Folate fortification and supplementation in prevention of folate-sensitive neural tube defects: a systematic review of policy

2020 ◽  
pp. 1-17
Author(s):  
Nathan A. Shlobin ◽  
Melissa A. LoPresti ◽  
Rebecca Y. Du ◽  
Sandi Lam
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Systematic Review ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Scientific Evidence ◽  
Cost Savings ◽  
Folate Supplementation ◽  
Effect Change

OBJECTIVENeural tube defects (NTDs) are common congenital neurological defects, resulting in mortality, morbidity, and impaired quality of life for patients and caregivers. While public health interventions that increase folate consumption among women who are or plan to become pregnant are shown to reduce folate-sensitive NTDs, public health policy reflecting the scientific evidence lags behind. The authors aimed to identify the types of policies applied, associated outcomes, and impact of folate fortification and supplementation on NTDs worldwide. By identifying effective legislation, the authors aim to focus advocacy efforts to more broadly effect change, reducing the burden of NTDs in neurosurgery.METHODSA systematic review was conducted exploring folate fortification and supplementation policies using the PubMed and Scopus databases. Titles and abstracts from articles identified were read and selected for full-text review. Studies meeting inclusion criteria were reviewed in full and analyzed for study design, aim, population, interventions, and outcomes.RESULTSOf 1637 resultant articles, 54 were included. Mandatory folate fortification was effective at reducing folate-sensitive NTDs. Mandatory fortification also decreased hospitalization rates and deaths after discharge and increased 1st-year survival for infants with NTDs. Recommended folate supplementation also resulted in decreased NTDs; however, issues with compliance and adherence were a concern and impacted effectiveness. Folate fortification and/or supplementation resulted in decreased NTD prevalence, although more change was attributed to fortification. Dual policies may hold the most promise. Furthermore, reductions in NTDs were associated with significant cost savings over time.CONCLUSIONSBoth mandatory folate fortification and recommended supplementation policies were found to effectively decrease folate-sensitive NTD rates when applied. A comprehensive approach incorporating mandatory folate fortification, appropriate folate supplementation, and improved infrastructure and access to prenatal care may lead to decreased NTDs worldwide. This approach should be context-specific, emphasize education, and account for regional access to healthcare and social determinants of health. With wide implications for NTDs, associated health outcomes, quality of life of patients and caregivers, and economic impacts, policy changes can drastically improve global NTD outcomes. As caretakers of children with NTDs, the authors as neurosurgeons advocate for a comprehensive policy, the engagement of stakeholders, and a broader global impact.

scholarly journals Palliative care services: Issues and public health challenges

2013 ◽  
Vol 2 (2) ◽  
pp. 5-15
Author(s):  
Riawati Jahja
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Systematic Review ◽  
Health Care ◽  
Palliative Care ◽  
Observational Studies ◽  
Care Services ◽  
Review Articles ◽  
Palliative Care Services

Trials have demonstrated improvement in patients’ quality of life through palliative care services (PCS). However, many of these trials are limited by their research methodologies. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched to conduct a systematic review of review articles related to PCS from January 2001 to December 2011. The paper examined evidence from studies on PCS that aimed to improve elderly patients’ end-of-life outcomes by i) systematically reviewing literature on models of palliative care (PC) delivery patients received; ii) exploring methodological issues surrounding recruitment of the patients, implementation of the studies and comparison of health care services; and iii) addressing the costs of care with/without a palliative program. Seventeen trials and three observational studies were selected from nine systematic review articles. Overall, early introduction of PC to patients following identification of their life-limiting conditions and needs re-quires an organized and coordinated care approach to ensure accessibility of these services. The ideal system that offers the potential of improving patients’ quality of life is one that is integrated, interdisciplinary and holistic. Dying is commonly institutionalized; however, providing outreach programs that allow patients to die at their place of wish, such as domiciliary care, offers the potential of addressing the issue of ever-increasing health-care expenditure for the aged. However, further investigation is needed to evaluate the cost effectiveness of these programs. Methodological problems and ethical issues surrounding the study of terminally-ill patients necessitate that researchers use a combination of observational studies and surveillance system over time. DOI: http://dx.doi.org/10.3329/seajph.v2i2.15937 South East Asia J Public Health | Jul-Dec 2012 | Vol 2 Issue 2 | 5-15

scholarly journals The Role of Physiotherapy in Pediatric Palliative Care: A Systematic Review

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1043
Author(s):  
Silvia Ortiz-Campoy ◽  
Cristina Lirio-Romero ◽  
Helena Romay-Barrero ◽  
David Martín-Caro Álvarez ◽  
Purificación López-Muñoz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Scientific Evidence ◽  
Pediatric Palliative Care ◽  
Cochrane Library ◽  
Her Family ◽  
Life Threatening ◽  
Respiratory Physiotherapy

