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International Journal of Environmental... Mar 2022This study presents a systematic review of the sociodemographic, clinical, and psychosocial factors associated with distress in elderly cancer patients. Relevant studies... (Review)
Review
This study presents a systematic review of the sociodemographic, clinical, and psychosocial factors associated with distress in elderly cancer patients. Relevant studies were identified using four electronic databases: PubMed, Scopus, Web of Science and ProQuest. Cross-sectional and longitudinal studies exploring factors associated with distress in people over 60 years of age were included and independently assessed using the Joanna Briggs Institute Critical Assessment Checklists. A total of 20 studies met the inclusion criteria. Research showed that being a woman, being single, divorced or widowed, having low income, having an advanced diagnosis, having functional limitations, having comorbidities, and having little social support were factors consistently associated with emotional distress. Data further showed that the impact of age, cancer type, and cancer treatment on symptoms of anxiety and/or depression in elderly patients is not yet well established. The findings of this review suggest that the emotional distress of elderly cancer patients depends on a myriad of factors that are not exclusive, but coexisting determinants of health. Future research is still needed to better understand risk factors for distress in this patient population, providing the resources for healthcare providers to better meet their needs.
Topics: Aged; Anxiety; Cross-Sectional Studies; Female; Humans; Middle Aged; Neoplasms; Patients; Social Support
PubMed: 35329112
DOI: 10.3390/ijerph19063424 -
Heliyon Feb 2023The COVID-19 pandemic has disproportionately affected women and threatens to overturn four decades of progress in Sustainable Development Goal (SDG) 5: Gender Equality... (Review)
Review
The COVID-19 pandemic has disproportionately affected women and threatens to overturn four decades of progress in Sustainable Development Goal (SDG) 5: Gender Equality and Women's Empowerment. To better grasp the key areas of concern that gender inequality exists, gender studies and sex-disaggregated evidence are required. Using the PRISMA technique, this review paper is the first attempt to present a comprehensive and current picture of the gendered dimensions of the COVID-19 pandemic in Bangladesh regarding economic well-being, resource endowments, and agency. This study found that women were more likely to face hardship as widows, mothers, or sole breadwinners after the loss of husbands and male household members because of the pandemic. The evidence suggests that the advancement of women during this pandemic was hampered by poor reproductive health outcomes; girls' dropping out of school; job loss; less income; a comparable wage gap; a lack of social security; unpaid work burnout; increased emotional, physical, and sexual abuse; an increase in child marriages; and less participation in leadership and decision-making. Our study found inadequate sex-disaggregated data and gender studies on COVID-19 in Bangladesh. However, our research concludes that policies must account for gender disparities and male and female vulnerability across multiple dimensions to achieve inclusive and effective pandemic prevention and recovery.
PubMed: 36811121
DOI: 10.1016/j.heliyon.2023.e13773 -
PloS One 2020Physical activity (PA) is a fluctuating behavior and prone to change across the life course. Changes in PA may be particularly due to the experience of life events and...
BACKGROUND
Physical activity (PA) is a fluctuating behavior and prone to change across the life course. Changes in PA may be particularly due to the experience of life events and transitions. For well-timed and successful PA interventions, it is important to understand when and why individuals take up or terminate PA.
OBJECTIVES
This scoping review aims to examine the extent, range, and nature of research on the impact of life events and transitions on PA and to summarize key findings.
METHODS
A systematic literature search was conducted in PubMed, PsycINFO, PsycARTICLES, SPORTDiscus, and Web of Science. Articles were included if they had been published in peer-reviewed journals between 1998 and 2020 and assessed the impact of at least one life event or transition on PA.
RESULTS
107 studies that assessed 72 distinct life events and transitions were included and summarized in ten categories. Events and transitions that are primarily associated with decreases in PA were starting cohabitation, getting married, pregnancy, evolving parenthood, and the transitions from kindergarten to primary school, from primary to secondary school, and from high school to college or into the labor market. Retirement was associated with increases in PA; yet, long-term trajectories across retirement indicated a subsequent drop in activity levels. Divorce was associated with no changes in PA. No trends could be identified for changing work conditions, quitting or losing a job, starting a new relationship, widowhood, moving, and diagnosis of illness.
