Preventive medicine最新文献

Objective: A diagnosis of childhood cancer is profoundly devastating for families, with well-recognized effects on parental mental health. However, its impact on parental somatic health remains poorly understood, particularly regarding potential long-term cumulative burden. These persistent somatic diseases require frequent clinic visits for ongoing management and adversely affect parents' quality of life.

Methods: Using several Swedish national registers, we identified biological parents of children diagnosed with cancer before age 14 between January 1, 1987, and December 31, 2016, and matched them with up to five parents of children without cancer. Parental somatic health conditions, encompassing both the initial occurrence and any recurrent episodes, were identified through the end of 2018 across 14 major disease groups using the National Patient Register and primary health care data. The marginal means/rates model was employed to compare recurrent somatic health events.

Results: A total of 6859 fathers and 7098 mothers of children diagnosed with cancer in Sweden were identified and followed for up to 32 years. Parents of children with cancer experienced increased rates of recurrent somatic health conditions compared to those without (84.14 vs. 80.63 per 1000 person-months). The increases were observed across multiple disease categories, including neoplasms, diseases related to blood and immune mechanisms, circulatory diseases, and genital organ diseases. Stratified analyses further revealed variations in risk estimates across subgroups.

Conclusions: Our findings highlight the long-term somatic health consequences of having a child with cancer and the need for supportive interventions to mitigate stress and improve parental somatic well-being.

Objective: To determine the effectiveness of multidisciplinary interventions including exercise in improving health outcomes for patients with non-specific chronic low back pain (NSCLBP) across different regions.

Methods: The search for studies was not restricted to a specific time period but was conducted based on the availability of existing literature within the selected databases. A comprehensive literature search was conducted in four databases: EBSCOhost (from 1995), PubMed (from 1996), Web of Science (from 1964), and Scopus (from 2004), up to November 3, 2021. After applying exclusion criteria, 31 studies published between 1998 and 2021 were selected for final inclusion. The methodological approach included both qualitative and quantitative analyses, ensuring a comprehensive evaluation of the available evidence.

Study selection criteria: Multidisciplinary interventions including exercise aimed at relieving symptoms of NSCLBP were included. Outcomes analyzed were disability, pain, fear avoidance, quality of life, perceived change, depression, anxiety and stress. The Comprehensive Meta-Analysis software was used for statistical analyses.

Results: Thirty-one studies were included in the qualitative analysis and 29 in the meta-analysis. The qualitative analysis showed improvements in favor of the intervention group (IG) in pain, fear avoidance, quality of life and perceived change. The meta-analysis reported significant pooled effect size (ES) in favor of the IGs in disability, pain, fear avoidance, quality of life, and perceived change among patients with NSCLBP.

Conclusion: Multidisciplinary approaches including exercise appear to be effective in reducing disability, pain, fear avoidance, quality of life and perceived change, but not depression, anxiety or stress in patients with NSCLBP. The findings should be interpreted cautiously in light of substantial heterogeneity and the limited quality of the available evidence.