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Journal of Neurology, Neurosurgery, and... Mar 2018Being married is associated with healthier lifestyle behaviours and lower mortality and may reduce risk for dementia due to life-course factors. We conducted a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Being married is associated with healthier lifestyle behaviours and lower mortality and may reduce risk for dementia due to life-course factors. We conducted a systematic review and meta-analysis of studies of the association between marital status and the risk of developing dementia.
METHODS
We searched medical databases and contacted experts in the field for relevant studies reporting the relationship, adjusted for age and sex, between marital status and dementia. We rated methodological quality and conducted random-effects meta-analyses to summarise relative risks of being widowed, divorced or lifelong single, compared with being married. Secondary stratified analyses with meta-regression examined the impact of clinical and social context and study methodology on findings.
RESULTS
We included 15 studies with 812 047 participants. Compared with those who are married, lifelong single (relative risk=1.42 (95% CI 1.07 to 1.90)) and widowed (1.20 (1.02 to 1.41)) people have elevated risk of dementia. We did not find an association in divorced people.Further analyses showed that less education partially confounds the risk in widowhood and worse physical health the elevated risk in lifelong single people. Compared with studies that used clinical registers for ascertaining dementia diagnoses, those which clinically examined all participants found higher risk for being unmarried.
CONCLUSIONS
Being married is associated with reduced risk of dementia than widowed and lifelong single people, who are also underdiagnosed in routine clinical practice. Dementia prevention in unmarried people should focus on education and physical health and should consider the possible effect of social engagement as a modifiable risk factor.
Topics: Confounding Factors, Epidemiologic; Dementia; Divorce; Educational Status; Humans; Marital Status; Marriage; Observational Studies as Topic; Protective Factors; Risk Factors; Single Person; Widowhood
PubMed: 29183957
DOI: 10.1136/jnnp-2017-316274 -
Cancers Sep 2022To date, there are heterogeneous studies related to childhood cancer survivors' (CCS) employment rates. Given the importance of this topic, we aimed to perform a... (Review)
Review
To date, there are heterogeneous studies related to childhood cancer survivors' (CCS) employment rates. Given the importance of this topic, we aimed to perform a systematic review and meta-analysis to investigate the prevalence of employment among CCS and to examine its association with socio-demographic and clinical factors. We followed the PRISMA guidelines to search for pertinent articles in relevant electronic databases. Eighty-nine articles comprising 93 cohorts were included. The overall prevalence of employment was 66% (CI: 95% 0.63-0.69). Subgroup meta-analyses showed that lower rates were found for central nervous system tumor survivors (51%, CI: 95% 0.43-0.59), and for CCS treated with cranial-radiotherapy (53%, CI: 95% 0.42-0.64) or haematopoietic stem-cell transplantation (56%, CI: 95% 0.46-0.65). The studies conducted in Asia highlighted employment rates of 47% (CI: 95%, 0.34-0.60). Univariate meta-regressions identified the following socio-demographic factors associated with higher rates of employment: a female gender ( = 0.046), a higher mean age at the time of investigation ( = 0.00), a longer time since diagnosis ( = 0.00), a higher educational level ( = 0.03), and a married status ( = 0.00). In conclusion, this systematic review and meta-analysis provides evidence that two-thirds of CCS are employed worldwide. Identifying vulnerable groups of CCS may allow for the design of multidisciplinary support strategies and interventions to promote employment in this population.
PubMed: 36230516
DOI: 10.3390/cancers14194586 -
The Journal of Maternal-fetal &... Nov 2020Given the increasing rate of cesarean delivery and request without maternal or fetal indication among pregnant women, this systematic review was conducted to obtain the...
Given the increasing rate of cesarean delivery and request without maternal or fetal indication among pregnant women, this systematic review was conducted to obtain the reasons for maternal request for elective cesarean section. We searched published studies from the first year of records through August 2018 in PubMed, Scopus, and Web of Science. The quality assessment of the studies was performed by the improved Newcastle-Ottawa Scale. Due to data heterogeneity; no meta-analysis was performed. Twenty-eight studies met the inclusion criteria and were included in the review. The results of studies on the reasons of maternal request for elective cesarean section were fear of labor pain, anxiety for fetal injury/death, fear of childbirth, urinary incontinence, pelvic floor and vaginal trauma, doctors suggestion, time of birth, experience of prior bad delivery, previous infertility, infertility, anxiety for gynecologic examination, anxiety for loss of control, avoid long labor, anxiety for lack of support from the staff, fear of fecal, emotional aspects, body weight of the infant at birth and abnormal prenatal examination. The results of studies on the demographic reasons of maternal request for elective cesarean section were advanced maternal age, parity, occupation, education, maternal obesity, family status, decreasing level of religiosity, household income, number of living children and age at marriage. Our study proposed that the comprehensive programs and the interventions of health promotion should be designed to reduce unnecessary cesarean section and improve the performance of vaginal delivery.
