scholarly journals Loneliness, social isolation, cardiovascular disease and mortality: a synthesis of the literature and conceptual framework

2020 ◽  
Vol 113 (5) ◽  
pp. 185-192 ◽  
Author(s):  
Sam Hodgson ◽  
Isabella Watts ◽  
Simon Fraser ◽  
Paul Roderick ◽  
Hajira Dambha-Miller
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Health Outcomes ◽  
Conceptual Framework ◽  
Social Isolation ◽  
English Language ◽  
Qualitative Studies ◽  
Socially Isolated ◽  
Poor Outcomes

To conduct a systematic review and develop a conceptual framework on the mechanisms linking loneliness, social isolation, health outcomes and mortality. Electronic databases were systematically searched (PubMed, MEDLINE, Scopus and EMBASE) from inception to October 2018 followed by manual searching to identify research on loneliness, social isolation and mortality in adults published in the English language. Articles were assessed for quality and synthesised into a conceptual framework using meta-ethnographical approaches. A total of 122 articles were included. These collated observational designs examining mediators and moderations of the association in addition to qualitative studies exploring potential mechanisms were included. A framework incorporating 18 discrete factors implicated in the association between loneliness, social isolation and mortality was developed. Factors were categorised into societal or individual, and sub-categorised into biological, behavioural and psychological. These findings emphasise the complex multidirectional relationship between loneliness, social isolation and mortality. Our conceptual framework may allow development of more holistic interventions, targeting many of the interdependent factors that contribute to poor outcomes for lonely and socially isolated people.

scholarly journals Community-Based Culturally Tailored Education Programs for Black Adults with Cardiovascular Disease, Diabetes, Hypertension, and Stroke: A Systematic Review Protocol

2021 ◽  
Author(s):  
Joseph Hawkins Fulton ◽  
Hardeep Singh ◽  
Oya Pakkal ◽  
Elizabeth M Uleryk ◽  
Michelle LA Nelson
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Health Outcomes ◽  
Cultural Values ◽  
Health Inequities ◽  
Black Communities ◽  
Black Adults ◽  
Community Based ◽  
Culturally Tailored ◽  
Specific Barriers

Background: Chronic conditions and stroke disproportionately affect Black adults in communities all around the world due patterns of systemic racism, disparities in care, and lack of resources. To address unequal care received by Black communities, a shift to community-based programs that deliver culturally tailored programs to meet the needs of the communities they serve, including Black adults who tend to have reduced access to postacute services, may give an alternative to a healthcare model which reinforces health inequities. However, community-based culturally tailored programs (CBCT) are relatively understudied but show promise to improve the delivery of services to marginalized communities. The objectives of this review are to: (i) determine key program characteristics and outcomes of CBCT programs that are designed to improve health outcomes in Black adults with cardiovascular disease, hypertension, diabetes, or stroke and (ii) identify which of the five categories of culturally appropriate programs from Kreuter and colleagues have been used to implement CBCT programs. Methods: This is a protocol for a systematic review that will search MEDLINE, CINAHL, and EMBASE databases to identify community-based culturally tailored programs for Black adults with cardiovascular disease, hypertension, diabetes, or stroke. Discussion: Health inequities have disproportionately impacted Black communities and will continue to persist if adjustments are not prioritized within healthcare to provide services, care, and programs meant to address the specific barriers to better health experienced. Many interventions, meant to improve the health outcomes of marginalized groups, are created with little input from target communities leading to interventions that may not address the specific barriers contributing to poor health outcomes and are designed and implemented from an outsider's perspective. The inclusion of community members allows for a deeper understanding of the issues facing the community and provides an opportunity to incorporate cultural values to potentially increase the efficacy, tailoring the intervention to distinct communities. An alternative to current healthcare interventions must be explored to reduce the health gap experienced by Black adults.

scholarly journals Cumulative Effect of Loneliness and Social Isolation on Health Outcomes among Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 920-920
Author(s):  
Timothy Barnes ◽  
Stephanie MacLeod ◽  
Rifky Tkatch ◽  
Manik Ahuja ◽  
Laurie Albright ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Health Outcomes ◽  
Social Isolation ◽  
Healthcare Utilization ◽  
Cumulative Effect ◽  
Cumulative Effects ◽  
Chi Square ◽  
Socially Isolated

