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Archives of Disease in Childhood Apr 2024Clinical guidelines outline the use of hormones for masculinisation/feminisation in adolescents experiencing gender dysphoria or incongruence. Robust evidence concerning...
BACKGROUND
Clinical guidelines outline the use of hormones for masculinisation/feminisation in adolescents experiencing gender dysphoria or incongruence. Robust evidence concerning risks and benefits is lacking. There is a need to aggregate evidence as research becomes available.
AIM
Identify and synthesise studies assessing the outcomes of hormones for masculinisation/feminisation in adolescents experiencing gender dysphoria/incongruence.
METHODS
Systematic review and narrative synthesis. Database searches (MEDLINE, Embase, CINAHL, PsycINFO, Web of Science) were performed in April 2022, with results assessed independently by two reviewers. An adapted version of the Newcastle-Ottawa Scale for Cohort Studies was used to assess study quality. Moderate- and high-quality studies were synthesised.
RESULTS
12 cohort, 9 cross-sectional and 32 pre-post studies were included (n=53). One cohort study was high-quality. Other studies were moderate (n=33) and low-quality (n=19). Synthesis of high and moderate-quality studies showed consistent evidence demonstrating induction of puberty, although with varying feminising/masculinising effects. There was limited evidence regarding gender dysphoria, body satisfaction, psychosocial and cognitive outcomes, and fertility. Evidence from mainly pre-post studies with 12-month follow-up showed improvements in psychological outcomes. Inconsistent results were observed for height/growth, bone health and cardiometabolic effects. Most studies included adolescents who received puberty suppression, making it difficult to determine the effects of hormones alone.
CONCLUSIONS
There is a lack of high-quality research assessing the use of hormones in adolescents experiencing gender dysphoria/incongruence. Moderate-quality evidence suggests mental health may be improved during treatment, but robust study is still required. For other outcomes, no conclusions can be drawn. More recent studies published since April 2022 until January 2024 also support the conclusions of this review. CRD42021289659.
PubMed: 38594053
DOI: 10.1136/archdischild-2023-326670 -
Anatolian Journal of Cardiology Jul 2024Women are often neglected in cardiovascular health prevention. Age at menarche (AAM) has been linked to cardiovascular (CVD) disease in women and is potentially... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Women are often neglected in cardiovascular health prevention. Age at menarche (AAM) has been linked to cardiovascular (CVD) disease in women and is potentially identified as one of the significant CVD risk factor. However, there is still limited comprehensive evidence addressing this issue. This systematic review and meta-analysis aimed to investigate how early menarche affects the outcome of all-cause mortality, CVD mortality, total cardiovascular disease event, stroke (ischemic, hemorrhagic, and total stroke), and coronary heart disease (CHD).
METHOD
The Cochrane Library, MEDLINE, Embase, ScienceDirect, and Google Scholar databases were searched from March 2013 to March 2023 for cohorts investigating the effect of early onset of menarche on CVD events with a minimum follow-up period of 5 years. Studies that observed specific population and/or included women with a history of CVD at baseline were excluded. The Newcastle-Ottawa scale was used for risk of bias assessment for each cohort included. The data were presented as dichotomous measure using risk ratios. I2 statistics were utilized to evaluate the heterogeneity of presented data.
RESULTS
Thirteen cohorts included 18 626 799 female patients with ages ranging from 43 to 62.6 years. These reported 6 estimates each for CHD (5 483 298 patients) and all-cause mortality (1 595 878 patients), 5 estimates each for total stroke (2 941 321 patients) and CVD mortality (1 706 742 patients), 4 estimates each for total CVD events (3 988 311 patients) and ischemic stroke (2 434 580 patients), and 1 estimate for hemorrhagic stroke (66 104 patients). Our study found that events of CHD were significantly lower in early menarche (RR 0.57; 95% CI 0.41-0.78; P <.00001), as well as total stroke (RR 0.51; 95% CI 0.35-0.73; P =.0003), CVD mortality (RR 0.47; 95% CI 0.22-0.98; P =.04), total CVD events (RR 0.44; 95% CI 0.25-0.76; P =.003), ischemic stroke (RR 0.31; 95% CI 0.15-0.61; P <.0008), and hemorrhagic stroke (RR 0.12; 95% CI 0.07-0.20; P <.00001); and insignificantly higher in all-cause mortality (RR 0.90, 95% CI 0.76-1.06, P =.20).
