Dataset Information

Is planned adaptation to heat reducing heat-related mortality and illness? A systematic review.

ABSTRACT: BACKGROUND:Extreme heat is an important public health risk. Climate change will likely increase the temperatures humans are exposed to through exacerbated heat wave intensity and frequency, possibly increasing health risks from heat. To prevent adverse effects on human health, heat prevention plans and climate change adaptation strategies are being implemented. But are these measures effectively reducing heat-related mortality and morbidity? This study assesses the evidence base in 2014. METHODS:We conducted a systematic review of peer-reviewed published literature. We applied a combined search strategy of automated search and journal content search using the electronic databases PubMed, Web of Knowledge, Biological Abstracts, CAB Abstracts and ProQuest Dissertation & Theses A&I. Quality appraisal was conducted using CASP checklists, and we identified recurrent themes in studies with content analysis methodology. We conducted sub-group analyses for two types of studies: survey and interview research on behavioral change and perception, and observational studies with regression. RESULTS:30 articles were included in the review. The majority of studies (n?=?17) assessed mortality or morbidity reductions with regression analysis. Overall, the assessments report a reduction of adverse effects during extreme heat in places where preventive measures have been implemented. Population perception and behavior change were assessed in five studies, none of which had carried out a pre-test. Two themes emerged from the review: methodological challenges are a major hindrance to rigorous evaluation, and what counts as proof of an effective reduction in adverse health outcomes is disputed. CONCLUSIONS:Attributing health outcomes to heat adaptation remains a challenge. Recent study designs are less rigorous due to difficulties assigning the counterfactual. While sensitivity to heat is decreasing, the examined studies provide inconclusive evidence on individual planned adaptation measures.

SUBMITTER: Boeckmann M

PROVIDER: S-EPMC4219109 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Is planned adaptation to heat reducing heat-related mortality and illness? A systematic review.

Boeckmann Melanie M Rohn Ines I

BMC public health 20141028

<h4>Background</h4>Extreme heat is an important public health risk. Climate change will likely increase the temperatures humans are exposed to through exacerbated heat wave intensity and frequency, possibly increasing health risks from heat. To prevent adverse effects on human health, heat prevention plans and climate change adaptation strategies are being implemented. But are these measures effectively reducing heat-related mortality and morbidity? This study assesses the evidence base in 2014. ...[more]

PMID: 25349109

Similar Datasets

Project description:Background: Increasing clinical evidence suggests that people with severe mental illness (SMI), including schizophrenia spectrum disorders, bipolar disorder (BD), and major depressive disorder (MDD), are at higher risk of dying from COVID-19. Several systematic reviews examining the association between psychiatric disorders and COVID-19-related mortality have recently been published. Although these reviews have been conducted thoroughly, certain methodological limitations may hinder the accuracy of their research findings. Methods: A systematic literature search, using the PubMed, Embase, Web of Science, and Scopus databases (from inception to July 23, 2021), was conducted for observational studies assessing the risk of death associated with COVID-19 infection in adult patients with pre-existing schizophrenia spectrum disorders, BD, or MDD. Methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Results: Of 1,446 records screened, 13 articles investigating the rates of death in patients with pre-existing SMI were included in this systematic review. Quality assessment scores of the included studies ranged from moderate to high. Most results seem to indicate that patients with SMI, particularly patients with schizophrenia spectrum disorders, are at significantly higher risk of COVID-19-related mortality, as compared to patients without SMI. However, the extent of the variation in COVID-19-related mortality rates between studies including people with schizophrenia spectrum disorders was large because of a low level of precision of the estimated mortality outcome(s) in certain studies. Most studies on MDD and BD did not include specific information on the mood state or disease severity of patients. Due to a lack of data, it remains unknown to what extent patients with BD are at increased risk of COVID-19-related mortality. A variety of factors are likely to contribute to the increased mortality risk of COVID-19 in these patients. These include male sex, older age, somatic comorbidities (particularly cardiovascular diseases), as well as disease-specific characteristics. Conclusion: Methodological limitations hamper the accuracy of COVID-19-related mortality estimates for the main categories of SMIs. Nevertheless, evidence suggests that SMI is associated with excess COVID-19 mortality. Policy makers therefore must consider these vulnerable individuals as a high-risk group that should be given particular attention. This means that targeted interventions to maximize vaccination uptake among these patients are required to address the higher burden of COVID-19 infection in this already disadvantaged group.