CONCLUSION
Life events and transitions can be conceptualized as natural interventions that occur across the life course and that are oftentimes associated with changes in PA behavior. Our study indicates that, despite some emerging trends, similar events do not necessarily have similar impacts on PA across individuals. It also shows that the research landscape is characterized by a lack of conceptual clarity and by disparate methodologies, making it difficult to synthesize results across studies.
Topics: Exercise; Humans
PubMed: 32569282
DOI: 10.1371/journal.pone.0234794 -
Cureus Dec 2021Patients with acute myocardial infarction (AMI) or ischaemic heart disease are at risk of developing anxiety and depression. This systematic review aims to identify the... (Review)
Review
Patients with acute myocardial infarction (AMI) or ischaemic heart disease are at risk of developing anxiety and depression. This systematic review aims to identify the various risk factors and the role of cardiac rehabilitation in reducing the risk of depression in patients after AMI. In this review, we included data on the prevalence of depression in patients post-AMI for the years 2016-2017 from a cardiac rehabilitation unit at Morriston Hospital, Swansea, a primary coronary angioplasty centre. Results from our meta-analysis were compared with the findings of previous studies. Our data showed the prevalence of depression to be 14% pre-cardiac rehabilitation and 3% post-cardiac rehabilitation. A meta-analysis of seven studies showed the prevalence to be approximately 20-35% depending on the type of questionnaire or screening method used. Gender, marital status, age, and sedentary lifestyle were found to be risk factors for depression post-acute coronary syndrome (ACS). Females, patients aged >65 years, and those who were single, lived alone, or widowed were at a higher risk of depression, and patients with sedentary lifestyles were more likely to have post-ACS depression. Depression in patients post-myocardial infarction was also associated with increased mortality and morbidity risk as well as higher hospital re-admission and future cardiac events. The meta-analysis showed significant publication bias, studies with negative results were less likely to be published, and the study data were heterogeneous. The pooled estimate for depression estimated using the random-effects model was 1.78 (95% confidence interval = 1.58-2.01).
PubMed: 35141096
DOI: 10.7759/cureus.20851 -
BMJ Open Apr 2015To identify patient and practitioner factors that influence cancer diagnosis via emergency presentation (EP). (Review)
Review
OBJECTIVE
To identify patient and practitioner factors that influence cancer diagnosis via emergency presentation (EP).
DESIGN
Systematic review.
DATA SOURCES
MEDLINE, EMBASE, CINAHL, EBM Reviews, Science and Social Sciences Citation Indexes, Conference Proceedings Citation Index-Science and Conference Proceedings Citation Index-Social Science and Humanities. Searches were undertaken from 1996 to 2014. No language restrictions were applied.
STUDY SELECTION
Studies of any design assessing factors associated with diagnosis of colorectal or lung cancer via EP, or describing an intervention to impact on EP, were included. Studies involving previously diagnosed cancer patients, assessing only referral pathway effectiveness, outcomes related to diagnosis or post-EP management were excluded. The population was individual or groups of adult patients or primary care practitioners. Two authors independently screened studies for inclusion.
RESULTS
22 studies with over 200,000 EPs were included, most providing strong evidence. Five were graded 'insufficient', primarily due to missing information rather than methodological weakness. Older patient age was associated with EP for lung and colorectal cancers (OR 1.11-11.03 and 1.19-5.85, respectively). Women were more at risk of EP for lung but not colorectal cancer. Higher deprivation increased the likelihood of lung cancer EP, but evidence for colorectal was less conclusive. Being unmarried (or divorced/widowed) increased the likelihood of EP for colorectal cancer, which was also associated with pain, obstruction and weight loss. Lack of a regular source of primary care, and lower primary care use were positively associated with EP. Only three studies considered practitioner factors, two involving diagnostic tests. No conclusive evidence was found.
