Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis

Background: Smoking is a major public health problem. Although physicians have a key role in the fight against smoking, some of them are still smoking. Thus, we aimed to conduct a systematic review and meta-analysis on the prevalence of smoking among physicians. Methods: PubMed, Cochrane, and Embase databases were searched. The prevalence of smoking among physicians was estimated and stratified, where possible, by specialties, continents, and periods of time. Then, meta-regressions were performed regarding putative influencing factors such as age and sex. Results: Among 246 studies and 497,081 physicians, the smoking prevalence among physicians was 21% (95CI 20 to 23%). Prevalence of smoking was 25% in medical students, 24% in family practitioners, 18% in surgical specialties, 17% in psychiatrists, 16% in medical specialties, 11% in anesthesiologists, 9% in radiologists, and 8% in pediatricians. Physicians in Europe and Asia had a higher smoking prevalence than in Oceania. The smoking prevalence among physicians has decreased over time. Male physicians had a higher smoking prevalence. Age did not influence smoking prevalence. Conclusion: Prevalence of smoking among physicians is high, around 21%. Family practitioners and medical students have the highest percentage of smokers. All physicians should benefit from targeted preventive strategies.

Download Full-text

Anemia as a risk factor for tuberculosis: a systematic review and meta-analysis

Environmental Health and Preventive Medicine ◽

10.1186/s12199-020-00931-z ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Yemataw Gelaw ◽

Zegeye Getaneh ◽

Mulugeta Melku

Keyword(s):

Systematic Review ◽

Risk Factor ◽

Infectious Diseases ◽

Low Socioeconomic Status ◽

Meta Analysis ◽

Public Health Problem ◽

Cochrane Library ◽

Major Public Health Problem ◽

Double Burden ◽

Mesh Terms

Abstract Background Tuberculosis is a major public health problem caused by Mycobacterium tuberculosis, occurring predominantly in population with low socioeconomic status. It is the second most common cause of death from infectious diseases. Tuberculosis becomes a double burden among anemic patients. Anemia increases an individual’s susceptibility to infectious diseases including tuberculosis by reducing the immunity level. Therefore, the purpose of this study was to determine whether anemia is a risk factor for tuberculosis. Method Relevant published articles were searched in electronic databases like PubMed, Google Scholar, EMBASE, and Cochrane Library using the following MeSH terms: risk factor, predictors, tuberculosis, TB, Anaemia, Anemia, hemoglobin, Hgb, and Hb. Articles written in the English, observational studies conducted on the incidence/prevalence of tuberculosis among anemic patients, or papers examined anemia as risk factors for tuberculosis were included. From those studies meeting eligibility criteria, the first author’s name, publication year, study area, sample size and age of participants, study design, and effect measure of anemia for tuberculosis were extracted. The data were entered using Microsoft Excel and exported to Stata version 11 for analysis. The random-effects model was applied to estimate the pooled OR and HR, and 95% CI. The sources of heterogeneity were tested by Cochrane I-squared statistics. The publication bias was assessed using Egger’s test statistics. Results A total of 17 articles with a 215,294 study participants were included in the analysis. The odd of tuberculosis among anemic patients was 3.56 (95% CI 2.53–5.01) times higher than non-anemic patients. The cohort studies showed that the HR of tuberculosis was 2.01 (95% CI 1.70–2.37) times higher among anemic patients than non-anemic patients. The hazard of tuberculosis also increased with anemia severity (HR 1.37 (95% CI 0.92–2.05), 2.08 (95% CI 1.14–3.79), and 2.66 (95% CI 1.71–4.13) for mild, moderate, and severe anemia, respectively). Conclusion According to the current systematic review and meta-analysis, we can conclude that anemia was a risk factor for tuberculosis. Therefore, anemia screening, early diagnose, and treatment should be provoked in the community to reduce the burden of tuberculosis.

