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Heliyon Mar 2024Self-harm (any self-injury or -poisoning regardless of intent) is highly prevalent in transgender and gender diverse (TGD) populations. It is strongly associated with... (Review)
Review
BACKGROUND
Self-harm (any self-injury or -poisoning regardless of intent) is highly prevalent in transgender and gender diverse (TGD) populations. It is strongly associated with various adverse health and wellbeing outcomes, including suicide. Despite increased risk, TGD individuals' unique self-harm pathways are not well understood. Following PRISMA guidelines we conducted the first systematic review of risk and protective factors for self-harm in TGD people to identify targets for prevention and intervention.
METHODS
We searched five electronic databases (PubMed, PsychInfo, Scopus, MEDLINE, and Web of Science) published from database inception to November 2023 for primary and secondary studies of risk and/or protective factors for self-harm thoughts and behaviours in TGD people. Data was extracted and study quality assessed using Newcastle-Ottawa Scales.
FINDINGS
Overall, 78 studies published between 2007 and 2023 from 16 countries (N = 322,144) were eligible for inclusion. Narrative analysis identified six key risk factors for self-harm in TGD people (aged 7-98years) were identified. These are younger age, being assigned female at birth, illicit drug and alcohol use, sexual and physical assault, gender minority stressors (especially discrimination and victimisation), and depression or depressive symptomology. Three important protective factors were identified: social support, connectedness, and school safety. Other possible unique TGD protective factors against self-harm included: chosen name use, gender-identity concordant documentation, and protective state policies. Some evidence of publication bias regarding sample size, non-responders, and confounding variables was identified.
INTERPRETATION
This systematic review indicates TGD people may experience a unique self-harm pathway. Importantly, the risk and protective factors we identified provide meaningful targets for intervention. TGD youth and those assigned female at birth are at increased risk. Encouraging TGD people to utilise and foster existing support networks, family/parent and peer support groups, and creating safe, supportive school environments may be critical for self-harm and suicide prevention strategies. Efforts to reduce drug and alcohol use and experiences of gender-based victimisation and discrimination are recommended to reduce self-harm in this high-risk group. Addressing depressive symptoms may reduce gender dysphoria and self-harm. The new evidence presented in this systematic review also indicates TGD people may experience unique pathways to self-harm related to the lack of social acceptance of their gender identity. However, robust longitudinal research which examines gender-specific factors is now necessary to establish this pathway.
PubMed: 38468947
DOI: 10.1016/j.heliyon.2024.e26074 -
Annals of Medicine and Surgery (2012) Mar 2024This study aims to investigate the factors affecting the severity of trauma caused by traffic accidents based on martrix Haddon; a systematic review and meta-analysis. (Review)
Review
OBJECTIVE
This study aims to investigate the factors affecting the severity of trauma caused by traffic accidents based on martrix Haddon; a systematic review and meta-analysis.
METHODS
In this study searched five international databases in this study, including Medline/PubMed, ProQuest, Scopus, Web of Knowledge, and Google Scholar, for published articles by the end of 2022. Data were entered into the statistical program and analyses were performed using STATA 17.0 software. Odds ratio (OR) values were computed for severity accidents.
RESULTS
Results of study showed that among the risk factors related to the host, not using helmet increased the risk of injury severity by 3.44 times compared to people who have used helmets (OR = 3.44, 95% CI: 2.27-5.00, =0.001, I=0.00%). Also, crossing over a centre divider has a protective role for the risk of injury severity compared to undertaking (OR =0.39, 95% CI: 0.20-0.75, =0.01, I=25.79%). in terms of the type of accident, accident of car-car reduces the risk of injury severity by 23% compared to accident of car-pedestrian (OR =0.77, 95% CI: 0.61-0.96, =0.02, I=0.00%).
CONCLUSIONS
It is necessary to pay attention to the intersection of human, vehicle and environmental risks and their contribution and how they interact. Based on the Haddon matrix approach, special strategies can be designed to prevent road damage. Safety standards for vehicles should also be addressed through stricter legal requirements and inspections.
