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The Cochrane Database of Systematic... Nov 2020Gender dysphoria is described as a mismatch between an individual's experienced or expressed gender and their assigned gender, based on primary or secondary sexual...
BACKGROUND
Gender dysphoria is described as a mismatch between an individual's experienced or expressed gender and their assigned gender, based on primary or secondary sexual characteristics. Gender dysphoria can be associated with clinically significant psychological distress and may result in a desire to change sexual characteristics. The process of adapting a person's sexual characteristics to their desired sex is called 'transition.' Current guidelines suggest hormonal and, if needed, surgical intervention to aid transition in transgender women, i.e. persons who aim to transition from male to female. In adults, hormone therapy aims to reverse the body's male attributes and to support the development of female attributes. It usually includes estradiol, antiandrogens, or a combination of both. Many individuals first receive hormone therapy alone, without surgical interventions. However, this is not always sufficient to change such attributes as facial bone structure, breasts, and genitalia, as desired. For these transgender women, surgery may then be used to support transition.
OBJECTIVES
We aimed to assess the efficacy and safety of hormone therapy with antiandrogens, estradiol, or both, compared to each other or placebo, in transgender women in transition.
SEARCH METHODS
We searched MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Biosis Preview, PsycINFO, and PSYNDEX. We carried out our final searches on 19 December 2019.
SELECTION CRITERIA
We aimed to include randomised controlled trials (RCTs), quasi-RCTs, and cohort studies that enrolled transgender women, age 16 years and over, in transition from male to female. Eligible studies investigated antiandrogen and estradiol hormone therapies alone or in combination, in comparison to another form of the active intervention, or placebo control.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane to establish study eligibility.
MAIN RESULTS
Our database searches identified 1057 references, and after removing duplicates we screened 787 of these. We checked 13 studies for eligibility at the full text screening stage. We excluded 12 studies and identified one as an ongoing study. We did not identify any completed studies that met our inclusion criteria. The single ongoing study is an RCT conducted in Thailand, comparing estradiol valerate plus cyproterone treatment with estradiol valerate plus spironolactone treatment. The primary outcome will be testosterone level at three month follow-up.
AUTHORS' CONCLUSIONS
We found insufficient evidence to determine the efficacy or safety of hormonal treatment approaches for transgender women in transition. This lack of studies shows a gap between current clinical practice and clinical research. Robust RCTs and controlled cohort studies are needed to assess the benefits and harms of hormone therapy (used alone or in combination) for transgender women in transition. Studies should specifically focus on short-, medium-, and long-term adverse effects, quality of life, and participant satisfaction with the change in male to female body characteristics of antiandrogen and estradiol therapy alone, and in combination. They should also focus on the relative effects of these hormones when administered orally, transdermally, and intramuscularly. We will include non-controlled cohort studies in the next iteration of this review, as our review has shown that such studies provide the highest quality evidence currently available in the field. We will take into account methodological limitations when doing so.
Topics: Androgen Antagonists; Drug Therapy, Combination; Estradiol; Estrogens; Female; Humans; Male; Placebos; Sex Reassignment Procedures; Transgender Persons
PubMed: 33251587
DOI: 10.1002/14651858.CD013138.pub2 -
Developmental Neuropsychology 2024This systematic review aimed to examine the possible implication of visual-perceptual, visuo-attentional and oculomotor processing in the reading deficits frequently... (Review)
Review
This systematic review aimed to examine the possible implication of visual-perceptual, visuo-attentional and oculomotor processing in the reading deficits frequently experienced by children with Neurofibromatosis type 1 (NF1), as previously shown in dyslexia. Using PRISMA methodological guidelines, we examined 49 studies; most of these reported visual-processing deficits in this population, raising the importance of directly studying the visuo-perceptual and visuo-attentional processes and eye-movement control involved in the learning-to-read process in NF1. The discussion provides a reflection for a better understanding of how visual-processing skills interact with reading deficits in NF1, as well as new avenues for their screening and care.
Topics: Child; Humans; Reading; Neurofibromatosis 1; Dyslexia; Visual Perception; Learning
PubMed: 38469855
DOI: 10.1080/87565641.2024.2326151 -
Clinical & Experimental Optometry Sep 2020This systematic review presents the existing scientific evidence for oculomotor anomalies in children with three different types of learning disorders - namely,...
This systematic review presents the existing scientific evidence for oculomotor anomalies in children with three different types of learning disorders - namely, dyslexia, dyspraxia and attention deficit-hyperactivity disorder (ADHD). This review was registered in the PROSPERO database (registration number: 139317). The QUADAS-2 tool was used to systematically evaluate the quality of the diagnostic tests used in the evaluated studies and to confirm whether the oculomotor alterations observed in the different groups of children with various learning disorders had a consistent diagnostic basis. Using this tool, the design of the articles was well elaborated, although concerns exist regarding the selection of patients and the diagnostic criteria for the binocular conditions. All the studies reviewed conclude that a pattern of oculomotor anomalies exist in the groups of children with these three types of learning disorders compared to healthy children. However, there is a concern regarding the diagnostic methodology, as no clear range of normality for the parameters used to characterise ocular motility was identified and no gold standard or reference test has been defined. In future studies, this range of normality must be developed for different oculomotor skills, and a reference test (possibly video-oculography) for the measurement of these skills must be established.
Topics: Attention Deficit Disorder with Hyperactivity; Child; Dyslexia; Eye Movements; Humans; Ocular Motility Disorders; Oculomotor Muscles
PubMed: 31869866
DOI: 10.1111/cxo.13024 -
Children (Basel, Switzerland) Jun 2024Neurodevelopmental disorders can be studied from two distinct perspectives: an internal approach, which examines the causes and consequences of these disorders; and a... (Review)
Review
UNLABELLED
Neurodevelopmental disorders can be studied from two distinct perspectives: an internal approach, which examines the causes and consequences of these disorders; and a contextual approach, which considers the role of the family in the lives of children and adolescents. Research has demonstrated that the most significant form of family involvement in families raising a child with NDD is through homework. This involvement has been shown to have an emotional impact on children with neurodevelopmental disorders such as ADHD or dyslexia. The objective of this study is to review published articles on homework and neurodevelopmental disorders, with particular attention to the role of the family and the emotional health of children and families.
METHOD
The review followed the PRISMA guidelines. The final sample consisted of 11 articles, with samples ranging from less than 30 participants to more than 100 at the international level.
RESULTS
The results demonstrate the complex methodological and bibliometric picture of the final sample, as well as the many emotional and contextual variables that influence the relationship between homework and neurodevelopmental disorders.
CONCLUSIONS
Future research should consider how emotional health affects the engagement of families with children with neurodevelopmental disorders.
PubMed: 38929292
DOI: 10.3390/children11060713 -
Clinical Pharmacology and Therapeutics Oct 2018Attention-deficit/hyperactivity disorder (ADHD), the most common pediatric neurobehavioral disorder, frequently presents with coexisting reading disorders (RDs). Despite...
Attention-deficit/hyperactivity disorder (ADHD), the most common pediatric neurobehavioral disorder, frequently presents with coexisting reading disorders (RDs). Despite this, it is unclear whether medication improves symptoms and function in children with comorbid ADHD and RD. We present a systematic review of studies investigating the effects of ADHD medications on ADHD symptoms, academic outcomes, and neuropsychological measures in this important group.
Topics: Academic Performance; Adolescent; Adolescent Behavior; Adolescent Development; Age Factors; Attention Deficit Disorder with Hyperactivity; Brain; Central Nervous System Stimulants; Child; Child Behavior; Child Development; Comorbidity; Dyslexia; Female; Humans; Male; Treatment Outcome
PubMed: 30053315
DOI: 10.1002/cpt.1192 -
Language, Speech, and Hearing Services... Oct 2022The present meta-analysis sought to investigate the effects of phonemic awareness instruction provided to children suspected of having a reading disability. (Meta-Analysis)
Meta-Analysis
PURPOSE
The present meta-analysis sought to investigate the effects of phonemic awareness instruction provided to children suspected of having a reading disability.
METHOD
Seven databases were systematically searched, and 1,643 unique manuscripts were reviewed for inclusion. Data were extracted from 138 included manuscripts to evaluate the use of phonemic awareness instruction with children suspected of having a reading disability. A random effects model was then used to conduct a meta-analysis of these data with regard to child outcomes.
