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The Cochrane Database of Systematic... Jan 2009Road traffic crashes are a major cause of death and injury, especially in low and middle-income countries. It is estimated that road traffic injuries will have risen... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Road traffic crashes are a major cause of death and injury, especially in low and middle-income countries. It is estimated that road traffic injuries will have risen from ninth to third in world disease burden rankings by 2020, accounting for 2.3 million deaths globally. Street lighting has been suggested as a relatively low cost intervention with the potential to prevent traffic crashes.
OBJECTIVES
To assess the effects of street lighting on injuries caused by road traffic crashes.
SEARCH STRATEGY
We searched the Cochrane Injuries Group's Specialised Register, CENTRAL, MEDLINE, EMBASE, TRANSPORT, Australian Transport Index. We also searched the Internet and checked reference lists of relevant papers. The search was not restricted by language or publication status. The searches were conducted to October 2008.
SELECTION CRITERIA
Randomised controlled trials, non-randomised controlled trials and controlled before-after studies, comparing new street lighting with unlit roads, or improved street lighting with the pre-existing lighting level.
DATA COLLECTION AND ANALYSIS
Two authors screened search results, extracted data, assessed risk of bias and analysed the data.
MAIN RESULTS
We found 16 controlled before-after studies of street lighting, all reporting crash data, of which 14 contributed data to the meta-analysis. Seven trials included a designated control site, the other nine collected data at one site with the daytime data being used as the control. The methodological quality of the trials was generally poor.Three trials compared street lighting with an area control on total crashes; pooled rate ratio (RR) = 0.45 (95% Confidence Interval (CI) 0.29 to 0.69). Two trials compared street lighting with an area control on total injury crashes (all severities); RR = 0.78 (95% CI 0.63 to 0.97). No trials compared the number of fatal crashes with an area control.Ten trials compared street lighting with a day time control on total crashes; pooled RR = 0.68 (95% CI 0.56 to 0.83). Five trials compared street lighting with a day time control on total injury crashes; pooled RR = 0.68 (95% CI 0.59 to 0.79). Three trials compared street lighting with a day time control on fatal crashes; pooled RR = 0.33 (95% CI 0.17 to 0.66).
AUTHORS' CONCLUSIONS
The results from this systematic review suggests that street lighting may prevent road traffic crashes, injuries and fatalities. However, further well designed studies are needed to determine the effectiveness of street lighting in middle and low-income countries.
Topics: Accidents, Traffic; Humans; Lighting; Wounds and Injuries
PubMed: 19160240
DOI: 10.1002/14651858.CD004728.pub2 -
PloS One 2018Drowning claims 7% of the global burden of injury-related deaths. Lifejackets are routinely recommended as a drowning prevention strategy; however, a review of related... (Review)
Review
OBJECTIVE
Drowning claims 7% of the global burden of injury-related deaths. Lifejackets are routinely recommended as a drowning prevention strategy; however, a review of related factors regarding lifejacket wear has not previously been investigated.
METHODS
This systematic review examined literature published from inception to December 2016 in English and German languages. The personal, social, and environmental factors associated with lifejacket wear among adults and children were investigated, a quantitative evaluation of the results undertaken, and gaps in the literature identified.
RESULTS
Twenty studies, with sample sizes of studies ranging between 20 and 482,331, were identified. Fifty-five percent were cross-sectional studies. All studies were scored IV or V on the Australian National Health and Medical Research Council (NHMRC) grading system indicating mostly descriptive and cross-sectional levels of evidence. Factors associated with increased wear included age (mostly children), gender (mostly female), boat type (non-motorised), boat size (small boats), role modelling (children influenced by adult lifejacket wear), and activity (water-skiing, fishing). Factors not associated or inconsistent with lifejacket wear included education, household income, ethnicity, boating ability, confidence in lifejackets, waterway type, and weather and water conditions. Factors associated with reduced lifejacket wear included adults, males, discomfort, cost and accessibility, consumption of alcohol, and swimming ability. Three studies evaluated the impact of interventions.
