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Public Health Nutrition Dec 2021To examine the literature and identify main themes, methods and results of studies concerning food and nutrition addressed in research on transgender populations. (Review)
Review
OBJECTIVE
To examine the literature and identify main themes, methods and results of studies concerning food and nutrition addressed in research on transgender populations.
DESIGN
A systematic review conducted through July 2020 in the MedLine/PubMed, Scopus and Web of Science databases.
RESULTS
Of the 778 studies identified in the databases, we selected thirty-seven. The studies were recent, most of them published after 2015, being produced in Global North countries. The most often used study design was cross-sectional; the least frequently used study design was ethnographic. Body image and weight control were predominant themes (n 25), followed by food and nutrition security (n 5), nutritional status (n 5), nutritional health assistance (n 1) and emic visions of healthy eating (n 1).
CONCLUSIONS
The transgender community presents body, food and nutritional relationships traversed by its unique gender experience, which challenges dietary and nutritional recommendations based on the traditional division by sex (male and female). We need to complete the lacking research and understand contexts in the Global South, strategically investing in exploratory-ethnographic research, to develop categories of analysis and recommendations that consider the transgender experience.
Topics: Cross-Sectional Studies; Diet, Healthy; Female; Humans; Male; Nutrition Therapy; Nutritional Status; Transgender Persons
PubMed: 33866993
DOI: 10.1017/S1368980021001671 -
Frontiers in Public Health 2022Employee alcohol and other drug use can negatively impact the workplace, resulting in absenteeism, reduced productivity, high turnover, and worksite safety issues. As...
UNLABELLED
Employee alcohol and other drug use can negatively impact the workplace, resulting in absenteeism, reduced productivity, high turnover, and worksite safety issues. As the workplace can influence employee substance use through environmental and cultural factors, it also presents a key opportunity to deliver interventions, particularly to employees who may not otherwise seek help. This is a systematic review of workplace-based interventions for the prevention and treatment of problematic substance use. Five databases were searched for efficacy, effectiveness and/or cost-effectiveness studies and reviews published since 2010 that measured use of psychoactive substances (i.e., alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, and stimulants) as a primary or secondary outcome, in employees aged over 18. Thirty-nine articles were identified, 28 describing primary research and 11 reviews, most of which focused solely on alcohol use. Heterogeneity between studies with respect to intervention and evaluation design limited the degree to which findings could be synthesized, however, there is some promising evidence for workplace-based universal health promotion interventions, targeted brief interventions, and universal substance use screening. The few studies that examined implementation in the workplace revealed specific barriers including lack of engagement with e-health interventions, heavy use and reluctance to seek help amongst male employees, and confidentiality concerns. Tailoring interventions to each workplace, and ease of implementation and employee engagement emerged as facilitators. Further high-quality research is needed to examine the effectiveness of workplace substance use testing, Employee Assistance Programs, and strategies targeting the use of substances other than alcohol in the workplace.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227598, PROSPERO [CRD42021227598].
Topics: Male; Humans; Adolescent; Adult; Workplace; Cost-Benefit Analysis; Substance-Related Disorders; Work Engagement; Cannabis; Ethanol
PubMed: 36419993
DOI: 10.3389/fpubh.2022.1051119 -
Medicina Clinica Jul 2014The aging of the population and changes in family and social structures have led to increasing care needs for elderly persons following an acute disease or accident,... (Review)
Review
The aging of the population and changes in family and social structures have led to increasing care needs for elderly persons following an acute disease or accident, with consequent concerns regarding costs and sustainability within the public health system. The main objective of postacute care (PAC) is to restore the functional capabilities of the patient after an acute event and contribute to determine the patient's outcome and future healthcare requirements. With this background, we carried out a systematic review of the published literature from 1990 to 2011 focused on the following aspects of PAC: a) objectives; b) estimations of the need and the indicators for access to it, and c) transfer strategies from acute care to PAC. The results of this review indicate that PAC is an efficient approach to improve patients' quality of life and to sustain the public healthcare system. The choice of candidates for PAC should be based on both health and social indicators, and the overall process viewed in a cross-sectional manner in order to avoid increases in total cost.
Topics: Acute Disease; Aftercare; Aged; Bed Conversion; Europe; Health Services Needs and Demand; Home Care Services; Humans; Medicare; Models, Economic; National Health Programs; Quality of Life; Recovery of Function; Subacute Care; United States
PubMed: 23896450
DOI: 10.1016/j.medcli.2013.05.032 -
Nutrients Feb 2017Overweight and obesity (OW/OB) is a pressing health concern among migrant and seasonal farmworker (MSFW) families in the US. The limited number of previously reported... (Review)
Review
Prevalence and Determinants of Overweight and Obesity in Children and Adolescents from Migrant and Seasonal Farmworker Families in the United States-A Systematic Review and Qualitative Assessment.
