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Geriatrics (Basel, Switzerland) May 2024Addressing informal caregivers' needs is essential for ensuring quality healthcare and promoting citizen-centred care. This systematic review assessed current knowledge... (Review)
Review
BACKGROUND
Addressing informal caregivers' needs is essential for ensuring quality healthcare and promoting citizen-centred care. This systematic review assessed current knowledge about programmes aimed at meeting the needs of informal caregivers of adults who are dependent on others for daily life activities.
METHODS
Following the PRISMA guidelines, the electronic databases EBSCOhost Research Platform, MEDLINE, CINAHL, Scopus, Web of Science and The Virtual Health Library were searched for randomized experimental studies published between 2012 and 2022 that implemented programmes addressing informal caregivers' needs to improve their experiences, health, and well-being. Quality was assessed using the standardized critical evaluation tools from the Joanna Briggs Institute. Two independent investigators performed the eligibility assessment and data extraction. Quantitative data on the effectiveness of interventions were collected, and the content of each intervention was synthesized and aggregated into categories, through narrative synthesis.
RESULTS
The majority of the included studies (n = 16) were conducted in European countries and implemented a structured intervention programme compared to the provision of usual care. The studies were of fair to high methodological quality, with a higher risk of bias related to blinding. The results supported the achievement of favourable health outcomes among informal caregivers, namely improvements in mental health (n = 3) and quality of life (n = 3) and a decrease in psychological symptomatology (n = 5) and burden (n = 3). None of the interventions reported adverse outcomes; however, five studies did not describe significant differences in the outcomes assessed after the implementation of the programmes. Interventions focusing on training and educating caregivers (n = 14) and cognitive-behavioural strategies (n = 7) were the most common, while programmes focusing on emotional and psychological support as a resource to improve caregivers' psychological outcomes were scarce.
CONCLUSIONS
This systematic review adds to the growing body of evidence and insight showing that programmes that address informal caregivers' needs seem to contribute to better physical and psychological health outcomes through the promotion of caregivers' educational support and the implementation of cognitive-behavioural strategies. Future research should implement methodologically robust cross-country programmes tailored to informal caregivers' physical, emotional, psychosocial, societal, and educational needs throughout the care trajectory.
PubMed: 38920427
DOI: 10.3390/geriatrics9030071 -
Frontiers in Bioengineering and... 2024Musculoskeletal simulations can be used to estimate biomechanical variables like muscle forces and joint torques from non-invasive experimental data using inverse and...
Musculoskeletal simulations can be used to estimate biomechanical variables like muscle forces and joint torques from non-invasive experimental data using inverse and forward methods. Inverse kinematics followed by inverse dynamics (ID) uses body motion and external force measurements to compute joint movements and the corresponding joint loads, respectively. ID leads to residual forces and torques (residuals) that are not physically realistic, because of measurement noise and modeling assumptions. Forward dynamic simulations (FD) are found by tracking experimental data. They do not generate residuals but will move away from experimental data to achieve this. Therefore, there is a gap between reality (the experimental measurements) and simulations in both approaches, the sim2real gap. To answer (patho-) physiological research questions, simulation results have to be accurate and reliable; the sim2real gap needs to be handled. Therefore, we reviewed methods to handle the sim2real gap in such musculoskeletal simulations. The review identifies, classifies and analyses existing methods that bridge the sim2real gap, including their strengths and limitations. Using a systematic approach, we conducted an electronic search in the databases Scopus, PubMed and Web of Science. We selected and included 85 relevant papers that were sorted into eight different solution clusters based on three aspects: how the sim2real gap is handled, the mathematical method used, and the parameters/variables of the simulations which were adjusted. Each cluster has a distinctive way of handling the sim2real gap with accompanying strengths and limitations. Ultimately, the method choice largely depends on various factors: available model, input parameters/variables, investigated movement and of course the underlying research aim. Researchers should be aware that the sim2real gap remains for both ID and FD approaches. However, we conclude that multimodal approaches tracking kinematic and dynamic measurements may be one possible solution to handle the sim2real gap as methods tracking multimodal measurements (some combination of sensor position/orientation or EMG measurements), consistently lead to better tracking performances. Initial analyses show that motion analysis performance can be enhanced by using multimodal measurements as different sensor technologies can compensate each other's weaknesses.
PubMed: 38919383
DOI: 10.3389/fbioe.2024.1386874 -
Frontiers in Endocrinology 2024The prevalence of obesity among women of reproductive age is increasing worldwide, with implications for serious pregnancy complications. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The prevalence of obesity among women of reproductive age is increasing worldwide, with implications for serious pregnancy complications.
