Social Problems

社会问题
  • 文章类型: Review
    目的:本范围审查旨在概述如何在开发或评估社会处方(SP)干预研究中使用理论。
    背景:SP描述了一种患者途径,其中全科医生(GP)通过转介将患者与社区活动联系起来,以联系工人。本审查旨在了解为SP的结果和实施过程提供的解释。
    方法:研究使用定义的理论来开发或评估初级保健和社区部门的特定SP干预措施。
    方法:本范围审查按照JBI方法进行。2022年7月8日搜索了以下数据库:PubMed,ASSIA,科克伦,Cinahl,PsycINFO,社会关怀在线,社会学文摘,Scopus,和WebofScience。搜索仅考虑英语文本。通过搜索相关网页和联系专家来确定其他文献。来源的选择和数据提取由两名审阅者独立完成。
    结果:搜索产生了4240份报告,其中18人被纳入范围审查。其中,16次在英国进行,一个在加拿大,一个在澳大利亚。大多数报告采用了定性方法(11/18)。三是研究方案。应用了11种不同的理论来解释结果(4种理论),结果差异(3种理论),以及干预的实施(4种理论)。从实际应用来看,确定的理论主要用于解释和理解定性发现.只有一种理论被用来定义假设检验的变量。所有理论均用于评估,没有用于SP的开发。
    结论:理论影响了评估评估的结果,预期哪种因果途径会产生这些结果,以及使用了哪些方法。确定的所有三组理论都集中在SP的相关方面:促进积极的患者/社区结果,通过考虑某人的个人情况来解决不平等,并通过跨职业和机构界限的协作成功实施SP。关于理论在实际应用中的最佳使用,需要额外的见解。
    OBJECTIVE: This scoping review aims to provide an overview of how theories were used in the development or evaluation of social prescribing (SP) intervention studies.
    BACKGROUND: SP describes a patient pathway where general practitioners (GPs) connect patients with community activities through referrals to link workers. This review seeks to understand the explanations provided for the outcomes and implementation process of SP.
    METHODS: Studies using a defined theory to develop or evaluate a specific SP intervention in primary care and the community sector.
    METHODS: This scoping review was conducted in accordance with JBI methodology. The following databases were searched on 8th of July 2022: PubMed, ASSIA, Cochrane, Cinahl, PsycINFO, Social Care Online, Sociological Abstracts, Scopus, and Web of Science. The search only considered English language texts. Additional literature was identified by searching relevant web pages and by contacting experts. The selection of sources and the data extraction was done by two reviewers independently.
    RESULTS: The search resulted in 4240 reports, of which 18 were included in the scoping review. Of these, 16 were conducted in the UK, one in Canada and one in Australia. The majority of reports employed a qualitative approach (11/18). Three were study protocols. 11 distinct theories were applied to explain outcomes (4 theories), differences in outcomes (3 theories), and the implementation of the intervention (4 theories). In terms of practical application, the identified theories were predominantly used to explain and understand qualitative findings. Only one theory was used to define variables for hypothesis testing. All theories were used for the evaluation and none for the development of SP.
    CONCLUSIONS: The theories influenced which outcomes the evaluation assessed, which causal pathway was expected to generate these outcomes, and which methodological approaches were used. All three groups of theories that were identified focus on relevant aspects of SP: fostering positive patient/community outcomes, addressing inequalities by considering the context of someone\'s individual circumstances, and successfully implementing SP by collaboratively working across professions and institutional boundaries. Additional insight is required regarding the optimal use of theories in practical applications.
