-
Canadian Journal of Psychiatry. Revue... Nov 2022The COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations...
OBJECTIVE
The COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations including women, young people, and people from ethnic minority backgrounds. This review aims to systematically address whether SARS-CoV-2 infection and/or COVID-19 disease confer elevated risk directly.
METHOD
As part of a larger Living Systematic Review examining self-harm and suicide during the pandemic, automated daily searches using a broad list of keywords were performed on a comprehensive set of databases with data from relevant articles published between January 1, 2020 and July 18, 2021. Eligibility criteria for our present review included studies investigating suicide and/or self-harm in people infected with SARS-CoV-2 with or without manifestations of COVID-19 disease with a comparator group who did not have infection or disease. Suicidal and self-harm thoughts and behaviour (STBs) were outcomes of interest. Studies were excluded if they reported data for people who only had potential infection/disease without a confirmed exposure, clinical/molecular diagnosis or self-report of a positive SARS-CoV-2 test result. Studies of news reports, treatment studies, and ecological studies examining rates of both SARS-CoV-2 infections and suicide/self-harm rates across a region were also excluded.
RESULTS
We identified 12 studies examining STBs in nine distinct samples of people with SARS-CoV-2. These studies, which investigated STBs in the general population and in subpopulations, including healthcare workers, generally found positive associations between SARS-CoV-2 infection and/or COVID-19 disease and subsequent suicidal/self-harm thoughts and suicidal/self-harm behaviour.
CONCLUSIONS
This review identified some evidence that infection with SARS-CoV-2 and/or COVID-19 disease may be associated with increased risks for suicidal and self-harm thoughts and behaviours but a causal link cannot be inferred. Further research with longer follow-up periods is required to confirm these findings and to establish whether these associations are causal.
Topics: Adolescent; COVID-19; Ethnicity; Female; Humans; Minority Groups; Pandemics; SARS-CoV-2; Self-Injurious Behavior; Suicidal Ideation
PubMed: 35532916
DOI: 10.1177/07067437221094552 -
BMC Public Health Mar 2019In recent years, researchers have begun applying a trajectory approach to identify homogeneous subgroups of physical activity (PA) in heterogeneous populations. This...
BACKGROUND
In recent years, researchers have begun applying a trajectory approach to identify homogeneous subgroups of physical activity (PA) in heterogeneous populations. This study systematically reviewed the articles identifying longitudinal PA trajectory classes and the related factors (e.g., determinants, predictors, and outcomes) in the general population during different life phases.
METHODS
The included studies used finite mixture models for identifying trajectories of PA, exercise, or sport participation. Three electronic databases, PubMed (Medline), Web of Science, and CINAHL, were searched from the year 2000 to 13 February 2018. The study was conducted according to the PRISMA recommendations.
RESULTS
Twenty-seven articles were included and organized into three age group: youngest (eleven articles), middle (eight articles), and oldest (eight articles). The youngest group consisted mainly of youth, the middle group of adults and the oldest group of late middle-aged and older adults. Most commonly, three or four trajectory classes were reported. Several trajectories describing a decline in PA were reported, especially in the youngest group, whereas trajectories of consistently increasing PA were observed in the middle and oldest group. While the proportion of persistently physically inactive individuals increased with age, the proportion was relatively high at all ages. Generally, male gender, being Caucasian, non-smoking, having low television viewing time, higher socioeconomic status, no chronic illnesses, and family support for PA were associated either with persistent or increasing PA.
CONCLUSIONS
The reviewed articles identified various PA subgroups, indicating that finite mixture modeling can yield new information on the complexity of PA behavior compared to studying population mean PA level only. The studies also provided novel information how different factors relate to changes in PA during life course. The recognition of the PA subgroups and their determinants is important for the more precise targeting of PA promotion and PA interventions.
TRIAL REGISTRATION
PROSPERO registration number: CRD42018088120 .