CONCLUSION
In our study, cardiovascular events are lower in women with early menarche; hence, the later age of menarche is a potential risk factor to be considered when assessing CVD risk in a patient. However, our sample characteristics were heterogenous, and we did not consider other female hormonal factors that might potentially contribute to the CVD outcomes observed; thus, further studies are needed to clarify.
Topics: Female; Humans; Middle Aged; Age Factors; Cardiovascular Diseases; Menarche; Protective Factors; Risk Factors; Adult
PubMed: 38940409
DOI: 10.14744/AnatolJCardiol.2024.3996 -
Sports Medicine (Auckland, N.Z.) Jan 2024To what extent does junior athletic performance predict senior athletic performance (i.e., in the highest, open-age category)? This question is the subject of a lively... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To what extent does junior athletic performance predict senior athletic performance (i.e., in the highest, open-age category)? This question is the subject of a lively debate in the literature. Following traditional theories of giftedness and expertise, some researchers and practitioners have proposed that a high level of junior performance is a prerequisite for the development of a high level of later senior performance. Sceptics of this view hold that junior performance has limited predictive value for later senior performance, pointing to empirical evidence indicating that predictors (e.g., participation patterns) of junior performance and of senior performance differ. The straightforward way to resolve this controversy empirically is to test the correlation between junior and senior performance.
OBJECTIVE
To provide robust and generalizable evidence on this issue, we performed a systematic review and meta-analysis of relevant studies. The aim was to quantify the overall correlation between junior and senior performance and then test whether correlations vary across junior age categories and subsamples (e.g., types of sports).
METHODS
A systematic literature search was conducted in SPORTDiscus, Eric, ProQuest, PsychInfo, PubMed, Scopus, WorldCat, and Google Scholar from 27 January through 30 April 2022. We searched for original studies that recorded athletes' junior and senior performance longitudinally and included measures of association between junior and senior performance. Quality of evidence was evaluated using the Mixed Methods Appraisal Tool version for nonrandomized studies.
RESULTS
The search yielded k = 129 effect sizes from N = 13,392 athletes from a wide range of Olympic sports, 62% male and 38% female, from 2006 to 2021. Four central findings emerged: (1) Overall, the meta-analytic pooled correlation between junior and senior performance was [Formula: see text] = 0.148. That is, junior performance explained only 2.2% of the reliable variance in senior performance. (2) The finding was robust across types of sports, sexes, wider or narrower performance ranges, national or international samples, and binary or continuous performance measures. (3) Effects varied across junior age categories: the younger the junior age category, the lower the correlation between junior and senior performance, with [Formula: see text] ranging from [Formula: see text] = - 0.052 to [Formula: see text] = 0.215. That is, across junior age categories, junior performance explained 0-4.6% of the reliable variance in senior performance. (4) The quality of primary studies was high.
DISCUSSION
The results suggest that junior performance has very little, if any, predictive value for senior performance. The findings run counter to claims from traditional theories of both giftedness and expertise. From an applied perspective, talent selection typically begins around puberty or younger-age ranges where youth performance is uncorrelated or negatively correlated with later senior performance. The evidence presented here raises serious questions about the use of junior performance for talent selection purposes. A PRISMA-P protocol was registered at https://osf.io/gck4a/ .
Topics: Female; Humans; Male; Aptitude; Athletes; Athletic Performance
PubMed: 37676619
DOI: 10.1007/s40279-023-01906-0 -
Journal of Applied Research in... Jul 2024Self-determination is associated with lifelong positive outcomes. Students with intellectual disabilities typically have lower self-determination than their peers.... (Review)
Review
BACKGROUND
Self-determination is associated with lifelong positive outcomes. Students with intellectual disabilities typically have lower self-determination than their peers. Universal basic education access offers schools the opportunity to rectify this disparity. This is the first systematic review investigating the school-based practices that target self-determination development for students with intellectual disabilities.
METHOD
The review follows the PRISMA guidelines, spanning five databases (ProQuest databases, EMBASE, Scopus, Sage Journals, Taylor and Francis Online) from 2006 to 2021.