CONCLUSION
This review identified factors associated with both increased and decreased lifejacket wear. Future research should address the motivational factors associated with individuals' decisions to wear or not wear lifejackets. This, combined with further research on the evaluation of interventions designed to increase lifejacket wear, will enhance the evidence base to support future drowning prevention interventions.
Topics: Adolescent; Adult; Child; Drowning; Emergencies; Female; Humans; Male; Ships; Swimming; Young Adult
PubMed: 29718971
DOI: 10.1371/journal.pone.0196421 -
BMJ Open Oct 2020To systematically review and quantify the effect of motor vehicle crashes (MVCs) in pregnancy on maternal and offspring outcomes. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To systematically review and quantify the effect of motor vehicle crashes (MVCs) in pregnancy on maternal and offspring outcomes.
DESIGN
Systematic review and meta-analysis of observational data searched from inception until 1 July 2018. Searching was from June to August 2018 in Medline, Embase, Web of Science, Scopus, Latin-American and Caribbean System on Health Sciences Information, Scientific Electronic Library Online, TRANSPORT, International Road Research Documentation, European Conference of Ministers of Transportation Databases, Cochrane Database of Systematic Reviews and Cochrane Central Register.
PARTICIPANTS
Studies were selected if they focused on the effects of exposure MVC during pregnancy versus non-exposure, with follow-up to verify outcomes in various settings, including secondary care, collision and emergency, and inpatient care.
DATA SYNTHESIS
For incidence data, we calculated a pooled estimate per 1000 women. For comparison of outcomes between women involved and those not involved in MVC, we calculated ORs with 95% CIs. Where possible, we statistically pooled the data using the random-effects model. The quality of studies used in the comparative analysis was assessed with Newcastle-Ottawa Scale.
RESULTS
We included 19 studies (3 222 066 women) of which the majority was carried out in high-income countries (18/19). In population-level studies of women involved in MVC, maternal death occurred in 3.6 per 1000 (95% CI 0.25-10.42; 3 studies, 12 000 women; Tau=1.77), and fetal death or stillbirth in 6.6 per 1000 (95% CI 3.81-10.12; 8 studies, 47 992 women; I=92.6%). Pooled incidence of complications per 1000 women involved in MVC was labour induction (276.43), preterm delivery (191.90) and caesarean section (166.65). Compared with women not involved in MVC, those involved had increased odds of placental abruption (OR 1.43, 95% CI 1.27-1.63; 3 studies, 1 500 825 women) and maternal death (OR 202.27; 95% CI 110.60-369.95; 1 study, 1 094 559 women).
CONCLUSION
Pregnant women involved in MVC were at higher risk of maternal death and complications than those not involved.
PROSPERO REGISTRATION NUMBER
CRD42018100788.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Accidents, Traffic; Caribbean Region; Cesarean Section; Motor Vehicles; Pregnancy Complications
PubMed: 33020077
DOI: 10.1136/bmjopen-2019-035562 -
Frontiers in Physiology 2022Age-related decreases in physical activity (PA) and a decline in physical functioning lead to increased fall risk. As falls are a major cause of accidental deaths and...
Age-related decreases in physical activity (PA) and a decline in physical functioning lead to increased fall risk. As falls are a major cause of accidental deaths and hospitalization in older adults, PA promotion and fall prevention are important measures, especially in nursing homes (NH). With advances in information and communication technology, e- and m-health solutions have been developed to positively influence various health-related factors. To date, only little research exists on the implementation of these technologies to promote health in NH. Therefore, the objective of this systematic review was to provide an overview of the effectiveness, acceptability, and feasibility of e- and m-health interventions aimed at promoting PA and preventing falls in NH. Additionally, the effectiveness of such interventions regarding the secondary outcomes physical function, cognitive function, neuropsychiatric symptoms, and psychosocial status was examined. A systematic literature search was performed in five databases and studies published until 15 November 2021, were considered for inclusion. All studies that examined the effectiveness and/or the acceptability and feasibility of e- or m-health interventions in promoting PA and preventing falls in NH, without restriction on language or date of publication, were included in the final synthesis. Of the 1,358 records retrieved, 28 studies were included in this systematic review. Twenty-four studies contained digital exergaming as an intervention or as a part of the intervention, the four additional studies on e-health interventions only examined a small number of outcomes. No m-health intervention study was identified. Data synthesis indicates that exergaming may be effective in reducing the number of falls and fall risk in NH residents. Several significant improvements were also reported regarding secondary outcomes albeit not consistent across studies. No conclusion can be drawn about the effects of exergaming and other e-health interventions on PA, as data is scarce. E-health interventions were mostly reported as feasible and well accepted by NH residents. However, these findings may not be applicable to NH residents with advanced physical and/or cognitive impairments, since they were excluded in many studies. Therefore, more research examining other digital solutions besides exergaming to promote PA in this specific population is critical. https://www.crd.york.ac.uk/prospero/, identifier CRD42021289488.
