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Healthcare (Basel, Switzerland) Mar 2024mHealth has been utilized in the care of patients with chronic kidney disease, allowing the collection of patient health-related data, offering disease-related... (Review)
Review
mHealth has been utilized in the care of patients with chronic kidney disease, allowing the collection of patient health-related data, offering disease-related information, enabling the tracking and recording of biochemical parameters, and enabling communication with healthcare providers in real time through applications. mHealth may improve the health outcomes in patients with peritoneal dialysis. This systematic review aimed to summarize evidence regarding the functionality and usability of mHealth apps in patients with peritoneal dialysis. We conducted a comprehensive literature review, searching in five databases, including CINAHL, Cochrane, PsycINFO, PubMed, and Web of Science, to retrieve titles and abstracts related to peritoneal dialysis and mHealth applications for PRISMA recommendations from January 2013 to December 2023. Overall, 11 studies met all the inclusion criteria. The functionality of mHealth apps included inform, instruct, record, display, guide, remind/alert, and communicate. Most of the apps have multifunctionality. The usability was categorized into three aspects: efficiency (self-efficacy and usability), satisfaction, and effectiveness (underwent kidney transplantation and switched to hemodialysis, rehospitalization, peritonitis rate, infection rates at exit sites, mortality, fluid overload, inadequate solute clearance, biochemical values, quality of life, consumer quality index, and technology readiness). Generally, outcomes in the intervention group had better effects compared to those in the control group. Multifunctional mHealth apps show a good potential in improving the efficiency, satisfaction, and effectiveness for patients compared to traditional care. Future research should include more studies and participants to explore and verify the long-term effectiveness of mHealth apps.
PubMed: 38470704
DOI: 10.3390/healthcare12050593 -
Frontiers in Endocrinology 2024Overweight and obesity are increasing global public health problems. Mazdutide is a new dual agonist drug that can potentially reduce weight and blood glucose levels... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Overweight and obesity are increasing global public health problems. Mazdutide is a new dual agonist drug that can potentially reduce weight and blood glucose levels simultaneously. However, the synthesis of evidence on the efficacy and safety of this drug is scarce. Therefore, this study aimed to synthesize evidence on the efficacy and safety of Mazdutide compared to placebo on weight reduction among adults with and without diabetes.
METHODS
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). Data were retrieved from six electronic databases: PubMed, Web of Science, Scopus, Cochrane Library, ClinicalTrial.gov, and Google Scholar, and manually searched from the included references. The data were synthesized using a random effect model. This analysis was performed in the R programming language using the Meta package.
RESULTS
A total of seven RCTs involving 680 participants were included in this study. Mazdutide was more effective in reducing body weight (mean difference [MD]= -6.22%, 95% confidence interval [CI]: -8.02% to -4.41%, I = 90.0%), systolic blood pressure (MD = -7.57 mmHg, 95% CI: -11.17 to -3.98 mmHg, I = 46%), diastolic blood pressure (MD = -2.98 mmHg, 95% CI: -5.74 to -0.22 mmHg, I = 56%), total cholesterol (MD = -16.82%, 95% CI: -24.52 to -9.13%, I = 61%), triglycerides (MD = -43.29%, 95% CI: -61.57 to -25.01%, I = 68%), low-density lipoprotein (MD= -17.07%, 95% CI: -25.54 to -8.60%, I = 53%), and high-density lipoprotein (MD = -7.54%, 95% CI: -11.26 to -3.83%, I = 0%) than placebo. Mazdutide was associated with reduced hemoglobin A1c (HbA1c) and fasting plasma glucose in participants with type 2 diabetes. In the subgroup and meta-regression analyses, weight reduction was more significant in non-diabetics compared to diabetics, and in those who received a longer treatment duration (24 weeks) than in those on shorter durations (12-20 weeks). Participants who received Mazdutide had a higher risk of transient mild or moderate gastrointestinal side effects.
CONCLUSION
Mazdutite appears to be effective in weight reduction among patients with and without diabetes, and it has an advantage over other associated comorbidities. However, it was associated with mild or moderate gastrointestinal side effects.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=403859, identifier CRD42023403859.
Topics: Humans; Diabetes Mellitus, Type 2; Fasting; Peptides; Randomized Controlled Trials as Topic; Weight Loss
PubMed: 38440786
DOI: 10.3389/fendo.2024.1309118 -
BMC Public Health Feb 2024Computer vision syndrome has become a significant public health problem, especially in developing countries. Therefore, this study aims to identify the prevalence of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Computer vision syndrome has become a significant public health problem, especially in developing countries. Therefore, this study aims to identify the prevalence of computer vision syndrome during the COVID-19 pandemic.
