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The Permanente Journal Jun 2023Burnout in the medical workforce is a growing global concern. Visual arts-based interventions can be a novel way to mitigate burnout and bolster resilience in medicine....
Burnout in the medical workforce is a growing global concern. Visual arts-based interventions can be a novel way to mitigate burnout and bolster resilience in medicine. Improving tolerance of ambiguity and uncertainty has been associated with decreased rates of burnout in clinicians. No known systematic review exists summarizing the evidence behind the use of visual arts-based interventions to mitigate burnout in clinicians. The authors conducted a systematic literature review of PubMed, EMBASE, and CINAHL in November 2022 using the terms: art, medicine, burnout, and uncertainty. The authors review the evidence for the effects of visual arts-based interventions on clinician burnout. The search identified 58 articles, of which 26 met study inclusion criteria and were assessed by 2 reviewers. These studies reported mixed methods assessments of changes in burnout, empathy, and stress. Overall, visual arts-based interventions promoted empathy, connectedness, and tolerance of ambiguity and had positive effects on burnout; however, some results were mixed. Visual arts-based interventions to mitigate burnout show promise, and additional research should focus on feasibility and longer-term outcomes.
Topics: Humans; Burnout, Psychological; Health Personnel; Empathy; Medicine
PubMed: 37303185
DOI: 10.7812/TPP/23.018 -
Environmental Research Oct 2022Heatwaves have received major attention globally due to their detrimental effects on human health and the environment. The frequency, duration, and severity of heatwaves... (Review)
Review
BACKGROUND
Heatwaves have received major attention globally due to their detrimental effects on human health and the environment. The frequency, duration, and severity of heatwaves have increased recently due to changes in climatic conditions, anthropogenic forcing, and rapid urbanization. Australia is highly vulnerable to this hazard. Although there have been an increasing number of studies conducted in Australia related to the heatwave phenomena, a systematic review of heatwave vulnerability has rarely been reported in the literature.
OBJECTIVES
This study aims to provide a systematic and overarching review of the different components of heatwave vulnerability (e.g., exposure, sensitivity, and adaptive capacity) in Australia.
METHODS
A systematic review was conducted using the PRISMA protocol. Peer-reviewed English language articles published between January 2000 and December 2021 were selected using a combination of search keywords in Web of Science, Scopus, and PubMed. Articles were critically analyzed based on three specific heatwave vulnerability components: exposure, sensitivity, and adaptive capacity.
RESULTS AND DISCUSSION
A total of 107 articles meeting all search criteria were chosen. Although there has been an increasing trend of heat-related studies in Australia, most of these studies have concentrated on exposure and adaptive capacity components. Evidence suggests that the frequency, severity, and duration of heatwaves in Australian cities has been increasing, and that this is likely to continue under current climate change scenarios. This study noted that heatwave vulnerability is associated with geographical and climatic factors, space, time, socioeconomic and demographic factors, as well as the physiological condition of people. Various heat mitigation and adaptation measures implemented around the globe have proven to be efficient in reducing the impacts of heatwaves.
CONCLUSION
This study provides increased clarity regarding the various drivers of heatwave vulnerability in Australia. Such knowledge is crucial in informing extreme heat adaptation and mitigation planning.
Topics: Australia; Cities; Climate Change; Extreme Heat; Hot Temperature; Humans
PubMed: 35716815
DOI: 10.1016/j.envres.2022.113703 -
Pathogens (Basel, Switzerland) Feb 2023The COVID-19 pandemic due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been plaguing the world since late 2019/early 2020 and has changed the... (Review)
Review
The COVID-19 pandemic due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been plaguing the world since late 2019/early 2020 and has changed the way we function as a society, halting both economic and social activities worldwide. Classrooms, offices, restaurants, public transport, and other enclosed spaces that typically gather large groups of people indoors, and are considered focal points for the spread of the virus. For society to be able to go "back to normal", it is crucial to keep these places open and functioning. An understanding of the transmission modes occurring in these contexts is essential to set up effective infection control strategies. This understanding was made using a systematic review, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PRISMA) 2020 guidelines. We analyze the different parameters influencing airborne transmission indoors, the mathematical models proposed to understand it, and discuss how we can act on these parameters. Methods to judge infection risks through the analysis of the indoor air quality are described. Various mitigation measures are listed, and their efficiency, feasibility, and acceptability are ranked by a panel of experts in the field. Thus, effective ventilation procedures controlled by CO-monitoring, continued mask wearing, and a strategic control of room occupancy, among other measures, are put forth to enable a safe return to these essential places.
