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The Lancet. Public Health Aug 2021Smoke-free policies in outdoor areas and semi-private and private places (eg, cars) might reduce the health harms caused by tobacco smoke exposure (TSE). We aimed to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Smoke-free policies in outdoor areas and semi-private and private places (eg, cars) might reduce the health harms caused by tobacco smoke exposure (TSE). We aimed to investigate the effect of smoke-free policies covering outdoor areas or semi-private and private places on TSE and respiratory health in children, to inform policy.
METHODS
In this systematic review and meta-analysis, we searched 13 electronic databases from date of inception to Jan 29, 2021, for published studies that assessed the effects of smoke-free policies in outdoor areas or semi-private or private places on TSE, respiratory health outcomes, or both, in children. Non-randomised and randomised trials, interrupted time series, and controlled before-after studies, without restrictions to the observational period, publication date, or language, were eligible for the main analysis. Two reviewers independently extracted data, including adjusted test statistics from each study using a prespecified form, and assessed risk of bias for effect estimates from each study using the Risk of Bias in Non-Randomised Studies of Interventions tool. Primary outcomes were TSE in places covered by the policy, unplanned hospital attendance for wheezing or asthma, and unplanned hospital attendance for respiratory tract infections, in children younger than 17 years. Random-effects meta-analyses were done when at least two studies evaluated policies that regulated smoking in similar places and reported on the same outcome. This study is registered with PROSPERO, CRD42020190563.
FINDINGS
We identified 5745 records and assessed 204 full-text articles for eligibility, of which 11 studies met the inclusion criteria and were included in the qualitative synthesis. Of these studies, seven fit prespecified robustness criteria as recommended by the Cochrane Effective Practice and Organization of Care group, assessing smoke-free cars (n=5), schools (n=1), and a comprehensive policy covering multiple areas (n=1). Risk of bias was low in three studies, moderate in three, and critical in one. In the meta-analysis of ten effect estimates from four studies, smoke-free car policies were associated with an immediate TSE reduction in cars (risk ratio 0·69, 95% CI 0·55-0·87; 161 466 participants); heterogeneity was substantial (I 80·7%; p<0·0001). One additional study reported a gradual TSE decrease in cars annually. Individual studies found TSE reductions on school grounds, following a smoke-free school policy, and in hospital attendances for respiratory tract infection, following a comprehensive smoke-free policy.
INTERPRETATION
Smoke-free car policies are associated with reductions in reported child TSE in cars, which could translate into respiratory health benefits. Few additional studies assessed the effect of policies regulating smoking in outdoor areas and semi-private and private places on children's TSE or health outcomes. On the basis of these findings, governments should consider including private cars in comprehensive smoke-free policies to protect child health.
FUNDING
Dutch Heart Foundation, Lung Foundation Netherlands, Dutch Cancer Society, Dutch Diabetes Research Foundation, Netherlands Thrombosis Foundation, and Health Data Research UK.
Topics: Child; Environmental Exposure; Humans; Non-Randomized Controlled Trials as Topic; Randomized Controlled Trials as Topic; Respiratory Tract Diseases; Smoke-Free Policy; Tobacco Smoke Pollution
PubMed: 34274050
DOI: 10.1016/S2468-2667(21)00097-9 -
International Journal of Qualitative... Dec 2020: In nursing and midwifery, the concept of environment is considered a meta-concept. Research findings suggest that the location is not the only important factor, as...
: In nursing and midwifery, the concept of environment is considered a meta-concept. Research findings suggest that the location is not the only important factor, as both place and space influence the practices of midwives. Moreover, research on the geography of health suggests a connection between place and health that could be extended to reproductive health. Therefore, to move beyond and expand traditional research expressions, it is beneficial to illuminate the concepts of place and space in relation to childbirth. : This study was undertaken to produce a synthesis of previous qualitative research of issues in childbirth in relation to the concepts of place and space. : In this Critical Interpretive Synthesis (CIS), four electronic databases; CINAHL, Medline, PsycINFO and Sociological abstracts, were used for the literature search. In total 734 papers were screened, and 27 papers met the final inclusion criteria after assessment. : The synthesis reveals a need to create a space for childbirth underpinned by four aspects; a homely space, a spiritual space, a safe space, and a territorial space. : Findings from this review will provide a basis for useful dialogue in midwifery education and in clinical settings.
