scholarly journals Folic Acid From Supplements or Fortified Foods Consumed During Pregnancy and/or Lactation and Health Outcomes in Mothers and Their Children: A NESR Systematic Review

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 795-795
Author(s):  
Julie Nevins ◽  
Maureen Spill ◽  
Sharon M Donovan ◽  
Kathryn Dewey ◽  
Rachel Novotny ◽  
...  
Keyword(s):  
Systematic Review ◽  
Folic Acid ◽  
Health Outcomes ◽  
Risk Of Bias ◽  
Dietary Guidelines ◽  
Fortified Foods ◽  
Folate Status ◽  
Moderate Evidence ◽  
Hypertensive Disorders ◽  
Folic Acid Supplements

Abstract Objectives To inform the Dietary Guidelines for Americans, 2020–2025, USDA and HHS identified the following important public health question for the 2020 Dietary Guidelines Advisory Committee to answer with support from USDA's Nutrition Evidence Systematic Review (NESR) team: What is the relationship between folic acid from supplements and/or fortified foods consumed before and during pregnancy and lactation and health outcomes? Methods The Committee developed protocols to describe how they would use NESR's systematic review methodology to examine the evidence. NESR conducted a literature search and dual-screened the results using pre-defined inclusion and exclusion criteria for articles published between 1980 and 2019. NESR extracted data and assessed risk of bias of included studies. The Committee synthesized the evidence, developed conclusion statements, and graded the strength of the evidence underlying the conclusion statements. Results This systematic review included 30 articles, most of which were well-designed RCTs. Observational studies had risk of bias concerns. The study populations did not fully represent the diversity of the U.S. population. Conclusions Strong evidence indicates that folic acid supplements consumed before and/or during pregnancy are positively associated with folate status. Moderate evidence indicates that folic acid supplements consumed during lactation are positively associated with folate status. Limited evidence suggests that folic acid supplements consumed during early pregnancy may have a beneficial effect on reducing the risk of hypertensive disorders during pregnancy among women at high-risk versus no supplementation. Moderate evidence indicates that higher versus lower levels of folic acid supplements consumed during pregnancy does not affect the risk of hypertensive disorders during pregnancy among women at low-risk. Moderate evidence indicates that folic acid supplements consumed during lactation does not influence folate levels in human milk. Insufficient or no evidence was available to examine folic acid and gestational diabetes or child developmental, or folic acid from fortified foods and any outcome. Funding Sources USDA, Food and Nutrition Service, Center for Nutrition Policy and Promotion.

Folic Acid from Fortified Foods and/or Supplements during Pregnancy and Lactation and Health Outcomes: A Systematic Review

2020 ◽  
Author(s):  
Sharon Donovan ◽  
Kathryn Dewey ◽  
Rachel Novotny ◽  
Jamie Stang ◽  
Elsie Taveras ◽  
...  
Keyword(s):  
Systematic Review ◽  
Folic Acid ◽  
Health Outcomes ◽  
Fortified Foods ◽  
Pregnancy And Lactation

scholarly journals How much evidence is there that political factors are related to population health outcomes? An internationally comparative systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e020886 ◽  
Author(s):  
Max Barnish ◽  
Michelle Tørnes ◽  
Becky Nelson-Horne
Keyword(s):  
Systematic Review ◽  
Welfare State ◽  
Health Outcomes ◽  
Population Health ◽  
Positive Association ◽  
Risk Of Bias ◽  
Secondary Outcome ◽  
Bibliographic Databases ◽  
Previous Systematic Review ◽  
Political Tradition

ObjectivesTo provide a 7-year update of the most recent systematic review about the relationships between political features and population health outcomes.SettingInternationally comparative scholarly literature.Data sourcesTen scholarly bibliographic databases plus supplementary searches in bibliographies and Google Scholar were used to update a previous systematic review. The final search was conducted in November 2017.Primary and secondary outcome measuresAny population health outcome measure, apart from healthcare spending.Results73 unique publications were identified from the previous systematic review. The database searches to update the literature identified 45 356 raw records with 35 207 remaining following de-duplication. 55 publications were identified from supplementary searches. In total, 258 publications proceeded to full-text review and 176 were included in narrative synthesis. 85 studies were assessed at low risk of bias, 89 at moderate risk of bias and none at high risk of bias. Assessment could not be conducted for two studies that had only book chapters. No meta-analysis was conducted. 102 studies assessed welfare state generosity and 79 found a positive association. Of the 17 studies that assessed political tradition, 15 were found to show a positive association with the left-of-centre tradition. 44 studies assessed democracy and 34 found a positive association. 28 studies assessed globalisation and 14 found a negative association, while seven were positive and seven inconclusive.ConclusionsThis review concludes that welfare state generosity, left-of-centre democratic political tradition and democracy are generally positively associated with population health. Globalisation may be negatively associated with population health, but the results are less conclusive. It is important for the academic public health community to engage with the political evidence base in its research as well as in stakeholder engagement, in order to facilitate positive outcomes for population health.

