scholarly journals A systematic review of population and community dietary interventions to prevent cancer

2007 ◽  
Vol 20 (1) ◽  
pp. 74-88 ◽  
Author(s):  
Margaret Thorogood ◽  
Iveta Simera ◽  
Elizabeth Dowler ◽  
Carolyn Summerbell ◽  
Eric Brunner
Keyword(s):  
Systematic Review ◽  
Vegetable Intake ◽  
Population Level ◽  
Dietary Interventions ◽  
Community Based Interventions ◽  
Effect Change ◽  
Positive Effects ◽  
Before And After ◽  
The Cost

Diet is an important factor in the causation of cancer. Previous systematic reviews of one-to-one interventions to encourage dietary change have found that such interventions can achieve modest improvements in diet. However, such interventions are resource intensive and unlikely to be good value for money at a population level. Interventions that address groups, communities or whole populations may be less resource intensive and effect change in a wider population. We report a systematic review of such interventions. We set wide inclusion criteria, including before-and-after studies and studies with a non-randomized comparison group as well as randomized trials. We found eighteen studies based in the community, seventeen based on worksites, five based in churches and one based in a supermarket. Interventions which targeted fruit and vegetable intake were most likely to be successful, particularly in worksites and churches. There was also evidence of small positive effects on reducing fat intake in worksites and churches. Overall the community-based interventions showed little effect. The studies included in the present review were generally poorly reported. Dietary changes are reported in the relatively short-term studies reviewed here but may not be sustained in the long term. The effects that we have identified are small but the reach is potentially very wide, in some cases as wide as a whole country. The cost effectiveness of such strategies remains to be evaluated.

Paradoxical population resilience of a keystone predator to a toxic invasive species

2020 ◽  
Vol 47 (3) ◽  
pp. 260
Author(s):  
J. Sean Doody ◽  
David Rhind ◽  
Simon Clulow
Keyword(s):  
Population Level ◽  
Population Monitoring ◽  
Cane Toad ◽  
Keystone Predator ◽  
Individual Effects ◽  
Before And After ◽  
Animal Communities ◽  
Better Than ◽  
Population Resilience

Abstract ContextThe invasive cane toad (Rhinella marina) has decimated populations of a keystone predator, the yellow-spotted monitor (Varanus panoptes), causing trophic cascades in Australian animal communities. Paradoxically, some V. panoptes populations coexist with toads. Demonstrating patterns in heterogeneous population-level impacts could reveal mechanisms that mediate individual effects, and provide managers with the ability to predict future impacts and assist in population recovery. AimsThe aim of the present study was to search for spatial patterns of population resilience of V. panoptes to invasive cane toads. MethodsPublished literature, unpublished data, reports and anecdotal information from trained herpetologists were used to test the emerging hypothesis that resilient predator populations are mainly coastal, whereas non-resilient populations are mostly inland. Key resultsPost-toad invasion data from 23 V. panoptes populations supported the idea that toad impacts on V. panoptes were heterogeneous; roughly half the populations could be designated as resilient (n=13) and half as non-resilient (n=10). Resilient populations had longer times since toad invasion than did non-resilient populations (39 versus 9 years respectively), supporting the idea that some recovery can occur. Non-resilient populations were exclusively inland (n=10), whereas resilient populations were split between inland (n=5) and coastal (n=8) populations. Resilient inland populations, however, were mainly confined to areas in which decades had passed since toad invasion. ConclusionsThe findings suggest that coastal V. panoptes populations fare much better than inland populations when it comes to surviving invading cane toads. ImplicationsUnambiguous recovery of monitor populations remains undemonstrated and will require long-term population monitoring before and after toad invasion.

scholarly journals The effect of exercise on anxiety in the elderly worldwide: a systematic review and meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mohsen Kazeminia ◽  
Nader Salari ◽  
Aliakbar Vaisi-Raygani ◽  
Rostam Jalali ◽  
Alireza Abdi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Elderly Care ◽  
Intervention Group ◽  
Exercise Program ◽  
The Elderly ◽  
Anxiety Score ◽  
Anxiety Reduction ◽  
Positive Effects ◽  
Before And After

