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Efficacy of Government-Sponsored Community Health Programs for Older Adults: A Systematic Review of Published Evaluation Studies. 政府资助的老年人社区健康计划的有效性:对已发表的评估研究的系统回顾。
IF 5.5 Q1 Nursing Pub Date : 2022-09-23 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604473
Arun Chandrashekhar, Harshad P Thakur

Objective: Population aging is an ongoing challenge for global health policy and is expected to have an increasing impact on developing economies in years to come. A variety of community health programs have been developed to deliver health services to older adults, and evaluating these programs is crucial to improving service delivery and avoiding barriers to implementation. This systematic review examines published evaluation research relating to public and community health programs aimed at older adults throughout the world. Methods: A literature search using standardized criteria yielded 58 published articles evaluating 46 specific programs in 14 countries. Results: Service models involving sponsorship of comprehensive facilities providing centralized access to multiple types of health services were generally evaluated the most positively, with care coordination programs appearing to have generally more modest success, and educational programs having limited effectiveness. Lack of sufficient funding was a commonly-cited barrier to successful program implementations. Conclusion: It is important to include program evaluation as a component of future community and public health interventions aimed at aging populations to better understand how to improve these programs.

目标:人口老龄化是全球卫生政策面临的一项持续挑战,预计未来几年将对发展中经济体产生越来越大的影响。已经制定了各种社区卫生计划,为老年人提供卫生服务,评估这些计划对于改善服务提供和避免实施障碍至关重要。本系统综述检查了与世界各地针对老年人的公共和社区卫生计划有关的已发表的评估研究。方法:使用标准化标准进行文献检索,获得58篇已发表的文章,评估14个国家的46个特定项目。结果:服务模式包括赞助综合设施,提供集中的多种类型的卫生服务,总体上评价最积极,护理协调方案一般表现出更适度的成功,教育方案的有效性有限。缺乏足够的资金是成功实施项目的一个常见障碍。结论:将项目评估作为未来针对老龄化人口的社区和公共卫生干预措施的组成部分,以更好地了解如何改进这些项目是很重要的。
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引用次数: 0
Nation-Wide Routinely Collected Health Datasets in China: A Scoping Review. 中国全国常规收集的健康数据集:范围综述
IF 5.5 Q1 Nursing Pub Date : 2022-09-21 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1605025
Yishu Liu, Shaoming Xiao, Xuejun Yin, Pei Gao, Jing Wu, Shangzhi Xiong, Carinna Hockham, Thomas Hone, Jason H Y Wu, Sallie Anne Pearson, Bruce Neal, Maoyi Tian

Objectives: The potential for using routinely collected data for medical research in China remains unclear. We sought to conduct a scoping review to systematically characterise nation-wide routinely collected datasets in China that may be of value for clinical research. Methods: We searched public databases and the websites of government agencies, and non-government organizations. We included nation-wide routinely collected databases related to communicable diseases, non-communicable diseases, injuries, and maternal and child health. Database characteristics, including disease area, data custodianship, data volume, frequency of update and accessibility were extracted and summarised. Results: There were 70 databases identified, of which 46 related to communicable diseases, 20 to non-communicable diseases, 1 to injury and 3 to maternal and child health. The data volume varied from below 1000 to over 100,000 records. Over half (64%) of the databases were accessible for medical research mostly comprising communicable diseases. Conclusion: There are large quantities of routinely collected data in China. Challenges to using such data in medical research remain with various accessibility. The potential of routinely collected data may also be applicable to other low- and middle-income countries.

