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Preventing suicide by restricting access to Highly Hazardous Pesticides (HHPs): A systematic review of international evidence since 2017
Get PDFSuicide is a leading cause of death worldwide. A previous systematic review showed that regulations limiting access to highly hazardous pesticides (HHPs) were successful in preventing suicides. As the WHO strongly supports regulation of pesticides, we aimed to update and strengthen the evidence on the effectiveness of HHP bans. We conducted a systematic review by searching MEDLINE, Embase, and PsycINFO databases in March 2024 for manuscripts published since 2017 that investigated the effects of regulatory changes limiting access to HHPs on pesticide suicide, at the population level. Two reviewers independently screened titles and abstracts, and extracted data using a standardized form, defined a priori. The study protocol was registered in PROSPERO (CRD42023441247). All nine studies in six Asian countries showed reductions in pesticide suicide rates following HHP bans (range 28.0% to 91.9%), of which six applied time series analyses to account for trends prior to the intervention (reductions in pesticide suicide rates ranged 28.0% to 60.5%). Only five studies assessed overall suicides; of those, four reported decreases in overall suicide rates following the intervention, of which three used time series analysis (range 7.0% to 45.1%). Only one study had a low risk of bias in all domains, with five studies having high risk of bias in at least one of the domains. Restricting access to HHPs leads to declines in both pesticide and overall suicide rates. Findings from this and the previous systematic review provide strong evidence to governments and public health officials that are considering implementing bans on HHPs in order to reduce suicides. However, this review only covered studies published since 2017 and there is a need for data from other regions to investigate the generalisability of this approach
Hormone replacement therapy, menopausal age and lifestyle variables are associated with better cognitive performance at follow-up but not cognition over time in older-adult women irrespective of APOE4 carrier status and co-morbidities
Get PDFA hybrid [18F]fluoropivalate PET-multiparametric MRI to detect and characterise brain tumour metastases based on a permissive environment for monocarboxylate transport
Get PDFHuman metapneumovirus associated acute respiratory infections burden in older adults globally
No full textBackground: The human metapneumovirus (hMPV)- associated disease burden in older adults remains under-researched. This review aimed to systematically estimate the global burden of hMPV-associated disease in older adults. Methods: We searched Medline, Embase, Global Health, CINAHL, Web of Science, and Global Index Medicus in February 2023, November 2023 and October 2024; and CNKI, Wanfang and CQVip in April 2024 and October 2024. We included studies conducted over ≥12 consecutive months, reporting on adults aged ≥60 years, and with laboratory-confirmed hMPV infections. Critical appraisal of included studies was conducted using the Joanna Briggs Institute critical appraisal tools. Random effects meta-analyses were conducted to estimate the pooled hMPV proportions positive in acute respiratory infections (ARIs). Using Monte Carlo simulation, we estimated the hMPV-associated hospitalisations globally, in high-income countries, low-and-middle-income countries and the USA in ≥65 years during 2019 as most studies reported on this age group. The hMPV-associated ARI incidence in countries other than the USA and outpatient/ community settings in the USA was summarised narratively. The review protocol was registered on PROSPERO (CRD42023422325). Findings: Forty-six studies conducted between 2005 and 2023, and reporting on hMPV proportion positive estimates (n=36, with 29,866 laboratory tests), hospitalisation rate in the USA (n=4), and hMPV incidence (n=6) were included. We estimated 473,000 (95% confidence interval [CI]: 396,000; 777,000) hMPV-associated hospitalisations globally, 185,000 (105,000; 340,000) in high-income countries (n=6), and 288,000 (193,000; 436,000) in low-and-middle-income countries (n=10) in people aged ≥65 years during 2019. In the USA, the pooled hMPV-associated hospitalisation rate (n=4) was 231 (95% confidence interval [CI]: 41; 421) per 100,000 persons in those aged ≥65 years, representing approximately 122,000 (41,000; 398,000) hospital admissions in this population during 2019. Interpretation: hMPV-associated ARIs contribute to a significant disease and hospitalisation burden in older adults. However, large-scale surveillance studies with more investment in research and diagnostic methods to develop reliable estimates are required
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