Pediatric palliative care (PPC) is a set of actions aimed at children who suffer from a severe or life-threatening disease to alleviate the symptoms of the disease and improve the quality of life of both the child and his/her family. One of the tools used to control symptoms is physiotherapy; however, its application in the child population has not been thoroughly studied. The main objective of this study was to gather, analyze, and critically evaluate the available scientific evidence on physiotherapy in children who require palliative care through a systematic review of the studies published in the last 10 years in the following databases: PubMed, Cochrane Library, PEDro, CINAHL, and Scopus. Of a total of 622 studies, the inclusion criteria were only met by seven articles, which were focused on the relationship between physiotherapy and PPC. This study analyzed: (1) the main pathologies treated, with a predominance of cerebral palsy and cancer; (2) the interventions applied, such as respiratory physiotherapy, neurological physiotherapy, therapeutic massage, and virtual reality; (3) the effects achieved in the child and his/her family, highlighting the control of symptoms and the improvement of the quality of life; and (4) the knowledge of the physiotherapists on PPC, observing that most of the professionals had not received training in this scope. The findings of this review indicate a lack of an adequate evidence foundation for physiotherapy in PPC.

scholarly journals Effect of Postpartum Anaemia on Maternal Health-Related Quality of Life: A Systematic Review

2021 ◽  
Author(s):  
Ernest Moya ◽  
Nomsa Phiri ◽  
Martin N. Mwangi ◽  
Kamija Phiri
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Systematic Review ◽  
Maternal Health ◽  
Health Related Quality ◽  
Physical Fatigue ◽  
Child Interaction ◽  
Related Quality ◽  
Health Related

Abstract Background: Postpartum anaemia remains a persistent and severe public health issue in many parts of the world. Studies have reported mixed findings on the effects of anaemia during the postpartum period on maternal health-related quality of life (HRQoL). We conducted this systematic review to summarise available evidence to inform public health practitioners on whether 1) anaemia negatively impact maternal health-related quality of life and 2) whether iron supplementation in anaemic women can improve maternal HRQoL during the postpartum period. Methods: This review’s protocol was registered online with PROSPERO (CRD42020206618). We extensively searched Embase, PubMed, Cochrane and Scopus through the HINARI website to identify studies that reported either association or effect of postpartum anaemia on fatigue, depression and mother-child interaction. We restricted our search to studies of human females published in English from databases inception until August 2020. We followed a guideline for reporting systematic reviews without meta-analysis to synthesise data. Results: Ten out of 15 studies where the direction of effect could be determined reported a significant association between lower Hb levels and physical fatigue symptoms. Fourteen out of 19 studies also reported a significant association between Hb levels and postpartum depression. There was evidence in six of the seven and seven of the eight randomised controlled trials that iron replenishment significantly decreased physical fatigue and postpartum depression respectively. Two of the four included studies showed that anaemic mothers were less responsive and had negative feelings towards their children than non-anaemic mother. Conclusion: Evidence from this review suggests that postpartum anaemia negatively affects health related quality of life and that iron replenishment improved both symptoms of fatigue and depression. Nevertheless, it remains unclear whether postpartum anaemia affects mother-child interaction.

scholarly journals Impact of aquatic exercise on persons with kidney disease: a systematic review and meta-analysis

2020 ◽  
Vol 37 (5) ◽  
pp. 339-347
Author(s):  
D Rodríguez Rey ◽  
MA Sanchez-Lastra ◽  
C Ayán Pérez
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Kidney Disease ◽  
Physical Exercise ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Aquatic Exercise ◽  
The Impact

Objective: Analyze the scientific evidence on the effects that aquatic physical exercise has on people with chronic kidney disease (CKD). Material and method: A systematic review was carried out following the checklist Preferred Reporting Items for Systematic review and Meta-Analysis Protocols, with the objective of locating the largest number of investigations that aimed to identify the effects of the practice of aquatic physical exercise in people with ERC. A search of the PubMed, PEDro, Scopus and Cochrane databases were carried out until March 2019, using the PEDro, CERT, MINORS and NIH scales to determine the methodological quality of the same. Results: Five investigations were located, two of them were randomized control trials, another two studies comparatives and one was uncontrolled. The mean score and the median obtained after applying PEDro scale were 4 and 4 respectively. All the interventions proposed aerobic exercise programs, being generally of short duration and highly supervised, without any adverse effects arising from their practice. In a large part of the studies, significant effects were observed in physical condition, physiological parameters and quality of life, to a lesser extent. The practice of exercise had no significant impact on either the activity of the disease or the perceived pain in patients. Conclusions: Practice of aquatic exercise is beneficial in people with ERC. More longitudinal studies are needed to assess the impact of aquatic exercises as well as its effect and quality of life in long term.

