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European Journal of Nutrition Oct 2018Several studies in recent years have investigated the relationship between alcohol intake and melanoma risk, with conflicting results. To help clarify this issue, we... (Meta-Analysis)
Meta-Analysis
PURPOSE
Several studies in recent years have investigated the relationship between alcohol intake and melanoma risk, with conflicting results. To help clarify this issue, we conducted a literature review and dose-response meta-analysis of studies published until June 30th, 2017, that examined the association between alcohol intake (overall and by beverage type) and melanoma risk.
METHODS
We used random effect models with maximum likelihood estimation to calculate summary relative risk (SRR) and 95% confidence intervals (95%CI).
RESULTS
We included 20 independent studies (encompassing 10,555 melanoma cases and over 1.6 million non-cases/controls) published during 1986-2016, of which six had a prospective cohort study design. Adjustment for phenotypic characteristics and sunlight exposure was performed in 11 and nine studies, respectively. Alcohol intake was moderately associated with melanoma risk: the SRR were 1.29 (95% CI 1.14-1.45) for those in the highest vs. lowest category of current alcohol intake, and 1.96 (95% CI 1.02-3.76, I = 0%) for cumulative intake. In the dose-response analysis, the increase in risk associated with a 10 g increment in daily alcohol intake was 1.07 (95% CI 1.03-1.11). Risk estimates did not differ by gender, study design and adjustment for confounders; between-studies heterogeneity was acceptable, and there was no evidence of publication bias.
CONCLUSIONS
Our findings suggest that alcohol drinking may be moderately associated with increased melanoma risk, although residual confounding and bias cannot be ruled out. Further research is needed to confirm these findings, clarify the role of the different alcohol sources, and investigate the interaction with known melanoma risk factors.
Topics: Alcohol Drinking; Alcoholic Beverages; Dose-Response Relationship, Drug; Ethanol; Humans; Melanoma; Prospective Studies; Risk Factors
PubMed: 29327230
DOI: 10.1007/s00394-018-1613-5 -
Journal of the American Society of... Jul 2006Current guidelines identify people with chronic kidney disease (CKD) as being at high risk for cardiovascular and all-cause mortality. Because as many as 19 million... (Meta-Analysis)
Meta-Analysis Review
Current guidelines identify people with chronic kidney disease (CKD) as being at high risk for cardiovascular and all-cause mortality. Because as many as 19 million Americans may have CKD, a comprehensive summary of this risk would be potentially useful for planning public health policy. A systematic review of the association between non-dialysis-dependent CKD and the risk for all-cause and cardiovascular mortality was conducted. Patient- and study-related characteristics that influenced the magnitude of these associations also were investigated. MEDLINE and EMBASE databases were searched, and reference lists through December 2004 were consulted. Authors of 10 primary studies provided additional data. Cohort studies or cohort analyses of randomized, controlled trials that compared mortality between those with and without chronically reduced kidney function were included. Studies were excluded from review when participants were followed for < 1 yr or had ESRD. Two reviewers independently extracted data on study setting, quality, participant and renal function characteristics, and outcomes. Thirty-nine studies that followed a total of 1,371,990 participants were reviewed. The unadjusted relative risk for mortality in participants with reduced kidney function compared with those without ranged from 0.94 to 5.0 and was significantly more than 1.0 in 93% of cohorts. Among the 16 studies that provided suitable data, the absolute risk for death increased exponentially with decreasing renal function. Fourteen cohorts described the risk for mortality from reduced kidney function, after adjustment for other established risk factors. Although adjusted relative hazards were consistently lower than unadjusted relative risks (median reduction 17%), they remained significantly more than 1.0 in 71% of cohorts. This review supports current guidelines that identify individuals with CKD as being at high risk for cardiovascular mortality. Determining which interventions best offset this risk remains a health priority.
Topics: Cardiovascular Diseases; Humans; Multivariate Analysis; Proportional Hazards Models; Randomized Controlled Trials as Topic; Renal Insufficiency, Chronic; Risk Assessment
PubMed: 16738019
DOI: 10.1681/ASN.2005101085 -
Psychological Trauma : Theory,... Sep 2023A core challenge in working with first responders worldwide (e.g., firefighters, emergency service personnel, police officers) is identifying theoretically and...
OBJECTIVE
A core challenge in working with first responders worldwide (e.g., firefighters, emergency service personnel, police officers) is identifying theoretically and empirically based individual-level factors that are associated with adjustment and that can be translated to interventions. The transactional model of stress and coping provides an excellent framework to guide interventions with first responders, yet no review to date has explicitly and comprehensively focused on coping responses in this population.
METHOD
The current study systematically evaluated global evidence linking primary appraisals and coping efforts to mental health and behavioral risk-taking in first responders, with an eye toward their application to interventions.
RESULTS
Seventeen studies from eight countries met review criteria and were summarized. Studies of coping efforts predominated; only two studies assessed primary appraisals. Overall, disengaged coping efforts, relative to engaged coping, were more often associated with adjustment. Further, for engaged coping, associations with adjustment largely were present for cognitive, versus behavioral, strategies; for disengaged coping, cognitive and behavioral strategies were associated equally with poorer adjustment. Two thirds of the studies assessed posttraumatic stress (PTS) symptoms. Given the nature of PTS, use of disengaged strategies may particularly exacerbate these symptoms relative to other adjustment outcomes.
CONCLUSIONS
Additional research focused on both primary appraisals and coping efforts and that employs longitudinal designs would expand our understanding of the role of coping processes in first responders' adjustment to duty-related stress. Further, these data suggest that interventions targeting individuals (vs. systems or environments) should focus on replacing cognitive and behavioral disengaged coping strategies with engaged strategies that are cognitive in nature. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Adaptation, Psychological; Emergency Responders; Occupational Stress; Stress Disorders, Post-Traumatic
PubMed: 35653742
DOI: 10.1037/tra0001258 -
Oncotarget Dec 2015Although evidence from epidemiological studies evaluating the association between cigarette smoking during pregnancy and preeclampsia risk has been systematically... (Meta-Analysis)
Meta-Analysis Review
Although evidence from epidemiological studies evaluating the association between cigarette smoking during pregnancy and preeclampsia risk has been systematically reviewed, the findings have been out of date. To further clarify the relationship, we conducted this comprehensive meta-analysis of prospective studies. We searched PubMed and Web of Science up to August 2015 to identify prospective studies that evaluated the association between cigarette smoking during pregnancy and preeclampsia risk. Random-effects models were used to estimate summarized relative risk (RR) and 95% confidence intervals (CIs). Seventeen prospective studies involving 62,089 preeclampsia patients from a total of approximately 1.8 million subjects were included. Overall, there was a significant negative association between smoking during pregnancy and incidence of preeclampsia (RR = 0.67, 95% CI: 0.60-0.75), with significant heterogeneity (I2 = 91.7%). Such an inverse association was also detected in strata of subgroup analyses according to study location, study sample size, parity of populations, singleton pregnancy, and adjustment for potential confounders including maternal age, diabetes mellitus, chronic hypertension, body mass index, and gender of infant. In summary, this meta-analysis suggests that smoking during pregnancy is inversely associated with incidence of preeclampsia. Further large scale multi-center prospective studies are warranted to validate our findings.
Topics: Female; Humans; Incidence; Pre-Eclampsia; Pregnancy; Prospective Studies; Risk; Smoking
PubMed: 26498356
DOI: 10.18632/oncotarget.6190 -
Psychological Medicine Jan 2016Recent studies suggest that psychotic experiences (PE) in the general population are associated with an increased risk of self-injurious behaviour. Both the magnitude of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Recent studies suggest that psychotic experiences (PE) in the general population are associated with an increased risk of self-injurious behaviour. Both the magnitude of this association and the level of adjustment for confounders vary among studies. A meta-analysis was performed to integrate the available evidence. The influence of possible confounders, including variably defined depression, was assessed.
METHOD
A systematic review and meta-analysis was conducted including general population studies reporting on the risk of self-injurious behaviour in individuals with PE. Studies were identified by a systematic search strategy in Pubmed, PsycINFO and Embase. Reported effect sizes were extracted and meta-analytically pooled.
RESULTS
The risk of self-injurious behaviour was 3.20 times higher in individuals with PE compared with those without. Subanalyses showed that PE were associated with self-harm, suicidal ideation as well as suicidal attempts. All studies had scope for considerable residual confounding; effect sizes adjusted for depression were significantly smaller than effect sizes unadjusted for depression. In the longitudinal studies, adjustment for psychopathology resulted in a 74% reduction in excess risk.
CONCLUSIONS
PE are associated with self-injurious behaviour, suggesting they have potential as passive markers of suicidality. However, the association is confounded and several methodological issues remain, particularly how to separate PE from the full range of connected psychopathology in determining any specific association with self-injurious behaviour. Given evidence that PE represent an indicator of severity of non-psychotic psychopathology, the association between PE and self-injurious behaviour probably reflects a greater likelihood of self-injurious behaviour in more severe states of mental distress.
Topics: Delusions; Hallucinations; Humans; Psychotic Disorders; Risk Factors; Self-Injurious Behavior; Suicidal Ideation; Suicide, Attempted
PubMed: 26419206
DOI: 10.1017/S0033291715001841 -
Journal of Child Psychology and... Jan 2013This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age <18 years) associated with armed forces and... (Review)
Review
AIMS AND SCOPE
This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age <18 years) associated with armed forces and armed groups (CAAFAG)--commonly referred to as child soldiers.
METHODS
PRISMA standards for systematic reviews were used to search PubMed, PsycInfo, JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries were analyzed for author, year of publication, journal, objectives, design, selection population, setting, instruments, prevalence estimates, and associations with war experiences. Opinion pieces, editorials, and qualitative studies were deemed beyond the scope of this study. Quality of evidence was rated according to the systematic assessment of quality in observational research (SAQOR).
FINDINGS
According to SAQOR criteria, among the available published studies, eight studies were of high quality, four were of moderate quality, and the remaining nine were of low quality. Common limitations were lack of validated mental health measures, unclear methodology including undefined sampling approaches, and failure to report missing data. Only five studies included a comparison group of youth not involved with armed forces/armed groups, and only five studies assessed mental health at more than one point in time. Across studies, a number of risk and protective factors were associated with postconflict psychosocial adjustment and social reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment.
CONCLUSIONS
Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising longitudinal study designs, and validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring.
Topics: Adolescent; Child; Female; Humans; Male; Mental Health; Military Personnel; Prevalence; Resilience, Psychological; Risk Factors; Social Adjustment; Social Support; Stress Disorders, Post-Traumatic; Violence; Warfare
PubMed: 23061830
DOI: 10.1111/j.1469-7610.2012.02620.x -
The Science of the Total Environment Aug 2021Although the association between ambient particulate matter and metabolic syndrome (MetS) has been investigated, the effect of particulate matter (PM) on MetS is... (Meta-Analysis)
Meta-Analysis Review
Although the association between ambient particulate matter and metabolic syndrome (MetS) has been investigated, the effect of particulate matter (PM) on MetS is inconclusive. We conducted a systematic review and meta-analysis to study the association between long-term ambient PM exposure and MetS risk. The data from five databases were extracted to analyze the association between ambient PM exposure and MetS risk. A random-effects model was performed to estimate the overall risk effect. The present systematic review and meta-analysis illustrated that an increase of 5 μg/m in annual PM or PM concentration was associated with 14% or 9% increases of MetS risk, respectively (PM, RR = 1.14, 95%CI [1.03, 1.25]; PM, RR = 1.09, 95%CI [1.00, 1.19]). The population-attributable risk (PAR) was 12.28% for PM exposure or 8.26% for PM exposure, respectively. There was statistical association between PM exposure and risk of MetS in male proportion ≥50%, Asia, related disease or medication non-adjustment subgroup as well as cohort study subgroups, respectively. The significant association between PM exposure and risk of MetS was observed in male proportion ≥50% and calories intake adjustment subgroups, respectively. Sensitivity analyses showed the robustness of our results. No publication bias was detected. In conclusion, there was positive association between long-term PM exposure and MetS risk. 12.28% of MetS risk could be attributable to PM exposure.
Topics: Air Pollutants; Air Pollution; Asia; Cohort Studies; Environmental Exposure; Humans; Male; Metabolic Syndrome; Particulate Matter
PubMed: 33839664
DOI: 10.1016/j.scitotenv.2021.146855 -
Clinical Psychology Review Dec 2022This pre-registered systematic review synthesised and evaluated the existing literature on self-reported mental health and wellbeing of siblings of individuals with... (Review)
Review
OBJECTIVE
This pre-registered systematic review synthesised and evaluated the existing literature on self-reported mental health and wellbeing of siblings of individuals with neurodevelopmental conditions (NDCs).
METHODS
From 2437 identified studies published 2000-2022, 81 studies were included: 14 population- or cohort-based, 39 quantitative, 7 mixed method, and 21 qualitative outcome studies.
