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Frontiers in Physiology 2023Swimming is a time-based sport and hence strongly dependent from velocity. Most studies about swimming refer to velocity as discrete variable, i.e., 0-D (no time...
Swimming is a time-based sport and hence strongly dependent from velocity. Most studies about swimming refer to velocity as discrete variable, i.e., 0-D (no time dimension). However, it was argued that using swimming velocity as a continuous variable (1-D, with time dimension) with Statistical Parametric Mapping (SPM) can bring deeper and detailed insights about swimming performance. Therefore, the aim of this study was to perform a systematic review about the current body of knowledge of using Statistical Parametric Mapping in a swimming context. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify relevant articles. After screening, nine articles related to Statistical Parametric Mapping (SPM) analysis in swimming were retained for synthesis. Results showed that four articles (44.4%) aimed to understand the kinematics, isokinetic joint torque or electromyographic (EMG) pattern of the swimmer's shoulder either on land or during front crawl trials. Two articles (22.2%) focused on understanding the swimming velocity while performing the breaststroke stroke. One article (11.1%) analyzed the swimmers' propulsion at front-crawl stroke, another one (11.1%) compared swimming velocity during a complete stroke cycle in young swimmers of both sexes as a discrete variable and as a continuous variable. Also, one article (11.1%) analyzed the underwater undulatory velocity. In an EMG context, some findings verified in SPM are not possible to be discovered with traditional 0-D statistical methods. Studies about swimming velocity (breaststroke, freestyle, and underwater undulatory velocity) and propulsion (front-crawl) also highlighted the SPM advantages in comparison to traditional statistical methods. By using SPM, researchers were able to verify specifically where within the stroke cycle significant differences were found. Therefore, coaches can get more detailed information to design specific training drills to overcome hypothetical handicaps.
PubMed: 37457037
DOI: 10.3389/fphys.2023.1213151 -
Journal of Global Health Dec 2020Rapid increase in life expectancy in low- and middle-income countries including the World Health Organization's Southeast Asia Region (SEAR) has resulted in an increase...
BACKGROUND
Rapid increase in life expectancy in low- and middle-income countries including the World Health Organization's Southeast Asia Region (SEAR) has resulted in an increase in the global burden of dementia, which is expected to become a leading cause of morbidity. Accurate burden estimates are key for informing policy and planning. Given the paucity of data, estimates were developed using both a Bayesian methodology and as well as a traditional frequentist approach to gain better insights into methodological approaches for disease burden estimates.
METHODS
Seven databases were searched for studies published between 2010-2018 regarding dementia prevalence in SEAR, generating 8 relevant articles. A random-effects model (REM) and a Bayesian normal-normal hierarchical model (NNHM) were used to obtain the pooled prevalence estimate of dementia for people aged 60 and above in SEAR. The latter model was also developed to estimate age-specific dementia prevalence. Using UN population estimates for SEAR, total and age-specific projections of the burden of dementia in 2015, 2020 and 2030 were calculated.
RESULTS
The prevalence of dementia in SEAR was found to be 3% (95% confidence interval (CI) = 2-6%) in those above age 60 based on REM, and 3.1% (95% credible interval = 1.5-5.0%) based on the NNHM. The estimated prevalence varies with age, increasing from 1.6% (95% credible interval = 0.8-2.5%) in people aged 60-69 to 12.4% (95% credible interval = 5.6-20%) in people above the age of 80. The risk of developing dementia increased exponentially with age. The number of people living with dementia in SEAR in 2015 was estimated at 5.51 million (95% credible interval = 2.66-8.82), with projections of 6.66 million (95% credible interval = 3.21-10.7) in 2020 and 9.6 million (95% credible interval = 4.62-15.36) in 2030.
CONCLUSION
The burden of dementia in SEAR is substantial and will continue to increase rapidly by 2030. The lack of research focusing on dementia in SEAR points to a significant under-recognition of this disease. The projected rise in dementia cases in the future should prompt urgent governmental response to address this growing public health issue. We also argue that given the overall paucity of data for the region, the Bayesian approach offers a promising methodology for improved estimates of disease prevalence and burden and should continue to be explored.
Topics: Aged; Aged, 80 and over; Asia, Southeastern; Bayes Theorem; Cost of Illness; Cross-Sectional Studies; Dementia; Humans; Middle Aged; Prevalence; World Health Organization
PubMed: 33282225
DOI: 10.7189/jogh.10.020701 -
PLOS Global Public Health 2024Antimicrobial resistance is a global public health crisis. Effective antimicrobial stewardship requires an understanding of the factors and context that contribute to...