PubMed: 38463059
DOI: 10.1097/MS9.0000000000001792 -
International Journal of Surgery... May 2024Endometrial cancer arising in adenomyosis (EC-AIA) is frequently detected accidentally following a general hysterectomy for adenomyosis. Whether supplemental... (Meta-Analysis)
Meta-Analysis
PURPOSE
Endometrial cancer arising in adenomyosis (EC-AIA) is frequently detected accidentally following a general hysterectomy for adenomyosis. Whether supplemental lymphadenectomy in patients with EC-AIA can improve the survival outcome remains inconclusive. Herein, the authors summarized the data of patients with EC-AIA and further explored the impact of lymphadenectomy on the prognosis of these patients.
METHODS
Five electronic databases, namely MEDLINE, Web of Science, PubMed, Embase, and the Cochrane Library were employed for searching articles from inception to May 2023.
RESULTS
In total, 38 eligible studies enrolling 56 patients were included. Of these, 44 patients had a traceable prognosis. Kaplan-Meier curves demonstrated that patients who had undergone lymphadenectomy had a better progression-free survival (PFS) compared with those who had not undergone lymphadenectomy ( P =0.016), but there was no difference in overall survival. Univariable ( P =0.025, HR=0.25, 95% CI=0.08-0.84) and multivariable ( P =0.042, HR=0.13, 95% CI=0.020-0.930) Cox regression analyses revealed that lymphadenectomy was an independent protective factor for PFS.
CONCLUSION
For patients diagnosed with EC-AIA following hysterectomy for benign disease, further supplementary lymphadenectomy is recommended to improve PFS.
Topics: Humans; Female; Endometrial Neoplasms; Adenomyosis; Lymph Node Excision; Hysterectomy; Prognosis
PubMed: 38445439
DOI: 10.1097/JS9.0000000000001234 -
ESMO Open Mar 2024Identifying the association between body mass index (BMI) or weight change and cancer prognosis is essential for the development of effective cancer treatments. We aimed... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Identifying the association between body mass index (BMI) or weight change and cancer prognosis is essential for the development of effective cancer treatments. We aimed to assess the strength and validity of the evidence of the association between BMI or weight change and cancer prognosis by a systematic evaluation and meta-analysis of relevant cohort studies.
METHODS
We systematically searched the PubMed, Web of Science, EconLit, Embase, Food Sciences and Technology Abstracts, PsycINFO, and Cochrane databases for literature published up to July 2023. Inclusion criteria were cohort studies with BMI or weight change as an exposure factor, cancer as a diagnostic outcome, and data type as an unadjusted hazard ratio (HR) or headcount ratio. Random- or fixed-effects models were used to calculate the pooled HR along with the 95% confidence interval (CI).
RESULTS
Seventy-three cohort studies were included in the meta-analysis. Compared with normal weight, overweight or obesity was a risk factor for overall survival (OS) in patients with breast cancer (HR 1.37, 95% CI 1.22-1.53; P < 0.0001), while obesity was a protective factor for OS in patients with gastrointestinal tumors (HR 0.67, 95% CI 0.56-0.80; P < 0.0001) and lung cancer (HR 0.67, 95% CI 0.48-0.92; P = 0.01) compared with patients without obesity. Compared with normal weight, underweight was a risk factor for OS in patients with breast cancer (HR 1.15, 95% CI 0.98-1.35; P = 0.08), gastrointestinal tumors (HR 1.54, 95% CI 1.32-1.80; P < 0.0001), and lung cancer (HR 1.28, 95% CI 1.22-1.35; P < 0.0001). Compared with nonweight change, weight loss was a risk factor for OS in patients with gastrointestinal cancer.
CONCLUSIONS
Based on the results of the meta-analysis, we concluded that BMI, weight change, and tumor prognosis were significantly correlated. These findings may provide a more reliable argument for the development of more effective oncology treatment protocols.
Topics: Humans; Female; Body Mass Index; Obesity; Cohort Studies; Breast Neoplasms; Lung Neoplasms; Gastrointestinal Neoplasms
PubMed: 38442453
DOI: 10.1016/j.esmoop.2024.102241 -
Journal of Psychiatric Research Apr 2024Clinical and subclinical forms of narcissism may increase suicide risk. However, little is known and there are controversies on this topic. This systematic review aims... (Review)
Review
BACKGROUND
Clinical and subclinical forms of narcissism may increase suicide risk. However, little is known and there are controversies on this topic. This systematic review aims at providing an overview of studies investigating this association.
