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Determinants of hormone therapy uptake and decision-making after bilateral oophorectomy (BO): A narrative review.
Siyam, T, Carbon, J, Ross, S, Yuksel, N
Maturitas. 2019;:68-76
Abstract
Objective Early surgical menopause (≤45 years) can have significant short- and long-term health consequences. Hormone therapy (HT) is recommended for women with no contraindications. However, HT is greatly underutilized among these women due to their fear of the associated risks. The objective of this study is to identify and describe determinants of HT uptake and decision-making in women after surgical menopause. Methods We searched Medline, EMBASE, and CINAHL, from inception to April 2018, to identify relevant literature. Inclusion criteria included studies that assessed factors affecting the uptake of HT and decision-making about HT after surgical menopause. Studies including both women with natural and surgical menopause were included. Search terms were derived from 3 main concepts: surgical menopause, hormone therapy, and decision-making. Papers included in the review had to be in the English language and to report human studies. Results Of the 1952 articles identified, 23 were eligible for inclusion. Studies were mostly published before the WHI (61%) and had a quantitative cross-sectional study design. Only 22% focused on surgical menopause per se. The mean age at time of surgical menopause was 43.6 years (range 29-68). HT uptake was associated with younger age, higher level of education, higher income and adopting positive lifestyle behaviors. Factors affecting decision-making were mostly perceptions, beliefs, and values women associate with HT, as well as knowledge of and experiences with HT and surgical menopause. External factors related to physicians' recommendations and information sources also influenced HT decision-making. Conclusion Our review highlights the complex nature of decision-making about HT after surgical menopause and the numerous factors involved. Women tend to rely on subjective perceptions and inferences from information sources, which may hamper the ability to make informed treatment decisions. There is a need for tailored decision-aid interventions to help support women and guide informed treatment decisions.
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2.
Cardiovascular Disease Healthcare Utilization in Sub-Saharan Africa: A Scoping Review.
Chikafu, H, Chimbari, MJ
International journal of environmental research and public health. 2019;(3)
Abstract
Sub-Saharan African (SSA) countries face a growing burden of cardiovascular disease (CVD), attributed to economic, nutritional, demographic, and epidemiological transitions. These factors increase the prevalence of CVD risk factors, and the CVD burden overlaps with a high prevalence of infectious diseases. This review aimed to understand CVD healthcare utilization determinants and levels in SSA. We conducted a systematic search of the literature on major databases for the period 2008⁻2018 using exhaustive combinations of CVD and utilization indicators as search terms. Eighteen studies from eight countries were included in this review. Most studies (88.8%) followed the quantitative methodology and largely focused on inpatient stroke care. Two-thirds of patients sought care within 24 h of suffering a stroke, and the length of stay (LOS) in hospital ranged between 6 and 81 days. Results showed a rising trend of CVD admissions within total hospital admissions. Coverage of physiotherapy services was limited and varied between countries. While few studies included rural populations, utilization was found to be negatively associated with rural residence and socioeconomic status. There is a need to extend healthcare provision in SSA to ensure access to the CVD continuum of care.
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Obesity: Are shared medical appointments part of the answer?
Shibuya, K, Pantalone, KM, Burguera, B
Cleveland Clinic journal of medicine. 2018;(9):699-706
Abstract
Shared medical appointments, in which a multidisciplinary team of healthcare providers meets with multiple patients in a group setting, may be an option for treating patients with obesity. To be effective, shared medical appointments need to address patients' nutrition, physical activity, appetite suppression, stress management, and sleep.
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The acceptability and tolerability of nasal douching in children with allergic rhinitis: A systematic review.
Gutiérrez-Cardona, N, Sands, P, Roberts, G, Lucas, JS, Walker, W, Salib, R, Burgess, A, Ismail-Koch, H
International journal of pediatric otorhinolaryngology. 2017;:126-135
Abstract
BACKGROUND Allergic rhinitis (AR) is a significant issue in children. Treatment options include allergen avoidance, pharmacotherapy and immunotherapy. The use of nasal saline douching (NSD) in children has recently gained acceptability. However, there is limited data regarding the acceptability and tolerability of NSD in children with AR. METHODS A search was conducted using Medline and Embase databases from January 1946 until June 2015 on the use of NSD in children aged 4-12 years with AR. All publications identified that assessed the beneficial effects, acceptability and tolerability were included. RESULTS 40 studies were analyzed. Data varied considerably in terms of saline solutions used, modality of application, participant numbers, study design, follow up and outcomes. Factors that appear to influence the acceptability and tolerability of NSD include parental and health professionals' preconceptions, and characteristics of the solution. CONCLUSIONS Nasal saline douching appears to be effective, being accepted and tolerated in the majority of children (78-100%). NSD has a significant positive impact on the quality of life in children with allergic rhinitis. When used as an adjunctive treatment having mainly a cleansing property, NSD potentiates the effects and may reduce the dose required of AR medications. Among the principal factors that influence the acceptability and tolerability of NSD are the child's age, delivery system and method, and tonicity. Nasal saline douching provides an accessible, low cost, low morbidity, easy to use treatment in children with allergic rhinitis.
