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Lifestyle-, environmental-, and additional health factors associated with an increased sperm DNA fragmentation: a systematic review and meta-analysis.
Szabó, A, Váncsa, S, Hegyi, P, Váradi, A, Forintos, A, Filipov, T, Ács, J, Ács, N, Szarvas, T, Nyirády, P, et al
Reproductive biology and endocrinology : RB&E. 2023;21(1):5
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The World Health Organization defines infertility as regular unprotected sexual intercourse without achieving conception within a year. In recent years, there has been a growing demand for functional, objective parameters reflecting fertility status more clearly than classical parameters. Of these, sperm DNA fragmentation (SDF) and the DNA fragmentation index – denoting the percentage of sperm with damaged DNA – seem to be of utmost importance. The aim of this study was to investigate all risk factors that may potentially be increasing SDF. This study is a systematic review and meta-analysis of one hundred and ninety articles. The earliest studies were published in 2003, and the latest in 2021. Results show that several modifiable risk factors negatively affect SDF, namely; a. health conditions: varicocele [when veins become enlarged inside the pouch of skin that holds the testicles] and impaired glucose tolerance, b. infections: Chlamydia, c. malignancies: testicular tumours, and d. lifestyle factors: smoking, alcohol consumption and body mass index. Authors conclude that several lifestyle-, environmental-, and additional health factors are associated with increased SDF.
Abstract
INTRODUCTION Infertility affects one in every six couples in developed countries, and approximately 50% is of male origin. In 2021, sperm DNA fragmentation (SDF) testing became an evidence-based test for fertility evaluations depicting fertility more clearly than standard semen parameters. Therefore, we aimed to summarize the potential prognostic factors of a higher SDF. METHODS We conducted a systematic search in three medical databases and included studies investigating any risk factors for SDF values. We calculated mean differences (MD) in SDF with 95% confidence interval (CI) for exposed and non-exposed individuals. RESULTS We included 190 studies in our analysis. In the group of associated health conditions, varicocele (MD = 13.62%, CI: 9.39-17.84) and impaired glucose tolerance (MD = 13.75%, CI: 6.99-20.51) had the most significant increase in SDF. Among malignancies, testicular tumors had the highest impact, with a maximum of MD = 11.3% (CI: 7.84-14.76). Among infections, the overall effects of both Chlamydia and HPV were negligible. Of lifestyle factors, smoking had the most disruptive effect on SDF - an increase of 9.19% (CI: 4.33-14.06). Different periods of sexual abstinence did not show significant variations in SDF values. Age seemed to have a more drastic effect on SDF from age 50 onwards, with a mean difference of 12.58% (CI: 7.31-17.86). Pollution also had a detrimental effect - 9.68% (CI: 6.85-12.52). CONCLUSION Of the above risk factors, varicocele, impaired glucose tolerance, testicular tumors, smoking, pollution, and paternal age of over 50 were associated with the highest SDF. TRIAL REGISTRATION CRD42021282533.
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Time of the day of exercise impact on cardiovascular disease risk factors in adults: a systematic review and meta-analysis.
Sevilla-Lorente, R, Carneiro-Barrera, A, Molina-Garcia, P, Ruiz, JR, Amaro-Gahete, FJ
Journal of science and medicine in sport. 2023;26(3):169-179
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In humans, shifted sleep patterns seem to interfere with several metabolic pathways. Shift work, short sleep duration, exposure to artificial light, inadequate eating time window, and lack of physical activity, are some characteristics of the modern lifestyle that contributes to the occurrence and worsening of cardiovascular disease (CVD). The aim of this study was to analyse the time of the day of exercise-induced effects on CVD risk factors in adults. This study was a systematic review and meta-analysis of twenty-two studies. Results showed that exercise produces an acute reduction of systolic blood pressure independently of the time of the day at which it is performed. Similarly, exercise produces an acute increase in blood glucose independently of the time of the day. Authors concluded that further research is needed to establish whether there is a diurnal variation of exercise on cardiovascular health and how it is related to health status, sex, or the type of exercise.
