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ABSTRACT:
SUBMITTER: Holman C
PROVIDER: S-EPMC8366301 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Alternative models of cardiac rehabilitation (CR) delivery, such as home or community-based programs, have been developed to overcome underutilization. However, their availability and characteristics have never been assessed globally. In this cross-sectional study, a piloted survey was administered online to CR programs globally. CR was available in 111/203 (54.7%) countries globally; data were collected in 93 (83.8% country response rate). 1082 surveys (32.1% program response rate) were initiated. Globally, 85 (76.6%) countries with CR offered supervised programs, and 51 (45.9%; or 25.1% of all countries) offered some alternative model. Thirty-eight (34.2%) countries with CR offered home-based programs, with 106 (63.9%) programs offering some form of electronic CR (eCR). Twenty-five (22.5%) countries with CR offered community-based programs. Where available, programs served a mean of 21.4% ± 22.8% of their patients in home-based programs. The median dose for home-based CR was 3 sessions (Q25-Q75 = 1.0⁻4.0) and for community-based programs was 20 (Q25⁻Q75 = 9.6⁻36.0). Seventy-eight (47.0%) respondents did not perceive they had sufficient capacity to meet demand in their home-based program, for reasons including funding and insufficient staff. Where alternative CR models are offered, capacity is insufficient half the time. Home-based CR dose is insufficient to achieve health benefits. Allocation to program model should be evidence-based.
| S-EPMC6162832 | biostudies-literature
Project description:BackgroundCardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region.MethodsIn this cross-sectional study, a piloted survey was administered online to CR programs globally. Cardiac associations and local champions facilitated program identification. Quality (benchmark of ≥ 75% of programs in a given country meeting each of 20 indicators) was ranked. Results were compared by WHO region using generalized linear mixed models.Findings111/203 (54.7%) countries in the world offer CR; data were collected in 93 (83.8%; N = 1082 surveys, 32.1% program response rate). The most commonly-accepted indications were: myocardial infarction (n = 832, 97.4%), percutaneous coronary intervention (n = 820, 96.1%; 0.10), and coronary artery bypass surgery (n = 817, 95.8%). Most programs were led by physicians (n = 680; 69.1%). The most common CR providers (mean = 5.9 ± 2.8/program) were: nurses (n = 816, 88.1%; low in Africa, p < 0.001), dietitians (n = 739, 80.2%), and physiotherapists (n = 733, 79.3%). The most commonly-offered core components (mean = 8.7 ± 1.9 program) were: initial assessment (n = 939, 98.8%; most commonly for hypertension, tobacco, and physical inactivity), risk factor management (n = 928, 98.2%), patient education (n = 895, 96.9%), and exercise (n = 898, 94.3%; lower in Western Pacific, p < 0.01). All regions met ≥ 16/20 quality indicators, but quality was < 75% for tobacco cessation and return-to-work counseling (lower in Americas, p = < 0.05).InterpretationThis first-ever survey of CR around the globe suggests CR quality is high. However, there is significant regional variation, which could impact patient outcomes.