Project description:BackgroundPost-catheter removal sepsis (PCRS) is a notable complication of indwelling central venous catheters (CVCs) in neonates, which is postulated to be secondary to the disruption of biofilms formed along catheter tips up on CVCs removal. It remains controversial whether this could be prevented by antibiotic use upon CVCs removal. We aimed to evaluate the protective effect of antibiotic administration at the time of CVCs removal.MethodsWe searched through PubMed, EMBASE, Cochrane databases and reference lists of review articles for studies comparing the use of antibiotics versus no use within 12 h of CVCs removal. Risk of bias was assessed using the modified Newcastle-Ottawa Scale and Cochrane risk-of-bias tool accordingly. Results of quantitative analyses were presented as mean differences (MD) or odds ratio (OR). Subgroup and univariate meta-regression analyses were performed to identify heterogeneity.ResultsThe review included 470 CVCs in the antibiotic group and 658 in the control group. Antibiotic use within 12 h of CVCs removal did not significantly reduce the incidence of PCRS (OR = 0.35, 95% CI: 0.08-1.53), but was associated with a lower incidence of post-catheter removal blood stream infection (OR = 0.31, 95% CI: 0.11-0.86). Dosage of vancomycin and world region were major sources of heterogeneity.ConclusionAntibiotic administration upon CVCs removal does not significantly reduce the incidence of PCRS but offers less post-catheter removal blood stream infection. Whether this will be converted to better clinical outcomes lacks evidential support. Further randomized controlled studies with longer follow-up are needed.SummaryResults of our meta-analysis suggest that antibiotic use at planned central line removal removal does not significantly reduce the incidence of PCRS but offers less blood stream infection, which might contribute to future management of central lines in neonates.Systematic review registrationhttps://www.crd.york.ac.uk/, PROSPERO (CRD42022359677).

Project description:BackgroundHeat adaptation regimes are used to prepare athletes for exercise in hot conditions to limit a decrement in exercise performance. However, the heat adaptation literature mostly focuses on males, and consequently, current heat adaptation guidelines may not be optimal for females when accounting for the biological and phenotypical differences between sexes.ObjectivesWe aimed to examine: (1) the effects of heat adaptation on physiological adaptations in females; (2) the impact of heat adaptation on performance test outcomes in the heat; and (3) the impact of various moderators, including duration (minutes and/or days), total heat dose (°C.min), exercise intensity (kcal.min-1), total energy expended (kcal), frequency of heat exposures and training status on the physiological adaptations in the heat.MethodsSPORTDiscus, MEDLINE Complete and Embase databases were searched to December 2022. Random-effects meta-analyses for resting and exercise core temperature, skin temperature, heart rate, sweat rate, plasma volume and performance tests in the heat were completed using Stata Statistical Software: Release 17. Sub-group meta-analyses were performed to explore the effect of duration, total heat dose, exercise intensity, total energy expended, frequency of heat exposure and training status on resting and exercise core temperature, skin temperature, heart rate and sweat rate. An explorative meta-regression was conducted to determine the effects of physiological adaptations on performance test outcomes in the heat following heat adaptation.ResultsThirty studies were included in the systematic review; 22 studies were meta-analysed. After heat adaptation, a reduction in resting core temperature (effect size [ES] = - 0.45; 95% confidence interval [CI] - 0.69, - 0.22; p < 0.001), exercise core temperature (ES = - 0.81; 95% CI - 1.01, - 0.60; p < 0.001), skin temperature (ES = - 0.64; 95% CI - 0.79, - 0.48; p < 0.001), heart rate (ES = - 0.60; 95% CI - 0.74, - 0.45; p < 0.001) and an increase in sweat rate (ES = 0.53; 95% CI 0.21, 0.85; p = 0.001) were identified in females. There was no change in plasma volume (ES = - 0.03; 95% CI - 0.31, 0.25; p = 0.835), whilst performance test outcomes were improved following heat adaptation (ES = 1.00; 95% CI 0.56, 1.45; p < 0.001). Across all moderators, physiological adaptations were more consistently observed following durations of 451-900 min and/or 8-14 days, exercise intensity ≥ 3.5 kcal.min-1, total energy expended ≥ 3038 kcal, consecutive (daily) frequency and total heat dose ≥ 23,000 °C.min. The magnitude of change in performance test outcomes in the heat was associated with a reduction in heart rate following heat adaptation (standardised mean difference = - 10 beats.min-1; 95% CI - 19, - 1; p = 0.031).ConclusionsHeat adaptation regimes induce physiological adaptations beneficial to thermoregulation and performance test outcomes in the heat in females. Sport coaches and applied sport practitioners can utilise the framework developed in this review to design and implement heat adaptation strategies for females.

Dataset Information

Is planned adaptation to heat reducing heat-related mortality and illness? A systematic review.

Publications

Is planned adaptation to heat reducing heat-related mortality and illness? A systematic review.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets