BackgroundUnderstanding the relationship between increasing educational attainment and mortality reduction has important policy and public health implications. This systematic review of the literature establishes a taxonomy to facilitate evaluation of the association between educational attainment and early mortality.MethodsFollowing PRISMA guidelines, we searched Ovid Medline, Embase, PubMed and hand searches of references for English-language primary data analyses using education as an independent variable and mortality as a dependent variable. Initial searches were undertaken in February 2015 and updated in April 2016.ResultsOne thousand, seven hundred and eleven unique articles were identified, 418 manuscripts were screened and 262 eligible studies were included in the review. After an iterative review process, the literature was divided into four study domains: (1) all-cause mortality (n = 68, 26.0%), (2) outcome-specific mortality (n = 89, 34.0%), (3) explanatory pathways (n = 51, 19.5%), and (4) trends over time (n = 54, 20.6%). These four domains comprise a novel taxonomy that can be implemented to better quantify the relationship between education and mortality.ConclusionsWe propose an organizational taxonomy for the education-mortality literature based upon study characteristics that will allow for a more in-depth understanding of this association. Our review suggests that studies that include mediators or subgroups can explain part, but not all, of the relationship between education and early mortality.Trial registrationPROSPERO registration # CRD42015017182.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4754-1) contains supplementary material, which is available to authorized users.
BackgroundObesity is a risk factor for inadequate receipt of recommended preventive care services. The objective of this study was to assess the relationship between increasing body mass index and receipt of influenza and pneumococcal vaccinations. A systematic review of the PubMed, Embase, and Web of Science databases was conducted from January 1966 to May 2015 for cohort and cross-sectional studies that assessed the relationship between body mass index and the receipt of vaccinations for influenza and pneumococcus. Separate meta-analyses by obesity classification were performed using a random effects model.ResultsSix cross-sectional and three cohort studies were included. Average vaccine uptake was 50.4 % for influenza vaccination and 34.6 % for pneumococcal vaccination. Compared to normal weight patients, combined odds ratio (95 % confidence interval) for influenza vaccination was 1.11 (95 % CI 0.97–1.25) for obese (≥30 kg/m2) patients. When the outcome was reported by obesity class, combined odds ratios of influenza vaccination were 1.13 (95 % CI 1.02–1.24) for Class I (30–34.9 kg/m2) obesity, 1.21 (95 % CI 1.05–1.37) for Class II obesity (35–39.9 kg/m2), and 1.19 (95 % CI 0.95–1.42) for Class III obesity (≥40 kg/m2) patients. Compared to normal weight patients, combined odds ratio of pneumococcal vaccination were 1.20 (95 % CI 1.13–1.27) for obese patients. When the outcome was reported by obesity class, combined odds ratios were 1.08 (95 % CI 1.04–1.13) for Class I obesity patients, 1.13 (95 % CI 1.10–1.16) for Class II obesity patients, and 1.26 (95 % CI 1.15–1.38) for Class III obesity patients for pneumococcal vaccination.ConclusionsCombined findings from the current literature suggest that adults with obesity are more likely than non-obese peers to receive vaccination for influenza and pneumococcus. However, suboptimal vaccination coverage was observed across all body sizes, so future interventions should focus on improving vaccination rates for all adults.Electronic supplementary materialThe online version of this article (doi:10.1186/s40608-016-0105-5) contains supplementary material, which is available to authorized users.
Acute compartment syndromes in the lower leg are well recognized following major trauma. However, although rare, they may occur following seemingly minor sporting injury. A case of acute compartment syndrome, following a football game and affecting the peroneal or lateral compartment, is described, in which prompt diagnosis and treatment led to a satisfactory outcome. The diagnosis and surgical management of acute compartment syndromes are discussed. Early recognition and treatment are important in the prevention of long-term disability.
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