Overweight and obesity (OW/OB) is a pressing health concern among migrant and seasonal farmworker (MSFW) families in the US. The limited number of previously reported research on MSFW families suggests that their unique sociodemographic characteristics and lifestyle predispose them to poor health outcomes including OW/OB. We aimed to synthesize and assess available data on the prevalence and modifiable health determinants of OW/OB in MSFW children and adolescents. Literature search, study selection, data extraction and synthesis, and qualitative assessment of selected studies were performed independently by two authors. Ten cross-sectional studies met the inclusion criteria: articles or dissertations investigating prevalence and association between health determinants and OW/OB in MSFW children and adolescents (<20 years) in the US. The prevalence of OW, OB, and OW/OB ranged from 10%-33%, 15%-37%, and 31%-73%, respectively. Children's education, household food insecurity, parents' weight status, parents' distorted perception of their children's weight status, and parents' participation in the federal nutrition assistance program were significantly associated with the children's and adolescents' risk of OW/OB. Promotion of culturally relevant public health programs and implementation of a systematic health surveillance plan for MSFWs and their children should be emphasized to combat OW/OB among MSFW children and adolescents.
Topics: Adolescent; Body Weight; Child; Family Characteristics; Farmers; Food Assistance; Food Supply; Humans; Life Style; Overweight; Parents; Pediatric Obesity; Prevalence; Risk Factors; Seasons; Socioeconomic Factors; Transients and Migrants; United States
PubMed: 28245565
DOI: 10.3390/nu9030188 -
Trauma, Violence & Abuse Jul 2024Gender-based violence (GBV) is a pervasive public health issue that harms victims. Bystanders' interventions are crucial in preventing the risks of GBV; however,... (Meta-Analysis)
Meta-Analysis Review
Gender-based violence (GBV) is a pervasive public health issue that harms victims. Bystanders' interventions are crucial in preventing the risks of GBV; however, numerous barriers impede their willingness and behaviors to intervene. As a part of efforts to thwart these barriers, this study used a systematic review and meta-analysis to identify such barriers and assess their impact on bystanders' engagement to intervene. The researchers explored academic databases and included 38 studies in the analysis; we extracted and coded the identified barriers (e.g., lack of responsibility, rape myth) and allocated them to six domains: , , , , , and . We calculated the overall and domain-specific effect sizes (ES) and performed moderator analysis. The overall ES of the barriers identified in the review were small but statistically significant. The most potent bystander intervention barrier domain was ; the greatest specific barriers therein were negative emotions and feelings of uncertainty after engaging in bystander behaviors. University/college populations were more vulnerable to barriers to intervention than community members. Moreover, the barriers were more prohibitive in incidents of violence against women and sexual assaults than in intimate partner violence. Bystander-focused programs that address negative emotions and feelings arising from prior intervention experiences are needed to foster continued bystander engagement and assistance in GBV; moreover, tailored program content should also be provided for groups most vulnerable to intervention barriers.
Topics: Humans; Gender-Based Violence; Female; Male
PubMed: 37902582
DOI: 10.1177/15248380231204887 -
Clinical Journal of the American... Apr 2020Compared with hemodialysis, home peritoneal dialysis alleviates the burden of travel, facilitates independence, and is less costly. Physical, cognitive, or psychosocial...
BACKGROUND AND OBJECTIVES
Compared with hemodialysis, home peritoneal dialysis alleviates the burden of travel, facilitates independence, and is less costly. Physical, cognitive, or psychosocial factors may preclude peritoneal dialysis in otherwise eligible patients. Assisted peritoneal dialysis, where trained personnel assist with home peritoneal dialysis, may be an option, but the optimal model is unknown. The objective of this work is to characterize existing assisted peritoneal dialysis models and synthesize clinical outcomes.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
A systematic review of MEDLINE, Cochrane Central Register of Controlled Trails, Cochrane Database of Systematic Reviews, Embase, PsycINFO, and CINAHL was conducted (search dates: January 1995-September 2018). A focused gray literature search was also completed, limited to developed nations. Included studies focused on home-based assisted peritoneal dialysis; studies with the assist provided exclusively by unpaid family caregivers were excluded. All outcomes were narratively synthesized; quantitative outcomes were graphically depicted.
RESULTS
We included 34 studies, totaling 46,597 patients, with assisted peritoneal dialysis programs identified in 20 jurisdictions. Two categories emerged for models of assisted peritoneal dialysis on the basis of type of assistance: health care and non-health care professional assistance. Reported outcomes were heterogeneous, ranging from patient-level outcomes of survival, to resource use and transfer to hemodialysis; however, the comparative effect of assisted peritoneal dialysis was unclear. In two qualitative studies examining the patient experience, the maintenance of independence was identified as an important theme.
