PUBLIC HEALTH REVIEWS最新文献

Objectives: To summarize the evidence on the association between sleep problems and multimorbidity. Methods: Six electronic databases (PubMed, Web of Science, Embase, China National Knowledge Infrastructure, VIP, and Wan fang) were searched to identify observational studies on the association between sleep problems and multimorbidity. A random-effects model was used to estimate the pooled odds ratios (ORs) and 95% confidence intervals for multimorbidity. Results: A total of 17 observational studies of 133,575 participants were included. Sleep problems included abnormal sleep duration, insomnia, snoring, poor sleep quality, obstructive sleep apnea (OSA) and restless legs syndrome (RLS). The pooled ORs (95% CIs) for multimorbidity were 1.49 (1.24-1.80) of short sleep duration, 1.21 (1.11-1.44) of long sleep duration and 2.53 (1.85-3.46) for insomnia. The association of other sleep problems with multimorbidity was narratively summarized due to limited number of comparable studies. Conclusion: Abnormal sleep duration and insomnia are associated with higher odds of multimorbidity, while the evidence on association of snoring, poor sleep quality, obstructive sleep apnea and restless legs syndrome with multimorbidity remains inconclusive. Interventions targeting sleep problems should be delivered for better management of multimorbidity.

Objectives: To provide a step-by-step, easy-to-understand, practical guide for systematic review and meta-analysis of observational studies. Methods: A multidisciplinary team of researchers with extensive experience in observational studies and systematic review and meta-analysis was established. Previous guidelines in evidence synthesis were considered. Results: There is inherent variability in observational study design, population, and analysis, making evidence synthesis challenging. We provided a framework and discussed basic meta-analysis concepts to assist reviewers in making informed decisions. We also explained several statistical tools for dealing with heterogeneity, probing for bias, and interpreting findings. Finally, we briefly discussed issues and caveats for translating results into clinical and public health recommendations. Our guideline complements "A 24-step guide on how to design, conduct, and successfully publish a systematic review and meta-analysis in medical research" and addresses peculiarities for observational studies previously unexplored. Conclusion: We provided 7 steps to synthesize evidence from observational studies. We encourage medical and public health practitioners who answer important questions to systematically integrate evidence from observational studies and contribute evidence-based decision-making in health sciences.

Background: Among the numerous challenges that Africa faces in improving its healthcare systems, the paucity of health data stands out as paramount. This study aims to examine the challenges related to the paucity of health data in Africa and its impact on the implementation of digital health and evidence-based practice. The findings of the study reveal that health data availability in Africa is both limited and frequently of poor quality. Several factors contribute to this concerning situation, encompassing inadequate infrastructure, a shortage of resources, and cultural barriers. Furthermore, the available data, despite its limitations, is often underutilized due to a lack of capacity and expertise in data analysis and interpretation. Policy Options and Recommendations: To improve healthcare delivery in Africa, we recommend implementing novel strategies for data collection. It's important to recognize that effective information technology service is crucial for enhancing healthcare delivery, and a holistic approach is necessary to achieve this. Conclusion: This brief presents information to help policymakers develop long-term solutions to Africa's health data poverty. Taking action based on this evidence can assist in addressing the problem.

Background: Approximately 40 million people in need of palliative care worldwide, while 80% of them live in low- and middle-income countries. Kazakhstan, a low-to middle-income country with a reforming healthcare system, is committed to improving quality and accessibility of care for its 100,000 terminal patients in need of palliative care. Policy Options and Recommendations: To join the group of countries where palliative care is available, accessible, and affordable, Kazakhstan must integrate palliative services into the mainstream healthcare system at all levels, from primary healthcare to hospices, and from major cities to remote villages. Based on the evidence thoroughly collected directly from the Ministry of Health, authors propose a feasible set of recommendations regarding palliative policy, pain relief, infrastructure, workforce, and education, which could be implemented in LMICs beyond Kazakhstan. Conclusion: This study presents an analysis of challenges, recent developments, and needs of palliative care in Kazakhstan, including funding, policy, workforce, education, and infrastructure, providing an evidence base and recommendations for future development of palliative care in Kazakhstan and in other LMICs.

Objective: To identify the frequency of vitamin A deficiency in children aged 6 months to 5 years hospitalized for pneumonia. Methods: An integrative literature review was carried out, where searches were made by two independent researchers, with no language limits or publication time in the databases PubMed, LILACS, Web of Science, Scopus and CINAHL, and in the gray literature-OpenGrey, Proquest and Google Scholar. In the eligibility phase, the screened studies were read in full and those that did not answer the research question were excluded. Methodological quality was assessed using the Downs & Black (1998) checklist. Results: 1642 articles were identified, after all stages of screening and selection, 10 studies were included, of which 5 were longitudinal, 4 were intervention and 1 transversal. All studies identified subclinical vitamin A deficiency in children hospitalized with pneumonia; the highest frequency of subclinical vitamin A deficiency was 93.2%. All studies evaluated showed frequencies of subclinical vitamin A deficiency >20%. Conclusion: There is a high frequency of subclinical vitamin A deficiency in children with pneumonia; these data need to be further explored in terms of their associations. For this reason, new studies that evaluate this topic are of fundamental importance.