Abstract Loneliness and social isolation are described similarly yet are distinct constructs. Numerous studies examine each construct separately; however, less research has been dedicated to exploring their impacts together. Using survey and claims data among adults age 65+ (N=6,994), the cumulative effects of loneliness and social isolation on late-life health outcomes were examined using Chi-square and multivariate regression models. Loneliness and social isolation were measured using the UCLA-3 Loneliness Scale and the Social Network Index. Participants were grouped into four categories of loneliness and social isolation based on overlap, including: lonely only (L), socially isolated only (SI), both lonely and socially isolated (LSI), or neither (N). Outcomes included quality of life and healthcare utilization and costs. Among participants, 9.8% were considered L, 20.6% SI, 9.1% LSI, and 60.5% N. Respondents were primarily female (55.0%) and 70-74 years of age (27.1%). Those considered LSI were more likely to be older, female, less healthy, depressed, with lower quality of life and greater healthcare utilization patterns. Participants who were L or LSI had higher rates of emergency room visits compared to the N group; LSI had the highest medical costs. Results demonstrate the cumulative effects of loneliness and social isolation among older adults. Findings not only fill a gap in research exploring the impacts of these constructs later in life, but also confirm the need for approaches targeting older adults who are both lonely and socially isolated. As the COVID-19 pandemic continues, this priority will continue to be urgent for older adults.

scholarly journals Patient values and preferences regarding VTE disease: a systematic review to inform American Society of Hematology guidelines

2020 ◽  
Vol 4 (5) ◽  
pp. 953-968 ◽  
Author(s):  
Itziar Etxeandia-Ikobaltzeta ◽  
Yuan Zhang ◽  
Francesca Brundisini ◽  
Ivan D. Florez ◽  
Wojtek Wiercioch ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Qualitative Studies ◽  
Health State ◽  
Cochrane Central Register ◽  
Theory Approach ◽  
Relative Importance ◽  
Health States ◽  
Quantitative Studies ◽  
American Society

Abstract Values and preferences relate to the importance that patients place on health outcomes (eg, bleeding, having a deep venous thrombosis) and are essential when weighing benefits and harms in guideline recommendations. To inform the American Society of Hematology guidelines for management of venous thromboembolism (VTE) disease, we conducted a systematic review of patients’ values and preferences related to VTE. We searched Medline, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature from inception to April of 2018 (PROSPERO-CRD42018094003). We included quantitative and qualitative studies. We followed Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance for rating the certainty and presenting findings for quantitative research about the relative importance of health outcomes and a grounded theory approach for qualitative thematic synthesis. We identified 14 quantitative studies (2465 participants) describing the relative importance of VTE-related health states in a widely diverse population of patients, showing overall small to important impact on patients’ lives (certainty of the evidence from low to moderate). Additionally, evidence from 34 quantitative studies (6424 participants) and 15 qualitative studies (570 participants) revealed that patients put higher value on VTE risk reduction than on the potential harms of the treatment (certainty of evidence from low to moderate). Studies also suggested a clear preference for oral medication over subcutaneous medication (moderate certainty). The observed variability in health state values may be a result of differences in the approaches used to elicit them and the diversity of included populations rather than true variability in values. This finding highlights the necessity to explore the variability induced by different approaches to ascertain values.

scholarly journals Relationships between positive psychological constructs and health outcomes in patients with cardiovascular disease: A systematic review

2015 ◽  
Vol 195 ◽  
pp. 265-280 ◽  
Author(s):  
Christina M. DuBois ◽  
Oriana Vesga Lopez ◽  
Eleanor E. Beale ◽  
Brian C. Healy ◽  
Julia K. Boehm ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Health Outcomes ◽  
Psychological Constructs

scholarly journals Effect of Vitamin D Deficiency on COVID-19 Status: A Systematic Review

COVID ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 97-104
Author(s):  
Pranta Das ◽  
Nandeeta Samad ◽  
Bright Opoku Ahinkorah ◽  
John Elvis Hagan ◽  
Prince Peprah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Health Outcomes ◽  
Vitamin D Deficiency ◽  
English Language ◽  
Positive Association ◽  
Current Evidence ◽  
Hydroxyvitamin D ◽  
Disease Outcomes ◽  
English Language Journal

One major micronutrient studied for its possible protective effect against the COVID-19 disease is vitamin D. This systematic review sought to identify and synthesize available evidence to aid the understanding of the possible effect of vitamin D deficiency on COVID-19 status and health outcomes in COVID-19 patients. Three databases (PubMed, ScienceDirect, and Google Scholar) were systematically used to obtain English language journal articles published between 1 December 2019 and 3 November 2020. The search consisted of the terms (“Vitamin D,” OR “25-Hydroxyvitamin D,” OR “Low vitamin D.”) AND (“COVID-19” OR “2019-nCoV” OR “Coronavirus” OR “SARS-CoV-2”) AND (“disease severity” OR “IMV” OR “ICU admission” OR “mortality” OR “hospitalization” OR “infection”). We followed the recommended PRISMA guidelines in executing this study. After going through the screening of the articles, eleven articles were included in the review. All the included studies reported a positive association between vitamin D sufficiency and improved COVID-19 disease outcomes. On the other hand, vitamin D deficiency was associated with poor COVID-19 disease outcomes. Specifically, two studies found that vitamin D-deficient patients were more likely to die from COVID-19 compared to vitamin D-sufficient patients. Three studies showed that vitamin D-deficient people were more likely to develop severe COVID-19 disease compared to vitamin D-sufficient people. Furthermore, six studies found that vitamin D-deficient people were more likely to be COVID-19 infected compared to vitamin D-sufficient people. Findings from these studies suggest that vitamin D may serve as a mitigating effect for COVID-19 infection, severity, and mortality. The current evidence supports the recommendations for people to eat foods rich in vitamin D such as fish, red meat, liver, and egg yolks. The evidence also supports the provision of vitamin D supplements to individuals with COVID-19 disease and those at risk of COVID-19 infection in order to boost their immunity and improve health outcomes.

