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Neurological Sciences : Official... Feb 2024Dystonia is a condition that affects the ability to control the movement and function of the body's muscles. It can cause not only physical problems, but also mental... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Dystonia is a condition that affects the ability to control the movement and function of the body's muscles. It can cause not only physical problems, but also mental problems, resulting in impaired health-related quality of life (HRQoL). However, the effect of deep brain stimulation on quality of life in acquired dystonia remains unclear.
METHODS
We conducted a systematic literature review from January 2000 to October 2022,determined the eligible studies, and performed a meta-analysis of HRQoL outcomes based on the Short-Form Health Survey-36 (SF-36) after DBS to evaluate the effects of DBS on physical and mental QoL.
RESULTS
A total of 14 studies met the inclusion criteria and were systematically reviewed. A comprehensive meta-analysis was performed for 9 studies that reported physical and psychological data or physical component summary (PCS), or mental component summary (MCS) for SF-36. The mean (SD) age at DBS implantation was 34.29 (10.3) years, and the follow-up period after implantation was 2.21 (2.80) years. The random effects model meta-analysis revealed that both physical and mental domains of the SF-36 improved following DBS. There was no statistically significant difference between the physical domains (effect size=1.34; p<0.0001) and the mental domains (effect size=1.38; p<0.0001).
CONCLUSION
This is the first meta-analysis that demonstrates significant benefits in HRQoL following DBS in patients with acquired dystonia. There were significant improvements in both physical QoL and mental QoL.
Topics: Humans; Dystonia; Quality of Life; Deep Brain Stimulation; Dystonic Disorders; Health Surveys; Treatment Outcome
PubMed: 37816931
DOI: 10.1007/s10072-023-07106-y -
International Angiology : a Journal of... Oct 2023Presence of varices after operative treatment (PREVAIT) is a common finding after varicose vein surgery, and has been shown to significantly reduce the quality of life...
INTRODUCTION
Presence of varices after operative treatment (PREVAIT) is a common finding after varicose vein surgery, and has been shown to significantly reduce the quality of life of those it affects. As such, long-term results after varicose vein interventions have to be taken into account when choosing a technique. This study aims to systematically review current evidence on the recurrence of varicose veins after three different techniques: conventional surgery (HLS), endovenous laser ablation (EVLA) and radiofrequency ablation (RFA).
EVIDENCE ACQUISITION
A literature search was performed on the PubMed and Web of Science databases, which returned 546 studies. Fourteen studies were included. Data were extracted using predefined forms.
EVIDENCE SYNTHESIS
A total of 2795 patients were included, for a total of 3056 legs treated. 503 legs (16.5%) were treated by HLS, 1791 (58.6%) by EVLA and 762 (25.0%) by RFA. PREVAIT was reported in 34.4% for patients treated by HLS, for a mean follow-up comprised between 18 months and 5 years; 16.6% by EVLA, for a mean follow-up between 112 days and 5 years and 6.7% of those treated by RFA, for a mean follow-up between 106 days and 5 years. Regarding patterns of recurrence, the development of new varicose veins was the most commonly reported mechanism of recurrence after HLS (range: 29.8-91%) and EVLA (range: 40-81.6%), but not RFA, where recanalization of the occluded saphenous trunk accounted for up to 67.0% of the cases. Only one study reported quality of life related recurrence, and included patients treated by HLS and EVLA, but not RFA. Aberdeen Varicose Vein Questionnaire (AVVQ) score, physical functioning domains of the SF-36 score and patient satisfaction were significantly worse in patients with clinical recurrence. Re-intervention rates after recurrence were reported in 5 studies, ranging between 7.7% and 37.7% for HLS and 0-57.0% for EVLA. Only one study reported data on re-intervention for RFA patients, which was 6.67%.
CONCLUSIONS
Recurrence is a reliable indicator of long-term efficacy of a varicose vein treatment and appears to occur more frequently after HLS. Although there are several mechanisms of recurrence, the development of new varicose veins was the most commonly observed. There is clear heterogeneity among definitions of recurrence and follow-up periods in literature.
