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Obesity and Risk of Colorectal Cancer: A Systematic Review of Prospective Studies  [PDF]
Yanlei Ma, Yongzhi Yang, Feng Wang, Peng Zhang, Chenzhang Shi, Yang Zou, Huanlong Qin
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0053916
Abstract: Background Mounting evidence indicates that obesity may be associated with the risk of colorectal cancer (CRC). To conduct a systematic review of prospective studies assessing the association of obesity with the risk of CRC using meta-analysis. Methodology/Principal Findings Relevant studies were identified by a search of MEDLINE and EMBASE databases before January 2012, with no restrictions. We also reviewed reference lists from retrieved articles. We included prospective studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the association between general obesity [measured using body mass index (BMI)] or central obesity [measured using waist circumference (WC)] and the risk of colorectal, colon, or rectal cancer. Approximately 9, 000, 000 participants from several countries were included in this analysis. 41 studies on general obesity and 13 studies on central obesity were included in the meta-analysis. The pooled RRs of CRC for the obese vs. normal category of BMI were 1.334 (95% CI, 1.253–1.420), and the highest vs. lowest category of WC were 1.455 (95% CI, 1.327–1.596). There was heterogeneity among studies of BMI (P<0.001) but not among studies of WC (P = 0.323). Conclusions Both of general and central obesity were positively associated with the risk of CRC in this meta-analysis.
Obesity, stigma, and responsibility in health care: A synthesis of qualitative studies  [cached]
Kirsti Malterud,Kjersti Ulriksen
International Journal of Qualitative Studies on Health & Well-Being , 2011, DOI: 10.3402/qhw.v6i4.8404
Abstract: Objective: To synthesize research findings on experiences and attitudes about obesity and stigma in health care. Methods: We compiled qualitative studies and applied Noblitt & Hare's meta ethnography to identify, translate, and summarize across studies. Thirteen qualitative studies on experiences and attitudes about obesity and stigma in health care settings were identified and included. Results: The study reveals how stigmatizing attitudes are enacted by health care providers and perceived by patients with obesity. Second-order analysis demonstrated that apparently appropriate advice can be perceived as patronizing by patients with obesity. Furthermore, health care providers indicate that abnormal bodies cannot be incorporated in the medical systems—exclusion of patients with obesity consequently happens. Finally, customary standards for interpersonal respect are legitimately surpassed, and patients with obesity experience contempt as if deserved. Third-order analysis revealed conflicting views between providers and patients with obesity on responsibility, whereas internalized stigma made patients vulnerable for accepting a negative attribution. A theoretical elaboration relates the issues of stigma with those of responsibility. Conclusion: Contradictory views on patients’ responsibility, efforts, knowledge, and motivation merge to internalization of stigma, thereby obstructing healthy coping and collaboration and creating negative contexts for empowerment, self-efficacy, and weight management. Professionals need to develop their awareness for potentially stigmatizing attitudes towards vulnerable patient populations.
Struggle for a Meaningful Life after Obesity Treatment—A Qualitative Systematic Literature Review  [PDF]
Kristine R?rtveit, Bodil Furnes, Elin Dysvik, Venke Ueland
Open Journal of Nursing (OJN) , 2017, DOI: 10.4236/ojn.2017.712103
Aim: The aim of this review was to describe and systemize existing literature on patient-experiences in the context of obesity treatment. The review question was: How do patients describe their experiences after obesity treatment? Background: Obesity problems vary on a continuum of intensity and types of problems during different periods of life. An increasing amount of available treatment requires patients and professionals to make choices concerning the suitability of the individual patient to undergo certain types of treatment. Surgical treatment is considered sustainable and more successful for weight loss than other interventions. Alternatively, conservative treatment of obesity may be a matter of dealing with mental issues as well as diet and exercise. In a qualitative context, a deeper understanding related to patients’ own posttreatment experiences is needed. Methods: A systematic qualitative literature review was conducted for the period from 2006 to November 2016. The search was done in Medline, Embase and CINAHL using the words: Obesity, binge eating, patient, experience or perspective, treat or therap or surgery or cognitive, intervention, programme. Results and discussion: 15 studies were included and an overview of the qualitative designs was presented. From the content analysis, one main theme, Struggle for a meaningful life during transition related to obesity treatment, was developed. The main theme was derived from three themes related to the patients’ challenges when searching for positive self-existence, for relevant treatment-support, and for a balance to obtain inner and outer control. Clinical implications: Different types of obesity treatment create processes of transitions. However, it is crucial that clinicians are aware of the potential existential struggle after obesity treatment that is experienced by the individual patients. Clearly, some patients need interventions targeting mental challenges at different levels. Future interventions should take into account that physical and mental treatment must work together.
