Prevalence of persistent hypertension following pregnancy complicated by hypertensive disorders in low- and middle-income countries: a systematic review.

Background: Hypertensive disorders of pregnancy can lead to persistent hypertension (pHTN) in the months and even years following delivery. However, its prevalence in low- and middle-income countries (LMICs) is not well characterized. Objective: To synthesize available evidence on the pHTN prevalence following a pregnancy complicated by hypertensive disorders of pregnancy in LMICs. Search strategy: PubMed, CINAHL Plus, Global Health (EBSCOhost), and Scopus from inception through a search date of July 12, 2022, and updated on January 2, 2024. Selection criteria: Cross-sectional studies and cohort studies reporting pHTN prevalence were eligible. Data collection and analysis: We conducted a narrative synthesis of data and categorized reported prevalence time points into several broader categories. We used the Newcastle-Ottawa checklist to assess the risk of bias. The protocol is registered in PROSPERO (CRD42022345739). Results: We reviewed 1,584 abstracts and identified 22 studies that reported pHTN between 2000 and 2023 from 14 LMICs. The overall prevalence of pHTN ranged between 6.9% and 62.2%, with the highest prevalence noted within African studies and the lowest in South American studies. Estimates at different follow-up periods postpartum were 6.9%-42.9% at six weeks, 34.0%-62.2% at three months, 14.8%-62.2% at six months, 12.7%-61.2% at 12 months, and 7.5%-31.8% at more than 12 months. The quality score of the selected studies ranged from 50% to 100%. Conclusions: The extant literature reports a high prevalence of pHTN in LMICs following a pregnancy complicated by hypertensive disorders. To reduce long-term complications of pHTN, programs should emphasize early screening and linkages to long-term care for at-risk women. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=345739, PROSPERO (CRD42022345739).

Designathons in health research: a global systematic review.

INTRODUCTION: A designathon is a three-stage participatory activity informed by design thinking. There is a growing literature on designathons in health. This study synthesised designathons' effectiveness and implementation-related factors to address health challenges. METHODS: We searched Cochrane Library, Embase, PubMed, Scopus and the ClinicalTrials.gov registry for articles containing primary data on designathons for health from their dates of inception to 29 November 2022. We retrieved additional studies from citation searching and a complementary open call. We synthesised data on designathons' effectiveness (ie, engagement, outputs and implementation), required resources and implementation-related factors (ie, resources, facilitators, barriers, strengths and limitations). We assessed the risk of bias using a checklist adapted from Joanna Briggs Institute Critical Appraisal tools. RESULTS: In total, 4973 citations were identified, and 42 studies were included. In total, 26 studies (62%) were from high-income countries. The median number of total participants was 49, divided into a median of 8 teams. The duration of the intensive collaboration phase ranged from 3 hours to 7 days. Common evaluation criteria were feasibility, innovation and impact. Idea and prototype outputs included mobile phone applications, educational programmes and medical devices. Interventions developed from a designathon was estimated to be highly cost-effective. The most common facilitators were interdisciplinary participants and high-quality mentorship. The most common barriers were suboptimal execution of the events, difficulties in balancing interdisciplinary participants across teams and limited support for participants along the process. There were limited data on required resources and further implementation of solutions after designathons. CONCLUSION: Given designathons' adaptability in terms of budget, mode of delivery, type of output and involvement of diverse participants, including end users, designathons can be implemented in a wide range of contexts to address various health issues. PROSPERO REGISTRATION NUMBER: CRD42023389685.

Scoping review of values elicitation tools for treatment decisions in hepatocellular carcinoma.

