scholarly journals Community use of face masks and similar barriers to prevent respiratory illness such as COVID-19: a rapid scoping review

2020 ◽  
Vol 25 (49) ◽  
Author(s):  
Julii Brainard ◽  
Natalia R. Jones ◽  
Iain R Lake ◽  
Lee Hooper ◽  
Paul R Hunter
Keyword(s):  
Respiratory Disease ◽  
Observational Studies ◽  
Disease Incidence ◽  
Meta Analysis ◽  
Respiratory Illness ◽  
Face Mask ◽  
Evidence Base ◽  
Cross Sectional ◽  
Assessment Development ◽  
Randomised Control Trials

Background Evidence for face-mask wearing in the community to protect against respiratory disease is unclear. Aim To assess effectiveness of wearing face masks in the community to prevent respiratory disease, and recommend improvements to this evidence base. Methods We systematically searched Scopus, Embase and MEDLINE for studies evaluating respiratory disease incidence after face-mask wearing (or not). Narrative synthesis and random-effects meta-analysis of attack rates for primary and secondary prevention were performed, subgrouped by design, setting, face barrier type, and who wore the mask. Preferred outcome was influenza-like illness. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) quality assessment was undertaken and evidence base deficits described. Results 33 studies (12 randomised control trials (RCTs)) were included. Mask wearing reduced primary infection by 6% (odds ratio (OR): 0.94; 95% CI: 0.75–1.19 for RCTs) to 61% (OR: 0.85; 95% CI: 0.32–2.27; OR: 0.39; 95% CI: 0.18–0.84 and OR: 0.61; 95% CI: 0.45–0.85 for cohort, case–control and cross-sectional studies respectively). RCTs suggested lowest secondary attack rates when both well and ill household members wore masks (OR: 0.81; 95% CI: 0.48–1.37). While RCTs might underestimate effects due to poor compliance and controls wearing masks, observational studies likely overestimate effects, as mask wearing might be associated with other risk-averse behaviours. GRADE was low or very low quality. Conclusion Wearing face masks may reduce primary respiratory infection risk, probably by 6–15%. It is important to balance evidence from RCTs and observational studies when their conclusions widely differ and both are at risk of significant bias. COVID-19-specific studies are required.

scholarly journals Impact of healthcare strikes on patient mortality: a protocol for a systematic review and meta-analysis of observational studies

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050826
Author(s):  
Ryan Essex ◽  
Sharon Marie Weldon ◽  
Trevor Thompson ◽  
Erika Kalocsanyiova ◽  
Paul McCrone ◽  
...  
Keyword(s):  
Observational Studies ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Well Being ◽  
Evidence Base ◽  
Risk Of Bias ◽  
Cross Sectional ◽  
The Impact ◽  
Hospital Clinic

IntroductionA strike is a collective, temporary and calculated action, which involves a temporary stoppage of work. For healthcare professionals strike action poses a unique dilemma. Perhaps most fundamentally, as strike action is designed to be disruptive it has the potential to impact the delivery of care and place patient well-being in jeopardy. The objective of this study is therefore to evaluate the impact of healthcare strike action on patient mortality outcomes globally using meta-analysis in order to provide a comprehensive evidence base that can advise healthcare professionals, governments and regulatory bodies on the impact that strike action has on patients.Methods and analysisA comprehensive literature search of major electronic databases (EMBASE, MEDLINE, CINAHL, BIOETHICSLINE, EconLit, WEB OF SCIENCE, OPEN GREY and SIGMA REPOSITORY) will be undertaken to identify observational studies of strike action among healthcare professionals where in-hospital/clinic and population/community mortality is examined, prestrike, during and poststrike. Meta-analysis will be performed to estimate in-hospital/clinic and population/community mortality during periods of strike action. The quality of evidence will be assessed using the National Institute of Health quality assessment tool for observational cohort and cross-sectional studies. Risk of bias will be assessed using the Cochrane Risk Of Bias In Non-Randomized Studies - of Interventions tool.Ethics and disseminationThis study does not require ethical approval. Findings will be submitted to an appropriate peer-reviewed journal.Trial registration numberCRD42021238879.