Abstract Background Physical activity and exercise are among the most important, simplest, and cheapest approaches to anxiety treatment, especially for the elderly. Their positive effects on improvement of mental disorders in the elderly have attracted a considerable level of attention. Therefore, the present study was conducted to determine the effect of sport on reducing anxiety in the elderly using meta-analysis. Methods In this study, national and international databases of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science were searched to find studies published electronically from 1999 to 2019. Heterogeneity between the collected studies was determined using the Cochran's test (Q) and I2. Due to presence of heterogeneity, the random effects model was used to estimate the standardized mean difference of sport test scores obtained from the measurement of anxiety reduction among the elderly, between the intervention group before and after the test. Results In this meta-analysis and systematic review, 19 papers finally met the inclusion criteria. The overall sample size of all collected studies for the meta-analysis was 841 s. Mean anxiety score before and after intervention were 38.7 ± 5.6 33.7 ± 3.4 respectively, denoting a decrease in anxiety score after intervention. Conclusion Results of this study indicates that Sport significantly reduces Anxiety in the Elderly. Therefore, a regular exercise program can be considered as a part of the elderly care program.

scholarly journals Impact of 2013 ASCO/CAP guidelines on various HER2 reporting categories in breast cancer by fluorescent in-situ hybridization and Immunohistochemistry: A meta-analysis with systematic review

2020 ◽  
Vol 5 ◽  
pp. 14-26 ◽  
Author(s):  
Sunil Pasricha ◽  
Smita Asthana ◽  
Satyanarayana Labani ◽  
Uma Kailash ◽  
Abhinav Srivastav ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Paired Data ◽  
Treatment Benefit ◽  
Before And After ◽  
Primary Test ◽  
The Cost ◽  
The Impact

Objective: The ASCO/CAP guidelines for reporting HER2 in breast cancer, first released in 2007, aimed to standardize the reporting protocol, and were updated in 2013 and 2018, to ensure right treatment. Several studies have analyzed the changes attributed to 2013 updated guidelines, and majority of them found increase in positive and equivocal cases. However, the precise implication of these updated guidelines is still contentious, in spite of the latest update (2018 guidelines) addressing some of the issues. We conducted systematic review and meta- analysis to see the impact of 2013 guidelines on various HER2 reporting categories by both FISH and IHC. Materials and Methods: After extensively searching the pertinent literature, 16 studies were included for the systematic review. We divided our approach in three strategies: (1) Studies in which breast cancer cases were scored for HER2 by FISH or IHC as a primary test concurrently by both 2007 and 2013 guidelines, (2) Studies in which HER2 results were equivocal by IHC and were followed by reflex-FISH test by both 2007 and 2013 guidelines, and (3) Studies in which trends of HER2 reporting were compared in the two periods before and after implementation of updated 2013 guidelines. All the paired data in these respective categories was pooled and analyzed statistically to see the overall impact of the updated guidelines. Results: In the first category, by pooled analysis of primary FISH testing there has been a significant increase in the equivocal cases (P < 0.001) and positive cases (P = 0.037). We also found 8.3% and 0.8% of all the negative cases from 2007 guidelines shifted to equivocal and positive categories, respectively. Similarly by primary IHC testing there has been a significant increase in both equivocal cases (P < 0.001) and positive cases (P = 0.02). In the second category of reflex-FISH testing there was a substantial increase in the equivocal cases (P < 0.0001); however there is insignificant decrease (10% to 9.7%; P = 0.66) in the amplified cases. In the third approach for evaluating the trend, with the implementation of 2013 guidelines, there was increase in the equivocal category (P = 0.025) and positive category (P = 0.0088) by IHC. By FISH test also there was significant increase in the equivocal category (P < 0.001) while the increase in the positive category was non-significant (P = 0.159). Conclusions: The updated 2013 guidelines has significantly increased the positive and equivocal cases using primary FISH or IHC test and with further reflex testing, thereby increasing the double equivocal cases and increasing the cost and delaying the decision for definite management. However, whether the additional patients becoming eligible for HDT will derive treatment benefit needs to be answered by further large clinical trials.

scholarly journals Dietary interventions and cognition of Alzheimer’s disease patients: a systematic review of randomized controlled trial

