-
The Cochrane Database of Systematic... Jan 2009Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth in the number of persons over the age of 65 years as the baby boomer... (Review)
Review
BACKGROUND
Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth in the number of persons over the age of 65 years as the baby boomer generation passes retirement age. As older adults make up an increasing proportion of the population, they are an important consideration when designing future evidence-based traffic safety policies, particularly those that lead to restrictions or cessation of driving. Research has shown that cessation of driving among older drivers can lead to negative emotional consequences such as loss of independence and depression. Those older adults who continue to drive tend to do so less frequently than other demographic groups and are more likely to be involved in a road traffic crash, probably due to what is termed the 'low mileage bias'. There is universal agreement among researchers that vision plays a significant role in driving performance, and that there are age-related visual changes. Vision testing of all drivers, and in particular of older drivers, is therefore an important road safety issue. The components of visual function essential for driving are acuity, field, depth perception and contrast sensitivity, which are currently not fully measured by licensing agencies. Furthermore, it is not known how effective vision screening tools are, and current vision screening regulations and cut-off values required to pass a licensing test vary from country to country. There is, therefore, a need to develop evidence-based tools for vision screening for driving, thereby increasing road safety.
OBJECTIVES
To assess the effects of vision screening interventions for older drivers to prevent road traffic injuries and fatalities.
SEARCH STRATEGY
We searched the Cochrane Injuries Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, issue 3), MEDLINE, EMBASE, TRANSPORT, AgeInfo, AgeLine, the National Research Register, the Science (and Social Science) Citation Index, IBSS (International Bibliography of Social Sciences), PsycINFO, and Zetoc. We also searched the Internet and checked the reference lists of relevant papers to identify any further studies. The searches were conducted up to September 2006.
SELECTION CRITERIA
Randomized controlled trials (RCTs) and controlled before and after studies comparing vision screening to non-screening of drivers aged 55 years and older, and which assessed the effect on road traffic crashes, injuries, fatalities and any involvement in traffic law violations, were included.
DATA COLLECTION AND ANALYSIS
Two authors independently screened the reference lists for eligible articles and independently assessed the articles for inclusion against the criteria. Two authors independently extracted data using a standardized extraction form.
MAIN RESULTS
No studies were found which met the inclusion criteria for this review.
AUTHORS' CONCLUSIONS
Most countries require a vision screening test for the renewal of an individual's driver's license. There is, however, insufficient evidence to assess the effect of vision screening tests on subsequent motor vehicle crash reduction. There is a need to develop valid and reliable tools of vision screening that can predict driving performance.
Topics: Accidents, Traffic; Aged; Automobile Driving; Humans; Vision Screening
PubMed: 19160271
DOI: 10.1002/14651858.CD006252.pub2 -
World Journal of Clinical Pediatrics Mar 2024Infants' nutrition significantly influences their growth, development, and overall well-being. With the increasing demand for organic infant formula driven by the...
BACKGROUND
Infants' nutrition significantly influences their growth, development, and overall well-being. With the increasing demand for organic infant formula driven by the perception of health benefits and growing awareness of natural feeding options, it is crucial to conduct a comparative analysis of the gastrointestinal tolerability between organic and traditional infant formulas.
AIM
To provide a concise and precise analysis of the gastrointestinal tolerability of organic infant formula compared to traditional infant formula. Due to limited direct comparisons, the review synthesizes available literature on each formula type, presenting insights into their potential effects on infants' digestive health.
METHODS
An extensive literature search was conducted, compiling studies on organic and traditional infant formulas, their compositions, and reported effects on gastrointestinal tolerability. We searched academic databases such as PubMed and Google Scholar and specialized nutrition, paediatrics, and infant health journals using relevant keywords till October 1, 2023. .
RESULTS
Although specific comparative studies are scarce and formula heterogeneity is a significant limitation, this systematic review provides an in-depth understanding of organic infant formulas' composition and potential benefits. While scientific evidence directly comparing gastrointestinal tolerability is limited, organic formulas strive to use carefully selected organic ingredients to imitate breast milk composition. Potential benefits include improved lipid profiles, higher methionine content, and decreased antibiotic-resistant bacteria levels. Understanding the gastrointestinal tolerability of organic and traditional infant formulas is crucial for parents and healthcare providers to make informed decisions.