BACKGROUND: Treatment choices in hepatocellular carcinoma (HCC) involve consideration of tradeoffs between the benefits, toxicities, inconvenience, and costs. Stated preference elicitation methods have been used in the medical field to help evaluate complex treatment decision-making. The aim of this study was to conduct a scoping review to assess the evidence base for the use of preference elicitation tools or willingness to pay/willingness to accept methods for HCC treatment decision-making from both the patient and provider perspective. METHODS: We performed a scoping review to identify abstracts or manuscripts focused on the role preference elicitation tools or willingness to pay/willingness to accept methods for HCC treatment options among patients, caregivers, and/or providers. Two researchers independently screened full-text references and resolved conflicts through discussion. We summarized key findings, including the type and setting of preference-elicitation tools used for HCC treatment decisions. RESULTS: Ten published abstracts or manuscripts evaluated the role of preference elicitation tools for HCC treatments. The studies revealed several attributes that are considered by patients and providers making HCC treatment decisions. Many of the studies reviewed suggested that while patients place the most value on extending their overall survival, they are willing to forgo overall survival to avoid risks of treatments and maintain quality of life. Studies of physicians and surgeons found that provider preferences are dependent on patient characteristics, provider specialty, and surgeon or hospital-related factors. CONCLUSION: This scoping review explored both patient and physician preferences towards treatment modalities in all stages of HCC. The studies revealed a large scope of potential attributes that may be important to patients and that many patients are willing to forgo survival to maintain quality of life. Further research should explore both preference elicitation of currently available and emerging therapies for HCC as well as the use of this data to develop patient-facing tools to assist in navigating treatment options.

Early Infant Feeding Practices among Women Engaged in Paid Work in Africa: A Systematic Scoping Review.

Around the world, paid work without appropriate structural support is a key barrier to optimal breastfeeding practices. To better protect, promote, and support optimal breastfeeding practices among working women in Africa, this scoping review sought to understand how paid work influences infant feeding practices in the first 6 mo of life and what support women need to manage work and optimal infant feeding practices. We systematically searched PubMed, Scopus, Global Health, and CINAHL Plus, screened 2436 abstracts, and reviewed 322 full-text articles using Covidence for review and charting. We identified 203 articles that met the inclusion criteria. We identified 32 quantitative, 10 qualitative, 3 mixed-methods, and 2 review articles that focused on examining the relationship between work and breastfeeding, and 109 quantitative, 22 qualitative, 21 mixed-methods, and 4 review articles that included work as part of broader breastfeeding research but did not focus on work. Most studies reported a significant negative association between work and exclusive breastfeeding. Three major domains were reported in the qualitative studies: challenges to managing work and infant feeding, receiving support from employers and family members/caregivers, and strategies for feeding infants when the mother is working. Reviewed studies proposed recommendations to increase support for breastfeeding through changes to policies and support within worksites, the health system, and childcare; however, evidence of previously implemented policies or programs is limited. We recommend more consistent definitions and measurement of women's work. Future research is needed on the impact of implementing various strategies and benefits for breastfeeding at workplaces, as well as efforts to support breastfeeding among informal workers.

Physical Activity Intervention Characteristics and Effects on Behavioral and Health-Related Outcomes Among Adolescents and Young Adults Living with and Beyond Cancer: A Systematic Review.

Participation in physical activity (PA) during and after cancer treatment is safe and beneficial in the adolescent and young adult (AYA) cancer population. PA can positively impact health-related outcomes; however, participation remains low. This systematic review aims to describe PA intervention characteristics and outcomes in AYA survivors of cancer (AYASCa). This review followed Preferred Reporting Index for Systematic Reviews and Meta Analyses (PRISMA) guidelines and was registered with Prospero (CRD42022365661). PubMed, CINAHL, and Scopus databases were searched for randomized control trials (RCTs) and pre/post-test studies without a control group through December 31, 2022. Data included: participant demographics, PA intervention characteristics, and health-related outcomes. Studies were assessed using the National Institute of Health Critical Appraisal Tools, and findings were synthesized to identify common characteristics of PA interventions and outcomes. Twenty-three studies were included: 15 RCTs and 8 pre/post-test studies. Heterogeneity existed across design, sample demographics, intervention timing, and observed outcomes. The most common characteristics of PA interventions were supervision of PA, wearable device use, tailored/individualized PA prescriptions, and goal setting. PA interventions positively affected health-related outcomes, with 21 studies reporting statistically significant findings. Implementing personalized PA prescriptions, utilizing wearable devices, and incorporating goal setting as characteristics in PA interventions hold potential benefits for AYASCa, leading to improved outcomes. Still, additional research is needed to explore interventions that utilize these PA characteristics and determine which ones are most effective for AYASCa. By further investigating and identifying optimal PA characteristics, interventions can be better tailored to meet this population's specific needs and preferences, ultimately enhancing their overall well-being and recovery.