Topics: Cesarean Section; Child; Delivery, Obstetric; Elective Surgical Procedures; Female; Humans; Infant, Newborn; Parity; Parturition; Pregnancy; Pregnant Women
PubMed: 30810436
DOI: 10.1080/14767058.2019.1587407 -
Reproductive Health Jun 2016The long acting and permanent contraceptive methods (LAPCMs) has not used unlike that of short-acting methods in Ethiopia. Ethiopia is the second most populous country... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The long acting and permanent contraceptive methods (LAPCMs) has not used unlike that of short-acting methods in Ethiopia. Ethiopia is the second most populous country in Sub Saharan Africa with a high total fertility rate, and high maternal and child mortality rates. This study summarized the evidence of practice and intention to use long acting and permanent family planning methods among women in Ethiopia using systemic review and meta-analysis.
METHODS
A systematic review and meta-analysis of the published and unpublished observational studies were conducted. Original studies were identified using databases of Medline/Pubmed, and Google Scholar. Heterogeneity across studies was checked using Cochrane Q test statistic and I(2)test. The pooled proportion of intention to use and the practice of long acting and permanent contraceptive methods were computed using a/the random effect model.
RESULTS
Based on the ten observational studies included in the meta-analysis, the pooled prevalence of intention to use long acting and permanent contraceptive methods among married women according to the random effect model was 42.98 % (95 % CI 32.53, 53.27 %). On the other hand, the pooled practice of long acting and permanent methods of contraceptive among the study participants was 16.64 % (95 % CI 12.4 to 20.87 %).
CONCLUSION
This meta-analysis revealed that women's intention to use LAPCMs is generally good but their utilization is low. It is recommended, therefore, that LAPMCs must be made more readily available and accessible to women at the lower level of health service delivery who are in need of it.
Topics: Contraception; Ethiopia; Family Planning Services; Female; Health Services Accessibility; Humans; Intention; Marriage; Observational Studies as Topic; Sterilization, Reproductive
PubMed: 27329147
DOI: 10.1186/s12978-016-0194-0 -
Breastfeeding Medicine : the Official... Feb 2023Breastfeeding as an important key to sustainable development strategies is the best nutrition for ensuring healthy growth and development in the first 1,000 days of... (Meta-Analysis)
Meta-Analysis Review
Breastfeeding as an important key to sustainable development strategies is the best nutrition for ensuring healthy growth and development in the first 1,000 days of life. The current systematic review and meta-analysis were conducted to evaluate the correlation between marital relationship satisfaction and breastfeeding self-efficacy and duration of breastfeeding. A systematical search was carried out in main electronic databases (PubMed, Scopus, Embase, ProQuest, and Web of Science) and gray literature until June 2022. The study's risk of bias was assessed using the Newcastle-Ottawa risk-of-bias tool. Publication bias was evaluated using a funnel plot, and Begg's and Egger's tests. The degree of heterogeneity was assessed using the test. To estimate common effect size coefficient () and confidence intervals (95% CIs), random-effect models were fitted, and the results were presented using forest plots. In total, 13 studies with 5,843 subjects were included in the meta-analysis. Overall, the pool estimates show a positive correlation between marital relationship satisfaction, and breastfeeding self-efficacy ( = 0.27, 95% CI (0.09-0.50), = 0.024), but this relationship was not found in the term of breastfeeding duration ( = 0.11, 95% CI [-0.01 to 0.23], = 0.079). The heterogeneity of studies was high ( = 95.2%) Our finding confirms a positive and moderate level of correlation between marital relationship satisfaction and breastfeeding self-efficacy. It is suggested to conduct more studies to reach appropriate conclusions regarding marital relationship satisfaction and breastfeeding duration.