Topics: Humans; Quality of Life; Saphenous Vein; Recurrence; Varicose Veins; Laser Therapy; Catheter Ablation; Treatment Outcome; Venous Insufficiency
PubMed: 37795801
DOI: 10.23736/S0392-9590.23.05082-4 -
Minerva Urology and Nephrology Apr 2024Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) is the first validated questionnaire to specifically evaluate the satisfaction of patients undergoing... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) is the first validated questionnaire to specifically evaluate the satisfaction of patients undergoing penile prosthesis implantation. Our primary aim was to conduct a systematic review and pooled analysis of articles reporting QoLSPP.
EVIDENCE ACQUISITION
A comprehensive bibliographic search on the MEDLINE, Scopus, Web of Science, and Cochrane Library databases was performed in April 2023. Studies were selected if they assessed male subjects (P) undergoing penile prosthesis implantation (I) with or without comparison with other treatments (C), reporting the patient satisfaction according to QoLSPP (O). Prospective and retrospective original studies were included (S). The risk of bias was assessed using the ROBINS-I tool and the Knoll method. Means and standard deviations (SDs) of QoLSPP scores were included in the pooled analysis. PROSPERO ID: "CRD42023427261."
EVIDENCE SYNTHESIS
A total of 10 studies investigating 1105 patients were included in the systematic review; of these, eight articles describing the outcomes of 693 subjects were eligible for the pooled analysis. Overall serious risk of bias was found in 2/3 of nonrandomized comparative studies (66%), while seven single-arm studies (100%) were classified as having a high risk of bias. Pooled analysis of the QoLSPP-Functional domain revealed an overall effect size (ES) of 4.22 points (95% CI 4.04-4.40; P<0.001). The QoLSPP-Relational pooled score was 4.17 points (95% CI 4.03-4.31; P<0.001). The QoLSPP-Social pooled score corresponded to 4.21 points (95% CI 4.02-4.40; P<0.001). Pooled analysis of the QoLSPP-Personal domain showed an overall ES of 3.97 points (95% CI 3.61-4.32; P<0.001). There was insufficient data to pool QoLSPP total scores.
CONCLUSIONS
Patients undergoing penile prosthesis implantation report positive scores in all QoLSPP domains, demonstrating high satisfaction levels. Future studies are needed to improve the evidence on the topic.
Topics: Humans; Quality of Life; Male; Penile Prosthesis; Patient Satisfaction; Sexuality; Penile Implantation
PubMed: 37795696
DOI: 10.23736/S2724-6051.23.05466-6 -
Frontiers in Sociology 2023Quantifying women's empowerment has become the focus of attention of many international organizations and scholars. We aimed to describe quantitative indicators of...
BACKGROUND
Quantifying women's empowerment has become the focus of attention of many international organizations and scholars. We aimed to describe quantitative indicators of women's empowerment that are based on individual-level data.
METHODS
In this scoping review, we searched PubMed, Scopus, Web of Science, Science Direct, Google, and Google Scholar for publications describing the operationalization of measures of women's empowerment.
RESULTS
We identified 36 studies published since 2004, half of them since 2019, and most from low- and middle-income countries. Twelve studies were based on data from the Demographic and Health Surveys and used 56 different variables from the questionnaires (ranging from one to 25 per study) to measure the overall empowerment of women 15-49 years. One study focused on rural women, two included married and unmarried women, and one analyzed the couple's responses. Factor analysis and principal component analysis were the most common approaches used. Among the 24 studies based on other surveys, ten analyzed overall empowerment, while the others addressed sexual and reproductive health (4 studies), agriculture (3) and livestock (1), water and sanitation (2), nutrition (2), agency (1), and psychological empowerment (1). These measures were mainly based on data from single countries and factor analysis was the most frequently analytical method used. We observed a diversity of indicator definitions and domains and a lack of consensus in terms of what the proposed indicators measure.
CONCLUSION
The proposed women's empowerment indicators represent an advance in the field of gender and development monitoring. However, the empowerment definitions used vary widely in concept and in the domains/dimensions considered, which, in turn influence or are influenced by the adopted methodologies. It remains a challenge to find a balance between the need for a measure suitable for comparisons across populations and over time and the incorporation of country-specific elements.