2020 ◽  
Vol 14 (3) ◽  
pp. 258-282 ◽  
Author(s):  
Sophia Camargos Moreira ◽  
Ann Kristine Jansen ◽  
Flávia Moraes Silva
Keyword(s):  
Systematic Review ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Controlled Trial ◽  
Small Samples ◽  
Omega 3 ◽  
Dietary Interventions ◽  
Positive Effects ◽  
Randomized Controlled ◽  
Early Stages

ABSTRACT. It is estimated that by 2030 there will be 82 million people in the world with dementia. Objective: To evaluate the effect of dietary interventions on the cognitive performance of individuals with Alzheimer’s disease (AD). Methods: A systematic review of randomized controlled trials (RCT) was conducted in the Scopus, PubMed, and Cochrane databases. Thirty-two RCT were included. Results: Omega-3 fatty acid showed positive effects at different doses. Fortasyn Connect seemed to be effective in the early stages of the disease. Probiotic, Ginseng, Inositol and specialized nutritional formulas seemed to have a positive effect on cognition. Most of the primary studies presented poor methodological quality, included patients with mild AD, small samples, and did not obtain significative results for all the cognitive outcomes. Conclusions: The effect of most dietary interventions on cognition in AD patients remains inconclusive, however, several nutrients, isolated or not, show potential to improve cognitive function in AD, especially in its early stages.

scholarly journals Effectiveness and Characterization of Severely Energy-Restricted Diets in People with Class III Obesity: Systematic Review and Meta-Analysis

2019 ◽  
Vol 9 (12) ◽  
pp. 144 ◽  
Author(s):  
Gabrielle Maston ◽  
Alice A. Gibson ◽  
H. Reza Kahlaee ◽  
Janet Franklin ◽  
Elisa Manson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Prediction Interval ◽  
Meta Analysis ◽  
Average Weight ◽  
Class Iii ◽  
Dietary Interventions ◽  
Initial Body Weight ◽  
Class Iii Obesity

Severely energy-restricted diets are used in obesity management, but their efficacy in people with class III obesity (body mass index ≥40 kg/m2) is uncertain. The aims of this systematic review and meta-analysis were to determine the effectiveness and characteristics of severely energy-restricted diets in people with class III obesity. As there was a lack of publications reporting long-term dietary interventions and randomised controlled trial designs, our original publication inclusion criteria were broadened to include uncontrolled study designs and a higher upper limit of energy intake. Eligible publications reported studies including adults with class III obesity and that assessed a diet with daily energy intake ≤5000 kJ for ≥4 weeks. Among 572 unique publications from 4 databases, 11 were eligible and 10 were suitable for meta-analysis. Our original intention was to classify comparison arms into short-term (<6 months) and long-term (>1 year) interventions. Due to the lack of long-term data found, comparison arms were classified according to the commonalities in dietary intervention length among the included publications, namely dietary interventions of 4 weeks’ duration and those of ≥6 weeks’ duration. After a 4-week severely energy-restricted diet intervention, the pooled average weight loss was 9.81 (95% confidence interval 10.80, 8.83) kg, with a 95% prediction interval of 6.38 to 13.25 kg, representing a loss of approximately 4.1 to 8.6% of initial body weight. Diets ≥6 weeks’ duration produced 25.78 (29.42, 22.15) kg pooled average weight loss, with a 95% prediction interval of 13.77 to 37.80 kg, representing approximately 10.2 to 28.0% weight loss. Daily dietary prescriptions ranged from 330 to 5000 kJ (mean ± standard deviation 2260 ± 1400 kJ), and had wide variations in macronutrient composition. The diets were administered mostly via liquid meal replacement products. While the included publications had a moderate risk of bias score, which may inflate reported weight loss outcomes, the published data to date suggest that severely energy-restricted diets, delivered via diets of varying composition, effectively produce clinically relevant weight loss (≥10% of initial body weight) when used for 6 weeks or more in people with class III obesity.

