSs) are recommended as first-line controller medications for persistent asthma. However, guidelines on the initial ICS doses, step-up and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Inhaled corticosteroids (ICSs) are recommended as first-line controller medications for persistent asthma. However, guidelines on the initial ICS doses, step-up and step-down algorithms, and when to switch to combination therapy vary.
OBJECTIVE
To understand the ideal starting doses of ICS therapy based on current evidence and to systematically compare low, moderate, and high starting doses of ICSs as monotherapy and in combination with long-acting β-agonists with respect to efficacy and safety.
METHODS
MEDLINE, Embase, and Cochrane databases were searched for relevant English-language articles published from 1980 to November 17, 2018. Randomized controlled trials with adult, steroid-naive, ICS-free (for ≥4 weeks) patients with asthma and a duration of 4 weeks or longer with an ICS treatment arm (monotherapy or combination therapy) were included. Separate fixed-effects Bayesian network meta-analyses were conducted on the extracted data for peak expiratory flow, forced expiratory volume in 1 second, nighttime rescue medication use, nighttime symptom score, and study withdrawal because of an adverse event.
RESULTS
A total of 31 randomized controlled trials were analyzed. All starting doses of ICSs were comparable with respect to nighttime rescue medication use, nighttime symptom score, change in forced expiratory volume in 1 second, and study withdrawal because of an adverse event. Significant improvement in morning peak expiratory flow was observed with high-dose ICSs and with low- and moderate-dose ICSs and long-acting β-agonists than with low-dose ICSs.
CONCLUSION
Overall, a high starting dose of ICSs had no additional clinical benefit in 3 of the 4 efficacy parameters compared with low or moderate ICS doses for controlling moderate to severe asthma but might have potential safety concerns.
Topics: Administration, Inhalation; Adrenal Cortex Hormones; Anti-Asthmatic Agents; Asthma; Drug Therapy, Combination; Drug-Related Side Effects and Adverse Reactions; Humans; Treatment Outcome
PubMed: 32302768
DOI: 10.1016/j.anai.2020.04.006 -
Iranian Journal of Nursing and... 2023Medication Error (ME) is a major patient safety concern in Intensive Care Units (ICUs). Critical care nurses play a crucial role in the safe administration of... (Review)
Review
BACKGROUND
Medication Error (ME) is a major patient safety concern in Intensive Care Units (ICUs). Critical care nurses play a crucial role in the safe administration of medication. This study was conducted to comprehensively review the literature concerning the prevalence of ME and associated factors and outcomes in Iranian ICU nurses.
MATERIALS AND METHODS
An extensive search of the literature was carried in international databases including PubMed, Web of Science, Scopus, and Google Scholar, as well as Persian databases such as Magiran and Scientific Information Database (SID) using ME-related keywords and the Persian equivalent of these keywords, from the first article written in this field to artcles published on March 30, 2021. The appraisal tool (AXIS tool) was used to assess the quality of the included studies.
RESULTS
Fifteen studies were included in this systematic review. The prevalence of MEs made by ICU nurses was 53.34%. The most common types of MEs were wrong infusion rate (14.12%), unauthorized medication (11.76%), and wrong time (8.49%) errors, respectively. MEs occurred more frequently in morning work shifts (44.44%). MEs happened more frequently for heparin, vancomycin, ranitidine, and amikacin. The most important influential factor in the occurrence of MEs in ICUs was management and human factors.
CONCLUSIONS
The prevalence of MEs made by Iranian ICU nurses is high. Therefore, nurse managers and policymakers should develop appropriate strategies, including training programs, to reduce the occurrence of MEs made by nurses in ICUs.
PubMed: 37332377
DOI: 10.4103/ijnmr.ijnmr_310_21 -
Annals of Palliative Medicine Jun 2021The risk of cardiovascular and cerebrovascular events is the highest during the first several hours post-awakening in patients with hypertension. This is largely due to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The risk of cardiovascular and cerebrovascular events is the highest during the first several hours post-awakening in patients with hypertension. This is largely due to surges in morning blood pressure (BP). The current meta-analysis explored whether morning BP is affected by the timing of antihypertensive drug administration.
