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Annals of Medicine Dec 2024Interstitial lung disease (ILD) is the most widespread and fatal pulmonary complication of rheumatoid arthritis (RA). Existing knowledge on the prevalence and risk... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Interstitial lung disease (ILD) is the most widespread and fatal pulmonary complication of rheumatoid arthritis (RA). Existing knowledge on the prevalence and risk factors of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is inconclusive. Therefore, we designed this review to address this gap.
MATERIALS AND METHODS
To find relevant observational studies discussing the prevalence and/or risk factors of RA-ILD, EMBASE, Web of Science, PubMed, and the Cochrane Library were explored. The pooled odds ratios (ORs) / hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated with a fixed/ random effects model. While subgroup analysis, meta-regression analysis and sensitivity analysis were carried out to determine the sources of heterogeneity, the statistic was utilized to assess between-studies heterogeneity. Funnel plots and Egger's test were employed to assess publication bias. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, our review was conducted.
RESULTS
A total of 56 studies with 11,851 RA-ILD patients were included in this meta-analysis. The pooled prevalence of RA-ILD was 18.7% (95% CI 15.8-21.6) with significant heterogeneity ( = 96.4%). The prevalence of RA-ILD was found to be more likely as a result of several identified factors, including male sex (ORs = 1.92 95% CI 1.70-2.16), older age (WMDs = 6.89, 95% CI 3.10-10.67), having a smoking history (ORs =1.91, 95% CI 1.48-2.47), pulmonary comorbidities predicted (HRs = 2.08, 95% CI 1.89-2.30), longer RA duration (ORs = 1.03, 95% CI 1.01-1.05), older age of RA onset (WMDs =4.46, 95% CI 0.63-8.29), positive RF (HRs = 1.15, 95%CI 0.75-1.77; ORs = 2.11, 95%CI 1.65-2.68), positive ACPA (ORs = 2.11, 95%CI 1.65-2.68), higher ESR (ORs = 1.008, 95%CI 1.002-1.014), moderate and high DAS28 (≥3.2) (ORs = 1.87, 95%CI 1.36-2.58), rheumatoid nodules (ORs = 1.87, 95% CI 1.18-2.98), LEF use (ORs = 1.42, 95%CI 1.08-1.87) and steroid use (HRs= 1.70, 1.13-2.55). The use of biological agents was a protective factor (HRs = 0.77, 95% CI 0.69-0.87).
CONCLUSION(S)
The pooled prevalence of RA-ILD in our study was approximately 18.7%. Furthermore, we identified 13 risk factors for RA-ILD, including male sex, older age, having a smoking history, pulmonary comorbidities, older age of RA onset, longer RA duration, positive RF, positive ACPA, higher ESR, moderate and high DAS28 (≥3.2), rheumatoid nodules, LEF use and steroid use. Additionally, biological agents use was a protective factor.
Topics: Humans; Male; Rheumatoid Nodule; Prevalence; Arthritis, Rheumatoid; Risk Factors; Lung Diseases, Interstitial; Steroids
PubMed: 38547537
DOI: 10.1080/07853890.2024.2332406 -
Revista Brasileira de Psiquiatria (Sao... 2021To review the literature regarding adolescent suicide risk and explore the associations between treatment compliance (expressed as a concept including measured adherence...
OBJECTIVE
To review the literature regarding adolescent suicide risk and explore the associations between treatment compliance (expressed as a concept including measured adherence to treatment and/or mental health service utilization) and risk and protective factors for suicidal behavior (SB), as well as the association between treatment compliance and reattempts.
METHODS
PubMed, LILACS, and Google Scholar were searched using the following terms: (adolescent*) AND (suicide*) AND (risk factor OR protective factors) AND (treatment compliance OR treatment attrition OR treatment adherence OR treatment drop out OR treatment retention OR mental health utilization). We retrieved studies that focused on the relation of treatment compliance to risk and protective factors for SB and that had only adolescent samples.