Toddler milk: a scoping review of research on consumption, perceptions, and marketing practices.

Toddler milk is an ultra-processed beverage consisting primarily of powdered milk, caloric sweeteners, and vegetable oil. Pediatric health authorities do not support the use of toddler milk, and emerging evidence suggests that toddler-milk marketing practices may mislead consumers. However, studies have not synthesized the extent of toddler-milk marketing practices or how these practices affect parents' decisions about whether to serve toddler milk. We aimed to summarize the literature about toddler milk to identify what is known about: (1) parents' toddler-milk purchasing and feeding behaviors, (2) toddler-milk marketing, and (3) how marketing practices influence parents' beliefs and perceptions about toddler milk. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), we systematically searched 8 databases (PubMed, APA PsycINFO, Scopus, Cochrane Central, Embase, CINAHL, Communication & Mass Media Complete, and Business Source Premier). We identified 45 articles about toddler milk. Studies were conducted in 25 countries across 6 continents. Five types of findings emerged: (1) consumption and feeding behaviors, (2) demographic correlates of toddler-milk purchasing and consumption, (3) misperceptions and beliefs, (4) increased sales, and (5) increased marketing and responses to marketing. The included articles suggested that toddler-milk sales are growing rapidly worldwide. Findings also revealed that toddler-milk packages (eg, labels, branding) resemble infant formula packages and that toddler-milk marketing practices may indirectly advertise infant formula. Purchasing, serving, and consumption of toddler milk were higher in Black and Hispanic populations than in non-Hispanic White populations, and parents with higher educational attainment and income were more likely to offer toddler milk to their children. Findings suggest a need for policies to prevent cross-marketing of toddler milk and infant formula, reduce provision of toddler milk to infants and toddlers, and prevent caregivers from being misled about toddler-milk healthfulness.

Unilateral Absent Pulmonary Artery in Pregnancy: A Case Report and Systematic Literature Review.

OBJECTIVE: Unilateral absence of a pulmonary artery (UAPA) is a rare congenital malformation associated with hemoptysis, pulmonary hypertension, and infection. Little is known about the impact on pregnancy outcomes. We sought to synthesize the existing literature on pregnancy outcomes in patients with maternal UAPA. STUDY DESIGN: We report a case of maternal UAPA and performed a systematic review of the existing literature. Articles in English reporting pregnancy outcomes among women with unilateral absence or hypoplasia of the pulmonary artery were included. Articles were reviewed at the abstract level and, if eligible, at the full-text level by two independent reviewers with disagreements adjudicated by a third reviewer. Data were abstracted by two independent reviewers. Outcomes of interest were mode of delivery, gestational age at delivery, intensive care admission, maternal death, and length of stay. Summary statistics for each outcome are presented. RESULTS: We identified 14 studies, including the presented case, reporting outcomes in 22 pregnancies impacted by maternal UAPA. Median age at diagnosis was 21 years. Concurrent cardiac comorbidities were reported in 6/13 (46.2%) with pulmonary hypertension in 5/20 (25%) of cases where this information was reported. We observed high rates of preterm birth (4/12, 33.3%), cesarean delivery (10/15, 66.7%), and operative vaginal delivery (2/5, 40.0%). There was one maternal death occurring in the immediate postpartum period for a mortality rate of 4.5%. CONCLUSION: Our study provides a comprehensive review of existing literature on maternal UAPA. Our findings suggest increased rates of adverse outcomes and underscore the importance of early diagnosis, identification of pulmonary hypertension, and multidisciplinary care. KEY POINTS: · There may be increased adverse outcomes in maternal UAPA.. · Concurrent cardiac abnormalities are common in maternal UAPA.. · Early diagnosis, identification of pulmonary hypertension, and multidisciplinary care are important..

A Systematic Review of Interpersonal Interactions Related to Racism in Studies Assessing Breast and Gynecological Cancer Health Outcomes Among Black Women.