METHODS
Four medical databases were searched for clinical trials that examined the relationship between the timing of antihypertensive drug administration and morning BP levels. This meta-analysis compared morning BP surges in patients administered medication at bedtime versus patients administered medication during the day.
RESULTS
The random effects model demonstrated that bedtime administration of antihypertensive drugs reduced morning systolic blood pressure (SBP) by 1.17 mmHg [with 95% confidence interval (CI): -2.47 to 0.37; P=0.08), and reduced morning diastolic blood pressure (DBP) by 0.95 mmHg (95% CI: -2.03 to 0.13; P=0.08), compared with patients who were administered medication during the daytime hours. However, the results did not demonstrate statistical significance. There was strong heterogeneity in both morning SBP (I2 =77.9% >50%, and Q test >0.1) and morning DBP results (I2 =77.9% >50%, and Q test >0.1). The funnel plots showed no publication bias in this study.
DISCUSSION
Studies have shown that a 1 mmHg change was sufficient to reduce the risk of cardiovascular-related deaths by 2.1%. Therefore, changing the time of taking antihypertensive medications may significantly reduce cardiovascular-associated mortality. There were certain limitations to this meta-analysis. First, the heterogeneity of the meta-analysis was strong, with undefined reasons. Second, the sample size was relatively small, and future studies involving larger cohorts are warranted to further assess the effects of bedtime antihypertensive medication on minimizing morning BP surges.
Topics: Antihypertensive Agents; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Circadian Rhythm; Humans; Hypertension
PubMed: 34237981
DOI: 10.21037/apm-21-1405 -
BMC Pediatrics Apr 2022Early morning sunlight exposure for infants is a good practice to prevent rickets and alleviate the problem of vitamin D deficiency. Rickets is a major public health... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Early morning sunlight exposure for infants is a good practice to prevent rickets and alleviate the problem of vitamin D deficiency. Rickets is a major public health problem in many countries especially in developing country including Ethiopia. As mothers are frontline person for their children who should know and practice about sunlight exposure, this systematic review and meta-analysis aimed to assess the pooled level of knowledge and practice towards sunlight exposure of their children among mothers in Ethiopia.
METHODS
PubMed, Google Scholar, Excerpta Medica database (EMBASE), Cochrane Library, Web of Science, and African Journal of Online (AJOL) were searched. The data were extracted using Microsoft Excel and analyzed using STATA version 14. Publication bias was checked by funnel plot and more objectively through Egger's regression test, with P < 0.05 considered to indicate potential publication bias. The heterogeneity of studies was checked using I statistics. Pooled analysis was conducted using a weighted inverse variance random-effects model. Subgroup analysis was done related to geographic region and time. A leave-one-out sensitivity analysis was also employed.
RESULT
A total of 8 studies with 2974 study participants for knowledge, nine studies with 3475 study participants for practice were used to estimate the pooled level of good knowledge and good practice of sunshine exposure among Ethiopian mothers. The overall estimated good level of knowledge and good practice towards sunshine exposure of their children among mothers was found to be 56.08% ((95% CI: 46.26 - 65.89%; I2 = 96.8%) and 55.632% (95%CI: 44.091 - 67.174%; I2 = 98.2%). Regional subgroup analysis showed that the pooled level of good practice in Amhara and Sidama regions found to be 54.41 and 58.32% respectively.
CONCLUSION
Study findings showed mothers knowledge and practice towards sunshine exposure of children was quite low in Ethiopia. This study therefore recommends that interventions are needed to increase knowledge and practice of sunlight exposure. This study provides much needed significant evidence for making health-policy recommendations for this vulnerable population group.
