-
Applied Health Economics and Health... Jan 2024In pursuit of universal health coverage, India has launched the world's largest government-sponsored health insurance scheme, Pradhan Mantri Jan Arogya Yojana (PM-JAY)...
BACKGROUND AND OBJECTIVE
In pursuit of universal health coverage, India has launched the world's largest government-sponsored health insurance scheme, Pradhan Mantri Jan Arogya Yojana (PM-JAY) in 2018. This study aims to provide a holistic review of the scheme's impact since its inception.
METHODS
We reviewed studies (based on interviews or surveys) published from September 2018 to January 2023, which were retrieved from PubMed, Web of Science, and Scopus database. The main outcomes studied were: (1) awareness; (2) utilization of scheme; (3) experiences; (4) financial protection; and (5) challenges encountered by both beneficiaries and healthcare providers.
RESULTS
A total of 18 studies conducted across 14 states and union territories of India were reviewed. The findings revealed that although PM-JAY has become a familiar name, there remains a low level of awareness regarding various facets of the scheme such as benefits entitled, hospitals empanelled, and services covered. The scheme is benefitting the poor and vulnerable population to access healthcare services that were previously unaffordable to them. However, financial protection provided by the scheme exhibited mixed results. Several challenges were identified, including continued spending by beneficiaries on drugs and diagnostic tests, delays in issuance of beneficiary cards, and co-payments demanded by healthcare providers. Additionally, private hospitals expressed dissatisfaction with low health package rates and delays in claims reimbursement.
CONCLUSIONS
Concerted efforts such as population-wide dissemination of clear and complete knowledge of the scheme, providing training to healthcare providers, addressing infrastructural gaps and concerns of healthcare providers, and ensuring appropriate stewardship are imperative to achieve the desired objectives of the scheme in the long-run.
Topics: Humans; Insurance, Health; Hospitals; Government; India
PubMed: 37801262
DOI: 10.1007/s40258-023-00838-0 -
Bulletin of the World Health... Oct 2023To consolidate recent information on elimination and eradication goals for infectious diseases and clarify the definitions and associated terminology for different goals. (Review)
Review
OBJECTIVE
To consolidate recent information on elimination and eradication goals for infectious diseases and clarify the definitions and associated terminology for different goals.
METHODS
We conducted a systematic search of the World Health Organization's Institutional Repository for Information Sharing (WHO IRIS) and a customized systematic Google advanced search for documents published between 2008 and 2022 on elimination or eradication strategies for infectious conditions authored by WHO or other leading health organizations. We extracted information on names of infectious conditions, the elimination and eradication goals and timelines, definitions of goals, non-standardized terminology, targets and assessment processes.
FINDINGS
We identified nine goals for 27 infectious conditions, ranging from disease control to eradication. In comparison with the hierarchy of disease control, as defined at the Dahlem Workshop in 1997, six goals related to disease control with varying levels of advancement, two related to elimination and one to eradication. Goals progressed along a disease-control continuum, such as end of disease epidemic to pre-elimination to elimination as a public health problem or threat. We identified the use of non-standardized terminology with certain goals, including elimination, of disease epidemics, public health and public health
CONCLUSION
As we approach the 2030 target date to achieve many of the goals related to disease control and for other infections to become candidates for elimination in the future, clarity of definitions and objectives is important for public health professionals and policy-makers to avoid misperceptions and miscommunication.
Topics: Humans; Goals; Disease Eradication; Public Health; Global Health; Communicable Diseases
PubMed: 37772196
DOI: 10.2471/BLT.23.289676 -
JPMA. the Journal of the Pakistan... Aug 2023To map literature on research ethics committees, institutional review boards and ethics review framework in Pakistan to identify key insights during public health...
OBJECTIVE
To map literature on research ethics committees, institutional review boards and ethics review framework in Pakistan to identify key insights during public health emergencies and normal times.
METHOD
The systematic scoping review was conducted in April 2022, and comprised literature search on PubMed, World Health Organisation Global Index Medicus and Summons databases for articles published between January 2005 and February 2022. Information extracted included authors' names, year of publication, title, study methodology, and key insights under the heads of challenges and solutions. Due to data heterogeneity, key themes were identified and analysed.