Abstract
OBJECTIVES To compare the effect of a single bout of morning vs. evening exercise on cardiovascular risk factors in adults. DESIGN Systematic review and meta-analysis. METHODS A systematic search of studies was conducted using PubMed and Web of Science from inception to June 2022. Selected studies accomplished the following criteria: crossover design, acute effect of exercise, blood pressure, blood glucose, and/or blood lipids as the study's endpoint, a washout period of at least 24 h, and adults. Meta-analysis was performed by analyzing: 1) separated effect of morning and evening exercise (pre vs. post); and 2) comparison between morning and evening exercise. RESULTS A total of 11 studies were included for systolic and diastolic blood pressure and 10 studies for blood glucose. Meta-analysis revealed no significant difference between morning vs. evening exercise for systolic blood pressure (g ∆ = 0.02), diastolic blood pressure (g ∆ = 0.01), or blood glucose (g ∆ = 0.15). Analysis of moderator variables (age, BMI, sex, health status, intensity and duration of exercise, and hour within the morning or evening) showed no significant morning vs. evening effect. CONCLUSIONS Overall, we found no influence of the time of the day on the acute effect of exercise on blood pressure neither on blood glucose.
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Cognitive stimulation and psychosocial results in older adults: A systematic review and meta-analysis.
Gómez-Soria, I, Iguacel, I, Cuenca-Zaldívar, JN, Aguilar-Latorre, A, Peralta-Marrupe, P, Latorre, E, Calatayud, E
Archives of gerontology and geriatrics. 2023;115:105114
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Individuals with dementia and brain function impairment may have difficulty in completing day-to-day tasks. Cognitive stimulation (CS), which involves brain processing activities such as puzzles, word games, and music normally performed in a group setting for around 45 minutes per week, has been shown to be a cost-effective therapy. This systematic review and meta-analysis of 30 studies aimed to analyse the effect of CS on quality of life (QoL). The results showed that personalised CS was associated with a significantly higher QoL, but had no effect on mood and depression, ability to perform daily activities, or mood and anxiety. Personalised CS improves QoL in older adults with healthy cognitive ageing, mild cognitive impairment, or dementia. This study could be used by healthcare professionals to recommend CS as a therapy for individuals with brain ageing, mild cognitive impairment, or dementia. For those who are also suffering from depression and low mood other strategies should be employed.
Abstract
INTRODUCTION Cognitive stimulation (CS) is a popular and cost-effective intervention, which applies different types of techniques focused on cognitive skills and can be administered by different professionals. CS can be defined as activities that involve cognitive processing usually conducted in a social context and often in a group. Therefore, CS can improve psychosocial functioning and quality of life (QoL), depression, anxiety and activities of daily living (ADLs) independent of the pharmacological treatment such as acetylcholinesterase inhibitors. The objective of this systematic review and meta-analysis was to evaluate the effects of CS on psychosocial outcomes in older adults (aged 65 years or over), with healthy cognitive ageing, mild cognitive impairment (MCI), and dementia. METHODS PubMed, Scopus and Web of Science databases were examined from inception to October 2021. A total of 1,997 studies were initially identified in these databases. After discarding studies that did not meet the inclusion criteria, 30 studies were finally included in the systematic review and the meta-analysis performed with robust variance estimator (RVE) due the inclusion of studies with repeated measurements. The quality assessment tools from the National Institutes of Health were used to evaluate the quality of the studies. RESULTS CS was significantly associated with a higher QoL in participants who received personalized/adapted CS (RVE = 0.11±0.19 [-0.76, 0.99], t(1.86) = 0.6, p = 0.61). . CONCLUSION Personalized/adapted CS seems to improve QoL in older adults.
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The neurological symptoms of COVID-19: a systematic overview of systematic reviews, comparison with other neurological conditions and implications for healthcare services.