| S-EPMC6733999 | biostudies-literature
Project description:BackgroundRadon is the primary source of environmental radiation exposure posing a significant human health risk in cold countries. In Canada, most provinces have revised building codes by 2017, requiring construction solutions to avoid radon in all new buildings. While various construction solutions and remediation techniques have been proposed and evaluated, the question about the best method that would effectively reduce radon in a variety of contexts remained unanswered. Radon practitioners, officials of radon control programs, and businesses offering radon testing and mitigation services, builders, property managers, homeowners and residents also have similar queries.ObjectiveThis paper systematically reviewed both experimental and observational studies (S) with radon interventions (I) used globally in residential houses (P) compared to other residential or model houses (C) to evaluate relative mitigation effectiveness (O) that could guide selecting the best radon reduction strategy for residential buildings.MethodsTwo researchers searched fifteen academic bibliographic and grey literature databases for radon intervention studies conducted around the world, with particular emphasis on areas of North America and Europe published from 1990 to 2018.Interventions in residential and model houses were included, but studies piloted purely in the lab were excluded; the PRISMA checklist was used to synthesize data; Cochrane and Hamilton tools were used to evaluate study quality.ResultsStudies around the globe have investigated a variety of construction solutions, radon mitigation and remediation systems with different levels of effectiveness. In most cases, sub-slab or sump depressurization system (SSDS) with active ventilation technique was found more effective in achieving a significant and sustained radon reduction than the passive methods such as sealing, membrane, block and beam, simple ventilation, or filtration. The choice of an optimal strategy largely depends on the factors related to the initial radon level, routes of entry, building design and age, as well as other geologic, atmospheric, and climatic conditions.ConclusionAlthough an active SSDS is the best mitigation systems, at places, it needs to be combined with another system and installed by a trained radon professional considering the pertinent factors to ensure radon level continues to remain below the action level. This study did not conduct any economic evaluation of the mitigation measures. Future review with studies on the implementation of new building codes will provide updated evidence.RecommendationFor the practical implementation of radon mitigation, training of the construction industry, information provision for residents, the establishment of public funds, incorporation of radon-prone areas in the land utilization maps, and enacting building codes deemed essential.
| S-EPMC6538966 | biostudies-literature
Project description:High levels of stress in the parenting domain can lead to parental burnout, a condition that has severe consequences for both parents and children. It is not yet clear, however, whether parental burnout varies by culture, and if so, why it might do so. In this study, we examined the prevalence of parental burnout in 42 countries (17,409 parents; 71% mothers; Mage = 39.20) and showed that the prevalence of parental burnout varies dramatically across countries. Analyses of cultural values revealed that individualistic cultures, in particular, displayed a noticeably higher prevalence and mean level of parental burnout. Indeed, individualism plays a larger role in parental burnout than either economic inequalities across countries, or any other individual and family characteristic examined so far, including the number and age of children and the number of hours spent with them. These results suggest that cultural values in Western countries may put parents under heightened levels of stress.Supplementary informationThe online version contains supplementary material available at 10.1007/s42761-020-00028-4.
| S-EPMC7970748 | biostudies-literature
Project description:Studies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the same and previous days' minimum and maximum temperatures. We used location-specific quasi-Poisson regression models with an interaction term between the cross-basis term for mean temperature and quartiles of TV to obtain heat-mortality associations under each quartile of TV, and then pooled estimates at the country, regional, and global levels. Results show the increased risk in heat-related mortality with increments in TV, accounting for 0.70% (95% confidence interval [CI]: -0.33 to 1.69), 1.34% (95% CI: -0.14 to 2.73), 1.99% (95% CI: 0.29-3.57), and 2.73% (95% CI: 0.76-4.50) of total deaths for Q1-Q4 (first quartile-fourth quartile) of TV. The modification effects of TV varied geographically. Central Europe had the highest attributable fractions (AFs), corresponding to 7.68% (95% CI: 5.25-9.89) of total deaths for Q4 of TV, while the lowest AFs were observed in North America, with the values for Q4 of 1.74% (95% CI: -0.09 to 3.39). TV had a significant modification effect on the heat-mortality association, causing a higher heat-related mortality burden with increments of TV. Implementing targeted strategies against heat exposure and fluctuant temperatures simultaneously would benefit public health.
| S-EPMC8942841 | biostudies-literature
Project description:Anticipating and mitigating the impacts of climate change on biodiversity requires a comprehensive understanding on key habitats utilized by species. Yet, such information for high mobile marine megafauna species remains limited. Here, we compile a global database comprising published satellite tracking data (n = 1035 individuals) to spatially delineate foraging grounds for seven sea turtle species and assess their thermal stability. We identified 133 foraging areas distributed around the globe, of which only 2% of the total surface is enclosed within an existing protected area. One-third of the total coverage of foraging hotspots is situated in high seas, where conservation focus is often neglected. Our analyses revealed that more than two-thirds of these vital marine habitats will experience new sea surface temperature (SST) conditions by 2100, exposing sea turtles to potential thermal risks. Our findings underline the importance of global ocean conservation efforts, which can meet climate challenges even in remote environments.