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Biases in Recommendations for and Acceptance of Prostate Biopsy Significantly Affect Assessment of Prostate Cancer Risk Factors: Results From Two Large Randomized Clinical Trials.
Tangen, CM, Goodman, PJ, Till, C, Schenk, JM, Lucia, MS, Thompson, IM
Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2016;(36):4338-4344
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Abstract
Purpose To identify factors related to who undergoes a prostate biopsy in a screened population and to estimate the impact of biopsy verification on risk factor-prostate cancer associations. Patients and Methods Men who were screened regularly from the placebo arms of two large prostate cancer prevention trials (Prostate Cancer Prevention Trial [PCPT] and Selenium and Vitamin E Cancer Prevention Trial [SELECT]) were examined to define incident prostate cancer cohorts. Because PCPT had an end-of-study biopsy, prostate cancer cases were categorized by a preceding prostate-specific antigen/digital rectal examination prompt (yes/no) and noncases by biopsy-proven negative status (yes v no). We estimated the association of risk factors (age, ethnicity, family history, body mass index, medication use) with prostate cancer and quantified differences in risk associations across cohorts. Results Men 60 to 69 years of age, those with benign prostatic hyperplasia, and those with a family history of prostate cancer were more likely, and those with a higher body mass index (≥ 25), diabetes, or a smoking history were less likely, to undergo biopsy, adjusting for age and longitudinal prostate-specific antigen and digital rectal examination. Medication use, education, and marital status also influenced who underwent biopsy. Some risk factor estimates for prostate cancer varied substantially across cohorts. Black ( v other ethnicities) had odds ratios (ORs) that varied from 1.20 for SELECT (community screening standards, epidemiologic-like cohort) to 1.83 for PCPT (end-of-study biopsy supplemented with imputed end points). Statin use in SELECT provided an OR of 0.65 and statin use in in PCPT provided an OR of 0.99, a relative difference of 34%. Conclusion Among screened men enrolled in prostate cancer prevention trials, differences in risk factor estimates for prostate cancer likely underestimate the magnitude of bias found in other cohorts with varying screening and biopsy recommendations and acceptance. Risk factors for prostate cancer derived from epidemiologic studies not only may be erroneous but may lead to misdirected research efforts.
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Colorectal Cancer in the Arab World--Screening Practices and Future Prospects.
Arafa, MA, Farhat, K
Asian Pacific journal of cancer prevention : APJCP. 2015;(17):7425-30
Abstract
Colorectal cancer (CRC) incidence and mortality rates have dropped 30% in the US in the last 10 years among adults ages 50 and older due to the widespread uptake of colonoscopy, yet incidences in the Arab countries have been increasing in the past ten years, albeit with lower figures when compared with developed countries. Lifestyle changes, food consumption patterns and obesity have been observed during the past years where the regular consumption of traditional foods is being replaced with more Western-style and ready-made foods. Most high income countries have implemented population based colorectal cancer screening programs, which aid in decreasing the incidence and mortality of cancer, while these are lacking in most of the Arab world countries due to many cultural and religious barriers to CRC screening as well as lack of high education or familiarity. What is needed is health education to modify risky lifestyle, and to increase motives and enhance positive attitudes towards early screening especially amongst high risk groups in addition to policy designed to encourage healthier living.
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The impact of conditional cash transfers on child health in low- and middle-income countries: a systematic review.
Owusu-Addo, E, Cross, R
International journal of public health. 2014;(4):609-18
Abstract
OBJECTIVES The review aimed to assess the effectiveness of conditional cash transfers (CCTs) in improving child health in low- and middle-income countries. METHODS Seven electronic databases were searched for papers: MEDLINE, EMBASE, PubMed, PsychINFO, BIOSIS Previews, Academic Search Complete, and CSA Sociological Abstracts. The included studies comprised of randomised controlled trials and controlled before-and-after studies evaluating the impact of CCTs on child health. Due to the substantial heterogeneity of the studies, a narrative synthesis was conducted on the extracted data. RESULTS Sixteen studies predominantly from Latin American countries met the inclusion criteria. The outcomes reported by the studies in relation to CCTs' effectiveness in improving child health were reduction in morbidity risk, improvement in nutritional outcomes, health services utilisation, and immunisation coverage. CONCLUSIONS The review suggests that to a large extent, CCTs are effective in improving child health by addressing child health determinants such as access to health care, child and maternal nutrition, morbidity risk, immunisation coverage, and household poverty in developing countries particularly middle-income countries. Of importance to both policy and practice, it appears that CCTs require effective functioning of health care systems to effectively promote child health.