METHODS
A systematic review and meta-analysis of the literature was conducted using the databases PubMed, Scopus, Web of Science, and Embase up to February 22, 2023, using the search terms "Computer Vision Syndrome" and "COVID-19". Three authors independently performed study selection, quality assessment, and data extraction, and the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used to evaluate study quality. Heterogeneity was assessed using the statistical test I, and the R version 4.2.3 program was used for statistical analysis.
RESULTS
A total of 192 studies were retrieved, of which 18 were included in the final meta-analysis. The total sample included 10,337 participants from 12 countries. The combined prevalence of computer vision syndrome was 74% (95% CI: 66, 81). Subgroup analysis based on country revealed a higher prevalence of computer vision syndrome in Pakistan (99%, 95% CI: 97, 100) and a lower prevalence in Turkey (48%, 95% CI: 44, 52). In addition, subgroup analysis based on study subjects showed a prevalence of 82% (95% CI: 74, 89) for computer vision syndrome in non-students and 70% (95% CI: 60, 80) among students.
CONCLUSION
According to the study, 74% of the participants experienced computer vision syndrome during the COVID-19 pandemic. Given this finding, it is essential to implement preventive and therapeutic measures to reduce the risk of developing computer vision syndrome and improve the quality of life of those affected.
TRIAL REGISTRATION
The protocol for this systematic review and meta-analysis was registered in the international registry of systematic reviews, the International Prospective Register of Systematic Reviews (PROSPERO), with registration number CRD42022345965.
Topics: Humans; COVID-19; Pandemics; Prevalence; Research Design; Vision Disorders
PubMed: 38424562
DOI: 10.1186/s12889-024-17636-5 -
Prevalence of latent tuberculosis infection in Asian nations: A systematic review and meta-analysis.Immunity, Inflammation and Disease Feb 2024Tuberculosis (TB) is a serious public health concern around the world including Asia. TB burden is high in Asian countries and significant population harbor latent... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Tuberculosis (TB) is a serious public health concern around the world including Asia. TB burden is high in Asian countries and significant population harbor latent tuberculosis infection(LTBI).
AIM
This systematic review and meta-analysis aims to evaluate the prevalence of LTBI in Asian countries.
METHOD
We performed a systematic literature search on PubMed, Embase, and ScienceDirect to identify relevant articles published between January 1, 2005, and January 1, 2023 investigating the overall prevalence of latent TB among people of Asia. Subgroup analysis was done for Asian subregions during the study period of 2011 to 2016 and 2017 to 2023, for tuberculin skin test (TST) and interferon gamma release assay (IGRA), respectively, as well as for QuantiFERON-TB (QFT) and TSPOT TB tests. Der Simonian and Laird's random-effects model was used to pool the prevalence of LTBI found using TST and IGRA.
RESULT
A total of 15 studies were included after a systematic search from standard electronic databases. The analysis showed that the prevalence of latent TB in Asia was 21% (95% confidence interval [CI]: 19%-23%) and 36% (95% CI: 12%-59%) according to IGRAs and TSTs (cut off 10 mm) results, respectively. Based on IGRA, the prevalence of latent TB was 20% (95% CI: 13%-25%) in 2011 to 2016 and 21% (95% CI: 18%-24%) in 2017 to 2023. Using QFT, the prevalence was 19% (95% CI: 17%-22%) and using TSPOT, the prevalence was 26% (95% CI: 21%-31%). According to the United Nations division of Asia, the prevalence was higher for the Southern region and least for the Western region using TST and higher in the South-Eastern region and least in the Western region using the IGRA test.
CONCLUSION
Almost a quarter of the Asian population has LTBI. Its diagnosis often poses a diagnostic challenge due to the unavailability of standard test in certain areas. Given this prevalence, a mass screening program is suggested with the available standard test and public awareness along with anti-TB regimen should be considered for individuals who test positive. However, for it to be implemented effectively, we need to take the affordability, availability, and cost-effectiveness of such interventions into account.
Topics: Humans; Latent Tuberculosis; Prevalence; Biological Assay; Databases, Factual
PubMed: 38411377
DOI: 10.1002/iid3.1200 -
BMC Medical Education Feb 2024Faculty evaluation is essential as a principle in educational organizations because it helps measure the quantity and quality of education in universities and...
BACKGROUND
Faculty evaluation is essential as a principle in educational organizations because it helps measure the quantity and quality of education in universities and educational institutions. There are various ambiguities regarding the desirable and deserving characteristics of a good teacher. Therefore, this study was conducted with the aim of investigating factors affecting the evaluation of teachers' medical universities from the perspective of students.
