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International Journal of Environmental... Apr 2024Diabetes self-management education helps to improve health outcomes and qualities of life for diabetic patients. This systematic review examines the effectiveness of... (Review)
Review
Diabetes self-management education helps to improve health outcomes and qualities of life for diabetic patients. This systematic review examines the effectiveness of several types of diabetes self-management education for patients at the early stages of type 2 diabetes mellitus (T2DM). A review of studies that have researched the use and impacts of health education on diabetic patients with T2DM was conducted using the electronic databases PubMed, Elsevier, JSTORE, Walters Kluwer, and the Cochrane Library between January 2017 and November 2022. We found 789 studies, and after selecting the PRISMA flowchart, we selected 19 studies, including those of 2512 adult patients diagnosed with T2DM. Biomedical results presented the pooled effect of a glycated hemoglobin (HbA1c) of -0.64% and a fasting blood glucose (FBG) of -0.32. Emotional and social results and behavioral effects were evaluated in 10 and nine studies, respectively. The education and support of diabetic patients at the early stages of the disease impact various aspects, including the biomedical profile, lifestyle, emotional and social well-being, and anthropometric parameters. Among the factors that have been identified to enhance the effectiveness of educational interventions are the following: conducting individualized sessions (or at least in small groups of patients), extending the duration of interventions by at least 12 months, adopting a combined approach that includes both face-to-face and online components, and ensuring the involvement of a multidisciplinary healthcare team.
Topics: Humans; Self-Management; Diabetes Mellitus, Type 2; Patient Education as Topic; Glycated Hemoglobin
PubMed: 38791737
DOI: 10.3390/ijerph21050522 -
Foods (Basel, Switzerland) May 2024This review article aims to provide an up-to-date overview of the main determinants of consumers' acceptance of novel foods (new foods and ingredients) in the EU with... (Review)
Review
This review article aims to provide an up-to-date overview of the main determinants of consumers' acceptance of novel foods (new foods and ingredients) in the EU with emphasis on product's intrinsic properties (sensory characteristics) and individual factors (socio-demographics, perceptive, psychological) by adopting a systematic approach following the PRISMA methodology. Case studies on terrestrial (i.e., insects, cultured meat and other animal origin products, plant-based food including mushrooms, plant-based analogues, pulses, and cereals) and aquatic systems (i.e., algae and jellyfish) are included focusing on age-related and cross-national differences in consumer acceptance of novel foods and ingredients. General trends have emerged that are common to all the novel foods analysed, regardless of their aquatic or terrestrial origin. Aspects such as food neophobia, unfamiliarity, and poor knowledge of the product are important barriers to the consumption of novel foods, while healthiness and environmental sustainability perception are drivers of acceptance. Sensory properties are challenging for more familiar ingredients such as plant-based food (e.g., novel food made by pulses, mushrooms, cereals and pseudocereals). Results are discussed in terms of feasibility of introducing these products in the EU food systems highlighting strategies that can encourage the use of new ingredients or novel foods.
PubMed: 38790835
DOI: 10.3390/foods13101534 -
BMJ Open Respiratory Research May 2024People with chronic obstructive pulmonary disease (COPD) are more likely to adopt a sedentary lifestyle. Increased sedentary behaviour is associated with adverse health...
BACKGROUND
People with chronic obstructive pulmonary disease (COPD) are more likely to adopt a sedentary lifestyle. Increased sedentary behaviour is associated with adverse health consequences and reduced life expectancy.
AIM
This mixed-methods systematic review aimed to report the factors contributing to sedentary behaviour in people with COPD.
METHODS
A systematic search of electronic databases (Medline, CINAHL, PsycINFO and Cochrane Library) was conducted and supported by a clinician librarian in March 2023. Papers were identified and screened by two independent researchers against the inclusion and exclusion criteria, followed by data extraction and analysis of quality. Quantitative and qualitative data synthesis was performed.
RESULTS
1037 records were identified, 29 studies were included (26 quantitative and 3 qualitative studies) and most studies were conducted in high-income countries. The most common influencers of sedentary behaviour were associated with disease severity, dyspnoea, comorbidities, exercise capacity, use of supplemental oxygen and walking aids, and environmental factors. In-depth findings from qualitative studies included a lack of knowledge, self-perception and motivation. However, sedentarism in some was also a conscious approach, enabling enjoyment when participating in hobbies or activities.
CONCLUSIONS
Influencers of sedentary behaviour in people living with COPD are multifactorial. Identifying and understanding these factors should inform the design of future interventions and guidelines. A tailored, multimodal approach could have the potential to address sedentary behaviour.
