Health Outcome Measures Research Articles

The effects of microprocessor prosthetic knee use in early rehabilitation: A pilot randomized controlled trial.

Microprocessor-controlled prosthetic knees (MPKs) improve safety, stability, and mobility for people with transfemoral amputation. Despite these benefits, MPKs are often not used for people in early rehabilitation. To assess the feasibility of a study that compares MPKs and nonmicroprocessor knees (NMPKs) for people with recent transfemoral amputation and report on health outcomes after 3 months of use. Investigators hypothesized that MPK users would have better outcomes than NMPK users. Pilot randomized controlled study. Institutional laboratory. Adults with recent unilateral transfemoral amputation, deemed ready for their first prosthesis, and weighed <125 kg. Eighteen participants enrolled; 15 completed the study. Participants were randomized to use a MPK or NMPK in their first prosthesis. Feasibility outcomes included recruitment, retention, and missing data. Health outcome measures included performance-based and self-reported measures of mobility, participation, step activity, and falls. Eighteen of 24 planned participants enrolled in the study. Fifteen participants received a study prosthesis and completed the 3-month trial (MPK: n = 9; NMPK: n = 6). Participants with an MPK had significantly higher Prosthetic Limb Users Survey of Mobility (p = .01, Hedges' g: 1.70), Activity-specific Balance Confidence (p = .01, Hedges' g: 1.75), and Return to Normal Living Index (p = .05, Hedges' g: 0.54) scores compared to patients with NMPK. No other outcomes significantly differed between groups; effect sizes (0.47-1.75) across mobility outcomes indicated better outcomes in the MPK group. Enrollment goals were limited by the COVID-19 pandemic, but all 15 participants who received a study prosthesis finished the 3-month pilot study. The MPK group generally had better 3-month outcomes than the NMPK group, but few statistically significant differences were found due to the small sample size and heterogeneity within groups. Results from this pilot study can inform and power future studies that compare MPKs and NMPKs in early rehabilitation.

Does Less Education Harm Health? Evidence From a Natural Experiment in a Developing Country

ABSTRACTWe investigate the health outcome effects of a reduction in years of schooling in Egypt in 1988, a policy change that moves in the opposite direction in relation to the extant literature. We exploit this policy change as a natural experiment and employ a fuzzy regression discontinuity design to investigate a range of objectively measured health outcomes and behaviours. Despite the policy's adverse effect on students' years of schooling and ability to complete educational milestones, there is no statistical effect on any health outcomes. Results also suggest that the reduction in years of schooling had no effect on labour market outcomes, thus providing a rationale for the lack of effect on health outcomes. While increasing education often leads to improved health outcomes, our findings suggest that decreasing education does not necessarily result in poorer health outcomes.

Exploring the involvement of people with lived experience of mental disorders in co-developing outcome measures: a systematic review.

People with lived experience of mental health difficulties have highlighted that research outcomes do not capture issues they feel are important. This mismatch might affect the validity of trials, such that beneficial effects could be missed or results could be counted as a benefit when they are not. Co-development of patient-reported outcome measures ensures patient perspectives are captured adequately. To identify mental health outcome measures that meet a strict definition of being co-developed and to describe the methods and quantity of involvement at each pre-defined stage of measure co-development, we searched five electronic databases (MEDLINE, Web of Science, Scopus, PsycINFO, and Embase) for relevant papers, alongside a search of the non-peer reviewed literature and handsearching. The study was registered on PROSPERO (CRD42024520941). Retrieved papers were independently screened and quality was assessed following PRISMA guidelines. Extracted data were synthesised narratively. The search identified 23 mental health outcome measures from 34 papers. The most frequent types of involvement to co-develop outcomes were service-user researchers and lived experience groups as advisors undertaking activities such as leading qualitative exercises, but there were gaps. Many benefits were reported such as increased relevancy and acceptability of the measures. Based on these findings, recommendations for methods and a novel scale for judging quantity of involvement for co-development were identified, but challenges for co-development remain. The reviewed papers show that co-development is possible and could provide more relevant and meaningful outcomes for clinical practice and research.