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  • 文章类型: Journal Article
    目标:有5岁以下儿童居住在临时住所的家庭中的无家可归问题日益引起全球关注,特别是在高收入国家(HIC)。尽管对健康和发展产生重大影响,这些“看不见的”儿童往往会陷入政策和服务的空白。该研究的主要目标是绘制针对5岁以下儿童在HIC中无家可归的文化敏感干预措施的内容和交付方法。
    方法:范围审查清单的系统评价和Meta分析扩展的首选报告项目指导范围审查。
    方法:数据库包括PubMed、Medline,Scopus,搜索了Cochrane图书馆和GoogleScholar,直到2022年3月24日。
    方法:本范围审查包括描述,衡量或评估旨在改善儿童健康计划的干预策略,特别是那些在喂养等关键领域产生积极成果的人,营养,护理实践和育儿。
    方法:文章由两名独立审稿人选择和评估,与争议解决系统有关,该系统涉及有争议的选择的第三位审阅者。使用各种工具评估研究的方法学质量,包括偏差风险(RoB)工具,CochraneRoBV.2.0,非随机研究的偏倚风险评估工具(RoBANS)和建议评估的分级,发展,和评估(等级),每个根据文章的类型选择。
    结果:数据库搜索产生951个结果。重复数据删除后,摘要筛选和全面审查,13条符合纳入标准。在这项研究中确定了两种主要的干预措施:基于小组的干预措施(教育会议)和基于个人的干预措施(家庭访问)。
    结论:本综述强调了促进5岁以下无家可归儿童健康和福祉的有效干预措施。包括教育会议和家访。研究支持家访有助于分解语言的重要性,文化和健康素养障碍。
    Homelessness among families with children under 5 residing in temporary accommodation is a growing global concern, especially in high-income countries (HICs). Despite significant impacts on health and development, these \'invisible\' children often fall through the gaps in policy and services. The study\'s primary objective is to map the content and delivery methods of culturally sensitive interventions for children under 5 experiencing homelessness in HICs.
    A scoping review guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.
    Databases include PubMed, Medline, SCOPUS, The Cochrane Library and Google Scholar were searched up to 24 March 2022.
    This scoping review includes studies that describe, measure or evaluate intervention strategies aimed at improving child health programmes, specifically those yielding positive outcomes in key areas like feeding, nutrition, care practices and parenting.
    Articles were selected and evaluated by two independent reviewers, with a dispute resolution system involving a third reviewer for contested selections. The methodological quality of the studies was assessed using various tools including the Risk of Bias (RoB) tool, Cochrane RoB V.2.0, the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), each selected according to the type of article.
    The database search yielded 951 results. After deduplication, abstract screening and full review, 13 articles met the inclusion criteria. Two predominant categories of intervention delivery methods were identified in this research: group-based interventions (educational sessions) and individual-based interventions (home visits).
    This review highlights effective interventions for promoting the health and well-being of children under 5 experiencing homelessness, including educational sessions and home visits. Research has supported the importance of home visiting to be instrumental in breaking down language, cultural and health literacy barriers.
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  • 文章类型: Journal Article
    背景:创伤是一种危及生命的经历(身体或情感),有害,或与众不同,并对心理健康和福祉产生持久影响。关于无家可归人群创伤的大部分信息都集中在童年时期的事件上。使用联合生产原理,我们的目的是综合定性证据,探索成年期间无家可归的创伤对心理健康的影响,包括物质使用。
    方法:在这篇定性系统综述中,我们搜索了ASSIA,CINAHL,科克伦,EMBASE,MEDLINE,论文和论文,PsychInfo,Scopus,和WebofScience从开始到2022年9月6日发表的研究,以及相关网站的灰色文献。搜索词是基于PICO框架开发的。没有语言,date,或应用了地理限制。任何报告成人无家可归期间创伤经历及其对心理健康影响的定性研究都是合格的。我们提取了相关数据(例如,方法论,样本特征,无家可归,和发现)。首席研究员为有无家可归经历的人提供了定制培训。他们为完善审查目标做出了贡献,筛选,编码,和主题发展。使用CASP定性研究清单评估质量。
    结果:我们纳入了26篇定性论文,包括876名年龄在18至70岁之间的无家可归的成年人(448名[51%]女性和428名[49%]男性)。所有论文都集中在城市环境上。八篇论文来自美国,五个来自加拿大,四个来自英国和澳大利亚,三个来自巴西,还有一个来自埃塞俄比亚和伊朗。这26篇论文的框架综合确定了三个初步主题。经历无家可归的人通过三种方式理解创伤:内在化的理解,与他人的关系,和生存镜头。管理恐惧感的应对策略,焦虑,抑郁症包括物质使用,自我合理化,以及安全感的策略。最后,当人们经历反复的创伤时,他们要么分离了,接受了他们的处境,或者有弹性,希望改变他们的情况。
    结论:在农村或沿海地区需要进一步的证据,无家可归的人可能会面临更大的孤立。创伤很少孤立地发生,通常,以前的创伤经历会塑造经历无家可归的人如何理解创伤并应对创伤。应对创伤影响的支持应侧重于确保人们不会变得脱敏,并防止心理健康和药物使用恶化。这篇评论的优势在于它与有生活经验的人共同制作。使用二次检查进行单人数据提取是一个限制。
    背景:国家健康与保健研究所(NIHR)初级保健研究学校作为三个NIHR研究学校心理健康计划的一部分。
    BACKGROUND: Trauma is an experience (physical or emotional) that is life-threatening, harmful, or out of the ordinary and has lasting effects on mental health and wellbeing. Much of the information about trauma within homeless populations focuses on events in childhood. Using coproduction principles, we aimed to synthesise qualitative evidence exploring the impact of trauma during adulthood homelessness on mental health, including substance use.