RESULTS
Of the 2,190 studies initially identified, 21(0.95%) were subjected to full-text review, and, from among them, 9(45%) were analysed in detail. There were 4 key insights identified: research ethics committees and institutional review boards in Pakistan remain unregulated as they are currently not registered or accredited by a competent national-level authority; most members of such committees are not formally trained to implement the mandate; internal and external pressures hinder independent decision-making of such committees; and other issues hindering the functionality and performance of research ethics committees and institutional review boards.
CONCLUSIONS
Despite existing publications calling for urgent policy and regulatory reforms, there is a dearth of literature and minimal policy actions underlying the fact that ethics review remains a neglected area in Pakistan.
Topics: Humans; Pakistan; Ethics Committees, Research; Learning; Databases, Factual
PubMed: 37697760
DOI: 10.47391/JPMA.8033 -
Obesity Research & Clinical Practice 2023The association between early-life exposure to antibiotics and overweight/obesity is unclear. We conducted a systematic review and meta-analysis to address this issue.
BACKGROUND
The association between early-life exposure to antibiotics and overweight/obesity is unclear. We conducted a systematic review and meta-analysis to address this issue.
METHODS
We searched PubMed, Web of Science, Scopus, and grey literature from inception to August 10, 2022, for cohort studies investigating the association between early-life exposure to antibiotics and weight outcomes. Two independent reviewers screened studies for eligibility, extracted data, assessed risk of bias, and examined the certainty of the evidence. Random-effects meta-analyses was used for pooling the data. The review was registered in PROSPERO, CRD42021265417.
RESULTS
We included 42 studies and data from 28 of them were pooled in the quantitative synthesis. Overall antenatal (OR 1.10, 95% CI 1.04-1.16; 518,095 children, very low certainty) and second trimester (OR 1.11, 95% CI 1.08-1.14, 248,469 children, low certainty) exposure to antibiotics were associated with increased risk of overweight/obesity in childhood/adolescence. Overall early postnatal antibiotic exposure was also associated with increased likelihood of overweight/obesity in childhood/adolescence (OR 1.09, 95% CI 1.05-1.12, 1,488,316 children, very low certainty). The magnitude of the association increased from exposure to one (OR 1.07, 95% CI 1.00-1.15, 512,954 children) to four or more courses of antibiotics (OR 1.31, 95% CI 1.17-1.46, 543,627 children).
CONCLUSION
Antenatal and early postnatal exposure to antibiotics is associated increased likelihood of overweight/obesity, although the findings are limited by the very low certainty of evidence. We highlight the need for homogeneous prospective studies addressing potential confounding factors to further explore the link between exposure to antibiotics and the risk of excess body weight.
PubMed: 37573229
DOI: 10.1016/j.orcp.2023.07.001 -
Frontiers in Pediatrics 2023Gastrointestinal (GI) symptoms are frequently experienced by children with autism spectrum disorder (ASD), and these symptoms cause difficulties for these children and... (Review)
Review
BACKGROUND
Gastrointestinal (GI) symptoms are frequently experienced by children with autism spectrum disorder (ASD), and these symptoms cause difficulties for these children and their families. However, studies of GI symptom prevalence differ significantly. This meta-analysis aimed to analyze the prevalence of GI symptoms in children with ASD.
METHODS AND FINDINGS
PubMed, Scopus, Web of Science, EMBASE were electronically searched to collect all literature on gastrointestinal symptoms of children with ASD collected through questionnaires or scales from January 2012 to May 2021. Four researchers independently scanned the literature and extracted information on general characteristics. First author name, year of publication, geographical location, type of study, sample sizes of ASD and control (if any) children, sex and average age, number of GI cases, number of GI symptoms, GI assessment tools (gastrointestinal symptoms scale), autism diagnosis methods, and other necessary data were collected and analyzed using Stata V16. The questionnaires included the Rome, 6-GSI, GIQ, GSRS, GSIQ, ADI-R, PedsQL-GI, parent-report, GI-related, and self-administered questionnaires. Compared with typically developing (TD) children, the odds ratio for In children with ASD with at least one GI symptom was 3.64, and the total prevalence was 55%. The cumulative prevalence rates of various symptoms were summarized, showing that 37% of children with ASD had constipation, 21% had abdominal pain, 19% had diarrhea, 8% had vomiting, and 23% had abdominal distension.
CONCLUSIONS
The results of this meta-analysis on GI symptoms in ASD show that patients with ASD are more likely to develop symptoms than TD children. The prevalence of GI symptoms in In children with ASD was 55%.