CONCLUSIONS
Reported outcomes and quality were heterogeneous, and relative efficacy of assisted peritoneal dialysis could not be determined from included studies. Although the patient voice was under-represented, suggestions to improve assisted peritoneal dialysis included using a person-centered model of care, ensuring continuity of nurses providing the peritoneal dialysis assist, and measures to support patient independence. Although attractive elements of assisted peritoneal dialysis are identified, further evidence is needed to connect assisted peritoneal dialysis outcomes with programmatic features and their associated funding models.
Topics: Caregivers; Continuity of Patient Care; Delivery of Health Care, Integrated; Health Personnel; Home Care Services; Humans; Kidney Diseases; Models, Organizational; Patient Satisfaction; Patient-Centered Care; Peritoneal Dialysis; Quality of Life; Treatment Outcome
PubMed: 32188636
DOI: 10.2215/CJN.11951019 -
Impact of public release of performance data on the behaviour of healthcare consumers and providers.The Cochrane Database of Systematic... Sep 2018It is becoming increasingly common to publish information about the quality and performance of healthcare organisations and individual professionals. However, we do not... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is becoming increasingly common to publish information about the quality and performance of healthcare organisations and individual professionals. However, we do not know how this information is used, or the extent to which such reporting leads to quality improvement by changing the behaviour of healthcare consumers, providers, and purchasers.
OBJECTIVES
To estimate the effects of public release of performance data, from any source, on changing the healthcare utilisation behaviour of healthcare consumers, providers (professionals and organisations), and purchasers of care. In addition, we sought to estimate the effects on healthcare provider performance, patient outcomes, and staff morale.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, and two trials registers on 26 June 2017. We checked reference lists of all included studies to identify additional studies.
SELECTION CRITERIA
We searched for randomised or non-randomised trials, interrupted time series, and controlled before-after studies of the effects of publicly releasing data regarding any aspect of the performance of healthcare organisations or professionals. Each study had to report at least one main outcome related to selecting or changing care.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened studies for eligibility and extracted data. For each study, we extracted data about the target groups (healthcare consumers, healthcare providers, and healthcare purchasers), performance data, main outcomes (choice of healthcare provider, and improvement by means of changes in care), and other outcomes (awareness, attitude, knowledge of performance data, and costs). Given the substantial degree of clinical and methodological heterogeneity between the studies, we presented the findings for each policy in a structured format, but did not undertake a meta-analysis.
MAIN RESULTS
We included 12 studies that analysed data from more than 7570 providers (e.g. professionals and organisations), and a further 3,333,386 clinical encounters (e.g. patient referrals, prescriptions). We included four cluster-randomised trials, one cluster-non-randomised trial, six interrupted time series studies, and one controlled before-after study. Eight studies were undertaken in the USA, and one each in Canada, Korea, China, and The Netherlands. Four studies examined the effect of public release of performance data on consumer healthcare choices, and four on improving quality.There was low-certainty evidence that public release of performance data may make little or no difference to long-term healthcare utilisation by healthcare consumers (3 studies; 18,294 insurance plan beneficiaries), or providers (4 studies; 3,000,000 births, and 67 healthcare providers), or to provider performance (1 study; 82 providers). However, there was also low-certainty evidence to suggest that public release of performance data may slightly improve some patient outcomes (5 studies, 315,092 hospitalisations, and 7502 providers). There was low-certainty evidence from a single study to suggest that public release of performance data may have differential effects on disadvantaged populations. There was no evidence about effects on healthcare utilisation decisions by purchasers, or adverse effects.
AUTHORS' CONCLUSIONS
The existing evidence base is inadequate to directly inform policy and practice. Further studies should consider whether public release of performance data can improve patient outcomes, as well as healthcare processes.
Topics: Canada; Clinical Decision-Making; Consumer Health Information; Evaluation Studies as Topic; Health Maintenance Organizations; Health Services Needs and Demand; Hospitals; Humans; Information Dissemination; Medicaid; Organizational Innovation; Quality Assurance, Health Care; Quality Improvement; Randomized Controlled Trials as Topic; Reproducibility of Results; Treatment Outcome; United States
PubMed: 30188566
DOI: 10.1002/14651858.CD004538.pub3 -
Ocular Immunology and Inflammation 2018Describe patient characteristics, treatment, and vision outcomes of Listeria monocytogenes endophthalmitis, an exceedingly rare form of listeriosis. (Review)
Review
PURPOSE
Describe patient characteristics, treatment, and vision outcomes of Listeria monocytogenes endophthalmitis, an exceedingly rare form of listeriosis.
METHODS
L. monocytogenes endophthalmitis cases in human adults, located through Medline (32) and from disease surveillance centers (11). L. monocytogenes conjunctivitis and keratitis were excluded.