Association of extreme heat events with sleep and cardiovascular health: a scoping review

BackgroundExtreme heat events (EHEs), driven by anthropogenic climate change, exacerbate the risk of cardiovascular disease (CVD), although the underlying mechanisms are unclear. A possible mechanism leading to heat-related CVD is disturbances in sleep health, which can increase the risk of hypertension, and is associated with ideal cardiovascular health. Thus, our objective was to systematically review the peer-reviewed literature that describes the relationship between EHEs, sleep health, and cardiovascular measures and outcomes and narratively describe methodologies, evidence, and gaps in this area in order to develop a future research agenda linking sleep health, EHEs, and CVD.MethodsA comprehensive literature search was performed in the following databases from inception–June 2023: Ovid MEDLINE, Ovid Embase, CINAHL, Web of Science, and the Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria. Then studies were described qualitatively in relation to study design, findings, and the evidence linking the relationship between sleep health, EHEs, and CVD.ResultsOf the 2035 records screened, only three studies met the inclusion criteria. In these three studies, EHE was measured as absolute temperatures (greater than 30 °C) or relative temperatures (i.e., 90th percentile daily maximum temperature within the region). Cardiovascular (CV) measures described included blood pressure (BP), heart rate (HR), and HR variability (no CVD outcomes were described), and objective and subjective measurements of sleep health outcomes included sleep duration, calmness, ease of falling asleep, ease of awakening, freshness after awakening, and sleep satisfaction. Two studies were controlled trials, and one was a cohort study. During EHEs, individuals slept for shorter periods of time and less efficiently, with greater degrees of HR variability in two of the three studies lasting at most 1–2 days; BP (both systolic and diastolic) significantly decreased during EHEs in two of the studies. No formal assessment of a mediating relationship between EHE exposure, sleep outcomes, and CV measures was undertaken.ConclusionsFew studies examine the link between CVD, sleep, and extreme heat as a possible mechanism of elevated CVD risk during EHEs, despite a strong physiological rationale. Our findings highlight an important gap in the literature that should be closely examined as EHEs become more frequent and their harmful impacts of health increase.

P0952 Effect of a Care Pathway for Inflammatory Bowel Disease on Patient Outcomes and Healthcare Utilization: results of the IBD Value Study

Abstract Background Eight hospitals in the southwest of the Netherlands collaborate to improve care for patients with inflammatory bowel disease (IBD). This collaboration aims to deliver high quality and uniform care across the region. To achieve this, a care pathway (CP) was developed and implemented for the management of IBD with biologicals or small new molecules. The CP is a decision-support tool that provides guidelines for medication prescribing, procedures, treatment adjustments, and recommendations for follow-up. The aim of this study is to evaluate the effect of a CP on patient outcomes and healthcare utilization. Methods We designed a longitudinal multicentre non-randomised cohort study with a baseline observation period (December 2020 – December 2021) and a follow-up period (March 2022 – March 2023), in which adult patients with IBD treated with biologics or small new molecules were included (1). Outcomes were collected according to the International Consortium for Health Outcomes Measurement (ICHOM) standard set from electronic medical records or through validated questionnaires. Effect of the CP on these outcomes were analysed with case-mix adjusted (generalized) linear mixed models. Results A total of 1,173 patients participated in the study, with the majority being female (55%) and a median age of 45 years (IQR 33-58). Most patients had Crohn’s disease (64%). The CP was associated with a 14% increase in the probability of patient-reported disease control (p=0.54). Increases in probability were also observed for patient-reported (β=0.25, p=0.29) and biochemical remission (β=0.17, p=0.37), and the presence of active fistulas (β=0.28, p=0.44). Decreases in probability were found for biological (β=-0.04, p=0.84) and clinician-reported remission (β=-0.16, p=0.48). Emergency room visits (β=-0.32, p=0.18), hospital admissions (β=-0.28, p=0.28), and length of stay (β=-0.23, p=0.20) showed reduction, although these associations were also not significant. The CP had no effect on quality of life (β=0.01, p=0.35) or on anaemia probability (β=0.05, p=0.84). Conclusion A CP for the management of IBD with biologicals and small new molecule has clinically significant potential to reduce healthcare utilization, while improving patient-reported disease control, and biochemical remission. These results emphasize the potential of a CP to improve care for a complex disease as IBD. However, the adherence to the CP and whether these results lead to a reduction in healthcare costs, should be further investigated.

