Goal: 16 - Barış, Adalet ve Güçlü Kurumlar
Barış, Adalet ve Güçlü Kurumlar Sürdürülebilir kalkınma için barışçıl ve kapsayıcı toplumlar tesis etmek, herkes için adalete erişimi sağlamak ve her düzeyde etkili, hesap verebilir ve kapsayıcı kurumlar oluşturmak. Barış, istikrar, insan hakları ve hukukun üstünlüğüne dayalı etkin yönetim olmadan, sürdürülebilir kalkınma olmasını bekleyemeyiz. Gittikçe artan ölçüde bölünmüş bir dünyada yaşıyoruz. Bazı bölgelerde barış, güvenlik ve refah sürekli iken, diğer bazı bölgelerde ise bitmek bilmeyen çatışma ve şiddet sarmalı var. Ancak bu, hiçbir şekilde kaçınılmaz sonuç değildir ve mutlaka çözümlenmelidir.
Publication Search Results
Now showing 1 - 10 of 11
- PublicationOpen AccessOrthostatic hypotension and health outcomes: an umbrella review of observational studies(2019-11-07) Veronese, Nicola; Smith, Lee; Torbahn, Gabriel; Jackson, Sarah E.; Yang, Lin; SOYSAL, PINAR; Rivasi, Giulia; Rafanelli, Martina; Petrovic, Mirko; Maggi, Stefania; Isik, Ahmet Turan; Demurtas, Jacopo; SOYSAL, PINARPurpose Orthostatic hypotension (OH) is associated with older age and many negative clinical outcomes in geriatric practice. We aimed to capture the breadth of outcomes that have been associated with the presence of OH and systematically assess the quality, strength and credibility of these associations using an umbrella review with integrated meta-analyses. Methods We systematically searched several major databases from their commencements through to 16th May 2019 for meta-analyses of observational studies of OH and any health-related outcome. We used these metrics to categorize the strength of evidence of significant outcomes (p < 0.05) from class I (convincing) to class IV (weak), according to the pre-established criteria. Results From 975 abstracts, seven meta-analyses of 12 outcomes were included. For each outcome, the median number of studies was four, and the median number of participants was 46,493, with a median of 3630 incident cases. There was suggestive (class III) evidence that OH was associated with significantly higher risk of coronary heart disease (HR = 1.32, 95% CI 1.12-1.56), stroke (HR = 1.22, 95% CI 1.08-1.38), congestive heart failure (HR = 1.30, 95% CI 1.09-1.55), all-cause mortality (RR = 1.50, 95% CI 1.24-1.81), falls (OR = 1.84, 95% CI 1.39-2.44), and dementia (HR = 1.22, 95% CI 1.11-1.35). Conclusion The current evidence base indicates that OH is significantly associated with a range of adverse cardiovascular, cognitive, and mortality outcomes in older people, although the strength of this evidence remains only suggestive. Further research in larger samples and with lower risk of bias is required to build a fuller picture of the impact of OH on health.
- PublicationOpen AccessThe efficacy and safety of influenza vaccination in older people: An umbrella review of evidence from meta-analyses of both observational and randomized controlled studies(2020-09-01T00:00:00Z) Demurtas, Jacopo; Celotto, Stefano; Beaudart, Charlotte; Sanchez-Rodriguez, Dolores; Balci, Cafer; SOYSAL, PINAR; Solmi, Marco; Celotto, Daniele; Righi, Elena; Smith, Lee; Lopalco, Pier Luigi; Noventa, Vania; Michel, Jean Pierre; Torbahn, Gabriel; Di Gennaro, Francesco; Pizzol, Damiano; Veronese, Nicola; Maggi, Stefania; SOYSAL, PINARVaccination is the main public health intervention to prevent influenza. We aimed to evaluate the efficacy and safety of influenza vaccination including systematic reviews and meta-analyses of observational studies and randomized controlled trials (RCTs). Peer-reviewed systematic reviews with meta-analyses of prospective studies that investigated the association of influenza vaccination with any health-related outcome, as well as RCTs that investigated the efficacy and safety of influenza vaccination, were included. Among 1240 references, 6 meta-analyses were included. In cohort studies of community-dwelling older people influenza vaccination was associated with a lower risk of hospitalization for heart disease and for influenza/pneumonia (strength of evidence: convincing). Evidence in lowering the risk of mortality in community-dwelling older people, of all deaths/severe respiratory diseases in high risk community-dwelling older people and of hospitalization for influenza/pneumonia in case-control studies, was highly suggestive. In RCTs, influenza vaccination, compared to placebo/no intervention, was associated to higher risk of local tenderness/sore arm and to a reduced risk of influenza like-illness. Both these associations showed moderate evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation). In conclusion, influenza vaccination in older people seems safe and effective. Further, the evidence on safety and efficacy of vaccines in this population might benefit by an extension of the follow-up period both in RCTs and in longitudinal studies, beyond the usual 6-month period, in order to be able to evaluate the impact of vaccination on long term outcomes.