Measuring, evaluating, and documenting social marketing impact

2021 ◽  
Vol 11 (3) ◽  
pp. 259-277
Author(s):  
V. Dao Truong ◽  
X. Dam Dong ◽  
Stephen Graham Saunders ◽  
Quynh Pham ◽  
Hanh Nguyen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Marketing ◽  
Social Impact ◽  
Vegetable Intake ◽  
Direct Products ◽  
Impact Measurement ◽  
Intervention Programme ◽  
Content Type ◽  
Use Of Resources

Purpose This paper aims to examine how social marketing intervention programmes to measure, evaluate and document social marketing impact. Design/methodology/approach A systematic review of 49 nutritional behaviour intervention programmes (2006–2020) was conducted. To examine the social marketing impact of the programmes, a logic model of social impact was used. The model comprises inputs (the resources used for an intervention programme), outputs (the direct products resulting from the use of resources), outcomes (short- to medium-term programme effects) and impacts (long-term programme effects on the individual, community or societal levels). Findings Most intervention programmes set the goal of encouraging their target audience to increase fruit and vegetable intake, choose healthy food items, drink less sugary beverages or consume low-fat diaries, while few others sought policy or systems change. Multiple criteria were used for impact evaluation (e.g. exposure and reach, changes in knowledge, awareness, attitudes, behaviours and body mass index). (Quasi) experiments were the most popular method used for impact measurement, followed by the pre-post model of impact. Positive changes were found in 33 programmes, often reported in terms of short-term outputs or outcomes. Long-term impact particularly on the broader societal level was not indicated. Originality/value This research offers a systematic review of how social marketing impact is measured, evaluated and documented. It also provides some guidance for social marketers on how to shift from a reductionist, behavioural outcome-focussed approach towards an “expansionist” impact approach that explicitly considers social marketing impacts on the quality of life of individuals, communities and societies.

Determining the efficacy of consolidating municipal electric utilities in Ontario, Canada

2019 ◽  
Vol 13 (2) ◽  
pp. 298-317
Author(s):  
Philip R. Walsh ◽  
Olalekan Ajibade
Keyword(s):  
Economies Of Scale ◽  
Detailed Examination ◽  
Content Type ◽  
Positive Effects ◽  
Electricity Rates ◽  
Efficiency Measures ◽  
Signed Rank ◽  
Service Efficiency ◽  
Before And After ◽  
The Cost

Purpose This paper aims to examine empirically if the encouragement by government policy of merger and acquisition activity involving municipal and provincially owned electricity distribution utilities (LDCs) in the Province of Ontario has had positive effects in terms of value creation, operating performance and economies of scale. Design/methodology/approach It was anticipated that with LDC consolidation, there will be increased operational efficiency and improvement in the cost-effectiveness of the merged electrical utility. Using matched pairs dependent t-testing and Wilcoxon signed-rank testing, the authors compared data for three years before and after the merger or acquisition of 16 municipal utilities (616 total observations) to determine if there were any statistically significant changes (positive or negative) in measures of financial, operational and service efficiency. Findings The findings indicate statistically significant increases in debt as a percentage of shareholder equity in post-merger/acquisition utilities and consequently leveraged higher returns on equity. However, there were no statistically significant changes in financial, operational or service efficiency measures (with the exception of decreased efficiency in telephone response). Research limitations/implications A total of 16 mergers or acquisitions were reviewed involving 32 of 79 LDCs, with the research implications pointing to a need for existing policy to be reviewed to determine whether a more detailed examination is required by the provincial energy regulator, including a closer examination of managerial motives, before approving mergers between municipal electricity distributors. This research involves only a quantitative approach and further research would examine these transactions using qualitative measures for a deeper examination as to managerial motives. Practical implications The results suggest that the mergers or acquisitions to date have served only to increase shareholder risk without improvement in other financial, operational or service efficiencies, a contradiction to the rationale behind the Province’s merger policy. Social implications The consolidation policy for Ontario LDCs has not resulted in any statistically significant improvement in electricity rates or service for consumers. Originality/value This paper is the first examination of the effects of Ontario’s LDC consolidation policy in terms of specific financial, operational and service efficiency measures.

