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The Patient Dec 2016Considerable emphasis is placed on the use of generic medicines because of the potential economic benefits associated with their use. The objective of this systematic... (Review)
Review
BACKGROUND AND OBJECTIVE
Considerable emphasis is placed on the use of generic medicines because of the potential economic benefits associated with their use. The objective of this systematic review is to compile and collate published research regarding patient/consumer perceptions and attitudes in relation to generic medicines, aiming to describe such views and detail patient experiences with generic medicines.
METHODS
Literature published between 2005 and July 2015, indexed in PubMed, Scopus and EMBASE, on the topic of consumer or patient opinions of generic medicines were collated, using systematic searches, and appraised.
RESULTS
A total of 59 papers were reviewed. Familiarity and trust in brand names appears to be a substantial barrier to the increased use of generics, with patients also appearing to hold the view that if a product is cheaper, then it must not be as good. Some publications report positive views of generics, with positively inclined consumers stating that they did not perceive any difference between a generic and the proprietary medicine. Acceptance of generics appears to be higher in consumers with higher levels of education while patients from lower socioeconomic demographic groups tend to have greater mistrust of generics.
CONCLUSIONS
The provision of information to consumers that dispels myths about generics may improve confidence in generic medicines. As patients demonstrate a high degree of trust in physicians, their opinions can impact on patient/consumer opinions. Therefore, enhancing the perceptions of generics held by physicians is likely to have a positive impact on patient/consumer opinions of, and trust in, generic medications.
Topics: Drugs, Generic; Health Knowledge, Attitudes, Practice; Humans; Patient Preference; Physicians; Public Opinion
PubMed: 27142371
DOI: 10.1007/s40271-016-0176-x -
American Journal of Public Health Mar 2023Schools are sites of dating and relationship violence (DRV) and of gender-based violence (GBV) victimization and perpetration. School-based interventions can reach a... (Meta-Analysis)
Meta-Analysis
Schools are sites of dating and relationship violence (DRV) and of gender-based violence (GBV) victimization and perpetration. School-based interventions can reach a broad range of students, targeting both individual and group processes that may underpin DRV and GBV. Considering DRV and GBV jointly is important because of their shared etiologies. Comparing the effectiveness of interventions using network meta-analysis (NMA) can support decision-making on optimal resource use. To evaluate the comparative effectiveness of school-based interventions for children aged 5 to 18 years on DRV and GBV victimization, perpetration, and related mediators. We searched 21 databases in July 2020 and June 2021, alongside extensive supplementary search methods, including gray literature searches, forward and backward citation chasing, and searches on first and last author names. We included randomized-controlled trials of interventions for children of compulsory school age implemented within the school setting, and either partially or wholly aimed at changing DRV or GBV outcomes. Pairwise meta-analyses using random-effects robust variance estimation considered intervention effectiveness on DRV and GBV victimization and perpetration using odds ratios, and on mediators (e.g., knowledge and attitudes) using standardized mean differences. Effects were divided into short-term (< 12 months postbaseline) and long-term (≥ 12 months postbaseline). NMAs on victimization and perpetration outcomes compared interventions categorized by breadth of mechanism and complexity of delivery and implementation. Meta-regression tested sensitivity to percentage of girls in the trial sample and country context. Our analysis included 68 trials. Evidence was stronger overall for effects on DRV than for GBV, with significant long-term impacts on DRV victimization (odds ratio [OR] = 0.82; 95% confidence interval [CI] = 0.68, 0.99) and DRV perpetration (OR = 0.78; 95% CI = 0.64, 0.94). Knowledge and attitudinal effects were predominantly short-term (e.g., for DRV-related violence acceptance, = 0.16; 95% CI = 0.08, 0.24). NMAs did not suggest the superiority of any intervention type; however, most analyses for GBV outcomes were inconsistent. A higher proportion of girls in the sample was associated with increased effectiveness on long-term victimization outcomes. Evidence is stronger for DRV than for GBV, despite considerable heterogeneity. Certainty of findings was low or very low overall. Violence reductions may require more than 1 school year to become apparent. More extensive interventions may not be more effective. A possible reason for stronger effectiveness for DRV is that whereas GBV is ingrained in school cultures and practices, DRV is potentially more open to change via addressing individual knowledge and attitudes. (. 2023;113(3):320-330. https://doi.org/10.2105/10.2105/AJPH.2022.307153).