PubMed: 37780693
DOI: 10.3389/fsoc.2023.1231790 -
Psychotherapy and Psychosomatics 2023Social functioning (SF) is the ability to fulfil one's social obligations and a key outcome in treatment. (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Social functioning (SF) is the ability to fulfil one's social obligations and a key outcome in treatment.
OBJECTIVE
The aim of the study was to estimate the effects of antidepressants on SF in patients with major depressive disorder (MDD).
METHODS
This meta-analysis and its reporting are based on Cochrane Collaboration's Handbook of Systematic Reviews and Meta-Analyses and PRISMA guidelines (protocol registration at OSF). We systematically searched CENTRAL, Medline, PubMed Central, and PsycINFO for double-blind RCTs comparing antidepressants with placebo and reporting on SF. We computed standardized mean differences (SMDs) with 95% CIs and prediction intervals.
RESULTS
We selected 40 RCTs out of 1,188 records screened, including 16,586 patients (mean age 46.8 years, 64.2% women). In 27 studies investigating patients with MDD (primary depression), antidepressants resulted in a SMD of 0.25 compared to placebo ([95% CI: 0.21; 0.30] I2: 39%). In 13 trials with patients suffering from MDD comorbid with physical conditions or disorders, the summary estimate was 0.24 ([0.10; 0.37] I2: 75%). In comorbid depression, studies with high/uncertain risk of bias had higher SMDs than low-risk studies: 0.29 [0.13; 0.44] versus 0.04 [-0.16; 0.24]; no such effect was evident in primary depression. There was no indication of sizeable reporting bias. SF efficacy correlated with efficacy on depression scores, Spearman's rho 0.67 (p < 0.001), and QoL, 0.63 (p < 0.001).
CONCLUSIONS
The effect of antidepressants on SF is small, similar to its effect on depressive symptoms in primary MDD, and doubtful in comorbid depression. Strong correlations with both antidepressive and QoL effects suggest overlap among domains.
Topics: Humans; Female; Middle Aged; Male; Depressive Disorder, Major; Quality of Life; Social Interaction; Antidepressive Agents; Comorbidity; Randomized Controlled Trials as Topic
PubMed: 37725934
DOI: 10.1159/000533494 -
BMC Oral Health Sep 2023Cleft lip and palate (CLP) is the most common facial birth defect worldwide and causes morphological, aesthetic, and functional problems with psychosocial implications... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cleft lip and palate (CLP) is the most common facial birth defect worldwide and causes morphological, aesthetic, and functional problems with psychosocial implications for an individual's life and well-being. The present systematic review and meta-analysis assessed whether the treatment of CLP impacts the oral health-related quality of life (OHRQoL) in children and adolescents in comparison to healthy controls.
METHODS
We searched MEDLINE/PubMed, EMBASE, and PsycINFO databases using terms related to CLP, and included articles until August 2023. Observational comparison studies that assessed OHRQoL in non-syndromic CLP patients aged 8-19 years with validated scales designed to such aim or scales capable to identify aspects related to oral health compared to healthy controls were included. We used the ROBINS-I tool for risk of bias assessment. A meta-analysis of continuous variables was performed using inverse variance for pooling estimates, Standardized Mean Difference (SMD) as a summary measure, with random effects model. Heterogeneity was estimated by the I statistics. Sensitivity analyses included subgrouping based on the scale, risk of bias and scale domains. Meta-regression was performed under a mixed-effects model considering the variables type of scale, scale domains and risk of bias.
RESULTS
Fourteen studies were included comprising 1,185 patients with CLP and 1,558 healthy controls. The direction of the effect of OHRQoL favoured the healthy group (-0.92; 95% CI:-1,55;-0,10) and I = 95%. After removing three studies, I dropped to 80%. Meta-regression showed no influence on risk of bias (p = 0.2240) but influence of scale type (p = 0.0375) and scale domains (p < 0.001). The subgroup analysis indicated that the CPQ and COHIP scales presented very discrepant SMD values, despite pointing to the same effect direction. In contrast, the OHIP scale showed a non-significant difference between cases and controls, with estimates much lower than the other two scales. Results also suggest that OHRQoL associated with oral functionality and social well-being is more influential on outcomes than emotional well-being.