The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Central Obesity ◽  
Assessment Tool ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Dietary Factors ◽  
Cross Sectional ◽  
Inflammatory Status ◽  
Obesity Indices

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.

scholarly journals Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies

2015 ◽  
Vol 18 (16) ◽  
pp. 3013-3019 ◽  
Author(s):  
Huashan Bi ◽  
Yong Gan ◽  
Chen Yang ◽  
Yawen Chen ◽  
Xinyue Tong ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Observational Studies ◽  
Meta Analysis ◽  
Adjusted Relative Risk ◽  
China National Knowledge Infrastructure ◽  
Cross Sectional ◽  
Breakfast Skipping ◽  
Risk Estimates ◽  
Increased Risk

AbstractObjectiveBreakfast skipping has been reported to be associated with type 2 diabetes (T2D), but the results are inconsistent. No meta-analyses have applied quantitative techniques to compute summary risk estimates. The present study aimed to conduct a meta-analysis of observational studies summarizing the evidence on the association between breakfast skipping and the risk of T2D.DesignSystematic review and meta-analysis.SettingRelevant studies were identified by a search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI) and SINOMED up to 9 August 2014. We also reviewed reference lists from retrieved articles. We included studies that reported risk estimates (including relative risks, odds ratios and hazard ratios) with 95 % confidence intervals for the association between breakfast skipping and the risk of T2D.SubjectsEight studies involving 106 935 participants and 7419 patients with T2D were included in the meta-analysis.ResultsA pooled adjusted relative risk for the association between exposure to breakfast skipping and T2D risk was 1·21 (95 % CI 1·12, 1·31; P=0·984; I2=0·0 %) in cohort studies and the pooled OR was 1·15 (95 % CI, 1·05, 1·24; P=0·770; I2=0·0 %) in cross-sectional studies. Visual inspection of a funnel plot and Begg’s test indicated no evidence of publication bias.ConclusionsBreakfast skipping is associated with a significantly increased risk of T2D. Regular breakfast consumption is potentially important for the prevention of T2D.

scholarly journals Oral health in children and adolescents with juvenile idiopathic arthritis – a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marit S. Skeie ◽  
Elisabeth G. Gil ◽  
Lena Cetrelli ◽  
Annika Rosén ◽  
Johannes Fischer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Juvenile Idiopathic Arthritis ◽  
Oral Health ◽  
Children And Adolescents ◽  
Observational Studies ◽  
Meta Analysis ◽  
Oral Diseases ◽  
Cross Sectional ◽  
Healthy Group ◽  
Health Measures

Abstract Background Observational studies examining the association between oral health and juvenile idiopathic arthritis (JIA) among children and adolescents have reported inconsistent findings. The aims of this systematic review and meta-analysis were to ascertain a potential difference in oral health and oral health-related quality of life (OHRQoL) among children and adolescents with JIA and healthy peers, and to assess the association of prevalence of oral diseases/conditions, temporomandibular disorders (TMD), including temporomandibular joint (TMJ) diseases, in relation to activity and severity of JIA. Method Medline Ovid, Embase, CINAHL, SweMed+ and Cochrane Library were searched up to 25 November 2018. All articles published in English, German and Scandinavian languages focusing on children and adolescents with JIA and without JIA in relation to oral health measures, were considered. Two authors independently evaluated observational studies for inclusion. The study quality was assessed using modified Newcastle Ottawa Scale. Meta-analysis was performed for studies focusing on dental caries as an outcome. Results Nineteen articles met the inclusion criteria, covering a range of oral diseases/conditions and OHRQoL. Eighteen studies had cross-sectional design. No mean difference of dmft/DMFT indices (decayed/missed/filled teeth) was observed between the JIA - and healthy group. None of the oral health measures including dental erosive wear, enamel defects, dental maturation and OHRQoL, indicated better oral health among children and adolescents with JIA compared to healthy group. However, periodontal conditions and TMD were more predominant among children and adolescents with JIA compared to healthy peers. Conclusions Based on the cross-sectional studies, periodontal diseases and TMD were found to be more frequent in children and adolescents with JIA compared to healthy peers. Furthermore, more high-quality studies with large sample size are needed before we infer any concrete conclusion regarding the association between the prevalence of oral and TMJ diseases or oral conditions in relation to activity and severity of JIA.