METHODS
A systematic review study was conducted by searching for studies in both Persian and English languages from 2014 to 2022 in the following databases: Pubmed, Web of Science, Scopus, Cochrane, Google Scholar, and ScienceDirect, Magiran, SID, Iran Doc using keywords including Evaluation, Assessment, Estimate, Appraisement, Appraisal, Faculty Member, Professor, University, and College, as well as their MeSH equivalents, using "AND" and "OR" operators. The results of the articles about investigating factors affecting the evaluation of teachers' medical universities from the perspective of students were reviewed, summarized, and reported.
RESULTS
In the initial search, 3949 articles were found, and after evaluation, finally 21 articles were included in the systematic review. Based on the findings, investigating factors affecting the evaluation of teachers' medical universities from the perspective of 130,187 students can be categorized into 6 dimensions and 53 components. These dimensions include individual and professional characteristics of the educational system, attitude within the educational system, educational programs and guides, teaching methodology, internal coherence of educational resources, and evaluation system information.
CONCLUSION
The results of the articles about investigating factors affecting the evaluation of teachers' medical universities from the perspective of students were reviewed, summarized, and reported. It is necessary to pay attention to the factors affecting the evaluation of teachers in the recruitment of faculty members. Additionally, by holding practical training workshops with consideration of various dimensions that have an impact on faculty evaluation and student learning, it is possible to enhance the expertise of faculty members.
Topics: Humans; Universities; Students; Faculty; Schools; Attitude
PubMed: 38395829
DOI: 10.1186/s12909-024-05161-3 -
BMC Public Health Feb 2024The objective of this study was to conduct a systematic review to summarize and assess the advancements lately made on the enjoyable impacts of game-based physical... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The objective of this study was to conduct a systematic review to summarize and assess the advancements lately made on the enjoyable impacts of game-based physical education interventions on children and adolescents. Additionally, it attempted to identify the effects and variables influencing the enjoyable outcomes of children and adolescents' engagement in physical education games, through meta-analysis.
METHODS
This study involves a comprehensive search of different databases like Web of Science, PubMed, Embase, EBSCOhost, Cochrane, and Scopus. Specific criteria are established for the selection process to make sure the relevant literature included. The quality assessment of the included researches is conducted based on the guidelines outlined in the Cochrane 5.1 handbook. Review Manager 5.3 software is employed to synthesis the effect sizes. Additionally, bias is assessed using funnel plots, and to identify potential sources of heterogeneity, subgroup analyses are performed.
RESULTS
A total of 1907 academic papers, out of which 2 articles were identified via other data sources. The present study examined the impact of a pedagogical intervention involving physical education games on the enjoyment experienced by children and adolescents. The results indicated a significant positive effect (MD = 0.53, 95%CI:[0.27,0.79], P < 0.05) of this intervention on enjoyment. Subgroup analyses further revealed that both boys (MD = 0.31, 95%CI:[0.13,0.50], P < 0.05) and girls (MD = 0.28, 95%CI:[0.05,0.51], P < 0.05) experienced increased pleasure compared to traditional physical education. Additionally, children under 12 years of age (MD = 0.41, 95%CI:[0.17,0.64], P < 0.05) benefited from sessions lasting at least 30 minutes or more per session (MD = 0.40, 95%CI:[0.19,0.60], P < 0.05), occurring 1 to 3 times per week (MD = 0.28, 95%CI:[0.16,0.40], P < 0.05), and lasting for more than 3 weeks (MD = 0.81, 95%CI:[0.29,1.34], P < 0.05). These findings suggest that the implementation of physical education games can be an effective approach to teaching this subject.
CONCLUSIONS
1) Interventions using physical games have been shown to yield beneficial outcomes in terms of enhancing the enjoyment experienced by children and adolescents. 2) The effectiveness of treatments aimed at promoting enjoyment among children and adolescents is influenced by several aspects, including gender, age, duration and frequency of physical activity, as well as the specific cycle of activity used.
Topics: Child; Male; Female; Humans; Adolescent; Pleasure; Pediatric Obesity; Physical Education and Training; Exercise; Men
PubMed: 38373997
DOI: 10.1186/s12889-024-18043-6 -
Journal of Medical Imaging and... Jun 2024Healthcare professions differ from each other, therefore need different approaches in teaching clinical practices. While teaching and learning designs for medical... (Review)
Review
INTRODUCTION
Healthcare professions differ from each other, therefore need different approaches in teaching clinical practices. While teaching and learning designs for medical students are widely present on databases, few information is available for radiographers. The aim of this research is to define tools and knowledge needed to develop successful tutor-training programs that can be cross-cutting and inter-disciplinary for radiography profession, taking inspiration from other healthcare professions' programs since the paucity of evidence for radiographers.