SYSTEMATIC REVIEW REGISTRATION
www.crd.york.ac.uk/PROSPERO, identifier, #CRD42017080579.
PubMed: 37565245
DOI: 10.3389/fped.2023.1120728 -
Journal of the Mechanical Behavior of... Sep 2023The purpose of this study was to systematically review the impact of nanofillers on the physicomechanical properties of resin-based pit and fissure sealants (RBS). This... (Review)
Review
The purpose of this study was to systematically review the impact of nanofillers on the physicomechanical properties of resin-based pit and fissure sealants (RBS). This review included in vitro studies with full-length English-language articles reporting on the physicomechanical properties of nanofilled RBS until February 2023. PubMed, Web of Sciences, Scopus, and LILACS databases were accessed for literature searches. The review was formulated based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and used the Consolidated Standards of Reporting Trials (CONSORT) guidelines and risk of bias Cochrane tool for quality assessment. The search resulted in 539 papers, of which 22 were eligible to be included in the review. Inorganic, polymeric, core-shell, and composite nanomaterials were used to reinforce the studied RBS. The inherent nature of the nanomaterial used, its morphology, concentration, and volume used were the primary parameters that determined the nanomaterial's success as a filler in RBS. These parameters also influenced their interaction with the resin matrix, which influenced the final physicomechanical properties of RBS. The use of nanofillers that were non-agglomerated and well dispersed in the resin matrix enhanced the physicomechanical properties of RBS.
Topics: Humans; Pit and Fissure Sealants; Nanostructures; Polymers; Reference Standards; Dental Caries
PubMed: 37499522
DOI: 10.1016/j.jmbbm.2023.106037 -
Journal of Bodywork and Movement... Jul 2023More than two-thirds of pregnant women experience low back pain during pregnancy. This condition increases with advancing pregnancy, interfering with work, daily... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
More than two-thirds of pregnant women experience low back pain during pregnancy. This condition increases with advancing pregnancy, interfering with work, daily activities and sleep.
OBJECTIVE
To assess the efficacy of the Pilates method in comparison to prenatal care on the control of lower back pain in pregnant women.
SEARCH METHODS
Electronic searches were carried out with no language or year of publication restriction in the databases Medline via Pubmed, Embase, CINAHL, LILACS, PEDro, and SPORTDiscus on 20 March 2021. The keywords "Pilates" and "Pregnancy" were applied and the search strategies, adapted to each databank.
SELECTION CRITERIA
Randomized clinical trials with pregnant women with muscle pain symptoms and Pilates as an intervention method in comparison to conventional prenatal care were considered.
DATA COLLECTION AND ANALYSIS
two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The critical evaluation was done using the Risk of Bias tool assess the quality and GRADE to assess the certainty of evidence. We conducted a meta-analysis for the main outcome "pain".
RESULTS
through our searches, 687 papers were identified, but only two fulfilled the inclusion criteria and were included in this review. Only two studies compared Pilates with a control group without physical exercise for pain in the short term. In the meta-analysis, there was a significant difference for pain in the comparison between the Pilates group and the control group without exercise; the mean difference (MD) was -23.09 (95% CI), from -31.07 to -15.10, p = 0.001, for 65 individuals (33 in the Pilates group and 32 in the conventional group). Limitation found was the lack of blinding of therapists and participants and the small sample size of individual studies. In addition, no adverse effects were reported.
CONCLUSION
There is moderate-quality evidence that Pilates exercise may reduce pregnancy-related low-back pain more than usual prenatal or no exercise. Prospero registration number CRD42021223243.