OBJECTIVE: To identify how studies measure racism-related variables at the interpersonal level and identify associated breast and gynecological cancer disparities among Black women. METHODS: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Searches were conducted in PubMed, CINAHL Plus, and Scopus using terms centered on racism and cancer. Inclusion criteria consisted of the study being conducted in the USA with Black or African American women and the study stating an outcome or focus identified as a breast or gynecological cancer health disparity. Two researchers independently screened titles and abstracts and full texts articles and completed quality assessments of included studies. Data were extracted into a matrix table, and common concepts were identified and synthesized using the matrix method. The quality of included studies was assessed using the Joanna Briggs Institute's critical appraisal tools. RESULTS: Thirteen studies that examined the effect of racism-related variables operating at the interpersonal level on breast, cervical, and ovarian cancer outcomes in Black women were identified for inclusion. Across studies, racism-related variables were measured as discrimination, trust, racism, and clinician-patient interactions. Additionally, across studies, disparities were identified in cancer screening, treatment received, survivorship quality of life, and incidence. CONCLUSION: This review highlights the need for valid, reliable, and consistent measurement of racism operating at the interpersonal level to first understand its impact on cancer health disparities and to also facilitate the development and evaluation of interventions aimed at mitigating interpersonal-level racism.

Characteristics of health care interventions in affordable senior housing: A scoping review.

AIMS: Older adults in affordable senior housing often experience chronic illness and unmet health care needs. This review describes studies reporting the characteristics and primary outcomes of health care interventions for older adults living in affordable senior housing. DESIGN: A scoping review METHODS: After a systematic search in three databases, a team of investigators screened 1,284 titles and abstracts and selected 31 records with reports on 28 studies for review. Narrative synthesis was used to describe studies of interventions in senior housing and primary outcomes. RESULTS: Studies typically used observational designs and added clinical staff, such as nurses and social workers, to provide health care interventions in groups (n = 15) or with individuals (n = 13). Outcomes were classified in four groups: wellness, symptom management, health care use, and physical function. A subset of 23 studies (82.1%) reported effective interventions. IMPACT: Findings identify innovative interventions to promote health in affordable senior housing.

Family-based psychosocial interventions for adult Latino patients with cancer and their caregivers: A systematic review.

Objective: This review aimed to systematically examine the characteristics and outcomes of family-based psychosocial interventions offered to adult Latino patients with cancer and their caregivers. Methods: We searched six databases from their inception dates through June 2022. Studies were eligible for inclusion if they (1) targeted both adult Latino patients diagnosed with cancer and their adult caregivers or reported subgroup analyses of Latino patients and caregivers; (2) included family-based psychosocial interventions; (3) used randomized controlled trial (RCT) or quasi-experimental designs; and (4) were published in English, Spanish or Portuguese. Members of our multidisciplinary team assessed the risk of bias in the reviewed studies using the Cochrane Collaboration's Risk of Bias Tool. Results: Our database searches yielded five studies. The studies were conducted in the U.S. and Brazil. Three studies were RCTs, and two used quasi-experimental designs. The sample sizes ranged from 18 to 230 patient-caregiver dyads. These studies culturally adapted the intervention contents and implementation methods and involved bilingual interventionists. The interventions had beneficial effects on multiple aspects of psychosocial outcomes for both patients and caregivers. We also identified methodological limitations in the reviewed studies. Conclusions: Findings from this systematic review help deepen our understanding of family-based psychosocial interventions for Latinos affected by cancer. The small number of psychosocial interventions focused on adult Latino cancer patients and their caregivers is concerning, considering that Latino populations are disproportionally burdened by cancer. Future research needs to design and evaluate culturally-appropriate interventions to support Latino patients and families who cope with cancer. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=274993, identifier CRD42021274993.

Systematic review of psychosocial interventions for adult cancer patients and their family caregivers in Sub-Saharan Africa.

Cancer is becoming a public health issue in the Sub-Saharan Africa (SSA). This systematic review aims to synthesise psychosocial interventions and their effects on the health outcomes of adult cancer patients and their family caregivers in SSA. We identified eligible publications in English language from PubMed, Cumulative Index of Nursing and Allied Health Literature Plus with Full Text, Embase, APA PsycInfo, Scopus, and African Index Medicus databases. We included psychosocial interventions targeted adult cancer patients/survivors or their family caregivers in SSA. This review identified five psychosocial interventions from six studies that support adult cancer patients and their family caregivers in SSA. The interventions focused on providing informational, psycho-cognitive, and social support. Three interventions significantly improved quality of life outcomes for cancer patients and their caregivers. Significant gaps exist between the rapidly increasing cancer burdens and the limited psychosocial educational interventions supporting adult cancer patients and their families in SSA. The reviewed studies provide preliminary evidence on development and testing interventions that aim to improve patients' and caregivers' quality of life.

