-
Otology & Neurotology Open Mar 2022To describe outcomes after bilateral cochlear implantation (CI) in a patient with a pathologic variant associated with Noonan syndrome (NS) and Noonan syndrome with...
OBJECTIVES
To describe outcomes after bilateral cochlear implantation (CI) in a patient with a pathologic variant associated with Noonan syndrome (NS) and Noonan syndrome with multiple lentigines (NSML). Additionally, to assess the utility of CI in this specific population based on our outcome and previous reports.
STUDY DESIGN
Retrospective case report with literature review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
PATIENTS
A young boy with various multiorgan abnormalities, speech and language delay, and persistent hearing loss who was found to have a heterozygous gene mutation at age 2.
INTERVENTIONS
Bilateral tympanostomy tube placement, diagnostic imaging, and eventual staged bilateral CI.
MAIN OUTCOME MEASURES
Objective audiometric testing and developmental milestone attainment.
RESULTS
Bilateral CI was successfully completed over a 2-month period. The patient illustrated significant improvement in objective audiologic measurement. However, he continues to sign as his main form of communication without significant speech progression.
CONCLUSIONS
Early diagnostic and therapeutic intervention in patients with NS/NSML can help improve long-term audiologic and speech development. Given the heterogeneity of NS/NSML, a multidisciplinary approach is needed for optimal outcomes.
PubMed: 38515811
DOI: 10.1097/ONO.0000000000000009 -
JAMA Health Forum Aug 2021Inadequate access to food is a risk factor for poor health and the effectiveness of federal programs targeting food insecurity, such as the Supplemental Nutrition... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Inadequate access to food is a risk factor for poor health and the effectiveness of federal programs targeting food insecurity, such as the Supplemental Nutrition Assistance Program (SNAP), are well-documented. The associations between other types of interventions to provide adequate food access and food insecurity status, health outcomes, and health care utilization, however, are unclear.
OBJECTIVE
To review evidence on the association between food insecurity interventions and food insecurity status, clinically-relevant health outcomes, and health care utilization among adults, excluding SNAP.
DATA SOURCES
A systematic search for English-language literature was performed in PubMed Central and Cochrane Trials databases (inception to January 23, 2020), the Social Interventions Research and Evaluation Network database (December 10, 2019); and the gray literature using Google (February 1, 2021).
STUDY SELECTION
Studies of any design that assessed the association between food insecurity interventions for adult participants and food insecurity status, health outcomes, and health care utilization were screened for inclusion. Studies of interventions that described addressing participants' food needs or reporting food insecurity as an outcome were included. Interventions were categorized as home-delivered food, food offered at a secondary site, monetary assistance in the form of subsidies or income supplements, food desert interventions, and miscellaneous.
DATA EXTRACTION AND SYNTHESIS
Data extraction was performed independently by 3 reviewers. Study quality was assessed using the Cochrane Risk of Bias Tool, the ROBINS-I (Risk of Bias in Non-Randomized Studies of Interventions) tool, and a modified version of the National Institutes of Health's Quality Assessment Tool for Before-After Studies With No Control. The certainty of evidence was based on GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria and supplemented with mechanistic and parallel evidence. For outcomes within intervention categories with at least 3 studies, random effects meta-analysis was performed.
MAIN OUTCOMES AND MEASURES
Food insecurity (measured through surveys; eg, the 2-item Hunger Vital Sign), health outcomes (eg, hemoglobin A), and health care utilization (eg, hospitalizations, costs).
RESULTS
A total of 39 studies comprising 170 605 participants were included (8 randomized clinical trials and 31 observational studies). Of these, 14 studies provided high-certainty evidence of an association between offering food and reduced food insecurity (pooled random effects; adjusted odds ratio, 0.53; 95% CI, 0.33-0.67). Ten studies provided moderate-certainty evidence of an association between offering monetary assistance and reduced food insecurity (pooled random effects; adjusted odds ratio, 0.64; 95% CI, 0.49-0.84). There were fewer studies of the associations between interventions and health outcomes or health care utilization, and the evidence in these areas was of low or very low certainty that any food insecurity interventions were associated with changes in either.
CONCLUSIONS AND RELEVANCE
This systematic review with meta-analysis found that providing food and monetary assistance was associated with improved food insecurity measures; however, whether it translated to better health outcomes or reduced health care utilization was unclear.