Responsible research in health disparities using the Adolescent Brain Cognitive DevelopmentSM (ABCD) study.

The Adolescent Brain Cognitive DevelopmentSM (ABCD) Study is the largest longitudinal study on brain development and adolescent health in the United States. The study includes a sociodemographically diverse cohort of nearly 12,000 youth born 2005-2009, with an open science model of making data rapidly available to the scientific community. The ABCD Study® data has been used in over 1100 peer-reviewed publications since its first data release in 2018. The dataset contains a broad scope and comprehensive set of measures of youths' behavioral, health, and brain outcomes, as well as extensive contextual and environmental measures that map onto the social determinants of health (SDOH). Understanding the impact of SDOH on the developmental trajectories of youth will help to address early lifecourse health inequities that lead to disparities later in life. However, the open science model and extensive use of ABCD data highlight the need for guidance on appropriate, responsible, and equitable use of the data. Our conceptual framework integrates the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework with strength-based and data equity perspectives. We use this framework to articulate best practices and methods for investigations that aim to identify the multilevel pathways by which structural and systemic inequities impact adolescent health trajectories. Using our conceptual model, we provide recommendations for equitable health disparities research using ABCD Study data. We identify over fifty ABCD measures that can encompass SDOH across five levels of influence: individual, interpersonal, school, community, and societal. We expand the societal level to acknowledge structural discrimination as the root cause of systemic and structural inequities resulting in health disparities among marginalized youth. We apply the methodological recommendations in an example data analysis using a multi-level approach that integrates strength-based and data equity perspectives to elucidate pathways by which social and structural inequities may influence cognitive decision making in youth. We conclude with recommendations for strengthening the utility of ABCD data for health disparities research now and in the future. Adolescence is a critical period of development with subsequent ramifications for health outcomes across the lifespan. Thus, understanding SDOH among diverse youth can inform prevention interventions before the emergence of health disparities in adulthood.

Trimodal brain imaging: A novel approach for simultaneous investigation of human brain function.

While advancements have improved the extent to which individual brain imaging approaches capture information regarding spatial or temporal dynamics of brain activity, the connections between these aspects and their relation to psychological functioning remain only partially understood. Acquisition and integration across multiple brain imaging modalities allows for the possible clarification of these connections. The present review provides an overview of three complementary modalities - functional magnetic resonance imaging (fMRI), electroencephalography/event-related potentials (EEG/ERP), and event-related optical signals (EROS)- and discusses progress and considerations for each modality, along with a summary of a novel protocol for acquiring them simultaneously. Initial evidence points to the feasibility of acquiring and integrating multiple measures of brain function that allows for addressing questions in ways not otherwise possible using traditional approaches. Simultaneous trimodal brain imaging in humans provides new possibilities for clarifying spatiotemporal dynamics of brain activity and for identifying multifaceted associations with measures of individual differences and important health outcomes.

Usual prevention in unusual settings: A scoping review of place-based health interventions in public-facing businesses.

Place-based health interventions may help reach underserved populations. This scoping review summarizes the peer-reviewed literature on the type and effects of place-based health interventions in unconventional public-facing business settings (e.g., retail and services). A literature search was conducted in PubMed, Google Scholar, and APA PsycNet for studies from 1990-2023. Inclusion criteria for studies were: conducted in the United States, delivered a health intervention, based on an unconventional business setting, and targeted a specific health condition. An initial search yielded 2,727 unduplicated studies, which was filtered to 42 studies included in this review. These 42 studies were categorized based on health conditions of focus, including cardiovascular health (12 studies); HIV (6 studies); diabetes (5 studies); cancers (13 studies); and all other conditions (14 studies). The most common unconventional public-facing business settings for health interventions included barbershops or beauty salons; interventions included health education, preventative screenings, pharmacy services, and connections to local healthcare providers and resources. Notably, 34 (81%) of the studies targeted Black populations. Studies reported positive responses from participants for place-based interventions, increased awareness and screening of health conditions, more referrals to healthcare services, and improved health outcomes. While there have been 9 randomized trials conducted across various health conditions, these trials are limited to focus on a few select settings and lack of objective health outcome measures. These findings highlight the need for more rigorously designed studies in diverse settings that can effectively evaluate the impact of place-based health interventions. The existing literature suggests health interventions delivered in public-facing business settings may be a promising strategy to reach underserved populations.

