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BMJ Open Nov 2019Neurotrauma is an important global health problem. This 'silent epidemic' is a major cause of death and disability in adolescents and young adults, with significant...
INTRODUCTION
Neurotrauma is an important global health problem. This 'silent epidemic' is a major cause of death and disability in adolescents and young adults, with significant societal and economic impacts. Globally, the largest cause of neurotrauma is road traffic collisions (RTCs). Neurotrauma and RTCs are largely preventable, and many preventative strategies and interventions have been established and implemented over the last decades, particularly in high-income countries. However, these approaches may not be applicable globally, due to variations in environment, resources, population, culture and infrastructure. This paper outlines the protocol for a scoping review, which seeks to map the evidence on strategies and interventions in neurotrauma and RTCs prevention globally, and to ascertain contextual factors that influence their implementation.
METHODS AND ANALYSIS
This scoping review will use the established methodology by Arksey and O'Malley. Eligible studies will be identified from five electronic databases (MEDLINE, EMBASE, CINAHL, Global Health/EBSCO and Cochrane Database of Systematic Reviews) and grey literature sources. We will also carry out bibliographical and citation searching of included studies. A two-stage selection process, which involves screening of titles and abstracts, followed by full-text screening, will be used to determine eligible studies which will undergo data abstraction using a customised, piloted data extraction sheet. The extracted data will be presented using evidence mapping and a narrative summary.
ETHICS AND DISSEMINATION
Ethical approval is not required for this scoping review, which is the first step in a multiphase public health research project on the global prevention of neurotrauma. The final review will be submitted for publication to a scientific journal, and results will be presented at appropriate conferences, workshops and meetings. Protocol registered on 5 April 2019 with Open Science Framework (https://osf.io/s4zk3/).
Topics: Accidents, Traffic; Brain Injuries; Global Health; Humans; Research Design; Review Literature as Topic
PubMed: 31722947
DOI: 10.1136/bmjopen-2019-031517 -
MMWR. Recommendations and Reports :... Oct 2005Reducing morbidity and mortality related to overweight and obesity is a public health priority. Various interventions in school and worksite settings aim to maintain or... (Review)
Review
Public health strategies for preventing and controlling overweight and obesity in school and worksite settings: a report on recommendations of the Task Force on Community Preventive Services.
Reducing morbidity and mortality related to overweight and obesity is a public health priority. Various interventions in school and worksite settings aim to maintain or achieve healthy weight. To identify effective strategies for weight control that can be implemented in these settings, the Task Force on Community Preventive Services (Task Force) has conducted systematic reviews of the evidence on nutrition, physical activity, combinations of these interventions, and other behavioral interventions (e.g., cognitive techniques such as self-awareness and cue recognition). Task Force recommendations are based on evidence of effectiveness, which is defined in this report as achieving a mean weight loss of > or =4 pounds, measured > or =6 months after initiation of the intervention program. The Task Force recommends multicomponent interventions that include nutrition and physical activity (including strategies such as providing nutrition education or dietary prescription, physical activity prescription or group activity, and behavioral skills development and training) to control overweight and obesity among adults in worksite settings. The Task Force determined that insufficient evidence existed to determine the effectiveness of combination nutrition and physical activity interventions to prevent or reduce overweight and obesity in school settings because of the limited number of qualifying studies reporting noncomparable outcomes. This report describes the methods used in these systematic reviews; provides additional information regarding these recommendations; and cites sources for full reviews containing details regarding applicability, other benefits and harms, barriers to implementation, research gaps, and economic data (when available) regarding interventions.
Topics: Health Behavior; Health Promotion; Humans; Motor Activity; Nutritional Physiological Phenomena; Obesity; Schools; Weight Loss; Workplace
PubMed: 16261131
DOI: No ID Found -
BMJ (Clinical Research Ed.) Aug 2013To evaluate the effectiveness of current medical and psychological interventions for individuals at risk of sexually abusing children, both in known abusers and those at... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the effectiveness of current medical and psychological interventions for individuals at risk of sexually abusing children, both in known abusers and those at risk of abusing.