Wildwing, T, Holt, N
Therapeutic advances in chronic disease. 2021;12:2040622320976979
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COVID-19 has been found to cause neurological manifestations in up to 50% of patients. The aim of this study was to inform future service provision for those who develop long-term neurological symptoms due to COVID-19, as well as exploring the effect of COVID-19 on health professionals’ perceptions towards those with symptoms of functional neurological disorder (FND). This study is a systematic overview of current systematic reviews which included 45 studies in qualitative synthesis. Results show that: - COVID-19 appears to be becoming chronic for some patients, presenting similar neurological symptoms to FND and to chronic fatigue syndrome; - the long-term neurological effects of COVID-19 may impact neurological and wider health care services; - the neurological symptoms seen in COVID-19 may affect health professionals’ perceptions of FND and chronic fatigue syndrome. Authors conclude that there is increasing evidence of the presence of long-COVID symptoms persisting beyond 3 months. Further research is recommended to explore whether the neurological symptoms of COVID-19 will improve acceptance and understanding of FND, or whether this will worsen the experience for those who suffer from FND.
Abstract
AIMS: In response to the rapid spread of COVID-19, this paper provides health professionals with better accessibility to available evidence, summarising findings from a systematic overview of systematic reviews of the neurological symptoms seen in patients with COVID-19. Implications of so-called 'Long Covid' on neurological services and primary care and similarities with other neurological disorders are discussed. METHODS Firstly, a systematic overview of current reviews of neurological symptoms of COVID-19 was conducted. Secondly, the implications of these findings are discussed in relation to the potential effect on neurological services and the similarities in the experience of patients with COVID-19 and those with other neurological disorders. A total of 45 systematic reviews were identified within seven databases, published between 11 April 2020 and 15 October 2020, following a search in June 2020, updated on 20 October 2020. RESULTS The results indicated that COVID-19 exhibits two types of neurological symptoms; life-threatening symptoms such as Guillain-Barre Syndrome (GBS) and encephalitis, and less devastating symptoms such as fatigue and myalgia. Many of these so-called lesser symptoms appear to be emerging as longer-term for some sufferers and have been recently labelled Long Covid. When compared, these less devastating symptoms are very similar to other neurological conditions such as chronic fatigue syndrome (CFS) and functional neurological disorder (FND). CONCLUSION Implications for neurological healthcare services in the United Kingdom (UK) may include longer waiting times and a need for more resources (including more qualified health professionals). There is also a possible change-effect on health professionals' perceptions of other neurological conditions such as CFS and FND. Future research is recommended to explore changes in health professionals' perceptions of neurological symptoms because of COVID-19.
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Digital Technology Interventions for Risk Factor Modification in Patients With Cardiovascular Disease: Systematic Review and Meta-analysis.
Akinosun, AS, Polson, R, Diaz-Skeete, Y, De Kock, JH, Carragher, L, Leslie, S, Grindle, M, Gorely, T
JMIR mHealth and uHealth. 2021;9(3):e21061
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Heart disease, stroke and their associated complications are a leading cause of death worldwide. Factors such as obesity, type 2 diabetes, smoking and inactivity all contribute to heart diseases, however these can be modified. Certain behavioural change strategies have been shown to be effective in reducing these diseases, however the emergence of the use of digital technologies to effect change needs to be better understood. This systematic review and meta-analysis aimed to determine the effectiveness of digital technology to affect change and highlight methods, which may be particularly effective. The results showed that the most researched digital device interventions were cell phones, smart phones, personal computers, and wearables coupled with the internet, SMS, and mobile sensors. Through these methods of delivery benefits were seen in total cholesterol, blood lipid concentrations, physical activity, and diet. However, there were no benefits to body mass index (BMI), blood pressure, blood sugar, alcohol intake, smoking or medication adherence. It was concluded that digital interventions may improve some clinical measures and behaviours, however some remained unaffected highlighting limitations of digital technology to affect change. This study could be used by healthcare professionals to understand that although digital interventions may help to change some aspects of behaviour, other support strategies may need to be employed in challenging cases.
