Objective: This systematic review assessed whether physician–patient language concordance, compared with discordance, is associated with better health outcomes.Methods: A systematic literature search was conducted, without language restrictions, using PubMed, EMBASE, Web of Science, and PsycINFO, from inception to July 2020. We included studies that evaluated the effects of physician–patient language concordance on health outcomes. Articles were screened, selected, and data-extracted in duplicate. Review protocol was prospectively registered (PROSPERO, CRD42020157229).Results: There were 541 citations identified through databases and eight citations through reverse search and Google Scholar. A total of 15 articles (84,750 participants) were included reporting outcomes within five domains: diabetes care (four studies), inpatient care (five studies), cancer screening (three studies), healthcare counseling (two studies), and mental health care (one study). Ten studies were of good quality, four were fair, and one was poor, according to the modified Newcastle-Ottawa Scale. Eight studies (53%) showed a significant negative association between language discordance and at least one clinical outcome. Five studies (33%) found no association.Conclusion: Over half the evidence collated showed that physician–patient language concordance was associated with better health clinical outcomes.
The gut microbiota is a key factor in the correct development of the gastrointestinal immune system. Studies have found differences between the gut microbiota of newborns delivered by cesarean section compared to those vaginally delivered. Our objective was to evaluate the effect of ingestion of probiotics, prebiotics, or synbiotics during pregnancy and/or lactation on the development of the gut microbiota of the C-section newborns. We selected experimental studies in online databases from their inception to October 2021. Of the 83 records screened, 12 met the inclusion criteria. The probiotics used belonged to the genera Lactobacillus, Bifidobacterium, Propionibacterium, and Streptococcus, or a combination of those, with dosages varying between 2 × 106 and 9 × 1011 CFU per day, and were consumed during pregnancy and/or lactation. Probiotic strains were combined with galacto-oligosaccharides, fructo-oligosaccharides, or bovine milk-derived oligosaccharides in the synbiotic formulas. Probiotic, prebiotic, and synbiotic interventions led to beneficial gut microbiota in cesarean-delivered newborns, closer to that in vaginally delivered newborns, especially regarding Bifidobacterium colonization. This effect was more evident in breastfed infants. The studies indicate that this beneficial effect is achieved when the interventions begin soon after birth, especially the restoration of bifidobacterial population. Changes in the infant microbial ecosystem due to the interventions seem to continue after the end of the intervention in most of the studies. More interventional studies are needed to elucidate the optimal synbiotic combinations and the most effective strains and doses for achieving the optimal gut microbiota colonization of C-section newborns.
Background: Post-traumatic stress disorder (PTSD) after birth has generated a growing interest in recent years. Although some risk factors associated with PTSD have been studied, information is still scarce to date on risk factors associated with PTSD. This systematic review aims to identify risk factors associated with the diagnosis of PTSD after childbirth. Methods: We searched on PubMed, Web of Science and SCOPUS databases, from inception to May 2022. Quality assessment of the articles was performed using the Newcastle-Ottawa Quality Assessment (“NOQAS”) scale. This systematic review was performed according to the PRISMA guidelines. Inclusion criteria were women with age ≥18 years; articles in English or Spanish; articles focused on physical, social, psychological, medical-obstetric, and environmental risk factors. Results: A total of n = 17,675 women were included among the studies in this systematic review. The main risk factors associated with PTSD after birth were obstetric interventions and obstetric violence such as emergency caesarean section or a non-compliant birth plan, a previous mental illness, having suffered from of a traumatic event or depression and/or anxiety, and having poor social support throughout pregnancy and/or during birth. Conclusions: Obstetric interventions, obstetric violence, experiencing a traumatic event or depression and/or anxiety, and a previous mental illness are factors associated with the diagnosis of PTSD after birth. Protective factors are multiparity, adherence to the mother’s birth plan and skin-to-skin contact.
1 November 2014 in Transportation Research Part F: Traffic Psychology and Behaviour