目的:在中国,常规收集数据用于医学研究的潜力尚不清楚。我们试图进行一项范围综述,以系统地描述中国全国范围内常规收集的数据集,这些数据集可能对临床研究有价值。方法:检索公共数据库、政府机构网站和非政府组织网站。我们纳入了全国范围内常规收集的与传染病、非传染性疾病、伤害和孕产妇和儿童健康相关的数据库。提取和总结数据库特征,包括疾病区域、数据保管、数据量、更新频率和可访问性。结果:共确定了70个数据库,其中46个与传染病有关,20个与非传染性疾病有关,1个与伤害有关,3个与妇幼保健有关。数据量从低于1000条到超过100,000条记录不等。超过一半(64%)的数据库可用于主要包括传染病的医学研究。结论:中国存在大量常规采集数据。在医学研究中使用这类数据的挑战仍然存在各种各样的可及性。常规收集数据的潜力也可能适用于其他低收入和中等收入国家。
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引用次数: 1
ASPHER Statement: 5 + 5 + 5 Points for Improving Food Security in the Context of the Russia-Ukraine War. An Opportunity Arising From the Disaster? 阿斯菲尔声明:在俄乌战争背景下改善粮食安全的5 + 5 + 5要点灾难带来机遇?
IF 5.5 Q1 Nursing Pub Date : 2022-09-21 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1605321
Henrique Lopes, Jose Martin-Moreno
The situation triggered by the war initiated by Russia in Ukraine, in addition to the widely known impacts that it has directly on the affected populations, has consequences that affect to almost the entire world population. The effects are verified either through increases in the reference prices of commodities, or by occasional ruptures in the supply chains, all of which contribute to the worsening of the economic and social conditions of most of the people. One of the sectors with predictably the greatest impact is food, through multiple mechanisms that end up having the same end result: the worsening of the quantity of food produced on the planet and potentially the decrease of diets quality. Russia and Ukraine are two of the biggest food exporters at a worldwide level, as illustrated by the WPF [1], accounting for 14% of world exports of maize, 18% of wheat and 40% of sunflower. The immediate consequence of the war was the rise in the prices of essential products, both for human and animal food, with historic high values being registered. There have also been financial speculative phenomena with food commodities, which amplifies the phenomenon of price elasticities [2–5]. Several countries depend on a large scale on imports from these countries at war, especially those in African and in the Near East [6, 7]. Therefore, there are strong reasons to believe that in addition to potential food shortages in the war zone, there may be a worsening of the food condition in the near future in regions where it was already fragile or perilous. Even for countries with sufficient economic conditions to continue to obtain supplies at rising prices of food raw materials, it must be considered that many vulnerable groups already faced difficulties before the war in maintaining a sufficient, healthy and balanced diet. In addition to the above-mentioned situation, Russia is the world’s largest exporter of fertilizers [8–12], particularly in the supply chain to Western Europe, a condition that has now been interrupted by countersanctions [13, 14] to the country. Given that it is not a type of product that can be easily found elsewhere and as it is directly indexed to energy prices, which are also rising, it is expected that in this agricultural year producers will find less availability of fertilizers on the market and those that are available are sold at very high prices. This also leads in the long term to a decrease in agricultural production outside the conflict zone. The months of March and April are critical for the volume and quality of European crops and plantations when many sowings are fertilized. The failure at this point ends up having repercussions Approved by: Sarah Mantwill, University of Lucerne, Switzerland
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引用次数: 2
Relationship Between Fruit and Vegetables Intake and Common Mental Disorders in Youth: A Systematic Review. 水果和蔬菜摄入量与青少年常见精神障碍之间的关系:系统综述。
IF 3.5 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-09-20 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604686
Julia Dabravolskaj, Shelby Marozoff, Katerina Maximova, Sandra Campbell, Paul J Veugelers

Objective: Recent evidence suggests that adequate fruit and vegetables intake (FVI) might be associated with lower risk of common mental disorders (CMDs) in adults, but studies in youth are also beginning to emerge and are synthesized in this systematic review. Methods: Online databases were searched from inception to 30 October 2020 to locate cross-sectional, cohort, and case-control studies focusing on the FVI and CMDs in youth (i.e., 10-18 years old). The risk of bias of studies was assessed using Joanna Briggs Institute Critical Appraisal Tool and the Newcastle-Ottawa quality assessment scale. Results: Among 3,944 records identified, 12 studies (8 cross-sectional, 1 case-control, and 3 prospective cohort studies) were included in the final synthesis. None of the prospective cohort studies identified a statistically significant association between FVI and CMDs in youth, although inconsistent associations were reported in cross-sectional and case-control studies. Conclusion: The lack of associations between FVI and CMDs in youth, along with consistent associations in adults, might be explained by the accumulation of risk theoretical model and methodological challenges.