RESULTS
Seven sibling mental health (any psychiatric disorder, anxiety, depression, bipolar disorder, schizophrenia, internalising and externalising difficulties) and five wellbeing indicators were identified (quality of life, emotional adjustment, social wellbeing, somatic/physical wellbeing, and resilience/growth). Overall, siblings had increased risk of any psychiatric disorder, but they also reported experiences of growth and resilience, primarily in qualitative studies. 41 risk factors and 24 resilience factors associated with these outcomes were identified; the most frequently cited risk factor was symptom severity of the NDC sibling, while the most common resilience factor was adaptive/active coping at the individual sibling level. Studies showed high methodological heterogeneity and 90 different self-report measures were used.
CONCLUSIONS
Sibling mental health indictors are heterogeneous and cumulative risk factors may result in poorer wellbeing. There is a need for consistent reporting of family and sibling characteristics, a strengths-based approach to assessment, and identification of protective and resilience-promoting factors.
Topics: Humans; Adaptation, Psychological; Anxiety; Mental Health; Quality of Life; Siblings
PubMed: 36368218
DOI: 10.1016/j.cpr.2022.102217 -
Journal of Parkinson's Disease 2022A substantial body of research has examined the relationship between alcohol consumption and risk of Parkinson's disease (PD). (Meta-Analysis)
Meta-Analysis
BACKGROUND
A substantial body of research has examined the relationship between alcohol consumption and risk of Parkinson's disease (PD).
OBJECTIVE
To provide an updated systematic review and meta-analysis of observational studies examining the relationship between alcohol consumption and risk of PD.
METHODS
Eligible studies comparing PD risk in ever vs. never alcohol drinkers were sourced from six databases. Outcomes were pooled using standard meta-analysis techniques. Separate female and male estimates were generated from studies reporting sex-specific data. Additionally, cohort studies stratifying participants by quantity of alcohol intake were integrated in a dose-response analysis.
RESULTS
52 studies were included, totaling 63,707 PD patients and 9,817,924 controls. Our meta-analysis supported a statistically significant overrepresentation of never drinkers among PD subjects; odds ratio (OR) for ever drinking alcohol 0.84 (95% confidence interval (CI) 0.76 - 0.92). A subgroup analysis revealed similar effect estimates in females and males. A further synthesis of seven cohort studies suggested a negative, dose-dependent association between alcohol and risk of PD.
CONCLUSION
In the absence of a known neuroprotective pathway, there may be reason to doubt a true biological effect. The role of survivor bias, selection and recall bias, misclassification, and residual confounding requires consideration. Alternatively, observations might be attributable to reverse causation if those predestined for PD alter their alcohol habits during the preclinical phase. Major limitations of our study include high between-study heterogeneity (I2 = 93.2%) and lack of adjustment for key confounders, namely smoking status.
Topics: Humans; Male; Female; Alcohol Drinking; Risk Factors; Parkinson Disease; Ethanol; Smoking
PubMed: 36442208
DOI: 10.3233/JPD-223522 -
Medicine Feb 2020Several studies have shown a relationship between psoriasis and hypertension, but no meta-analysis has been restricted to studies that adjusted for confounders. The aim... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several studies have shown a relationship between psoriasis and hypertension, but no meta-analysis has been restricted to studies that adjusted for confounders. The aim of the study was to estimate the association between psoriasis and hypertension with adjustment for covariates.
METHODS
A systematic literature search in the MEDLINE, Embase, Cochrane databases, and Google Scholar was conducted to identify relevant studies which reported the association of psoriasis with the risk of hypertension published up to November 2018 in English. Data analysis was performed with Stata V.12, and Begg adjusted rank correlation test and Egger regression asymmetry test were used to detect publication bias.
RESULTS
A total of 16 adjusted-for-covariates studies, involving 50,291 cases with hypertension in 255,132 psoriasis patients and 76,547 cases with hypertension in 814,631 controls (no psoriasis), were included in this meta-analysis. The results indicated that psoriasis was associated with an increased risk of hypertension compared to those without psoriasis, and the prevalence of hypertension in severe psoriasis patients was higher than that in mild psoriasis patients, and the risk of hypertension in psoriasis patients was higher than that in nonpsoriasis patients in Europe and Asia.
CONCLUSION
We conducted this meta-analysis using the adjusted-for-covariates odds ratio, demonstrating that psoriasis was associated with an increased risk of hypertension compared to those without psoriasis.
Topics: Correlation of Data; Humans; Hypertension; Odds Ratio; Psoriasis; Risk Assessment
PubMed: 32118749
DOI: 10.1097/MD.0000000000019303