Topics: Birth Setting; Delivery of Health Care; Delivery, Obstetric; Environment; Female; Humans; Midwifery; Parturition; Pregnancy; Qualitative Research
PubMed: 33103631
DOI: 10.1080/17482631.2019.1667143 -
Journal of Indian Prosthodontic Society 2022The aim of this systematic review is to evaluate the survival rate of dental implant placed using different maxillary sinus floor elevation techniques. (Meta-Analysis)
Meta-Analysis
AIM
The aim of this systematic review is to evaluate the survival rate of dental implant placed using different maxillary sinus floor elevation techniques.
SETTING AND DESIGN
PRISMA guidelines were used for this systematic review and meta-analysis.
MATERIALS AND METHODS
Relevant articles were searched from Medline, PubMed, Google Scholar, ScienceDirect, and Cochrane trials. Articles published in English language were selected. Hand search was further conducted. For risk of bias, two tools were used, i.e., Cochrane tool for randomized controlled trials (RCTs) and new castle Ottawa quality assessment tool for non-RCTs.
STATISTICAL ANALYSIS
For statistical meta-analysis RevMan 5.4 software was used.
RESULTS
Seventeen studies were finalized. All studies were included in the meta-analysis to check the implant survival rate. There is no statistical difference between direct and indirect techniques, and forest plot was derived for direct approach (P = 0.688, 95% confidence interval [CI] 0.9691) and for indirect approach (P = 0.686 and 95% CI 0.970).
CONCLUSION
There is no statistically significant difference in the survival rate of implant placed using direct or indirect sinus lift approach procedures. Hence, the technique is selected as per the indications given for each direct and indirect procedure.
Topics: Maxillary Sinus; Sinus Floor Augmentation; Dental Implants; Dental Implantation, Endosseous; Dental Restoration Failure; Survival Rate
PubMed: 36511050
DOI: 10.4103/jips.jips_283_22 -
JAMA Internal Medicine Jan 2017Firearm homicide is a leading cause of injury death in the United States, and there is considerable debate over the effectiveness of firearm policies. An analysis of the... (Review)
Review
IMPORTANCE
Firearm homicide is a leading cause of injury death in the United States, and there is considerable debate over the effectiveness of firearm policies. An analysis of the effectiveness of firearm laws on firearm homicide is important to understand optimal policies to decrease firearm homicide in the United States.
OBJECTIVE
To evaluate the association between firearm laws and preventing firearm homicides in the United States.
EVIDENCE REVIEW
We evaluated peer-reviewed articles from 1970 to 2016 focusing on the association between US firearm laws and firearm homicide. We searched PubMed, CINAHL, Lexis/Nexis, Sociological Abstracts, Academic Search Premier, the Index to Legal Periodicals and Books, and the references from the assembled articles. We divided laws into 5 categories: those that (1) curb gun trafficking, (2) strengthen background checks, (3) improve child safety, (4) ban military-style assault weapons, and (5) restrict firearms in public places and leniency in firearm carrying. The articles were assessed using the standardized Guide to Community Preventive Services data collection instrument and 5 additional quality metrics: (1) appropriate data source(s) and outcome measure(s) were used for the study, (2) the time frame studied was adequate, (3) appropriate statistical tests were used, (4) the analytic results were robust, and (5) the disaggregated results of control variables were consistent with the literature.