RESULTS
Gains in this population associated with phonemic awareness instruction can vary as a function of the outcome being used. On average, phonemic awareness instruction had a medium effect on composite ( = 0.511) and segmentation ( = 0.571) outcomes and a small effect on outcomes measuring blending ( = 0.341), first sound identification ( = 0.428), and deletion ( = 0.248). Instruction effects were strongest in kindergarten and first grade, but positive outcomes were also found for older children. There was not a significant relationship between cumulative intervention intensity and child performance.
CONCLUSIONS
The present meta-analysis confirms that phonemic awareness instruction can be effective with children of varying ages and that significant gains can be observed on the key outcome measures of segmentation and blending. Graphemes should be incorporated into phonemic awareness instruction, and future studies need to provide information on dosage beyond just the length and frequency of sessions to clarify which aspects of these interventions are most efficient.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.20277714.
Topics: Adolescent; Awareness; Child; Dyslexia; Educational Status; Humans; Phonetics; Schools
PubMed: 35858272
DOI: 10.1044/2022_LSHSS-21-00160 -
Human Brain Mapping Feb 2022Noninvasive brain stimulation (NIBS) allows to actively and noninvasively modulate brain function. Aside from inhibiting specific processes, NIBS may also enhance...
Noninvasive brain stimulation (NIBS) allows to actively and noninvasively modulate brain function. Aside from inhibiting specific processes, NIBS may also enhance cognitive functions, which might be used for the prevention and intervention of learning disabilities such as dyslexia. However, despite the growing interest in modulating learning abilities, a comprehensive, up-to-date review synthesizing NIBS studies with dyslexics is missing. Here, we fill this gap and elucidate the potential of NIBS as treatment option in dyslexia. The findings of the 15 included studies suggest that repeated sessions of reading training combined with different NIBS protocols may induce long-lasting improvements of reading performance in child and adult dyslexics, opening promising avenues for future research. In particular, the "classical" reading areas seem to be most successfully modulated through NIBS, and facilitatory protocols can improve various reading-related subprocesses. Moreover, we emphasize the need to further explore the potential to modulate auditory cortex function as a preintervention and intervention approach for affected children, for example, to avoid the development of auditory and phonological difficulties at the core of dyslexia. Finally, we outline how future studies may increase our understanding of the neurobiological basis of NIBS-induced improvements in dyslexia.
Topics: Dyslexia; Humans; Transcranial Direct Current Stimulation; Transcranial Magnetic Stimulation
PubMed: 34716977
DOI: 10.1002/hbm.25700 -
International Journal of Health... Jun 2018The relationships between food environments and dietary intake have been assessed via a range of methodologically diverse measures of spatial exposure to food outlets,...
BACKGROUND
The relationships between food environments and dietary intake have been assessed via a range of methodologically diverse measures of spatial exposure to food outlets, resulting in a largely inconclusive body of evidence, limiting informed policy intervention.
OBJECTIVE
This systematic review aims to evaluate the influence of methodological choice on study outcomes by examining the within-study effect of availability (e.g., counts) versus accessibility (e.g., proximity) spatial exposure measures on associations with diet.
METHODS
(PROSPERO registration: CRD42018085250). PubMed, Web of Science, Scopus and ScienceDirect databases were searched for empirical studies from 1980 to 2017, in the English language, involving adults and reporting on the statistical association between a dietary outcome and spatial exposure measures of both availability and accessibility. Studies were appraised using an eight-point quality criteria with a narrative synthesis of results.
RESULTS
A total of 205 associations and 44 relationships (i.e., multiple measures of spatial exposure relating to a particular food outlet type and dietary outcome) were extracted from 14 eligible articles. Comparative measures were dominated by counts (availability) and proximity (accessibility). Few studies compared more complex measures and all counts were derived from place-based measures of exposure. Sixteen of the 44 relationships had a significant effect involving an availability measure whilst only 8 had a significant effect from an accessibility measure. The largest effect sizes in relationships were mostly for availability measures. After stratification by scale, availability measure had the greatest effect size in 139 of the 176 pairwise comparisons. Of the 33% (68/205) of associations that reached significance, 53/68 (78%) were from availability measures. There was no relationship between study quality and reported study outcomes.