Obesity studies in the circumpolar Inuit: a scoping review  [cached]
Tracey Galloway,Hilary Blackett,Susan Chatwood,Charlotte Jeppesen
International Journal of Circumpolar Health , 2012, DOI: 10.3402/ijch.v71i0.18698
Abstract: Background. Among circumpolar populations, recent research has documented a significant increase in risk factors which are commonly associated with chronic disease, notably obesity. Objective. The present study undertakes a scoping review of research on obesity in the circumpolar Inuit to determine the extent obesity research has been undertaken, how well all subpopulations and geographic areas are represented, the methodologies used and whether they are sufficient in describing risk factors, and the prevalence and health outcomes associated with obesity. Design. Online databases were used to identify papers published 1992–2011, from which we selected 38 publications from Canada, the United States, and Greenland that used obesity as a primary or secondary outcome variable in 30 or more non-pregnant Inuit (“Eskimo”) participants aged 2 years or older. Results. The majority of publications (92%) reported cross-sectional studies while 8% examined retrospective cohorts. All but one of the studies collected measured data. Overall 84% of the publications examined obesity in adults. Those examining obesity in children focused on early childhood or adolescence. While most (66%) reported 1 or more anthropometric indices, none incorporated direct measures of adiposity. Evaluated using a customized quality assessment instrument, 26% of studies achieved an “A” quality ranking, while 18 and 39% achieved quality rankings of “B” and “C”, respectively. Conclusions. While the quality of studies is generally high, research on obesity among Inuit would benefit from careful selection of methods and reference standards, direct measures of adiposity in adults and children, studies of preadolescent children, and prospective cohort studies linking early childhood exposures with obesity outcomes throughout childhood and adolescence.
Experiences of abortion: A narrative review of qualitative studies
Mabel LS Lie, Stephen C Robson, Carl R May
BMC Health Services Research , 2008, DOI: 10.1186/1472-6963-8-150
Abstract: To undertake a narrative review of qualitative studies of women's experiences of TOP and their perspectives on surgical or medical methods.Keyword searches of Medline, CINAHL, ISI, and IBSS databases. Manual searches of other relevant journals and reference lists of primary articles.Qualitative studies (n = 18) on women's experiences of abortion were identified. Analysis of the results of studies reviewed revealed three main themes: experiential factors that promote or inhibit the choice to seek TOP; experiences of TOP; and experiential aspects of the environment in which TOP takes place.Women's choices about TOP are mainly pragmatic ones that are related to negotiating finite personal and family and emotional resources. Women who are well informed and supported in their choices experience good psychosocial outcomes from TOP. Home TOP using mifepristone appears attractive to women who are concerned about professionals' negative attitudes and lack of privacy in formal healthcare settings but also leads to concerns about management and safety.Although abortion or termination of pregnancy (TOP) by clinical means is politically contentious in some countries (notably the US), in most developed countries it has become a normalized [1] component of women's health care [2] over the past forty years. For most of this period, TOP was a surgical procedure but since the mid-1990s, pharmaceutical developments (i.e. RU-486 also known as mifepristone, and methotrexate [3]), have made medical TOP possible. Clinical trials have established that medical TOP provides a clinical and cost effective alternative to vacuum aspiration for the early termination of pregnancy [4-8]. While a Cochrane systematic review highlighted inadequate evidence [9], a more recent systematic review concluded that the incidence of side effects in medical abortion was low [10]. Even so, mifepristone has only been approved in the US since September 2000, whereas the UK and Sweden have had more than a decade of
Childhood and adolescent obesity and adult mortality: a systematic review of cohort studies
Adami, Fernando;Vasconcelos, Francisco de Assis Guedes de;
Cadernos de Saúde Pública , 2008, DOI: 10.1590/S0102-311X2008001600008
Abstract: this systematic review addressed cohort studies on obesity in childhood and adolescence and adult mortality, published from january 1990 to march 2007. we searched the pubmed database with the following uniterms: obesity, mortality, child, adolescent; obesity and mortality; overweight and mortality. references were also analyzed. the age limit was 2 to 18 years. quality of the articles was assessed, and eight were identified and reviewed. all used weight and stature for determination of obesity, and seven used body mass index (bmi). the quality score varied from 9 to 17. evidence of association between obesity in childhood and adolescence and adult mortality should be viewed with caution. use of bmi and potential confounders were discussed. further research is needed to analyze the relationship between childhood and adolescent obesity and adult mortality.
A Qualitative Systematic Review of the Homeopathic Outcome Studies in Patients with HIV/AIDS
Subhranil Saha,Malay Mundle,Shubhamoy Ghosh,Munmun Koley
International Journal of High Dilution Research , 2013,
Abstract: Background & Aim: Systematic reviews of high-quality randomized controlled trials are crucial to evidence-based medicine. The objective of this review is to test whether there is enough evidence of efficacy of homeopathy from conducted clinical trials in humans suffering from HIV/AIDS. Methods: The study design was criteria-based systematic review of cumulative research and assessment of the methodological quality of only 5 published clinical trials and one review article. Among the clinical outcome studies, 3 studies were of open-label, non-randomized, non-controlled format, 2 were randomized controlled trials and one was a set of replication study. The qualities of the trials were evaluated using a list of validated and pre-defined criteria of good methodology, and the outcomes of the trials were interpreted in relation to their quality. Main outcome measures were methodological qualities in terms of consideration of threats to external, internal, construct and statistical conclusion validity. Results: Trials were too few in number and were not of very high quality. The results showed a positive trend regardless of the quality of the trial or the variety of homeopathy used. The results of this review may be complicated by publication bias. Conclusions: At this moment, the evidences are not sufficient to draw definitive conclusions. So, further evaluation of homeopathy by well-performed controlled trials of high methodological quality is required.