PubMed: 35669573
DOI: 10.3389/fphys.2022.894397 -
Preventive Medicine Reports Dec 2016The health risks associated with electronic cigarettes (ECs) are largely unknown. The purpose of this systematic review was to evaluate published case reports that deal... (Review)
Review
The health risks associated with electronic cigarettes (ECs) are largely unknown. The purpose of this systematic review was to evaluate published case reports that deal with health effects attributed to EC use. An Internet search was conducted to identify case reports dealing with the effects of EC use on health. Twenty-six case reports representing 27 individuals (one study contained reports for two individuals) were published between April 2012 and January 2016, and these were grouped into categories of effect according to their health outcomes. Of the 27 individuals, 25 had negative effects subsequent to use or exposure to ECs and their refill fluids, while two reported improvement in chronic immune and gastrointestinal conditions. Three categories of negative health effects were identified: systemic effects, nicotine poisoning, and mechanical injury. Thirteen cases reported EC effects on different systems including: respiratory (6), gastrointestinal or developing intestine of an infant (3), cardiovascular (2), neurological (1), and immune (1). Twelve cases involved nicotine poisoning resulting from accidental (N = 3), misuse/abuse (N = 1), or suicidal/intentional ingestion (N = 8); four of these involved children and three resulted in adult fatalities. Two cases reported mechanical injury caused by an EC battery explosion. Most case reports show that the health of children and adults can be negatively affected by EC products and that if death does not occur, negative effects can be reversed. Data further indicate that EC use can cause negative health effects in previously healthy individuals and exacerbate pre-existing conditions.
PubMed: 27413679
DOI: 10.1016/j.pmedr.2016.06.002 -
Brazilian Journal of Otorhinolaryngology 2022Tracheostomy is a procedure that can be associated with several well-described complications in the literature, which can be divided into transoperative, early...
INTRODUCTION
Tracheostomy is a procedure that can be associated with several well-described complications in the literature, which can be divided into transoperative, early postoperative and late postoperative. When performed in children, these risks are more common than in adults.
OBJECTIVE
To perform a systematic review of complications, including deaths, in tracheostomized pediatric patients.
METHODS
A search was carried out for articles in the Latin American and Caribbean Health Sciences Literature and PubMed databases. Cohort studies and series reports were selected, in addition to systematic reviews, published between January 1978 and June 2020, with patients up to 18 years old, and written in English, Spanish or Portuguese.
RESULTS
1560 articles were found, of which 49 were included in this review. The average complication rate was 40%, which showed an association with age, birth weight, prematurity, comorbidities, and emergency procedures. The most common complications were cutaneous lesions and granulomas. Mortality related to the procedure reached up to 6% in children and was mainly related to cannula obstruction or accidental decannulation.
CONCLUSION
Pediatric tracheostomy is associated with several complications. The tracheostomy-related mortality rate is low, but the overall mortality of tracheostomized patients is not negligible.
Topics: Adult; Child; Humans; Tracheostomy; Cohort Studies; Comorbidity; Retrospective Studies; Postoperative Complications
PubMed: 33472759
DOI: 10.1016/j.bjorl.2020.12.006 -
Gastric Cancer : Official Journal of... Jul 2016S-1 is first-line therapy for advanced gastric cancer in Asia and is used with increased frequency in Western counties. We conducted a meta-analysis to investigate the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
S-1 is first-line therapy for advanced gastric cancer in Asia and is used with increased frequency in Western counties. We conducted a meta-analysis to investigate the efficacy and toxicity of S-1-based therapy compared with 5-fluorouracil (5-FU)/capecitabine-based therapy and S-1-based combination therapy compared with S-1 monotherapy.