scholarly journals The Burden of Hidradenitis Suppurativa Signs and Symptoms in Quality of Life: Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (13) ◽  
pp. 6709
Author(s):  
Trinidad Montero-Vilchez ◽  
Pablo Diaz-Calvillo ◽  
Juan-Angel Rodriguez-Pozo ◽  
Carlos Cuenca-Barrales ◽  
Antonio Martinez-Lopez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Hidradenitis Suppurativa ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Signs And Symptoms ◽  
Sexual Distress ◽  
The Mean ◽  
The Impact

Hidradenitis suppurativa (HS) is a chronic, recurrent and debilitating inflammatory skin disease of the hair follicle that usually presents as painful, deep-seated inflamed lesions in the apocrine gland-bearing areas of the body. HS patients suffer from uncomfortable signs and symptoms, such as pain, pruritus, malodour and suppuration, which may impair patients’ quality of life (QoL). Although HS patients frequently experience these signs and symptoms, they are only occasionally assessed by clinicians and, unexpectedly, the scientific evidence available is limited and heterogeneous. The aim of this study is to summarize the evidence regarding the impact of HS signs and symptoms on QoL to serve as a basis for future research and help clinicians to consider them in the daily care of HS patients. A systematic review and meta-analysis were conducted following PRISMA Guidelines. The following search algorithm was used: (hidradenitis or “acne inversa”) and (pain or itch or odour or malodour or suppuration or oozing or drainage) and (“quality of life”). The literature search identified 836 references, 17 of them met the eligible criteria and were included for analysis, representing 4929 HS patients. Mean age of the participants was 36.28 years and there was a predominance of female sex among study participants. The BMI of the population was in the range of over-weight and about two out five patients were active smokers. Studies included patients with mild to moderate HS, with a mean disease duration of 13.69 years. The HS signs and symptoms assessed were pain, pruritus, malodour and suppuration. Overall, the higher intensity of a sign or symptom correlated with poorer general QoL or specific QoL dimensions including sexual distress, anxiety, depression and sleep. The most frequently employed tool to assess QoL was the Dermatology Life Quality Index (DLQI). DLQI was used in 52.9% of the studies (9/17) with a mean value of 10.70 (2.16 SD). The scores employed to assess signs and symptoms severity were subjective and varied between studies, being the numerical rating scale (NRS) for each of the most used symptoms. The mean NRS value for pain was 3.99 and the mean NRS for pruritus was 4.99. In conclusion, we have summarized, categorized and analyzed the scientific evidence regarding signs and symptoms in HS patients and their impairment in QoL. Their assessment should be thorough and included during routine evaluation of HS patients to motivate therapeutic modifications and increase patients’ health.

scholarly journals Surgical Treatment of Neural Tube Defects

2021 ◽  
Author(s):  
Juraj Šutovský
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spina Bifida ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Neural Tissue ◽  
Prenatal Development ◽  
Nerve Roots ◽  
Live Births

Neural tube defects (NTDs) are developmental pathologies associated with undesirable lifelong consequences. Incidence of these pathologies differs between countries and regions depending on socio-economic and healthcare quality. It is also influenced by folic acid and zinc supplementation. Genetic factors influence probability of NTD, increasing risk of defect in siblings up to 3–8%. Estimated incidence in United States is 3–4/10000 live births, and worldwide incidence increases on about 10/10000 live births. Despite various types and localizations of spina bifida, in all of them neural tissue is in danger. This can lead to various types of neurologic disorders. Not only due to direct damaging of spinal cord and nerve roots but also other parts of central nervous system are also endangered by disturbed prenatal development. Other consequences as orthopedic abnormalities, bladder, and bowel dysfunction influence quality of life. Surgical therapy is often the only possibility to preserve existing function of neural tissue, allows its further development and prevents complications. In this chapter surgical techniques with aim to restore spinal cord and nerve roots anatomy, preservation of its function and defect closures are presented. Also, treatment of possible comorbidities and complications is discussed. Spina bifida management requires multi-speciality cooperation and care to monitor, prevent and treat various potential complication that can negatively influence quality of life and even survival. Prenatal diagnosis is based on maternal screening of serum alpha fetoprotein (AFP) levels and prenatal ultrasonography examination. As the suspicion of neural tube defect arises, an amniocentesis is recommended to complete a genetic analysis and obtain amniotic fluid for more precise AFP and acetylcholinesterase examination. Some types of neural tube defects are diagnosed after delivery, some are symptomatic until adulthood and some are diagnosed incidentally. Each of them requires specific management, based on underlying pathology.