RESULTS
Most cases occurred in 2000-2015 (22/43), and almost all in Europe or North America (40/43). Patients were a median 61 years, 57% male (24/42) and half were immunosuppressed. Median days from entering care to diagnosis was 8 (IQR = 5-17). Only four were exogenous infections. L. monocytogenes was identified in 31/35 of anterior eye fluid samples (89%). Antibiotic regimens varied markedly (mostly ≥3 drugs). At diagnosis, most were blind in the affected eye (85%, 28/33), only a third regained normal vision (12/36). Older patients had poorer outcomes.
CONCLUSIONS
Cases increased over time. Diagnostic delays were common and visual impairment often refractory to treatment, especially in older adults. The condition's rarity and variation in treatment makes it difficult to identify optimum therapy.
Topics: Anti-Bacterial Agents; Endophthalmitis; Eye Infections, Bacterial; Humans; Listeria monocytogenes; Listeriosis
PubMed: 28145786
DOI: 10.1080/09273948.2016.1276788 -
Nursing Open Sep 2023The aim of this study was to identify the influencing factors of sleep disorders and sleep quality in healthcare workers during the COVID-19 pandemic. (Meta-Analysis)
Meta-Analysis Review
AIM
The aim of this study was to identify the influencing factors of sleep disorders and sleep quality in healthcare workers during the COVID-19 pandemic.
DESIGN
Systematic review and meta-analysis of observational research.
METHODS
The databases of the Cochrane Library, Web of Science, PubMed, Embase, SinoMed database, CNKI, Wanfang Data, and VIP were systematically searched. The quality of studies was assessed using the Agency for Healthcare Research and Quality evaluation criteria and the Newcastle-Ottawa scale.
RESULTS
A total of 29 studies were included, of which 20 were cross-sectional studies, eight were cohort studies, and 1 was a case-control study; 17 influencing factors were finally identified. Greater risk of sleep disturbance was associated with female gender, single relationship status, chronic disease, insomnia history, less exercise, lack of social support, frontline work, days served in frontline work, department of service, night shift, years of work experience, anxiety, depression, stress, received psychological assistance, worried about being infected, and degree of fear with COVID-19.
CONCLUSIONS
During the COVID-19 pandemic, healthcare workers did have worse sleep quality than the general population. The influencing factors of sleep disorders and sleep quality in healthcare workers are multifaceted. Identification and timely intervention of resolvable influencing factors are particularly important for preventing sleep disorders and improving sleep.
PATIENT OR PUBLIC CONTRIBUTION
This is a meta-analysis of previously published studies so there was no patient or public contribution.
Topics: United States; Humans; Female; Sleep Quality; COVID-19; Case-Control Studies; Pandemics; Health Personnel
PubMed: 37282352
DOI: 10.1002/nop2.1871 -
Forensic Sciences Research 2021Epigenetic mechanisms are potential mediators of the physiological response to abuse by altering the genetic predisposition of the cellular response to the environment,... (Review)
Review
Epigenetic mechanisms are potential mediators of the physiological response to abuse by altering the genetic predisposition of the cellular response to the environment, leading to changes in the regulation of multiple organ systems. This study was established to review the epigenetic mechanisms associated with childhood abuse as well as the long-term determinants that these epigenetic changes may have on future illness. We retrospectively analysed the effect of exposure to adverse childhood experiences (ACEs, specifically those relating to childhood maltreatment) between the ages of 0 and 16 years on the human epigenome, as well as possible clinical associations. After meeting inclusion and exclusion criteria, 36 articles were included in this systematic review. Eight of these studies did not find a relationship between childhood maltreatment and DNA methylation. Of the remaining 28 studies, nine were genome-wide association studies, whereas the rest were candidate gene studies, mainly studying effects on neuroendocrine, serotoninergic and immunoregulatory systems. Meta-analysis of correlation coefficients from candidate gene studies estimated an association of childhood adversity and DNA methylation variation at = 0.291 ( < 0.0001), and meta-analysis of two epigenome-wide association studies (EWASs) identified 44 differentially methylated CpG sites. In conclusion, childhood maltreatment may mediate epigenetic mechanisms through DNA methylation, thereby affecting physiological responses and conferring a predisposition to an increased risk for psychopathology and forensic repercussions. Similar evidence for somatic illnesses is not yet available. KEY POINTSAdverse childhood experiences are associated with increased mortality partly explained by acquired epigenetic changesThere is a positive correlation between childhood abuse and DNA methylation at specific gene sitesThe cumulative effect of different types of childhood abuse and neglect may lead to changes in DNA methylationEpigenome changes associated with childhood abuse appear to be involved in the development of psychiatric illness in adulthoodStudying epigenetic changes may have important public health and forensic applications in the future.
PubMed: 34377567
DOI: 10.1080/20961790.2019.1641954