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Prevalence and risk factors for food allergy in older people: protocol for a systematic review

Por: Laia-Dias · I. · Lozoya-Ibanez · C. · Skypala · I. · Gama · J. M. R. · Nurmatov · U. · Lourenco · O. · Taborda-Barata · L.
Introduction

Studies suggest that the prevalence of food allergy may be increasing worldwide. Results regarding the prevalence and features of adverse food reactions older people have, however, scarcely been analysed in the literature. Thus, the objective of the present systematic review will be to describe the prevalence of food allergy in older individuals, its risk factors, clinical features, as well as the most frequently and commonly involved foods.

Methods and analysis

We will conduct a systematic review and meta-analysis of the incidence, prevalence and risk factors for food allergy in older individuals. We will search international electronic databases including MEDLINE, EMBASE, Cochrane Library, CINAHL, AMED and ISI Web of Science for published, unpublished and ongoing studies from 1980 toJanuary 2019. There will be no restriction on the language or geography of publication. We will use the critical appraisal skills programme quality assessment tool to appraise the methodological quality of included studies. A descriptive summary with data tables will be elaborated, and if deemed clinically relevant and statistically adequate, meta-analysis using random-effects modelling will be carried out, given the expected clinical, methodological and statistical heterogeneity of studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will guide reporting of the systematic review.

Ethics and dissemination

Since this systematic review will be solely based on published and retrievable literature, no ethics approval will be obtained. This study will allow us to draw up-to-date estimates of the prevalence of adverse food reactions in older individuals, worldwide, besides allowing the identification of its major risk factors, clinical manifestations and predominant foods responsible for such reactions. A multidisciplinary team has been assembled for this systematic review and will participate in relevant dissemination activities, namely reports, publications and presentations.

PROSPERO registration number

CRD42018102140

PREVALENCE OF SPONTANEOUS, INDUCED LABOUR OR PLANNED CAESAREAN SECTION AND FACTORS ASSOCIATED WITH CAESAREAN SECTION IN LOW-RISK WOMEN IN SOUTHERN BRAZIL

A global epidemic of caesarean section has been observed in the last decades, characterized by the high growth of rates internationally (Boerma et al., 2018). When analyzing the Brazilian situation, the evolution of caesarean rates shows an upward growth, in addition to presenting one of the highest caesarean rates found in the world (Betrán et al., 2016). In the 1970s, the first records in Brazil showed a rate of 15.0%, which rose to 40.2% in the 90s and reached the apex in 2014, with 57.0% of births by caesarean (Brasil, 2014a; Victora et al., 2011).

La salud del hombre en la perspectiva de la sexualidad: un relato de experiencia

La salud del hombre ha sido tema ampliamente discutido en los últimos años, especialmente tras la creación de la Política Nacional de Atención Integral a la Salud del Hombre (PNAISH) por el Ministerio de Salud en el año 2009. De esta forma, este artículo tiene por objeto relatar la experiencia de la salud actuación de los residentes multiprofesionales en salud de la familia en la implantación y desarrollo de un grupo de educación en salud con hombres en una Unidad de Salud de la Familia, sobre la temática de la sexualidad. Se determinó la realización de encuentros semanales, con un grupo de hombres de riesgo, que solían encontrarse cerca de sus residencias, en la calzada, debajo de un árbol, ociosos, generalmente alcohólicos, y haciendo uso del tabaco y en su mayoría con problemas sociales, psicológicos y familiares y que no buscaban los servicios de salud. A partir de eso, se inició el proceso de realización de acciones de promoción en salud con los sujetos elegidos. Se percibió la importancia del uso de metodologías innovadoras que traspasen la transferencia de informaciones para abordar cuestiones como la sexualidad, lo que sirvió para estrechar vínculos entre hombres y servicios de salud, así como para discutir cuestiones que todavía se denominan tabúes.