Topics: Child; Female; Humans; Gender-Based Violence; Network Meta-Analysis; Violence; Crime Victims; Attitude
PubMed: 36791352
DOI: 10.2105/AJPH.2022.307153 -
Environmental Pollution (Barking, Essex... Dec 2022Per-and polyfluoroalkyl substances (PFAS) is a collective name for approximately 4700 synthetic chemicals ubiquitous in the aquatic environment worldwide. They are used... (Meta-Analysis)
Meta-Analysis Review
Per-and polyfluoroalkyl substances (PFAS) is a collective name for approximately 4700 synthetic chemicals ubiquitous in the aquatic environment worldwide. They are used in a wide array of products and are found in living organisms around the world. Some PFAS have been associated with cancer, developmental toxicity, endocrine disruption, and other health effects. Only a fraction of PFAS are currently monitored and regulated and the presence and effects on aquatic organisms of many PFAS are largely unknown. The aim of this study is to investigate the health effects of environmentally relevant concentrations of PFAS on aquatic organisms at different consumer trophic levels through a systematic review and meta-analysis. The main result shows that PFAS in concentrations up to 13.5 μg/L have adverse effects on body size variables for secondary consumers. However, no significant effects on liver or gonad somatic indices and neither on fecundity were found. In addition, the results show that there are large research gaps for PFAS effects on different organisms in aquatic environments at environmentally relevant concentrations. Most studies have been performed on secondary consumers and there is a substantial lack of studies on other consumers in aquatic ecosystems.
Topics: Fluorocarbons; Aquatic Organisms; Ecosystem
PubMed: 36244496
DOI: 10.1016/j.envpol.2022.120422 -
Cancer Medicine Mar 2024Due to encouraging pre-clinical data and supportive observational studies, there has been growing interest in applying cardiovascular drugs (including aspirin,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Due to encouraging pre-clinical data and supportive observational studies, there has been growing interest in applying cardiovascular drugs (including aspirin, angiotensin-converting enzyme [ACE] inhibitors, statins, and metformin) approved to treat diseases such as hypertension, hyperlipidemia, and diabetes mellitus to the field of oncology. Moreover, given growing costs with cancer care, these medications have offered a potentially more affordable avenue to treat or prevent recurrence of cancer. We sought to investigate the anti-cancer effects of drugs repurposed from cardiology or anti-inflammatories to treat cancer. We specifically evaluated the following drug classes: HMG-CoA reductase inhibitors (statins), cyclo-oxygenase inhibitors, aspirin, metformin, and both angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors. We also included non-steroidal anti-inflammatory drugs (NSAIDs) because they exert a similar mechanism to aspirin by blocking prostaglandins and reducing inflammation that is thought to promote the development of cancer.
METHODS
We performed a systematic literature review using PubMed and Web of Science with search terms including "aspirin," "NSAID," "statin" (including specific statin drug names), "metformin," "ACE inhibitors," and "ARBs" (including specific anti-hypertensive drug names) in combination with "cancer." Searches were limited to human studies published between 2000 and 2023.
MAIN OUTCOMES AND MEASURES
The number and percentage of studies reported positive results and pooled estimates of overall survival, progression-free survival, response, and disease-free survival.
RESULTS
We reviewed 3094 titles and included 67 randomized clinical trials. The most common drugs that were tested were metformin (n = 21; 30.9%), celecoxib (n = 20; 29.4%), and simvastatin (n = 8; 11.8%). There was only one study that tested cardiac glycosides and none that studied ACE inhibitors. The most common tumor types were non-small-cell lung cancer (n = 19; 27.9%); breast (n = 8; 20.6%), colorectal (n = 7; 10.3%), and hepatocellular (n = 6; 8.8%). Most studies were conducted in a phase II trial (n = 38; 55.9%). Most studies were tested in metastatic cancers (n = 49; 72.1%) and in the first-line setting (n = 36; 521.9%). Four studies (5.9%) were stopped early because of difficulty with accrual. The majority of studies did not demonstrate an improvement in either progression-free survival (86.1% of studies testing progression-free survival) or in overall survival (94.3% of studies testing overall survival). Progression-free survival was improved in five studies (7.4%), and overall survival was improved in three studies (4.4%). Overall survival was significantly worse in two studies (3.8% of studies testing overall survival), and progression-free survival was worse in one study (2.8% of studies testing progression-free survival).