CONCLUSION
The global OHRQoL is slightly worst in the CLP patients than control group. The difference between OHRQoL was mainly detected through OHIP. The most affected domains are functional, emotional and social.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42022336956.
Topics: Adolescent; Child; Humans; Cleft Lip; Quality of Life; Cleft Palate; Health Status
PubMed: 37716942
DOI: 10.1186/s12903-023-03382-4 -
Archives of Physical Medicine and... Jun 2024To synthesize the outcomes reported in the rehabilitation and community literature for adults with traumatic lower limb amputation (LLA).
OBJECTIVE
To synthesize the outcomes reported in the rehabilitation and community literature for adults with traumatic lower limb amputation (LLA).
DATA SOURCES
The search strategy was conducted in 3 databases (Medline, EMBASE, and CINAHL) from inception to April 2022.
STUDY SELECTION
To be eligible, articles could be of any design but were required to have at least 50% adult individuals with traumatic LLA and had to report on interventions and outcomes in either a rehabilitation or community setting.
DATA EXTRACTION
The extracted outcomes were classified using Dodd's framework, which is designed for organizing research outcomes. Heterogeneity was observed in the outcome measures (OMs) used for evaluation. Two reviewers independently conducted the data extraction, which was verified by a third reviewer.
DATA SYNTHESIS
Of the 7,834 articles screened, 47 articles reporting data on 692 individuals with traumatic LLA, met our inclusion criteria. Four core areas encompassing 355 OMs/indicators were identified: life effect (63.4%), physiological/clinical (30.1%), resource use (5.1%), and adverse events (1.4%). Physical functioning (eg, gait, mobility) was the most frequently reported outcome domain across studies, followed by nervous system outcomes (eg, pain) and psychiatric outcomes (eg, depression, anxiety). Domains such as global quality of life and role/emotional functioning were seldomly reported.
CONCLUSION
The study provides a list of outcome indicators explicitly published for adults with traumatic LLA, highlighting inconsistent reporting of outcome indicators. The lack of a standardized set of OMs is a barrier to performing meta-analyses on interventions, preventing the identification of effective care models and clinical pathways. Developing a core outcome set that includes OMs relevant to the needs of the traumatic LLA population may address these issues.
Topics: Humans; Amputation, Surgical; Amputation, Traumatic; Lower Extremity; Outcome Assessment, Health Care; Quality of Life
PubMed: 37708929
DOI: 10.1016/j.apmr.2023.08.028 -
Dementia (London, England) Nov 2023Population ageing in low and middle-income Asian countries is associated with increased prevalence of dementia. The proportion of people with dementia in countries such...
BACKGROUND
Population ageing in low and middle-income Asian countries is associated with increased prevalence of dementia. The proportion of people with dementia in countries such as Bangladesh and Thailand are increasing. People with dementia can have complex care and health service needs. If these needs are not adequately met, this can result in a decreased quality of life and burden on the health system. There is considerable research into the needs of people with dementia in high-income countries. However, research on the needs of people living with dementia in low and middle-income countries remains underexplored. The aim of this study was to review and summarise the literature on the health and social care needs of older people with dementia in low and middle-income Asian countries.
METHODS
Five online databases (PubMed, Scopus, Web of Science, CINAHL and PsycINFO) and google scholar were searched. The databases were searched using a selection of key words. PRISMA-ScR approach was followed in reporting the process.
KEY FINDINGS
We extracted eight studies related to the health and social care needs of people with dementia that met our inclusion criteria. From the available literature, needs were categorised across five categories: (i) social, cognitive, and mental health needs; (ii) physical needs; (iii) care and service needs; (iv) knowledge-related needs; and (v) spiritual care needs.
CONCLUSION
While eight papers were located which discussed the needs of people with dementia across a range of domains, this review demonstrates a deficit in the current evidence-base about the health and social care needs of people living with dementia in low and middle-income Asian countries. Further research is needed to identify health and care needs of people with dementia and how these needs are being met.