Abstract
BACKGROUND Approximately 50% of cardiovascular disease (CVD) cases are attributable to lifestyle risk factors. Despite widespread education, personal knowledge, and efficacy, many individuals fail to adequately modify these risk factors, even after a cardiovascular event. Digital technology interventions have been suggested as a viable equivalent and potential alternative to conventional cardiac rehabilitation care centers. However, little is known about the clinical effectiveness of these technologies in bringing about behavioral changes in patients with CVD at an individual level. OBJECTIVE The aim of this study is to identify and measure the effectiveness of digital technology (eg, mobile phones, the internet, software applications, wearables, etc) interventions in randomized controlled trials (RCTs) and determine which behavior change constructs are effective at achieving risk factor modification in patients with CVD. METHODS This study is a systematic review and meta-analysis of RCTs designed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) statement standard. Mixed data from studies extracted from selected research databases and filtered for RCTs only were analyzed using quantitative methods. Outcome hypothesis testing was set at 95% CI and P=.05 for statistical significance. RESULTS Digital interventions were delivered using devices such as cell phones, smartphones, personal computers, and wearables coupled with technologies such as the internet, SMS, software applications, and mobile sensors. Behavioral change constructs such as cognition, follow-up, goal setting, record keeping, perceived benefit, persuasion, socialization, personalization, rewards and incentives, support, and self-management were used. The meta-analyzed effect estimates (mean difference [MD]; standard mean difference [SMD]; and risk ratio [RR]) calculated for outcomes showed benefits in total cholesterol SMD at -0.29 [-0.44, -0.15], P<.001; high-density lipoprotein SMD at -0.09 [-0.19, 0.00], P=.05; low-density lipoprotein SMD at -0.18 [-0.33, -0.04], P=.01; physical activity (PA) SMD at 0.23 [0.11, 0.36], P<.001; physical inactivity (sedentary) RR at 0.54 [0.39, 0.75], P<.001; and diet (food intake) RR at 0.79 [0.66, 0.94], P=.007. Initial effect estimates showed no significant benefit in body mass index (BMI) MD at -0.37 [-1.20, 0.46], P=.38; diastolic blood pressure (BP) SMD at -0.06 [-0.20, 0.08], P=.43; systolic BP SMD at -0.03 [-0.18, 0.13], P=.74; Hemoglobin A1C blood sugar (HbA1c) RR at 1.04 [0.40, 2.70], P=.94; alcohol intake SMD at -0.16 [-1.43, 1.10], P=.80; smoking RR at 0.87 [0.67, 1.13], P=.30; and medication adherence RR at 1.10 [1.00, 1.22], P=.06. CONCLUSIONS Digital interventions may improve healthy behavioral factors (PA, healthy diet, and medication adherence) and are even more potent when used to treat multiple behavioral outcomes (eg, medication adherence plus). However, they did not appear to reduce unhealthy behavioral factors (smoking, alcohol intake, and unhealthy diet) and clinical outcomes (BMI, triglycerides, diastolic and systolic BP, and HbA1c).
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Nutrition, Physical Activity, and New Technology Programs on Obesity Prevention in Primary Education: A Systematic Review.
Navidad, L, Padial-Ruz, R, González, MC
International journal of environmental research and public health. 2021;18(19)
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Obesity in children is increasing and low rates of activity and poor eating habits appear to be at the heart of the problem. New digital technologies and interventions to encourage physical activity are becoming popular and have been assessed in previous reviews, but none of these have focused on children. This systematic review aimed to determine the effectiveness of new digital technologies being used to encourage physical activity in primary school aged children. The results showed that using new digital technologies to improve eating habits and levels of physical activity were of benefit to primary school aged children, however this had limited effect on body mass index. It was concluded that the use of digital technologies in school aged children may be of benefit to health through the prevention of obesity. This study could be used by healthcare professionals to understand that obesity in children is increasing and the use of digital technology to improve physical activity and eating habits may be an effective strategy to combat this.
Abstract
Early acquisition of healthy lifestyle habits is crucial for good adult health. For this reason, the primary stage of education is a critical period to implement educational policies in this regard. The aim of this review is to compile the published evidence regarding school interventions at the primary stage aimed at preventing obesity, and which integrate as part of their action plan two features: an improvement in knowledge or nutrition habits and the promotion of physical activity (PA), and the use of new information and communications technologies (ICT) to do this. The method used for this review is the searching of different databases for publications that include these criteria. The results show beneficial effects of such interventions in improved eating habits and increased PA. The effect on BMI is limited, and the use of ICT can be of help at a motivational level for the maintenance and fulfilment of the health objectives. However, studies of this type in elementary school are very limited, so it would be necessary to continue researching on this line. In conclusion, this review demonstrates the suitability of carrying out mixed interventions (improved nutrition and PA) together with the use of new technologies to improve health and prevent obesity at an early age.