METHODS
A systematic review (PubMed/Embase) was performed according to the PRISMA checklist. Original articles on learning environment related to healthcare practitioners were included. Inclusion criteria comprehended articles covering design and frameworks of peer-assisted-learning (PAL) programs and training-the-trainer (TTT) curricula, skills required to become tutors, tips to install successful tutor-training programs along with benefits for tutors involved. From 1618 retrieved articles, after two selection rounds, 15 articles met the inclusion criteria.
RESULTS
Out of the 15 articles, none is addressed to radiographers and only 7 % (1/15) to other healthcare professions, opposed to the 93 % (14/15) addressed to medical students. All articles discuss feedback providing, 66 % (10/15) debates which the best behaviour to maintain towards students is to maximize learning, and 46 % (7/15) inform about the importance of briefing and de-briefing activities. An identical percentage (46 %, 7/15) underlines the advantages of tutoring experiences. 11 articles (73 %) enhance that tutors aren't adequately trained to carry out tutoring activities.
DISCUSSION
Through curricula designed on TTT and PAL programs, radiographers are provided with necessary teachings and frameworks to set up effective training paths. Few institutes promote educational tutor-training courses, even though these are beneficial both for tutors and students, consolidating professionals' knowledge and maximizing students' practical skills.
CONCLUSION
Offering tutor-training curricula contributes to the development of radiographers as teachers, providing them with guiding principles to improve their formative skills towards future colleagues, therefore optimizing efficacy and effectiveness of programs.
Topics: Humans; Curriculum; Radiology; Teaching; Radiography
PubMed: 38368143
DOI: 10.1016/j.jmir.2024.01.009 -
Frontiers in Nutrition 2024Healthy eating habits are the basis for good health status, especially for children and adolescents, when growth and development are still ongoing. Nutrition educational...
UNLABELLED
Healthy eating habits are the basis for good health status, especially for children and adolescents, when growth and development are still ongoing. Nutrition educational programs are essential to prevent and treat chronic diseases. Nutritional counseling (NC), as a collaborative process between the counselor and the client process, could help to achieve better outcomes. This review aims to collect information about the utilization of NC during childhood and adolescence and to highlight its possible impact on adherence/compliance rates, nutrition knowledge, status and dietary intake. The methods applied in this systematic review followed the instruction of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search in PubMed/Medline, Scopus, Web of Science, LILACS, and Science Direct included observational or randomized studies. RoB 2.0 and Robins-I tools was used for the risk of bias assessment in randomized and non-randomized studies, respectively. The quality of evidence was checked by the Mixed Methods Appraisal Tool system. A total of 21 articles were selected, computing 4,345 individuals. 11 achieved at least 4 stars quality level. The highest risk of bias for randomized studies was related to the randomization process. 42.9% of non-randomized studies had some concerns of bias, mainly because of a lack of control of all confounding factors. Different strategies of NC were used in children and adolescents with positive results for health or diseases. NC strategies can be effectively used in children and adolescents. In general, NC showed benefits in pediatrics age for anthropometric or body composition parameters, dietary intake, nutrition knowledge and physical activity improvement. Performing NC in pediatrics is challenging due to the counseling strategies that must be adapted in their contents to the cognitive ability of each age. More structured research must be done focused on this population. Investments in healthy eating behaviors in pediatrics can lead to better health outcomes in the future population with substantial benefits to society.
SYSTEMATIC REVIEW REGISTRATION
[https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42022374177].
PubMed: 38362101
DOI: 10.3389/fnut.2024.1270048 -
Health Technology Assessment... Jan 2024Up to 30% of children have constipation at some stage in their life. Although often short-lived, in one-third of children it progresses to chronic functional...
BACKGROUND
Up to 30% of children have constipation at some stage in their life. Although often short-lived, in one-third of children it progresses to chronic functional constipation, potentially with overflow incontinence. Optimal management strategies remain unclear.
OBJECTIVE
To determine the most effective interventions, and combinations and sequences of interventions, for childhood chronic functional constipation, and understand how they can best be implemented.