PROSPERO REGISTRATION NUMBER
CRD42023387335.
Topics: Humans; Sedentary Behavior; Pulmonary Disease, Chronic Obstructive; Exercise Tolerance; Exercise
PubMed: 38789283
DOI: 10.1136/bmjresp-2023-002261 -
Annals of the Royal College of Surgeons... May 2024Robotic surgery (RS) is gaining prominence in colorectal procedures owing to advantages like three-dimensional vision and enhanced dexterity, particularly in rectal... (Review)
Review
INTRODUCTION
Robotic surgery (RS) is gaining prominence in colorectal procedures owing to advantages like three-dimensional vision and enhanced dexterity, particularly in rectal surgery. Although recent reviews report similar outcomes between laparoscopic surgery (LS) and RS, this study investigates the evolving trends in outcomes over time, paralleling the increasing experience in RS.
METHODS
A systematic review, meta-analysis and meta-regression were conducted of randomised controlled trials exploring postoperative outcomes in patients undergoing RS or LS for colorectal pathology. The primary outcome measure was postoperative complications. Risk of bias was evaluated using the Cochrane Collaboration's assessment tool. Randomised controlled trials were identified from the PubMed, Embase and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases via the Cochrane Central Register of Controlled Trials.
RESULTS
Of 491 articles screened, 13 fulfilled the inclusion criteria. Meta-analysis of postoperative complications revealed no significant difference between RS and LS (relative risk [RR]: 0.96, 95% confidence interval [CI]: 0.79 to 1.18, =0.72). Meta-regression analysis of postoperative complications demonstrated a significant trend favouring RS over time (yearly change in Ln(RR): -0.0620, 95% CI: -0.1057 to -0.0183, =0.005). Secondary outcome measures included operative time, length of stay, blood loss, conversion to open surgery, positive circumferential resection margins and lymph nodes retrieved. The only significant findings were shorter operative time favouring LS (mean difference: 41.48 minutes, 95% CI: 22.15 to 60.81 minutes, <0.001) and fewer conversions favouring RS (RR: 0.57, 95% CI: 0.37 to 0.85, =0.007).
CONCLUSIONS
As experience in RS grows, evidence suggests an increasing safety profile for patients. Meta-regression revealed a significant temporal trend with complication rates favouring RS over LS. Heterogeneous reporting of complications hindered subgroup analysis of minor and major complications. LS remains quicker. Rising adoption of RS coupled with emerging evidence is expected to further elucidate its clinical efficacy.
PubMed: 38787311
DOI: 10.1308/rcsann.2024.0038 -
Tropical Medicine and Infectious Disease May 2024Lyme disease (LD) is an emergent vector-borne disease caused by spp. and transmitted through infected ticks, mainly spp. Our objective was to determine meteorological... (Review)
Review
BACKGROUND
Lyme disease (LD) is an emergent vector-borne disease caused by spp. and transmitted through infected ticks, mainly spp. Our objective was to determine meteorological and environmental factors associated with LD transmission in Europe and the effect of climate change on LD.
MATERIALS AND METHODS
A systematic review following the PRISMA guidelines was performed. We selected studies on LD transmission in the European Union (EU) and the European Economic Area (EEA) published between 2000 and 2022. The protocol was registered in the PROSPERO database.
RESULTS
We included 81 studies. The impact of environmental, meteorological or climate change factors on tick vectors was studied in 65 papers (80%), and the impact on human LD cases was studied in 16 papers (19%), whereas animal hosts were only addressed in one study (1%). A significant positive relationship was observed between temperature and precipitation and the epidemiology of LD, although contrasting results were found among studies. Other positive factors were humidity and the expansion of anthropized habitats.
CONCLUSIONS
The epidemiology of LD seems to be related to climatic factors that are changing globally due to ongoing climate change. Unfortunately, the complete zoonotic cycle was not systematically analyzed. It is important to adopt a One Health approach to understand LD epidemiology.