Download Full-text

Pharmacological and behavioural interventions to promote smoking cessation in adults with schizophrenia and bipolar disorders: a systematic review and meta-analysis of randomised trials

BMJ Open ◽

10.1136/bmjopen-2018-027389 ◽

2019 ◽

Vol 9 (11) ◽

pp. e027389 ◽

Cited By ~ 4

Author(s):

Robert Pearsall ◽

Daniel J Smith ◽

John R Geddes

Keyword(s):

Systematic Review ◽

Mental Illness ◽

Smoking Cessation ◽

Serious Mental Illness ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Public Health Problem ◽

Controlled Trials ◽

Major Public Health Problem ◽

Randomised Controlled

ObjectiveSmoking in people with serious mental illness is a major public health problem and contributes to significant levels of morbidity and mortality. The aim of the review was to systematically examine the efficacy of methods used to aid smoking cessation in people with serious mental illness.MethodA systematic review and meta-analysis of randomised controlled trials to compare the effectiveness and safety of pharmacological and behavioural programmes for smoking cessation in people with serious mental illness. Electronic databases were searched for trials to July 2018. We used the Cochrane Collaboration’s tool for assessing the risk of bias.ResultsTwenty-eight randomised controlled trials were identified. Varenicline increased the likelihood of smoking cessation at both 3 months (risk ratio (RR) 3.56, 95% CI 1.82 to 6.96, p=0.0002) and at 6 months (RR 3.69, 95% CI 1.08 to 12.60, p=0.04). Bupropion was effective at 3 months (RR 3.96, 95% CI 1.86 to 8.40, p=0.0003), especially at a dose of 300 mg/day, but there was no evidence of effect at 6 months (RR 2.22, 95% CI 0.52 to 9.47, p=0.28). In one small study, nicotine therapy proved effective at increasing smoking cessation up to a period of 3 months. Bupropion used in conjunction with nicotine replacement therapy showed more effect than single use. Behavioural and bespoke interventions showed little overall benefit. Side effects were found to be low.ConclusionThe new information of this review was the effectiveness of varenicline for smoking cessation at both 3 and 6 months and the lack of evidence to support the use of both bupropion and nicotine products for sustained abstinence longer than 3 months. Overall, the review found relatively few studies in this population.

Download Full-text

Lowest wealth quintiles predispose under-five children to stunting in Ethiopia: Updates of systematic review and meta-analysis

10.21203/rs.3.rs-58090/v1 ◽

2020 ◽

Author(s):

Mesfin Wudu Kassaw ◽

Aschalew Afework ◽

Alemayehu Digssie ◽

Netsanet Fentahun ◽

Murat Açık ◽

...

Keyword(s):

Systematic Review ◽

Publication Bias ◽

Meta Analysis ◽

Public Health Problem ◽

Wealth Index ◽

Forest Plot ◽

Major Public Health Problem ◽

Under Five ◽

Under Five Children ◽

Pooled Prevalence

Abstract Background: Malnutrition remains as a major public health problem in the world, particularly in developing countries such as Ethiopia. The prevalence of stunting in Ethiopia has been decreased considerably from 58% in 2000 to 44% in 2011 and 38% in 2016. The aim of this systematic review and meta-analysis is to assess the prevalence of stunting and its associations with wealth index among under-five children in Ethiopia. Methodology: The databases screened were PubMed/MEDLINE, Scopus, HINARI and grey literatures. The studies’ qualities were assessed by two reviewers independently, and any controversy was handled by other reviewers using the JBI critical appraisal checklist. In the statistical analysis, the funnel plot, Egger’s test, and Begg’s test were used to assess publication bias. The I2 statistic, forest plot, and Cochran’s Q test were used to deal with heterogeneity. Results: The pooled prevalence of stunting was 41.5% among under-five children, despite its considerable heterogeneity (I2=97.6%, p<0.001). However, the included studies had no publication bias in calculating the pooled prevalence (Egger’s test p=0.26; Begg’s test p=0.87). Children from households with a medium or low/poor wealth index had higher odds of stunting (AOR 1.33, 95% CI: 1.07, 1.65 or AOR 1.92, 95% CI: 1.46, 2.54, respectively) compared to children from households with a high/rich wealth index. Conclusions: The pooled prevalence of stunting is great. In the subgroup analysis, the Amhara region, followed by the Oromia region and then the Tigray region had the highest prevalence of stunting

Download Full-text

Sero-epidemiology and associated factors of HIV, HBV, HCV and syphilis among blood donors in Ethiopia: a systematic review and meta-analysis

BMC Infectious Diseases ◽

10.1186/s12879-021-06505-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mulugeta Melku ◽

Sintayehu Ambachew ◽

Bamlaku Enawgaw ◽

Molla Abebe ◽

Zegeye Abebe ◽

...