Topics: Female; Humans; Breast Feeding; Marriage; Self Efficacy
PubMed: 36800333
DOI: 10.1089/bfm.2022.0210 -
Campbell Systematic Reviews Sep 2022A growing body of research shows the promise and efficacy of technology-based or digital interventions in improving the health and well-being of survivors of intimate... (Review)
Review
BACKGROUND
A growing body of research shows the promise and efficacy of technology-based or digital interventions in improving the health and well-being of survivors of intimate partner violence (IPV). In addition, mental health comorbidities such as anxiety, post-traumatic stress disorder (PTSD), and depression occur three to five times more frequently in survivors of IPV than non-survivors, making these comorbidities prominent targets of technology-based interventions. Still, research on the long-term effectiveness of these interventions in reducing IPV victimization and adverse mental health effects is emergent. The significant increase in the number of trials studying technology-based therapies on IPV-related outcomes has allowed us to quantify the effectiveness of such interventions for mental health and victimization outcomes in survivors. This meta-analysis and systematic review provide critical insight from several randomized controlled trials (RCTs) on the overall short and long-term impact of technology-based interventions on the health and well-being of female IPV survivors.
OBJECTIVES
To synthesize current evidence on the effects of technology-based or digital interventions on mental health outcomes (depression, anxiety, and PTSD) and victimization outcomes (physical, psychological, and sexual abuse) among IPV survivors.
SEARCH METHODS
We examined multiple traditional and grey databases for studies published from 2007 to 2021. Traditional databases (such as PubMed Central, Web of Science, CINAHL Plus, and PsychINFO) and grey databases were searched between April 2019 and February 2021. In addition, we searched clinical trial registries, government repositories, and reference lists. Authors were contacted where additional data was needed. We identified 3210 studies in traditional databases and 1257 from grey literature. Over 2198 studies were determined to be duplicates and eliminated, leaving 64 studies after screening titles and abstracts. Finally, 17 RCTs were retained for meta-analysis. A pre-registered protocol was developed and published before conducting this meta-analysis.
SELECTION CRITERIA
We included RCTs targeting depression, anxiety, PTSD outcomes, and victimization outcomes (physical, sexual, and psychological violence) among IPV survivors using a technology-based intervention. Eligible RCTs featured a well-defined control group. There were no study restrictions based on participant gender, study setting, or follow-up duration. Included studies additionally supplied outcome data for calculating effect sizes for our desired outcome. Studies were available in full text and published between 2007 and 2021 in English.
DATA COLLECTION AND ANALYSIS
We extracted relevant data and coded eligible studies. Using Cochrane's RevMan software, summary effect sizes () were assessed using an independent fixed-effects model. Standardized mean difference (SMD) effect sizes (or Cohen's ) were evaluated using a Type I error rate and an alpha of 0.05. The overall intervention effects were analyzed using the -statistic with a -value of 0.05. Cochran's test and Higgins' statistics were utilized to evaluate and confirm the heterogeneity of each cumulative effect size. The Cochrane risk of bias assessment for randomized trials (RoB 2) was used to assess the quality of the studies. Campbell Systematic Reviews registered and published this study's protocol in January 2021. No exploratory moderator analysis was conducted; however, we report our findings with and without outlier studies in each meta-analysis.
MAIN RESULTS
Pooled results from 17 RCTs yielded 18 individual effect size comparisons among 4590 survivors (all females). Survivors included college students, married couples, substance-using women in community prisons, pregnant women, and non-English speakers, and sample sizes ranged from 15 to 672. Survivors' ages ranged from 19 to 41.5 years. Twelve RCTs were conducted in the United States and one in Canada, New Zealand, China (People's Republic of), Kenya, and Australia. The results of this meta-analysis found that technology-based interventions significantly reduced among female IPV survivors at 0-3 months only (SMD = -0.08, 95% confidence interval [CI] = -0.17 to -0.00), among IPV survivors at 0-3 months (SMD = -0.27, 95% CI = -0.42 to -0.13, = 0.00, = 25%), and among IPV survivors at 0-6 months (SMD = -0.22, 95% CI = -0.38 to -0.05). We found significant reductions in psychological violence victimization at 0-6 months (SMD = -0.34, 95% CI = -0.47 to -0.20) and at >6 months (SMD = -0.29, 95% CI = -0.39 to -0.18); however, at both time points, there were outlier studies. At no time point did digital interventions significantly reduce (SMD = -0.04, 95% CI = -0.14 to 0.06, = .46, = 0%), or (SMD = -0.02, 95% CI = -0.14 to 0.11, = 21%) among female IPV survivors for all. With outlier studies removed from our analysis, all summary effect sizes were small, and this small number of comparisons prevented moderator analyses.