Topics: Child; Employment; Ethiopia; Female; Humans; Infant; Mothers; Prevalence; Rickets
PubMed: 35436897
DOI: 10.1186/s12887-022-03281-7 -
Evidence-based Complementary and... 2022Zhengqing Fengtongning release tablet (ZQFTN) is a proprietary Chinese medicine preparation of sinomenine, the main active component of the traditional Chinese medicine... (Review)
Review
BACKGROUND
Zhengqing Fengtongning release tablet (ZQFTN) is a proprietary Chinese medicine preparation of sinomenine, the main active component of the traditional Chinese medicine (TCM) . It is used in China as a complementary and alternative medicine (CAM) for knee osteoarthritis (KOA). The objective of this study was to evaluate the clinical efficacy and safety of ZQFTN in KOA treatment.
METHOD
Randomized controlled trials of ZQFTN in KOA treatment were searched in PubMed, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database, and Wanfang database. Two reviewers independently conducted the screening, extracted the data, and assessed the methodological quality. Statistical analysis was performed using RevMan 5.3 software.
RESULTS
Eighteen studies were assessed that included 1512 participants (757 in the treatment group and 755 in the control group). The results showed that compared with the control group, the Visual Analogue Scale (standardized mean difference (SMD) = -0.87, 95% confidence interval (CI): [-1.08, -0.66], < 0.001), Western Ontario and Mc Master University (WOMAC) Osteoarthritis Index pain score (SMD = -0.67, 95% CI: [-0.88, -0.46], < 0.001), WOMAC stiffness score (SMD = -0.53, 95% CI: [-0.86, -0.20], =0.001), WOMAC function score (SMD = -0.76, 95% CI: [-0.97, -0.55], < 0.001), serum interleukin-1 level (SMD = -4.36, 95% CI: [-6.41, -2.31], < 0.001), and serum tumor necrosis factor- level (SMD = -8.45, 95% CI: [-11.20, -5.69], < 0.001) of the ZQFTN treatment group were lower, and the total effective rate was higher relative risk ( = 1.15, 95% CI [1.07, 1.23], < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups ( = 0.96, 95% CI: [0.69, 1.35], =0.82).
CONCLUSION
ZQFTN can effectively relieve knee pain, morning stiffness, and daily activity function disorders, reduce the expression of inflammatory factors in serum, and improve the total clinical response rate without increasing the incidence of adverse reactions. Therefore, ZQFTN has considerable potential as a CAM for KOA. However, due to the limitation of the quality of the included studies, the strength of this conclusion is affected. In the next step, multicenter, large sample, high-quality randomized controlled studies are needed to further confirm the present conclusion.
PubMed: 35096105
DOI: 10.1155/2022/2768444 -
Frontiers in Endocrinology 2020Obstructive sleep apnea syndrome (OSAS) may be associated with an increase in hypothalamic-pituitary-adrenocortical axis activity (HPA AA). We reviewed research... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Obstructive sleep apnea syndrome (OSAS) may be associated with an increase in hypothalamic-pituitary-adrenocortical axis activity (HPA AA). We reviewed research comparing morning salivary and blood (serum and plasma) cortisol concentrations of individuals with OSAS to those of healthy controls.
METHODS
We made a systematic search without any restrictions of the PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases for relevant articles published up to August 25, 2019.
RESULTS
Sixteen studies were analyzed in this meta-analysis; five studies compared morning salivary concentrations, five compared serum concentrations, four compared plasma cortisol concentrations, and two compared both salivary and plasma concentrations. In pediatric samples, compared to healthy controls, those with OSAS had significantly lower saliva morning cortisol concentrations (MD = -0.13 µg/dl; 95% CI: 0.21, -0.04; = 0.003). In contrast, no significant differences were observed for serum cortisol concentrations, plasma cortisol concentrations, or salivary morning cortisol concentrations between adults with and without OSAS ( = 0.61, = 0.17, = 0.17).
CONCLUSION
Cortisol concentrations did not differ between adults with OSAS and healthy controls. In contrast, morning salivary cortisol concentrations were lower in children with OSAS, compared to healthy controls. Given that a reduced HPA AA is observed among individuals with chronic stress, it is conceivable that children with OSAS are experiencing chronic psychophysiological stress.