RESULTS
Across the 18 studies, the most used practice is the SDLMI. Research focuses on United States-based transition-aged students with mild to moderate intellectual disabilities. Social validity tends to be assessed in summative and informal ways. Students are not generally involved in decision-making about practices and individualisation of support.
CONCLUSIONS
Self-determination development for this population can begin before puberty. Future research should critically investigate social validity and holistic integration of student self-determination learning opportunities throughout the pedagogical cycle.
Topics: Humans; Intellectual Disability; Child; Personal Autonomy; Adolescent; Schools; Students
PubMed: 38797718
DOI: 10.1111/jar.13247 -
African Journal of Reproductive Health Feb 2024A systematic literature review was conducted to examine all recent academic, peer-reviewed studies of menstrual hygiene management (MHM) across adolescent girls in...
A systematic literature review was conducted to examine all recent academic, peer-reviewed studies of menstrual hygiene management (MHM) across adolescent girls in Anglophone West Africa. The objective was to assess the status of the scholarship surrounding the knowledge, attitudes, and practices of MHM across English-speaking West African countries and identify gaps in the literature for further research. The authors searched the epidemiological literatures indexed in PubMed and cross-referenced bibliographies for studies published between 2010-2022. Of 59 abstracts and articles screened, 35 met the final inclusion criteria. Despite differences in study design, setting, and data sources, the study results concurred on an average age of menarche between 12-15 years old among adolescent girls. The knowledge of MHM came from multiple sources, most commonly mothers, female siblings, and teachers and higher knowledge was associated with age, source, wealth, religion, and education level. Less than half of the adolescent girls knew about menstruation before menarche. Many studies showed that girls were shocked by their first period and fearful of staining. Menstruation was associated with dysmenorrhea, fear/embarrassment, and missing school. The existing studies suggest that more implementation and evaluation of menstrual hygiene management materials, education, and facilities are needed to address the educational, physical, and social disparities that exist among girls in West African countries.
Topics: Female; Adolescent; Humans; Child; Menstruation; Hygiene; Health Knowledge, Attitudes, Practice; Menarche; Schools; Africa, Western
PubMed: 38308560
DOI: 10.29063/ajrh2024/v28i1.12 -
Frontiers in Endocrinology 2024Central precocious puberty (CPP) is a common endocrine disorder in children, and its diagnosis primarily relies on the gonadotropin-releasing hormone (GnRH) stimulation... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Central precocious puberty (CPP) is a common endocrine disorder in children, and its diagnosis primarily relies on the gonadotropin-releasing hormone (GnRH) stimulation test, which is expensive and time-consuming. With the widespread application of artificial intelligence in medicine, some studies have utilized clinical, hormonal (laboratory) and imaging data-based machine learning (ML) models to identify CPP. However, the results of these studies varied widely and were challenging to directly compare, mainly due to diverse ML methods. Therefore, the diagnostic value of clinical, hormonal (laboratory) and imaging data-based ML models for CPP remains elusive. The aim of this study was to investigate the diagnostic value of ML models based on clinical, hormonal (laboratory) and imaging data for CPP through a meta-analysis of existing studies.
METHODS
We conducted a comprehensive search for relevant English articles on clinical, hormonal (laboratory) and imaging data-based ML models for diagnosing CPP, covering the period from the database creation date to December 2023. Pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), summary receiver operating characteristic (SROC) curve, and area under the curve (AUC) were calculated to assess the diagnostic value of clinical, hormonal (laboratory) and imaging data-based ML models for diagnosing CPP. The I test was employed to evaluate heterogeneity, and the source of heterogeneity was investigated through meta-regression analysis. Publication bias was assessed using the Deeks funnel plot asymmetry test.
RESULTS
Six studies met the eligibility criteria. The pooled sensitivity and specificity were 0.82 (95% confidence interval (CI) 0.62-0.93) and 0.85 (95% CI 0.80-0.90), respectively. The LR+ was 6.00, and the LR- was 0.21, indicating that clinical, hormonal (laboratory) and imaging data-based ML models exhibited an excellent ability to confirm or exclude CPP. Additionally, the SROC curve showed that the AUC of the clinical, hormonal (laboratory) and imaging data-based ML models in the diagnosis of CPP was 0.90 (95% CI 0.87-0.92), demonstrating good diagnostic value for CPP.