目的:最近的证据表明,充足的水果和蔬菜摄入量(FVI)可能与降低成人常见精神障碍(CMD)的风险有关,但针对青少年的研究也开始出现,本系统综述对这些研究进行了总结。研究方法检索了从开始到 2020 年 10 月 30 日的在线数据库,以查找有关青少年(即 10-18 岁)FVI 和 CMD 的横断面、队列和病例对照研究。研究的偏倚风险采用乔安娜-布里格斯研究所的关键评估工具和纽卡斯尔-渥太华质量评估量表进行评估。结果:在确定的 3,944 份记录中,有 12 项研究(8 项横断面研究、1 项病例对照研究和 3 项前瞻性队列研究)被纳入最终的综合研究。尽管横断面研究和病例对照研究中的相关性并不一致,但没有一项前瞻性队列研究发现青少年的 FVI 与 CMD 之间存在统计学意义上的显著关联。结论青少年中的 FVI 与 CMD 之间缺乏关联,而成人中的关联则是一致的,这可能是由于风险理论模型的积累和方法上的挑战造成的。
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引用次数: 0
Innovation in Rural Health Services Requires Local Actors and Local Action. 农村卫生服务创新需要地方行动者和地方行动。
IF 5.5 Q1 Nursing Pub Date : 2022-09-14 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604921
Dean Carson, Robyn Preston, Anna-Karin Hurtig

Objectives: We examine the role of "local actors" and "local action" (LALA) in health service innovation in high-resource small rural settings and aim to inform debates about the extent to which communities can be empowered to drive change in service design and delivery. Methods: Using an adapted roles and activities framework we analyzed 32 studies of innovation projects in public health, clinical interventions, and service models. Results: Rural communities can investigate, lead, own and sustain innovation projects. However, there is a paucity of research reflecting limited reporting capacity and/or understanding of LALA. Highlighting this lack of evidence strengthens the need for study designs that enable an analysis of LALA. Conclusion: Innovation and community participation in health services are pressing issues in small rural settings where population size and distance from health infrastructure make service delivery challenging. Current reviews of community participation in rural health give little insight into the process of innovation nor understanding of how local actors produce improvements in innovation. This review outlines how communities and institutions can harness the essential role of LALA in supporting health innovations.

目标:我们研究了“地方行动者”和“地方行动”(LALA)在高资源小型农村环境中卫生服务创新中的作用,旨在为有关社区在多大程度上能够推动服务设计和提供方面的变革的辩论提供信息。方法:采用调整后的角色和活动框架,对公共卫生、临床干预和服务模式方面的32项创新项目进行了分析。结果:农村社区可以调查、领导、拥有和维持创新项目。然而,缺乏研究反映了有限的报告能力和/或对LALA的理解。强调这种证据的缺乏加强了对能够分析LALA的研究设计的需求。结论:创新和社区参与卫生服务是小农村地区的紧迫问题,这些地区的人口规模和距离卫生基础设施的距离使得服务提供具有挑战性。目前对社区参与农村卫生的审查几乎没有深入了解创新的过程,也没有了解地方行动者如何在创新方面取得进展。本综述概述了社区和机构如何利用LALA在支持卫生创新方面的重要作用。
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引用次数: 1
Best Nursing Intervention Practices to Prevent Non-Communicable Disease: A Systematic Review. 预防非传染性疾病的最佳护理干预措施:系统综述。
IF 5.5 Q1 Nursing Pub Date : 2022-09-14 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604429
Mercedes Gomez Del Pulgar, Miguel Angel Cuevas-Budhart, Sonsoles Hernández-Iglesias, Maria Kappes, Veronica Andrea Riquelme Contreras, Esther Rodriguez-Lopez, Alina Maria De Almeida Souza, Maximo A Gonzalez Jurado, Almudena Crespo Cañizares