CONCLUSIONS
Patient-related factors, such as age, gender and deprivation, increase the likelihood of cancer being diagnosed as the result of an EP, while cancer symptoms and patterns of healthcare utilisation are also relevant. Further work is needed to understand the context in which risk factors for EP exist and influence help-seeking.
Topics: Colorectal Neoplasms; Emergencies; Female; Humans; Lung Neoplasms; Male; Primary Health Care; Risk Factors; Socioeconomic Factors
PubMed: 25838506
DOI: 10.1136/bmjopen-2014-006965 -
Health Science Reports Feb 2024Multimorbidity among older adults is a growing concern in India. Multimorbidity is defined as the coexistence of two or more chronic health conditions in an individual....
BACKGROUND
Multimorbidity among older adults is a growing concern in India. Multimorbidity is defined as the coexistence of two or more chronic health conditions in an individual. Primary studies have been conducted on risk factors of multimorbidity in India, but no systematic review has been conducted on this topic. This systematic review aimed to synthesize the existing evidence on risk factors of multimorbidity among older adults in India.
METHODS
The JBI and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Several databases were searched for published and unpublished studies until August 03, 2022. The screening of titles and abstracts and full texts, data extraction, and quality assessment were conducted by two independent reviewers. Any disagreements were resolved through discussion or by involving a third reviewer. Data synthesis was conducted using narrative synthesis and random effects meta-analysis, where appropriate.
RESULTS
Out of 8781 records identified from the literature search, 16 and 15 studies were included in the systematic review and meta-analysis, respectively. All included studies were cross-sectional, and 10 met a critical appraisal score of more than 70%. Broadly, sociodemographic, lifestyle, and health conditions-related factors were explored in these studies. The pooled odds of multimorbidity were higher in people aged ≥70 years compared to 60-69 years (odds ratio (OR) 1.51; 95% confidence interval (CI) 1.20-1.91), females compared to males (1.38; 1.09-1.75), single, divorced, separated, and widowed compared to married (1.29; 1.11-1.49), economically dependent compared to economically independent (1.54; 1.21-1.97), and smokers compared to non-smokers (1.33; 1.16-1.52) and were lower in working compared to not working (0.51; 0.36-0.72).
CONCLUSION
This systematic review and meta-analysis provided a comprehensive picture of the problem by synthesizing the existing evidence on risk factors of multimorbidity among older adults in India. These synthesized sociodemographic and lifestyle factors should be taken into consideration when developing health interventions for addressing multimorbidity among older adults in India.
PubMed: 38420204
DOI: 10.1002/hsr2.1915 -
PloS One 2013As global environmental change accelerates, biodiversity losses can disrupt interspecific interactions. Extinctions of mutualist partners can create "widow" species,... (Review)
Review
BACKGROUND
As global environmental change accelerates, biodiversity losses can disrupt interspecific interactions. Extinctions of mutualist partners can create "widow" species, which may face reduced ecological fitness. Hypothetically, such mutualism disruptions could have cascading effects on biodiversity by causing additional species coextinctions. However, the scope of this problem - the magnitude of biodiversity that may lose mutualist partners and the consequences of these losses - remains unknown.
METHODOLOGY/PRINCIPAL FINDINGS
We conducted a systematic review and synthesis of data from a broad range of sources to estimate the threat posed by vertebrate extinctions to the global biodiversity of vertebrate-dispersed and -pollinated plants. Though enormous research gaps persist, our analysis identified Africa, Asia, the Caribbean, and global oceanic islands as geographic regions at particular risk of disruption of these mutualisms; within these regions, percentages of plant species likely affected range from 2.1-4.5%. Widowed plants are likely to experience reproductive declines of 40-58%, potentially threatening their persistence in the context of other global change stresses.
CONCLUSIONS
Our systematic approach demonstrates that thousands of species may be impacted by disruption in one class of mutualisms, but extinctions will likely disrupt other mutualisms, as well. Although uncertainty is high, there is evidence that mutualism disruption directly threatens significant biodiversity in some geographic regions. Conservation measures with explicit focus on mutualistic functions could be necessary to bolster populations of widowed species and maintain ecosystem functions.
