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Archives of Environmental Health 1984The typical occupational cohort study includes all causes of mortality. However, emphasis is usually placed on the presence or absence of excess cancer mortality. A... (Review)
Review
The typical occupational cohort study includes all causes of mortality. However, emphasis is usually placed on the presence or absence of excess cancer mortality. A systematic review of completed occupational cohort studies to assess the findings and patterns of cardiovascular mortality would be useful. Although many of these studies will illustrate the "healthy worker effect" with deficits in mortality, particularly from cardiovascular causes, a thorough review should indicate certain exposures needing further research. A recently published study of heart disease mortality in the rubber industry illustrates the potential use of such a literature review with subsequent follow up. Production workers in the rubber industry have shown small excesses in CAHD mortality. A follow-up study at one plant confirmed the known association between carbon disulfide and atherosclerosis, as well as suggested two new causal associations between CAHD and the use of phenol and ethanol as solvents. What additional techniques can be used to generate hypotheses on heart disease and occupation? Some possibilities include: A recent article describes the use of the results of occupational disease surveillance systems for occupational cancer research. A review of such systems for heart disease would be equally useful. It would be useful to review the quality and quantity of occupational data that has been collected in prospective cohort studies, such as those in Framingham and Evans County. The importance of examining the association between occupational exposures and heart disease include: Assessing whether adequate protection is afforded by current limits on exposure to substances known to cause heart disease (carbon disulfide, nitrates, and carbon monoxide).(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Adult; Animals; Antimony; Arsenic Poisoning; Carbon Disulfide; Carbon Monoxide Poisoning; Child; Cold Temperature; Coronary Disease; Fluorocarbons; Hot Temperature; Humans; Hydrocarbons; Middle Aged; Nitrates; Noise; Occupational Diseases; Pneumoconiosis; Radiation Effects; Vibration
PubMed: 6380427
DOI: 10.1080/00039896.1984.9939528 -
Health Policy and Planning Nov 2017Integration of services for patients with more than one diagnosed condition has intuitive appeal but it has been argued that the empirical evidence to support it is... (Review)
Review
Integration of services for patients with more than one diagnosed condition has intuitive appeal but it has been argued that the empirical evidence to support it is limited. We report the findings of a systematic review that sought to identify health system factors, extrinsic to the integration process, which either facilitated or hindered the integration of services for two common disorders, HIV and chronic non-communicable diseases. Findings were initially extracted and organized around a health system framework, followed by a thematic cross-cutting analysis and validation steps. Of the 150 articles included, 67% (n = 102) were from high-income countries. The articles explored integration with services for one or several chronic disorders, the most studied being alcohol or substance use disorders (47.7%), and mental health issues (29.5%). Four cross-cutting themes related to the health system were identified. The first and most common theme was the requirement for effective collaboration and coordination: formal and informal productive relationships throughout the system between providers and within teams, and between staff and patients. The second was the need for adequate and appropriately skilled and incentivized health workers-with the right expertise, training and operational support for the programme. The third was the need for supportive institutional structures and dedicated resources. The fourth was leadership in terms of political will, effective managerial oversight and organizational culture, indicating that actual implementation is as important as programme design. A fifth theme, outside the health system, but underpinning all aspects of the system operation, was that placing the patient at the centre of service delivery and responding holistically to their diverse needs. This was an important facilitator of integration. These findings confirm that integration processes in service delivery depend substantially for their success on characteristics of the health systems in which they are embedded.
Topics: Chronic Disease; Cooperative Behavior; Delivery of Health Care, Integrated; HIV Infections; Humans; Systems Integration
PubMed: 28666336
DOI: 10.1093/heapol/czw149 -
American Journal of Rhinology & Allergy 2016An exciting development in upper respiratory tract disease is the pathophysiology of vitamin D (VD3). There now is substantial literature to indicate that VD3 acts as an... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
An exciting development in upper respiratory tract disease is the pathophysiology of vitamin D (VD3). There now is substantial literature to indicate that VD3 acts as an immunomodulator of adaptive and innate immunity locally within the respiratory epithelium. Chronic rhinosinusitis (CRS) places a relatively large socioeconomic burden on developed nations, yet remains a difficult disease to treat. VD3, therefore, has become an area of clinical interest because it may provide an adjunctive drug therapy option in CRS, thereby potentially improving the quality of life of these patients.