METHODS
MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, American Society of Clinical Oncology meeting abstracts, European Society for Medical Oncology meeting abstracts and ClinicalTrials.gov were searched for randomized clinical trials until May 2015. Data were extracted for overall survival (OS), progression-free-survival (PFS), objective response rate (ORR) and grade 1-2 and grade 3-4 adverse events. Stratified OS data for subgroups were extracted.
RESULTS
S-1 was not different from 5-FU (eight studies, n = 2788) in terms of OS [hazard ratio (HR) 0.93, 95 % confidence interval (CI) 0.85-1.01] and PFS (HR 0.87, 95 % CI 0.73-1.04), whereas ORR was higher (risk ratio 1.43, 95 % CI 1.05-1.96). There was no subgroup difference in efficacy among Asian and Western patients, but in Western patients S-1 was associated with a lower rate of febrile neutropenia, toxicity-related deaths and grade 3-4 stomatitis and mucositis compared with 5-FU. S-1 showed no difference in efficacy compared with capecitabine (three studies, n = 329), but was associated with a lower rate of grade 3-4 neutropenia and grade 1-2 hand-foot syndrome. S-1-combination therapy was superior to S-1 monotherapy (eight studies, n = 1808) in terms of OS (HR 0.76, 95 % CI 0.65-0.90), PFS (HR 0.68, 95 % CI 0.56-0.82) and ORR (risk ratio 1.20, 95 % CI 1.04-1.38) but was more toxic. Survival benefit of S-1 combination therapy over S-1 monotherapy was most pronounced in patients with non-measurable disease, diffuse-type histological features and peritoneal metastasis.
CONCLUSIONS
S-1 is effective and tolerable as first-line therapy for advanced gastric cancer in both Asian and Western countries.
Topics: Drug Combinations; Humans; Oxonic Acid; Safety; Stomach Neoplasms; Tegafur; Treatment Outcome
PubMed: 26754295
DOI: 10.1007/s10120-015-0587-8 -
Journal of Neurosciences in Rural... 2023South and South-East Asian countries report a great liability for the world's road traffic injuries (RTIs) and deaths. A vast number of research studies tested various... (Review)
Review
BACKGROUND
South and South-East Asian countries report a great liability for the world's road traffic injuries (RTIs) and deaths. A vast number of research studies tested various interventions including specific protective devices to prevent accidents, but no review papers have been conducted to find out the prevalence of RTIs in South-East and South Asian countries.
OBJECTIVE
This review paper was an attempt to find out the prevalence of RTIs and their associated factors in South-East and South Asian countries.
METHODS
Following the guidelines of Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), we searched the articles in the electronic databases of PubMed/Medline, Scopus, CINAHL, ProQuest, and Web of Science. Articles were selected if they reported the prevalence of RTI, or road traffic accident (RTA) deaths. In addition, a data quality assessment was done.
RESULTS
Out of the 10,818 article hits from the literature search, ten articles found the eligibility and inclusion criteria. Most of the studies reported that males are involved in the RTIs more than females. The male mortality rate is more than the female mortality in RTI mortality. Young adult males are the major victims when compared with the different age groups of male victims. Two-wheelers are the major contributors to the accident rate. Religious or national festivals are not free from accident-prone times. Climatic seasons and nighttime have a major influence on the RTIs. RTIs are increasing due to the sudden and huge increase in the number of motor vehicles and the development of cities and towns.
CONCLUSION
Accidents are non-predictable but controllable disasters in society. Overspeeding, bad conditions on road, the vulnerability of the vehicles, and careless driving are the major reported reasons for RTIs. Making and implementing strict laws can help us to control RTAs. The major effect on the reduction of RTI can be assured only with the presence of responsible people. That can be achieved only by creating awareness in society about traffic rules and responsibilities.