DESIGN
Systematic review of interventions designed to prevent reoffending among known abusers and prevention for individuals at risk of sexually abusing children. Randomised controlled trials and prospective observational studies were eligible. Primary outcomes were arrests, convictions, breaches of conditions, and self reported sexual abuse of children after one year or more.
RESULTS
After review of 1447 abstracts, we retrieved 167 full text studies, and finally included eight studies with low to moderate risk of bias. We found weak evidence for interventions aimed at reducing reoffending in identified sexual abusers of children. For adults, evidence from five trials was insufficient regarding both benefits and risks with psychological treatment and pharmacotherapy. For adolescents, limited evidence from one trial suggested that multisystemic therapy prevented reoffence (relative risk 0.18, 95% confidence interval 0.04 to 0.73); lack of adequate research prevented conclusions about effects of other treatments. Evidence was also inadequate regarding effectiveness of treatment for children with sexual behavioural problems in the one trial identified. Finally, we found no eligible research on preventive methods for adults and adolescents who had not sexually abused children but were at higher risk of doing so (such as those with paedophilic sexual preference).
CONCLUSION
There are major weaknesses in the scientific evidence, particularly regarding adult men, the main category of sexual abusers of children. Better coordinated and funded high quality studies including several countries are urgently needed. Until conclusive evidence is available, realistic clinical strategies might involve reduction of specific risk factors for sex crimes, such as sexual preoccupation, in abusers at risk of reoffending.
Topics: Adolescent; Adult; Androgen Antagonists; Child; Child Abuse, Sexual; Criminals; Humans; Male; Psychotherapy; Randomized Controlled Trials as Topic
PubMed: 23935058
DOI: 10.1136/bmj.f4630 -
Environmental Science and Pollution... Aug 2021The COVID-19 pandemic needs immediate solution before inflicting more devastation. So far, China has successfully controlled transmission of COVID-19 through...
The COVID-19 pandemic needs immediate solution before inflicting more devastation. So far, China has successfully controlled transmission of COVID-19 through implementing stringent preventive measures. In this study, we analyze the effectiveness of preventive measures taken in thirteen regions of China based on the feedback provided by 1135 international students studying in China. The study uses factor analysis combined with varimax rotation of variables. It was found that awareness raising and dispersing actionable knowledge regarding trust and adapting measures remained significantly important. Therefore, recognition of information gaps, improvements in the level of alertness, and development of preventive measures in each sector are imperative. The findings of this study revealed that trust, students' health, waste disposal, and the efforts of the Chinese government/international institute of education to prevent this pandemic were significantly and positively associated with preventive measures. The results showed that prior knowledge, global pandemics, and food and grocery purchases were firmly related to the preventive measures of COVID-19. Moreover, anxiety, transportation, and economic status were negatively related to the preventive measures. During this epidemic situation, international students suffered various types of mental stresses and anxiety, especially living in most affected regions of China. The study adopted a mixed (qualitative and quantitative) approach where the findings can act as a set of guidelines for governmental authorities in formulating, assisting in the preparation, instructing, and guiding policies to prevent and control the epidemic COVID-19 at national, local, and divisional levels.
Topics: COVID-19; China; Cross-Sectional Studies; Humans; Pandemics; Perception; SARS-CoV-2; Students; Surveys and Questionnaires
PubMed: 33037960
DOI: 10.1007/s11356-020-10932-8 -
International Journal of Environmental... Sep 2022The purpose of this study is to evaluate compliance with preventive measures and COVID-19 vaccination acceptance among Slovenian students of healthcare and medicine,...
INTRODUCTION
The purpose of this study is to evaluate compliance with preventive measures and COVID-19 vaccination acceptance among Slovenian students of healthcare and medicine, identify the predictive socio-demographic factors, establish the possible causes, and propose vaccination strategies and programs in response to the findings.