scholarly journals Effect of dose administration aids on adherence to self-administered medications: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030536
Author(s):  
Kanika Chaudhri ◽  
Madeleine Kearney ◽  
Richard O Day ◽  
Anthony Rodgers ◽  
Emily Atkins
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Study Participant ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Dose Administration ◽  
Common Solution ◽  
The Impact

IntroductionForgetting to take a medication is the most common reason for non-adherence to self-administered medication. Dose administration aids (DAAs) are a simple and common solution to improve unintentional non-adherence for oral tablets. DAAs can be in the form of compartmentalised pill boxes, automated medication dispensing devices, blister packs and sachets packets. This protocol aims to outline the methods that will be used in a systematic review of the current literature to assess the impact of DAAs on adherence to medications and health outcomes.Methods and analysisRandomised controlled trials will be identified through electronic searches in databases including EMBASE, MEDLINE, CINAHL and the Cochrane Library, from the beginning of each database until January 2020. Two reviewers will independently screen studies and extract data using the standardised forms. Data extracted will include general study information, characteristics of the study, participant characteristics, intervention characteristics and outcomes. Primary outcome is to assess the effects of DAAs on medication adherence. Secondary outcome is to evaluate the changes in health outcomes. The risk of bias will be ascertained by two reviewers in parallel using The Cochrane Risk of Bias Tool. A meta-analysis will be performed if data are homogenous.Ethics and disseminationEthics approval will not be required for this study. The results of the review described within this protocol will be disseminated through publication in a peer-reviewed journal and relevant conference presentations.PROSPERO registration numberCRD42018096087

scholarly journals Physically Active Lessons Meta-Analysis - Norris et al. POST-PRINT

2019 ◽  
Author(s):  
Emma Norris ◽  
Tommy van Steen ◽  
Artur Direito ◽  
Emmanuel Stamatakis
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Health Outcomes ◽  
Educational Outcomes ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Control Group ◽  
Physically Active ◽  
Meta Analyses

Objective: This review provides the first meta-analysis of the effects of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes. Design: Systematic review and meta-analysis. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias. Data sources: PubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019. Studies eligibility criteria: Physically active lessons compared to a control group in a randomised or non-randomised design, within single component interventions in general school populations. Results: 42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible for inclusion in the systematic review and 37 of them were included across the six meta-analyses (n=12,663). Physically active lessons were found to produce large, significant increases in lesson-time PA (d=2.33; 95%CI 1.42, 3.25: k=16) and small, significant effects on overall PA (d= 0.32, 95%CI 0.18, 0.46: k=8). A large, significant effect was shown on lesson-time educational outcomes (d=0.81; 95%CI 0.47, 1.14: k=7) and a small, significant effect on overall educational outcomes (d=0.36, 95%CI [0.09, 0.63], k=25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least 2 domains. Conclusion: In elementary and preschool settings, when physically active lessons were added into the curriculum they had a positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool settings.

scholarly journals The impact of clinical pharmacist services on patient health outcomes in Pakistan: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ali Ahmed ◽  
Muhammad Saqlain ◽  
Maria Tanveer ◽  
Ali Qais Blebil ◽  
Juman Abdulelah Dujaili ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Clinical Pharmacist ◽  
Risk Of Bias ◽  
Economic Outcomes ◽  
Cochrane Library ◽  
Clinical Pharmacists ◽  
Pharmacist Interventions ◽  
Patient Health ◽  
Pharmacist Services

Abstract Background The pharmacist’s role shifts from dispensing to bedside care, resulting in better patient health outcomes. Pharmacists in developed countries ensure rational drug use, improve clinical outcomes, and promote health status by working as part of a multidisciplinary team of healthcare professionals. However, clinical pharmacist services on healthcare utilization in low-and middle-income countries (LMICs) like Pakistan are unclear. As a result, we aim to systematically review pharmacists’ clinical roles in improving Pakistani patients’ therapeutic, safety, humanistic, and economic outcomes. Methods We searched PubMed, Scopus, EMBASE, CINAHL, and Cochrane Library for relevant articles published from inception to 28th February 2021. All authors were involved in the screening and selection of studies. Original studies investigating the therapeutic, humanistic, safety, and economic impact of clinical pharmacists in Pakistani patients (hospitalised or outpatients) were selected. Two reviewers independently assessed the risk of bias in studies, and discrepancies were resolved through mutual consensus. All of the included studies were descriptively synthesised, and PRISMA reporting guidelines were followed. Results The literature search found 751 articles from which nine studies were included; seven were randomized controlled trials (RCTs), and two were observational studies. Three RCTs included were having a low risk of bias (ROB), two RCTs were having an unclear ROB, while two RCTs were having a high ROB. The nature of clinical pharmacist interventions included one or more components such as disease-related education, lifestyle changes, medication adherence counselling, medication therapy management, and discussions with physicians about prescription modification if necessary. Clinical pharmacist interventions reduce medication-related errors, improve therapeutic outcomes such as blood pressure, glycemic control, lipid control, CD4 T lymphocytes, and renal functions, and improve humanistic outcomes such as patient knowledge, adherence, and health-related quality of life. However, no study reported the economic outcomes of interventions. Conclusions The findings of the studies included in this systematic review suggest that clinical pharmacists play important roles in improving patients’ health outcomes in Pakistan; however, it should be noted that the majority of the studies have a high risk of bias, and more research with appropriate study designs is needed.