    METHODS: In this qualitative systematic review, we searched ASSIA, CINAHL, Cochrane, EMBASE, MEDLINE, Proquest theses and dissertations, PsychInfo, Scopus, and Web of Science for studies published from inception until Sept 6, 2022, alongside grey literature from relevant websites. Search terms were developed based on the PICO framework. No language, date, or geographical limits were applied. Any qualitative research reporting experiences of trauma and its impact on mental health during homelessness in adults was eligible. We extracted relevant data (eg, methodology, sample characteristics, homelessness, and findings). People with lived experience of homelessness were provided with bespoke training by the lead researcher. They contributed to refining the review aims, screening, coding, and theme development. Quality was assessed using the CASP Qualitative Studies Checklist.
    RESULTS: We included 26 qualitative papers, including 876 adults experiencing homelessness between ages 18 and 70 years (448 [51%] women and 428 [49%] men). All papers focused on urban settings. Eight papers were from the USA, five from Canada, four from the UK and Australia, three from Brazil, and one from Ethiopia and Iran. A framework synthesis of these 26 papers identified three preliminary themes. People experiencing homelessness make sense of trauma in three ways: internalised understanding, relationality to others, and with a survival lens. Coping strategies for managing feelings of fear, anxiety, and depression included substance use, self-rationalisation, and strategies to feel safe. Finally, when people experienced repeated trauma, they became either dissociated, and accepted their situation, or resilient, wishing to change their circumstances.
    CONCLUSIONS: Further evidence is needed in rural or coastal regions, where people experiencing homelessness may face greater isolation. Trauma rarely takes place in isolation, and often previous experiences of trauma shape how people experiencing homelessness make sense of trauma and cope with it. Support to address coping with the effects of trauma should focus on ensuring people do not become desensitised and prevent deterioration of mental health and substance use. The strength of this review is its coproduction with people with lived experience. Single person data extraction with secondary checks was a limitation.
    BACKGROUND: National Institute for Health and Care Research (NIHR) School for Primary Care Research as part of the Three NIHR Research Schools Mental Health Programme.
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  • 文章类型: Journal Article
    背景:自杀是全球死亡率的重要因素。与普通人群相比,使用药物(PWUD)的人死于自杀的风险增加,但是,在这一群体中,缺乏有关自杀的相关候选因素的信息。这项研究的目的是全面概述有关PWUD自杀死亡的潜在因素的现有证据。
    方法:根据Arksey和O\'Malley框架进行范围审查。文章是使用Medline识别的,CINAHL,PsycINFO,SOCIndex,Cochrane系统评论数据库和坎贝尔系统评论协作数据库;辅以灰色文献,技术报告,与专家协商。对研究设计没有限制。包括2000年1月至2021年12月的英文出版物。两名审稿人独立筛选了全文出版物。提取的数据使用表格和随附的叙述性描述性摘要进行整理。使用系统评论和Meta分析扩展范围评论的首选报告项目(PRISMA-ScR)指南报告了该评论。
    结果:最初的搜索确定了12,389篇出版物,其中53人符合纳入标准。大多数(87%)的出版物是初级研究,一个不受控制的,回顾性研究设计。最常见的数据来源是药物治疗数据库或国家死亡指数。确定了与PWUD中自杀死亡相关的11个潜在因素:性别;精神健康状况;脆弱性加剧的时期;年龄概况;使用兴奋剂,大麻,或新的精神活性物质;特定的医疗条件;缺乏双重诊断服务;无家可归;监禁;静脉吸毒;和种族或族裔。阿片类药物,其次是大麻和兴奋剂药物是自杀死亡的PWUD中最普遍的使用药物。很大一部分证据与阿片类药物的使用有关;因此,需要对自杀和明确的危险因素进行更多的初步研究。
    结论:探索与PWUD中自杀死亡相关因素的大多数研究涉及描述性流行病学数据,对明确的危险因素的深入分析有限。为了防止PWUD自杀,重要的是要考虑潜在的危险因素和药物使用类型,并相应地调整政策和做法。
    Suicide is a significant contributor to global mortality. People who use drugs (PWUD) are at increased risk of death by suicide relative to the general population, but there is a lack of information on associated candidate factors for suicide in this group. The aim of this study was to provide a comprehensive overview of existing evidence on potential factors for death by suicide in PWUD.