PubMed: 36986304
DOI: 10.3390/pathogens12030382 -
Sensors (Basel, Switzerland) Jul 2021The concepts brought by Industry 4.0 have been explored and gradually applied.The cybersecurity impacts on the progress of Industry 4.0 implementations and their... (Review)
Review
The concepts brought by Industry 4.0 have been explored and gradually applied.The cybersecurity impacts on the progress of Industry 4.0 implementations and their interactions with other technologies require constant surveillance, and it is important to forecast cybersecurity-related challenges and trends to prevent and mitigate these impacts. The contributions of this paper are as follows: (1) it presents the results of a systematic review of industry 4.0 regarding attacks, vulnerabilities and defense strategies, (2) it details and classifies the attacks, vulnerabilities and defenses mechanisms, and (3) it presents a discussion of recent challenges and trends regarding cybersecurity-related areas for Industry 4.0. From the systematic review, regarding the attacks, the results show that most attacks are carried out on the network layer, where dos-related and mitm attacks are the most prevalent ones. Regarding vulnerabilities, security flaws in services and source code, and incorrect validations in authentication procedures are highlighted. These are vulnerabilities that can be exploited by dos attacks and buffer overflows in industrial devices and networks. Regarding defense strategies, Blockchain is presented as one of the most relevant technologies under study in terms of defense mechanisms, thanks to its ability to be used in a variety of solutions, from Intrusion Detection Systems to the prevention of Distributed dos attacks, and most defense strategies are presented as an after-attack solution or prevention, in the sense that the defense mechanisms are only placed or thought, only after the harm has been done, and not as a mitigation strategy to prevent the cyberattack. Concerning challenges and trends, the review shows that digital sovereignty, cyber sovereignty, and data sovereignty are recent topics being explored by researchers within the Industry 4.0 scope, and GAIA-X and International Data Spaces are recent initiatives regarding data sovereignty. A discussion of trends is provided, and future challenges are pointed out.
Topics: Blockchain; Computer Security; Forecasting; Industry; Technology
PubMed: 34372425
DOI: 10.3390/s21155189 -
International Journal of Infectious... Sep 2023The burden of asymptomatic dengue infections is understudied. Therefore, we systematically reviewed the literature to estimate the global prevalence of asymptomatic... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The burden of asymptomatic dengue infections is understudied. Therefore, we systematically reviewed the literature to estimate the global prevalence of asymptomatic dengue infections.
METHODS
We searched cross-sectional studies reporting the prevalence of asymptomatic dengue infections from PubMed, Scopus, and Embase. Prevalence of asymptomatic dengue infections was pooled and reported as proportions with a 95% confidence interval (CI). This systematic review protocol was a priori registered in The International Prospective Register of Systematic Reviews (Reg: No. CRD42020218446).
RESULTS
We included 41 studies with 131,953 cases in our analysis. The overall pooled prevalence of asymptomatic dengue infections was 59.26% (95% CI: 43.76-74.75, I = 99.93%), with 65.52% (95% CI: 38.73-92.32, I = 99.95%) during outbreaks and 30.78% (95% CI: 21.39-40.16, I = 98.78%) during non-outbreak periods. The pooled prevalence among the acutely infected individuals was 54.52% (95% CI: 17.73-46.76, I = 99.91%), whereas, among primary and secondary asymptomatic dengue infections, it was 65.36% (95% CI: 45.76-84.96, I = 98.82) and 48.99% (95% CI: 27.85-70.13, I = 99.08%) respectively.
CONCLUSION
The majority of dengue cases are asymptomatic and may play a significant role in disease transmission. Public health strategies aimed at dengue outbreak response and mitigation of disease burden should include early detection of asymptomatic cases.