Relationship Satisfaction Can Help to Maintain the Positive Effect of Childbirth on Parental Self-Esteem

2020 ◽  
pp. 194855062097153
Author(s):  
Mario Wenzel ◽  
Doris Staab ◽  
Zarah Rowland ◽  
Manon A. van Scheppingen
Keyword(s):  
Relationship Satisfaction ◽  
Transition To Parenthood ◽  
Self Esteem ◽  
Control Group ◽  
Positive Effects ◽  
Before And After ◽  
Adaptive Processes ◽  
Baseline Levels ◽  
Positive Effect

The transition to parenthood is accompanied by declined self-esteem levels, which may be explained by parents’ relationship satisfaction. However, prior research examined self-esteem only shortly before and after childbirth and had no or only unmatched childless respondents as a control group, limiting the possibility to examine long-term adaptive processes and the causal interpretation of the associations. Thus, we used panel data (10 years, 4,075 individuals, and 16,122 observations) to compare self-esteem and relationship satisfaction trajectories of parents with matched childless respondents using propensity score matching. We found a quadratic trajectory for parents’ self-esteem, which declined and increased before birth and declined and returned to baseline levels after birth. In contrast, matched childless respondents’ self-esteem decreased linearly before childbirth and then recovered. The quadratic postpartum process in parents was significantly associated with reduced relationship satisfaction. Thus, a fulfilling relationship may help to maintain the positive effects of childbirth on self-esteem in parents.

scholarly journals A Systematic Review of the Cost-Effectiveness of Long-Term Mechanical Circulatory Support

2016 ◽  
Vol 19 (4) ◽  
pp. 494-504 ◽  
Author(s):  
Abraham J. Nunes ◽  
Roderick G.G. MacArthur ◽  
Daniel Kim ◽  
Gurmeet Singh ◽  
Holger Buchholz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
The Cost

Abstract 22: Impact Of Drug Policy On Regional Trends In Ezetimibe Use

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Lingyun Lu ◽  
Harlan Krumholz ◽  
Jack Tu ◽  
Dennis Ko ◽  
Joseph Ross ◽  
...  
Keyword(s):  
Outcome Measure ◽  
Population Level ◽  
Publicly Funded ◽  
The Public ◽  
The Past ◽  
Regional Trends ◽  
Before And After ◽  
Observational Cohort ◽  
The Cost ◽  
Time Point

Background: Ezetimibe use has gradually but steadily increased in Canada during the past decade even with the absence of outcomes evidence. Among the 4 most populated provinces in Canada, there is a gradient in the restrictiveness of ezetimibe in the public-funded formularies (most strict to least strict: British Columbia (BC), Alberta (AB), Quebec (QC) and Ontario (ON)). We examined ezetimibe use trends in these 4 provinces in the period before and after the ENHANCE trial, which was published in January 2008 to better understand the association between use and formulary restrictiveness. Methods: We conducted a population-level observational cohort study using the data collected by IMS Health Canada’s CompuScript Audit® from June 1, 2003 to December 31, 2012. The main outcome measure was monthly ezetimibe expenditures, which were used as a proxy for the total number of prescriptions. The differences in ezetimibe-associated expenditures between the 4 provinces were tested using a linear regression model with interaction effects for province and time. Results: The monthly population standardized ezetimibe-associated costs increased in different patterns in the 4 provinces over the past decade. From June 2003 to December 2012, BC had the lowest monthly increasing rate from $ 261 to $21,926 ($190/100,000 population/month), ON had the most rapid monthly increase from $223 to $ 74,030 ($ 647/100,000 population/month) and QC from $ 130 to $ 59,690 ($522/100,000 population/month) and AB from $ 356 to $ 37604 ($327/100,000 population/month) were in between. (P<0.001) The cost for ezetimibe appeared to increase steadily in QC over the study period. In contrast, the increasing rate began declining in BC, AB and ON at the time point which coincided with the publication of ENHANCE. Conclusions: Distinct patterns of ezetimibe use emerged within the 4 biggest provinces in Canada, which was associated with the restrictiveness of their publicly-funded drug formularies. Without the support of clinical outcomes evidence, ezetimibe remains commonly used in the provinces with least strict formularies (QC and ON). In contrast, the use of ezetimibe seemed to plateau post-ENHANCE in BC and AB, which have more restrictive formularies. The strictness of the drug formulary appears to be influencing ezetimibe prescribing in Canada.

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