PubMed: 38787046
DOI: 10.3390/tropicalmed9050113 -
Healthcare (Basel, Switzerland) May 2024Advances in anti-retroviral therapy (ART) have decreased mortality rates and subsequently led to a rise in the number of HIV-positive people living longer. The housing... (Review)
Review
Advances in anti-retroviral therapy (ART) have decreased mortality rates and subsequently led to a rise in the number of HIV-positive people living longer. The housing experiences of this new population of interest-older adults (50 years and older) living with HIV-are under-researched. Understanding the housing experiences and unmet needs of older people with HIV can better provide comprehensive care services for them. This study's systematic review evaluated the peer-reviewed literature reporting housing access/insecurity/assistance/options, housing impact, and unmet needs of older individuals living with HIV in North America from 2012 to 2023. Furthermore, Latent Semantic Analysis (LSA), a text-mining technique, and Singular Value Decomposition (SVD) for text clustering were utilized to examine unstructured data from the abstracts selected from the review. The goal was to allow for a better understanding of the relationships between terms in the articles and the identification of emerging public health key themes affecting older adults living with HIV. The results of text clustering yielded two clusters focusing on (1) improvements to housing and healthcare services access and policies and (2) unmet needs-social support, mental health, finance, food, and sexuality insecurities. Topic modeling demonstrated four topics, which we themed to represent (1) a holistic care approach; (2) insecurities-food, financial, sexuality, and other basic needs; (3) access to housing and treatment/care; and (4) homelessness and HIV-related health outcomes. Stable housing, food, and healthcare services access and availability are critical elements to incorporating comprehensive, holistic healthcare for older adults living with HIV. The aging population requires high-priority policies for accessible and equitable healthcare. Clinicians and policymakers should address individual barriers, adopt a patient-centered approach, increase doctor visits, provide competency training, ensure long-term follow-up, involve families, and improve patient education in care management, contributing to HIV/AIDS geriatric care models.
PubMed: 38786403
DOI: 10.3390/healthcare12100992 -
Frontiers in Aging 2024The critical importance of technological innovation in home care for older adults is indisputable. Less well understood is the question of how to measure its performance...
The critical importance of technological innovation in home care for older adults is indisputable. Less well understood is the question of how to measure its performance and impact on the delivery of healthcare to older adults who are living with chronic illness and disability. Knowing how well digital technologies, such as smartphones, tablets, wearable devices, and Ambient Assisted Living Technologies (AAL) systems "work" should certainly include assessing their impact on older adults' health and ability to function in daily living but that will not guarantee that it will necessarily be adopted by the user or implemented by a healthcare facility or the healthcare system. Technology implementation is a process of planned and guided activities to launch, introduce and support technologies in a certain context to innovate or improve healthcare, which delivers the evidence for adoption and upscaling a technology in healthcare practices. Factors in addition to user acceptance and clinical effectiveness require investigation. Failure to appreciate these factors can result in increased likelihood of technology rejection or protracted procurement decision at the "adoption decision" stage or delayed or incomplete implementation or discontinuance (following initial adoption) during implementation. The aim of our research to analyze research studies on the effectiveness of digital health technologies for older adults to answer the question, "How well do these studies address factors that affect the implementation of technology?" We found common problems with the conceptualization, design, and methodology in studies of digital technology that have contributed to the slow pace of implementation in home care and long-term care. We recommend a framework for improving the quality of research in this critical area. https://archive.org/details/osf-registrations-f56rb-v1, identifier osf-registrations-f56rb-v1.
PubMed: 38784681
DOI: 10.3389/fragi.2024.1349520 -
Breast Cancer Research and Treatment Jul 2024Vaginal oestrogens can be used to treat genitourinary symptoms in women with early breast cancer. Studies evaluating vaginal oestrogens have commonly measured serum...
PURPOSE
Vaginal oestrogens can be used to treat genitourinary symptoms in women with early breast cancer. Studies evaluating vaginal oestrogens have commonly measured serum oestrogen levels as a surrogate marker of safety, but methods vary. We sought to summarise the data on serum oestrogen measurement in women with breast cancer using vaginal oestrogens to better understand the methods, levels and reliability.
METHODS
We searched Medline, Embase, CENTRAL, SCOPUS and CINAHL from inception to October 2023 for clinical studies where serum oestrogen was measured in women with a history of early breast cancer using vaginal oestrogens. Studies with a reported testing methodology were included.
RESULTS
Nine studies met the inclusion criteria for this systematic review. Methods used to measure oestradiol and oestriol in selected studies included mass spectrometry and immunoassays; several studies used more than one with variable concordance. Mass spectrometry detected oestradiol levels down to a lower limit between 1.0 pg/mL and 3.0 pg/mL. Immunoassays such as ELISA (enzyme-linked immunosorbent assay), ECLIA (enhanced chemiluminiscence immunoassay) and RIA (radioimmunoassay) had lower detection limits ranging between 0.8 pg/mL and 10 pg/mL. Studies were heterogeneous in testing techniques used, timing of testing, and the population including with subsequent varying results in the effect on oestrogens reported.