Parental Decision-Making Around Introducing Complementary Foods: An Integrative Review.

A primary role in infant parenting is feeding, and this role undergoes a significant transition when introducing complementary foods (CF), with important long-term health implications. Understanding the influences on parental decision-making around timing the introduction to CF can help health care providers provide parents with effective support for feeding; however, the factors that influence parental decision-making have not been recently reviewed in the United States. To determine influences and information sources, this integrative review examined the literature from 2012 to 2022. Results indicated that parents are confused and distrustful of inconsistent and changing guidelines around CF introduction. Instead, developmental readiness signs may be a more appropriate way for practitioners and researchers to support parents in appropriate CF introduction. Future work is needed to evaluate interpersonal and societal influences on parental decision-making, as well as to develop culturally sensitive practices to support healthful parental decisions.

Psychosocial experiences of cancer survivors and their caregivers in sub-Saharan Africa: A synthesis of qualitative studies.

OBJECTIVE: To synthesize and examine current literature on survivorship experiences and psychosocial oncologic care programs of individuals affected by cancer in sub-Saharan Africa (SSA). METHODS: This was a systematic review guided by the PRISMA 2020 guidelines. We searched 6 databases for articles published from inception to 21 October 2021. Articles were appraised using the Johanna Briggs Institute's Checklist for Qualitative Research. For data synthesis, we used the World Health Organization (WHO) quality of life framework [WHOQOL] to organize experiences into 6 domains/themes. RESULTS: Twenty-five qualitative studies were included in the synthesis. Studies focused on psychosocial care of adults (>18 years) affected by cancer in SSA. The common WHOQOL domains were social relations, spirituality/religion/personal beliefs, and psychological. CONCLUSION: Findings echo need for individuals with cancer and their caregivers. Healthcare professionals are an essential resource for information and support services that can be tailored to individuals need. This synthesis highlighted caregiver stress and stressors from the community that could impact care of individuals with cancer. A holistic approach is needed that incorporates professional and social aspects of care.

Mapping definitions, measures and methodologies of assessing police violence in the health literature: a scoping review protocol.

INTRODUCTION: Police violence is a growing public health issue in the USA. Emerging evidence suggests that negative police encounters are associated with adverse physical and mental health outcomes. There is a critical need to examine the relationship between police violence and health disparities. However, the lack of consensus on a conceptual and operational definition of police violence is a limitation in scientific investigations on police violence and its health impacts. Here, we present the protocol for a scoping review that maps definitions, measures and methodologies of assessing police violence in the health literature. METHODS AND ANALYSIS: We will comprehensively search PubMed, Cumulative Index to Nursing and Allied Health Literature and APA PsycInfo databases. We will use the following string of key terms separated with the Boolean operator 'or': 'police violence', 'police brutality', 'police use of force', 'law enforcement violence', 'law enforcement brutality', 'law enforcement use of force' and 'legal intervention'. An English language limit will be applied. We will include studies published in English or that have an English language abstract available. Eligible studies will include: (1) a definition of police violence and/or (2) a measurement of police violence. ETHICS AND DISSEMINATION: This scoping review does not require ethical approval. The findings of this review will be disseminated through publication in a peer-reviewed journal and at conferences.

Quality and safety education for nurses: A bibliometric analysis.