Objectives: To explore nursing health education interventions for non-communicable disease patients. Methods: The design was a systematic review of research work published between 2008 and 2018. The data sources included the Web of Science, PubMed, Scopus, COCHRANE, and LILACS. The studies that met the inclusion were assessed, and the analysis for methodological quality through the recommended tools CASPe, and JADAD. Results: Fifteen original studies from eight counties were included in the review; Findings revealed 13 studies with randomized samples and six used power analysis. Nurses' interventions included house calls, home care, and individual and group health education. Conclusion: Nursing interventions showed 76.4% the effectiveness of results in patient outcomes to promote and improve healthier lifestyles and quality of life of non-communicable disease patients. This review discloses the significant impact of nursing health education interventions. Nursing leadership and political decision-makers should consider providing programs to enhance health education knowledge and abilities. All of this can favor the sustainability of the global economy by changing the life style of thousands of people worldwide. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42020208809.

目的:探讨非传染性疾病患者护理健康教育干预措施。方法:本设计是对2008年至2018年发表的研究工作进行系统回顾。数据来源包括Web of Science、PubMed、Scopus、COCHRANE和LILACS。对符合纳入标准的研究进行评估,并通过推荐的工具CASPe和JADAD对方法学质量进行分析。结果:来自8个县的15项原始研究被纳入综述;研究结果显示,13项研究随机抽样,6项使用功率分析。护士的干预措施包括出诊、家庭护理以及个人和团体健康教育。结论:护理干预在促进和改善非传染性疾病患者健康生活方式和生活质量方面的效果为76.4%。这篇综述揭示了护理健康教育干预的显著影响。护理领导和政治决策者应考虑提供方案,以提高健康教育的知识和能力。所有这些都可以通过改变全世界成千上万人的生活方式来促进全球经济的可持续发展。注册:https://www.crd.york.ac.uk/prospero/,编号CRD42020208809。
{"title":"Best Nursing Intervention Practices to Prevent Non-Communicable Disease: A Systematic Review.","authors":"Mercedes Gomez Del Pulgar,&nbsp;Miguel Angel Cuevas-Budhart,&nbsp;Sonsoles Hernández-Iglesias,&nbsp;Maria Kappes,&nbsp;Veronica Andrea Riquelme Contreras,&nbsp;Esther Rodriguez-Lopez,&nbsp;Alina Maria De Almeida Souza,&nbsp;Maximo A Gonzalez Jurado,&nbsp;Almudena Crespo Cañizares","doi":"10.3389/phrs.2022.1604429","DOIUrl":"https://doi.org/10.3389/phrs.2022.1604429","url":null,"abstract":"<p><p><b>Objectives:</b> To explore nursing health education interventions for non-communicable disease patients. <b>Methods:</b> The design was a systematic review of research work published between 2008 and 2018. The data sources included the Web of Science, PubMed, Scopus, COCHRANE, and LILACS. The studies that met the inclusion were assessed, and the analysis for methodological quality through the recommended tools CASPe, and JADAD. <b>Results:</b> Fifteen original studies from eight counties were included in the review; Findings revealed 13 studies with randomized samples and six used power analysis. Nurses' interventions included house calls, home care, and individual and group health education. <b>Conclusion:</b> Nursing interventions showed 76.4% the effectiveness of results in patient outcomes to promote and improve healthier lifestyles and quality of life of non-communicable disease patients. This review discloses the significant impact of nursing health education interventions. Nursing leadership and political decision-makers should consider providing programs to enhance health education knowledge and abilities. All of this can favor the sustainability of the global economy by changing the life style of thousands of people worldwide. <b>Systematic Review Registration:</b> https://www.crd.york.ac.uk/prospero/, identifier CRD42020208809.</p>","PeriodicalId":35944,"journal":{"name":"PUBLIC HEALTH REVIEWS","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9516617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Tackling Cholera Outbreak Amidst COVID-19 Pandemic in Nigeria: Challenges and Recommendations. 在尼日利亚应对COVID-19大流行期间的霍乱疫情:挑战和建议。
IF 5.5 Q1 Nursing Pub Date : 2022-09-12 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604776
Alhaji Umar Sow, Usman Abubakar Haruna, Oladunni Abimbola Amos, Edward Olorunfemi Olajide, Terhemen Amene, Oluwatomisin Dara Odususi, Bukola Adedoyin Adewusi, Chinedu Abia, Jackson Safari, Florence Wuraola Sorinola, Hassan Olayemi Alaka, Sulaiman Muhammad Musa