Keyword(s):

Systematic Review ◽

Random Effects ◽

Blood Donor ◽

Blood Donors ◽

Meta Analysis ◽

National Level ◽

Public Health Problem ◽

Major Public Health Problem ◽

Random Effects Model ◽

Syphilis Infection

Abstract Background Transfusion transmissible infections (TTIs) remain a major public health problem in developing countries including Ethiopia. In Ethiopia, comprehensive information about sero-epidemiology of major TTIs is lacking at the national level. Therefore, this systematic review and meta-analysis was aimed at providing the pooled estimate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among blood donors in Ethiopia. Methods Relevant studies published until May 31, 2019 were searched through PubMed/Medline, EMBASE, SCOPUS, HINARI, Cochrane database library, Web of Science, Google Scholar and Google. The methodological quality of articles was assessed using Joanna Brigg’s Institute critical appraisal checklist for prevalence and analytical studies. The pooled sero-epidemiology of HIV, HBV, HCV and syphilis were determined using the random-effects model. Heterogeneity between the studies was assessed using the I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics. Results A total of 7921 articles were retrieved, and 7798 were screened for eligibility after duplicates removed. Forty-nine full-text articles were assessed for eligibility; of which 45 were eligible for qualitative and quantitative synthesis: categorized as 36, 34, 31 and 23 studies for estimations of HBV, HIV, HCV and syphilis, respectively. In the random-effects model, the pooled sero-epidemiology of HBV, HIV, HCV and syphilis was 5.20, 2.83, 0.93 and 1.50%, respectively. Moreover, being a male blood donor was significantly associated with HBV and syphilis infection, whereas being a replacement blood donor was significantly associated with a high burden of HIV, HBV and HCV infections. Conclusion The pooled sero-epidemiology of major TTIs among blood donors was high. Therefore, there is a need to design prevention and control strategies in a comprehensive approach to reduce the burden.

Download Full-text

Mechanism of Action of Limonene in Tumor Cells: A Systematic Review and Metanalysis

Current Pharmaceutical Design ◽

10.2174/1381612826666201026152902 ◽

2020 ◽

Vol 26 ◽

Author(s):

Juliana de Vasconcelos Cerqueira Braz ◽

Fernanda Oliveira de Carvalho ◽

Daniele de Vasconcelos Cerqueira Meneses ◽

Fernanda Araújo Felipe Calixto ◽

Hericalizandra Santa Rosa Santana ◽

...

Keyword(s):

Systematic Review ◽

Tumor Regression ◽

Case Reports ◽

Meta Analysis ◽

Public Health Problem ◽

Major Public Health Problem ◽

Kappa Index ◽

Induced Apoptosis

Background: Cancer is a complex, multifactorial disease, and a major public health problem, as it is a leading cause of morbidity and mortality worldwide. Although treatments have significantly improved, there is a still a search for more effective drugs. One source for these are natural products (NPs). One NP that has shown anticancer activity is Limonene. However, the mechanisms of limonene's antiproliferative, anticancer and antineoplastic activity are not fully understood. Objective: The objective of this study is, therefore, to undertake a systematic review and meta-analysis of the literature on this subject. Methods: A comprehensive literature search was performed using the Scopus, MEDLINE-PubMed, Web of Science, and Science Direct databases using the keywords: "limonene", “cancer”, “neoplasm”, “tumor”. The inclusion criteria were: in vivo and in vitro studies on the use of limonene in cancer published in English, Portuguese and Spanish until December 2019. Review articles, meta-analyses, abstracts, conference papers, editorials/letters and case reports were excluded. Results: The search identified 3568 articles. Of which 126 were selected for full reading with 11 papers meeting the review criteria. Six more papers were added from the references of the initial 11 texts, giving a total of 17 papers. There was a high level of agreement on inclusion/exclusion (Kappa index > 80%). Risk of bias I the texts was shown to be high. Conclusion: The meta-analysis suggests that limonene acts mainly on tumor regression induced apoptosis, and is a promising natural product for use in the treatment of several types of cancer.