The invisible enemy: A systematic review and meta-analysis of maternal smokeless tobacco use as a risk factor for low birth weight.

Smokeless tobacco use is a growing public health concern, with potential adverse implications for foetal outcomes if consumed during pregnancy. Birth weight is an important predictive measure for health outcomes of a child throughout their lifespan. Despite extensive literature, it is unclear whether smokeless tobacco consumption during pregnancy has an adverse effect on birth weight. Hence, this review was conducted to determine whether an association exists between maternal smokeless tobacco consumption during pregnancy and birth weight of infants. Systematic literature search was performed in Medline (via PubMed), Embase, Scopus, and CINAHL with no restrictions on language or time until May 2024. All observational studies that examined the relationship between maternal smokeless tobacco use and low birth weight of infants were eligible for inclusion. Methodological quality of included studies was assessed using the Newcastle Ottawa Scale. Thirty-three studies were eligible for the review, including twenty-eight cohort, three case-control and two cross-sectional studies. A statistically significant association between use of smokeless tobacco and low birth weight was reported in thirteen studies. Eleven studies reported a statistically significant reduction in mean birth weight in maternal smokeless tobacco users. Pooled estimates of eighteen studies with 733,061 participants showed that there was a statistically significant association (OR = 2.25 [1.63, 3.11] P<0.001); between maternal smokeless tobacco use during pregnancy and low birth weight. Subgroup analysis found a significant association between mishri consumption during pregnancy and low birth weight (n = 646 participants, OR = 10.98 [2.03, 59.34], P = 0.005), but not betel nut (n = 8007 participants, OR = 1.02 [0.84, 1.25]), betel quid (n = 483 participants, OR = 1.51 [0.47, 4.89]) or khat (n = 475 participants, OR = 1.41 [0.64-3.09]). This review presents an association between maternal smokeless tobacco use and low birth weight, and reduction in mean birth weight. It is suggested that cessation and reduction of maternal smokeless tobacco use should receive specific attention within routine prenatal care. The results of this study highlight the need for further preventive public health campaigns to create awareness about detrimental effects of smokeless tobacco on foetal outcomes. Patient education in the primary care setting will aid in promoting smokeless tobacco cessation prior to pregnancy.

A Naturalistic Examination of the Acute Effects of High-Potency Cannabis on Emotion Regulation Among Young Adults: A Pilot Study.

Despite the popular public perception that cannabis use may be beneficial for relieving mental health symptoms, the empirical evidence remains equivocal. Various legal hurdles limit the ability to research whether acute high-potency cannabis use affects mental health-related processes. Therefore, the current study used a novel methodology to examine the acute effects of high-potency cannabis flower on emotion regulation. Using a remote, within-subjects study design, 12 young adult (ages 21-30) cannabis users (who used cannabis at least 1day/week on average across the past year) completed measures of emotion regulation while sober and acutely intoxicated in a counterbalanced manner. Participants completed the Emotional Go/No-Go Task to measure implicit emotion regulation and a cognitive reappraisal task to assess explicit emotion regulation. For the intoxication condition, participants were observed smoking cannabis flower in their homes via videoconferencing. Participants reported a more positive mood and decreases in anxiety while intoxicated. There was no evidence that acute high-potency cannabis affected participants' implicit or explicit emotion regulation task performance. Future research with larger samples might consider adopting this novel remote study design to assess the acute effects of high-potency cannabis use on different measures of emotion regulation and other health outcomes.

Impact of pharmacist-led education session (ples) on quality of life among type 2 diabetes mellitus patients in Hospital Besut