METHODS
Following PRISMA guidelines, a systematic search was conducted in both Chinese and English databases up to December 30, 2020. Pregnancy complications and outcomes including gestational diabetes mellitus (GDM), gestational hypertension (GHTN), pre-eclampsia, cesarean section (CS), induction of labor (IOL), and postpartum hemorrhage (PPH) were analyzed. Random-effects or fixed-effects models were utilized to calculate the odds ratio (OR) with 95% confidence intervals (CIs).
RESULTS
Women with overweight and obesity issues exhibited significantly higher risks of GDM (OR, 2.92, 95%CI, 2.18-2.40 and 3.46, 95%CI, 3.05-3.94, respectively) and GHTN (OR, 2.08, 95%CI, 1.72-2.53 and 3.36, 95%CI, 2.81-4.00, respectively) compared to women of normal weight. Pre-eclampsia was also significantly higher in women with overweight or obesity, with ORs of 1.70 (95%CI, 1.44-2.01) and 2.82 (95%CI, 2.66-3.00), respectively. Additionally, mothers with overweight or obesity issues had significantly higher risks of CS (OR, 1.44, 95%CI, 1.41-1.47, and 2.23, 95%CI, 2.08-2.40), IOL (OR, 1.33, 95%CI, 1.30-1.35 and 1.96, 95%CI, 1.85-2.07), and PPH (OR, 1.67, 95%CI, 1.42-1.96 and 1.88, 95%CI, 1.55-2.29).
CONCLUSION
Women with overweight or obesity issues face increased risks of pregnancy complications and adverse outcomes, indicating dose-dependent effects.
Topics: Humans; Pregnancy; Female; Pregnancy Complications; Pregnancy Outcome; Body Mass Index; Obesity; Diabetes, Gestational; Pre-Eclampsia; Cesarean Section; Overweight; Postpartum Hemorrhage
PubMed: 38894748
DOI: 10.3389/fendo.2024.1280692 -
Nutrients Jun 2024The purpose of our systematic review was to examine the effects of any physical activity/exercise intervention combined with any diet/nutrition intervention on any... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The purpose of our systematic review was to examine the effects of any physical activity/exercise intervention combined with any diet/nutrition intervention on any biological/biochemical index, quality of life (QoL), and depression in breast, lung, colon and rectum, prostate, stomach, and liver cancer patients and/or cancer survivors.
METHODS
A systematic review and meta-analysis were undertaken, using PRISMA guidelines and the Cochrane Handbook. The systematic review protocol can be found in the PROSPERO database; registration number: CRD42023481429.
RESULTS
We found moderate-quality evidence that a combined intervention of physical activity/exercise and nutrition/diet reduced body mass index, body weight, fat mass, insulin, homeostatic model assessment for insulin resistance, C-reactive protein, triglycerides, and depression, while it increased high-density lipoprotein, the physical component of QoL, and general functional assessment of cancer therapy.
CONCLUSIONS
We conclude that a combined intervention of physical activity/exercise and diet/nutrition may decrease body weight, fat mass, insulin levels, and inflammation, and improve lipidemic profile, the physical component of QoL, and depression in cancer patients and survivors. These outcomes indicate a lower risk for carcinogenesis; however, their applicability depends on the heterogeneity of the population and interventions, as well as the potential medical treatment of cancer patients and survivors.
Topics: Humans; Neoplasms; Exercise; Quality of Life; Cancer Survivors; Diet; Depression; Male; Body Mass Index; Female
PubMed: 38892682
DOI: 10.3390/nu16111749 -
Nutrients May 2024Palmitoylethanolamide (PEA) emerged over the years as a promising approach in the management of chronic pain. Despite the fact that the efficacy of micron-size PEA... (Meta-Analysis)
Meta-Analysis Review
Palmitoylethanolamide (PEA) emerged over the years as a promising approach in the management of chronic pain. Despite the fact that the efficacy of micron-size PEA formulations appears to be time-dependent, the optimal timing has not yet been elucidated. This systematic review and meta-analysis aim to estimate the possible advantage of an extended treatment in the relief of chronic pain. The literature search was conducted consulting scientific databases, to identify clinical trials in which micron-size PEA was administered for at least 60 days, and pain assessed by the Visual Analogue Scale (VAS) or Numeric Rating Scale (NRS). Nine studies matched the required criteria, for a total of 742 patients involved. The meta-analysis showed a statistically and clinically significant pain intensity reduction after 60 days of micron-size PEA supplementation, compared to 30 days (1.36 points, < 0.01). The secondary analysis revealed a weighted NRS/VAS score decrease of 2.08 points within the first month of treatment. These two obtained scores corresponded to a 35.1% pain intensity reduction within the first month, followed by a further 35.4% during the second month. Overall, these results confirm the clinically relevant and time-depended pain-relieving effect of micron-size PEA and therefore the advantage of an extended treatment, especially in patient with incomplete pain management.