    A scoping review was conducted according to the Arksey and O\'Malley framework. Articles were identified using Medline, CINAHL, PsycINFO, SOCIndex, the Cochrane Database of Systematic Reviews and the Campbell Collaboration Database of Systematic Reviews; supplemented by grey literature, technical reports, and consultation with experts. No limitations were placed on study design. Publications in English from January 2000 to December 2021 were included. Two reviewers independently screened full-text publications for inclusion. Extracted data were collated using tables and accompanying narrative descriptive summaries. The review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines.
    The initial search identified 12,389 individual publications, of which 53 met the inclusion criteria. The majority (87%) of included publications were primary research, with an uncontrolled, retrospective study design. The most common data sources were drug treatment databases or national death indexes. Eleven potential factors associated with death by suicide among PWUD were identified: sex; mental health conditions; periods of heightened vulnerability; age profile; use of stimulants, cannabis, or new psychoactive substances; specific medical conditions; lack of dual diagnosis service provision; homelessness; incarceration; intravenous drug use; and race or ethnicity. Opioids, followed by cannabis and stimulant drugs were the most prevalent drugs of use in PWUD who died by suicide. A large proportion of evidence was related to opioid use; therefore, more primary research on suicide and explicit risk factors is required.
    The majority of studies exploring factors associated with death by suicide among PWUD involved descriptive epidemiological data, with limited in-depth analyses of explicit risk factors. To prevent suicide in PWUD, it is important to consider potential risk factors and type of drug use, and to tailor policies and practices accordingly.
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  • 文章类型: Systematic Review
    背景:无家可归是一个复杂的社会和公共卫生挑战。关于有无家可归经历(PEH)的人的人口水平健康和社会护理相关预测因素以及后果的信息有限。专注于人口亚组或临时问卷调查以收集数据的研究对于整个人口健康监测和规划的适用性相对有限。这项研究的目的是寻找和综合有关危险因素的信息,以及后果,在使用常规管理数据的全人群研究中经历无家可归。
    方法:我们使用EMBASE进行了系统搜索,MEDLINE,Cochrane图书馆,从开始到2023年2月发表的用于英语研究的护理和联合健康文献(CINAHL)和PsycINFO研究数据库的累积指数,报告了有关无家可归,健康和社会护理相关预测因素和后果的行政数据分析。我们遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目。
    结果:在所审查的1224篇文章中,30份出版物符合纳入标准。纳入的研究考察了广泛的主题领域,每个人使用的无家可归定义都有很大差异。研究分为几个主题领域:死亡率,发病率和COVID-19;医疗保健使用和重新入院;养老院入住和收容所;以及其他(例如就业,犯罪受害)。研究报告说,无家可归的人的身心健康状况比普通人群差。无家可归的人更有可能有更高的住院风险,更有可能使用急诊室,与一般人群相比,死亡率更高,需要重症监护或死于COVID-19的风险更高。此外,无家可归的人更有可能被监禁或失业。与那些在以后的生活中经历过无家可归的人相比,对那些小时候无家可归的人的影响最大。
    结论:这是对全人群观察性研究的首次系统评价,该研究使用行政数据来确定与无家可归个体相关的原因和后果。虽然科学文献提供了一些与无家可归相关的可能风险因素的证据,对这一研究课题的研究有限,差距仍然存在。需要更标准化的最佳实践方法,以更好地了解与无家可归相关的原因和后果。
    Homelessness is a complex societal and public health challenge. Limited information exists about the population-level health and social care-related predictors and consequences of persons with lived experience of homelessness (PEH). Studies that focus on population subgroups or ad hoc questionnaires to gather data are of relatively limited generalisability to whole-population health surveillance and planning. The aim of this study was to find and synthesise information about the risk factors for, and consequences of, experiencing homelessness in whole-population studies that used routine administrative data.