Interaction between leukocyte aldo-keto reductase 1C3 activity, genotypes, biological, lifestyle and clinical features in a prostate cancer cohort from New Zealand

by Nishi Karunasinghe, Eva Symes, Amy Gamage, Alice Wang, Pam Murray, Shuotun Zhu, Megan Goudie, Jonathan Masters, Lynnette R. Ferguson

Introduction

Aldo-keto reductase 1C3 (AKR1C3) is known for multiple functions including its catalytic activity towards producing extra-testicular androgen. The present study is towards understanding interaction between biological, lifestyle and genetic impacts of AKR1C3 and their influence on clinical factors in a prostate cancer (PC) cohort from New Zealand (NZ).

Method

Characteristics of 516 PC patients were collected from the Auckland Regional Urology Facility, NZ. These men were genotyped for the AKR1C3 rs12529 single nucleotide polymorphism (SNP). The leukocyte AKR1C3 activity was measured in a sub-cohort. Variability of leukocyte AKR1C3 activity between biological, lifestyle and clinical features as well as correlation between biological and clinical features were assessed with and without genetic stratification.

Results

The leukocyte AKR1C3 activity was associated with age at diagnosis (0.51 vs 0.34 μM coumberol units for >69y vs ≤69y, P = 0.03); and with anatomic stage/prognostic grouping among the AKR1C3 rs12529 CC genotype carriers (0.50 vs 28 μM coumberol units among low- and high-risk groups respectively, P = 0.02). Significant correlation between leukocyte AKR1C3 activity and age at PC diagnosis was also observed (correlation coefficient 0.20 and P = 0.02). Ever- smoking impacted both age and PSA at PC diagnosis among AKR1C3 rs12529 GG and CG genotype carriers respectively. Age at diagnosis significantly correlated with PSA at diagnosis in the main (correlation coefficient 0.29, and PAKR1C3 rs12529 CG and GG genotypes in both the main (correlation coefficient 0.30, and P Conclusions

Age dependent PSA thresholds in PC screening could have been valid only in men carrying the AKR1C3 rs12529 CG and GG genotypes in this NZ cohort.

Cohort Profile: Perinatal depression and child socioemotional development ; the Bachpan cohort study from rural Pakistan

Por: Sikander · S. · Ahmad · I. · Bates · L. M. · Gallis · J. · Hagaman · A. · ODonnell · K. · Turner · E. L. · Zaidi · A. · Rahman · A. · Maselko · J.
Purpose

This is a prospective pregnancy–birth cohort designed to investigate the effects of depression on socioemotional development of children. Perinatal depression is a risk factor for poor child development and for many it has a recurring chronic course. Thus, the exposure to depression can continue through the early years of the child with detrimental developmental outcomes.

Participants

Between October 2014 and February 2016, we recruited 1154 pregnant women from a rural subdistrict of Pakistan. Data include longitudinal and repeated measures of maternal psychosocial measures and child growth, cognitive and socioemotional measures. Follow-up include mother–child dyad assessments at 3rd, 6th, 12th, 24th and 36th months of child age. All these follow-ups are community based at the household level. We have competed baseline assessment.

Findings to date

Of the eligible dyads, we followed 885 (76.6%), 929 (91%) and 940 (93.3%) at 3, 6 and 12 months post-childbirth. We include a subsample mother–child dyad DNA and inflammatory biomarkers, 73 and 104, respectively.

Future plans

While we continue to do 24-month and 36-month follow-up assessments, we plan to follow these mother–child dyads up to the age of 7–8 years with some children being exposed to at least 1 year of school environment. Investigators interested in learning more about the study can contact (jmaselko@unc.edu) and (siham.sikander@hdrfoundation.org).

Evaluating 3D-printed models of coronary anomalies: a survey among clinicians and researchers at a university hospital in the UK

Por: Lee · M. · Moharem-Elgamal · S. · Beckingham · R. · Hamilton · M. · Manghat · N. · Milano · E. G. · Bucciarelli-Ducci · C. · Caputo · M. · Biglino · G.
Objective

To evaluate the feasibility of three-dimensional (3D) printing models of coronary artery anomalies based on cardiac CT data and explore their potential for clinical applications.