FINDINGS
In the aggregate, stronger gun policies were associated with decreased rates of firearm homicide, even after adjusting for demographic and sociologic factors. Laws that strengthen background checks and permit-to-purchase seemed to decrease firearm homicide rates. Specific laws directed at firearm trafficking, improving child safety, or the banning of military-style assault weapons were not associated with changes in firearm homicide rates. The evidence for laws restricting guns in public places and leniency in gun carrying was mixed.
CONCLUSIONS AND RELEVANCE
The strength of firearm legislation in general, and laws related to strengthening background checks and permit-to-purchase in particular, is associated with decreased firearm homicide rates. High-quality research is important to further evaluate the effectiveness of these laws. Legislation is just 1 part of a multipronged approach that will be necessary to decrease firearm homicides in the United States.
Topics: Firearms; Homicide; Humans; United States; Wounds, Gunshot
PubMed: 27842178
DOI: 10.1001/jamainternmed.2016.7051 -
The British Journal of Oral &... Dec 2021The importance of teams' and individuals' non-technical skills in reducing adverse events is well-recognised. We undertook a systematic review of the published... (Review)
Review
The importance of teams' and individuals' non-technical skills in reducing adverse events is well-recognised. We undertook a systematic review of the published literature to assess the research undertaken to date on non-technical skills and behaviours within oral and maxillofacial, and head and neck (OMFS-H&N) surgery. The aim was to assess the applicability of published studies to current practice, to look at how these studies could guide future research, and look for areas that could be developed further. The search terms included 'non technical skills', 'nontechnical skills', 'NOTSS', 'non-technical skills for surgeons', 'oral surgery', 'oral maxillofacial surgery', 'OMFS', 'maxillofacial surgery', 'head and neck surgery', 'microsurgery', 'behavioural markers', 'behavioural assessment tool', and 'behavioural ratings system'. Three publications were included, involving 83 participants. Participants consistently achieved the highest scores in the 'situational awareness' category and showed a tendency to achieve lower mean scores in the 'communication and teamwork' and 'decision-making' categories. The majority of research into surgeons' non-technical skills has occurred in simulated environments and not in the genuine environments in which actual surgery is being performed on patients. Research involving 'real' patients has been done in the field of OMFS-H&N and this places the specialty in a stronger position than many other surgical specialties.
Topics: Awareness; Clinical Competence; Communication; General Surgery; Humans; Specialties, Surgical; Surgeons
PubMed: 34740468
DOI: 10.1016/j.bjoms.2020.08.052 -
The Open Dentistry Journal 2018Periodontal implications of orthodontic therapy are frequent, gingival and periodontal conditions need to be evaluated for every appointment. Several studies have... (Review)
Review
BACKGROUND
Periodontal implications of orthodontic therapy are frequent, gingival and periodontal conditions need to be evaluated for every appointment. Several studies have analyzed the effects of fixed appliance on periodontal health.
OBJECTIVE
To evaluate whether there is updated scientific evidence on the relationship between fixed orthodontic therapy and periodontal health.
METHODS
A literature search was performed using the Pubmed and Cochrane databases and manual search; the search was carried out using the keywords "orthodontic" and "periodontal". Articles published only in the English language from January 1997 to April 2017 were included. The inclusion criteria were: RCTs, cohort studies, cross-sectional studies and case-control studies only in English language; only studies on humans, with a minimum sample size of 20 patients and no restriction in terms of patient ages; orthodontic fixed appliances placed into the buccal tooth surface; standardization and training in oral hygiene; Periodontal Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), Pocket Probing Depth (PPD), at least at baseline (before appliance was placed) and after follow up (with a minimum period of 3 months). The exclusion criteria were as follows: absence of baseline data before fixed appliances was placed; patients with systemic diseases, periodontal disease or craniofacial anomalies; removable appliances or orthodontic appliance on the lingual dental surface; and no standardization or training in oral hygiene.Studies were selected by abstract and title; then, inclusion and exclusion criteria were applied. The studies that satisfied the inclusion criteria were evaluated and classified as having low, moderate or high methodology quality.