    We performed a systematic search using EMBASE, MEDLINE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO research databases for English-language studies published from inception until February 2023 that reported analyses of administrative data about homelessness and health and social care-related predictors and consequences. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
    Of the 1224 articles reviewed, 30 publications met the inclusion criteria. The included studies examined a wide range of topic areas, and the homelessness definitions used in each varied considerably. Studies were categorised into several topic areas: Mortality, morbidity and COVID-19; health care usage and hospital re-admission; care home admission and shelter stay; and other (e.g. employment, crime victimisation). The studies reported that that the physical and mental health of people who experience homelessness was worse than that of the general population. Homeless individuals were more likely to have higher risk of hospitalisation, more likely to use emergency departments, have higher mortality rates and were at greater risk of needing intensive care or of dying from COVID-19 compared with general population. Additionally, homeless individuals were more likely to be incarcerated or unemployed. The effects were strongest for those who experienced being homeless as a child compared to those who experienced being homeless later on in life.
    This is the first systematic review of whole-population observational studies that used administrative data to identify causes and consequences associated with individuals who are experiencing homelessness. While the scientific literature provides evidence on some of the possible risk factors associated with being homeless, research into this research topic has been limited and gaps still remain. There is a need for more standardised best practice approaches to understand better the causes and consequences associated with being homeless.
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  • 文章类型: Journal Article
    背景:无家可归是一个复杂的社会问题,严重损害了受影响者的健康。经历无家可归(PEH)的人有较高的不良健康结果的患病率,包括过早死亡,与普通人群相比,癌症是第二大死因.本范围审查的目的是绘制证据,以评估PEH对已知癌症风险因素的暴露,并确定PEH在获得癌症预防服务方面的障碍和促进者经验。
    方法:此范围审查将根据JoannaBriggsInstitute的范围审查指南进行。在从数据库建立之日起至2023年2月20日的时间窗口中,研究团队将创建详细的搜索策略,并将其应用于以下数据库:CINAHL,Embase,全球指数Medicus,PubMed,Scopus和WebofScience此外,我们将在OpenGrey和Google搜索灰色文献,并联系非政府组织以索取相关报告。在第一阶段,资格标准将通过盲目的标题/摘要评估进行评估,根据这一评估,将进行全文筛选。随后,研究小组将进行数据提取,并综合与范围审查问题有关的所有相关信息。
    背景:由于此协议不涉及收集主要数据,道德批准是不必要的。这项审查的结果将发表在同行评审的期刊和机构网站上。
    Homelessness is a complex social issue that significantly impairs the health of those affected. People experiencing homelessness (PEH) have a higher prevalence of adverse health outcomes, including premature mortality, compared with the general population, with cancer being the second-leading cause of death. The objective of this scoping review is to map the evidence to assess the exposure of PEH to known cancer risk factors and identify barriers and facilitators PEH experience in accessing cancer prevention services.
    This scoping review will be conducted in line with the Joanna Briggs Institute guidelines for scoping reviews. For a time window from the date of database establishment until 20 February 2023, the research team will create a detailed search strategy and apply it to the following databases: CINAHL, Embase, Global Index Medicus, PubMed, Scopus and Web of Science. In addition, we will search OpenGrey and Google for grey literature and contact non-governmental organisations to request relevant reports. In the first stage, eligibility criteria will be assessed through a blinded title/abstract assessment, and following this assessment, a full-text screening will be performed. Subsequently, the research team will perform the data extraction and synthesise all relevant information in relation to the scoping review question.