Type 2 Diabetes Mellitus (T2DM) is a chronic and progressive disease that has reached an epidemic level. To achieve a better quality of life among diabetic patients, patient education has become an essential role. Quality of life (QOL) is used as an important health outcome measure. Thus, this interventional study aimed to determine the effect of pharmacist-led education sessions (PLES) on QOL among T2DM patients in Hospital Besut and the association of sociodemographic factors with QOL. T2DM patients attending the Medical and Nephrology Clinic from July until November 2021 were recruited and randomised into the PLES and control groups. A guided questionnaire was used to evaluate their QOL in the satisfaction, impact and worry domains. The educational session was provided by the pharmacist via counselling, and all outcomes pre- and post-intervention were evaluated after a 3-month interval. Data were analysed using paired and independent t-tests, with p &lt; 0.05 considered statistically significant. A total of 70 patients were enrolled in this study, with around half being female (52.8%) and a mean age of 58.6 ± 9.7. The increase in QOL after the intervention in the PLES group for all domains was significantly higher than that in the control group (p &lt; 0.001). The mean QOL scores in the PLES group in terms of satisfaction, impact, and worry domains before intervention were 40.48 ± 14.1, 49.86 ± 17.84 and 45.14 ± 18.72, respectively, while the overall score was 44.44 ± 13.60. There was a significant improvement of QOL after PLES in satisfaction 31.43 ± 10.61 (p &lt; 0.012), impact 38.86 ± 10.95 (p &lt; 0.001), worry domain 36.76 ± 12.56 (p &lt; 0.040) and an overall score of 35.25 ± 9.04 (p &lt; 0.022). No significant improvement was observed in the control group (p = 0.447). There was no significant association between sociodemographic factors and QOL (P &gt; 0.05). This study suggested that PLES had a positive impact on the quality of life of patients with diabetes.

Behavioral Medicine Can Help Reduce Premature Mortality among People who Experience Homelessness

Unprecedented numbers of Americans experienced homelessness in 2023. Homelessness causes premature mortality from several preventable causes. Historically, research in homelessness has been driven by psychiatric and social science fields and has focused on neither health behavior nor valid measurement of health outcomes. Only in HIV/AIDS populations is there specific evidence linking housing with improved health outcomes. A partnership between behavioral medicine researchers and housing and homeless service providers could address health behaviors linked to premature mortality. This requires improving measurement of homeless mortality and validating health and wellness measures for people experiencing homelessness. We outline implications for policy to pair support for health behavior change in the context of homelessness with various housing support programs. When done with attention to multi-level health drivers and inclusion of people with lived experience, this partnership could improve health outcomes and reduce premature mortality for people without housing.

Early motor developmental milestones and health outcomes in preadolescent children

IntroductionThe prevalence of depression and anxiety in children has risen in recent years, while childhood obesity and sedentary behavior continue to be a major public health concern. Existing evidence suggests early motor development and locomotor experiences contribute to psychosocial and physical development. By further understanding the far-reaching effects of early motor development, early life interventions aimed at preventing physical and mental health adversity may benefit from investigating early motor developmental milestones (MDM) attainment. The current study is the first to assess the longitudinal association between parent-reported gross MDM timing with objective measures of mental health, cardiorespiratory fitness (CRF), subcutaneous abdominal (SAAT), and visceral adipose tissue (VAT) outcomes later in childhood.MethodIn total, 131 children aged 8–11 years (46% female) were recruited. The parents of these children reported the age of attainment for five MDMs: holding their head unsupported, rolling over, sitting unsupported, standing, and walking independently. The study encompassed a comprehensive assessment, including measures of mental health, CRF (VO2 max), body–mass index (BMI), SAAT, and VAT. Data were analyzed using multiple stepwise linear regressions, adjusting for demographic and parental factors in Step 1 and including each MDM individually in Step 2.ResultsOur findings indicated earlier rolling over and walking were associated with higher CRF during preadolescence. Earlier rolling over was also linked to healthier BMI and lower levels of VAT, lower levels of trait anxiety, and fewer symptoms of depression.ConclusionThis study provides further evidence with potential clinical implications that parent-reported MDM age of attainment is related to later preadolescent physical and mental health. The age at which a child first rolls over emerges as a particularly predictive factor for various preadolescent health outcomes, highlighting the multi-finality of MDM timing in understanding developmental trajectories.