Topics: Africa; Animals; Asia; Biodiversity; Caribbean Region; Extinction, Biological; Magnoliopsida; Oceania; Pollination; Symbiosis; Vertebrates
PubMed: 23840571
DOI: 10.1371/journal.pone.0066993 -
Social Psychiatry and Psychiatric... Jul 2019To conduct a systematic review and meta-analysis examining the association of the prevalence of depression and time since spousal loss in widowed people. (Meta-Analysis)
Meta-Analysis
PURPOSE
To conduct a systematic review and meta-analysis examining the association of the prevalence of depression and time since spousal loss in widowed people.
METHODS
The databases MEDLINE, Embase and PsycInfo were searched (May 2017) for papers reporting on time since spousal loss in widowed people and the prevalence of common mental disorders. A systematic review was conducted according to MOOSE guidelines. Random effects meta-analyses of the prevalence of depression were conducted by intervals of time since spousal loss.
RESULTS
The literature search identified 12,982 studies of which 22 were eligible for inclusion in the systematic review. Of these, 14 were furthermore eligible for inclusion in the meta-analysis. The summary estimates found in the meta-analysis for the prevalence of depression in the intervals of time since spousal loss were: ≤ 1 month: 38.2% (21.9-55.8%); > 1 month to 3 months: 25.0% (17.3-33.5%); > 3 months to 6 months: 23.1% (18.0-28.7%); > 6 months to 12 months: 19.4% (15.2-24.0%); > 12 months to 18 months: 11.1% (5.3-18.7%); > 18 months to 24 months: 15.2% (12.3-18.2%); > 24 months to 60 months: 10.5% (4.3-18.5%).
CONCLUSION
Widowhood is associated with a high prevalence of depression and the study identifies a population group needing special attention in daily clinical practice. The prevalence is highest in the first month of widowhood, however, continues to be high at least 5 years into widowhood.
Topics: Depression; Female; Humans; Prevalence; Time Factors; Widowhood
PubMed: 30887075
DOI: 10.1007/s00127-019-01680-3 -
The Cochrane Database of Systematic... Feb 2018Available evidence has been inconclusive on whether pulmonary artery perfusion during cardiopulmonary bypass (CPB) is associated with decreased or increased mortality,... (Review)
Review
BACKGROUND
Available evidence has been inconclusive on whether pulmonary artery perfusion during cardiopulmonary bypass (CPB) is associated with decreased or increased mortality, pulmonary events, and serious adverse events (SAEs) after open heart surgery. To our knowledge, no previous systematic reviews have included meta-analyses of these interventions.
OBJECTIVES
To assess the benefits and harms of single-shot or continuous pulmonary artery perfusion with blood (oxygenated or deoxygenated) or a preservation solution compared with no perfusion during cardiopulmonary bypass (CPB) in terms of mortality, pulmonary events, serious adverse events (SAEs), and increased inflammatory markers for adult surgical patients.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Science Citation Index Expanded, and advanced Google for relevant studies. We handsearched retrieved study reports and scanned citations of included studies and relevant reviews to ensure that no relevant trials were missed. We searched for ongoing trials and unpublished trials in the World Health Organization International Clinical Trials Registry Platform (ICTRP) and at clinicaltrials.gov (4 July 2017). We contacted medicinal firms producing preservation solutions to retrieve additional studies conducted to examine relevant interventions.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) that compared pulmonary artery perfusion versus no perfusion during CPB in adult patients (≧ 18 years).
DATA COLLECTION AND ANALYSIS
Two independent review authors extracted data, conducted fixed-effect and random-effects meta-analyses, and calculated risk ratios (RRs) or odds ratios (ORs) for dichotomous outcomes. For continuous data, we have presented mean differences (MDs) and 95% confidence intervals (CIs) as estimates of the intervention effect. To minimize the risk of systematic error, we assessed risk of bias of included trials. To reduce the risk of random errors caused by sparse data and repetitive updating of cumulative meta-analyses, we applied Trial Sequential Analyses (TSAs). We used GRADE principles to assess the quality of evidence.