METHODS
Data were collected using an online survey as part of a large cross-sectional study of full-time students engaged in higher-level study. The survey took place between 9 February and 8 March 2021.
RESULTS
A total of 56.3% of medical and other healthcare students surveyed expressed their intention to receive the vaccine at the earliest opportunity, 22.4% said that they would do so at a later date and 21.3% said that they did not intend to get vaccinated. The medical students surveyed showed a greater readiness to get vaccinated at the earliest opportunity than those studying other healthcare disciplines, men more than women, and single persons more than those in a relationship. Students attending a vocational college, professional higher education or university study program (Bologna first cycle) showed less readiness than other students to get vaccinated as soon as they were able.
CONCLUSION
Our research found that 56.3% of those studying health-related subjects intended to get vaccinated at the earliest opportunity. There were significant differences between medical and other healthcare students, as well as differences resulting from the level of higher education study being undertaken. In addition, the conclusions show that there needs to be a strengthening of communication with students regarding COVID-19 and the importance of vaccination. Lessons that we learned in this pandemic should prepare us for the future. Clearer and more effective communication and education in the future regarding the importance of vaccination is the most effective way of preventing communicable diseases.
Topics: COVID-19; COVID-19 Vaccines; Cross-Sectional Studies; Female; Humans; Influenza Vaccines; Influenza, Human; Intention; Male; Patient Acceptance of Health Care; Students, Medical; Vaccination
PubMed: 36141928
DOI: 10.3390/ijerph191811656 -
Diabetes/metabolism Research and Reviews Feb 2012Treatment of diabetic foot ulceration is very challenging, costly and often needs to be of long duration. This leads to substantial economic burden. Population-based... (Review)
Review
Treatment of diabetic foot ulceration is very challenging, costly and often needs to be of long duration. This leads to substantial economic burden. Population-based research suggests that a meaningful reduction of the incidence of amputations caused by diabetes mellitus has already been achieved since the St. Vincent resolution in 1989. Still, it cannot be inferred from these studies that the current preventive efforts are (cost-)effective because reduction of amputation incidence can also be the result of improvements in ulcer treatment. Nevertheless, education of people with diabetes is widely advocated and implemented in standard practice. Despite the fact that preventive interventions are often combined in daily practice, there is little scientific evidence demonstrating the effect of those efforts. In systematically reviewing the evidence, there is insufficient evidence that limited patient education alone is effective in achieving clinically relevant reductions in ulcer and amputation incidence. To date, high quality evidence that more complex interventions including patient education can prevent diabetic foot ulceration is not available either. This, however, should be interpreted as lack of evidence rather than evidence of no effect. Future directions for research and practice may be to concentrate preventive effort on those patients who appear to be at highest risk of foot ulceration after careful screening and selection.
Topics: Diabetes Complications; Diabetes Mellitus; Diabetic Foot; Humans; Patient Education as Topic
PubMed: 22271733
DOI: 10.1002/dmrr.2237 -
International Journal of Environmental... Oct 2022While a number of population preventive measures for COVID-19 exist that help to decrease the spread of the virus in the community, there are still many areas in...
A Community-Based Participatory Research Approach to Developing and Testing Social and Behavioural Interventions to Reduce the Spread of SARS-CoV-2: A Protocol for the '' Programme of Research with Five Interconnected Studies in the Hong Kong Context.