Stress, Anxiety, And Depression Among Dentists Three Years into The Pandemic

The COVID-19 pandemic had a significant impact on healthcare workers globally, including the psychological wellbeing of dentists. To evaluate the effect of the early phase of the pandemic on the long-term psychological well-being of dentists, this study assessed dentists’ mental health outcomes at two time points, at fall 2020 (six months into the pandemic), and at winter 2023 (three years into the pandemic). Specifically measuring the prevalence of symptoms of depression, anxiety, stress, and potential associated risk factors. The study surveyed dentists in Libya who responded to the study questionnaire Specifically measuring the prevalence of symptoms of depression, anxiety, stress, and potential associated risk factors. The study surveyed dentists in Libya who responded the study questionnaire in fall 2020 (n = 67) and winter 2023 (n = 38). The survey included self-report measures assessing four mental health outcomes: depression, anxiety, and stress. The chi-square test was used to compare mental health outcome measures between fall and winter. The prevalence of self-reported depression, anxiety, and stress decreased between fall 2020 and winter 2023 (40% vs. 37%, p =0.27; 55% vs. 42%, p = 0.37; 97% vs. 71%, p = 0.11 respectively). These estimates were particularly higher among those with a history of psychiatric disorder. Three years into the coronavirus disease 2019 pandemic, poor mental health outcomes were highly prevalent among dentists. Further research is needed to assess contributing factors in this specific population. Dental syndicates should promote targeted programs and services aimed at improving dentists’ well-being.

OP62 Economic Evaluations Submitted For Reimbursement To The Brazilian Unified Health System: A Meta-Epidemiological Study

IntroductionAllocating financial resources efficiently poses a significant challenge for health systems worldwide. In this context, economic evaluations (EE) are pivotal for the health technology assessment (HTA) process, particularly in standardizing approaches to enhance decision-making accuracy. This study focuses on delineating methodological nuances of EE submissions within Brazil’s Unified Health System (SUS).MethodsThis meta-epidemiological study analyzed dossiers submitted to the National Committee for Health Technology Incorporation (Conitec) for drug reimbursement from January 2022 to May 2023. We selected dossiers that included complete EE studies such as cost–utility or cost-effectiveness analyses. Our evaluation involved extracting data on the characteristics of the studies, reimbursement decisions, elements of the base case scenario, and parameters used in utility and sensitivity analyses. [Protocol: DOI 10.17605/OSF.IO/JVYEC]ResultsWe included 56 dossiers, leading to 11 favorable reimbursement decisions. EE study methods were cost-effectiveness (17) and cost–utility analyses (17), with some employing both (16). Markov chain models were used in 27 dossiers, primarily utilizing quality-adjusted life years as the health outcome measure. Additional outcomes included life years gained and frequency of avoided events. While utility assessment was reported in 33 dossiers, only six adjusted for age and seven accounted for disutility from adverse events. Thirty-two conducted deterministic or probabilistic sensitivity analyses, but only four presented parameters like credibility intervals, and 17 presented acceptability curves.ConclusionsThis study highlights the need for more standardized and refined methods in the EE submitted to Conitec. The existing EE methodological guidelines, dating from 2014, are currently under revision. This update is crucial to integrate recent advancements in health technology assessment and to better address contemporary requirements, particularly in light of the newly defined willingness-to-pay threshold.

Assessing the relationship between mental health and AUDIT score among older sexual and gender minorities.

Alcohol use, and its relationship with mental health outcomes, remains a public health priority. Yet, little research has focused on this association among aging sexual and gender minority (SGM) populations with even less dedicated to the unique issues of those aging with HIV, a gap we begin to fill here. Data for this analysis originated from the Columbus Healthy Aging Project (CHAP), a cross-sectional survey among adults ≥50 years who reside in the Columbus, Ohio. Multivariable linear regression models were utilized to assess the relationship between alcohol use (via AUDIT score) and several mental health outcomes (e.g., depression, anxiety, perceived stress, and sexual orientation microaggressions), adjusting for demographic characteristics and other risk factors. Models were assessed for moderation by self-reported HIV status. Among the entire sample (N = 787), mean perceived stress score was 18.2 (SD=5.5), mean anxiety score was 9.1 (5.9), and mean depression score was 9.9 (SD=6.7). 32 (7.4%) self-reported as PLWH. Among those reporting any alcohol use, mean AUDIT score use was 10.5 (SD=10.9). Each of the mental health outcome measures were positively associated with AUDIT score. Meanwhile, there was significant moderation of each of the mental health outcome measures by HIV status, suggesting a stronger association with AUDIT score in each case. Our results suggest that there are broad stressors impacting alcohol use not only among older SGM broadly but in particular among PLWH. Although a diverse set of results, these data highlight the need for more research on alcohol use among aging SGM populations, particularly PLWH and those identifying as a different gender identity.