OBJECTIVE
A systematic review of the relationship among serum VD3 levels, CRS phenotype, and disease severity by using outcome assessments.
METHODS
A systematic search was performed by using the PubMed, MEDLINE, and EMBASE databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Studies that measured serum VD3 levels and correlated the measurements to any subtype of CRS (with or without nasal polyps) were included for qualitative analysis.
RESULTS
Seven articles were included (four prospective and three retrospective studies), with a total of 539 patients. There were significantly lower VD3 levels in the polypoid phenotypes of CRS compared with controls. Low VD3 levels were often associated with an increased degree of inflammation.
CONCLUSION
The available evidence indicated that there is a significant relationship between low VD3 levels and polypoid CRS phenotypes. The association between VD3 levels and disease severity and VD3 potential for drug therapy remains unclear, which warrants further research in the area.
Topics: Animals; Asthma; Chronic Disease; Disease Progression; Humans; Rhinitis; Sinusitis; Vitamin D
PubMed: 26867526
DOI: 10.2500/ajra.2016.30.4267 -
Health Promotion Perspectives 2020Contemporary cosmetology, apart from beautifying and caring for the human body, deals also with prevention aimed at maintaining health and physical fitness as long as... (Review)
Review
Contemporary cosmetology, apart from beautifying and caring for the human body, deals also with prevention aimed at maintaining health and physical fitness as long as possible. The profession of a cosmetologist so understood is closely related to the modern concept of health promotion, the part of which is health education. The objective of this review was to evaluate whether a cosmetologist may be a health promoter, and whether a beauty salon mayserve as a place for conducting educational programs. A systematic review was done using several electronic databases such as PubMed(including MEDLINE), Web of Science Core Collection, Scopus, Embase, and Academic Search Ultimate (EBSCO) and related keywords. The studies published in English between 2008 and 2018 which had specifically mentioned the role of a cosmetologist in the area of health promotion and health education were included. In total, 7 articles met the study criteria. It was found that cosmetologists have the potential to promote pro-health activities. The results of this review also suggest that beauty salons are suitable places for increasing pro-health awareness and can be successfully used to conduct educational programs about healthy lifestyle, as well as skin, breast and cervical cancer prevention. A well-educated and aware of health risks cosmetologist seems to be the right person to transmit and spread knowledge about the proper lifestyle in her workplace and the local environment. A beauty salon, as a place of social interaction, may constitute an area of implementation of pro-health educational programs.
PubMed: 33312929
DOI: 10.34172/hpp.2020.52 -
Health & Place Jul 2018The role of place in mental health recovery was investigated by synthesizing qualitative research on this topic.
BACKGROUND AND AIM
The role of place in mental health recovery was investigated by synthesizing qualitative research on this topic.
METHODS
Using a meta-ethnographic approach, twelve research papers were selected, their data extracted, coded and synthesized.
FINDINGS
Place for doing, being, becoming and belonging emerged as central mechanisms through which place impacts recovery. Several material, social, natural and temporal characteristics appear to enable or constrain the potential of places to support recovery.
CONCLUSIONS
The impact of place on recovery is multi-faceted. The multidimensional interactions between people, place and recovery can inform recovery-oriented practice. Further research is required to uncover the role of place in offering opportunities for active engagement, social connection and community participation.
Topics: Anthropology, Cultural; Community Participation; Housing; Humans; Interpersonal Relations; Mental Disorders; Mental Health Recovery; Residence Characteristics; Social Environment; Social Support
PubMed: 29885554
DOI: 10.1016/j.healthplace.2018.05.008 -
Palliative Medicine Sep 2019Socio-economic factors play important roles in place of death. However, up-to-date knowledge on socio-economic determinants for place of death is warranted including...
BACKGROUND
Socio-economic factors play important roles in place of death. However, up-to-date knowledge on socio-economic determinants for place of death is warranted including analysis of collinearity between socio-economic determinants.
AIM
To examine associations between socio-economic determinants (social class, deprivation level in area of residence, income, education, occupation, urbanisation) and place of death among adult patients with life-limiting illnesses. Furthermore, to describe how these factors are operationalised and examined for collinearity.
DESIGN
A systematic review was performed (PROSPERO, record: CRD42018091218) and quality was assessed using the Newcastle-Ottawa Scale.
DATA SOURCES
A comprehensive search of PubMed, Embase, CINAHL, Scopus and PsycINFO was conducted for studies published from 1 January 2008 until the date of the search (23 March 2018) in English or Scandinavian languages.
RESULTS
Of the 1599 unique citations identified, 34 studies were eligible. Dying at home was to a high degree associated with better financial situation and living in rural areas. Furthermore, hospital death was associated with a high level of deprivation in the area of residence and being employed. Regarding educational level, we found mixed and inconclusive results.
CONCLUSION
Inequalities concerning place of death were found, and attention towards socio-economic inequality concerning place of death is necessary, especially in patients with a poor financial status, patients living in deprived and metropolitan areas and patients who are employed. Furthermore, we found a low degree of assessment for collinearity and adjustment of socio-economic variables. These issues should be considered in planning of future studies of socio-economic determinants for place of death.
Topics: Death; Educational Status; Humans; Income; Patient Preference; Social Class; Terminal Care; Urbanization
PubMed: 31187687
DOI: 10.1177/0269216319847089 -
JAMA Internal Medicine Jan 2015Overuse of medical care, consisting primarily of overdiagnosis and overtreatment, is a common clinical problem. (Review)
Review
IMPORTANCE
Overuse of medical care, consisting primarily of overdiagnosis and overtreatment, is a common clinical problem.
OBJECTIVE
To identify and highlight the most significant clinical articles published in 2013 related to medical overuse.
EVIDENCE REVIEW
A systematic review of English-language articles published in 2013 that related to medical overuse in adults.
FINDINGS
We reviewed 478 published articles that met our inclusion criteria. Of these, 126 were ranked most relevant based on quality of methodology, strength of results, potential effects on patient care, and the number of patients potentially affected. The 10 most relevant articles were selected using the same criteria. These 10 articles (organized into the categories overdiagnosis, overtreatment, and methods to avoid overuse) were reviewed and interpreted for their effect on clinical medicine.
CONCLUSIONS AND RELEVANCE
The literature on overuse of medical care is rapidly expanding. In 2013, both clinical trials and observational studies highlighted frequently overused or unnecessary care. Overuse of testing causes false-positive results and overdiagnosis. Negative test results do not appear to genuinely reassure patients. Overtreatment, with both medical therapies and procedural interventions, places patients at risk of unnecessary adverse events.
Topics: Health Services Misuse; Humans
PubMed: 25365707
DOI: 10.1001/jamainternmed.2014.5444 -
Folia Medica Cracoviensia Apr 2023Carcinoma of unknown primary (CUP) is a heterogeneous group of oncological diseases in which it is impossible to determine the primary tumor. The incidence is 3-5% of...
Carcinoma of unknown primary (CUP) is a heterogeneous group of oncological diseases in which it is impossible to determine the primary tumor. The incidence is 3-5% of oncologic patients, but the survival time varies from 6 weeks to 5 months. The diagnostics should begin with a clinical evaluation and basic laboratory tests. For CUP placed in head and neck the positron emission tomography - computed tomography is recommended; pancreatic or lung neoplasms are diagnosed with the computed tomography as well. Recently, the magnetic resonance, especially whole-body diffusion-weighted imaging has been introduced to the imaging panel. The lesion obtained during surgically removed metastases or biopsy material should be histopathological and molecularly examined to define the type of tumor. The basic immunoexpression panel should include cytokeratin-5/6, -7 and -20, EMA, synaptophysin, chromogranin, vimentin and GATA3 and molecular expression of ERBB2, PIK3CA, NF1, NF2, BRAF, IDH1, PTEN, FGFR2, EGFR, MET and CDK6. During the accurate diagnostics enable to classify malignancy of undefined primary origin as provisional CUP or finally confirmed CUP in which the primary place of tumor remains undetectable. The detailed diagnostics should be performed in highly specified centers to establish an accurate diagnosis and to initiate personalized treatment. Majority of patients are diagnosed with adenocarcinoma (70%), undifferentiated carcinoma (20%), squamous cell or transitional cell/uroepithelial carcinoma (5-10%), neuroendocrine tumor (5%) and with minor incidence other histological types, including melanoma.