CONCLUSIONS
Adopting consistent and standardised methods of measuring oestrogens in clinical trials involving women with early breast cancer on vaginal oestrogens is critical. Serum oestrogens are used as a surrogate marker of safety in this population, and good-quality data are necessary to enable clinicians and patients to feel confident in prescribing and taking vaginal oestrogens. Mass spectrometry, although more expensive, gives more reliable results when dealing with very low levels of oestrogens often found in women on aromatase inhibitors, compared to immunoassays.
Topics: Female; Humans; Administration, Intravaginal; Breast Neoplasms; Cancer Survivors; Estradiol; Estriol; Estrogens; Vagina
PubMed: 38780887
DOI: 10.1007/s10549-024-07364-0 -
Journal of Medical Internet Research May 2024In recent years, there has been an upwelling of artificial intelligence (AI) studies in the health care literature. During this period, there has been an increasing... (Review)
Review
BACKGROUND
In recent years, there has been an upwelling of artificial intelligence (AI) studies in the health care literature. During this period, there has been an increasing number of proposed standards to evaluate the quality of health care AI studies.
OBJECTIVE
This rapid umbrella review examines the use of AI quality standards in a sample of health care AI systematic review articles published over a 36-month period.
METHODS
We used a modified version of the Joanna Briggs Institute umbrella review method. Our rapid approach was informed by the practical guide by Tricco and colleagues for conducting rapid reviews. Our search was focused on the MEDLINE database supplemented with Google Scholar. The inclusion criteria were English-language systematic reviews regardless of review type, with mention of AI and health in the abstract, published during a 36-month period. For the synthesis, we summarized the AI quality standards used and issues noted in these reviews drawing on a set of published health care AI standards, harmonized the terms used, and offered guidance to improve the quality of future health care AI studies.
RESULTS
We selected 33 review articles published between 2020 and 2022 in our synthesis. The reviews covered a wide range of objectives, topics, settings, designs, and results. Over 60 AI approaches across different domains were identified with varying levels of detail spanning different AI life cycle stages, making comparisons difficult. Health care AI quality standards were applied in only 39% (13/33) of the reviews and in 14% (25/178) of the original studies from the reviews examined, mostly to appraise their methodological or reporting quality. Only a handful mentioned the transparency, explainability, trustworthiness, ethics, and privacy aspects. A total of 23 AI quality standard-related issues were identified in the reviews. There was a recognized need to standardize the planning, conduct, and reporting of health care AI studies and address their broader societal, ethical, and regulatory implications.
CONCLUSIONS
Despite the growing number of AI standards to assess the quality of health care AI studies, they are seldom applied in practice. With increasing desire to adopt AI in different health topics, domains, and settings, practitioners and researchers must stay abreast of and adapt to the evolving landscape of health care AI quality standards and apply these standards to improve the quality of their AI studies.
Topics: Artificial Intelligence; Humans; Delivery of Health Care; Quality of Health Care
PubMed: 38776538
DOI: 10.2196/54705 -
BMC Public Health May 2024For healthcare delivery to be optimally effective, health systems must possess adequate levels and we must ensure a fair distribution of human resources aimed at...
BACKGROUND
For healthcare delivery to be optimally effective, health systems must possess adequate levels and we must ensure a fair distribution of human resources aimed at healthcare facilities. We conducted a scoping review to map the current state of human resources for health (HRH) in India and the reasons behind its shortage.
METHODS
A systematic search was conducted in various electronic databases, from the earliest available date till February 2024. We applied a uniform analytical framework to all the primary research reports and adopted the "descriptive-analytical" method from the narrative paradigm. Inductive thematic analysis was conducted to arrange the retrieved data into categories based on related themes after creating a chart of HRH problems.
RESULTS
A total of 9675 articles were retrieved for this review. 88 full texts were included for the final data analysis. The shortage was addressed in 30.6% studies (n = 27) whereas 69.3% of studies (n = 61) addressed reasons for the shortage. The thematic analysis of data regarding reasons for the shortage yielded five kinds of HRH-related problems such as inadequate HRH production, job dissatisfaction, brain drain, regulatory issues, and lack of training, monitoring, and evaluation that were causing a scarcity of HRH in India.
CONCLUSION
There has been a persistent shortage and inequitable distribution of human resources in India with the rural expert cadres experiencing the most severe shortage. The health department needs to establish a productive recruitment system if long-term solutions are to be achieved. It is important to address the slow and sporadic nature of the recruitment system and the issue of job insecurity among medical officers, which in turn affects their other employment benefits, such as salary, pension, and recognition for the years of service.
Topics: Humans; Health Care Sector; Health Personnel; Health Workforce; India; Job Satisfaction
PubMed: 38773422
DOI: 10.1186/s12889-024-18850-x