Dietary acid load and cardiometabolic risk factors: a systematic review and meta-analysis of observational studies

2019 ◽  
Vol 22 (15) ◽  
pp. 2823-2834 ◽  
Author(s):  
Elnaz Daneshzad ◽  
Fahimeh Haghighatdoost ◽  
Leila Azadbakht
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Blood Pressure ◽  
Observational Studies ◽  
Cardiometabolic Risk ◽  
Meta Analysis ◽  
Cardiometabolic Risk Factors ◽  
Cross Sectional ◽  
Dietary Acid ◽  
Acid Load

AbstractObjective:Dietary acid load (DAL) might contribute to change the levels of cardiometabolic risk factors; however, the results are conflicting. The present review was conducted to determine the relationship between DAL and cardiometabolic risk factors.Design:Systematic review and meta-analysis.Setting:A systematic search was conducted in electronic databases including ISI Web of Science, PubMed/MEDLINE, Scopus and Google Scholar for observational studies which assessed cardiometabolic risk factors across DAL. Outcomes were lipid profile, glycaemic factors and anthropometric indices. Effect sizes were derived using a fixed- or random-effect model (DerSimonian–Laird). Also, subgroup analysis was performed to find the probable source of heterogeneity. Egger’s test was performed for finding any publication bias.Results:Thirty-one studies were included in the current review with overall sample size of 92 478. There was a significant relationship between systolic blood pressure (SBP; weighted mean difference (WMD) = 1·74 (95 % CI 0·25, 3·24) mmHg;P= 0·022;I2= 95·3 %), diastolic blood pressure (DBP; WMD = 0·75 (95 % CI 0·07, 1·42) mmHg;P= 0·030;I2= 80·8 %) and DAL in cross-sectional studies. Serum lipids, glycaemic parameters including fasting blood sugar, glycated Hb, serum insulin, homeostatic model assessment of insulin resistance and waist circumference had no significant relationship with DAL. No publication bias was found. BMI was not associated with DAL in both cross-sectional and cohort studies.Conclusions:Higher DAL is associated with increased SBP and DBP. More studies are needed to find any relationship of DAL with lipid profile and glycaemic factors.

scholarly journals Neighbourhood socioeconomic status and overweight/obesity: a systematic review and meta-analysis of epidemiological studies

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028238 ◽  
Author(s):  
Shimels Hussien Mohammed ◽  
Tesfa Dejenie Habtewold ◽  
Mulugeta Molla Birhanu ◽  
Tesfamichael Awoke Sissay ◽  
Balewgizie Sileshi Tegegne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Observational Studies ◽  
Data Extraction ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Neighbourhood Socioeconomic Status

ObjectiveLow neighbourhood socioeconomic status (NSES) has been linked to a higher risk of overweight/obesity, irrespective of the individual’s own socioeconomic status. No meta-analysis study has been done on the association. Thus, this study was done to synthesise the existing evidence on the association of NSES with overweight, obesity and body mass index (BMI).DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Scopus, Cochrane Library, Web of Sciences and Google Scholar databases were searched for articles published until 25 September 2019.Eligibility criteriaEpidemiological studies, both longitudinal and cross-sectional ones, which examined the link of NSES to overweight, obesity or BMI, were included.Data extraction and synthesisData extraction was done by two reviewers, working independently. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale for the observational studies. The summary estimates of the relationships of NSES with overweight, obesity and BMI statuses were calculated with random-effects meta-analysis models. Heterogeneity was assessed by Cochran’s Q and I2 statistics. Subgroup analyses were done by age categories, continents, study designs and NSES measures. Publication bias was assessed by visual inspection of funnel plots and Egger’s regression test.ResultA total of 21 observational studies, covering 1 244 438 individuals, were included in this meta-analysis. Low NSES, compared with high NSES, was found to be associated with a 31% higher odds of overweight (pooled OR 1.31, 95% CI 1.16 to 1.47, p<0.001), a 45% higher odds of obesity (pooled OR 1.45, 95% CI 1.21 to 1.74, p<0.001) and a 1.09 kg/m2 increase in mean BMI (pooled beta=1.09, 95% CI 0.67 to 1.50, p<0.001).ConclusionNSES disparity might be contributing to the burden of overweight/obesity. Further studies are warranted, including whether addressing NSES disparity could reduce the risk of overweight/obesity.PROSPERO registration numberCRD42017063889

