The influence of quality of life in treatment adherence of diabetic patients: a systematic review

AbstractOBJECTIVETo verify the influence of quality of life in treatment adherence of patients with diabetes mellitus.METHODSystematic review of the literature using the databases MEDLINE, CINAHL, Scopus, LILACS, SciELO and Web of Science with studies published between 2003 and 2014 in English, Portuguese or Spanish.RESULTSSix studies were included in the review, three were identified as having better quality of life scores, being related to better adherence to diabetes treatment measured by glycated hemoglobin or characteristics related to diet, exercise, use of medication and foot care. No association was found between quality of life and adherence in two investigations and a study found a negative association between these variables.CONCLUSIONThere is causal relationship between quality of life and adherence with diabetes treatment. It is suggested that psychosocial aspects of patients should be considered by health professionals in the search for better clinical outcomes in diabetes care

Second hand smoke exposure and the risk of invasive meningococcal disease in children: systematic review and meta-analysis

Background Invasive meningococcal disease remains an important cause of serious morbidity and mortality in children and young people. There is a growing body of literature to suggest that exposure to passive smoke may play a role in the development of the disease, therefore we have performed a systematic review to provide a comprehensive estimate of the magnitude of this effect for smoking by any household member, by individual family members, and of maternal smoking before and after birth. Methods Four databases (Medline, Embase, PsychINFO and CAB Abstracts database) were searched to identify studies (to June 2012) and reference lists scanned for further studies. Titles, abstracts and full texts were checked for eligibility independently by two authors. Quality of included studies was assessed using the Newcastle-Ottawa Scale. Pooled odds ratios (OR) with 95% confidence intervals (CI) were estimated using random effect models, with heterogeneity quantified using I2. Results We identified 18 studies which assessed the effects of SHS on the risk of invasive meningococcal disease in children. SHS in the home doubled the risk of invasive meningococcal disease (OR 2.18, 95% CI 1.63 to 2.92, I2 = 72%), with some evidence of an exposure-response gradient. The strongest effect was seen in children under 5 years (OR 2.48, 95% CI 1.51 to 4.09, I2 = 47%). Maternal smoking significantly increased the risk of invasive meningococcal disease by 3 times during pregnancy (OR 2.93, 95% CI 1.52-5.66) and by 2 times after birth (OR 2.26, 95% CI 1.54-3.31). Conclusions SHS exposure, and particularly passive foetal exposure to maternal smoking during pregnancy, significantly increases the risk of childhood invasive meningococcal disease. It is likely that an extra 630 cases of invasive meningococcal disease annually in children under 16 are directly attributable to SHS exposure in UK homes