    As this protocol does not involve gathering primary data, ethical approval is not necessary. The results of this review will be published in a peer-reviewed journal and on institutional websites.
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  • 文章类型: Journal Article
    为了确定干预计划对有新出现的心理健康需求的幼儿(4-9岁)的有效性,我们对干预文献进行了荟萃分析和系统综述.在确定的41,061份摘要和筛选的15,076份摘要中,152篇评论文章符合纳入标准。我们回顾了多个学科的干预措施,目标是:(1)一般心理健康问题;(2)内在化症状;(3)外在化症状;(4)焦虑;(5)抑郁;(6)创伤;(7)注意力缺陷/多动障碍的症状;(8)与自闭症谱系障碍相关的心理健康问题。有大量证据表明行为和认知行为干预对一般心理健康问题的有效性,外化症状(通常,以及多动症,行为,和其他行为症状)和内化症状(通常,以及焦虑)4-9岁。发现了针对创伤症状的干预措施的新证据,抑郁症状,社会,4-9岁儿童自闭症谱系障碍的情绪和行为症状。目前,针对4-9岁儿童的非行为或非认知行为干预方案的证据有限,目的是提供一个基于证据的方案,以改善儿童社会,情绪和/或行为功能。鉴于最近报告的儿童心理健康需求增加,有针对性的行为和/或认知行为疗法为基础的干预措施应广泛提供给症状升高的儿童(及其家庭).
    To determine the efficacy of intervention programs for young children (4-9 years) with emerging mental health needs, we conducted a review of meta-analytic and systematic reviews of the intervention literature. Of 41,061 abstracts identified and 15,076 screened, 152 review articles met the inclusion criteria. We reviewed interventions across multiple disciplines targeting: (1) general mental health concerns; (2) internalizing symptoms; (3) externalizing symptoms; (4) anxiety; (5) depression; (6) trauma; (7) symptoms of attention-deficit/hyperactivity disorder; and (8) mental health concerns associated with autism spectrum disorder. Substantial evidence was found for the efficacy of behavioral and cognitive behavioral interventions for general mental health concerns, externalizing symptoms (generally, as well as ADHD, conduct, and other behavioral symptoms) and internalizing symptoms (generally, as well as anxiety) aged 4-9 years. Emerging evidence was identified for interventions targeting trauma symptoms, depression symptoms, and social, emotional and behavioral symptoms in autism spectrum disorder in children aged 4-9 years. Currently there is only limited emerging evidence regarding non-behavioral or non-cognitive behavioral interventions for programs targeting children ages 4-9 years where the aim is to deliver an evidence-based program to improve child social, emotional and/or behavioral functioning. Given the recent rises in mental health needs reported in children, targeted behavioral-and/or cognitive behavior therapy-based interventions should be made widely available to children (and their families) who experience elevated symptoms.
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  • 文章类型: Journal Article
    Il problema sociale della presbistasia e il ruolo della riabilitazione vestibolare nell’anziano: una revisione della letteratura.
    Il termine presbistasia si riferisce a una condizione di comune riscontro negli anziani, caratterizzata da un progressivo e multifattoriale disordine dell’equilibrio; la fisiopatogenesi può originare dalla concomitanza di diversi fattori, tra i quali patologie del sistema nervoso centrale, da una neuropatia periferica, disordini osteoarticolari (che provocano una riduzione della velocità di marcia), patologie del sistema cardiovascolare e visivo, ma può anche avere come concausa deficit del sistema vestibolare periferico e centrale; soprattutto la Vertigine Parossistica Posizionale Benigna (VPPB) è comune nei soggetti di età superiore a 70 anni. La presbistasia rappresenta oggi una delle principali cause di cadute negli anziani e ha come conseguenza una riduzione dell’aspettativa e qualità di vita. Scopo del nostro lavoro è stato quello di rivedere la recente letteratura focalizzandoci sul ruolo del sistema vestibolare nella patogenesi e sulle possibilità terapeutiche offerte dalla riabilitazione vestibolare. Sono state inoltre riassunte nella review le altre concause del disturbo.
