scholarly journals Physical Comorbidities and Their Relationship with Cancer Treatment and Its Outcomes in Older Adult Populations: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Mathew George ◽  
Alexandra Smith ◽  
Sabe Sabesan ◽  
Geetha Ranmuthugala
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Older Adult ◽  
Treatment Initiation ◽  
Evidence Synthesis ◽  
Geographical Location ◽  
Survival Outcomes ◽  
Original Research ◽  
Appropriate Treatment ◽  
The Impact

BACKGROUND Cancer is one of the predominant causes of morbidity and mortality in older adult populations worldwide. Among a range of barriers, comorbidity particularly poses a clinical challenge in cancer diagnosis, prognosis, and treatment owing to its heterogeneous nature. While accurate comorbidity assessments and appropriate treatment administration can result in better patient outcomes, evidence related to older adult cancer populations is limited as these individuals are often excluded from regular clinical trials due to age and comorbid conditions. OBJECTIVE To determine the prevalence of physical comorbidity and the impact of physical comorbidities and rurality on treatment and its outcomes in older adult cancer populations. METHODS Scientific databases Embase and PubMed were searched for published scientific literature on physical comorbidity and older adult cancer patients. Google Scholar was searched for scholarly literature published in nonindexed journals. Snowballing was utilized to identify research papers missed in the above searches. Included studies : (1) reported on original research involving cancer patients; (2) included patients aged 65 years or older; (3) had patients receiving cancer-related treatment and (4) cancer survivors; (5) reported on physical comorbidity as a variable; (6) were published in English; and (7) conducted from any geographical location. RESULTS In total, 29 studies were selected for data extraction, evidence synthesis, and quality assessment. In these, comorbidities ranged from 37.9%-74.3% in colorectal cancer, 74%-81% in head and neck cancer, and 12.6%-49% in breast cancer. Moderate comorbidities ranged from 13%-72.9%, and severe comorbidities from 2.5%-68.2%. Comorbidity increased with age, with comorbidity affecting both treatment choice and process. Physical comorbidities significantly affected treatment initiation, causing delay, toxicity, and discontinuation. Older adult cancer patients were given less vigorous and nonstandard treatments and were also less likely to be offered treatment. Where patients are given more vigorous treatment, several studies showed better survival outcomes. Appropriate treatment in older adult cancer patients increased both overall and disease-related survival rates. None of the studies noted rurality as a distinct variable. CONCLUSIONS This systematic review concludes that there is evidence to substantiate the adverse effect of comorbidity on treatment and survival outcomes. However, the mechanism by which comorbidity impedes or impacts treatment is unknown in many cases. Some low-quality evidence is available for considering the functional status and biological age in treatment decisions. Future studies that substantiate the value of comprehensive older adult assessments before treatment initiation in cancer patients, including assessing the nature and severity of comorbidities, and additional consideration of rurality as a factor, could lessen the effect of comorbidities on the treatment process.

988 The Prevalence and Incidence of Gender Bias and Sexual Discrimination in Orthopaedics, and Mitigating Strategies: A Systematic Review

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Elbayouk ◽  
U Halim ◽  
A Ali ◽  
S Javed ◽  
C Cullen
Keyword(s):  
Systematic Review ◽  
Gender Bias ◽  
Role Models ◽  
Educational Interventions ◽  
Original Research ◽  
Sexual Discrimination ◽  
Orthopaedic Training ◽  
Orthopaedic Community ◽  
Training Programmes ◽  
The Impact

Abstract Background The aim of this systematic review was to outline the prevalence and impact of Gender bias and sexual discrimination (GBSD) in orthopaedics, and to investigate interventions countering such behaviours. Method Original research papers pertaining to the prevalence and impact of gender bias or sexual discrimination, or mitigating strategies in orthopaedics, were suitable for inclusion. PRISMA guidelines were adhered to in this review. Results Of 570 papers, 27 were eligible for inclusion. A total of 13 papers discussed the prevalence of GBSD, whilst 13 related to the impact of these behaviours, and 6 discussed mitigating strategies. GBSD were found to be prevalent in the orthopaedic workplace, with all sources showing females to be the victims. The impact of GBSD includes poor workforce representation, lower salaries, barriers to career progression, and reduced academic output for females in orthopaedics. Mitigating strategies in the literature are focussed on encouraging females to apply for orthopaedic training programmes, by providing female role models, mentors, and educational interventions. Conclusions GBSD are highly prevalent in orthopaedic surgery, impacting females at all stages of their careers. Mitigating strategies have been tested but are limited in their scope. As such, the orthopaedic community as a whole is obliged to do more to tackle GBSD.