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COVID-19: Exposing and addressing health disparities among ethnic minorities and migrants.
Greenaway, C, Hargreaves, S, Barkati, S, Coyle, CM, Gobbi, F, Veizis, A, Douglas, P
Journal of travel medicine. 2020;27(7)
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The coronavirus disease 2019 (COVID-19) has swept across the world affecting all countries. As COVID-19 has spread within countries, vulnerable and marginalized populations, and those with low income and low socioeconomic status have been unduly affected. Every country has vulnerable populations that require special attention from policy makers in their response to the current pandemic. In fact, current literature shows that migrants living in refugee camps, detention centres and reception centres are at particularly high risk for COVID-19 exposure. Therefore, they should be included in national surveillance and be entitled to health care. In addition, it is essential to foster trust between public health practitioners and the leadership of these communities so that they may work together to effectively deliver prevention and intervention strategies. Authors conclude that COVID-19 pandemic has exposed health disparities among ethnic minorities and certain migrant groups. Thus, they highlight the importance of prompting greater health equity for diverse ethnocultural communities.
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COVID-19: Unique public health issues facing Black, Asian and minority ethnic communities.
Abuelgasim, E, Saw, LJ, Shirke, M, Zeinah, M, Harky, A
Current problems in cardiology. 2020;45(8):100621
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The 2019 coronavirus disease (COVID-19), is a public health emergency with serious adverse implications for populations, healthcare systems, and economies globally. The aim of this review was to explore the possible association between ethnicity, incidence and outcomes of COVID-19 using both recent COVID-19 studies and studies of previous pandemics. Findings show that: - ethnic minorities have lower lung function compared to their Caucasian counterparts. - Black, Asian and Minority Ethnics communities are prone to higher rates of cardiovascular disease and are subject to adverse healthcare disparities. - ethnic minorities are disproportionately affected, and experience worse health outcomes compared to other groups. They are also more likely to be socioeconomically disadvantaged compared to white communities. - Africans are at a higher risk of receiving later and more indigent healthcare compared to other ethnic groups. Authors conclude that data on ethnicity should be routinely collected by governments to robustly determine magnitude of association. In addition, governments should also recommend strategies to mitigate risks on minority ethnicities due to socioeconomic disadvantages.
Abstract
The 2019 coronavirus disease is a serious public health emergency, with serious adverse implications for populations, healthcare systems, and economies globally. Recently, concerns have been raised about possible association between ethnicity, incidence and outcomes of COVID-19 arisen from early government data. In this review, we will explore the possible association using both recent COVID-19 studies and studies of previous pandemics. We call for data on ethnicity to be routinely collected by governments, as part of an international collaboration, alongside other patient demographics and further research to robustly determine the magnitude of association. Moreover, governments must learn from previous pandemics and recommended strategies to mitigate risks on minority ethnicities due to socioeconomic disadvantages.
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The potential long-term impact of the COVID-19 outbreak on patients with non-communicable diseases in Europe: consequences for healthy ageing.