Background: Since the first confirmed case of the Novel Coronavirus Disease 2019 (COVID-19) in Nigeria, the pandemic has become a major public health challenge, affecting different sectors of the country. While Nigeria is battling to control the spread of COVID-19, the eruption of new cholera cases has put additional pressure on the strained healthcare system. Evidence: We showed how the overwhelming focus on COVID-19 has jeopardized key cholera containment measures such as disease surveillance, risk communication, and case management. Policy Options and Recommendations: We recommend provision and universal access to safe water and sanitation as key cholera preventive and control measures. However, these are resources that developing countries including Nigeria find rather challenging to provide. We also proposed the implementation of well-coordinated multi-sectoral interventions that involve strengthening disease surveillance including access to safe drinking water, vaccines, and treatment, especially in vulnerable communities. Conclusion: This policy brief provides evidence for policymakers, which if acted upon, will foster sustainable solutions to the lingering cholera outbreaks in Nigeria.

背景:自尼日利亚出现首例新型冠状病毒病(COVID-19)确诊病例以来,该大流行已成为一项重大公共卫生挑战,影响到该国的不同部门。虽然尼日利亚正在努力控制COVID-19的传播,但新的霍乱病例的爆发给本已紧张的医疗系统带来了额外的压力。证据:我们展示了过度关注COVID-19如何危及疾病监测、风险沟通和病例管理等关键霍乱控制措施。政策选择和建议:我们建议提供和普遍获得安全饮用水和卫生设施,作为主要的霍乱预防和控制措施。然而,包括尼日利亚在内的发展中国家发现提供这些资源相当具有挑战性。我们还提议实施协调良好的多部门干预措施,其中涉及加强疾病监测,包括获得安全饮用水、疫苗和治疗,特别是在脆弱社区。结论:本政策简报为决策者提供了证据,如果采取行动,将促进可持续解决尼日利亚持续不断的霍乱疫情。
{"title":"Tackling Cholera Outbreak Amidst COVID-19 Pandemic in Nigeria: Challenges and Recommendations.","authors":"Alhaji Umar Sow,&nbsp;Usman Abubakar Haruna,&nbsp;Oladunni Abimbola Amos,&nbsp;Edward Olorunfemi Olajide,&nbsp;Terhemen Amene,&nbsp;Oluwatomisin Dara Odususi,&nbsp;Bukola Adedoyin Adewusi,&nbsp;Chinedu Abia,&nbsp;Jackson Safari,&nbsp;Florence Wuraola Sorinola,&nbsp;Hassan Olayemi Alaka,&nbsp;Sulaiman Muhammad Musa","doi":"10.3389/phrs.2022.1604776","DOIUrl":"https://doi.org/10.3389/phrs.2022.1604776","url":null,"abstract":"<p><p><b>Background:</b> Since the first confirmed case of the Novel Coronavirus Disease 2019 (COVID-19) in Nigeria, the pandemic has become a major public health challenge, affecting different sectors of the country. While Nigeria is battling to control the spread of COVID-19, the eruption of new cholera cases has put additional pressure on the strained healthcare system. <b>Evidence</b>: We showed how the overwhelming focus on COVID-19 has jeopardized key cholera containment measures such as disease surveillance, risk communication, and case management. <b>Policy Options and Recommendations:</b> We recommend provision and universal access to safe water and sanitation as key cholera preventive and control measures. However, these are resources that developing countries including Nigeria find rather challenging to provide. We also proposed the implementation of well-coordinated multi-sectoral interventions that involve strengthening disease surveillance including access to safe drinking water, vaccines, and treatment, especially in vulnerable communities. <b>Conclusion:</b> This policy brief provides evidence for policymakers, which if acted upon, will foster sustainable solutions to the lingering cholera outbreaks in Nigeria.</p>","PeriodicalId":35944,"journal":{"name":"PUBLIC HEALTH REVIEWS","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2022-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9511573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40381550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Palliative Care Within the Primary Health Care Setting in Australia: A Scoping Review. 澳大利亚初级卫生保健环境中的姑息治疗:范围审查。
IF 5.5 Q1 Nursing Pub Date : 2022-09-06 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604856
Deborah van Gaans, Katrina Erny-Albrecht, Jennifer Tieman