Social health and nutrition impacts of community kitchens: a systematic review

2012 ◽  
Vol 16 (3) ◽  
pp. 535-543 ◽  
Author(s):  
Marina Iacovou ◽  
Deanna C Pattieson ◽  
Helen Truby ◽  
Claire Palermo
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Food Insecurity ◽  
Social Interactions ◽  
Evidence Synthesis ◽  
Nutritional Intake ◽  
Cooking Skills ◽  
Nutritional Health ◽  
Community Kitchens ◽  
The Impact

AbstractObjectiveCommunity kitchens have been implemented by communities as a public health strategy to prevent food insecurity through reducing social isolation, improving food and cooking skills and empowering participants. The aim of the present paper was to investigate whether community kitchens can improve the social and nutritional health of participants and their families.DesignA systematic review of the literature was conducted including searches of seven databases with no date limitations.SettingCommunity kitchens internationally.SubjectsParticipants of community kitchens across the world.ResultsTen studies (eight qualitative studies, one mixed-method study and one cross-sectional study) were selected for inclusion. Evidence synthesis suggested that community kitchens may be an effective strategy to improve participants’ cooking skills, social interactions and nutritional intake. Community kitchens may also play a role in improving participants’ budgeting skills and address some concerns around food insecurity. Long-term solutions are required to address income-related food insecurity.ConclusionsCommunity kitchens may improve social interactions and nutritional intake of participants and their families. More rigorous research methods, for both qualitative and quantitative studies, are required to effectively assess the impact of community kitchens on social and nutritional health in order to confidently recommend them as a strategy in evidence-based public health practice.

scholarly journals Sleep in youth with autism spectrum disorders: systematic review and meta-analysis of subjective and objective studies

2018 ◽  
Vol 21 (4) ◽  
pp. 146-154 ◽  
Author(s):  
Amparo Díaz-Román ◽  
Junhua Zhang ◽  
Richard Delorme ◽  
Anita Beggiato ◽  
Samuele Cortese
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorders ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Newcastle Ottawa Scale ◽  
Spectrum Disorders ◽  
Sleep Alterations ◽  
The Impact ◽  
Ottawa Scale

BackgroundSleep problems are common and impairing in individuals with autism spectrum disorders (ASD). Evidence synthesis including both subjective (ie, measured with questionnaires) and objective (ie, quantified with neurophysiological tools) sleep alterations in youth with ASD is currently lacking.ObjectiveWe conducted a systematic review and meta-analysis of subjective and objective studies sleep studies in youth with ASD.MethodsWe searched the following electronic databases with no language, date or type of document restriction up to 23 May 2018: PubMed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge. Random-effects models were used. Heterogeneity was assessed with Cochran’s Q and I2 statistics. Publication (small studies) bias was assessed with final plots and the Egger’s test. Study quality was evaluated with the Newcastle Ottawa Scale. Analyses were conducted using Review Manager and Comprehensive Meta-Analysis.FindingsFrom a pool of 3359 non-duplicate potentially relevant references, 47 datasets were included in the meta-analyses. Subjective and objective sleep outcome measures were extracted from 37 and 15 studies, respectively. Only five studies were based on comorbidity free, medication-naïve participants. Compared with typically developing controls, youth with ASD significantly differed in 10/14 subjective parameters and in 7/14 objective sleep parameters. The average quality score in the Newcastle-Ottawa Scale was 5.9/9.Discussion and clinical implicationsA number of subjective and, to a less extent, objective sleep alterations might characterise youth with ASD, but future studies should assess the impact of pharmacological treatment and psychiatric comorbidities.

scholarly journals Cancer services during the COVID-19 pandemic: systematic review of patients' and caregivers' experiences

2021 ◽  
Author(s):  
Symran Dhada ◽  
Derek Stewart ◽  
Ejaz Cheema ◽  
Muhammed Abdul Hadi ◽  
Vibhu Paudyal
Keyword(s):  
Systematic Review ◽  
Cancer Screening ◽  
Cancer Patients ◽  
English Language ◽  
Resource Constraints ◽  
Data Extraction ◽  
Psychological Wellbeing ◽  
Cancer Services ◽  
Data Extraction Form ◽  
The Impact