CONCLUSIONS AND RELEVANCE
Despite promising pre-clinical and population-based data, cardiovascular drugs and anti-inflammatory medications have overall not demonstrated benefit in the treatment or preventing recurrence of cancer. These findings may help guide future potential clinical trials involving these medications when applied in oncology.
Topics: Humans; Angiotensin-Converting Enzyme Inhibitors; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Carcinoma, Non-Small-Cell Lung; Angiotensin Receptor Antagonists; Lung Neoplasms; Randomized Controlled Trials as Topic; Anti-Inflammatory Agents, Non-Steroidal; Anti-Inflammatory Agents; Aspirin; Antihypertensive Agents; Metformin
PubMed: 38491813
DOI: 10.1002/cam4.7049 -
Obesity Research & Clinical Practice 2015Childhood obesity, with its growing prevalence, detrimental effects on population health and economic burden, is an important public health issue in the United States... (Review)
Review
INTRODUCTION
Childhood obesity, with its growing prevalence, detrimental effects on population health and economic burden, is an important public health issue in the United States and worldwide. There is need for expansion of the role of primary care physicians in obesity interventions. The primary aim of this review is to explore primary care physician (PCP) mediated interventions targeting childhood obesity and assess the roles played by physicians in the interventions.
METHODS
A systematic review of the literature published between January 2007 and October 2014 was conducted using a combination of keywords like "childhood obesity", "paediatric obesity", "childhood overweight", "paediatric overweight", "primary care physician", "primary care settings", "healthcare teams", and "community resources" from MEDLINE and CINAHL during November 2014. Author name(s), publication year, sample size, patient's age, study and follow-up duration, intervention components, role of PCP, members of the healthcare team, and outcomes were extracted for this review.
RESULTS
Nine studies were included in the review. PCP-mediated interventions were composed of behavioural, education and technological interventions or a combination of these. Most interventions led to positive changes in Body Mass Index (BMI), healthier lifestyles and increased satisfaction among parents. PCPs participated in screening and diagnosing, making referrals for intervention, providing nutrition counselling, and promoting physical activity. PCPs, Dietitians and nurses were often part of the healthcare team.
CONCLUSION
PCP-mediated interventions have the potential to effectively curb childhood obesity. However, there is a further need for training of PCPs, and explain new types of interventions such as the use of technology.
Topics: Body Mass Index; Child; Delivery of Health Care; Directive Counseling; Health Promotion; Humans; Life Style; Patient Education as Topic; Pediatric Obesity; Physicians, Primary Care; Primary Health Care; Public Health; Referral and Consultation; United States; Weight Loss
PubMed: 26259684
DOI: 10.1016/j.orcp.2015.07.005 -
Spine Nov 2019A systematic search and review OBJECTIVE.: The aim of this study was to investigate the term, degenerative disc disease, to elucidate its current usage and inform...
STUDY DESIGN
A systematic search and review OBJECTIVE.: The aim of this study was to investigate the term, degenerative disc disease, to elucidate its current usage and inform clinical, research, and policy recommendations.
SUMMARY OF BACKGROUND DATA
Degenerative disc disease has long been a dominant concept in common, painful spinal disorders. Yet, despite its pervasiveness and important clinical consequences and controversies, there has not been a systematic examination of its use and meaning in the scientific literature.
METHODS
We conducted a systematic search of publications using the term degenerative disc disease from 2007 through 2016 in Ovid MEDLINE (R), Embase, CINAHL, and Scopus. Two investigators independently reviewed all publications in the primary sample. Publication and author identifiers, and qualitative study descriptors were extracted. Finally, the definition of degenerative disc disease was placed in one of eight categories. Data were summarized using descriptive statistics.
RESULTS
Degenerative disc disease appeared in the titles of 402 publications in the primary sample and increased in frequency by 189% from the first to the last 3 years of the decade. No single definition was used in the majority of publications, and most frequently, the term was used without any definition provided (30.1%). In other cases, degenerative disc disease specifically included radiculopathy or myelopathy (14.4%), or only back or neck pain (5.5%), or was equated with disc degeneration regardless of the presence of symptoms (15.4%), or with discogenic pain or disc degeneration as a presumed cause of axial pain (12.7%). Another 7.2% comprised a mix of broad ranging findings and diagnoses. The most notable differences in definitions occurred between surgeons and other disciplines, and when applied to cervical versus lumbar regions.