Climate change and health outcomes in Sub-Saharan African countries

This paper examines the effect of climate change on health outcomes in sub-Saharan Africa (SSA). Greenhouse gas emission was used as the measure of climate change, while life expectancy rate was used as the measure of health outcomes. This paper's significant contribution is how the interaction of climate change and government effectiveness index influence health outcomes in SSA. We estimated the impact of climate change on health outcomes using the panel system generalized method of moments (GMM) method. Our empirical result show that there is a negative and significant relationship between climate change and life expectancy in the short and long run. In addition, we find that if effective government policy is interacted with climate change, this mutes the negative impact of climate change on health outcomes in SSA. This implies that, with effective government policies targeted toward achieving net zero carbon emission, climate change is not expected to have a significant impact on health outcomes in SSA.

Psychometric properties and clinical utility of spinal health outcome measures in school-based interventions among children and adolescents: a systematic review protocol

IntroductionSpinal health in children and adolescents has global implications, impacting school attendance, academic performance and physical activity. Effective school-based interventions are essential for promoting spinal health literacy, positive behaviours and...

Evaluating the Effectiveness of Lifestyle Interventions in Preventing Chronic Diseases: A Systematic Review

This systematic review evaluates the effectiveness of lifestyle interventions, including dietary changes, physical activity, smoking cessation, and alcohol reduction, in preventing chronic diseases such as cardiovascular disease, diabetes, and obesity. Chronic diseases pose a significant burden globally, and lifestyle interventions are increasingly recommended to reduce risk factors. A comprehensive search was conducted in databases like PubMed, Cochrane Library, and Embase, focusing on studies published in the past decade. Included studies assessed adult populations at risk of chronic diseases, using interventions targeting lifestyle modifications with measurable health outcomes. Findings indicate that dietary changes and increased physical activity significantly reduce chronic disease risk, while smoking cessation and alcohol reduction further contribute to improved health outcomes. Combination interventions generally showed the most substantial impact on preventing chronic disease. Although the evidence strongly supports lifestyle changes for disease prevention, variations in intervention type, duration, and adherence remain a limitation. Future research should explore long-term effects and implementation strategies in diverse populations. This review underscores the need for integrating effective lifestyle interventions into healthcare policies to improve public health.

Effectiveness of technology-based psychosocial interventions for improving health-related outcomes of family caregivers of stroke survivors: A systematic review and meta-analysis.

To synthesize evidence regarding the effectiveness of technology-based psychosocial interventions in improving health-related outcomes among family caregivers of stroke survivors. A systematic review and meta-analysis was reported by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials that investigated the effects of psychosocial interventions delivered through information and communication technologies on self-efficacy, caregiving competence, caregiver burden, perceived social support, anxiety, depression, health-related quality of life and cost-effectiveness were included. Two researchers independently selected studies, extracted data, and appraised the quality of the included studies. Subgroup analysis, sensitivity analysis, and narrative synthesis were conducted. Ten electronic databases (PubMed, CENTRAL, Web of Science, Scopus, CINHAL, Embase, Institution of Electrical Engineers Xplore, Ovid Medline, PsycINFO, ProQuest Dissertations and Thesis) were searched up to February 2023. Nineteen studies involving 1717 participants fulfilled the eligibility criteria. Technology-based psychosocial interventions significantly improved self-efficacy (SMD = .62), caregiving competence (SMD = .55), depression (SMD = -.25) and anxiety (SMD = -.35). However, perceived social support, caregiver burden, and health-related quality of life did not show significant improvements. Subgroup analyses revealed that the interventions, lasting from 4 to 6 weeks and encompassing comprehensive contents, exhibited larger effect sizes. None of the studies measured cost-effectiveness. The technology-based psychosocial interventions are effective in enhancing self-efficacy and caregiving competence, as well as alleviating anxiety, and depression among family caregivers of stroke survivors. Future research should investigate interventions delivered through various digital platforms using well-designed RCTs with in-depth qualitative data collection and measurement of health and cost-effectiveness outcomes. Through psychosocial interventions, healthcare providers in clinical and community settings, particularly nurses, could incorporate technologies into current stroke care practices. It is not applicable as this is a systematic review. The protocol was registered on PROSPERO (CRD42023402871).