Download Full-text

Burnout in medical students before residency: A systematic review and meta-analysis

European Psychiatry ◽

10.1016/j.eurpsy.2018.08.006 ◽

2019 ◽

Vol 55 ◽

pp. 36-42 ◽

Cited By ~ 38

Author(s):

Ariel Frajerman ◽

Yannick Morvan ◽

Marie-Odile Krebs ◽

Philip Gorwood ◽

Boris Chaumette

Keyword(s):

Systematic Review ◽

Medical Students ◽

English Language ◽

Meta Analysis ◽

Personal Accomplishment ◽

Preventive Strategies ◽

Validated Questionnaires ◽

Current Prevalence ◽

Medical Population ◽

High Level

AbstractBackground:Applying the concept of burnout to medical students before residency is relatively recent. Its estimated prevalence varies significantly between studies. Our objective was to estimate the prevalence of burnout in medical students worldwide.Methods:We systematically searched Medline for English-language articles published between January 1, 2010 and December 31, 2017. We selected all the original studies about the prevalence of burnout in medical students before residency, using validated questionnaires for burnout. Statistical analyses were conducted using the OpenMetaAnalyst software.Results:Prevalence of current burnout was extracted from 24 studies encompassing 17,431 medical students. Among them, 8060 suffered from burnout and we estimated the prevalence to be 44.2% [33.4%–55.0%]. The information about the prevalence of each subset of burnout dimensions was given in nine studies including 7588 students. Current prevalence was estimated to be 40.8% for ‘emotional exhaustion’ [32.8%–48.9%], 35.1% [27.2%–43.0%] for ‘depersonalization’ and 27.4% [20.5%–34.3%] for ‘personal accomplishment’. There is no significant gender difference in burnout. The prevalence of burnout is slightly different across countries with a higher prevalence in Oceania and the Middle East than in other continents.Conclusions:The results of this meta-analysis suggest that one student out of two is suffering from burnout, even before residency. Again, our findings highlight the high level of distress in the medical population. These results should encourage the development of preventive strategies.

Download Full-text

Hepatitis B infection in the general population of China: a systematic review and meta-analysis

BMC Infectious Diseases ◽

10.1186/s12879-019-4428-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 13

Author(s):

Huai Wang ◽

Peixuan Men ◽

Yufeng Xiao ◽

Pei Gao ◽

Min Lv ◽

...

Keyword(s):

Systematic Review ◽

General Population ◽

Hepatitis B ◽

Rural Areas ◽

Urban Areas ◽

Meta Analysis ◽

Public Health Problem ◽

Hbv Infection ◽

Control Measures ◽

Major Public Health Problem

Abstract Background Hepatitis B virus (HBV) infection is a major public health problem in China. Over a decade has passed since the last National Hepatitis Seroepidemiological Survey was conducted in 2006. The lack of updated data on hepatitis B in China makes assessing the current prevalence and burden of the disease inadequate. In response to the above situation, a systematic review and meta-analysis was conducted to provide a better understanding of hepatitis B epidemiology in the general population of China. Methods A systematic search was conducted in international databases (Medline through PubMed, EMBASE, Cochrane, Web of Science) and national databases (CBM, CNKI, WanFang Data) to retrieve primary studies published between January 1, 2013 and December 31, 2017. The pooled prevalence of HBV infection and 95% confidence intervals were calculated. Quality assessment, heterogeneity testing and publication bias assessment were also performed. Results Of the 27 studies included in the meta-analysis, the pooled estimated prevalence of HBV infection in the general population of China from 2013 to 2017 was 6.89% (95% CI:5.84–7.95%), which could be extrapolated to an estimated population of 84 million living with HBsAg in 2018. The prevalence of HBV infection in males was higher than that in females (5.88% vs 5.05%), and rural areas had a higher prevalence than urban areas (5.86% vs 3.29%). The highest prevalence of HBV infection was reported in Western provinces (8.92, 95% CI: 7.19–10.64%). In adults older than 20 years, the prevalence of HBV infection was approximately 7%, which was higher than that in children. Conclusion The prevalence of HBV infection in the general population of China was classified as higher intermediate prevalence (5–7.99%), of which more than 90% of the HBV infection population included adults older than 20 years. The blocking of mother-to-infant hepatitis B transmission and plans involving timely birth dose of hepatitis B vaccine within 24 h should be implemented. Additionally, improving the quality of life and survival rate of the infected population through antiviral therapy and high-risk adult vaccination will be the priority of our future work. Moreover, various control measures should be implemented in different provinces across China.