METHODS
Key stakeholders, comprising two parents of children with chronic functional constipation, two adults who experienced childhood chronic functional constipation and four health professional/continence experts, contributed throughout the research. We conducted pragmatic mixed-method reviews. For all reviews, included studies focused on any interventions/strategies, delivered in any setting, to improve any outcomes in children (0-18 years) with a clinical diagnosis of chronic functional constipation (excluding studies of diagnosis/assessment) included. Dual reviewers applied inclusion criteria and assessed risk of bias. One reviewer extracted data, checked by a second reviewer. We systematically searched electronic databases (including Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature) (January 2011 to March 2020) and grey literature, including studies (any design) reporting any intervention/strategy. Data were coded, tabulated and mapped. Research quality was not evaluated. For each different intervention, we included existing systematic reviews judged to be low risk of bias (using the Risk of Bias Assessment Tool for Systematic Reviews), updating any meta-analyses with new randomised controlled trials. Where there was no existing low risk of bias systematic reviews, we included randomised controlled trials and other primary studies. The risk of bias was judged using design-specific tools. Evidence was synthesised narratively, and a process of considered judgement was used to judge certainty in the evidence as high, moderate, low, very low or insufficient evidence. Included studies (any design, English-language) detailed intervention-related costs. Studies were categorised as cost-consequence, cost-effectiveness, cost-utility or cost-benefit, and reporting quality evaluated using the consensus health economic criteria checklist. Included studies reported data relating to implementation barriers or facilitators. Using a best-fit framework synthesis approach, factors were synthesised around the consolidated framework for implementation research domains.
RESULTS
Stakeholders prioritised outcomes, developed a model which informed evidence synthesis and identified evidence gaps.
SCOPING REVIEW
651 studies, including 190 randomised controlled trials and 236 primary studies, conservatively reported 48 interventions/intervention combinations.
EFFECTIVENESS SYSTEMATIC REVIEWS
studies explored service delivery models ( = 15); interventions delivered by families/carers ( = 32), wider children's workforce ( = 21), continence teams ( = 31) and specialist consultant-led teams ( = 42); complementary therapies ( = 15); and psychosocial interventions ( = 4). One intervention (probiotics) had moderate-quality evidence; all others had low to very-low-quality evidence. Thirty-one studies reported evidence relating to cost or resource use; data were insufficient to support generalisable conclusions. One hundred and six studies described implementation barriers and facilitators.
CONCLUSIONS
Management of childhood chronic functional constipation is complex. The available evidence remains limited, with small, poorly conducted and reported studies. Many evidence gaps were identified. Treatment recommendations within current clinical guidelines remain largely unchanged, but there is a need for research to move away from considering effectiveness of single interventions. Clinical care and future studies must consider the individual characteristics of children.
STUDY REGISTRATION
This study is registered as PROSPERO CRD42019159008.
FUNDING
This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 128470) and is published in full in ; Vol. 28, No. 5. See the NIHR Funding and Awards website for further award information.
Topics: Child; Adult; Humans; Systematic Reviews as Topic; Health Personnel; Constipation
PubMed: 38343084
DOI: 10.3310/PLTR9622 -
Journal of Orthopaedic Surgery and... Feb 2024Chronic Achilles tendon ruptures (CATR) often require surgical intervention to restore function. Despite numerous treatment modalities available, the optimal management...
BACKGROUND
Chronic Achilles tendon ruptures (CATR) often require surgical intervention to restore function. Despite numerous treatment modalities available, the optimal management strategy remains controversial given the limited high-quality evidence available. This article aims to provide evidence-based guidelines for the surgical management of CATR through a comprehensive systematic review of the available data. The consensus reached by synthesizing the findings will assist clinicians in making informed decisions and improving patient outcomes.
METHODS
A group of 9 foot surgeons in three continents was consulted to gather their expertise on guidelines regarding the surgical management of CATR. Following the proposal of 9 clinical topics, a thorough and comprehensive search of relevant literature published since 1980 was conducted for each topic using electronic databases, including PubMed, MEDLINE, and Cochrane Library, to identify relevant studies published until 1 October 2023. All authors collaborated in drafting, discussing, and finalizing the recommendations and statements. The recommendations were then categorized into two grades: grade a (strong) and grade b (weak), following the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Additionally, feedback from 21 external specialists, who were independent from the authors, was taken into account to further refine and finalize the clinical guidelines.
RESULTS
Nine statements and guidelines were completed regarding surgical indications, surgical strategies, and postoperative rehabilitation protocol.
CONCLUSION
Based on the findings of the systematic review, this guideline provides recommendations for the surgical management of CATR. We are confident that this guideline will serve as a valuable resource for physicians when making decisions regarding the surgical treatment of patients with CATR.
Topics: Humans; Achilles Tendon; Orthopedic Procedures; Ankle Injuries; Tendon Injuries; Consensus; Rupture
PubMed: 38341569
DOI: 10.1186/s13018-024-04559-5