- PublicationMetadata onlyAcetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis(2016-12-01T00:00:00Z) Soysal, PINAR; Isik, Ahmet Turan; Stubbs, Brendon; Solmi, Marco; Volpe, Marco; Luchini, Claudio; D'Onofrio, Grazia; Pilotto, Alberto; Manzato, Enzo; Sergi, Giuseppe; Schofield, Patricia; Veronese, Nicola; SOYSAL, PINARWe conducted a systematic review and meta-analysis investigating the influence of acetylcholinesterase inhibitors (AChEIs) therapy on nutritional status and weight across observational and interventional studies. Two authors searched major electronic databases from inception until 10/14/2015 for longitudinal, open-label and randomised double-blind placebo controlled (randomised controlled trials (RCTs)) studies of AChEIs in patients with dementia reporting nutritional status outcome data. Out of 3551 initial hits, 25 studies (12 open-label trials, 9 RCTs and 4 longitudinal studies) including 10 792 patients with dementia were metaanalysed. In longitudinal studies (median follow-up 6 months), a significant cumulative incidence of weight loss between baseline and follow-up evaluation was observed (studies= 2; 5%; 95% CI 1% to 34%, p< 0.0001; I2= 95%). These findings were confirmed in open-label trials (6%; 95% CI 4% to 7%, p< 0.0001; I-2= 78%). In 9 RCTs (median followup 5 months), those taking AChEIs more frequently experienced weight loss than participants taking placebo (OR= 2.18; 95% CI 1.50 to 3.17, p< 0.0001; I-2= 29%). AChEIs therapy contributes to weight loss in patients with dementia, with a 2-fold increased risk observed in the meta-analysis of RCTs. Clinicians should carefully consider the benefit and risk of prescribing AChEIs. Nutritional status should be routinely evaluated in patients with dementia treated with AChEIs.
- PublicationOpen AccessDietary Protein Intake and Falls in Older People: Longitudinal Analyses From the Osteoarthritis Initiative(2019-05-01) SOYSAL, PINAR; Veronese, Nicola; STUBBS, Brendon; Maggi, Stefania; Jackson, Sarah E; DEMURTAS, Jacopo; Celotto, S.; KOYANAGI, AI; Bolzetta, F.; Smith, Lee; SOYSAL, PINAR
- PublicationOpen AccessNutritional supplements for neuropsychiatric symptoms in people with dementia: A systematic review and meta-analysis(2020-08-01T00:00:00Z) Haider, Sandra; Schwarzinger, Angela; Stefanac, Sinisa; SOYSAL, PINAR; Smith, Lee; Veronese, Nicola; Dorner, Thomas E.; Grabovac, Igor; SOYSAL, PINARObjectives The aim of the present study was to assess the effects of nutritional supplementation on neuropsychiatric symptoms among people with dementia. Methods/Design Randomized controlled trials (RCTs) were searched in the Databases PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and from inception until January 31, 2020. Studies of RCTs carried out on people with any type of dementia who were taking nutritional supplements and had neuropsychiatric symptoms were included in this systematic review and meta-analysis. Neuropsychiatric symptoms were assessed with the validated Neuropsychiatric Inventory (NPI). Effect sizes were calculated with standardized mean differences (SMD) and 95% confidence intervals (95%CI), applying a random effect model. Results The search yielded 1034 studies with four studies being included in the meta-analysis with a total of 377 people with dementia (mean age 69.3 [SD: 7.7] years). The diagnoses comprised mild to late Alzheimer-s disease and frontotemporal dementia. Two studies included a multicomponent supplementation, one an omega-3, and one a special supplement tailored for cognitive impairment. The median follow-up was 18 weeks, with a range from 12 to 24 weeks. Pooled data showed that nutritional supplementation did not improve NPI (SMD = -0.33; [95%CI: -0.74 to 0.08];P= 0.11; I-2= 45%). Conclusions The findings of this meta-analysis demonstrated no significant impact on NPI through nutritional supplementation. However, the generalization of the results is limited, as different supplements were used in different stages of dementia with a short follow-up time.