Antenatal corticosteroids in impending preterm deliveries before 25 weeks’ gestation

2017 ◽  
Vol 103 (2) ◽  
pp. F173-F176 ◽  
Author(s):  
Mangesh Deshmukh ◽  
Sanjay Patole
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Periventricular Leukomalacia ◽  
Intraventricular Haemorrhage ◽  
Random Effects Model ◽  
Antenatal Corticosteroids ◽  
Level Of Evidence ◽  
Previous Systematic Review ◽  
Assessment Development ◽  
Low Incidence

Antenatal corticosteroid (ANC) use before 25 weeks’ gestation is controversial. Our previous systematic review (eight observational studies, n=10 109) showed that ANC exposure was associated with significantly reduced mortality and severe intraventricular haemorrhage (IVH)/periventricular leukomalacia (PVL) in neonates born <25 weeks. We update our review by adding data (n=3334) from a recent study. We used Cochrane methodology and summarised the results using GRADE (The Grading of Recommendations Assessment, Development and Evaluation) guidelines. Nine high-quality observational studies were included. Meta-analysis (random effects model) showed reduced mortality (n=13 443; OR=0.48 (95% CI 0.42 to 0.55) P<0.00001; level of evidence (LOE): moderate) and IVH or PVL (n=8418; OR=0.70 (95% CI 0.63 to 0.79), P<0.00001; LOE: moderate) in neonates born <25 weeks exposed to ANC. There was no difference in necrotising enterocolitis (NEC) ≥stage II (n=8737; OR=1.01 (95% CI 0.84 to 1.22), P=0.89; LOE: low); incidence of chronic lung disease (CLD) was higher (n=7983; OR=1.32 (95% CI 1.04 to 1.67), P=0.02; LOE: low) in ANC group. Composite outcomes of death/major morbidities (eg, severe IVH, NEC, CLD) were improved after ANC exposure.

Childhood adversity in schizophrenia: a systematic meta-analysis

2012 ◽  
Vol 43 (2) ◽  
pp. 225-238 ◽  
Author(s):  
S. L. Matheson ◽  
A. M. Shepherd ◽  
R. M. Pinchbeck ◽  
K. R. Laurens ◽  
V. J. Carr
Keyword(s):  
Longitudinal Design ◽  
Meta Analysis ◽  
Childhood Adversity ◽  
Interactive Effects ◽  
Current Evidence ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Assessment Development ◽  
Evidence Quality ◽  
Putative Risk Factor

BackgroundChildhood adversity is a putative risk factor for schizophrenia, although evidence supporting this suggestion is inconsistent and controversial. The aim of this review was to pool and quality assess the current evidence pertaining to childhood adversity in people with schizophrenia compared to other psychiatric disorders and to non-psychiatric controls.MethodIncluded were case-control, cohort and cross-sectional studies. Medline, EMBASE and PsycINFO databases were searched. Study reporting was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist and pooled evidence quality was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsTwenty-five studies met inclusion criteria. Moderate to high quality evidence suggests increased rates of childhood adversity in schizophrenia compared to controls [odds ratio (OR) 3.60, p < 0.00001]. Increased childhood adversity was also reported in schizophrenia compared to anxiety disorders (OR 2.54, p = 0.007), although the effect was not significant in the subgroup analysis of five studies assessing only sexual abuse. No differences in rates of childhood adversity were found between schizophrenia and affective psychosis, depression and personality disorders whereas decreased rates of childhood adversity were found in schizophrenia relative to dissociative disorders and post-traumatic stress disorder (OR 0.03, p < 0.0001).ConclusionsThis is the first meta-analysis to report a medium to large effect of childhood adversity in people with schizophrenia and to assess specificity for schizophrenia. Further research is required that incorporates longitudinal design and other potentially causal variables to assess additive and/or interactive effects.

scholarly journals Oxytocin Use in Trial of Labor after Cesarean and Its Relationship with Risk of Uterine Rupture in Women with One Previous Cesarean Section: A Meta-analysis of Observational Studies.