BACKGROUND
While a number of population preventive measures for COVID-19 exist that help to decrease the spread of the virus in the community, there are still many areas in preventative efforts that need improvement or refinement, particularly as new strains of the virus develop. Some of the key issues currently include incorrect and/or inconsistent use of face masks, low acceptance of early screening or vaccination for COVID-19, vaccine hesitance, and misinformation. This is particularly the case in some vulnerable populations, such as older people with chronic illnesses, ethnic minorities who may not speak the mainstream language well and children. The current protocol introduces a large programme of research through five interrelated studies that all focus on social and behavioural interventions to improve different aspects of community-related preventative indicators. Hence, the specific objectives of the overall programme are to (1) increase early testing for COVID-19 and promote the uptake of COVID-19 vaccines in the community (Study 1); (2) increase COVID-19-related health literacy and vaccine literacy and promote improved preventative measures in minority ethnic groups, chronically ill populations and caregivers (Study 2); (3) strengthen the public's motivation to stay at home and avoid nonessential high-risk activities (Study 3); (4) decrease COVID-19 vaccine hesitancy (Study 4); and (5) enhance the adherence to COVID-19-related hygiene practices and the uptake of early testing in school children (Study 5).
METHODS
We will utilise a community-based participatory research (CBPR) approach in the proposed studies. All studies will incorporate an intervention development phase in conjunction with key community stakeholders, a feasibility study and an execution stage. A variety of self-reported and objective-based measures will be used to assess various outcomes, based on the focus of each study, in both the short- and long-term, including, for example, the 8-item self-reported eHealth Literacy Scale (eHEAL) and objective measures such as vaccine uptake.
DISCUSSION
Theory-driven interventions will address each study's focus (e.g., social distancing, promotion of vaccine uptake, eHealth education, preventive measures and early detection). Improvements are expected to be seen in the outcomes of vulnerable and high-risk groups. Decreased infection rates are expected due to improved preventative behaviours and increased vaccine uptake. Long-term sustainability of the approach will be achieved through the CBPR model. The publication of this protocol can assist not only in sharing a large-scale and complex community-based design, but will also allow all to learn from this, so that we will have better insight in the future whether sharing of study designs can elicit timely research initiatives.
Topics: Child; Humans; Aged; SARS-CoV-2; COVID-19; Community-Based Participatory Research; COVID-19 Vaccines; Hong Kong; COVID-19 Testing; Vaccines; Chronic Disease
PubMed: 36293972
DOI: 10.3390/ijerph192013392 -
Travel Medicine and Infectious Disease 2024Approximately 10-40 million travelers get Traveler's Diarrhea (TD) yearly. A significant decrease in TD incidence has not been achieved by depending solely on antibiotic... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Approximately 10-40 million travelers get Traveler's Diarrhea (TD) yearly. A significant decrease in TD incidence has not been achieved by depending solely on antibiotic prophylaxis and educational initiatives. Using prebiotics to prevent TD has also not been examined in previous evaluations of probiotics for TD, which failed to consider the strain-specificity of probiotic efficacy. This review investigates the overall effects of probiotics on preventing TD, including the impact of dosage, duration, and age.
METHODS
Standard literature databases were searched without restriction on publication year or language. The following criteria are included: randomized controlled trials (RCTs) in English or non-English unrestricted to publication year, excluding animal and observational studies. This systematic review applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
RESULTS
Of the 166 screened papers, 10 RCTs were included. Lactobacillus acidophilus showed no efficacy in preventing TD except when mixed with other strains. Other genera of lactobacilli showed a protection rate of up to 39% against TD. Similarly, Saccharomyces cerevisiae and Saccharomyces boulardii have been effective in preventing TD.
CONCLUSION
Studies investigating probiotics as a preventive measure for TD remain limited. Only a few probiotics that reduce TD risk exist. Based on this systematic review and meta-analysis, specific probiotic strains, including L. acidophilus, L. rhamnosus, L. fermentum, S. cerevisiae, and S. boulardii, may prevent TD. The effect of additional probiotic strains on TD prevention must be further investigated.