Topics: Palmitic Acids; Humans; Amides; Ethanolamines; Chronic Pain; Pain Measurement; Administration, Oral; Treatment Outcome; Analgesics
PubMed: 38892586
DOI: 10.3390/nu16111653 -
BMC Geriatrics Jun 2024Reviews of depression interventions in nursing home residents resulted in positive findings. However, because of the heterogeneity of the studies, it remains unclear... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Reviews of depression interventions in nursing home residents resulted in positive findings. However, because of the heterogeneity of the studies, it remains unclear what works for whom. Considering moderator effects may contribute to a comprehensive understanding of depression treatment in residents. Therefore, this study aims to review depression interventions, examining moderator effects of (1) residents' factors, and (2) components specific of interventions.
METHODS
A Bayesian network meta-analysis of randomized controlled trials primarily aimed at reducing depressive symptoms among residents was conducted. First, intervention types, e.g., exercise interventions, were compared to care as usual. Second, meta-regression analyses were conducted for moderator effects of residents' factors (i.e., severity of depressive symptoms, physical dependency, and cognitive impairment) and components identified as specific to an intervention (e.g., music, creativity, positivity).
RESULTS
Our search across six databases resulted in 118 eligible studies: 16 on neurobiological interventions, 102 on non-pharmacological interventions. Compared to care as usual, cognitive interventions, such as cognitive behavioral therapy and goal-oriented therapy, showed the strongest effects (MD = -1.00, 95% CrI [-1.40 to -0.66]). Furthermore, the severity of depressive symptoms moderated the effect of interventions (ƅ = -0.63, CrI 95% [-1.04 to -0.22]), while none of fifteen identified intervention-specific components did. In residents with a depression diagnosis, there were larger effect sizes for interventions including daily structure, psychoeducation, healthy food, creativity, positivity, and an activating/encouraging environment, whereas interventions focusing on distraction and relaxation had larger effect sizes in those residents without.
CONCLUSIONS
By examining the moderator effects, we provided an integrative perspective on the observed variations in effects across different target groups, and components of depression interventions. This approach underscores the complex nature of interventions, emphasizing the need for continued transdisciplinary research, and the exploration of potential moderators. Future investigations should carefully assess residents' factors and choose interventions and their components accordingly.
Topics: Humans; Nursing Homes; Bayes Theorem; Randomized Controlled Trials as Topic; Depression; Aged; Network Meta-Analysis; Homes for the Aged
PubMed: 38872075
DOI: 10.1186/s12877-024-05117-8 -
Physical independence and related factors among older adults: a systematic review and meta-analysis.Annals of Medicine and Surgery (2012) Jun 2024Adopting a physically active lifestyle is advocated as a strategy to prevent loss of physical independence and support healthy aging. This study aimed to evaluate the...
BACKGROUND
Adopting a physically active lifestyle is advocated as a strategy to prevent loss of physical independence and support healthy aging. This study aimed to evaluate the physical independence and related factors among older adults.
MATERIALS AND METHODS
This systematic review and meta-analysis was conducted through electronic databases such as Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database from the earliest to 1 April 2022. Two researchers independently extracted information from the studies and evaluated the quality of the studies. The analysis was conducted using CMA program version 3, and each study's importance was determined based on its inverse variance.
RESULTS
Five thousand seven hundred thirty-three older adults participated in this review in six studies. All evaluated studies had high quality. The mean score of physical independence in older adults was 20.07 (SE=0.76) out of 24 (95% CI: 18.58-21.56; =98.573%; <0.001). Physical activity is very important for physical independence and reduces the risk of physical dependence in older adults. Other factors, such as sex, BMI, age, abnormal performance, timed performance, sufficiently active, muscle function, handgrip strength, lower extremity function, lower body strength, maximal isometric knee extension power, lung function, aerobic endurance, sedentary time, agility, and the prevalence of arthritis, had a significant relationship with physical independence in older adults.
CONCLUSION
Older adults demonstrate favourable levels of physical independence. Notably, physical activity emerges as a significant determinant positively associated with such independence. Thus, policymakers and administrators are encouraged to strategize the creation of conducive environments for walking and exercise among older adults.
PubMed: 38846859
DOI: 10.1097/MS9.0000000000002100 -
Health Informatics Journal 2024: This systematic review and meta-analysis aimed to investigate the effect of fall prevention interventions using information and communication technology (ICT). : A... (Meta-Analysis)
Meta-Analysis
: This systematic review and meta-analysis aimed to investigate the effect of fall prevention interventions using information and communication technology (ICT). : A comprehensive search across four databases was performed. The inclusion criteria were fall prevention interventions including telehealth, computerized balance training, exergaming, mobile application education, virtual reality exercise, and cognitive-behavioral training for community-dwelling adults aged ≥60 years. : Thirty-four studies were selected. Telehealth, smart home systems, and exergames reduced the risk of falls (RR = 0.63, 95% CI [0.54, 0.75]). Telehealth and exergame improved balance (MD = 3.30, 95% CI [1.91, 4.68]; MD = 4.40, 95% CI [3.09, 5.71]). Telehealth improved physical function (SMD = 0.69, 95% CI [0.23, 1.16]). Overall, ICT fall interventions improved fall efficacy but not cognitive function. For quality of life (QOL), mixed results were found depending on the assessment tools. : Future investigations on telehealth, smart home systems, or exergames are needed to motivate older adults to exercise and prevent falls.