RESULTS
Fifty-five records were reviewed on the basis of title and abstract. After full-text reading, 47 full texts were excluded, and 3 articles were classified as having low methodological quality and 5 as having moderate methodological quality.
CONCLUSIONS
The present systematic analysis suggests that there is moderate scientific evidence that a fixed appliance influences periodontal status; no article reported a high score.
PubMed: 30369970
DOI: 10.2174/1745017901814010614 -
Journal of Oral & Maxillofacial Research 2022The purpose of this systematic review and meta-analysis is to examine the success rate of osseointegrated dental implants placed secondarily in fibula free flaps using... (Review)
Review
OBJECTIVES
The purpose of this systematic review and meta-analysis is to examine the success rate of osseointegrated dental implants placed secondarily in fibula free flaps using the Albrektsson and colleagues criteria.
MATERIAL AND METHODS
A computerized database search was performed using PubMed, Embase, Web of Science and Cochrane CENTRAL. Specific ascertainment criteria were applied for the inclusion of the eligible studies. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis PRISMA checklist. Risk of bias was assessed for all the included studies.
RESULTS
The meta-analysis was carried using ten studies that met the inclusion criteria. The present review pooled data obtained from 242 patients (167 males and 75 females), with the age range of 13 to 79 years. A total of 848 dental implants were placed in the free fibula flaps. All dental implants were placed in a delayed fashion, ranging from 14 to 192 months. The estimated proportion of successful implants placed in fibula flaps used to reconstruct the maxillomandibular complex was 0.94 or 94% (95% CI [confidence interval] = 0.91 to 0.96]) with an insignificant heterogeneity of 37%, P = 0.12. Using a random effect model the annual implant failure rate was 0.02 with a 95% CI = 0.01 to 0.03.
CONCLUSIONS
The results of this systematic review and meta-analysis strongly indicate that using objective criteria, delayed implant placement in free fibula flaps is highly successful.
PubMed: 35574211
DOI: 10.5037/jomr.2022.13103 -
Heliyon Jan 2023Dark tourists experience negative and positive feelings in Holocaust places, suggesting emotional ambivalence. The research question of this study is, "is feeling...
Dark tourists experience negative and positive feelings in Holocaust places, suggesting emotional ambivalence. The research question of this study is, "is feeling well-being, as a consequence of dark tourism, a way of banalizing the horror?". The purpose of this study is threefold: to provide an updated systematic literature review (SLR) of dark tourism associated with Holocaust sites and visitors' well-being; to structure the findings into categories that provide a comprehensive overview of the topics; and to identify which topics are not well covered, thus suggesting knowledge gaps. Records to be included should be retrievable articles in peer-reviewed academic journals, books, and book chapters, all focused on the SLR's aims and the research question; other types of publications were outrightly excluded. The search was performed in Web of Science, Scopus, and Google Scholar databases with three keywords and combinations: "dark tourism", "Holocaust", and "well-being". Methodological decisions were based on the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. During the process, 144 documents were included, of which 126 were journal articles, 8 were books, and 10 were book chapters. The results point out a hierarchical structure with the main category (Dark tourism - Holocaust - Well-being) and three second-order categories (Dark tourism - Holocaust, Dark tourism - Well-being, and Holocaust - Well-being), from which different subcategories emerge: motivations for visiting places and guiding; ambivalent emotional experience that leads to the transformation of the self; and intergenerational trauma. The gaps identified were the trivialization of horror in Holocaust places; dark tourist profile; motivations and constraints behind visiting dark places; Holocaust survivors and their descendants' well-being; how dark tourism associated with the Holocaust positively or negatively impacts well-being. Major limitations included: lack of randomized allocation; lack of standard outcome definitions; and suboptimal comparison groups. Positive and negative impacts on the well-being of the Holocaust dark tourist were sought, as they are associated with the marketing and management, promotion, digital communication, guiding, or storytelling design of such locations.