Topics: Probiotics; Humans; Diarrhea; Travel; Randomized Controlled Trials as Topic; Saccharomyces boulardii
PubMed: 38458507
DOI: 10.1016/j.tmaid.2024.102703 -
The Cochrane Database of Systematic... Oct 2013Chronic venous insufficiency (CVI) is a common problem, affecting up to 50% of the population in industrialised countries. It is a chronic condition which, if untreated,... (Review)
Review
BACKGROUND
Chronic venous insufficiency (CVI) is a common problem, affecting up to 50% of the population in industrialised countries. It is a chronic condition which, if untreated, can progress to serious complications that in turn can interfere with working ability. Standing at work is a known risk factor for CVI, yet the true effect of non-pharmacological preventive strategies remains unknown. This is an update of a review first published in 2012.
OBJECTIVES
To assess the efficacy of non-pharmacological strategies and devices to prevent CVI in a standing worker population.
SEARCH METHODS
For this update the Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched September 2013) and CENTRAL (2013, Issue 8). We also handsearched reference lists of relevant studies.
SELECTION CRITERIA
Randomised and non-randomised controlled trials that recruited standing workers to evaluate non-pharmacological devices or strategies used to prevent CVI were eligible for inclusion. Trials had to report an objective measure of clinical features of CVI or complaints associated with this condition in order to be included.
DATA COLLECTION AND ANALYSIS
Selection of the trials, quality assessment and data abstraction were completed independently by two review authors. We resolved disagreements by discussion. Only one trial was eligible for inclusion in the review so we did not perform meta-analyses.
MAIN RESULTS
The primary outcomes of this review were clinical features of CVI and its associated symptoms. No new included studies were identified for this update. One prospective cross-over trial was included in this review. It measured the effect of no compression followed by two phases with different gradients of compression stockings on symptoms in 19 female flight attendants who were required to stand, almost continuously, for long periods of time. The included study provided some evidence that compression stockings improved symptoms of leg fatigue in standing workers. However, the strength of the evidence in this review is weak as it is based on only one very small trial which was at high risk of bias. The included study did not address any of the secondary outcomes including quality of life or economic impact of the interventions. Nor did the study report the length of time that the population were required to stand at work. Furthermore, no trials were found which measured the effectiveness of other non-pharmacological interventions or strategies aimed at preventing CVI in standing workers.
AUTHORS' CONCLUSIONS
Due to the extremely limited number of trials, there is insufficient evidence to draw any conclusions about the effectiveness of non-pharmacological interventions for preventing CVI in standing workers. Further large-scale studies examining all possible non-pharmacological interventions and outcomes are required.
Topics: Air Travel; Chronic Disease; Cross-Over Studies; Female; Humans; Occupational Diseases; Posture; Prospective Studies; Stockings, Compression; Venous Insufficiency
PubMed: 24127117
DOI: 10.1002/14651858.CD006345.pub3 -
Canadian Family Physician Medecin de... Oct 2002To review recent evidence on dietary factors associated with diverticular disease (DD) with special emphasis on dietary fibre. (Review)
Review
OBJECTIVE
To review recent evidence on dietary factors associated with diverticular disease (DD) with special emphasis on dietary fibre.
QUALITY OF EVIDENCE
MEDLINE was searched from January 1966 to December 2001 for articles on the relationship between dietary and other lifestyle factors and DD. Most articles either focused on dietary intervention in treating symptomatic DD or were case-control studies with inherent limitations for studying diet-disease associations. Only one large prospective study of male health professionals in the United States assessed diet at baseline and before initial diagnosis of DD.
MAIN MESSAGE
A diet high in fibre mainly from fruits and vegetables and low in total fat and red meat decreases risk of DD. Evidence indicates that the insoluble component of fibre is strongly associated with lower risk of DD; this association was particularly strong for cellulose. Caffeine and alcohol do not substantially increase risk of DD, nor does obesity, but higher levels of physical activity seem to reduce risk of DD.
CONCLUSION
A diet high in fibre and low in total fat and red meat and a lifestyle with more physical activity might help prevent DD.
Topics: Dietary Fats; Dietary Fiber; Diverticulitis; Evidence-Based Medicine; Exercise; Fruit; Humans; Life Style; Meat; Vegetables
PubMed: 12449547
DOI: No ID Found