CONCLUSION
Despite limitations in direct comparisons, this systematic review provides insights into the composition and potential benefits of organic infant formulas. It emphasizes the need for further research to elucidate their gastrointestinal effects comprehensively.
PubMed: 38596433
DOI: 10.5409/wjcp.v13.i1.88783 -
BMJ Open Respiratory Research May 2024People with chronic obstructive pulmonary disease (COPD) are more likely to adopt a sedentary lifestyle. Increased sedentary behaviour is associated with adverse health...
BACKGROUND
People with chronic obstructive pulmonary disease (COPD) are more likely to adopt a sedentary lifestyle. Increased sedentary behaviour is associated with adverse health consequences and reduced life expectancy.
AIM
This mixed-methods systematic review aimed to report the factors contributing to sedentary behaviour in people with COPD.
METHODS
A systematic search of electronic databases (Medline, CINAHL, PsycINFO and Cochrane Library) was conducted and supported by a clinician librarian in March 2023. Papers were identified and screened by two independent researchers against the inclusion and exclusion criteria, followed by data extraction and analysis of quality. Quantitative and qualitative data synthesis was performed.
RESULTS
1037 records were identified, 29 studies were included (26 quantitative and 3 qualitative studies) and most studies were conducted in high-income countries. The most common influencers of sedentary behaviour were associated with disease severity, dyspnoea, comorbidities, exercise capacity, use of supplemental oxygen and walking aids, and environmental factors. In-depth findings from qualitative studies included a lack of knowledge, self-perception and motivation. However, sedentarism in some was also a conscious approach, enabling enjoyment when participating in hobbies or activities.
CONCLUSIONS
Influencers of sedentary behaviour in people living with COPD are multifactorial. Identifying and understanding these factors should inform the design of future interventions and guidelines. A tailored, multimodal approach could have the potential to address sedentary behaviour.
PROSPERO REGISTRATION NUMBER
CRD42023387335.
Topics: Humans; Sedentary Behavior; Pulmonary Disease, Chronic Obstructive; Exercise Tolerance; Exercise
PubMed: 38789283
DOI: 10.1136/bmjresp-2023-002261 -
Journal of the American Academy of... 2005A systematic review of the literature addressed the question "Is there evidence of a good correlation between unaided prefitting speech measures and aided satisfaction... (Review)
Review
A systematic review of the literature addressed the question "Is there evidence of a good correlation between unaided prefitting speech measures and aided satisfaction on self-report measures?" This restricted question is only one of several possible questions related to speech measures and hearing aid fittings. The levels of evidence that were accepted included meta-analyses, randomized controlled trials, and nonrandomized intervention studies. Nearly 300 articles and book chapters were identified during the initial search; 220 were eliminated on the basis of their abstracts; and 80 papers and book chapters were reviewed in depth. Five studies met the criteria set forth in this review. No significant correlation between traditional unaided prefitting speech measures and aided satisfaction was found in any of the five studies. One of the studies showed a correlation between the results of a prefitting speech-in-noise test and self-reported aided satisfaction.
Topics: Hearing Aids; Hearing Loss; Humans; Patient Satisfaction; Prosthesis Fitting; Reproducibility of Results; Speech Perception
PubMed: 16295231
DOI: 10.3766/jaaa.16.7.4 -
Frontiers in Physiology 2021Cardiovascular diseases (CVDs) are one of the most fatal disease groups worldwide. Electrocardiogram (ECG) is a widely used tool for automatically detecting cardiac...