Design

Cardiac CT datasets of patients with various coronary artery anomalies (n=8) were retrospectively reviewed and processed, reconstructing detailed 3D models to be printed in-house with a desktop 3D printer (Form 2, Formlabs) using white resin.

Setting

A University Hospital (division of cardiology) in the UK.

Participants

The CT scans, first and then 3D-printed models were presented to groups of clinicians (n=8) and cardiovascular researchers (n=9).

Intervention

Participants were asked to assess different features of the 3D models and to rate the models’ overall potential usefulness.

Outcome measures

Models were rated according to clarity of anatomical detail, insight into the coronary abnormality, overall perceived usefulness and comparison to CT scans. Assessment of model characteristics used Likert-type questions (5-point scale from ‘strongly disagree’ to ‘strongly agree’) or a 10-point rating (from 0, lowest, to 10, highest). The questionnaire included a feedback form summarising overall usefulness. Participants’ imaging experience (in a number of years) was also recorded.

Results

All models were reconstructed and printed successfully, with accurate details showing coronary anatomy (eg, anomalous coronary artery, coronary roofing or coronary aneurysm in a patient with Kawasaki syndrome). All clinicians and researchers provided feedback, with both groups finding the models helpful in displaying coronary artery anatomy and abnormalities, and complementary to viewing 3D CT scans. The clinicians’ group, who had substantially more imaging expertise, provided more enthusiastic ratings in terms of models’ clarity, usefulness and future use on average.

Conclusions

3D-printed heart models can be feasibly used to recreate coronary artery anatomy and enhance understanding of coronary abnormalities. Future studies can evaluate their cost-effectiveness, as well as potentially explore other printing techniques and materials.

Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care

Por: Lazzerini · M. · Senanayake · H. · Mohamed · R. · Kaluarachchi · A. · Fernando · R. · Sakalasuriya · A. · Ihsan · F. R. · Saravanabhava · N. · Gamaathige · N. · Jayawardane · M. · Gamage · R. V. · Covi · B. · Wanzira · H. · Businelli · C. · Piccoli · M.
Objectives

This study was aimed at piloting a prospective individual patient database on hospital deliveries in Colombo, Sri Lanka, and at exploring its use for developing recommendations for improving quality of care (QoC).

Design

Observational study.

Setting

De Soysa Maternity Hospital, the largest referral hospital for maternity care in Sri Lanka.

Data collection and analysis

From July 2015 to June 2017, 150 variables were collected for each delivery using a standardised form and entered into a database. Data were analysed every 8 months, and the results made available to local staff. Outcomes of the study included: technical problems; data completeness; data accuracy; key database findings; and use of data.

Results

7504 deliveries were recorded. No technical problem was reported. Data completeness exceeded that of other existing hospital recording systems. Less than 1% data were missing for maternal variables and less than 3% for newborn variables. Mistakes in data collection and entry occurred in 0.01% and 0.09% of maternal and newborn data, respectively. Key QoC indicators identified in comparison with international standards were: relatively low maternal mortality (0.053%); relatively high maternal near-miss cases (3.4%); high rate of induction of labour (24.6%), caesarean section (30.0%) and episiotomy (56.1%); relatively high rate of preterm births (9.4%); low birthweight rate (16.5%); stillbirth (0.97%); and of total deaths in newborn (1.98%). Based on key indicators identified, a list of recommendations was developed, including the use checklists to standardise case management, training, clinical audits and more information for patients. A list of lessons learnt with the implementation of the data collection system was also drawn.

Conclusions

The study shows that the implemented system of data collection can produce a large quantity of reliable information. Most importantly, this experience provides an example on how database findings can be used for discussing hospital practices, identifying gaps and to agree on recommendations for improving QoC.

Perceived HIV‐related physical fatigue, sociodemographic characteristics and physical activity : a cross‐sectional study

Abstract

Aims and objectives

The aim of this study was to get a deeper understanding of correlates of perceived HIV‐related fatigue by exploring its associations with sociodemographic characteristics and physical activity level of HIV‐infected people.