Topics: Age Factors; Exercise; Health Behavior; Health Status; Humans; Longitudinal Studies; Racial Groups; Recreation; Sex Factors; Socioeconomic Factors
PubMed: 30841921
DOI: 10.1186/s12889-019-6513-y -
Ciencia & Saude Coletiva Apr 2018Food security and the vulnerability among indigenous and peasant populations has become a topic of interest to public health all around the world, leading to the... (Review)
Review
Food security and the vulnerability among indigenous and peasant populations has become a topic of interest to public health all around the world, leading to the investigation about measurement, classification and factors that determine it. This systematic review aims to describe the situation of food security in indigenous and peasant communities, and the methods used for evaluation. The literature search was performed on the Pub Med (5), ScienceDirect (221) and Scopus (377) databases searching for publications between 2004 and 2015, a total of 603 items were located with the search engines. At the end of the screening process and after adding the items found in the gray literature, 25 papers were obtained to write the review. In the 11 years evaluated between 2004 and 2015, scientific activity around the theme was poor with just 4.54% of the publications on this subject, but for 2011 the percentage increased to 13 publications, 63%. Various factors that influence the development of food insecurity are climate change, the diversity of agriculture, globalization and market westernization.
Topics: Agriculture; Climate Change; Food Supply; Global Health; Humans; Internationality; Population Groups; Public Health
PubMed: 29694594
DOI: 10.1590/1413-81232018234.13882016 -
Alzheimer Disease and Associated... 2016Population aging has been accompanied by worldwide growth in dementia. However, little is known about the prevalence of dementia and cognitive impairment not dementia in... (Review)
Review
Population aging has been accompanied by worldwide growth in dementia. However, little is known about the prevalence of dementia and cognitive impairment not dementia in ethnically diverse populations, such as indigenous populations conceptualized as groups of persons who self-identify as indigenous and who are recognized as distinctive communities reproducing ancestral, historical, and territorial culture. This is particularly relevant in view of increasing life expectancy in indigenous populations and, consequently, in the number of elderly people, as well as the changes in their multimorbidity profile. In this study, a systematic review of the literature on the subject "cognitive impairment in indigenous elderly population" in the databases MEDLINE via PubMed, Lilacs, and Scopus showed that the prevalence of dementia in indigenous populations between 45 and 94 years old, originally from different countries, varied between 0.5% and 26.8% for age 60 and older, whereas the prevalence of cognitive impairment not dementia varied between 4.4% and 17.7%. Early onset of the disease, older age, low education level, and several poor health conditions were associated with prevalence rates and conversion from normal to any cognitive impairment. Cultural inadequacy of neuropsychological tests was the main factor reported in the selected studies, which makes the investigation of dementia a challenge in indigenous populations. These data reveal that the prevalence rates of dementia ranged from low to very high for those aged 60 years and older, with early onset of the disease and elevated mortality rate after initial diagnosis compared with the current global prevalence studies, suggesting that these individuals may be more vulnerable to cognitive disorders. Cognitive reserve and exposure to poor health status throughout life span may be considered in the interpretation of results.
Topics: Age Factors; Aging; Cognitive Dysfunction; Dementia; Humans; Neuropsychological Tests; Population Groups; Prevalence
PubMed: 26840546
DOI: 10.1097/WAD.0000000000000140 -
Obesity Reviews : An Official Journal... Sep 2022This systematic review aims to identify the multilevel correlates of sedentary behavior (SB) and its sub-domains among preschool-aged children aged 0-7 years in Asia.... (Review)
Review
This systematic review aims to identify the multilevel correlates of sedentary behavior (SB) and its sub-domains among preschool-aged children aged 0-7 years in Asia. We systematically searched for studies published from 2000 onwards using terms related to SB correlates and Asia in six databases. Eligible studies were observational and used quantitative methods to examine correlates of total, and domain-specific SB (screen viewing [SV] and non-screen-based SB) in Asian children living in Asia. Two reviewers independently screened identified references. Following quality assessment of included studies, we performed narrative synthesis to summarize the evidence on the intrapersonal, interpersonal, environmental correlates of total and domain-specific SB (PROSPERO: CRD42018095268). Twenty-two studies from 4 regions and 12 countries/territories were included. Out of the 94 correlates explored, the following associations were consistent: older age, being a boy, non-Chinese ethnicity (Southeast Asia), younger maternal age, higher maternal and paternal television-viewing time with higher SV; higher SV at earlier age with higher SV and total SB; and presence of TV/computer in the bedroom with higher leisure-time SB. We encourage more studies from low- and middle-income Asian countries with an increased focus on different SB domains, further exploration of environmental correlates, and the use of objective measurements to capture SB.