Cardiovascular diseases (CVDs) are one of the most fatal disease groups worldwide. Electrocardiogram (ECG) is a widely used tool for automatically detecting cardiac abnormalities, thereby helping to control and manage CVDs. To encourage more multidisciplinary researches, PhysioNet/Computing in Cardiology Challenge 2020 (Challenge 2020) provided a public platform involving multi-center databases and automatic evaluations for ECG classification tasks. As a result, 41 teams successfully submitted their solutions and were qualified for rankings. Although Challenge 2020 was a success, there has been no in-depth methodological meta-analysis of these solutions, making it difficult for researchers to benefit from the solutions and results. In this study, we aim to systematically review the 41 solutions in terms of data processing, feature engineering, model architecture, and training strategy. For each perspective, we visualize and statistically analyze the effectiveness of the common techniques, and discuss the methodological advantages and disadvantages. Finally, we summarize five practical lessons based on the aforementioned analysis: (1) Data augmentation should be employed and adapted to specific scenarios; (2) Combining different features can improve performance; (3) A hybrid design of different types of deep neural networks (DNNs) is better than using a single type; (4) The use of end-to-end architectures should depend on the task being solved; (5) Multiple models are better than one. We expect that our meta-analysis will help accelerate the research related to ECG classification based on machine-learning models.
PubMed: 35095568
DOI: 10.3389/fphys.2021.811661 -
Orvosi Hetilap Mar 2021Összefoglaló. Gyulladásos bélbetegségben (IBD) a fájdalomérzés komplex szomatikus és pszichés jelenség. Ez utóbbi komponens pontosabb megértése segíthet a...
Összefoglaló. Gyulladásos bélbetegségben (IBD) a fájdalomérzés komplex szomatikus és pszichés jelenség. Ez utóbbi komponens pontosabb megértése segíthet a megfelelő kezelési stratégia megállapításában. A szorongásos hangulati zavarok és egyes maladaptív viselkedési minták (dohányzás és alkoholfogyasztás) előfordulási gyakorisága jól dokumentált IBD-ben, a kannabiszhasználat hatása ugyanakkor kevésbé ismert. A szerzők szisztematikus áttekintést végeztek annak megértéséhez, hogy vajon magasabb-e a marihuánahasználat gyakorisága felnőtt IBD-s betegek között egészséges kontrollpopulációhoz viszonyítva, és ha igen, akkor melyek a szerhasználat legfontosabb jellemzői. A kutatási periódust szándékosan az elmúlt 7 évre korlátoztuk, ugyanis 2013-tól jelentős változások álltak be a kannabinoidok jogi és orvosi megítélésében az USA-ban. Öt elsődleges és több másodlagos adatbázisban kutattunk előre meghatározott kulcsszavak segítségével 2013 óta teljes szöveggel megjelent, angol nyelvű felnőtt IBD-s populációt vizsgáló epidemiológiai tanulmányok vonatkozásában. 143 rekord közül 7 cikk felelt meg a beválogatási kritériumoknak. Eredményeink szerint a kannabiszhasználat gyakorisága IBD-ben szenvedő felnőtt betegek körében valószínűleg magasabb, mint a kontrollpopulációban: a "valaha, bármikor" használók aránya 54-70% között változott (szemben a 46-60% gyakorisággal a kontrollcsoportban), míg az "aktív használók" esetén a gyakoriság 6,8-25% között változott (vs. a kontrollcsoportban tapasztalt 8,6-14%-kal). A prevalenciaadatok széles variabilitása arra utal, hogy a beválogatott epidemiológiai tanulmányok valószínűleg vagy nem voltak megfelelően tervezve, vagy jelentős heterogenitással bírtak. A pszichés tényezők ellentmondásos mintája azt sugallja, hogy a kannabinoidok egyes esetekben ronthatták, más esetben valószínűleg javították bizonyos prominens tünetek megélését. Javasoljuk ezért, hogy a valós prevalencia megállapítása érdekében a keresztmetszeti vizsgálatok mellé ismételt pszichometriai vizsgálatokon alapuló vizsgálatok is bekerüljenek a további kutatásba. Orv Hetil. 2021; 162(12): 443-448. Summary. Pain perception in inflammatory bowel disease (IBD) is beyond a purely somatic process. In-depth understanding of psychologic elements might enable more effective management in this patient group. Anxiety disorders and certain maladaptive coping strategies like smoking and alcohol consumption are well-documented in IBD, unlike the scarcely researched cannabis use. The authors designed a systematic review, to investigate if the prevalence of cannabis use is higher in IBD that in unselected controls. The research window was intentionally set to cover for the past 7 years, as in 2013 major legislative changes took place in the cannabis decriminalisation process in the United States. 