CONCLUSION
Despite longstanding use and important consequences, degenerative disc disease represents an underdeveloped concept, with greatly varying, disparate definitions documented. Such inconsistencies challenge clear, accurate communication in medicine and science, create confusion and misconceptions among clinicians, patients and others, and hinder the advancement of related knowledge.
LEVEL OF EVIDENCE
4.
Topics: Adult; Female; Humans; Intervertebral Disc Degeneration; Lumbosacral Region; Male; Middle Aged; Neck Pain; Radiculopathy; Spinal Fusion
PubMed: 31135628
DOI: 10.1097/BRS.0000000000003103 -
The Lancet. Infectious Diseases Mar 2012Food-borne trematodiases are a group of neglected tropical diseases caused by liver, lung, and intestinal parasitic fluke infections. As part of the Global Burden of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Food-borne trematodiases are a group of neglected tropical diseases caused by liver, lung, and intestinal parasitic fluke infections. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2010 study) and a WHO initiative, we assessed the global burden of human food-borne trematodiasis, as expressed in disability-adjusted life years (DALYs) for the year 2005.
METHODS
We systematically searched electronic databases for reports about human food-borne trematodiasis without language restriction, between Jan 1, 1980, and Dec 31, 2008. We used a broad search strategy with a combination of search terms and parasite and disease names. The initial search results were then screened on the basis of title, abstract, and, finally, full text. Relevant quantitative and qualitative data on human prevalence, morbidity, and mortality of food-borne trematodiasis were extracted. On the basis of available information on pathological and clinical appearance, we developed simplified disease models and did meta-analyses on the proportions and odds ratios of specified sequelae and estimated the global burden of human food-borne trematodiasis.
FINDINGS
We screened 33,921 articles and identified 181 eligible studies containing quantitative information for inclusion in the meta-analyses. About 56·2 million people were infected with food-borne trematodes in 2005: 7·9 million had severe sequelae and 7158 died, most from cholangiocarcinoma and cerebral infection. Taken together, we estimate that the global burden of food-borne trematodiasis was 665,352 DALYs (lower estimate 479,496 DALYs; upper estimate 859,051 DALYs). Furthermore, knowledge gaps in crucial epidemiological disease parameters and methodological features for estimating the global burden of parasitic diseases that are characterised by highly focal spatial occurrence and scarce and patchy information were highlighted.
INTERPRETATION
Despite making conservative estimates, we found that food-borne trematodiases are an important cluster of neglected diseases.
FUNDING
Swiss National Science Foundation; Institute for Health Metrics and Evaluation.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cost of Illness; Female; Foodborne Diseases; Global Health; Humans; Infant; Infant, Newborn; Male; Middle Aged; Prevalence; Quality-Adjusted Life Years; Trematode Infections
PubMed: 22108757
DOI: 10.1016/S1473-3099(11)70294-8 -
The Gerontologist Feb 2015The purpose of this study was to analyze the range of critiques of successful aging models and the suggestions for improvement as expressed in the social gerontology... (Review)
Review
PURPOSE OF THE STUDY
The purpose of this study was to analyze the range of critiques of successful aging models and the suggestions for improvement as expressed in the social gerontology literature.
DESIGN AND METHODS
We conducted a systematic literature review using the following criteria: journal articles retrieved in the Abstracts in Social Gerontology, published 1987-2013, successful aging/ageing in the title or text (n = 453), a critique of successful aging models as a key component of the article. Sixty-seven articles met the criteria. Qualitative methods were used to identify key themes and inductively configure meanings across the range of critiques.
RESULTS
The critiques and remedies fell into 4 categories. The Add and Stir group suggested a multidimensional expansion of successful aging criteria and offered an array of additions. The Missing Voices group advocated for adding older adults' subjective meanings of successful aging to established objective measures. The Hard Hitting Critiques group called for more just and inclusive frameworks that embrace diversity, avoid stigma and discrimination, and intervene at structural contexts of aging. The New Frames and Names group presented alternative ideal models often grounded in Eastern philosophies.
IMPLICATIONS
The vast array of criteria that gerontologists collectively offered to expand Rowe and Kahn's original successful model is symptomatic of the problem that a normative model is by definition exclusionary. Greater reflexivity about gerontology's use of "successful aging" and other normative models is needed.