- PublicationOpen AccessObjectively measured far vision impairment and sarcopenia among adults aged ≥ 65 years from six low- and middle-income countries.(2021-03-28T00:00:00Z) Smith, Lee; López-Sánchez, Guillermo F; Jacob, Louis; Barnett, Yvonne; Pardhan, Shahina; Veronese, Nicola; Soysal, PINAR; Tully, Mark A; Gorely, Trish; Shin, Jae Il; Koyanagi, Ai; SOYSAL, PINAR
- PublicationMetadata onlyPhysical Activity and Exercise in Mild Cognitive Impairment and Dementia: An Umbrella Review of Intervention and Observational Studies(2020-10-01T00:00:00Z) Demurtas, Jacopo; Schoene, Daniel; Torbahn, Gabriel; Marengoni, Alessandra; Grande, Giulia; Zou, Liye; Petrovic, Mirko; Maggi, Stefania; Cesari, Matteo; Lamb, Sarah; Soysal, Pınar; Kemmler, Wolfgang; Sieber, Cornel; Mueller, Christoph; Shenkin, Susan D.; Schwingshackl, Lukas; Smith, Lee; Veronese, Nicola; SOYSAL, PINARObjectives: The aim of this umbrella review was to determine the effect of physical activity/exercise on improving cognitive and noncognitive outcomes in people with MCI (mild cognitive impairment) and dementia.
- PublicationOpen AccessProspective associations between alcohol use, binge drinking and sexual activity in older adults: the English Longitudinal Study Of Ageing(2019-11-08) Grabovac, Igor; Koyanagi, Ai; Yang, Lin; SOYSAL, PINAR; McDermott, Daragh; Isik, Ahmet Turan; Veronese, Nicola; Smith, Lee; SOYSAL, PINARThe present study aimed to investigate associations between alcohol consumption and sexual activity. Data were from 1,622 men and 2,195 women aged >= 50 years participating in the English Longitudinal Study of Ageing. Adjusted multivariable logistic regression was used to assess associations between baseline frequency of alcohol use in the last year or binge drinking in the last week and sexual activity at 8-year follow-up. Regular alcohol consumption in the last year at baseline was associated with 111% higher odds (95% CI 1.36-3.27) of any past-year sexual activity at follow-up in men and 76% higher odds (95% CI 1.26-2.46) in women. Frequent alcohol consumption was associated with 175% higher odds (95% CI 1.75-4.32) of sexual activity in men and 100% higher odds (95% CI 1.38-2.89) in women, relative to drinking alcohol never or rarely. Binge drinking was positively associated with sexual activity at follow-up, with odds of being sexually active at follow-up 52% higher (95% CI 1.07-2.15) among men who reported binge drinking at baseline and 57% higher (95% CI 1.11-2.23) among females. These findings do not outweigh the health risks associated with excessive alcohol consumption. Health practitioners should consider these findings when encouraging older adults to reduce their alcohol consumption.