PURPOSE: Since its origin in the United States in 2005, Quality and Safety Education for Nurses (QSEN) has guided nurses' preparation for alleviating preventable harm and improving quality safe care. QSEN's value is illustrated through specific inclusion in the competency-based 2021 American Association for Colleges of Nursing (AACN) Essentials. The purpose of this bibliometric analysis is to explore publication patterns of the extant QSEN literature to assess QSEN's spread and global penetration and to map the available knowledge and data regarding quality and safety education for nurses. DESIGN: Bibliometric analysis. METHOD: Two QSEN investigators and two health science librarians completed database searches to identify articles with keywords QSEN or Quality and safety education for nursing. Inclusion criteria were (1) QSEN-specific and (2) published in a peer-reviewed journal. Using PRISMA screening, the final sample included 221 articles between 2007 and 2021. RESULTS: Average annual QSEN publications was 14.5 articles; the highest was 26 publications in 2017. Article types were 84 research, 77 descriptive/reviews, 28 quality improvement projects or case studies, 20 statements, and 12 editorials. Focus analysis revealed 165 education articles, 35 clinical practice, 17 professional development, and 4 leadership/administration. Fourteen journals published three or more; eight were education journals. Nine topic clusters indicated areas of publication focus, including clinical teaching, simulations, performance, context, and criteria of analysis, factors of efficacy, innovation and advanced practice, patient care and outcomes, academic concepts, and research frameworks. CONCLUSIONS: Results reveal far less QSEN penetration for guiding professional practice, research measuring outcomes and impact, and global collaboration to examine cultural implications for diversity and inclusion. Results present future recommendations to assure all nurses worldwide have access to competency development to alleviate preventable healthcare harm. CLINICAL RELEVANCE: Originating in the United States (US), the QSEN project provided the seminal framework for transforming education and practice through defining the six quality and safety competencies (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics) essential to alleviate preventable healthcare harm. Results reveal opportunities to advance QSEN penetration in developing professional practice, guiding research measuring outcomes and impact, and extending global collaboration to examine cultural implications for diversity and inclusion.

Systematic Review of the Relation Between Feeding Problems and Sensory Processing in Children With Autism Spectrum Disorder.

PURPOSE: Many studies have linked sensory sensitivities to feeding problems in children with autism spectrum disorder (ASD). Despite the importance of sensory processing for a variety of mealtime and eating skills, the specific sensory processes that may impact feeding problems in children with ASD have not been comprehensively reviewed. Thus, the goal of this systematic review was to understand the associations between sensory processing and feeding difficulties in children with ASD. METHOD: This systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, CINAHL Plus with Full Text (EBSCOhost), Scopus (Elsevier), and Embase (Elsevier) databases were searched from their dates of inception through the final search date of April 19, 2022, for English language studies that examined both sensory processing and feeding among children with ASD. Studies were assessed for quality using the Joanna Briggs Institute critical appraisal tools. RESULTS: A total of 27 studies were included. Findings supported the existence of a relationship between sensory processing and feeding problems in children with ASD. Specifically, studies reported that overall scores on sensory processing measures as well as measures of oral sensory processing were frequently associated with feeding problems. CONCLUSIONS: This review supports the development of future feeding interventions focusing on sensory processing given the relationship between sensory processing and feeding problems among children with ASD. Future research should focus on utilizing consistent feeding assessments specific to children with ASD and collect information on medical diagnoses that can impact feeding in order to report on feeding more holistically in this population. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21453909.

Communication Between Black Patients With Cancer and Their Oncology Clinicians: Exploring Factors That Influence Outcome Disparities.

PROBLEM IDENTIFICATION: Significant cancer disparities exist between Black and White patients. One important contributor to patient outcomes disparities is patient-clinician communication. Conversations between clinicians and Black patients are often shorter and less detailed compared to White patients. LITERATURE SEARCH: A systematic literature search was conducted. Databases were searched to identify studies that included (a) participants with a cancer diagnosis, (b) information specific to Black or African American participants, and (c) information on patient-clinician communication. A total of 67 articles underwent full review; 24 studies met inclusion criteria. DATA EVALUATION: Each included study was scored for level of evidence, and common themes were identified across studies using the Matrix Method. SYNTHESIS: The following themes were identified: relationship building, building trust, empowering patients for shared decision-making, addressing topics of patient concern, and consideration of community and family. IMPLICATIONS FOR RESEARCH: Results identify several ways that nurses can improve communication with Black patients. Research aimed at identifying interpersonal strategies to mitigate cancer disparities is needed.

Post-Traumatic Stress Disorder and Post-Traumatic Growth following Kidney Transplantation.