Background Cancer patients have faced intersecting crises in the face of COVID-19 pandemic. This review aimed to examine patients' and caregivers' experiences of accessing cancer services during the COVID-19 pandemic and perceived impact of the pandemic on their psychological wellbeing. Methods A protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020-12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline. Results A total of 1110 articles were screened of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Several themes were identified which were categorised into seven categories. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services because of infection worries contributed to the delay. Financial and social distress, isolation; and spiritual distress due to the uncertainty of rites as well as fulfilment of last wishes were also commonly reported. Caregivers felt anxious about infecting cancer patients with COVID-19. Conclusions Patients and caregivers experienced extensive impact of COVID-19 on cancer screening, treatment and care, and their own psychological wellbeing. Patient and caregiver views and preferences should be incorporated in ensuring resilient cancer services that can minimise the impact of ongoing and future pandemic on cancer care and mitigate patient fears.

Effects of school-based before-school physical activity programmes on children’s physical activity levels, health and learning-related outcomes: a systematic review

2021 ◽  
pp. bjsports-2021-104470
Author(s):  
James Woodforde ◽  
Tahlia Alsop ◽  
Jo Salmon ◽  
Sjaan Gomersall ◽  
Michalis Stylianou
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Physical Health ◽  
Primary Schools ◽  
Psychosocial Outcomes ◽  
Original Research ◽  
Inverse Association ◽  
School Based ◽  
Before School ◽  
The Impact

ObjectiveTo review and evaluate the impact of school-based, before-school physical activity (PA) programmes on children’s PA levels, health and learning-related outcomes.DesignSystematic review.Data sourcesPubMed, PsycINFO, Scopus, Embase and ERIC were searched in January 2021.Eligibility criteria for selecting studies(1) Original research published in English, (2) sample included typically developing school-age children and/or adolescents, (3) examined school-based PA programmes delivered before school, (4) included a comparator and (5) reported associations with PA, physical health, learning-related and/or psychosocial outcomes. Studies examining before-school active transport or sport were excluded.ResultsThirteen articles representing 10 studies were included (published 2012–2020); seven conducted in primary schools. Programmes ranged between 3 weeks and 6 months, primarily operating daily and for 25–40 min. One study examined a programme informed by theory; six incorporated fidelity measures. Data synthesis, considering consistency of findings, showed indeterminate associations for the domains of physical health, learning-related and psychosocial outcomes. Among subdomains, synthesis showed positive associations with before-school and daily PA, cardiorespiratory and muscular fitness, readiness to learn and an inverse association with adiposity. Risk of bias was high/serious or insufficiently detailed across studies and outcome domains, except PA, which included moderate-risk studies.ConclusionThere is limited available evidence on school-based, before-school PA programmes, with some positive associations at domain and subdomain levels. Continued research is justified to understand the role of before-school programmes for facilitating PA. Future research should follow recommended practice for intervention design and process evaluation, and address under-represented contexts, including secondary schools.PROSPERO registration numberCRD42020181108.

PIK3CA Mutations and Their Impact on Survival Outcomes of Patients with Cervical Cancer: A Systematic Review

2020 ◽  
Vol 64 (6) ◽  
pp. 547-555
Author(s):  
Vasilios Pergialiotis ◽  
Christina Nikolaou ◽  
Dimitrios Haidopoulos ◽  
Maximos Frountzas ◽  
Nikolaos Thomakos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Progression ◽  
Meta Analysis ◽  
Current Evidence ◽  
Survival Outcomes ◽  
Cochrane Central Register ◽  
Wild Type ◽  
Pik3ca Mutations ◽  
The Impact