scholarly journals Investigating the use of ultrasonography for the antenatal diagnosis of structural congenital anomalies in low-income and middle-income countries: systematic review protocol

2019 ◽  
Vol 3 (1) ◽  
pp. e000538 ◽  
Author(s):  
Stephanie Michele Goley ◽  
Sidonie Sakula-Barry ◽  
Ann Kelly ◽  
Naomi Wright
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Low Income ◽  
Congenital Anomalies ◽  
Antenatal Diagnosis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Middle Income ◽  
Antenatal Ultrasound ◽  
Middle Income Countries

IntroductionCongenital anomalies are the fifth leading cause of mortality in children under 5 years globally. The greatest burden is faced by those in developing countries, where over 95% of deaths occur. Many of these deaths may have been preventable through antenatal diagnosis and early intervention. This study aims to conduct a systematic review that investigates the use of antenatal ultrasound to diagnose congenital anomalies and improve the health outcomes of infants in low-income and middle-income countries (LMICs).Methods and analysisA systematic literature review will be conducted using three search strings: (1) structural congenital anomalies, (2) LMICs and (3) antenatal diagnosis. Four electronic databases will be searched: MEDLINE, Embase, PubMed and the Cochrane Library. Title, abstract and full-text screening will be undertaken in duplicate by two reviewers independently using Covidence. Consensus will be sought from the wider authorship for discrepancies. Data extraction will be undertaken by the principal investigator. The primary analysis will focus on the availability and effectiveness of antenatal ultrasound for structural congenital anomalies. Secondary outcomes will include neonatal morbidity and mortality, termination rates and referral rates for further antenatal care. Descriptive statistics and a narrative synthesis will be included in the final report. The methodological quality of the included studies will be evaluated using the Cochrane-approved Risk of Bias for Non-Randomised Studies of Intervention and Risk of Bias in Randomised Trials V.2.0 tools.Ethics and disseminationEthical approval is not required for conducting the systematic review as there will be no direct collection of data from individuals. The results will be submitted for publication in a scientific journal and presented internationally.ConclusionThis is the first study, to our knowledge, to systematically review current literature on the use of antenatal ultrasound for the detection of congenital anomalies in LMICs. This is vital to define current practice, highlight global disparities and evaluate effects on health outcomes for infants in low-resource settings.PROSPERO registration numberCRD42019105620.

scholarly journals The association between depressive symptoms or depression and health outcomes in adults with low back pain with or without radiculopathy: protocol of a systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Jessica J. Wong ◽  
Andrea C. Tricco ◽  
Pierre Côté ◽  
Laura C. Rosella
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Depressive Symptoms ◽  
Health Outcomes ◽  
Risk Of Bias ◽  
Considerable Proportion ◽  
Low Back ◽  
The Impact

Abstract Background A considerable proportion of adults with low back pain (LBP) suffer from depressive symptoms or depression. Those with depressive symptoms or depression may be at risk of poorer LBP recovery and require more health care. Understanding the role of prognostic factors for LBP is critically important to guide management and health services delivery. Our objective is to conduct a systematic review to assess the association between depressive symptoms or depression and health outcomes in adults with LBP with or without radiculopathy. Methods Electronic databases including MEDLINE, Embase, CINAHL, and PsycINFO will be searched from inception to April 2019 to identify relevant studies. Additional citations will be identified by searching reference lists of included studies and related systematic reviews. Cohort and case-control studies assessing the association between depressive symptoms/depression and health outcomes in adults aged 16 years and older with LBP with or without radiculopathy will be included. The following will be included: depressive symptoms as measured on standardized questionnaires (e.g., Center for Epidemiologic Studies Depression Scale, Beck Depression Index), and depression as standardized diagnoses (e.g., International Classification of Diseases codes) or self-reported depression diagnosis on standardized questionnaires. Outcomes of interest are standardized measures for pain, disability, overall health status, satisfaction with care, and health care utilization. These are informed by core outcome domains that international expert panels consider important for LBP research. Pairs of reviewers will screen articles retrieved from the search, extract data, and assess risk of bias using the Risk Of Bias In Non-randomized Studies-of Exposures (ROBINS-E) tool. Reviewers will use these criteria to inform their judgment on the internal validity of studies (e.g., low, moderate, or high risk of bias). If studies are deemed homogeneous, a random effects meta-analysis on the association between depressive symptoms and health outcomes will be performed. The results of the included studies will be descriptively outlined if studies are deemed heterogeneous. Discussion The impact of depressive symptoms and depression on health- and health care-related outcomes for LBP with or without radiculopathy will be assessed and quantified. Findings of this systematic review will advance our understanding of LBP prognosis, and guide decision-making and improve quality of care for adults with LBP. Systematic review registration PROSPERO CRD42019130047

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