Download Full-text

Vitamin D deficiency during pregnancy in Turkey and the effect of the sunlight: a systematic review and meta-analysis

Turkish Journal of Biochemistry ◽

10.1515/tjb-2020-0059 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Burkay Yakar ◽

Mehmet Onur Kaya

Keyword(s):

Systematic Review ◽

Vitamin D ◽

Vitamin D Deficiency ◽

English Language ◽

Web Of Science ◽

Citation Index ◽

Meta Analysis ◽

Public Health Problem ◽

Major Public Health Problem ◽

In Pregnancy

Abstract Objectives vitamin D deficiency is a common and important problem during pregnancy. vitamin D deficiency in pregnancy can cause serious health problems for both mother and fetus. The aim of this study was to systematically review the literature for studies that assessed vitamin D status during pregnancy in the Turkey and affects of the sunlight on Vitamin D deficiency. Methods We conducted a systematic review and meta-analysis focused on vitamin D deficiency among pregnancy. PubMed, Scopus, Web of Science and Turkey citation index databases were searched between January 2010 and October 2019 was undertaken using keywords for ‘Vitamin D deficiency’ and ‘Pregnancy’ and ‘Turkey’ with English language restrictions imposed. Results A total of 66 studies were identified; 14 were included in the review. The prevalence of vitamin D deficiency in pregnancy was 83%, including all studies regardless of time in Turkey. When evaluated seasonal period, the prevalence of vitamin D deficiency was 73% in pregnant women in the sunny period, while it was 90% in the less sunny period. Conclusions The prevalence of vitamin D deficiency is high in pregnancy and is a major public health problem in Turkey. Turkey specific strategies should be developed for reducing vitamin D deficiency prevalence by investigation of risk factors and protective factors of vitamin D deficiency.

Download Full-text

Customary physical activity and odds of depression: a systematic review and meta-analysis of 111 prospective cohort studies

British Journal of Sports Medicine ◽

10.1136/bjsports-2020-103140 ◽

2021 ◽

pp. bjsports-2020-103140

Author(s):

Rodney K Dishman ◽

Cillian P McDowell ◽

Matthew Payton Herring

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Depressive Symptoms ◽

Cohort Studies ◽

Prospective Cohort ◽

Observational Studies ◽

Meta Analysis ◽

Vigorous Physical Activity ◽

Prospective Cohort Studies ◽

Over Time

ObjectiveTo explore whether physical activity is inversely associated with the onset of depression, we quantified the cumulative association of customary physical activity with incident depression and with an increase in subclinical depressive symptoms over time as reported from prospective observational studies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, PsycINFO, PsycARTICLES and CINAHL Complete databases, supplemented by Google Scholar.Eligibility criteriaProspective cohort studies in adults, published prior to January 2020, reporting associations between physical activity and depression.Study appraisal and synthesisMultilevel random-effects meta-analysis was performed adjusting for study and cohort or region. Mixed-model meta-regression of putative modifiers.ResultsSearches yielded 111 reports including over 3 million adults sampled from 11 nations in five continents. Odds of incident cases of depression or an increase in subclinical depressive symptoms were reduced after exposure to physical activity (OR, 95% CI) in crude (0.69, 0.63 to 0.75; I2=93.7) and adjusted (0.79, 0.75 to 0.82; I2=87.6) analyses. Results were materially the same for incident depression and subclinical symptoms. Odds were lower after moderate or vigorous physical activity that met public health guidelines than after light physical activity. These odds were also lower when exposure to physical activity increased over time during a study period compared with the odds when physical activity was captured as a single baseline measure of exposure.ConclusionCustomary and increasing levels of moderate-to-vigorous physical activity in observational studies are inversely associated with incident depression and the onset of subclinical depressive symptoms among adults regardless of global region, gender, age or follow-up period.

Download Full-text