<b><i>Introduction:</i></b> Several studies have implicated the PIK3/AKT pathway in the pathophysiology of cancer progression as its activation seems to be aberrant in several forms of cancer. The purpose of the present systematic review is to evaluate the impact of PIK3CA mutations on survival outcomes of patients with cervical cancer. <b><i>Methods:</i></b> We used the Medline (1966–2020), Scopus (2004–2020), ClinicalTrials.gov (2008–2020), EMBASE (1980–2020), Cochrane Central Register of Controlled Trials (CENTRAL) (1999–2020), and Google Scholar (2004–2020) databases in our primary search along with the reference lists of electronically retrieved full-text papers. Statistical meta-analysis was performed with the RevMan 5.3 software. <b><i>Results:</i></b> Overall, 12 articles were included in the present study that comprised 2,196 women with cervical cancer. Of those, 3 studies did not report significant differences in survival outcomes among patients with mutated versus wild-type PIK3CA tumors, 5 studies reported decreased survival outcomes, and 3 studies revealed increased survival rates. The meta-analysis revealed that patients with the mutated PIK3CA genotypes had worse overall survival compared to patients with wild-type PIK3CA (HR 2.31; 95% CI: 1.51, 3.55; 95% PI: 0.54, 9.96; data from 3 studies) and the same was observed in the case of DFS rates (HR 1.82; 95% CI: 1.47, 2.25; 95% PI: 1.29, 2.56; data from 4 studies). <b><i>Conclusion:</i></b> Current evidence concerning the impact of PIK3CA mutations on survival outcomes of patients with cervical cancer is inconclusive, although the majority of included studies support a potential negative effect, primarily among those with squamous cell carcinoma tumors.

scholarly journals University Service-Learning in Physical Education and Sport Sciences: A systematic review

2019 ◽  
Vol 30 (4) ◽  
pp. 1147-1164 ◽  
Author(s):  
Oscar Chiva-Bartoll ◽  
Pedro Jesús Ruiz-Montero ◽  
Ricardo Martín Moya ◽  
Isaac Pérez López ◽  
Javier Giles Girela ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Education ◽  
Service Learning ◽  
Teaching Practice ◽  
Geographical Location ◽  
Academic Learning ◽  
Teaching Methodology ◽  
Special Educational Needs ◽  
Distribution Profile ◽  
The Impact

Higher education requires a pedagogical transformation to guide teaching practice toward true educational competences. Service-Learning (SL) has become a teaching methodology that promotes social and personal skills. This systematic review of the literature reports SL experiences and research of university subjects related to physical education and sport sciences. All of them are based on different descriptive axes such as the type of publication: description of educational experiences, research articles or theoretical works. Similarly, this review has considered the geographical location, the methodological approaches used, the type of service provided and the different profiles of service recipient groups. Following an exhaustive search, 18 peer-reviewed publications were organized according to the methodology used, characteristics of the sample, duration and intensity of intervention programmes, instruments used, geographic distribution, profile of the group receiving the service and effects on students’ academic learning. The results indicate that the methodologies used tended to be qualitative, while the variety of samples and duration of interventions was very broad. The instruments used were mainly interviews and questionnaires. Most of the groups receiving SL included people with functional diversity or disabilities, children with attention deficit and hyperactivity disorder, children with special educational needs, people at a disadvantage or social exclusion and curricular lag. The publications in the present review highlight the impact of SL in university subjects related to physical education and sport sciences.

scholarly journals Cancer Services During the COVID-19 Pandemic: Systematic Review of Patients’ and Caregivers’ Experiences

2021 ◽  
Author(s):  
Symran Dhada ◽  
Derek Stewart ◽  
Ejaz Cheema ◽  
Muhammed Abdul Hadi ◽  
Vibhu Paudyal
Keyword(s):  
Systematic Review ◽  
Cancer Screening ◽  
Cancer Patients ◽  
English Language ◽  
Resource Constraints ◽  
Data Extraction ◽  
Psychological Wellbeing ◽  
Cancer Services ◽  
Data Extraction Form ◽  
The Impact

Abstract Background Cancer patients have faced intersecting crises in the face of COVID-19 pandemic. This review aimed to examine patients’ and caregivers’ experiences of accessing cancer services during the COVID-19 pandemic and perceived impact of the pandemic on their psychological wellbeing.Methods A protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020-12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline. Results A total of 1110 articles were screened of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Several themes were identified which were categorised into seven categories. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services because of infection worries contributed to the delay. Financial and social distress, isolation; and spiritual distress due to the uncertainty of rites as well as fulfilment of last wishes were also commonly reported. Caregivers felt anxious about infecting cancer patients with COVID-19. Conclusions Patients and caregivers experienced extensive impact of COVID-19 on cancer screening, treatment and care, and their own psychological wellbeing. Patient and caregiver views and preferences should be incorporated in ensuring resilient cancer services that can minimise the impact of ongoing and future pandemic on cancer care and mitigate patient fears. Protocol Registration Published protocol registered with Centre for Review and Dissemination CRD42020214906 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214906)

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