Antimicrobial resistance is a global public health crisis. Effective antimicrobial stewardship requires an understanding of the factors and context that contribute to inappropriate use of antimicrobials. The goal of this qualitative systematic review was to synthesize themes across levels of the social ecological framework that drive inappropriate use of antimicrobials in South Asia. In September 2023, we conducted a systematic search using the electronic databases PubMed and Embase. Search terms, identified a priori, were related to research methods, topic, and geographic location. We identified 165 articles from the initial search and 8 upon reference review (n = 173); after removing duplicates and preprints (n = 12) and excluding those that did not meet eligibility criteria (n = 115), 46 articles were included in the review. We assessed methodological quality using the qualitative Critical Appraisal Skills Program checklist. The studies represented 6 countries in South Asia, and included data from patients, health care providers, community members, and policy makers. For each manuscript, we wrote a summary memo to extract the factors that impede antimicrobial stewardship. We coded memos using NVivo software; codes were organized by levels of the social ecological framework. Barriers were identified at multiple levels including the patient (self-treatment with antimicrobials; perceived value of antimicrobials), the provider (antimicrobials as a universal therapy; gaps in knowledge and skills; financial or reputational incentives), the clinical setting (lack of resources; poor regulation of the facility), the community (access to formal health care; informal drug vendors; social norms), and policy (absence of a regulatory framework; poor implementation of existing policies). This study is the first to succinctly identify a range of norms, behaviors, and policy contexts driving inappropriate use of antimicrobials in South Asia, emphasizing the importance of working across multiple sectors to design and implement approaches specific to the region.
PubMed: 38573955
DOI: 10.1371/journal.pgph.0002507 -
BMC Geriatrics Aug 2019Interventions that enable people to remain in their own home as they age are of interest to stakeholders, yet detailed information on effective interventions is scarce....
BACKGROUND
Interventions that enable people to remain in their own home as they age are of interest to stakeholders, yet detailed information on effective interventions is scarce. Our objective was to systematically search and synthesise evidence for the effectiveness of community-based, aged care interventions in delaying or avoiding admission to residential aged care.
METHOD
Nine databases were searched from January 2000 to February 2018 for English publications. Reference lists of relevant publications were searched. The databases yielded 55,221 citations and 50 citations were gleaned from other sources. Where there was sufficient homogeneity of study design, population, intervention and measures, meta-analyses were performed. Studies were grouped by the type of intervention: complex multifactorial interventions, minimal/single focus interventions, restorative programs, or by the target population (e.g. participants with dementia).
RESULTS
Data from 31 randomised controlled trials (32 articles) that met our inclusion criteria were extracted and analysed. Compared to controls, complex multifactorial interventions in community aged care significantly improved older adults' ability to remain living at home (risk difference - 0.02; 95% CI -0.03, - 0.00; p = 0.04). Commonalities in the 13 studies with complex interventions were the use of comprehensive assessment, regular reviews, case management, care planning, referrals to additional services, individualised interventions, frequent client contact if required, and liaison with General Practitioners. Complex interventions did not have a significantly different effect on mortality. Single focus interventions did not show a significant effect in reducing residential aged care admissions (risk difference 0, 95% CI -0.01, 0.01; p = 0.71), nor for mortality or quality of life. Subgroup analysis of complex interventions for people with dementia showed significant risk reduction for residential aged care admissions (RD -0.05; 95% CI -0.09, -0.01; p = 0.02). Compared to controls, only interventions targeting participants with dementia had a significant effect on improving quality of life (SMD 3.38, 95% CI 3.02, 3.74; p < 0.000001).
CONCLUSIONS
Where the goal is to avoid residential aged care admission for people with or without dementia, there is evidence for multifactorial, individualised community programs. The evidence suggests these interventions do not result in greater mortality and hence are safe. Minimal, single focus interventions will not achieve the targeted outcomes.
TRIAL REGISTRATION
PROSPERO Registration CRD42016050086 .
Topics: Aged; Aged, 80 and over; Case Management; Community Health Services; Dementia; Female; Health Services Needs and Demand; Homes for the Aged; Hospitalization; Humans; Independent Living; Male; Patient Admission; Quality of Life; Randomized Controlled Trials as Topic; Residential Facilities
PubMed: 31395018
DOI: 10.1186/s12877-019-1210-3