METHODS
We used PubMed, Scopus, and PsycInfo databases and followed PRISMA. We focused on cohort, case-control, cross-sectional and case series studies. We referred to both clinical (i.e., narcissistic personality disorder (NPD) and/or NPD criteria) and subclinical forms (i.e., grandiose and vulnerable narcissistic traits) of narcissism. Moreover, we considered: Suicidal Ideation (SI), Non-Suicidal Self-Injury(s) (NSSI), Deliberate Self-Harm (DSH), Suicide Attempt(s) (SA), Suicide Risk (SR), and Capability for Suicide.
RESULTS
We included 47 studies. Lack of association between NPD diagnosis/criteria and suicide-related outcomes (SI) or mixed results (SA) were found. Higher homogeneity emerged when considering narcissistic traits. Vulnerable narcissism was associated with SI, less impulsive NSSI, and DSH. Grandiose narcissism was associated with severe NSSI and multiple SA with high intent to die, but it was protective against SI and SR. Vulnerable narcissism seemed to be associated with suicide-related outcomes characterized by low intent to die, while grandiose narcissism seemed to be a risk factor for outcomes with high planning and severity.
LIMITATIONS
Between-study heterogeneity and lack of longitudinal studies.
CONCLUSIONS
Assessing suicide risk in subjects with clinical or subclinical forms of narcissism may be useful. Moreover, considering the most vulnerable form of narcissism, and not just the grandiose one, may contribute to a more nuanced risk stratification and to the identification of distinct therapeutic approaches.
Topics: Humans; Personality Disorders; Narcissism; Cross-Sectional Studies; Suicide, Attempted; Risk Factors
PubMed: 38437765
DOI: 10.1016/j.jpsychires.2024.02.017 -
Frontiers in Psychiatry 2024Post-traumatic stress disorder is an important psychological problem affecting the physical mental health of Chinese healthcare workers during the COVID-19 pandemic.
BACKGROUND
Post-traumatic stress disorder is an important psychological problem affecting the physical mental health of Chinese healthcare workers during the COVID-19 pandemic.
AIMS
To estimate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) among Chinese healthcare workers during COVID-19.
METHODS
Search of Chinese and English literature in PubMed, EMbase, Web of Science, Medline, Elsevier, SpringerLink, China Biomedical Literature Database, CNKI, Wan-fang, and CQVIP for the period from December 2019 to August 2023. Stata 14.0 software was used for data analysis. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated using the Random-effects model. Publication bias was evaluated using Egger's test and Begg's test.
RESULTS
Twenty-one studies included 11841 Chinese healthcare workers in this review. First, the overall prevalence of Post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic was 29.2% (95% CI: 20.7% to 33.7%). Twelve factors included in the meta-analysis were found to be protective against PTSD among Chinese healthcare workers: female, nurse, married, front-line work, less work experience, family or friend diagnosed with COVID-19, history of chronic disease and fear of COVID-19. Conversely, outside Hubei, higher education, social support and psychological resilience are protective factors.
CONCLUSION
These recent findings increase our understanding of the psychological status of Chinese healthcare workers and encourage that long-term monitoring and long-term interventions should be implemented to improve the mental health of Chinese healthcare workers in the aftermath of the COVID-19.
PubMed: 38425999
DOI: 10.3389/fpsyt.2024.1323111 -
BMC Pediatrics Feb 2024Necrotizing enterocolitis (NEC) is a multifactorial gastrointestinal disease with high morbidity and mortality among premature infants. However, studies with large... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Necrotizing enterocolitis (NEC) is a multifactorial gastrointestinal disease with high morbidity and mortality among premature infants. However, studies with large samples on the factors of NEC in China have not been reported. This meta-analysis aims to systematically review the literature to explore the influencing factors of necrotizing enterocolitis in premature infants in China and provide a reference for the prevention of NEC.
METHODS
PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), Wanfang and VIP databases were systematically searched from inception to February 2023. We used Stata14.0 software to perform the systematic review and meta-analysis. We used fixed or random effects models with combined odds ratios (ORs) and 95% confidence intervals (CIs), and quality was evaluated using the Newcastle‒Ottawa Scale (NOS).