Topics: Humans; Prevalence; Cross-Sectional Studies; Asymptomatic Infections; Coinfection; Dengue
PubMed: 37463631
DOI: 10.1016/j.ijid.2023.07.010 -
International Journal of Neonatal... Sep 2022Genomic advances have contributed to a proliferation of newborn screening (NBS) programs. Psychosocial consequences of NBS have been identified as risks to these public... (Review)
Review
Genomic advances have contributed to a proliferation of newborn screening (NBS) programs. Psychosocial consequences of NBS have been identified as risks to these public health initiatives. Following PRISMA guidelines, this systematic review synthesizes findings from 92 evidence-based, peer-reviewed research reports published from 2000 through 2020 regarding psychosocial issues associated with NBS. Results describe parents' knowledge of and attitudes towards NBS, reactions to and understanding of positive NBS results, experiences of communication with health providers, decisions about carrier testing, and future pregnancies. Findings also explain the impact of positive NBS results on parent-child relationships, child development, informing children about carrier status, family burden, quality of life, and disparities. In conclusion, psychosocial consequences of receiving unexpected neonatal screening results and unsolicited genetic information remain significant risks to expansion of NBS. Findings suggest that risks may be mitigated by improved parent NBS education, effective communication, individualized genetic counseling, and anticipatory developmental guidance. Clinicians need to take extra measures to ensure equitable service delivery to marginalized subpopulations. Future investigations should be more inclusive of culturally and socioeconomically diverse families and conducted in low-resource countries. Providing these countries with adequate resources to develop NBS programs is an essential step towards achieving international health equity.
PubMed: 36278623
DOI: 10.3390/ijns8040053 -
Public Health Reviews 2022Hospital outbreaks of SARS-CoV-2 infection are dreaded but preventable catastrophes. We review the literature to examine the pattern of SARS-CoV-2 transmission in... (Review)
Review
Hospital outbreaks of SARS-CoV-2 infection are dreaded but preventable catastrophes. We review the literature to examine the pattern of SARS-CoV-2 transmission in hospitals and identify potential vulnerabilities to mitigate the risk of infection. Three electronic databases (PubMed, Embase and Scopus) were searched from inception to July 27, 2021 for publications reporting SARS-CoV-2 outbreaks in hospital. Relevant articles and grey literature reports were hand-searched. Twenty-seven articles that described 35 SARS-CoV-2 outbreaks were included. Despite epidemiological investigations, the primary case could not be identified in 37% of outbreaks. Healthcare workers accounted for 40% of primary cases (doctors 17%, followed by ancillary staff 11%). Mortality among infected patients was approximately 15%. By contrast, none of the infected HCWs died. Several concerning patterns were identified, including infections involving ancillary staff and healthcare worker infections from the community and household contacts. Continuous efforts to train-retrain and enforce correct personal protective equipment use and regular routine screening tests (especially among ancillary staff) are necessary to stem future hospital outbreaks of SARS-CoV-2.
PubMed: 35296115
DOI: 10.3389/phrs.2022.1604572 -
International Journal of Preventive... 2023The authorities recently emphasized the importance of dietary control for COVID-19 patients in hospitals. However, there is limited detail about the obesity and death of... (Review)
Review
BACKGROUND
The authorities recently emphasized the importance of dietary control for COVID-19 patients in hospitals. However, there is limited detail about the obesity and death of COVID-19 patients who are hospitalized in the Asian and Western countries. The aim of this study was to find the role of obesity and mortality of the hospitalized COVID-19 patients. A systematic review of the studies on obesity and mortality of hospitalized COVID.19 patients in the Asian and western countries.
METHODS
Databases of ProQuest, PubMed, and EBSCO were used to find relevant articles published between January 2020 and March 2021. A total of 3,70,836 patients in 17 studies were included. Results: We found significant correlation between obesity and mortality in hospitalized COVID-19 patients (pooled odds ratio [POR] = 1.28, 95% CI: 1.23-1.33). In particular, this study demonstrated that the Asian countries had higher POR (1.44, 95% CI: 1.16-1.79) compared to the western countries (1.28, 95%CI: 1.23-1.33). The heterogeneity calculation showed heterogenous among studies included (I > 50%).
CONCLUSIONS
The mortality of COVID-19-hospitalized patients is related to obesity, which requires a multi-stakeholder mitigation approach to avoid and control obesity and its impacts.
CONCLUSIONS
The mortality of COVID-19-hospitalized patients is related to obesity, which requires a multi-stakeholder mitigation approach to avoid and control obesity and its impacts.