CONCLUSION
Based on the outcomes of our meta-analysis, clinical and imaging data-based ML models are excellent diagnostic tools with high sensitivity, specificity, and AUC in the diagnosis of CPP. Despite the geographical limitations of the study findings, future research endeavors will strive to address these issues to enhance their applicability and reliability, providing more precise guidance for the differentiation and treatment of CPP.
Topics: Child; Humans; Artificial Intelligence; Machine Learning; Puberty, Precocious; Reproducibility of Results; Sensitivity and Specificity
PubMed: 38590824
DOI: 10.3389/fendo.2024.1353023 -
Frontiers in Neuroendocrinology Oct 2023Mucosal secretory immunoglobulin A (s-IgA) has been recognized as a key component of human first line defense against infection. However, its reactivity to psychosocial...
Mucosal secretory immunoglobulin A (s-IgA) has been recognized as a key component of human first line defense against infection. However, its reactivity to psychosocial stressors is poorly understood. This systematic review aimed to explore whether s-IgA levels changed after psychosocial stress in subjects under the age of 18. Fifteen articles were included. s-IgA basal levels are increased in children older than 9 years old exposed to stress. Furthermore, s-IgA seems to follow a circadian rhythm, which is altered under stress conditions. Finally, the collective evidence suggests that salivary s-IgA rapidly increases under acute stress after puberty. Overall, our review indicates that s-IgA could be considered a potential psychosocial stress biomarker of interest for pediatric and child-juvenile psychiatric population. Further studies are needed to validate the role of s-IgA circadian rhythm and basal levels as psychosocial stress biomarkers and disentangle the role of age and type of stressor.
Topics: Humans; Child; Immunoglobulin A, Secretory; Saliva; Stress, Psychological; Biomarkers; Circadian Rhythm
PubMed: 37479062
DOI: 10.1016/j.yfrne.2023.101083 -
Clinical Endocrinology Nov 2023Duncan et al. reviewed the response to growth hormone stimulation testing after priming in peripubertal children. The concern is that there is little research...
Duncan et al. reviewed the response to growth hormone stimulation testing after priming in peripubertal children. The concern is that there is little research documenting the response to growth hormone treatment in patients with sex hormone primed growth hormone stimulation testing and those unprimed. The controversy about priming or not can be summarized as follows: if one wants to know if the production of growth hormone during puberty will be adequate in terms of peak growth hormone responses then stimulation with priming should be done.
Topics: Humans; Child; Adolescent; Growth Hormone; Human Growth Hormone; Gonadal Steroid Hormones; Puberty; Steroids; Growth Disorders; Body Height
PubMed: 37723940
DOI: 10.1111/cen.14972 -
Acta Bio-medica : Atenei Parmensis Aug 2023Proper nutrition during childhood and puberty is essential to ensure healthy growth of children and good health in adulthood. Different types of interventions have been...
BACKGROUND AND AIM
Proper nutrition during childhood and puberty is essential to ensure healthy growth of children and good health in adulthood. Different types of interventions have been suggested to promote nutritional health in children. This systematic review aims to summarize the available evidence from experimental studies on the efficacy of digital media tools for the promotion of a healthy diet in school-aged children.
METHODS
According to PRISMA guidelines, a literature search was conducted in the three main electronic databases (PubMed/Medline, Embase e Scopus) until April 2022. We included all experimental studies assessing the effectiveness of digital media tools for nutritional health promotion in children from 5 to 12 years of age.
RESULTS
Four studies were included in our analysis, all carried out in school settings. Three of them investigated the use of a videogame, while one study involved watching a cartoon. Each intervention tested was effective in promoting a healthy diet in school-aged children in the short term, regardless of the type of intervention and age of the children involved. A statistically significant increase was observed post-intervention in all studies, both in knowledge of food groups and food frequencies, and in practices (i.e. the amount of fruit and vegetables servings consumed per meal), although the effect faded over time (when follow-up was available).
CONCLUSIONS
Digital media tools can be used to effectively implement health promotion interventions to improve knowledge and adherence to healthy diets in school-aged children. Further studies are needed to assess the long-term effectiveness of these interventions.
Topics: Humans; Child; Diet, Healthy; Internet; Databases, Factual; Food; Health Promotion
PubMed: 37695189
DOI: 10.23750/abm.v94iS3.14293