RESULTS
Of 4,841 articles, 30 original articles were selected for review. Most studies indicated high mental health service (MHS) utilization and poor treatment adherence by SB patients. Social minority status and conduct disorder were associated with less treatment adherence, while female sex, parental perceived need for treatment, and major depression were associated with greater treatment adherence. Inpatient and intensive emergency care after SA and family interventions improved MHS utilization and treatment compliance. However, we found no substantial protective effect of treatment compliance against reattempts.
CONCLUSION
Effective treatment planning for compliance requires considering psychopathology, treatment planning, and social, familial, and individual factors.
Topics: Adolescent; Female; Humans; Male; Patient Compliance; Protective Factors; Risk Factors; Suicidal Ideation; Suicide, Attempted; Suicide, Completed
PubMed: 33533823
DOI: 10.1590/1516-4446-2020-1026 -
Journal of Thrombosis and Haemostasis :... May 2011An increased risk of venous thromboembolic events has been reported in thalassemic patients, in particular in patients with thalassemia intermedia. The association... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
An increased risk of venous thromboembolic events has been reported in thalassemic patients, in particular in patients with thalassemia intermedia. The association between β-thalassemia trait and atherothrombotic cardiovascular events is not well established.
METHODS
In a systematic review and meta-analysis of the literature, we evaluated the association between β-thalassemia trait and arterial cardiovascular disease. Studies were identified from the MEDLINE and EMBASE (until July 2010) electronic databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with a random-effects model. Statistical heterogeneity was evaluated with the I(2) statistic.
RESULTS
Of the 354 identified articles, eight case-control studies were eligible for the analysis. β-Thalassemia trait was associated with a reduced risk of arterial cardiovascular disease (OR 0.45; 95% CI 0.45-0.60). Heterogeneity among studies was low (I(2) = 13%). The protective effect of β-thalassemia trait was confined to male patients (OR 0.39; 95% CI 0.24-0.62), and was not observed in female subjects (OR 0.89; 95% CI 0.52-1.53).
CONCLUSIONS
β-Thalassemia trait may act as a protective factor against the development of arterial cardiovascular and cerebrovascular disease in male subjects. Larger prospective studies are necessary to confirm these preliminary findings and to further investigate the mechanisms underlying this protective effect.
Topics: Cardiovascular Diseases; Case-Control Studies; Cerebrovascular Circulation; Cohort Studies; Female; Humans; Male; Models, Statistical; Odds Ratio; Research Design; Risk Factors; Thromboembolism; beta-Thalassemia
PubMed: 21382170
DOI: 10.1111/j.1538-7836.2011.04253.x -
Healthcare (Basel, Switzerland) Dec 2021Taking care of a person with a physical disability can become a challenge for caregivers as they must combine the task of caring with their personal and daily needs. The... (Review)
Review
Taking care of a person with a physical disability can become a challenge for caregivers as they must combine the task of caring with their personal and daily needs. The aim of this study was to assess the impact that taking care of a person who needs support has on caregivers and to analyze certain characteristics they present, such as self-esteem and resilience. To that end, a bibliographic review was carried out from 1985, when the first article of taking care of a person who needs support was published, to 2020 (inclusive), in the databases of Web of Science (WoS), Scopus, Pubmed, Eric, Psycinfo, and Embase. The search yielded a total of ( = 37) articles subject to review, following the guidelines established in the PRISMA declaration. The results show that caregiving was highly overburdening and negatively affected the physical condition and the psychological and mental states of caregivers. In addition, certain psychological characteristics present in caregivers such as having high self-esteem and being resilient were found to act as protective factors against the caregiving burden.
PubMed: 34946416
DOI: 10.3390/healthcare9121690 -
Cadernos de Saude Publica Jul 2011This review aimed to investigate risk and protective factors for breast cancer and to analyze whether scientific evidence from the World Cancer Research Fund and... (Review)
Review
This review aimed to investigate risk and protective factors for breast cancer and to analyze whether scientific evidence from the World Cancer Research Fund and American Institute for Cancer Research, published in 2007, was confirmed by new research. In May 2010 we reviewed cohort and case-control analytical studies from 2007 to 2010 in the PubMed, LILACS, and SciELO databases. We selected 27 articles (14 case-control and 13 cohort studies). Breastfeeding and physical activity were protective factors against breast cancer, and alcohol consumption was a risk factor. A direct proportional relationship was observed between larger waist circumference, weight throughout adulthood, and height and risk of breast cancer in postmenopausal women. The association between body fat and breast cancer is contradictory in both premenopausal and postmenopausal women. According to the accumulated evidence, breastfeeding and healthy lifestyle are the factors most strongly associated with breast cancer prevention.