scholarly journals Patients’ and health professionals’ attitudes and perceptions towards the initiation of preventive drugs for primary prevention of cardiovascular disease: a systematic review of qualitative studies

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101087
Author(s):  
Olla Qadi ◽  
Nakawala Lufumpa ◽  
Nicola Adderley ◽  
Danai Bem ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Health Professional ◽  
Health Professionals ◽  
Antihypertensive Agents ◽  
Qualitative Studies ◽  
Professional Relationship ◽  
Patient Health ◽  
Prevention Of Cardiovascular Disease

BackgroundStatins and antihypertensive agents are recommended for primary prevention of cardiovascular disease (CVD), but they are not always prescribed to eligible patients.Design & settingA systematic review of qualitative studies.AimTo explore health professionals’ and patients’ attitudes towards cardiovascular preventive drugs.MethodMEDLINE, Embase, PsychINFO, CINAHL, ASSIA, HMIC, Conference Proceedings Citation Index, and Open Grey were searched for studies of qualitative design without restrictions on date or language. Two reviewers performed study selection, data extraction, quality assessment, and thematic synthesis.ResultsIn total, 2585 titles and abstracts were screened, yielding 27 studies, of which five met eligibility criteria on full text assessment. These included 62 patients and 47 health professionals. Five themes emerged about patient attitudes: questioning preventive drugs; perceived benefit and risks, such as improving quality of life; patient preferences; trust in health professional judgement; and family, friends, and media influences. Five themes emerged about health professional attitudes: addressing patient concerns and information; duty as a health professional to prescribe; uncertainty about preventive drug prescribing; recognising consequences of prescribing, such as unnecessary medicalisation; and personalised treatment.ConclusionThe attitudes of patients and health professionals regarding drug initiation for primary prevention reflect the complexity of the patient–health professional encounter in primary practice. For prescribing to be more adherent to guidelines, research should further investigate the patient–health professional relationship and the appropriate communication methods required when discussing drug initiation, specifically for primary prevention.

scholarly journals Yogurt, cultured fermented milk, and health: a systematic review

2020 ◽  
Author(s):  
Dennis A Savaiano ◽  
Robert W Hutkins
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
English Language ◽  
Dairy Product ◽  
Quality Criteria ◽  
Fermented Milk ◽  
Dietary Guidelines ◽  
Milk Products ◽  
Dairy Consumption ◽  
Fermented Milk Products

Abstract Consumption of yogurt and other fermented products is associated with improved health outcomes. Although dairy consumption is included in most dietary guidelines, there have been few specific recommendations for yogurt and cultured dairy products. A qualitative systematic review was conducted to determine the effect of consumption of fermented milk products on gastrointestinal and cardiovascular health, cancer risk, weight management, diabetes and metabolic health, and bone density using PRISMA guidelines. English language papers in PubMed were searched, with no date restrictions. In total, 1057 abstracts were screened, of which 602 were excluded owing to lack of appropriate controls, potential biases, and experimental design issues. The remaining 455 papers were independently reviewed by both authors and 108 studies were included in the final review. The authors met regularly to concur, through consensus, on relevance, methods, findings, quality, and conclusions. The included studies were published between 1979 and 2017. From the 108 included studies, 76 reported a favorable outcome of fermented milks on health and 67 of these were considered to be positive or neutral quality according to the Academy of Nutrition and Dietetics’ Quality Criteria Checklist. Of the 32 remaining studies, the study outcomes were either not significant (28) or unfavorable (4), and most studies (18) were of neutral quality. A causal relationship exists between lactose digestion and tolerance and yogurt consumption, and consistent associations exist between fermented milk consumption and reduced risk of breast and colorectal cancer and type 2 diabetes, improved weight maintenance, and improved cardiovascular, bone, and gastrointestinal health. Further, an association exists between prostate cancer occurrence and dairy product consumption in general, with no difference between fermented and unfermented products. This article argues that yogurt and other fermented milk products provide favorable health outcomes beyond the milk from which these products are made and that consumption of these products should be encouraged as part of national dietary guidelines. Systematic review registration:  PROSPERO registration no. CRD42017068953.

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