5 primary and several secondary databases were researched with a pre-formulated algorithm registered at PROSPERO for full text epidemiological studies published in English language involving adult IBD patients. Out of 143 records, 7 articles met the in/exclusion criteria. Our results suggest that cannabis use among adult patients with IBD is likely to be higher than in the unselected control population. The proportion of "ever" users varied from 54% to 70% (vs. 46-60% in the control group); and for 'active users', the prevalence ranged between 6.8% to 25% (vs. 8.6-14% in the control group). The wide variability in prevalence data suggests that the selected epidemiological studies were either inappropriately designed or were too heterogeneous (or both). The contradictory pattern of psychological factors suggests that cannabinoids might improve or worsen IBD depending on case by case basis. We therefore opine that in addition to cross-sectional papers, studies based on repeated psychometric analysis are needed to establish the real prevalence and inform cannabinoid prescription and holistic management in inflammatory bowel disease. Orv Hetil. 2021; 162(12): 443-448.
Topics: Humans; Inflammatory Bowel Diseases; Marijuana Use
PubMed: 33764022
DOI: 10.1556/650.2021.32021 -
Current Gerontology and Geriatrics... 2012Background. Recurrent falls are common among the aged. Vision is needed in maintaining balance, and impaired vision may be an intrinsic risk factor of recurrent falls....
Background. Recurrent falls are common among the aged. Vision is needed in maintaining balance, and impaired vision may be an intrinsic risk factor of recurrent falls. The aim was to perform a systematic review about the relationships between eye diseases or impaired vision and the risk of recurrent falls in the aged. Material and Methods. MEDLINE and CINAHL databases were searched in order to find longitudinal epidemiological studies about the associations between eye diseases or impaired vision and the risk of recurrent falls. Altogether 19 studies were found. A qualitative systematic analysis of these studies was performed. Results and Conclusions. The evidence about poor depth perception/stereoacuity and poor low-contrast visual acuity as risk factors of recurrent falls is quite convincing. Discrepant vision, a decrease in visual acuity, and loss of visual field may be risk factors, but more studies are needed. The results concerning the relationships between poor visual acuity and poor contrast sensitivity and the risk of recurrent falls are controversial. More studies about the relationships between different measures of vision and the risk of recurrent falls are needed before final conclusions about poor vision as a risk factor for recurrent falling can be done.
PubMed: 22927843
DOI: 10.1155/2012/271481 -
British Journal of Anaesthesia Aug 2019Pain is recognised to have both a sensory dimension (intensity) and an affective dimension (unpleasantness). Pain feels like a single unpleasant bodily experience, but...
BACKGROUND
Pain is recognised to have both a sensory dimension (intensity) and an affective dimension (unpleasantness). Pain feels like a single unpleasant bodily experience, but investigations of human pain have long considered these two dimensions of pain to be separable and differentially modifiable. The evidence underpinning this separability and differential modifiability is seldom presented. We aimed to fill this gap by evaluating the current evidence base for whether or not the sensory and affective dimensions of pain can be selectively modulated using cognitive manipulations.
METHODS
A rigorous systematic search, based on a priori search terms and consultation with field experts, yielded 4270 articles. A detailed screening process was based on the following recommendations: (i) evaluation of effectiveness; (ii) examination of methodological rigour, including each study having an a priori intention to cognitively modulate one of the two dimensions of pain; and (iii) sound theoretical reasoning. These were used to ensure that included studies definitively answered the research question.
RESULTS
After in-depth critique of all 12 articles that met the inclusion criteria, we found that there is no compelling evidence that the sensory and affective dimensions of pain can be selectively and intentionally modulated using cognitive manipulations in humans.
CONCLUSIONS
We offer potential explanations for this discrepancy between assumptions and evidence and contend that this finding highlights several important questions for the field, from both the research and clinical perspectives.
Topics: Affect; Humans; Mind-Body Therapies; Pain; Pain Measurement; Pain Perception
PubMed: 31053232
DOI: 10.1016/j.bja.2019.03.033 -
Aging & Mental Health May 2021Perceptions of dementia are important determinants of support, treatment and care received in the dementia community. Understanding these perceptions are vital for...
Perceptions of dementia are important determinants of support, treatment and care received in the dementia community. Understanding these perceptions are vital for regions such as Latin America, where there is a rapid increase in people living with dementia. The aim of this study is to review and synthesise the general public's perceptions of dementia in Latin America, what factors are associated with these perceptions, and how they differ between countries in the region. Searches were completed across five databases (Medline, SCOPUS, PsychINFO, SciELO, and WoS). Studies were required to capture attitudes or knowledge of dementia in the general public residing within Latin America. English, Spanish and Portuguese search terms were used. Results were synthesised narratively. About 1574 unique records were identified. Following lateral searches, de-duplication and screening, six articles (four studies) met the inclusion criteria for this review. All the studies were quantitative research from Brazil (median, = 722). There was evidence of a limited to moderate knowledge of dementia, though a significant minority had negative or stigmatising attitudes. Only higher levels of education were consistently associated with better attitudes and knowledge of dementia in the region. There is a need for more in-depth research about attitudes of the general public across Latin America, particularly outside of São Paulo state, Brazil. There appears to be a greater need to raise awareness of dementia amongst less educated Latin American groups.
Topics: Brazil; Dementia; Educational Status; Humans; Latin America; Perception
PubMed: 32048522
DOI: 10.1080/13607863.2020.1725738 -
Surgical Endoscopy Jun 2018Three-dimensional view in laparoscopic general, gynaecologic and urologic surgery is an efficient, safe and sustainable innovation. The present paper is an extract taken...
Why laparoscopists may opt for three-dimensional view: a summary of the full HTA report on 3D versus 2D laparoscopy by S.I.C.E. (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie).
BACKGROUND
Three-dimensional view in laparoscopic general, gynaecologic and urologic surgery is an efficient, safe and sustainable innovation. The present paper is an extract taken from a full health technology assessment report on three-dimensional vision technology compared with standard two-dimensional laparoscopic systems.
METHODS
A health technology assessment approach was implemented in order to investigate all the economic, social, ethical and organisational implications related to the adoption of the innovative three-dimensional view. With the support of a multi-disciplinary team, composed of eight experts working in Italian hospitals and Universities, qualitative and quantitative data were collected, by means of literature evidence, validated questionnaire and self-reported interviews, applying a final MCDA quantitative approach, and considering the dimensions resulting from the EUnetHTA Core Model.
RESULTS
From systematic search of literature, we retrieved the following studies: 9 on general surgery, 35 on gynaecology and urology, both concerning clinical setting. Considering simulated setting we included: 8 studies regarding pitfalls and drawbacks, 44 on teaching, 12 on surgeons' confidence and comfort and 34 on surgeons' performances. Three-dimensional laparoscopy was shown to have advantages for both the patients and the surgeons, and is confirmed to be a safe, efficacious and sustainable vision technology.
CONCLUSIONS
The objective of the present paper, under the patronage of Italian Society of Endoscopic Surgery, was achieved in that there has now been produced a scientific report, based on a HTA approach, that may be placed in the hands of surgeons and used to support the decision-making process of the health providers.
Topics: Costs and Cost Analysis; Depth Perception; Humans; Imaging, Three-Dimensional; Italy; Laparoscopy; Operative Time; Patient Safety; Postoperative Complications; Psychomotor Performance; Technology Assessment, Biomedical
PubMed: 29368286
DOI: 10.1007/s00464-017-6006-y