Although systematic reviews have numerous advantages, they are vulnerable to biases that can mask the true results of the study and therefore should be interpreted with caution. This article aims at critically reviewing the literature about systematic reviews of observational studies, emphasizing the errors that can affect this type of study design and possible strategies to overcome these errors. This is an integrative literature review whose search was conducted in the databases States National Library of Medicine, Scientific Electronic Library Online and Google Scholar. The following descriptors were used: review, bias (epidemiology) and observational studies as the subject, including relevant books and documents which were consulted. Data collection was conducted between June and July 2016. The most known errors present in the design of systematic reviews were those related to the selection and publication. Although this type of study is subject to possible errors, preventive measures used during the planning of systematic reviews and even during and after their implementation can help ensure scientific rigor. This literature can serve as an important tool for the development and interpretation of systematic reviews of observational studies.
Delays in diagnosis of TB cases are major impeding factors in the control of TB. The objectives of this study were to describe the health care seeking behavior of TB patients, assessing patient delay and the number of health care facilities visited before the start of TB treatment. A cross-sectional study was carried out with adult patients with pulmonary TB presenting to two TB facilities to start treatment. We found a median patient delay of 20 days. The factors associated negatively with patient delay in multivariate analysis were weight loss, and have sought treatment because of the first symptom. We also demonstrated that 44.8% of patients incorrectly reported the mode of transmission of TB. In addition, the local of first attendance was an emergency room of public hospitals in 37.3% of patients. We demonstrated that the median patient delay in TB diagnosis in two TB services in a region with a high prevalence of TB was 20 days, and the protective factors associated with this delay in multivariate analysis were weight loss, and have sought treatment because of the first symptom.
Obesity is a global epidemic with substantial health and economic impacts, making scalable weight management strategies essential. A comprehensive synthesis of eHealth interventions for weight management is needed to guide clinical practice. This umbrella review evaluated mobile and web-based interventions for weight loss in adults with overweight or obesity, compared to conventional or non-intervention controls. Systematic reviews were identified across five electronic databases from inception to February 2025. Two reviewers independently selected studies and assessed methodological quality using AMSTAR 2. Pooled estimates were calculated using random-effects models. Eleven systematic reviews (261 primary studies, 62,407 participants) were included. Mobile app interventions yielded a significant reduction in body weight (MD = −1.32 kg; I2 = 82%), as did long-term eHealth interventions (MD = −1.13 kg; I2 = 76%). Most meta-analyses showed high heterogeneity. Web-based interventions showed no significant effect. In conclusion, mobile apps and long-term eHealth interventions resulted in modest but statistically significant reductions in body weight, body mass index, and waist circumference. The evidence for web-based approaches remains inconclusive. Further research should focus on low-resource settings, primary care, and the integration of emerging technologies such as artificial intelligence. (PROSPERO CRD42025644218).
Nursing work is in increasing demand, becoming strenuous especially during the COVID-19 pandemic. Thus, the objective of the study was to assess the impacts of the COVID-19 pandemic on the health of nursing professionals through a systematic review of the literature with meta-analysis, including studies published in 2020 in Web of Science, PubMed and SciELO. Regarding the systematic review, we included 25 studies with a cross-sectional design, from 12 countries. The participants were mostly nurses or nursing teams. Mental impacts such as anxiety, depression, discouragement and a feeling of obligation to work were frequently reported by study participants. The meta-analyses included psychological distress variables, and no association was found between psychological distress and being a frontline healthcare professional (OR 0.94; 95% CI 0.33-2.67). The mental health of nursing professionals has been negatively impacted by the Covid-19 pandemic. The main symptoms presented were anxiety, depression and discouragement, and many nurses felt obliged to work on the front lines of the fight against the pandemic; although they suffer emotional impacts and work overload in health services.
Background: Brazil remains one of the 30 countries with the highest tuberculosis (TB) and TB-HIV coinfection burden. Post-TB lung disease (PTLD) is a set of sequelae that can occur in people who have been cured of TB.Aim: To learn about the experiences of people living with PTLD (PLPTLD) and how healthcare workers (HCW) manage PTLD.Methods: An exploratory qualitative study with a purposive sample of PLPTLD and HCW from two different cities. Open-ended interviews were conducted using a semi-structured interview guide, which were recorded and transcribed. Two researchers analyzed the interviews using an inductive approach and applied a content analysis framework to define categories.Results: Forty-six participants were interviewed, and four categories emerged: PTLD as a social disease; stigma; the fragility of access; and limitations. The categories encompassed two main aspects like PTLD in activities of daily living and emotions in everyday life, for instance, challenges with preparing meals, getting a job, barriers to set clinical appointments or getting social assistance, and stigma.Conclusion: This study reveals specific needs from patients and providers such as a lack of knowledge about PTLD, physical limitations, and stigmatization due to PTLD. It is crucial to address these issues in public health policies.
6 January 2024 in The Lancet Regional Health - Americas