Topics: Humans; Accidental Falls; Aged; Telemedicine; Independent Living; Quality of Life; Information Technology
PubMed: 38825745
DOI: 10.1177/14604582241259324 -
Journal of Translational Medicine May 2024The appropriate use of predictive equations in estimating body composition through bioelectrical impedance analysis (BIA) depends on the device used and the subject's... (Review)
Review
The appropriate use of predictive equations in estimating body composition through bioelectrical impedance analysis (BIA) depends on the device used and the subject's age, geographical ancestry, healthy status, physical activity level and sex. However, the presence of many isolated predictive equations in the literature makes the correct choice challenging, since the user may not distinguish its appropriateness. Therefore, the present systematic review aimed to classify each predictive equation in accordance with the independent parameters used. Sixty-four studies published between 1988 and 2023 were identified through a systematic search of international electronic databases. We included studies providing predictive equations derived from criterion methods, such as multi-compartment models for fat, fat-free and lean soft mass, dilution techniques for total-body water and extracellular water, total-body potassium for body cell mass, and magnetic resonance imaging or computerized tomography for skeletal muscle mass. The studies were excluded if non-criterion methods were employed or if the developed predictive equations involved mixed populations without specific codes or variables in the regression model. A total of 106 predictive equations were retrieved; 86 predictive equations were based on foot-to-hand and 20 on segmental technology, with no equations used the hand-to-hand and leg-to-leg. Classifying the subject's characteristics, 19 were for underaged, 26 for adults, 19 for athletes, 26 for elderly and 16 for individuals with diseases, encompassing both sexes. Practitioners now have an updated list of predictive equations for assessing body composition using BIA. Researchers are encouraged to generate novel predictive equations for scenarios not covered by the current literature.Registration code in PROSPERO: CRD42023467894.
Topics: Electric Impedance; Humans; Body Composition; Male; Female; Reference Standards; Adult; Middle Aged
PubMed: 38812005
DOI: 10.1186/s12967-024-05272-x -
Journal of the Mechanical Behavior of... Aug 2024This systematic review aimed to compare the physical-mechanical properties of 3D-printed (additively manufactured (AM)) zirconia compared to conventionally milled... (Meta-Analysis)
Meta-Analysis
AIM OF STUDY
This systematic review aimed to compare the physical-mechanical properties of 3D-printed (additively manufactured (AM)) zirconia compared to conventionally milled (subtractive manufactured: SM) zirconia specimens.
MATERIALS AND METHODS
A thorough search of Internet databases was conducted up to September 2023. The search retrieved studies that evaluated AM zirconia specimens and restorations regarding the physical-mechanical properties and mechanical behavior of zirconia. The main topic focused on 3Y-TZP. However, records of 4YSZ and 5YSZ were also included to gather more comprehensive evidence on additively manufactured zirconia ceramic. The quality of studies was assessed using the ROB2 tool, Newcastle Ottawa scale, and the Modified Consort Statement. Of 1736 records, 57 were assessed for eligibility, and 38 records were included in this review, only two clinical trials meet the inclusion criteria and 36 records were laboratory studies. There were no signs of mechanical complications and wear to antagonists with short-term clinical observation. SM thin specimens ≤1.5 mm showed statistically significant higher flexural strength than AM zirconia (p ≤ 0.01), while thicker specimens showed comparable outcomes (p > 0.5). The fracture resistance of dental restorations was dependent on the aging protocol, restoration type, and thickness. The bond strength of veneering ceramic to zirconia core was comparable.
CONCLUSIONS
The results pooled from two short-term clinical trials showed no signs of mechanical or biological complications of additively manufactured 3Y-TZP zirconia crowns. The flexural strength might depend on the specimens' thickness, but it showed promising results to be used in clinical applications, taking into account the printing technique and orientation, material composition (yttria content), solid loading, and sintering parameters. 3D-printed restorations fracture resistance improved when adhered to human teeth. The veneering ceramic bond was comparable to milled zirconia specimens. Long-term RCTs are recommended to confirm the mechanical behavior of 3D-printed restorations.
Topics: Humans; Dental Materials; Materials Testing; Mechanical Phenomena; Printing, Three-Dimensional; Zirconium
PubMed: 38810545
DOI: 10.1016/j.jmbbm.2024.106601