Topics: Pregnancy; Female; Humans; Quality of Life; Low Back Pain; Exercise Therapy; Exercise Movement Techniques; Exercise
PubMed: 37330773
DOI: 10.1016/j.jbmt.2023.04.076 -
Current Problems in Cardiology Oct 2023Twelve CCI patients were studied with confirmed or suspected COVID-19 infection. The majority of these patients were males (83.3%) with a median age of 55 years from... (Review)
Review
Twelve CCI patients were studied with confirmed or suspected COVID-19 infection. The majority of these patients were males (83.3%) with a median age of 55 years from three geographical locations, constituting the Middle East (7), Spain (3), and the USA (1). In 6 patients, IgG/IgM was positive for COVID-19, 4 with high pretest probability and 2 with positive RT-PCR. Type 2 DM, hyperlipidemia, and smoking were the primary risk factors. Right-sided neurological impairments and verbal impairment were the most common symptoms. Our analysis found 8 (66%) synchronous occurrences. In 58.3% of cases, neuroimaging showed left Middle Cerebral Artery (MCA) infarct and 33.3% right. Carotid artery thrombosis (16.6%), tandem occlusion (8.3%), and carotid stenosis (1%) were also reported in imaging. Dual antiplatelet therapy (DAPT) and anticoagulants were conservative therapies (10). Two AMI patients had aspiration thrombectomy, while three AIS patients had intravenous thrombolysis/tissue plasminogen activator (IVT-tPA), 2 had mechanical thrombectomy (MT), and 1 had decompressive craniotomy. Five had COVID-19-positive chest X-rays, whereas 4 were normal. four of 8 STEMI and 3 NSTEMI/UA patients complained chest pain. LV, ICA, and pulmonary embolism were further complications (2). Upon discharge, 7 patients (70%) had residual deficits while 1 patient unfortunately died.
Topics: Female; Humans; Male; Middle Aged; Anticoagulants; COVID-19; Infarction, Middle Cerebral Artery; Stroke; Thrombectomy; Thrombolytic Therapy; Tissue Plasminogen Activator; Treatment Outcome; Case Reports as Topic
PubMed: 37209804
DOI: 10.1016/j.cpcardiol.2023.101814 -
Journal of Medical Internet Research May 2023The prevalence of mental health problems in children and adolescents is high. As these problems can impact this population's developmental trajectories, they constitute... (Review)
Review
BACKGROUND
The prevalence of mental health problems in children and adolescents is high. As these problems can impact this population's developmental trajectories, they constitute a public health concern. This situation is accentuated by the fact that children and adolescents infrequently seek help. Digital health interventions (DHIs) offer an opportunity to bridge the treatment gap between health care needs and patient engagement in care. Additional detailed research is needed to identify how children and adolescents can be empowered to access help through DHIs. In this context, an understanding of their attitudes toward digital health appears to be a necessary first step in facilitating the effective implementation of DHIs.
OBJECTIVE
This study aimed to establish an inventory of children's, adolescents', and their parents' attitudes toward DHIs.
METHODS
A scoping review following PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) recommendations was performed using the MEDLINE, Embase, and PsycINFO databases. This research was conducted using 3 key concepts: "child and adolescent mental health service users," "digital health interventions," and "attitudes." Data extracted included the name of the publishing journal, the methodology used, the target population, the DHI studied, and the principal results.
RESULTS
Of 1548 studies found, 30 (1.94%) were included in our analysis. Among these, 13 concerned satisfaction, 24 concerned preferences, 22 concerned the use of DHI, 11 concerned perception, and 10 concerned needs.
CONCLUSIONS
The results of this study provide a better understanding of the factors influencing children's and adolescents' attitudes toward digital health and DHIs. The continued growth of DHIs can help reduce barriers to mental health care. Future research on these interventions should investigate the needs of the targeted populations to increase their engagement in care.
Topics: Child; Humans; Adolescent; Telemedicine; Parents; Mental Health Services; Patient Participation
PubMed: 37129931
DOI: 10.2196/43102 -
Medicina (Kaunas, Lithuania) Mar 2023Human histology provides critical information on the biological potential of various regenerative protocols and biomaterials, which is vital to advancing the field of... (Review)
Review
Human histology provides critical information on the biological potential of various regenerative protocols and biomaterials, which is vital to advancing the field of periodontal regeneration, both in research and clinical practice. Outcomes of histologic studies are particularly valuable when interpreted considering additional evidence available from pre-clinical and clinical studies. One of the best-documented growth factors areproven to have positive effects on a myriad of oral regenerative procedures is recombinant human platelet-derived growth factor-BB (rhPDGF-BB). While a systematic review of clinical studies evaluating rhPDGF in oral regenerative procedures has been recently completed, a review article that focuses on the histologic outcomes is needed. Hence, this communication discusses the histologic effects of rhPDGF-BB on oral and periodontal regenerative procedures, including root coverage and soft tissue augmentation, intrabony defects, furcation defects, peri-implant bone augmentation, and guided bone regeneration. Studies from 1989 to 2022 have been included in this review.
Topics: Humans; Becaplermin; Proto-Oncogene Proteins c-sis; Recombinant Proteins; Intercellular Signaling Peptides and Proteins; Furcation Defects
PubMed: 37109634
DOI: 10.3390/medicina59040676