scholarly journals Public health nursing interventions to promote quality of life in older adult populations: A systematic review

2017 ◽  
Vol 7 (11) ◽  
pp. 92
Author(s):  
Marjorie A. Schaffer ◽  
Mary Kalfoss ◽  
Kari Glavin
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Systematic Review ◽  
Older Adult ◽  
Experimental Studies ◽  
Public Health Intervention ◽  
Well Being ◽  
Functional Health ◽  
Public Health Nurses

This review analyzes how nurse-led public health interventions promote quality of life (QoL) among older populations. Using Medline and Cinahl databases, authors completed a systematic review of experimental and quasi-experimental studies published between January 2010 and March 2016 that described interventions used by public health nurses to address health needs of older adult populations. Lawton’s theoretical QoL concepts and the Public Health Intervention Wheel model, which names interventions at the individual, community and systems levels, were used to interpret results. The 23 studies were widely distributed geographically. Four of Lawton’s theoretical QoL domains (Health, Functional Health, Personal Competency, Psychological Well-Being) were addressed in the majority of studies. Although public health nurses used Wheel interventions at all levels of practice, individual level interventions were featured in studies to a greater extent in comparison to community and systems level interventions. Few studies used QoL measures to determine intervention effectiveness.  Nurses should consider QoL domains, as they design individual, community, and systems level interventions to improve the health of older adult populations.

scholarly journals Exercise as a Therapeutic and Supporting Strategy for Climacteric Symptoms: an Evidence-Based Review

2021 ◽  
Vol 23 (1) ◽  
pp. 35-38
Author(s):  
Rodrigo Gomes Pereira Pinto ◽  
David Michel de Oliveira ◽  
Anderson Geremias Macedo ◽  
Giselle Soares Passos
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Physical Exercise ◽  
Scientific Evidence ◽  
Experimental Studies ◽  
Health Improvement ◽  
Climacteric Symptoms ◽  
Eligibility Criteria ◽  
Cross Sectional

AbstractClimacteric is a natural process characterized by the female hormones reduction and increased symptoms that interfere in the woman's quality of life. The objective was to raise scientific evidence on the physical exercise effects as a therapeutic strategy on climacteric symptoms. This systematic review study accessed the Virtual Health Library (VHL) and consulted articles from the last 10 years, with the following eligibility criteria; inclusion, scientific articles published in the last 10 years, with clinical, quasi-experimental, cross-sectional design and case studies conducted with women in the climacteric. Articles published before 2010 with delineations were excluded; epidemiological, systematic review, meta-analyzes, experimental studies with animal model. The studies included in the review were read in full, critically analyzed and categorized. The findings showed that active women have a reduction in vasomotor and somatic symptoms of the climacteric, also collaborating in the prevention of diseases prevalent in this period. Aerobic physical exercise improves physical fitness and quality of life indicators of climacteric women. In clinical practice, aerobic exercise can be considered an auxiliary strategy in the climacteric symptoms treatment and female health improvement. Keywords: Climacteric. Health. Physical Exercise. ResumoO climatério é um processo natural caracterizado pela redução dos hormônios femininos e aumento de sintomas que interferem na qualidade de vida da mulher. Objetivou-se levantar evidências científicas sobre os efeitos do exercício físico como estratégia terapêutica na sintomatologia climatérica. Este estudo de revisão sistemática acessou a Biblioteca Virtual de Saúde (BVS) e consultou artigo dos últimos 10 anos, com os seguintes critérios de elegibilidade; inclusão, artigos científicos com delineamento clínico, quase-experimental, transversal e estudos de caso realizados com mulheres no climatério. Foram excluídos artigos publicados anterior a 2010, com delineamentos; epidemiológico, revisão sistemática, metanálises, estudos experimentais com modelo animal. Os estudos incluídos na revisão foram lidos na integra, analisados criticamente e categorizados. Os achados demonstraram que mulheres ativas apresentam redução dos sintomas vasomotores e somáticos do climatério, também colabora na prevenção de doenças prevalentes nesse período. O exercício físico aeróbio melhora a aptidão física e indicadores de qualidade de vida de mulheres climatéricas. Na prática clínica o exercício aeróbio pode ser considerado uma estratégia auxiliar no tratamento dos sintomas do climatério e melhora da saúde feminina. Palavras-chave: Climatério. Saúde. Exercício Físico.

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