PubMed: 37181173
DOI: 10.25259/JNRP_25_2022 -
Clinical and Experimental Allergy :... Dec 2013Food allergy is a common cause of anaphylaxis, but the incidence of fatal food anaphylaxis is not known. The aim of this study was to estimate the incidence of fatal... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Food allergy is a common cause of anaphylaxis, but the incidence of fatal food anaphylaxis is not known. The aim of this study was to estimate the incidence of fatal food anaphylaxis for people with food allergy and relate this to other mortality risks in the general population.
METHODS
We undertook a systematic review and meta-analysis, using the generic inverse variance method. Two authors selected studies by consensus, independently extracted data and assessed the quality of included studies using the Newcastle-Ottawa assessment scale. We searched Medline, Embase, PsychInfo, CINAHL, Web of Science, LILACS or AMED, between January 1946 and September 2012, and recent conference abstracts. We included registries, databases or cohort studies which described the number of fatal food anaphylaxis cases in a defined population and time period and applied an assumed population prevalence rate of food allergy.
RESULTS
We included data from 13 studies describing 240 fatal food anaphylaxis episodes over an estimated 165 million food-allergic person-years. Study quality was mixed, and there was high heterogeneity between study results, possibly due to variation in food allergy prevalence and data collection methods. In food-allergic people, fatal food anaphylaxis has an incidence rate of 1.81 per million person-years (95%CI 0.94, 3.45; range 0.63, 6.68). In sensitivity analysis with different estimated food allergy prevalence, the incidence varied from 1.35 to 2.71 per million person-years. At age 0-19, the incidence rate is 3.25 (1.73, 6.10; range 0.94, 15.75; sensitivity analysis 1.18-6.13). The incidence of fatal food anaphylaxis in food-allergic people is lower than accidental death in the general European population.
CONCLUSION
Fatal food anaphylaxis for a food-allergic person is rarer than accidental death in the general population.
Topics: Age Factors; Anaphylaxis; Food Hypersensitivity; Humans; Incidence; Mortality; Population Surveillance; Prevalence; Risk Factors
PubMed: 24118190
DOI: 10.1111/cea.12211 -
Revista Do Colegio Brasileiro de... 2024burns represent a pivotal component of trauma in Brazil, accounting for 2 million incidents and 2,500 deaths annually. Self-intentional burns are associated with a worse... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
burns represent a pivotal component of trauma in Brazil, accounting for 2 million incidents and 2,500 deaths annually. Self-intentional burns are associated with a worse prognosis, larger burned surface area, higher infection rates, and death. The lack of studies on the issue of self-immolation raises epidemiological questions regarding Brazilian victims. This study aimed to investigate the profile of burn events associated with self-injurious behavior among Brazilian victims.
METHODS
this systematic review was performed according to PRISMA 2020 guidelines and evaluated the correlation between self-injurious behavior as a cause of burns in Brazilian victims and its epidemiological implications in the last 20 years (2003-2023). The MeSH terms "Burns", "Self-Injurious Behavior", "Epidemiology" and "Brazil" were queried in the PubMed/MEDLINE, SciELO, and Cochrane Library databases, and, after selection by inclusion/exclusion criteria, the most relevant studies were critically analyzed.
RESULTS
From 1,077 pre-selected studies, 92 were potentially eligible, resulting in 7 manuscripts incorporated in this review. From 3,510 burned victims assembled in the pool of selected studies, 311 cases displayed self-injurious behavior. Burned patients who attempted to burn their lives have a higher risk of death (p<0.05; RR=5.1 [3.2-8.1]) and larger burned surface area (p<0.05; MD=19.2 [10-28.2]), compared to accidental cases. Moreover, the female gender was at a higher risk of attempting self-immolation (p<0.05; RR=4.01 [2.9-5.5]).
CONCLUSION
our results show that self-inflicted burn cases were associated with a larger burned surface area and a higher risk of death, and the female gender was identified as a relevant risk factor in Brazil.
Topics: Humans; Brazil; Burns; Self-Injurious Behavior; Female; Male
PubMed: 38716915
DOI: 10.1590/0100-6991e-20243665-en