Epidemiologic Studies in Child and Adolescent Psychiatry: A Review of Methodology  [PDF]
Onur Burak Dursun,Taner Güvenir,Aylin ?zbek
Psikiyatride Guncel Yaklasimlar , 2010,
Abstract: Childhood psychiatric disorders are estimated to influence about 9 to 21% of relevant age group and interest in this disorders are increasing all over the world. The growing need to child and adolescent mental health leads the task of establishing proposals and policies in this field to become a priority for governments. The first step of such proposals should be determination of prevalence of child and adolescent mental disorders in that country. However, several major methodological problems make it hard to provide accurate prevalence estimates from epidemiological studies. Most common problems are within the fields of sampling, case definition, case ascertainment and data analyses. Such issues increases the costs of studies and hinder to reach large sample sizes. To minimize these problems, investigators have to be careful on choosing the appropriate methodology and diagnostic tools in their studies. Although there are many interviews and questionnaires for screening and diagnosing in child and adolescent psychiatry, only a few of them are suitable for epidemiological research. In parallel with the improvement in all fields of child and adolescent mental health in our country, some of the major screening and diagnosing tools used in prevalence studies in literature have already been translated and validated in Turkish. Most important of this tools for screening purposes are Child Behavior Checklist and Strengths and Difficulties Questionnaire and for diagnosing purposes are Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version and Development and Well-Being Assessment. The aims of this article are to review the methodological problems of epidemiologic studies in child and adolescent psychiatry and to briefly discuss suitable diagnostic tools for extended sampled epidemiologic studies in our country.
The experience of living with chronic heart failure: a narrative review of qualitative studies
Yun-Hee Jeon, Stefan G Kraus, Tanisha Jowsey, Nicholas J Glasgow
BMC Health Services Research , 2010, DOI: 10.1186/1472-6963-10-77
Abstract: We searched eight relevant electronic databases using the terms based on the diagnosis of 'chronic heart failure', 'heart failure' and 'congestive heart failure' and qualitative methods, with restrictions to the years 1990-May 2008. We also used snowballing, hand searching and the expert knowledge of the research team to ensure all relevant papers were included in the review. Of 65 papers collected less than half (n = 30) were found relevant for this review. These papers were subsequently summarised and entered into QSR NVivo7 for data management and analysis.The review has identified the most prominent impacts of CHF on a person's everyday life including social isolation, living in fear and losing a sense of control. It has also identified common strategies through which patients with CHF manage their illness such as sharing experiences and burdens with others and being flexible to changing circumstances.Finally, there are multiple factors that commonly impact on patients' self care and self-management in the disease trajectory including knowledge, understanding and health service encounters. These health service encounters encompass access, continuity and quality of care, co-morbid conditions, and personal relationships.The core and sub-concepts identified within this study provide health professionals, service providers, policy makers and educators with broad insights into common elements of people's experiences of CHF and potential options for improving their health and wellbeing. Future studies should focus on building a comprehensive picture of CHF through examination of differences between genders, and differences within age groups, socioeconomic groups and cultural groups.In 2005 approximately 30% of global deaths (17.5 million) were attributable to cardiovascular disease (CVD) [1]. Chronic heart failure (CHF) significantly contributes to this disease burden and is the leading cause of all hospitalisations and readmissions in older people, accounting for a l
Systematic review on obesity in Brazilian adolescents
Rafael Miranda Tassitano,Maria Cecília Marinho Tenório,Pedro Curi Hallal
Revista Brasileira de Cineantropometria e Desempenho Humano , 2009,
Abstract: The purpose of this study was to systematically review the Brazilian literature on the prevalence of obesity and associated factors in adolescents. The literature search was carried out in the electronic databases Pubmed and Bireme, using the keywords: obesity, overweight, BMI, adolescents and Brazil. The following inclusion criteria were considered: Brazilian adolescents, BMI-based obesity estimates, publication until 2007, and adequate methodology. After the examination of titles, abstracts and full texts, 27 papers fulfilled our inclusion criteria. For describing the studies, the following variables were used: type of survey, design, age range, sample size, place of data collection. For evaluating the evidence, the following indicators were used: methods used, independent variables studied, statistical analyses employed, and cut-off used for defining obesity. Most studies used cross-sectional designs (77.7%) and were carried out through home interviews (51.7%). Only one study used a nationally-based sample and three used regional-based samples (Northeast and Southeast). Regardless the design, place, type of survey, age range and cut-off used, the prevalence of obesity tended to be higher in the following groups: adolescents living in the Southeast region, living in urban areas, from high socioeconomic level and from private schools. In terms of behavioral determinants of obesity, the paucity of prospective studies and the difficulties of adequately measuring physical activity and food consumption, make the results less clear. Although the number of studies has increased, it is still necessary to stimulate surveys in the North, Southeast and Mideast regions. Prospective studies are also necessary, in order to evaluate the association between obesity and behavioral exposures.
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