Topics: Asian People; Child; Child, Preschool; Computers; Ethnicity; Health Behavior; Humans; Male; Sedentary Behavior
PubMed: 35698280
DOI: 10.1111/obr.13485 -
JAMA Internal Medicine Jan 2023Since the onset of the COVID-19 pandemic, there have been calls for COVID-19 clinical trials to be fully representative of all demographic groups. However, limited... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Since the onset of the COVID-19 pandemic, there have been calls for COVID-19 clinical trials to be fully representative of all demographic groups. However, limited evidence is available about the sex, racial, and ethnic representation among COVID-19 prevention and treatment trials.
OBJECTIVE
To investigate whether female participants and racial and ethnic minority individuals are adequately represented in COVID-19 prevention and treatment trials in the US.
DATA SOURCES
Identified studies were registered on ClinicalTrials.gov or published in the PubMed database from October 2019 to February 2022.
STUDY SELECTION
Included studies must have provided the number of enrolled participants by sex, race, or ethnicity. Only interventional studies conducted in the US for the primary purpose of the diagnosis, prevention, or treatment of (or supportive care for) COVID-19 conditions were included.
DATA EXTRACTION AND SYNTHESIS
Data on counts of enrollments by demographic variables (sex, race, and ethnicity) and location (country and state) were abstracted. Studies were broadly categorized by primary purpose as prevention (including vaccine and diagnosis studies) vs treatment (including supportive care studies). A random effects model for single proportions was used. Trial estimates were compared with corresponding estimates of representation in the US population with COVID-19.
MAIN OUTCOMES AND MEASURES
Sex, racial, and ethnic representation in COVID-19 clinical trials compared with their representation in the US population with COVID-19.
RESULTS
Overall, 122 US-based COVID-19 clinical trials comprising 176 654 participants were analyzed. Studies were predominantly randomized trials (n = 95) for treatment of COVID-19 (n = 103). Sex, race, and ethnicity were reported in 109 (89.3%), 95 (77.9%), and 87 (71.3%) trials, respectively. Estimated representation in prevention and treatment trials vs the US population with COVID-19 was 48.9% and 44.6% vs 52.4% for female participants; 23.0% and 36.6% vs 17.7% for Hispanic or Latino participants; 7.2% and 16.5% vs 14.1% for Black participants; 3.8% and 4.6% vs 3.7% for Asian participants; 0.2% and 0.9% vs 0.2% for Native Hawaiian or Other Pacific Islander participants; and 1.3% and 1.4% vs 1.1% for American Indian or Alaska Native participants. Compared with expected rates in the COVID-19 reference population, female participants were underrepresented in treatment trials (85.1% of expected; P < .001), Black participants (53.7% of expected; P = .003) and Asian participants (64.4% of expected; P = .003) were underrepresented in prevention trials, and Hispanic or Latino participants were overrepresented in treatment trials (206.8% of expected; P < .001).
CONCLUSIONS AND RELEVANCE
In this systematic review and meta-analysis, aggregate differences in representation for several demographic groups in COVID-19 prevention and treatment trials in the US were found. Strategies to better ensure diverse representation in COVID-19 studies are needed, especially for prevention trials.