RESULTS
The total sample was 8616 cases, including 2456 cases in the intervention group and 6160 cases in the control group. It was found that 16 risk factors and 3 protective factors were related to necrotizing enterocolitis in premature infants. Septicemia (OR = 3.91), blood transfusion (OR = 2.41), neonatal asphyxia (OR = 2.46), pneumonia (OR = 6.17), infection (OR = 5.99), congenital heart disease (OR = 4.80), intrahepatic cholestasis of pregnancy (ICP) (OR = 2.71), mechanical ventilation (OR = 1.44), gestational diabetes mellitus (GDM) (OR = 3.08), respiratory distress syndrome (RDS) (OR = 3.28), hypoalbuminemia (OR = 2.80), patent ductus arteriosus (PDA) (OR = 3.10), respiratory failure (OR = 7.51), severe anemia (OR = 2.86), history of antibiotic use (OR = 2.12), and meconium-stained amniotic fluid (MSAF) (OR = 3.14) were risk factors for NEC in preterm infants in China. Breastfeeding (OR = 0.31), oral probiotics (OR = 0.36), and prenatal use of glucocorticoids (OR = 0.38) were protective factors for NEC in preterm infants.
CONCLUSIONS
Septicemia, blood transfusion, neonatal asphyxia, pneumonia, infection, congenital heart disease, ICP, GDM, RDS, hypoproteinemia, PDA, respiratory failure, severe anemia, history of antibiotic use and MSAF will increase the risk of NEC in premature infants, whereas breastfeeding, oral probiotics and prenatal use of glucocorticoids reduce the risk. Due to the quantity and quality of the included literature, the above findings need to be further validated by more high-quality studies.
Topics: Infant; Pregnancy; Female; Infant, Newborn; Humans; Infant, Premature; Enterocolitis, Necrotizing; Asphyxia; Ductus Arteriosus, Patent; Fetal Diseases; Respiratory Distress Syndrome, Newborn; Diabetes, Gestational; Pneumonia; Sepsis; Anemia; Anti-Bacterial Agents; Respiratory Insufficiency; Cholestasis, Intrahepatic; Pregnancy Complications
PubMed: 38418993
DOI: 10.1186/s12887-024-04607-3 -
RMD Open Feb 2024Dysregulation of several inflammatory cytokines including tumour necrosis factor (TNF) in dementia patients has also been identified as a key factor in the pathogenesis... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dysregulation of several inflammatory cytokines including tumour necrosis factor (TNF) in dementia patients has also been identified as a key factor in the pathogenesis of rheumatoid arthritis (RA). We aimed to investigate the association of disease-modifying antirheumatic drugs (DMARDs) therapy for RA with risk of incident dementia.
METHODS
Electronic database searches of PubMed, EMBASE and Cochrane Library were performed. Observational studies that assessed the association of dementia with DMARDs in RA were included. Pooled risk ratios (RRs) with 95% CIs were used as summary statistic. The certainty of evidence was judged by using the Grading of Recommendations Assessment, Development and Evaluation system.
RESULTS
Overall, 14 studies involving 940 442 patients with RA were included. Pooled RR for developing dementia was 0.76 (95% CI 0.72 to 0.80) in patients taking biological DMARDs overall versus those taking conventional synthetic DMARDs, with 24% for TNF inhibitors (RR 0.76, 95% CI 0.71 to 0.82), 24% for non-TNF biologics (RR 0.76, 95% CI 0.70 to 0.83), separately. There was a significant subgroup effect among different types of TNF inhibitors (RR 0.58 [95%CI 0.53 to 0.65], 0.65 [95% CI 0.59 to 0.72], 0.80 [95% CI 0.72 to 0.88] for etanercept, adalimumab, infliximab, respectively; p value between groups=0.002). However, compared with non-users of DMARDs or investigative treatment, no significant effect on dementia incidence was observed in those receiving conventional synthetic DMARDs overall (RR 0.84, 95% CI 0.59 to 1.20), methotrexate (RR 0.78, 95% CI 0.54 to 1.12), hydroxychloroquine (RR 0.95, 95% CI 0.63 to 1.44), except for sulfasalazine (RR 1.27, 95% CI 1.06 to 1.50).
CONCLUSIONS
Biological DMARDs for RA are associated with decreased dementia risk, while protective effect is not observed in conventional synthetic DMARDs. Controlled clinical trials on TNF inhibitors are necessary to test their neuroprotective potentials.