Objectives: This scoping review identifies and details the scope of practice of health professionals who provide palliative care within the primary health setting in Australia. Methods: A scoping review approach was conducted on the Cinahl (Ebsco), Scopus, Medline (Ovid) and PubMed databases to extract articles from 1 December 2015 to 1 December 2020. Broad text words and MeSH headings were used with relevance to palliative care, general practice, primary health, and community setting. Extracted journal articles were limited to those based on the Australian population or Australian health system. Results: Eighty-four papers met the inclusion criteria and were included in the review. The review identified the following health professional roles within the Primary Health Care setting undertaking palliative care: General Practitioner, Nurse, Pharmacist, Paramedics, Carers, and Allied Health professionals. Conclusion: This review offers a first understanding of the individual health professional roles and multidisciplinary team approach to actively providing palliative care within the Primary Health Care setting in Australia.

目的:本范围审查确定并详细说明了在澳大利亚初级卫生机构中提供姑息治疗的卫生专业人员的实践范围。方法:采用范围综述的方法对中国数据库(Ebsco)、Scopus、Medline (Ovid)和PubMed数据库进行检索,提取2015年12月1日至2020年12月1日的文章。使用与姑息治疗、全科实践、初级卫生和社区环境相关的宽泛文本词和MeSH标题。提取的期刊文章仅限于那些基于澳大利亚人口或澳大利亚卫生系统的文章。结果:84篇符合纳入标准的文献被纳入。本综述确定了在初级卫生保健机构中从事姑息治疗的卫生专业人员角色如下:全科医生、护士、药剂师、护理人员、护理人员和联合卫生专业人员。结论:本综述首次了解了在澳大利亚初级卫生保健环境中积极提供姑息治疗的个人卫生专业角色和多学科团队方法。
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引用次数: 1
Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review. 糖尿病、高血压和血脂异常药物获取的障碍和促进因素:范围综述。
IF 5.5 Q1 Nursing Pub Date : 2022-09-02 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604796
Carla Castillo-Laborde, Macarena Hirmas-Adauy, Isabel Matute, Anita Jasmen, Oscar Urrejola, Xaviera Molina, Camila Awad, Catalina Frey-Moreno, Sofia Pumarino-Lira, Fernando Descalzi-Rojas, Tomás José Ruiz, Barbara Plass

Objective: Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives. Methods: Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO Citation Index, and grey literature. Two researchers conducted screening and eligibility phases. Data were thematically analyzed. Results: The review included 219 documents. Diabetes was the most studied condition; most of the evidence comes from patients and the United States. Affordability and availability of medicines were the most reported dimension and specific barrier respectively, both cross-cutting concerns. Among high- and middle-income countries, identified barriers were cost of medicines, accompaniment by professionals, long distances to facilities, and cultural aspects; cost of transportation emerges in low-income settings. Facilitators reported were financial accessibility, trained health workers, medicines closer to communities, and patients' education. Conclusion: Barriers and facilitators are determined by socioeconomic and cultural conditions, highlighting the role of health systems in regulatory and policy context (assuring financial coverage and free medicines); providers' role bringing medicines closer; and patients' health education and disease management.