Topics: Humans; Female; United States; Ethnicity; COVID-19; Minority Groups; Pandemics; Hispanic or Latino
PubMed: 36469312
DOI: 10.1001/jamainternmed.2022.5600 -
Journal of Research in Health Sciences Oct 2017The Arg213His (rs9282861) polymorphism of Sulfotransferase Family 1A Member 1 (SULT1A1) gene has been associated with risk of breast cancer in some epidemiological... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The Arg213His (rs9282861) polymorphism of Sulfotransferase Family 1A Member 1 (SULT1A1) gene has been associated with risk of breast cancer in some epidemiological studies. Therefore, this systematic review and meta-analysis was conducted to evaluate the association of SULT1A1 Arg213His (rs9282861) polymorphism with susceptibility to breast cancer.
STUDY DESIGN
A systematic review and meta-analysis.
METHODS
A comprehensive literature search for eligible studies was conducted in PubMed, Elsevier, Science Direct, Scopus and Google Scholar databases up to Oct 5, 2017. Pooled odds ratios (ORs) with their corresponding 95% confidence intervals (95% CIs) were used to evaluate the strength of the association using fixed effects models and random effects models.
RESULTS
Twenty relevant case-control studies involving 11077 cases and 14798 controls were included in this meta-analysis. Overall, there was a significant association between the SULT1A1 Arg213His (rs9282861) polymorphism and risk of breast cancer in the allele mode (A vs. G: OR=1.117, 95% CI: 1.011, 1.233, P=0.029) and the homozygote model (AA vs. GG: OR=1.288, 95% CI: 1.036, 1.601, P=0.022). Subgroup analysis based on ethnicity suggested SULT1A1 Arg213His (rs9282861) polymorphism had a subtly increased breast cancer risk among Asian population, but not Caucasians. Further, subgroup analyses, significant associations were observed in hospital-based group, RFLP-PCR group, and high-quality studies subgroups.
CONCLUSIONS
SULT1A1 Arg213His (rs9282861) polymorphism might be associated with breast cancer risk, especially among Asian population. Moreover, the SULT1A1 Arg213His polymorphism is of high clinical relevance by ethnicity and would be a useful marker to identify patients who are at higher risk for breast cancer.
Topics: Alleles; Arylsulfotransferase; Asian People; Breast Neoplasms; Female; Genetic Predisposition to Disease; Genotype; Humans; Polymorphism, Genetic; White People
PubMed: 29233949
DOI: No ID Found -
Telemedicine Journal and E-health : the... May 2017African Americans (AA) experience high levels of health disparities for several diseases, yet remain underrepresented in clinical trials and other types of research. The... (Review)
Review
BACKGROUND
African Americans (AA) experience high levels of health disparities for several diseases, yet remain underrepresented in clinical trials and other types of research. The high ownership of smartphones among AA puts them in a unique position to be recruited into e-Health/m-Health interventions.
OBJECTIVE
This article is a systematic review of the participation of AA in e-Health/m-Health interventions, the diseases/health conditions targeted, and the recruitment and retention strategies used.
MATERIALS AND METHODS
A systematic review was done with PubMed, PsycINFO, Web of Science, EBSCOhost, and CINAHL databases, as well as hand searches of 14 journals. The search was restricted to studies conducted in the United States and that were published between January 2000 and June 2016. Twenty-three distinct search terms were used.
RESULTS
After removal of duplicates, 565 studies were screened and assessed for eligibility, and 56 met the inclusion criteria. Eight studies had exclusively AA participants. Eighty percent of the studies had female participants. Participants were recruited primarily from clinics/healthcare facilities. Forty-five percent of the studies provided monetary incentives. Only five studies addressed retention of participants. The diseases/health conditions that were studied included overweight/obesity, diabetes, physical activity, cardiovascular conditions, nutrition, prenatal health, and HIV.
CONCLUSION
There was a low representation of AA in the studies in this review. Opportunities exist to engage AA in e-Health/m-Health research, but researchers must go beyond the traditional one-size-fits-all approach to determine what mixture of incentives and recruitment/retention strategies would work best for a particular health condition, population group, or community.