    The term “presbystasis” refers to a common clinical condition in the elderly, characterised by a multifactorial and progressive impairment of balance. The pathophysiology may be related to various concomitant factors including central nervous system diseases, peripheral neuropathy, osteoarticular disorders (leading to a reduction of the speed gait), and cardiovascular or visual disorders, but it may also be a consequence of deficits of the peripheral or central vestibular system (which is generally represented by a bilateral and symmetric vestibular dysfunction). Benign paroxysmal positional vertigo (BPPV) is far from being rare in subjects over the age of 70 years. Nowadays, presbystasis represents one of the main causes of accidental falls in the elderly, leading to a reduction in quality of life and life expectancy. The aim of our work was to review the current literature on presbystasis, focusing on the role of the vestibular system in the pathogenesis and on the possibilities offered by vestibular rehabilitation in the management of these subjects. Other clinical conditions related to the disorder are also discussed.
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  • 文章类型: Journal Article
    背景:经历无家可归的人健康状况不佳。众所周知,身体活动可以改善健康状况。没有对该人群的身体活动干预措施进行公开的系统评价。我们旨在系统地综合证据,为无家可归的人进行身体活动干预。
    方法:我们搜索了EMBASE,WebofScience,CINAHL,PubMed,PsycINFO,SPORTDiscus,和Cochrane图书馆从1970年1月1日至2021年2月8日,用于仅以英文发表的研究。搜索词包括“无家可归的人”和“身体干预”。我们纳入了对来自高收入国家的无家可归者的定量和定性研究,这些研究在任何情况下都有身体活动干预,无论是否有标准护理,评估任何健康或福祉相关的结果-例如,心血管,抑郁症。乔安娜·布里格斯研究所(JBI)的关键分析工具用于质量评估,质量很差的研究被拒绝了。遵循JBI混合方法系统评价方法,具有定量数据的资格和证据的汇聚综合。协议注册到PROSPERO,编号CRD42020216716。
    结果:我们筛选了2837条记录,生成14份报告(13项研究:8项定性和5项定量[一项随机对照试验,三个准实验,一个分析横截面])来自英国的足够质量,美国,丹麦,澳大利亚,包括403名参与者。干预措施包括足球(n=6),小组活动(例如,园艺[n=5]),和多模式个人干预(例如,提供安全培训的自行车[n=2])。定量研究报告了19个结果(13个目标,六个主观)量化身体健康(例如,VO2max;n=13),心理健康(例如,贝克抑郁量表;n=5),和社会福祉(结果评定量表;n=1)。9个量化结果发生了实质性变化,有利于干预。在三个结果中没有报告变化,剩余结局的相对变化无法量化。定性研究的综合发现,主题报告主要是对身心健康和社会福祉的积极感知影响,通过汇编合成证实了定量结果。
    结论:确定的定性研究多于定量研究,定性证据表明,身体活动干预措施可以有益于健康和福祉。然而,定量证据要么是积极的,要么是不确定的。证据表明,对无家可归的人进行身体活动干预的初步建议。
    背景:国家卫生研究所公共卫生研究学院。
    People experiencing homelessness have poor health. Physical activity is known to improve health outcomes. No published systematic review of physical activity interventions in this population exists. We aimed to systematically synthesise evidence for physical activity interventions in people experiencing homelessness.
    We searched EMBASE, Web of Science, CINAHL, PubMed, PsycINFO, SPORTDiscus, and Cochrane Library from Jan 1, 1970, to Feb 8, 2021, for studies only published in English. Search terms included \"people experiencing homelessness\" and \"physical interventions\". We included quantitative and qualitative studies of people experiencing homelessness from high-income countries with physical activity interventions in any setting that was compared with or without standard of care, evaluating any health or wellbeing-related outcome-eg, cardiovascular, depression. The Joanna Briggs Institute\'s (JBI) critical analysis tools were used for quality assessment, with very poor-quality studies rejected. JBI mixed-methods systematic reviews methodology was followed, with qualitisation of quantitative data and convergent synthesis of evidence. The protocol is registered with PROSPERO, number CRD42020216716.