Topics: Adaptation, Psychological; Aged; Aging; Female; Geriatrics; Health Status; Humans; Male; Models, Theoretical; Quality of Life; Social Support
PubMed: 24814830
DOI: 10.1093/geront/gnu037 -
Journal of Science and Medicine in Sport Feb 2024To review cut-points calibrated and independently validated from wrist-worn ActiGraph accelerometers to measure moderate to vigorous physical activity (MVPA) and time... (Review)
Review
OBJECTIVES
To review cut-points calibrated and independently validated from wrist-worn ActiGraph accelerometers to measure moderate to vigorous physical activity (MVPA) and time spent sedentary (SED) in children and adolescents.
DESIGN
Systematic literature review.
METHODS
Five databases were searched for relevant cut-point calibration and independent validation studies relating to wrist worn ActiGraphs in children and adolescents from inception through 30 April 2022. Extracted data included: country of publication; study name; population; device model; wear location; sampling frequency; epoch length; activity protocol; criterion method and definitions used to classify PA intensity; statistical methods for calibration; statistical methods for validation/cross-validation; and MVPA and SED outcome.
RESULTS
Fourteen calibration studies and seven independent validation studies were identified. Calibrated cut-points for MVPA vector magnitude counts ranged from 7065 to 9204 counts per minute (cpm) and 63.5 to 201 milli-gravitational units (mg). For SED, calibrated cut-points ranged from <2556 cpm to 4350 cpm and 30.8 to 48.1 mg. Classification accuracy values determined by independent validation studies varied, with kappa values ranging from 0.31 to 0.60 and area under the curve statistics ranging from 0.51 to 0.84 for MVPA and kappa values ranging from 0.31 to 0.44 and area under the curve statistics ranging from 0.70 to 0.85 for SED.
CONCLUSIONS
The results of this systematic literature review support the use of the Crouter and colleagues cut-points for the measurement of MVPA and SED for children and adolescents aged 6-12 years. Further work is required to independently validate cut-points developed in younger children and older adolescents.
Topics: Child; Humans; Adolescent; Wrist; Exercise; Calibration; Wrist Joint; Research Design; Accelerometry
PubMed: 38087661
DOI: 10.1016/j.jsams.2023.11.008 -
International Journal of Epidemiology Jun 2011It is presumed that physical activity (PA) level declines during the lifespan, particularly in adolescence. However, currently, there is no study that quantifies these... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
It is presumed that physical activity (PA) level declines during the lifespan, particularly in adolescence. However, currently, there is no study that quantifies these changes and pools results for a common interpretation. Therefore, the purpose was to systematically review the international literature regarding PA change during adolescence, and to quantify that change according to a series of study variables, exploring gender-and-age differences.
METHODS
An electronic search was conducted in the Medline/PubMed and Web of Science databases. Longitudinal studies with, at least, two PA measures throughout adolescence (10-19 years old) or the first PA measure during childhood and the second one during adolescence were selected. From each article, study project name, country, year of the first data collection, sample size, baseline age, follow-up duration, characteristics of the instrument (type, recall time, PA intensity and PA domain), unit of PA measure and report of statistical significance were collected.
RESULTS
Overall, 26 studies matched the inclusion criteria. Most were carried out in the USA, assessed PA by questionnaire, and found a decline in PA levels during the adolescence. On average, the mean percentage PA change per year, across all studies, was -7.0 (95% confidence interval: -8.8 to -5.2), ranging from -18.8 to 7.8. The decline was significant according to most sub-groups of variables analysed. Although earlier studies revealed a higher PA decline in boys, the decline has been greater in girls in more recent studies (commenced after 1997). Moreover, although the decline among girls was higher in younger ages at baseline (9-12 years), it was higher in older ages (13-16 years) among boys.
CONCLUSIONS
The decline of PA during adolescence is a consistent finding in the literature. Differences between boys and girls were observed and should be explored in future studies. Interventions that attempt to attenuate the PA decline, even without an increase in PA levels, could be considered as effective.
Topics: Adolescent; Age Factors; Brazil; Child; Exercise; Female; Humans; Longitudinal Studies; Male; Motor Activity; Needs Assessment; Physical Education and Training; Risk Factors; Sex Factors; Sports
PubMed: 21245072
DOI: 10.1093/ije/dyq272