Topics: Adult; Black or African American; Aged; Aged, 80 and over; Biomedical Research; Female; Humans; Male; Middle Aged; Motivation; Patient Selection; Telemedicine; United States
PubMed: 27792475
DOI: 10.1089/tmj.2016.0067 -
The Journal of Allergy and Clinical... May 2019Atopic eczema is a common inflammatory skin disease. Various inflammatory conditions have been linked to cardiovascular disease, a major cause of global mortality and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Atopic eczema is a common inflammatory skin disease. Various inflammatory conditions have been linked to cardiovascular disease, a major cause of global mortality and morbidity.
OBJECTIVE
We sought to systematically review and meta-analyze population-based studies assessing associations between atopic eczema and specific cardiovascular outcomes.
METHODS
MEDLINE, Embase, and Global Health were searched from inception to December 2017. We obtained pooled estimates using random-effects meta-analyses. We used a multivariate Bayesian meta-regression model to estimate the slope of effect of increasing atopic eczema severity on cardiovascular outcomes.
RESULTS
Nineteen relevant studies were included. The effects of atopic eczema reported in cross-sectional studies were heterogeneous, with no evidence for pooled associations with angina, myocardial infarction, heart failure, or stroke. In cohort studies atopic eczema was associated with increased risk of myocardial infarction (n = 4; relative risk [RR], 1.12; 95% CI, 1.00-1.25), stroke (n = 4; RR, 1.10; 95% CI, 1.03-1.17), ischemic stroke n = 4; RR, 1.17; 95% CI, 1.14-1.20), angina (n = 2; RR, 1.18; 95% CI, 1.13-1.24), and heart failure (n = 2; RR, 1.26; 95% CI, 1.05-1.51). Prediction intervals were wide for myocardial infarction and stroke. The risk of cardiovascular outcomes appeared to increase with increasing severity (mean RR increase between severity categories, 1.15; 95% credibility interval, 1.09-1.21; uncertainty interval, 1.04-1.28).
CONCLUSION
Significant associations with cardiovascular outcomes were more common in cohort studies but with considerable between-study heterogeneity. Increasing atopic eczema severity was associated with increased risk of cardiovascular outcomes. Improved awareness among stakeholders regarding this small but significant association is warranted.
Topics: Bayes Theorem; Cardiovascular Diseases; Cohort Studies; Cross-Sectional Studies; Dermatitis, Atopic; Humans; Population Groups
PubMed: 30576754
DOI: 10.1016/j.jaci.2018.11.030 -
Journal of Racial and Ethnic Health... Dec 2023Individuals from Black and Hispanic backgrounds represent a minority of the overall US population, yet are the populations most affected by the disease of obesity and... (Review)
Review
A Systematic Review on Participant Diversity in Clinical Trials-Have We Made Progress for the Management of Obesity and Its Metabolic Sequelae in Diet, Drug, and Surgical Trials.
OBJECTIVE
Individuals from Black and Hispanic backgrounds represent a minority of the overall US population, yet are the populations most affected by the disease of obesity and its comorbid conditions. Black and Hispanic individuals remain underrepresented among participants in obesity clinical trials, despite the mandate by the National Institutes of Health (NIH) Revitalization Act of 1993. This systematic review evaluates the racial, ethnic, and gender diversity of clinical trials focused on obesity at a national level.
METHODS
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of clinicaltrials.gov, PubMed, Cochrane Central, and Web of Science was undertaken to locate phase 3 and phase 4 clinical trials on the topic of obesity that met associated inclusion/exclusion criteria. Ultimately, 18 studies were included for review.
RESULTS
White non-Hispanic individuals represented the majority of clinical trial participants, as did females. No study classified participants by gender identity. Reporting of race/ethnicity was not uniform, with noted variability among racial/ethnic subgroups.
CONCLUSIONS
Our findings suggest that disparities remain in the diverse racial, ethnic, and gender representation of participants engaged in clinical trials on obesity relative to the prevalence of obesity in underrepresented populations. Commitment to inclusive and intentional recruiting practices is needed to increase the representation of underrepresented groups, thus increasing the generalizability of future research.
Topics: Humans; Male; Female; Gender Identity; Ethnicity; Obesity; Diet; White
PubMed: 36536164
DOI: 10.1007/s40615-022-01487-0