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Global Health Research and Policy 2018Little is known about the health of GMS commercial fishers and seafarers, many of whom are migrants and some trafficked. This systematic review summarizes evidence on... (Review)
Review
Occupational, physical, sexual and mental health and violence among migrant and trafficked commercial fishers and seafarers from the Greater Mekong Subregion (GMS): systematic review.
BACKGROUND
Little is known about the health of GMS commercial fishers and seafarers, many of whom are migrants and some trafficked. This systematic review summarizes evidence on occupational, physical, sexual and mental health and violence among GMS commercial fishers/seafarers.
METHODS
We searched 5 electronic databases and purposively searched grey literature. Quantitative or qualitative studies reporting prevalence or risk of relevant outcomes were included. Two reviewers independently screened articles. Data were extracted on nationality and long/short-haul fishing where available.
RESULTS
We identified 33 eligible papers from 27 studies. Trafficked fishers/seafarers were included in =12/13 grey literature and =1/20 peer-reviewed papers. Among peer-reviewed papers: 11 focused on HIV/AIDS/sexual health; nine on occupational/physical health; one study included mental health of trafficked fishers. Violence was quantitatively measured in eight papers with prevalence of: 11-26% in port convenience samples; 68-100% in post-trafficking service samples. Commercial fishers/seafarers whether trafficked or not worked extremely long hours; trafficked long-haul fishers had very limited access to care following injuries or illness. Lesser-known risks reported among fishers included penile oil injections and beriberi. We found just one work safety intervention study and inconclusive evidence for differences in the outcomes by nationality. Findings are limited by methodological weaknesses of primary studies.
CONCLUSION
Results show an absence of high-quality epidemiological studies beyond sexual health. Formative and pilot intervention research on occupational, physical and mental health among GMS commercial fishers and seafarers is needed. Future studies should include questions about violence and exploitation. Ethical and reporting standards of grey literature should be improved.
TRIAL REGISTRATION
Review registration number: PROSPERO 2014: CRD42014009656.
PubMed: 30288452
DOI: 10.1186/s41256-018-0083-x -
Obesity Facts 2014The epidemic growth of morbid obesity has led to an increase in the number of bariatric interventions. During the distribution process of bariatric surgical... (Review)
Review
BACKGROUND
The epidemic growth of morbid obesity has led to an increase in the number of bariatric interventions. During the distribution process of bariatric surgical interventions, the risk for severe nutritious complications such as bariatric beriberi can rise.
METHODS
By means of systematic literature review, epidemiological data, clinical characteristics and diagnostic as well as therapeutic recommendations for bariatric beriberi were elicited. Databases and registries such as PubMed, Cochrane and Ovid were searched for a defined time period with the key words 'lack of thiamine' / 'Wernicke-Korsakoff syndrome' / 'encephalopathy' after bariatric surgical interventions.
RESULTS
Up to December 2013, overall 255 patients had been found as published cases, indicating that the risk for the postoperative occurrence of thiamine deficiency and Wernicke-Korsakoff syndrome is increased in women. In addition, the risk correlates with patient's age. The majority of patients developed symptoms of a dry beriberi with peripheral neuritis, ataxia and paraplegia, indicating an advanced stage of disease approximately 4-12 weeks postoperatively. Laboratory analysis in case of a suspicious clinical finding is the appropriate diagnostics. As treatment, prompt initiation of parenteral thiamine substitution under clinical monitoring is required.
CONCLUSION
Bariatric beriberi can occur within the first 1-3 postoperative months. To minimize the risk of severe consequences, immediate substitution of thiamine in clinical suspicion or prolonged parenteral nutrition is necessary. A delayed diagnosis or missing the correct diagnosis can lead to irreversible damages of the CNS with coma and fatal outcome. Knowledge on the subject, including development of thiamine deficiency, symptomatology and emergency treatment, are considered essential for bariatric surgeons but also for further medical disciplines involved in treatment.
Topics: Bariatric Surgery; Beriberi; Humans; Korsakoff Syndrome; Obesity, Morbid; Postoperative Complications; Thiamine
PubMed: 25095897
DOI: 10.1159/000366012