PubMed: 37351029
DOI: 10.4103/ijpvm.IJPVM_236_21 -
Epidemiology and Psychiatric Sciences Jan 2022Stigma related to mental disorders is a barrier to quality mental healthcare. This scoping review aimed to synthesise literature on stigma related to mental disorders in... (Meta-Analysis)
Meta-Analysis Review
AIMS
Stigma related to mental disorders is a barrier to quality mental healthcare. This scoping review aimed to synthesise literature on stigma related to mental disorders in Nepal to understand stigma processes. The anthropological concept of 'what matters most' to understand culture and stigma was used to frame the literature on explanatory models, manifestations, consequences, structural facilitators and mitigators, and interventions.
METHODS
We conducted a scoping review with screening guided by the Preferred Reporting Items for Systematic Review and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR). A structured search was done using three international databases (PsycINFO, Medline and Web of Science), one Nepali database (NepJol) and cross-referencing for publications from 1 January 2000 through 24 June 2020. The search was repeated to include structural stigma-related terms. Quality of quantitative studies was assessed using the Systematic Assessment of Quality in Observational Research (SAQOR) tool. The review was registered through the Open Science Framework (OSF) (osf.io/u8jhn).
RESULTS
The searches yielded 57 studies over a 20-year period: 19 quantitative, 19 qualitative, nine mixed methods, five review articles, two ethnographies and three other types of studies. The review identified nine stigma measures used in Nepal, one stigma intervention, and no studies focused on adolescent and child mental health stigma. The findings suggest that 'what matters most' in Nepali culture for service users, caregivers, community members and health workers include prestige, productivity, privacy, acceptance, marriage and resources. Cultural values related to 'what matters most' are reflected in structural barriers and facilitators including lack of policies, programme planning and resources. Most studies using quantitative tools to assess stigma did not describe cultural adaptation or validation processes, and 15 out of the 18 quantitative studies were 'low-quality' on the SAQOR quality rating. The review revealed clear gaps in implementation and evaluation of stigma interventions in Nepal with only one intervention reported, and most stigma measures not culturally adapted for use.
CONCLUSION
As stigma processes are complex and interlinked in their influence on 'what matters most' and structural barriers and facilitators, more studies are required to understand this complexity and establish effective interventions targeting multiple domains. We suggest that stigma researchers should clarify conceptual models to inform study design and interpretations. There is a need to develop procedures for the systematic cultural adaptation of stigma assessment tools. Research should be conducted to understand the forms and drivers of structural stigma and to expand intervention research to evaluate strategies for stigma reduction.
Topics: Adolescent; Child; Health Personnel; Humans; Mental Disorders; Mental Health; Nepal; Social Stigma
PubMed: 35086602
DOI: 10.1017/S2045796021000809 -
Veterinary Sciences Sep 2022In this study, a systematic review and meta-analysis was conducted to assess the efficacy of commercial vaccines against PPE in accordance with the Preferred Reporting... (Review)
Review
The Effectiveness of Commercial Vaccination against in Mitigating the Reduction in ADWG, the Increased Mortality and Fecal Shedding of the Vaccinated Pigs: A Systematic Review and Meta-Analysis.
In this study, a systematic review and meta-analysis was conducted to assess the efficacy of commercial vaccines against PPE in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Of the 373 articles reviewed, 16 fulfilled the pre-specified inclusion criteria. Three independent reviewers extracted the data, and vaccine effectiveness was assessed using the outcomes of interest. The majority of studies had a low or unclear risk of bias as assessed using the ARRIVE guidelines. The results of the meta-analysis indicated that the vaccination resulted in statistically significant reductions in bacterial fecal shedding (odds ratio, OR = 0.122, 95% confidence interval, CI 0.054−0.278) and mortality rate (risk ratio, RR = 0.199; 95% CI, 0.066−0.605). Furthermore, ADWG was significantly increased in the vaccinated pigs compared to the unvaccinated controls (standardized mean difference (SMD) = 0.606, 95% CI 0.243−0.969). In the subgroup analysis, the production phase and study type significantly influenced the effect size (p < 0.1). The Egger’s regression test showed no evidence of publication bias (p > 0.1). The effectiveness of commercially available vaccines against PPE-related weight loss, fecal shedding, and mortality suggests that the vaccines may help control PPE on affected swine farms.
PubMed: 36288149
DOI: 10.3390/vetsci9100536