Topics: Humans; Neoplasms, Unknown Primary; Carcinoma; Adenocarcinoma; Tomography, X-Ray Computed; Magnetic Resonance Imaging; Head and Neck Neoplasms
PubMed: 37406274
DOI: 10.24425/fmc.2023.145427 -
The Psychiatric Quarterly Dec 2011Religion and spirituality (RS) as a coping resource for facing stressful life events is encountered with increasing frequency in the medical literature. RS is associated... (Review)
Review
Religion and spirituality (RS) as a coping resource for facing stressful life events is encountered with increasing frequency in the medical literature. RS is associated with more favourable outcomes among people suffering from mental disorders. Detention is a stressful situation and the prevalence of mental disorders in places of detention is increased compared with the community. This literature review examined the association between RS and the mental health of detainees. PubMed, PsycINFO, Web of Science and the Internet were systematically searched from inception of each data base to August 1st 2010. Peer reviewed articles that reported primary empirical data about the impact of spirituality on the mental health and behaviour of detained persons were selected. Qualitative studies are also discussed. Twelve empirical studies including a total of 4,823 individuals met our inclusion criteria. RS is associated with lower frequency and severity of depressive episodes. The strongest reported effect of RS on prison life is a reduction of incidents and disciplinary sanctions. Prospective targeted studies are needed in order verify the hypothesis that RS reduces suicide among detainees.
Topics: Criminal Psychology; Humans; Mental Health; Prisoners; Religion
PubMed: 21311972
DOI: 10.1007/s11126-011-9170-6 -
Clinical Oral Investigations Mar 2018The aim of this article is to systematically review the effect of subcrestal implant placement compared with equicrestal position on hard and soft tissues around dental... (Meta-Analysis)
Meta-Analysis Review
Influence of subcrestal implant placement compared with equicrestal position on the peri-implant hard and soft tissues around platform-switched implants: a systematic review and meta-analysis.
AIM
The aim of this article is to systematically review the effect of subcrestal implant placement compared with equicrestal position on hard and soft tissues around dental implants with platform switch.
MATERIAL AND METHODS
A manual and electronic search (National Library of Medicine and Cochrane Central Register of Controlled Trials) was performed for animal and human studies published up to December 2016. Primary outcome variable was marginal bone level (MBL) and secondary outcomes were crestal bone level (CBL), soft tissue dimensions (barrier epithelium, connective tissue, and peri-implant mucosa), and changes in the position of soft tissue margin. For primary and secondary outcomes, data reporting mean values and standard deviations of each study were extracted and weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated.
RESULTS
A total of 14 publications were included (7 human studies and 7 animal investigations). The results from the meta-analyses have shown that subcrestal implants, when compared with implants placed in an equicrestal position, exhibited less MBL changes (human studies: WMD = - 0.18 mm; 95% CI = - 1.31 to 0.95; P = 0.75; animal studies: WMD = - 0.45 mm; 95% CI = - 0.66 to - 0.24; P < 0.001). Furthermore, the CBL was located at a more coronal position in subcrestal implants with respect to the implant shoulder (WMD = - 1.09 mm; 95% CI = - 1.43 to - 0.75; P < 0.001). The dimensions of the peri-implant mucosa seem to be affected by the positioning of the microgap and were greater at implants placed in a subcrestal position than those inserted equicrestally (WMD = 0.60 mm; 95% CI = 0.26 to 0.95; P < 0.001). While the length of the barrier epithelium was significantly greater in implants placed in a subcrestal position (WMD = 0.39 mm; 95% CI = 0.19 to 0.58; P < 0.001), no statistical significant differences were observed between equicrestal and subcrestal implant positioning for the connective tissue length (WMD = 0.17 mm; 95% CI = - 0.03 to 0.36; P = 0.10).
CONCLUSION
This systematic review suggests that PS implants placed in a subcrestal position have less MBL changes when compared with implants placed equicrestally. Furthermore, the location of the microgap seems to have an influence on the dimensions of peri-implant soft tissues. Clinical relevance When compared with PS placed in an equicrestal position, subcrestal implant positioning demonstrated less peri-implant bone remodeling.
Topics: Alveolar Process; Animals; Bone Remodeling; Dental Implant-Abutment Design; Dental Implantation, Endosseous; Dental Implants; Humans
PubMed: 29313133
DOI: 10.1007/s00784-017-2301-1