Topics: Biomarkers; Circadian Rhythm; Humans; Hydrocortisone; Saliva; Sleep Apnea, Obstructive
PubMed: 33542703
DOI: 10.3389/fendo.2020.568823 -
Timing of physical activity within the 24-hour day and its influence on health: a systematic review.Health Promotion and Chronic Disease... Apr 2022Recent studies report that the health benefits of physical activity differ depending on whether the activity is performed in the morning, afternoon or evening. The...
BACKGROUND
Recent studies report that the health benefits of physical activity differ depending on whether the activity is performed in the morning, afternoon or evening. The purpose of this systematic review was to examine whether the timing of physical activity within the 24-hour day is associated with health.
METHODS
Five databases were searched for English or French language peer-reviewed studies that examined whether the timing of physical activity within the day is associated with health. No limits were placed on publication year, study population, study design or health outcomes. Studies that examined acute effects of physical activity or timing of physical activity around food intake were excluded.
RESULTS
This systematic review examined 35 studies, with 17 259 participants, and the following health outcomes: measures of sleep health, adiposity, fat-free mass and muscle size, cardiometabolic biomarkers, physical function and mobility, mental health, and risk of cardiovascular disease, cancer, and mortality. Heterogeneity across studies precluded meta-analyses, and we present our findings using narrative syntheses. Of the 35 studies, 11 reported that morning physical activity provides greater health benefits than afternoon/ evening physical activity, while 12 found that morning physical activity provides fewer health benefits than afternoon/evening physical. In the remaining 12 studies, there was no clear difference in health benefits based on the timing of physical activity. The quality of evidence for the different health outcomes across study designs was very low.
CONCLUSION
There is no consistent evidence that physical activity at one time of day provides more favourable health benefits than physical activity at a different time of day. (PROSPERO registration no.: CRD42021231088).
Topics: Adiposity; Cardiovascular Diseases; Exercise; Humans; Obesity; Sleep
PubMed: 35481335
DOI: 10.24095/hpcdp.42.4.02 -
Advances in Nutrition (Bethesda, Md.) Mar 2023Workers employed in rotating shift schedules are at a higher metabolic risk compared with those in regular day and fixed shift schedules; however, the contribution of... (Meta-Analysis)
Meta-Analysis Review
Workers employed in rotating shift schedules are at a higher metabolic risk compared with those in regular day and fixed shift schedules; however, the contribution of diet is unclear. This systematic review aimed to investigate how rotating shift work schedules affect dietary energy intake and dietary patterns compared with regular day and fixed shift schedules. In addition, intraperson energy intake and dietary pattern comparisons within rotating shift schedules were investigated. Database searches were conducted on MEDLINE, Cochrane, CINAHL, PSYCinfo, EMBASE, and Scopus, in addition to manual search of bibliographic references, to identify articles. Two separate meta-analyses compared dietary intake between day work and rotating shift work schedules and within the rotational shift work group (morning/day and night shifts). Differences in dietary patterns were synthesized narratively. Thirty-one studies (n = 18,196 participants) were included in the review, and meta-analyses were conducted with 24-hour mean energy intake data from 18 (n = 16,633 participants) and 7 (n = 327 participants) studies, respectively. The average 24-hour energy intake of rotating shift workers was significantly higher than that of workers in regular daytime schedules [weighted mean difference (WMD): 264 kJ; 95% confidence interval (CI): 70, 458 kJ; P < 0.008; I = 63%]. However, the mean difference in 24-hour energy intake between morning/day shifts compared with night shifts within rotational shift schedules was not statistically significant (WMD: 101 kJ; 95% CI: -651, 852 kJ; P = 0.79; I = 77%). Dietary patterns of rotating shift workers were different from those of day workers, showing irregular and more frequent meals, increased snacking/eating at night, consumption of fewer core foods, and more discretionary foods. This review highlights that dietary intake in rotational shift workers is potentially higher in calories and features different eating patterns as a consequence of rotating shift work schedules. This review was registered at PROSPERO as ID 182507.
Topics: Humans; Shift Work Schedule; Circadian Rhythm; Diet; Energy Intake; Feeding Behavior; Sleep
PubMed: 36805319
DOI: 10.1016/j.advnut.2023.01.006