| S-EPMC10958041 | biostudies-literature
Project description: Not available
| S-EPMC7361219 | biostudies-literature
Project description:Survival rates of patients with either early and advanced stage non-small-cell lung cancer (NSCLC) have improved with newer systemic therapy and radiation techniques, including combination regimens, targeted therapies, and immunotherapies. The cancer cooperative groups have historically played a critical role in the advancement of NSCLC therapy. Annually, representatives from cooperative groups worldwide convene at the International Lung Cancer Congress (ILCC). In summer 2015, the ILCC reached its 16th anniversary. This article highlights the NSCLC studies presented by participating groups in 2015.
| S-EPMC5361177 | biostudies-literature
Project description:BackgroundKidney disease is a major global public health problem, and laboratory testing of kidney health measures is essential for diagnosis and monitoring. The availability and affordability of kidney health laboratory tests across countries has not been systematically described.MethodsThe International Society of Nephrology (ISN), in partnership with leaders of a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference, surveyed a representative subset of ISN-Global Kidney Health Atlas (ISN-GKHA) respondents from April to June 2020. We assessed the association between country gross national income (GNI) per capita and laboratory testing availability and affordability.ResultsOf 33 regional expert nephrologists invited, 24 (73%) responded, representing all 10 ISN regions around the world. Availability of kidney health laboratory tests was as follows: serum Cr (100%), serum cystatin C (67%), urine albumin (96%), urine Cr (100%), and dipstick urinalysis (100%). Median (IQR) reimbursement values in international dollars were as follows: serum Cr Int$ 6.61 (3.42-8.84), serum cystatin C Int$ 31.51 (17.36-46.25), urine albumin Int$ 10.22 (5.90-15.42), urine Cr Int$ 7.50 (1.66-8.84), and dipstick urinalysis Int$ 6.26 (2.56-8.40). Reimbursement values did not differ significantly by World Bank income group or by GNI per capita.ConclusionThere was widespread availability of kidney health laboratory tests and substantial variation in reimbursement values. To achieve meaningful progress across nations in mitigating the growth of kidney disease, access to affordable diagnostic technology is essential. Our results are highly relevant to policymakers and researchers as countries increasingly consider national strategies for kidney disease detection and management.
| S-EPMC8482418 | biostudies-literature
Project description:There are 26 million refugees globally, with as many as 80% facing food insecurity irrespective of location. Food insecurity results in malnutrition beginning at an early age and disproportionately affects certain groups such as women. Food security is a complex issue and must consider gender, policies, social and cultural contexts that refugees face. Our aim is to assess what is known about food security interventions in refugees and identify existing gaps in knowledge. This scoping review followed the guidelines set out in the PRISMA Extension for Scoping Reviews. We included all articles that discussed food security interventions in refugees published between 2010 and 2020. A total of 57 articles were eligible for this study with most interventions providing cash, vouchers, or food transfers; urban agriculture, gardening, animal husbandry, or foraging; nutrition education; and infant and young child feeding. Urban agriculture and nutrition education were more prevalent in destination countries. While urban agriculture was a focus of the FAO and cash/voucher interventions were implemented by the WFP, the level of collaboration between UN agencies was unclear. Food security was directly measured in 39% of studies, half of which used the UN's Food Consumption Score, and the remainder using a variety of methods. As substantiated in the literature, gender considerations are vital to the success of food security interventions, and although studies include this in the planning process, few see gender considerations through to implementation. Including host communities in food security interventions improves the refugee-host relationship. Collaboration should be encouraged among aid organizations. To assess intervention efficacy, food security should be measured with a consistent tool. With the number of refugees in the world continuing to rise, further efforts are required to transition from acute aid to sustainability through livelihood strategies.
| S-EPMC8839314 | biostudies-literature