AUTHORS' CONCLUSIONS
The results of this meta-analysis are promising. Our findings highlight the effectiveness of IPV-mitigating digital intervention as an add-on (not a replacement) to traditional modalities using a coordinated response strategy. Our findings contribute to the current understanding of "what works" to promote survivors' mental health, safety, and well-being. Future research could advance the science by identifying active intervention ingredients, mapping out intervention principles/mechanisms of action, best modes of delivery, adequate dosage levels using the treatment intensity matching process, and guidelines to increase feasibility and acceptability.
PubMed: 36909881
DOI: 10.1002/cl2.1271 -
Frontiers in Public Health 2022Chronic rhinosinusitis (CRS) can be seen in people of all ages. CRS heavily affects the quality of a patient's daily life and also causes tremendous economic burdens on... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chronic rhinosinusitis (CRS) can be seen in people of all ages. CRS heavily affects the quality of a patient's daily life and also causes tremendous economic burdens on patients' families and society. The prevalence of CRS in different countries varies and no systematic review of the prevalence of CRS among Chinese has been published previously. The objective of this systematic review and meta-analysis is to determine the prevalence of CRS among Chinese and to explore the main risk factors of CRS among Chinese.
METHODS
Using relevant keywords, data resources including PubMed, Scopus, Web of Science, Google Scholar, Embase, Cochrane Library, Chinese National Knowledge of Infrastructure (CNKI), WANGFANG, VIP, and China Biomedical Literature database (CMB) were searched to obtain literature reporting the prevalence of and risk factors of CRS among Chinese which were clearly diagnosed with CRS from inception to 30 June 2022. The random/fixed effect model was used for meta-analysis, and the I index was employed to assess heterogeneity among studies. All analyses were performed by using the STATA version 16.0 software. The study was registered with PROSPERO, register number. CRD42022341877.
RESULT
A total of 12 relevant kinds of literature were qualified for the present systematic review, including 4,033 patients. The results showed that the overall prevalence of CRS among Chinese was 10% (95%CI: 0.06-0.13, I = 99.6%, < 0.001). The prevalence of CRS among Chinese who lived in urban cities was 18% (95%CI: -0.07 to 0.43, I = 99.9%, < 0.001), which was obviously lower than the prevalence of CRS among Chinese who lived in rural areas (27%, 95%CI: -0.14 to 0.68, I = 99.8%, < 0.001). The prevalence of CRS among Chinese before 2010 was 23% (95%CI: -0.05 to 0.50, I = 99.8%, < 0.001), which was remarkably higher than the prevalence of CRS among Chinese after 2010 (7%, 95%CI: 0.05-0.09, I = 99.0%, < 0.001). The prevalence of CRS among Chinese who were divorced was 17% (95%CI: 0.12-0.22, I = 0.0%, = 0.436), while the prevalence of CRS among Chinese who were married, widowed, and unmarried was 9% (95%CI: 0.06-0.11, I = 88.1%, = 0.004), 9% (95%CI: 0.06-0.11, I = 0.0%, = 0.863), and 9% (95%CI: 0.08-0.10, I = 0.0%, = 0.658), respectively. The prevalence of CRS among Han and minority Chinese was 8% (95%CI: 0.07-0.10, I = 69.6%, = 0.070) and 12% (95%CI: 0.10-0.15, I = 38.6%, = 0.202), respectively. The prevalence of CRS among Chinese who was never exposed to moldy or damp environments was 8% (95%CI: 0.08-0.09, I = 0.0%, = 0.351), the prevalence of CRS among Chinese who was occasionally exposed to moldy or damp environments was 16% (95%CI: 0.10-0.22, I = 78.9%, = 0.030), and the prevalence of CRS among Chinese who was frequently or every day exposed to moldy or damp environments was up to 20% (95%CI: 0.15-0.24, I = 0.0%, = 0.558).
CONCLUSION
This meta-analysis shows that the prevalence of CRS among Chinese is at a high level. People who have some risk factors, such as occasional or frequent or everyday exposure to moldy or damp environments, have a higher prevalence of CRS. We should attach more importance to the risk factors of CRS in clinical practice and disseminate scientific information and carry out education to lower the prevalence of CRS in China.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=341877, identifier: CRD42022341877.
Topics: Humans; Prevalence; Risk Factors; Asian People; Chronic Disease; Minority Groups
PubMed: 36699933
DOI: 10.3389/fpubh.2022.986026 -
Advances in Life Course Research Jun 2022This article reviews ever published quantitative evidence on in-work poverty and family demographic processes in OECD and EU-28 countries. Despite the increasing...
This article reviews ever published quantitative evidence on in-work poverty and family demographic processes in OECD and EU-28 countries. Despite the increasing attention to in-work poverty in Europe and beyond, a comprehensive and critical review on how family demographic processes shape in-work poverty risks is still missing. In this systematic review, we first provide a quantitative review of results from analyses that estimated the association between in-work poverty and parental home leaving, union formation, marriage, parenthood, and dissolution of non-marital and marital unions. This allows us to formulate tentative conclusions about whether and in which direction family demographic processes are associated with in-work poverty. Second, we discuss in detail conceptual and methodological advances in in-work poverty research, such as longitudinal analytical designs or attempts to make in-work poverty research more sensitive to policy context, gender, and the life course. Our review highlights theoretical and methodological challenges for future studies linking in-work poverty and family demography.
Topics: Humans; Marital Status; Population Dynamics; Poverty; Family Characteristics; Marriage; Fertility
PubMed: 36652318
DOI: 10.1016/j.alcr.2022.100462 -
Asia-Pacific Journal of Public Health Jul 2017The rapid influx of married immigrant women from low-income Asian countries is a concern in South Korea, Japan, and Taiwan. In South Korea, 1 in 10 couples includes a... (Meta-Analysis)
Meta-Analysis Review
The rapid influx of married immigrant women from low-income Asian countries is a concern in South Korea, Japan, and Taiwan. In South Korea, 1 in 10 couples includes a Korean man and a migrant woman, increasing the need for prenatal and postnatal care interventions. Studies published in English or Korean after 2000 were retrieved from 8 databases and reviewed via a systematic review and meta-analysis of the effectiveness of prenatal and postnatal psychosocial and educational interventions in Korea. Of 3583 records, 10 studies (1 randomized controlled trial [RCT] and 9 non-RCTs) involving 408 married immigrant women fulfilled the inclusion criteria. A meta-analysis of the non-RCTs showed that prenatal and postnatal care interventions were effective in improving family support, knowledge regarding self-care management and infant rearing, and self-efficacy regarding self-care management and infant rearing. Subgroup analysis showed that interventions involving husbands and individualized care were most effective. This study illustrated the extent to which strategies are needed for developing prenatal and postnatal care interventions for married immigrant women. Further studies should explore other factors and identify the most important factor for improving the effectiveness of such interventions. Robust study designs published in peer-reviewed journals are required for examining the effectiveness of these interventions.
Topics: Emigrants and Immigrants; Female; Health Promotion; Humans; Infant, Newborn; Marital Status; Postnatal Care; Pregnancy; Prenatal Care; Program Evaluation; Randomized Controlled Trials as Topic; Republic of Korea
PubMed: 28719791
DOI: 10.1177/1010539517717364 -
Ageing Research Reviews Nov 2021While widowhood is known to be associated with poorer physical and mental health outcomes, studies examining the association of widowhood with cognition have yielded... (Meta-Analysis)
Meta-Analysis Review
While widowhood is known to be associated with poorer physical and mental health outcomes, studies examining the association of widowhood with cognition have yielded mixed results. This review aimed to elucidate the link between widowhood and cognitive decline. A systematic search of Medline, Embase, PsycInfo, CINAHL and Scopus (until December 2020) was conducted to identify studies on the association between widowhood (vs. being married) and cognition in cognitively healthy adults aged 50 +. A cross-sectional meta-analysis (of 10 studies; n = 24,668) found a significant association of widowhood with cognition (g = - 0.36, 95% CI [- 0.47, - 0.25], p = < 0.001). Meta-regressions suggested that study design, cognitive domain measured, sample age, difference in mean age between widowed and married groups, and study continent did not account for observed heterogeneity. A longitudinal meta-analysis (of 3 studies; n = 10,378) found that the "continually widowed" group (from baseline to follow-up) showed significantly steeper declines in cognition compared to the "continually married" group (g = - 0.15, 95%CI [- 0.19, - 0.10], p = < 0.001). Findings indicate that widowhood may be a risk factor for cognitive decline. As there are no effective treatments for cognitive impairment, studying mechanisms by which widowhood might be associated with poorer cognition could inform prevention programs for those who have experienced spousal bereavement.
Topics: Aged; Bereavement; Cognitive Dysfunction; Cross-Sectional Studies; Female; Humans; Longitudinal Studies; Middle Aged; Widowhood
PubMed: 34534681
DOI: 10.1016/j.arr.2021.101461