PubMed: 36711286
DOI: 10.1016/j.heliyon.2023.e13064 -
The International Journal on Drug Policy Jan 2015The use of Cannabis for Therapeutic Purposes (CTP) has recently become legal in many places. These policy and legal modifications may be related to changes in cannabis... (Review)
Review
BACKGROUND
The use of Cannabis for Therapeutic Purposes (CTP) has recently become legal in many places. These policy and legal modifications may be related to changes in cannabis perceptions, availability and use and in the way cannabis is grown and sold. This may in turn have effects on public health and safety. To better understand the potential effects of CTP legalization on public health and safety, the current paper synthesizes and critically discusses the relevant literature.
METHODS
Twenty-eight studies were identified by a comprehensive search strategy, and their characteristics and main findings were systematically reviewed according to the following content themes: CTP and illegal cannabis use; CTP and other public health issues; CTP, crime and neighbourhood disadvantage.
RESULTS
The research field is currently limited by a lack of theoretical and methodological rigorous studies. The review shows that the most prevalent theme of investigation so far has been the relation between CTP and illegal cannabis use. In addition, the literature review shows that there is an absence of evidence to support many common concerns related to detrimental public health and safety effects of CTP legalization.
CONCLUSION
Although lack of evidence provides some reassurance that CTP legalization may not have posed a substantial threat to public health and safety, this conclusion needs to be examined in light of the limitations of studies conducted so far. Furthermore, as CTP policy continues to evolve, including incorporation of greater commercialization, it is possible that the full effects of CTP legalization have yet to take place. Ensuring study quality will allow future research to better investigate the complex role that CTP plays in relation to society at large, and public health and safety in particular.
Topics: Cannabis; Drug and Narcotic Control; Humans; Marijuana Smoking; Medical Marijuana; Public Health
PubMed: 25304050
DOI: 10.1016/j.drugpo.2014.09.005 -
Systematic Reviews Sep 2022Results of new studies should be interpreted in the context of what is already known to compare results and build the state of the science. This systematic review and...
BACKGROUND
Results of new studies should be interpreted in the context of what is already known to compare results and build the state of the science. This systematic review and meta-analysis aimed to identify and synthesise results from meta-research studies examining if original studies within health use systematic reviews to place their results in the context of earlier, similar studies.
METHODS
We searched MEDLINE (OVID), EMBASE (OVID), and the Cochrane Methodology Register for meta-research studies reporting the use of systematic reviews to place results of original clinical studies in the context of existing studies. The primary outcome was the percentage of original studies included in the meta-research studies using systematic reviews or meta-analyses placing new results in the context of existing studies. Two reviewers independently performed screening and data extraction. Data were synthesised using narrative synthesis and a random-effects meta-analysis was performed to estimate the mean proportion of original studies placing their results in the context of earlier studies. The protocol was registered in Open Science Framework.
RESULTS
We included 15 meta-research studies, representing 1724 original studies. The mean percentage of original studies within these meta-research studies placing their results in the context of existing studies was 30.7% (95% CI [23.8%, 37.6%], I=87.4%). Only one of the meta-research studies integrated results in a meta-analysis, while four integrated their results within a systematic review; the remaining cited or referred to a systematic review. The results of this systematic review are characterised by a high degree of heterogeneity and should be interpreted cautiously.
CONCLUSION
Our systematic review demonstrates a low rate of and great variability in using systematic reviews to place new results in the context of existing studies. On average, one third of the original studies contextualised their results. Improvement is still needed in researchers' use of prior research systematically and transparently-also known as the use of an evidence-based research approach, to contribute to the accumulation of new evidence on which future studies should be based.
SYSTEMATIC REVIEW REGISTRATION
Open Science registration number https://osf.io/8gkzu/.
PubMed: 36064741
DOI: 10.1186/s13643-022-02062-8