Background

Previous studies on HIV‐related fatigue have mainly focused on physiological and psychological characteristics, but few have considered its associations with sociodemographic variables. In addition, while physical activity has been found to reduce acute fatigue among HIV‐infected people, its links with chronic HIV‐related fatigue remain to be explored.

Design

The study employed an observational and cross‐sectional survey design. The manuscript was organized according to STROBE guidelines.

Method

A total of 560 people living with HIV in France completed a measure of perceived physical fatigue using the Fatigue Intensity Scale. The predictors targeted sociodemographic characteristics and two measures of individuals’ reported level of physical activity. Data were analyzed by a stepwise multiple regression model.

Results

The results showed that lower age, higher physical activity level and socioeconomic status were significantly associated with reduced perceived physical fatigue, explaining 25% of the variance.

Conclusions

The results highlighted the importance of considering sociodemographic and lifestyle characteristics to better characterize HIV‐related fatigue, in particular in an era where HIV as a chronic illness challenges questions of quality of life throughout increasingly longer lifespans.

Relevance to clinical practice

The results of this study have implications for HIV care professionals in terms of improving strategies for managing chronic fatigue or promoting physical activity according to more specific profiles of HIV‐infected people.

This article is protected by copyright. All rights reserved.

Factors affecting Pap smear uptake in a maternity hospital: A descriptive cross‐sectional study 影响妇产医院子宫颈抹片检查增长的因素:描述性横断面研究

Abstract

Aim

To understand factors that influence women's decisions to go for Pap smears.

Background

Globally, cervical cancer is the fourth most common cancer among women. In Singapore, cervical cancer is on the rise and has been found to be the eighth highest cause of death among women. Research has shown that regular screening for cervical cancer with Pap smear reduces cervical cancer‐related mortality. However, Pap smear awareness is still limited and its uptake in Singapore is highly opportunistic, requiring the need for a deeper understanding of the factors that influence Pap smear uptake among women in Singapore.

Design

A descriptive cross‐sectional study design was used.

Methods

Convenience sampling was used to recruit 350 participants (postnatal women of at least 21 years old) from a local maternity hospital. Data were collected using validated questionnaires. Logistic regression was used to analyse the data.

Results

Demographic factors, such as age, ethnicity and religion, as well as women's beliefs about the effectiveness of Pap smear in detecting cervical cancer, the desire to discover health problems early and considering Pap smear to be painful, were found to be factors significantly influencing Pap smear uptake. Healthcare professionals need to be mindful of these factors to address women's needs to encourage women to go for Pap smears.

Conclusion

Various factors were found to influence Pap smear uptake. Future interventions can take these factors into account for increasing Pap smear awareness.

目标

了解影响女性决定接受子宫颈抹片检查的因素。

背景

在全球范围内,宫颈癌是女性中的第四大常见癌症。在新加坡,宫颈癌患者也正在增加,并且已确定是导致女性死亡的第八大原因。研究表明,用子宫颈抹片检查定期筛查宫颈癌可降低宫颈癌相关死亡率。然而,接受子宫颈抹片检查的意识仍然有限,并且新加坡检查数量增加也是高度机会主义的。所以需要更深入地了解影响新加坡女性子宫颈抹片检查增加的因素。

设计

使用描述性横断面研究设计

方法

使用便利样本从当地妇产医院招募350名受试者(21岁以上的产后妇女)。使用有效问卷收集数据,并应用逻辑回归分析数据。

结果

人口统计学因素(如年龄、种族和宗教等)、妇女对子宫颈抹片检测宫颈癌有效性的信心、早期发现健康问题的愿望,以及认为子宫颈抹片检查具有高疼痛性是影响子宫颈抹片检查增长的主要因素。专业医疗人员需要注意这些因素,以满足女性需求,鼓励她们进行子宫颈抹片检查。

结论

发现了影响子宫颈抹片检查增长的各种因素。未来的干预措施可以将这些因素考虑在内,以增加接受子宫颈抹片检查的意识。

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