CONCLUSIONS
The limited evidence suggests that availability measures may produce significant and greater effect sizes than accessibility measures. However, both availability and accessibility measures may be important concepts of spatial exposure depending on the food outlet type and dietary outcome examined. More studies reporting on multi-method effects are required to differentiate findings by the type of spatial exposure assessment and build an evidence base regarding the appropriateness and robustness of measures under different circumstances.
Topics: Adult; Diet; Environment; Female; Food Supply; Geographic Information Systems; Humans; Male; Residence Characteristics; Spatial Analysis
PubMed: 29885662
DOI: 10.1186/s12942-018-0139-7 -
Research in Developmental Disabilities Nov 2018While an understanding of the genetic contributions to specific reading disorder (RD) is emerging, there is no agreement about which putative hazard factors are clearly...
BACKGROUND
While an understanding of the genetic contributions to specific reading disorder (RD) is emerging, there is no agreement about which putative hazard factors are clearly involved in the aetiology of this disorder.
AIMS
A literature review looking at the impact of environmental risk variables implicated in RD either per se or when interacting with the genes.
METHODS AND PROCEDURES
We performed a systematic literature review using the following keywords: dyslexia OR reading disability AND environmental risk factors OR environmental hazard factors, in the following electronic databases: PubMed, Scopus and PsycINFO, without any time restrictions.
OUTCOMES AND RESULTS
Gestational weeks and birth weight are among the pre- and peri-natal risk factors shown to reliably predict reading readiness and the odds of having RD. Inconclusive findings have been reported for maternal cigarette smoking, family history of psychiatric and medical diseases, and risk of miscarriage. A broad definition of familial socio-economic status and home literacy environment have been identified as good life-long risk predictors of reading skills.
CONCLUSIONS AND IMPLICATIONS
We highlighted the need to consider environmental hazards, their interactions and interactions with RD-candidate genes in the study of the aetiology of RD in order to provide much-needed insight into how these variables influence reading skills.
Topics: Dyslexia; Gene-Environment Interaction; Genetic Predisposition to Disease; Humans; Risk Factors; Social Environment
PubMed: 29566979
DOI: 10.1016/j.ridd.2018.03.005 -
Drugs & Aging Apr 2019We aimed to assess the safety of topical non-steroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis (OA) in a systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
We aimed to assess the safety of topical non-steroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo-controlled trials.
METHODS
A comprehensive literature search was undertaken in the MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus electronic databases. Randomized, double-blind, placebo-controlled, parallel-group trials that assessed adverse events (AEs) with topical NSAIDs in patients with OA were eligible for inclusion. Authors and/or study sponsors were contacted to obtain the full report of AEs. The primary outcomes were overall severe and serious AEs, as well as the following MedDRA System Organ Class (SOC)-related AEs: gastrointestinal, vascular, cardiac, nervous system, skin and subcutaneous tissue, musculoskeletal and connective tissue.
RESULTS
The search strategy identified 1209 records, from which 25 papers were included in the qualitative synthesis and 19 were included in the meta-analysis, after exclusions. Overall, more total AEs (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.04-1.29; I = 0.0%) and more withdrawals due to AEs (OR 1.49, 95% CI 1.15-1.92; I = 0.0%) were observed with topical NSAIDs compared with placebo. The same results were achieved with topical diclofenac, largely driven by an increase in skin and subcutaneous tissue disorders (OR 1.73, 95% CI 0.96-3.10), although the difference was not statistically significant compared with placebo. No significant difference in the odds for gastrointestinal disorders was observed between topical NSAIDs and placebo (OR 0.96, 95% CI 0.73-1.27).
CONCLUSIONS
Topical NSAIDs may be considered safe in the management of OA, especially with regard to low gastrointestinal toxicity. The use of topical NSAIDs in OA should be considered, taking into account their risk: benefit profile in comparison with other anti-OA treatments.
Topics: Administration, Cutaneous; Anti-Inflammatory Agents, Non-Steroidal; Diclofenac; Drug-Related Side Effects and Adverse Reactions; Humans; Osteoarthritis; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 31073923
DOI: 10.1007/s40266-019-00661-0