Palmer, K, Monaco, A, Kivipelto, M, Onder, G, Maggi, S, Michel, JP, Prieto, R, Sykara, G, Donde, S
Aging clinical and experimental research. 2020;32(7):1189-1194
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Individuals with non-communicable diseases (NCD's), i.e. diseases that are not transmitted from person to person, such as diabetes and heart disease, are at a much higher risk of death from Covid-19. But for individuals who contract Covid-19 and survive, there could be considerable implications on the progression of their pre-existing condition. This review study aimed to discuss how the Covid-19 pandemic might impact management and outcomes in individuals with NCD's. The paper outlined that higher Covid-19 death rates in individuals with NCD's, will cause a decline of these diseases within populations. Although there is little peer reviewed research to support this, circumstantial reports are already suggesting lower hospital admissions for stroke and heart attacks. However it should be noted that it is obvious that this paper was written at the start of the pandemic. The paper went on to discuss that the pandemic and subsequent government actions to control the infection will affect individuals with NCD's through reductions in physical activity, social interaction, and vitamin D intake. Changes to medical management, the subsequent possibility of decreased adherence to medications and the halting of much needed research on NCD's in favour of Covid-19 research, will further exacerbate the impact on individuals with pre-existing conditions. Finally, areas upon which the healthcare system and government should be focusing in order to help individuals with NCD's were discussed. Amongst these was the acknowledgement that the public and private healthcare systems have collaborated with success and this should continue and that on-going support through technology such as Telehealth services and patient advocacy associations is a necessity. Clinicians could use this paper to understand how Covid-19 could accelerate disease progression in individuals with NCD’s and that close monitoring is essential. For individuals with NCD’s who do not have Covid-19, close monitoring would still be required to ensure that government strategies to contain the virus do not exacerbate their condition.
Abstract
The early stages of the COVID-19 pandemic have focused on containing SARS-CoV-2 infection and identifying treatment strategies. While controlling this communicable disease is of utmost importance, the long-term effect on individuals with non-communicable diseases (NCD) is significant. Although certain NCDs appear to increase the severity of COVID-19 and mortality risk, SARS-CoV-2 infection in survivors with NCDs may also affect the progression of their pre-existing clinical conditions. Infection containment measures will have substantial short- and long-term consequences; social distancing and quarantine restrictions will reduce physical activity and increase other unhealthy lifestyles, thus increasing NCD risk factors and worsening clinical symptoms. Vitamin D levels might decrease and there might be a rise in mental health disorders. Many countries have made changes to routine management of NCD patients, e.g., cancelling non-urgent outpatient visits, which will have important implications for NCD management, diagnosis of new-onset NCDs, medication adherence, and NCD progression. We may have opportunities to learn from this unprecedented crisis on how to leverage healthcare technologies and improve procedures to optimize healthcare service provision. This article discusses how the COVID-19 outbreak and related infection control measures could hit the most frail individuals, worsening the condition of NCD patients, while further jeopardizing the sustainability of the healthcare systems. We suggest ways to define an integrated strategy that could involve both public institutional entities and the private sector to safeguard frail individuals and mitigate the impact of the outbreak.
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Coronavirus disease 2019 (COVID-19) and obesity. Impact of obesity and its main comorbidities in the evolution of the disease.
Cornejo-Pareja, IM, Gómez-Pérez, AM, Fernández-García, JC, Barahona San Millan, R, Aguilera Luque, A, de Hollanda, A, Jiménez, A, Jimenez-Murcia, S, Munguia, L, Ortega, E, et al
European eating disorders review : the journal of the Eating Disorders Association. 2020;28(6):799-815
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The Covid-19 pandemic has caused thousands of deaths worldwide. Being obese is associated with worse outcomes following infection with Covid-19. This review aimed to summarise the data available on the relationship between Covid-19 and obesity, and explored some of the possible reasons for this relationship. The researchers found that obesity is an independent and strong risk factor for severe infection, Intensive Care Unit (ICU) admission and death. The impact of obesity might be of particular relevance in males and in younger individuals. Long‐term complications of Covid‐19 could also be more frequent and severe in obese subjects. There are many potential mechanisms that could explain this relationship. These include the effects of obesity and related diseases such as diabetes, high blood pressure and heart disease on the immune system, lung function, vitamin D deficiency and male hormones. The researchers also discussed the possibility of fat cells acting as a possible reservoir for Covid-19 infection. Research into Covid-19 is still at a very early stage and more studies are needed.
Abstract
The COVID-19 pandemic is posing a great challenge worldwide. Its rapid progression has caused thousands of deaths worldwide. Although multiple aspects remain to be clarified, some risk factors associated with a worse prognosis have been identified. These include obesity and some of its main complications, such as diabetes and high blood pressure. Furthermore, although the possible long-term complications and psychological effects that may appear in survivors of COVID-19 are not well known yet, there is a concern that those complications may be greater in obese patients. In this manuscript, we review some of the data published so far and the main points that remain to be elucidated are emphasized.