Topics: Alcohol Drinking; Anthropometry; Breast Neoplasms; Female; Humans; Lactation; Motor Activity; Risk Factors
PubMed: 21808811
DOI: 10.1590/s0102-311x2011000700002 -
Campbell Systematic Reviews Sep 2022Family-related risk and protective factors are crucial for different antisocial behaviors, but their role in radicalization requires synthesis. Radicalization is likely... (Review)
Review
BACKGROUND
Family-related risk and protective factors are crucial for different antisocial behaviors, but their role in radicalization requires synthesis. Radicalization is likely to have a negative impact on families, and well-designed and implemented family-focused intervention programs have the potential to decrease radicalization.
OBJECTIVES
Research questions were: (1) What are the family-related risk and protective factors for radicalization? (2) What is the impact of radicalization on families? (3) Are family-based interventions against radicalization effective?
SEARCH METHODS
Searches included 25 databases and hand searches of gray literature from April to July 2021. Leading researchers in the field were asked to provide published and unpublished studies on the topic. Reference lists of the included studies and previously published systematic reviews on risk and protective factors for radicalization were scanned.
SELECTION CRITERIA
Published and unpublished quantitative studies on family-related risk and protective factors for radicalization, the impact of radicalization on families, and family-focused interventions were eligible with no restrictions regarding the study year, location, or any demographic characteristic. Studies were included if they measured the relation between a family-related factor and radicalization or if they included a family-focused intervention against radicalization. For family-related risk and protective factors, radicalized individuals needed to be compared to general population. Studies were included if they defined radicalization as support or commission of violence to defend a cause, including support for radical groups.
DATA COLLECTION AND ANALYSIS
The systematic search identified 86,591 studies. After screening, 33 studies focused on family-related risk and protective factors were included, with 89 primary effect sizes and 48 variables grouped in 14 factors. For the factors that included two or more studies, meta-analyses with random effects were conducted. When possible, moderator analyses were performed together with sensitivity and publication bias analyses. No studies on the impact of radicalization on families or family-focused interventions were included.
RESULTS
The current systematic review based on studies with 148,081 adults and adolescents from diverse geographic locations showed that parental ethnic socialization ( = 0.27), having extremist family members ( = 0.26), and family conflict ( = 0.11) were related to more radicalization, whereas high family socioeconomic status ( = -0.03), bigger family size ( = -0.05), and high family commitment ( = -0.06) were related to less radicalization. Separate analyses described family-factors for behavioral versus cognitive radicalization, and different radical ideologies including Islamist, right-wing and left-wing. It was not possible to distinguish risk and protective factors from correlates and the level of overall bias was mostly high. No results regarding the impact of radicalization on families or family-focused interventions were included.
AUTHORS' CONCLUSIONS
Although causal relations between family-related risk and protective factors could not be established, it is reasonable to suggest that policies and practice should aim at decreasing family-related risks and increasing protective factors for radicalization. Tailored interventions including these factors should be urgently designed, implemented and evaluated. Studies focused on the impact of radicalization on families and family-focused interventions are urgently needed together with longitudinal studies on family-related risk and protective factors.
PubMed: 36913228
DOI: 10.1002/cl2.1266 -
International Journal of Environmental... Mar 2021The present study aims analyze the risk factors that lead to high levels of burnout among nurses and physicians and the protective factors that prevent them. Thus, it is...