MAIN RESULTS
We included in this review four RCTs (210 participants) reporting relevant outcomes. Investigators randomly assigned participants to pulmonary artery perfusion with blood versus no perfusion during CPB. Only one trial included the pulmonary artery perfusion intervention with a preservation solution; therefore we did not perform meta-analysis. Likewise, only one trial reported patient-specific data for the outcome "pulmonary events"; therefore we have provided no results from meta-analysis. Instead, review authors added two explorative secondary outcomes for this version of the review: the ratio of partial pressure of oxygen in arterial blood (PaO) to fraction of inspired oxygen (FiO); and intubation time. Last, review authors found no comparable data for the secondary outcome inflammatory markers.The effect of pulmonary artery perfusion on all-cause mortality was uncertain (Peto OR 1.78, 95% CI 0.43 to 7.40; TSA adjusted CI 0.01 to 493; 4 studies, 210 participants; GRADE: very low quality). Sensitivity analysis of one trial with overall low risk of bias (except for blinding of personnel during the surgical procedure) yielded no evidence of a difference for mortality (Peto OR 1.65, 95% CI 0.27 to 10.15; 1 study, 60 participants). The TSA calculated required information size was not reached and the futility boundaries did not cross; thus this analysis cannot refute a 100% increase in mortality.The effect of pulmonary artery perfusion with blood on SAEs was likewise uncertain (RR 1.12, 95% CI 0.66 to 1.89; 3 studies, 180 participants; GRADE: very low quality). Data show an association between pulmonary artery perfusion with blood during CPB and a higher postoperative PaO/FiO ratio (MD 27.80, 95% CI 5.67 to 49.93; 3 studies, 119 participants; TSA adjusted CI 5.67 to 49.93; GRADE: very low quality), although TSA could not confirm or refute a 10% increase in the PaO/FiO ratio, as the required information size was not reached.
AUTHORS' CONCLUSIONS
The effects of pulmonary artery perfusion with blood during cardiopulmonary bypass (CPB) are uncertain owing to the small numbers of participants included in meta-analyses. Risks of death and serious adverse events may be higher with pulmonary artery perfusion with blood during CPB, and robust evidence for any beneficial effects is lacking. Future randomized controlled trials (RCTs) should provide long-term follow-up and patient stratification by preoperative lung function and other documented risk factors for mortality. One study that is awaiting classification (epub abstract with preliminary results) may change the results of this review when full study details have been published.
Topics: Adult; Cardiac Surgical Procedures; Cardiopulmonary Bypass; Cause of Death; Humans; Lung; Lung Diseases; Organ Preservation Solutions; Oxygen Consumption; Perfusion; Postoperative Complications; Pulmonary Artery; Pulmonary Circulation; Randomized Controlled Trials as Topic
PubMed: 29419895
DOI: 10.1002/14651858.CD011098.pub2 -
Death Studies 2021This study systematically reviewed the methodology and findings of 19 peer-reviewed studies on the experience of bereavement among widowed Latinos, including risk and...
This study systematically reviewed the methodology and findings of 19 peer-reviewed studies on the experience of bereavement among widowed Latinos, including risk and protective factors to the health of this vulnerable population. Of these studies, 10 included quantitative data, 3 were qualitative studies, and 6 were narrative reviews. Results emphasized the relevance of cultural beliefs about death, rituals, religion, and Latino values (i.e., , , o) as common themes in the included studies, along with expressions of grief (e.g., somatization) that vary by gender and acculturation. Risk factors associated with diminished well-being in this population included being a male, financial strain, cultural stressors, having an undocumented legal status, experiencing widowhood at a younger age, and having poor physical health. Effective coping strategies identified included having adequate social support primarily from family, religion and religious practices, the use of folk medicine, volunteering, and the use of emotional release strategies. Moreover, the results highlight that researches informing the health needs of widowed Latinos in the US is limited, and studies with enhanced methodological rigor are needed to better understand the complex needs of this vulnerable population.
Topics: Bereavement; Female; Grief; Hispanic or Latino; Humans; Male; Religion; United States; Widowhood
PubMed: 31402785
DOI: 10.1080/07481187.2019.1648328