Background: Kidney transplantation (KT) is a life-saving therapy for kidney failure. However, KT recipients can suffer from debilitating depression, post-traumatic stress disorder (PTSD), and suicide. In contrast to PTSD, post-traumatic growth (PTG) is a positive psychologic change in response to a challenging situation. PTG has been studied in other chronic diseases, but less is known about its role in the setting of KT. We sought to elucidate the prevalence, predictors, and the effect of PTSD and PTG on post-KT outcomes. We also considered the roles of benefit finding and resilience. Methods: In a literature review, we identified publications that examined PTSD, PTG, benefit finding, and/or resilience in KT recipients. We excluded case reports and first-person narratives. Publications meeting the specified criteria after full text review underwent data abstraction and descriptive analysis. Results: Of the 1013 unique citations identified, 39 publications met our criteria. PTSD was the most common construct evaluated (16 publications). Resilience was studied in 11 publications, PTG in nine, and benefit finding in five. Up to 21% of adult and 42% of pediatric KT recipients may experience PTSD, which is associated with lower quality of life (QOL), impaired sleep, and other psychiatric comorbidity. PTG was associated with improved QOL, kidney function, and reduced risk of organ rejection. Although benefit finding tended to increase post KT, resilience remained stable post KT. Like PTG, resilience was associated with lower psychologic distress and increased treatment adherence and confidence in the health care team. Conclusions: PTG, resilience, and benefit finding appear to reduce the risk of PTSD, promote well-being, and reduce risk of graft failure in KT recipients. Future research to understand these relationships better will allow clinicians and researchers to develop interventions to promote PTG, resilience, and benefit finding, and potentially improve post-transplant outcomes such as adherence and reducing risk of organ rejection.

Cognitive Function in Adults With Acute Myeloid Leukemia Treated With Chemotherapy: A Systematic Review.

BACKGROUND: Chemotherapy is essential for treating acute myeloid leukemia (AML). Previous studies concluded that survivors of cancer who were treated with chemotherapy experience cognitive impairment. Therefore, it is important to understand cognitive function in survivors of AML. OBJECTIVE: The aim of this study was to explore distributions and correlates of cognitive function, and prediction of cognitive function on other outcomes in adults with AML who were treated with chemotherapy. METHODS: A health science librarian systematically searched PubMed, CINAHL, PsycINFO, and EMBASE databases. Two reviewers independently conducted the title, abstract, and full-text screening. Data were extracted and synthesized based on the aims of the review. RESULTS: A total of 10 articles were included. Findings indicate that up to 62.2% of adults with AML experienced impaired cognitive function after starting chemotherapy. Three studies found cognitive function remained stable over time. Education and cytokines were potential correlates of cognitive function. Worse cognitive function may predict lower physical performance and higher mortality, although the results were inconsistent across studies. CONCLUSION: Impaired cognitive function was observed in adults with AML who were treated with chemotherapy. However, no study used a validated subjective cognitive-function-specific patient-reported questionnaire, and previous studies focusing on cognitive function included relatively young samples. Hence, further research on cognitive function in older adults with AML is needed. IMPLICATIONS FOR PRACTICE: Because of the high prevalence of cognitive impairment identified, it is important to screen cognitive function in adults with AML who are planning to receive chemotherapy to intervene and provide support earlier.

Trends and Insights from Transportation Congestion Pricing Policy Research: A Bibliometric Analysis.

Toll-based congestion pricing (CP) policies are increasingly implemented globally for alleviating road traffic congestion. Several interconnected factors affecting or induced by CP implementation include air quality/emissions, travel time, and road user safety. We sought to examine and characterize research output and patterns across several domains (e.g., health, policy acceptability) surrounding toll-based CP policies, in order to identify where research has focused and where gaps exist. We conducted a structured review and identified 2333 relevant publications, using semi-supervised and machine learning strategies combined with manual review. Annual publication counts peaked in 2015 (n = 122). Themes identified from title and abstract terms included policy implementation characteristics, advanced transportation modeling methods and approaches, and public perception and acceptability. Authorship networks indicated a lack of interdisciplinary research. Country analyses identified the US, China, and the UK as the most frequently represented countries, and underrepresentation from low-income countries. Findings indicate that research focused on specific road user types (e.g., pedestrians) and safety impacts, and equity considerations were relatively sparse compared to other topics (e.g., policy economics, public perception). Additional research on these critical topics is necessary to ensure that such policies are designed to promote positive and equitable effects on road user health and safety.