    We screened 2837 records, generating 14 reports (13 studies: eight qualitative and five quantitative [one randomised control trial, three quasi-experimental, one analytical cross-sectional]) of sufficient quality from the UK, USA, Denmark, and Australia, including 403 participants. Interventions included soccer (n=6), group activities (eg, gardening [n=5]), and multi-modal individual interventions (eg, bicycle provision with safety-training [n=2]). Quantitative studies reported 19 outcomes (13 objective, six subjective) quantifying physical health (eg, VO2max; n=13), mental health (eg, Beck Depression Inventory; n=5), and social wellbeing (Outcomes Rating Scale; n=1). Nine quantitative outcomes changed substantially in favour of the intervention. No change was reported in three outcomes, and the relative change of remaining outcomes could not be quantified. Synthesis of qualitative studies found themes reporting predominantly positive perceived impact on physical and mental health and social wellbeing, which corroborated the quantitative findings through convergent synthesis.
    More qualitative than quantitative studies were identified, with qualitative evidence suggesting physical activity interventions can benefit health and wellbeing. However, quantitative evidence was either positive or inconclusive. Evidence suggests a tentative recommendation for physical activity interventions in people experiencing homelessness.
    National Institute for Health Research School for Public Health Research.
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  • 文章类型: Journal Article
    UNASSIGNED:我们进行了范围审查,目的是全面调查在一般实践研究中检查了哪些工具或方法,这些工具或方法可以捕获广泛的心理社会问题(PSP)并用于识别患者并突出其特征。
    UNASSIGNED:我们遵循了用于范围审查的系统审查和荟萃分析扩展的首选报告项目,以及JoannaBriggsInstituteReviewer的范围审查手册。在四个电子数据库(Medline[Ovid],WebofScience核心合集,PsycInfo,Cochrane图书馆),用于定量和定性研究,西班牙语,法语,和德国没有时间限制。该协议已在开放科学框架中注册,并在BMJOpen上发布。
    未经批准:在确定的839篇文章中,66符合研究资格标准,从中鉴定出61种仪器。出版物来自18个不同的国家,大多数研究采用观察性设计,主要包括成年患者。在所有工具中,22份报告已验证,我们在本文中介绍。总的来说,质量标准报告不同,研究通常提供很少的细节。大多数仪器被用作纸和铅笔问卷。我们在理论概念化中发现了相当大的异质性,定义,和PSP的测量,从精神病病例发现到具体的社会问题。
    UNASSIGNED:这篇综述提出了一些已经在一般实践研究中研究和使用的工具和方法。因地制宜,实践人群,和需要,它们可能有助于在日常GP实践中识别患有PSP的患者;然而,这需要进一步的研究。鉴于研究和仪器的异质性,未来的研究工作应包括对工具进行更结构化的评估,并纳入共识方法,以从工具研究转向日常实践中的实际使用。
    UNASSIGNED: We conducted a scoping review with the aim of comprehensively investigating what tools or methods have been examined in general practice research that capture a wide range of psychosocial problems (PSPs) and serve to identify patients and highlight their characteristics.
    UNASSIGNED: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and the Joanna Briggs Institute Reviewer\'s Manual on scoping reviews. A systematic search was conducted in four electronic databases (Medline [Ovid], Web of Science Core Collection, PsycInfo, Cochrane Library) for quantitative and qualitative studies in English, Spanish, French, and German with no time limit. The protocol was registered with Open Science Framework and published in BMJ Open.
    UNASSIGNED: Of the 839 articles identified, 66 met the criteria for study eligibility, from which 61 instruments were identified. The publications were from 18 different countries, with most studies employing an observational design and including mostly adult patients. Among all instruments, 22 were reported as validated, which we present in this paper. Overall, quality criteria were reported differently, with studies generally providing little detail. Most of the instruments were used as paper and pencil questionnaires. We found considerable heterogeneity in the theoretical conceptualisation, definition, and measurement of PSPs, ranging from psychiatric case findings to specific social problems.
    UNASSIGNED: This review presents a number of tools and methods that have been studied and used in general practice research. Adapted and tailored to local circumstances, practice populations, and needs, they could be useful for identifying patients with PSPs in daily GP practice; however, this requires further research. Given the heterogeneity of studies and instruments, future research efforts should include both a more structured evaluation of instruments and the incorporation of consensus methods to move forward from instrument research to actual use in daily practice.
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