The present study aims analyze the risk factors that lead to high levels of burnout among nurses and physicians and the protective factors that prevent them. Thus, it is also intended to explore the possible correlation between physical and verbal violence produced at work and the symptoms derived from burnout. Methods: The search was carried out on the Scopus, PubMed and Web of Science databases between 2000 and 2019 (on which date the bibliographic search ends). Descriptive studies estimating the prevalence of workplace violence and risk and protective factors and burnout were included. An adapted version of the Downs and Black quality checklist was used for article selection. 89.6 percent of the studies analysed were in the health sector. There is a significant correlation between burnout symptoms and physical violence at work. On the one hand, the risk factors that moderate this correlation were of structural/organisational type (social support, quality of the working environment, authoritarian leadership, little autonomy or long working days, etc.) and personal type (age, gender, nationality or academic degree, etc.). On the other hand, protective factors were the quality of the working environment, mutual support networks or coping strategies. The results were analysed in-depth and intervention strategies were proposed.
Topics: Burnout, Professional; Burnout, Psychological; Cross-Sectional Studies; Humans; Physicians; Protective Factors; Risk Factors; Workplace; Workplace Violence
PubMed: 33810020
DOI: 10.3390/ijerph18063280 -
Epidemiology (Cambridge, Mass.) Sep 2016Engaging in late-life cognitive activity is often proposed as a strategy to delay or prevent Alzheimer's disease (AD) and other dementias. However, it is unclear to what... (Review)
Review
BACKGROUND
Engaging in late-life cognitive activity is often proposed as a strategy to delay or prevent Alzheimer's disease (AD) and other dementias. However, it is unclear to what extent the available evidence supports a causal effect of cognitive activity in dementia prevention.
METHODS
We systematically searched PubMed and EMBASE through June 2014 to identify peer-reviewed epidemiologic studies of cognitive activity and incidence of AD or all-cause dementia. Eligible articles analyzed data from cohort or nested case-control studies, explicitly defined cognitive activity, evaluated participants for AD or all-cause dementia using clearly defined criteria, and provided effect estimates adjusted for at least age and sex. We describe methodologic issues and biases relevant to interpretation of these studies, and quantify the degree of bias due to confounding and reverse causation required to nullify typically observed associations.
RESULTS
We reviewed 12 studies involving 13,939 participants and 1,663 dementia cases, of which 565 were specifically evaluated as AD. Most studies found associations between late-life cognitive activity and lower AD and/or all-cause dementia incidence. Differences in cognitive activity operationalization across studies precluded meta-analysis of effect estimates. Our bias analysis indicated that the observed inverse associations are probably robust to unmeasured confounding, and likely only partially explained by reverse causation.
CONCLUSION
Our systematic review and bias analyses provide support for the hypothesis that late-life cognitive activity offers some reduction in AD and all-cause dementia risk. However, more data are needed to confirm this relationship and on the optimal type, duration, intensity, and timing of that activity.
Topics: Alzheimer Disease; Bias; Case-Control Studies; Causality; Cognition; Cohort Studies; Confounding Factors, Epidemiologic; Dementia; Humans; Incidence; Proportional Hazards Models; Protective Factors
PubMed: 27227783
DOI: 10.1097/EDE.0000000000000513 -
JSES Reviews, Reports, and Techniques Aug 2022Since its approval for use, reverse shoulder arthroplasty (RSA) has become the primary treatment for cuff tear arthropathy, with indications expanding more recently to... (Review)
Review
BACKGROUND
Since its approval for use, reverse shoulder arthroplasty (RSA) has become the primary treatment for cuff tear arthropathy, with indications expanding more recently to include revision fracture, osteoarthritis with significant glenoid bone loss, tumor, and chronic instability. Instability is a well-described postoperative complication, occurring in 1to 31% of relatively small cohorts and case series. Given the relative infrequency of instability, there remains a need for a comprehensive review of instability with a focus on risk factors and management. Our goal of this systematic review is to describe the prevalence, risk factors, and management strategies for instability following RSA.
METHODS
A systematic review of the PubMed, EMBASE, MEDLINE, Scopus, and Cochrane Library databases was performed according to PRISMA guidelines. Inclusion criteria included primary RSA cohorts ≥ 100 patients, revision RSA cohorts of any size, and minimum 1-year follow-up. The primary outcome of interest was postoperative instability. MINORS criteria were used to assess study bias. Descriptive statistical analysis was performed with data reported as ranges.