目的:从患者、卫生服务提供者和卫生系统的角度出发,确定糖尿病、高血压和血脂异常药物获取的障碍和促进因素。方法:基于Joanna Briggs方法的范围审查。检索考虑了PubMed、Cochrane Library、CINAHL、Academic search Ultimate、Web of Science、SciELO引文索引和灰色文献。两名研究人员进行了筛选和资格阶段。对数据进行主题分析。结果:共纳入219篇文献。糖尿病是研究最多的疾病;大多数证据来自患者和美国。药品的可负担性和可获得性分别是报告最多的方面和具体障碍,两者都是交叉关注的问题。在高收入和中等收入国家,确定的障碍是药品费用、专业人员陪同、距离设施很远以及文化方面;交通成本出现在低收入环境中。据报告,促进因素包括经济可及性、训练有素的卫生工作者、离社区更近的药品以及患者的教育。结论:障碍和促进因素是由社会经济和文化条件决定的,突出了卫生系统在监管和政策背景下的作用(确保财政覆盖和免费药品);提供者拉近药品距离的作用;以及患者健康教育和疾病管理。
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引用次数: 1
Industrial Air Pollution Leads to Adverse Birth Outcomes: A Systematized Review of Different Exposure Metrics and Health Effects in Newborns. 工业空气污染导致不良的出生结果:不同暴露指标和新生儿健康影响的系统综述。
IF 5.5 Q1 Nursing Pub Date : 2022-08-10 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604775
Triin Veber, Usha Dahal, Katrin Lang, Kati Orru, Hans Orru

Objectives: To review the evidence of associations between adverse birth outcomes (ABO) and industrial air pollution. Methods: Searches were conducted in PubMed, and Scopus databases, and additional articles were found from snowball search techniques. The included studies feature a study population of mothers with live-born babies exposed to industrial air pollutants, and they examine the effects of industrial pollutants on adverse birth outcomes-namely, low birth weight, term low birth weight, preterm birth, and small for gestational age. Results: Altogether, 45 studies were included in this review. Exposure to PM2.5, PAHs, benzene, cadmium, and mixtures of industrial air pollutants and living near an industrial area affect birth outcomes. Conclusion: This study concludes that industrial air pollution is an important risk factor for ABO, especially low birth weight and preterm birth. The strongest evidence is associations between ABO and air pollution from power plants and petrochemical industries. Understanding of specific chemicals that are critical to birth outcomes is still vague. However, the evidence is strongest for more specific air pollutants from the industry, such as PAH, benzene, BTEX, and cadmium.

目的:回顾不良出生结局(ABO)与工业空气污染之间关系的证据。方法:在PubMed和Scopus数据库中进行检索,并通过滚雪球搜索技术找到额外的文章。纳入的研究以活产婴儿暴露于工业空气污染物的母亲为研究对象,研究了工业污染物对不良出生结果的影响,即低出生体重、足月低出生体重、早产和胎龄小。结果:本综述共纳入45项研究。暴露在PM2.5、多环芳烃、苯、镉和工业空气污染物的混合物中,并居住在工业区附近,都会影响出生结果。结论:工业空气污染是ABO发病的重要危险因素,尤其是低出生体重和早产。最有力的证据是ABO与发电厂和石化工业产生的空气污染之间的联系。对对出生结果至关重要的特定化学物质的了解仍然模糊不清。然而,来自工业的更具体的空气污染物,如多环芳烃、苯、苯醚和镉,证据是最有力的。
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引用次数: 2
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