Topics: Humans; Antirheumatic Agents; Antibodies, Monoclonal; Tumor Necrosis Factor Inhibitors; Arthritis, Rheumatoid; Tumor Necrosis Factor-alpha; Dementia
PubMed: 38413170
DOI: 10.1136/rmdopen-2023-004016 -
BMC Palliative Care Feb 2024Music therapy interventions with informal carers of individuals with life-threatening illness at pre- and post-bereavement is an increasingly important clinical area....
BACKGROUND
Music therapy interventions with informal carers of individuals with life-threatening illness at pre- and post-bereavement is an increasingly important clinical area. This systematic review is the first to synthesise and critically evaluate the international evidence associated with music therapy with adult informal carers pre- and post-bereavement. Specifically, the objectives were: i) to describe the characteristics and effectiveness of music therapy interventions which aim to improve health-related outcomes for adult informal carers of adults with life-threatening illness (pre- and post-bereavement), and ii) to describe the experience of music therapy for adult informal carers of adults with life-threatening illness (pre- and post-bereavement).
METHODS
Eligibility: adult informal carers of adults at end of life or bereaved; music therapy interventions for improving health-related outcomes; qualitative; mixed-method; and quantitative studies including comparators of any other intervention; published in English from 1998 onwards. Six databases were searched up to July 2022. A JBI mixed-methods systematic review approach was followed throughout, including quality appraisal, data extraction and a convergent segregated approach to synthesis and integration.
RESULTS
A total of 34 studies were included, published between 2003 and 2022. Most were conducted in North America (n = 13), Australia (n = 10), or Europe (n = 8). No studies were conducted in low- and middle-income countries or in the UK. The majority were qualitative (n = 17), followed by quasi-experimental (n = 8), mixed-methods (n = 7) and two RCTs. The majority focused on carers of individuals with dementia (n = 21) or advanced cancer (n = 7). Seventeen studies were purely quantitative or included a quantitative component. During meta-synthesis, findings were aligned to core outcomes for evaluating bereavement interventions in palliative care and previously identified risk factors for complicated grief. Commonly targeted outcomes in quantitative studies included quality of life and mental wellbeing, showing equivocal effectiveness of music therapy with significant and non-significant results. Twenty-two studies either purely qualitative or with a qualitative component underwent meta synthesis and suggested a diverse range of improved pre- and post-bereavement outcomes for informal carers across all core outcomes, and across all risk and protective factors, including psychological, spiritual, emotional, and social outcomes.
CONCLUSIONS
Qualitative studies provide moderate to strong evidence for improved health-related outcomes for adult informal carers of adults with life-threatening illness pre-bereavement. Limited studies including those bereaved negates conclusions for the bereavement phase. Comparisons and explanations for effectiveness across quantitative and qualitative studies are equivocal, with a high risk of bias and small samples in the limited number of quantitative studies, demonstrating a need for high-quality RCTs.
SYSTEMATIC REVIEW PRE-REGISTRATION
PROSPERO [CRD42021244859].
Topics: Adult; Humans; Music Therapy; Quality of Life; Caregivers; Grief; Bereavement
PubMed: 38408966
DOI: 10.1186/s12904-024-01364-z -
Behavioral Sciences (Basel, Switzerland) Jan 2024This study conducted a meta-analysis to identify the primary risk and protective factors associated with the revictimization in intimate partner violence against women... (Review)
Review
This study conducted a meta-analysis to identify the primary risk and protective factors associated with the revictimization in intimate partner violence against women (IPVAW). Out of 2382 studies initially identified in eight databases, 22 studies met the inclusion criteria and provided the necessary data for calculating pooled effect sizes. The analysis focused on non-manipulative quantitative studies examining revictimization in heterosexual women of legal age. Separate statistical analyses were performed for prospective and retrospective studies, resulting in findings related to 14 variables. The Metafor package in RStudio was used with a random-effects model. The meta-analysis revealed that childhood abuse was the most strongly associated risk factor for revictimization, while belonging to a white ethnicity was the most prominent protective factor. Other significant risk factors included alcohol and drug use, recent physical violence, severity of violence, and PTSD symptomatology. The study also found that older age was a protective factor in prospective studies. The consistency of results across different study designs and sensitivity analyses further supported the robustness of the findings. It is important to note that the existing literature on revictimization in women facing intimate partner violence is limited and exhibits significant heterogeneity in terms of methodology and conceptual frameworks.
PubMed: 38392456
DOI: 10.3390/bs14020103