2020 ◽  
Author(s):  
Huan ZHANG ◽  
Haiyan LIU ◽  
Shouling LUO ◽  
Weirong Gu
Keyword(s):  
Cesarean Section ◽  
Uterine Rupture ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Assessment Development ◽  
Trial Of Labor ◽  
Significant Difference ◽  
Newcastle Ottawa Scale ◽  
Previous Cesarean

Abstract Background Trial of labor after a previous cesarean delivery (TOLAC) has helped to reduce the rate of cesarean section (CS). But the increased rate of adverse outcomes limites the spread of TOLAC. The most serious one is the risk of symptomatic uterine rupture, which is possibly associated with oxytocin. This meta-analysis was to evaluate the risk association between oxytocin use and uterine rupture in TOLAC. Methods Multiple electronic databases (PubMed, Embase, Web of Science, and Google Scholar) were searched for case-control or cross-sectional studies about TOLAC, oxytocin and uterine rupture, which were published between January 1986 and October 2019. The bias-corrected Hedge's g was calculated as the effect size using the random-effects model. The risk of bias was evaluated by the Newcastle-Ottawa Scale (NOS). Quality of the evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) certainty ratings system. Results There were 14 studies meeting inclusion criteria including 48457 women undergoing TOLAC. The pooled rate of VBAC and rate of uterine rupture in spontaneous labor were 74.3% and 0.7%. And the pooled rate of VBAC and rate of uterine rupture in induction labor were 60.7% and 2.2%. The women with spontaneous labor had significantly higher rate of VBAC (p=0.0032) and lower rate of uterine rupture (p=0.0003) than that with induction labor. The pooled rates of uterine rupture in women using oxytocin and women not using oxytocin in TOLAC were 1.4% and 0.5%. There was significant difference between these two groups (p=0.0002). Conclusions In TOLAC, women with induction labor had higher risk of uterine rupture than that with spontaneous labor. Oxytocin use may increase the risk. So simplified and standardized intrapartum management, precise procotol and cautiously monitoring of oxytocin in TOLAC are necessary.

scholarly journals Tocilizumab and Mortality in Hospitalised Patients with Covid-19. A Systematic Review Comparing Randomised Trials with Observational Studies

2021 ◽  
Vol 4 (4) ◽  
pp. 01-29
Author(s):  
Nawab Qizilbash ◽  
Bélène Podmore ◽  
Alessandra Lacetera ◽  
Itziar Ubillos ◽  
Kirsty Andresen ◽  
...  
Keyword(s):  
Relative Risk ◽  
Hospital Mortality ◽  
Observational Studies ◽  
Meta Analysis ◽  
Evidence Base ◽  
Risk Of Bias ◽  
Significant Heterogeneity ◽  
Moderate Risk ◽  
Relative Risks ◽  
Hospitalised Patients

Background: Early observational studies suggested that tocilizumab might produce clinical improvement in covid-19 patients leading to the use of tocilizumab. Early underpowered randomised controlled trials (RCTs) however did not show benefit until the most recent largest trial. RECOVERY trial. We aimed to compare the evidence from RCTs and observational studies of the effect of tocilizumab on in-hospital mortality in patients with covid-19. Materials and Methods: Embase and PubMed were searched from July 2020 until 1 March 2021. Observational studies and RCTs assessing in-hospital mortality in patients receiving tocilizumab compared with standard care or placebo were included. The primary outcome was in-hospital mortality closest to 30 days. The risk of bias in observational studies was assessed using the ROBINS-I tool. A fixed effect meta-analysis was used to combine relative risks, with random effects and risk of bias as a sensitivity analysis. Results: Of 5,792 publications screened for inclusion, eight RCTs and 33 observational studies were identified. The RCTs showed an overall relative risk reduction in in-hospital mortality at 30 days of 0.86 (95% confidence interval (CI) 0.78 to 0.96) with no statistically significant heterogeneity. 23 of the observational studies had a severe risk of bias, 10 of which did not adjust for potential confounders. The 10 observational studies with moderate risk of bias reported a larger reduction in mortality at 30-days (relative risk 0.72, 95% CI 0.64 to 0.81) but with significant heterogeneity (P<0.01). Conclusion: This meta-analysis provides strong evidence from RCTs that tocilizumab reduces the risk of mortality in hospitalised covid-19 patients. Observational studies with moderate risk of bias exaggerated the benefits on mortality two-fold and showed heterogeneity. Collectively observational studies provide a less reliable evidence base for evaluating treatments for covid-19.

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