Topics: Aged; Humans; Dementia; Developing Countries; Quality of Life; Social Support; Asian People
PubMed: 37708304
DOI: 10.1177/14713012231198952 -
Journal of Affective Disorders Dec 2023Depression is highly prevalent in low- and middle- income countries (LMIC) and associated with significant cognitive dysfunction across multiple domains. However, little... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Depression is highly prevalent in low- and middle- income countries (LMIC) and associated with significant cognitive dysfunction across multiple domains. However, little is known about neurocognitive tests used in people with depression in LMIC. We aimed to investigate cognitive performance and cognitive tests in depression research in LMIC.
METHODS
APA PsycInfo, Embase, Ovid MEDLINE, and Global Health were systematically searched for studies that implemented a cognitive performance test in a depressed, LMIC population. Tool quality was assessed using an adapted scale for quality of measures in cross-cultural settings. Data extracted included demographics, depression and cognitive performance measures, and cognitive performance comparisons between depression and control groups.
RESULTS
29 studies met eligibility criteria, involving a total of 19,100 participants from 11 LMIC. 93.1 % of studies were conducted in upper middle-income countries. 67 cognitive performance tools were implemented. Reliability was reported for 5.6 % of cognitive performance tests and validity was reported for 8.3 %. 36.1 % of tests used were culturally adapted. 75.9 % of included studies implemented at least one memory test. Cognitive deficits were observed in all depressed groups, especially in memory (Cohen's d = -1.60, 95 % CI -2.02 to -1.18).
LIMITATIONS
Heterogeneity between studies; averaged results across memory subtypes; no assessment of depression severity and cognitive deficits associations; restrictive search terms.
CONCLUSIONS
Cognitive impairments in depression, especially in memory, are prevalent in LMIC. This research has drawn attention to the burden of cognitive dysfunction in depression in LMIC, and to the disparate research gap in LMIC. PROSPERO registration CRD42022315397.
Topics: Humans; Developing Countries; Depression; Reproducibility of Results; Poverty; Cognition
PubMed: 37690541
DOI: 10.1016/j.jad.2023.09.007 -
PloS One 2023Most eye problems among children can be detected and treated at an early age to reduce the prevalence of visual impairment. Understanding the knowledge, attitude, and...
BACKGROUND
Most eye problems among children can be detected and treated at an early age to reduce the prevalence of visual impairment. Understanding the knowledge, attitude, and practice (KAP) among parents about common children's eye problems is fundamental to encourage parents to seek early eye care services for their children. This study aims to develop a Parental Knowledge, Attitude, and Practice in Eye Problem among Children Questionnaire (PEPC-KAPQ) and evaluate its psychometric properties.
METHODS
This study involved developing a questionnaire and was conducted in Kuala Lumpur, Malaysia from July 2021 until June 2022. The questionnaire was developed based on a literature review and expert consultation. The first phase includes a systematic literature review to generate the items for the questionnaire. A group of five panels was then invited to perform content validity for the questionnaire. Face validity was conducted among ten parents to get feedback for the questionnaire. Construct validity and reliability of the questionnaire were measured by which the questionnaire was administered to a total of 134 parents and 64 parents for reliability test.
RESULT
The final PEPC-KAPQ consists of four main sections: demographic, knowledge, attitude, and practice with 52 items. The content validity index was 0.85 for all domains of KAP. Modified kappa showed excellent value for most items for all domains. The Kaiser-Meyer-Olkin sampling adequacy showed acceptable scores of 0.84, and Bartlett's Test of Sphericity was significant (x2 = 3172.09, p<0.0001). Kuder-Richardson-2 of the domain knowledge was 0.95. Cronbach's α coefficient of domain attitude and practice were 0.92 and 0.88, respectively and the intraclass correlation of domain attitude and practice were 0.93 and 0.94 respectively. Bland and Altman's plots show that majority of the data fell within the limits of agreement.
CONCLUSION
The findings of this validation and reliability study show that the developed questionnaire has a satisfactory psychometric property for measuring the KAP of parents regarding eye problems among children.
Topics: Humans; Child; Health Knowledge, Attitudes, Practice; Reproducibility of Results; Knowledge; Malaysia; Parents
PubMed: 37682886
DOI: 10.1371/journal.pone.0291062