RESULTS
Seventeen studies that included 7885 cases of RSA were reviewed. The mean follow-up ranged from 12 to 84 months. Mean age ranged from 64 to 77 years old, and males represented 19 to 39% of cohorts. There were 204 (2.5%) dislocations in 7885 cases, accounting for a rate of instability from 0.4 to 49% across all studies. By intervention, instability rates ranged from 1 to 5% (primary RSA cases), 1 to 49% (revision RSA cases only), and 0.4 to 10% (mixed cohorts). Subscapularis insufficiency and proximal humerus fractures, and fracture sequelae (malunion and nonunion) were identified as risk factors for instability. Closed reduction and casting and revision RSA were reported as successful treatment strategies with acceptable rates of stable prostheses (28-100% and 55-100%, respectively, across studies). Hemiarthroplasty or resection arthroplasty due to recurrent instability was not uncommon after 2 or more episodes of instability.
CONCLUSION
Instability following RSA occurs infrequently (1-5%) following primary RSA and more commonly following revision RSA (1-49%). RSA for acute proximal humerus fracture and fracture sequelae carries a higher risk of instability. Subscapularis repair appears to be a protective factor. While instability may be successfully treated with closed management or revision RSA, recurrent instability may ultimately require hemiarthroplasty or resection arthroplasty.
PubMed: 37588866
DOI: 10.1016/j.xrrt.2022.02.009 -
Campbell Systematic Reviews Sep 2021Two of the most central questions in radicalization research are, (1) why do some individuals radicalize when most of those from the same groups or exposed to similar... (Review)
Review
BACKGROUND
Two of the most central questions in radicalization research are, (1) why do some individuals radicalize when most of those from the same groups or exposed to similar conditions do not? and (2) why do radicalized individuals turn to radical violence while the majority remain inert? It has been suggested that the answer to both questions lie in the cumulative and interactive effects of a range of risk factors. While risk assessment and counter-radicalization take a risk-protective factor approach, there is widespread debate as to what these factors are and which are most important.
OBJECTIVES
This review has two primary objectives.1) To identify what the putative risk and protective factors for different radicalization outcomes are, without any predeterminations.2) To synthesize the evidence and identify the relative magnitude of the effects of different factors.The review's secondary objectives are to:1) Identify consistencies in the estimates of factors across different radicalization outcomes.2) Identify whether any significant heterogeneity exists within factors between (a) geographic regions, and (b) strains of radicalizing ideologies.
SEARCH METHODS
Over 20 databases were searched for both published and gray literature. In order to provide a more comprehensive review, supplementary searches were conducted in two German and one Dutch database. Reference harvesting was conducted from previous reviews and contact was made with leading researchers to identify and acquire missing or unpublished studies.
SELECTION CRITERIA
The review included observational studies assessing the outcomes of radical attitudes, intentions, and/or radical behaviors in OECD countries and which provided sufficient data to calculate effect sizes for individual-level risk and protective factors.
DATA COLLECTION AND ANALYSIS
One-hundred and twenty-seven studies, containing 206 samples met the inclusion criteria and provided 1302 effect sizes pertaining to over 100 different factors. Random effects meta-analyses were carried out for each factor, and meta-regression and moderator analysis were used to explore differences across studies.
RESULTS
Studies were primarily cross-sectional, with samples representing 20 countries OECD countries. Most studies examined no specific radicalizing ideology, while others focussed on specific ideologies (e.g., Islamist, right-wing, and left-wing ideologies). The studies generally demonstrated low risk of bias and utilized validated or widely acceptable measures for both indicators and outcomes. With some exceptions, sociodemographic factors tend to have the smallest estimates, with larger estimates for experiential and attitudinal factors, followed by traditional criminogenic and psychological factors.
AUTHORS' CONCLUSIONS
While sociodemographic factors are the most commonly examined factors (selective availability), they also tend to have the smallest estimates. So too, attitudinal and even experiential factors, do not have effect sizes of the magnitude that could lead to significant reductions in risk through targeting by interventions. Conversely, traditional criminogenic factors, as well as psychological factors tend to display the largest estimates. These findings suggest the need to broaden the scope of factors considered in both risk assessment and intervention, and this review provides much needed evidence for guiding the selection of factors.
PubMed: 37133261
DOI: 10.1002/cl2.1174