- PublicationMetadata onlyPaper Associations between mental and oral health in Spain: a cross-sectional study of more than 23,000 people aged 15 years and over(2020-09-01T00:00:00Z) Jacob, Louis; Lopez-Sanchez, Guillermo F.; Carvalho, Andre F.; Shin, Jae Il; Oh, Hans; Yang, Lin; Veronese, Nicola; SOYSAL, PINAR; Grabovac, Igor; Koyanagi, Ai; Smith, Lee; SOYSAL, PINARBackground: This study aimed to investigate associations between mental health and several parameters of oral health, controlling for a variety of important covariates, in a large representative sample of Spanish people. Methods: Data from the Spanish National Health Survey 2017 were analysed. Mental (i.e., depression, chronic anxiety, other psychiatric disorders) and oral health (i.e., dental caries, dental extraction, dental filling, gingival bleeding, tooth movement, dental material, missing tooth) were evaluated. Control variables included sex, age, marital status, education, smoking, alcohol consumption, and physical multimorbidity. Associations between psychiatric conditions (independent variables) and the number of poor oral health outcomes (dependent vari-able) were assessed using Poisson regression models. The associations were investigated in the overall popu-lation, in married participants and in those who were single/widowed/divorced/separated. Results: There were 23,089 participants [54.1% women; mean (standard deviation) age 53.4 (18.9) years]. The prevalence of at least one psychiatric condition was 15.4% in the overall sample, while the mean (standard deviation) number of poor oral health outcomes was 2.9 (1.4). There was a positive association between any psychiatric condition and the number of poor oral health outcomes [incidence rate ratio (IRR)=1.10; 95% con fidence interval: 1.07-1.12], and there was a signi ficant interaction between any psychiatric condition and marital status. The association was stronger in those participants who were single/widowed/divorced/sepa-rated. Limitations: Cross-sectional study. Oral and mental health were assessed with Yes/No questions. Exposure, outcome and covariates were self-reported. Conclusions: Those with poor mental health have worse oral health but being married has some protective benefits.
- PublicationOpen AccessSarcopenia and health-related outcomes: an umbrella review of observational studies(2019-12-01) Veronese, Nicola; Demurtas, Jacopo; SOYSAL, PINAR; Smith, Lee; Torbahn, Gabriel; Schoene, Daniel; Schwingshackl, Lukas; Sieber, Cornel; Bauer, Jurgen; Cesari, Matteo; Bruyere, Oliviere; Reginster, Jean-Yves; Beaudart, Charlotte; Cruz-Jentoft, Alfonso J.; Cooper, Cyrus; Petrovic, Mirko; Maggi, Stefania; SOYSAL, PINARKey summary pointsAimTo investigate associations of sarcopenia with adverse health-related outcomes, through an umbrella review method.FindingsSarcopenia appears to be significantly associated with several adverse outcomes in older people, with a strong evidence for increased risk of mortality, disability, and falls.MessageSarcopenia is associated with several adverse health-related outcomes in older people, indicating the need of assessing this condition in daily practice. AbstractBackgroundThe clinical relevance of sarcopenia has increasingly been recognized. However, whether it is associated with the development of other medical conditions is still unclear. Therefore, we aimed to capture the scale of outcomes that have been associated with the presence of sarcopenia and systematically assess the quality, strength, and credibility of these associations using an umbrella review methodology.MethodsA systematic review in several databases was carried out, until 20th February 2019. For each association, random-effects summary effect size, 95% confidence intervals (CIs), heterogeneity (I-2), evidence for small-study effect, evidence for excess significance bias, and 95%-prediction intervals were estimated. We used these metrics to categorize the evidence of significant outcomes (p<0.05) from class I (convincing) to class IV (weak), according to pre-established criteria.ResultsFrom 358 abstracts, 6 meta-analyses with 14 associations were included. Sarcopenia was associated with higher risk of other comorbidities and mortality in 11 of 14 outcomes explored. However, only 3 outcomes (i.e., association between sarcopenia and increased risk of death in community-dwelling older people [odds ratio, OR=3.60; 95% CI 2.96-4.37; n=14,305], disability [OR=3.04; 95% CI 1.80-5.12; n=8569], and falls [OR=1.60; 95% CI 1.31-1.97; n=12,261]) presented a highly suggestive evidence (class II). Other association was classified as having only a weak evidence.ConclusionSarcopenia is associated with several adverse health-related outcomes in older people, and its associations with mortality, disability, and falls are supported by a highly suggestive evidence. The effect of interventions on sarcopenia to improve these outcomes needs to be investigated.