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Incentives and barriers to lifestyle interventions for people with severe mental illness: a narrative synthesis of quantitative, qualitative and mixed methods studies.
Roberts, SH, Bailey, JE
Journal of advanced nursing. 2011;(4):690-708
Abstract
AIM: To examine the evidence for incentives and barriers to lifestyle interventions for people with severe mental illness. BACKGROUND People with severe mental illnesses, particularly those with schizophrenia, have poorer physical health than the general population with increased mortality and morbidity rates. Social and lifestyle factors are reported to contribute to this health inequality, though antipsychotic therapy poses additional risk to long-term physical health. Many behavioural lifestyle interventions including smoking cessation, exercise programmes and weight-management programmes have been delivered to this population with promising results. Surprisingly little attention has been given to factors that may facilitate or prevent engagement with these interventions in this population. DATA SOURCES Eight electronic databases were searched [1985-March 2009] along with the Cochrane Library and Google Scholar. Electronic 'hand' searches of key journals and explosion of references were undertaken. REVIEW METHODS A narrative synthesis of qualitative, quantitative and mixed-methods studies was undertaken. RESULTS No studies were identified that specifically explored the incentives and barriers to participation in lifestyle intervention for this population. Existing literature report some possible incentives and barriers including: illness symptoms, treatment effects, lack of support and negative staff attitudes as possible barriers; and symptom reduction, peer and staff support, knowledge, personal attributes and participation of staff as possible incentives. CONCLUSIONS Healthcare professionals, in particular nurses, should consider issues that may hinder or encourage individuals in this clinical group to participate in lifestyle interventions if the full benefits are to be achieved. Further research is needed to explore possible incentives and barriers from the service users' own perspective.
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Psychological and psychosocial aspects of the solid organ transplant experience--a practice review.
Rainer, JP, Thompson, CH, Lambros, H
Psychotherapy (Chicago, Ill.). 2010;(3):403-12
Abstract
There is an increasing need for empirically based psychotherapy interventions for individuals and their caregiving systems undergoing the solid organ transplant process. Research suggests that the organ transplant recipient experiences an improvement in physical and social functioning and return to daily activities, but not consistently positive change in psychological health. The transplantation process leaves the recipient with a mixture of distressing and challenging experiences. Three temporal stages have been identified in the process: the pretransplant stage, preoperative/candidacy waiting period, and the posttransplant stage, each holding psychological and social issues. The construct of quality-of-life, identified by critical factors and benchmarks in the therapeutic process for transplant recipients, is defined differently in the medical and psychological literature. Differences are discussed in terms of therapeutic interventions. Caregivers are found to experience their own challenges when an intimate has a solid organ transplant. Therapeutic interventions for the caregiving system include stress management, psychoeducation, and repair of relational ruptures.
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Subjective well-being as a determinant of individuals' responses to symptoms: a biopsychosocial perspective.
Kirana, PS, Rosen, R, Hatzichristou, D
International journal of clinical practice. 2009;(10):1435-45
Abstract
BACKGROUND Although many models have been developed to explain health behaviour, differences in individual response to symptoms remain largely unexplained; moreover, they tend to underestimate affective (i.e., emotional) processes and they neglect the construct of well-being, despite its predominant role in the definition of health. AIM: The development of a novel conceptual framework to explain and predict variability in individuals' responses to symptoms, through a bio-psychosocial perspective, considering also the potential role of subjective well-being. MATERIALS & METHODS The most widely used health behaviour models were being reviewed, as well as their limitations. Based on the evidence in the literature, major domains that influence response to symptoms are identified and analysed. RESULTS A new conceptual framework that is not limited to explanation of common health behaviours such as treatment seeking or problem identification, but draws attention to a broad spectrum of individual reactions and experiences following the physical experience of a symptom or medical condition. The role of subjective well-being and its determinants are considered as a central concept in the proposed framework. DISCUSSION The present conceptual framework provides a comprehensive bio-psychosocial perspective on behavioural outcomes related to individual response to symptoms. CONCLUSION The proposed framework opens a new window to patient centred care. Research to evaluate the proposed framework may improve the quality of clinical care and overall patient satisfaction.