Topics: Adult; Dietary Supplements; Food Assistance; Food Insecurity; Hospitalization; Humans; Income; Randomized Controlled Trials as Topic; United States
PubMed: 35977189
DOI: 10.1001/jamahealthforum.2021.2001 -
Journal of Autism and Developmental... Dec 2015Powerful, portable, off-the-shelf handheld devices, such as tablet based computers (i.e., iPad(®); Galaxy(®)) or portable multimedia players (i.e., iPod(®)), can be... (Meta-Analysis)
Meta-Analysis Review
Powerful, portable, off-the-shelf handheld devices, such as tablet based computers (i.e., iPad(®); Galaxy(®)) or portable multimedia players (i.e., iPod(®)), can be adapted to function as speech generating devices for individuals with autism spectrum disorders or related developmental disabilities. This paper reviews the research in this new and rapidly growing area and delineates an agenda for future investigations. In general, participants using these devices acquired verbal repertoires quickly. Studies comparing these devices to picture exchange or manual sign language found that acquisition was often quicker when using a tablet computer and that the vast majority of participants preferred using the device to picture exchange or manual sign language. Future research in interface design, user experience, and extended verbal repertoires is recommended.
Topics: Autism Spectrum Disorder; Communication Aids for Disabled; Computer-Assisted Instruction; Computers, Handheld; Humans; Sign Language; Speech
PubMed: 25413144
DOI: 10.1007/s10803-014-2314-4 -
American Annals of the Deaf 2023The authors examine the effects of American Sign Language (ASL) on English reading achievement and English reading comprehension. A systematic review of relevant primary... (Review)
Review
The authors examine the effects of American Sign Language (ASL) on English reading achievement and English reading comprehension. A systematic review of relevant primary research and research-integrated journal articles was conducted. Based on interpretations of a few salient articles and other sources (e.g., books) selected in a professional review, background on the ASL-English situation is provided. The authors discuss whether the findings reflect a pattern or suggest instructional implications for improving English reading comprehension. Also discussed is whether the findings are confounded by a lack of desirable research characteristics associated with sample sociodemography, teacher-student interactions, or school environment. The article concludes with recommendations for further research to examine the merits of ASL-English approaches or bilingual programs, focusing on improvement of the English reading skills of d/Deaf and hard of hearing children and adolescents.
Topics: Humans; Sign Language; Reading; Child; Comprehension; Education of Hearing Disabled; Adolescent; Persons With Hearing Impairments; Multilingualism; United States; Deafness
PubMed: 38661782
DOI: 10.1353/aad.2023.0010 -
International Journal of Pediatric... Oct 2015Mometasone has been reported to improve the symptoms of nasal obstruction in children with adenoidal hypertrophy. This systematic review and meta-analysis were conducted... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Mometasone has been reported to improve the symptoms of nasal obstruction in children with adenoidal hypertrophy. This systematic review and meta-analysis were conducted to evaluate the role of mometasone on different nasal symptoms, otitis media with effusion, adenoid size, and quality of life in children with adenoidal hypertrophy.
METHODS
A comprehensive search of MEDLINE, EMBASE, CINAHL and COCHRANE Collaboration databases was undertaken. We identified all the randomized controlled trials (RCTs) in children with adenoidal hypertrophy that compared the effects of mometasone nasal spray and normal saline nasal spray on different outcomes. The deadline of the search was April 2015. The search was supplemented by hand searching of cross-references in the studies and reviews and by contacting the authors of various studies. Only English language RCTs were considered for the systematic review. The primary outcomes were improvement in symptoms of nasal obstruction, mouth breathing, rhinorrhea, snoring, cough, and total nasal symptoms. The secondary outcomes were improvement in otitis media with effusion, quality of life, and size of adenoid. Quality assessment of RCTs was performed using SIGN 50 and Cochrane risk of bias tools. Risk ratio (RR), weighted mean differences (WMD) and their 95% confidence intervals (CI) were calculated for dichotomous and continuous data, respectively. Random effects model was used for the analyses. Heterogeneity was measured by using the I(2) statistics and p value <0.05.
RESULTS
Our search generated 87 citations, of which eight RCTs met the inclusion criteria. The methodological quality of all the RCTs was poor. There was no significant difference between mometasone and control groups for the patient's characteristic and grades of different nasal symptoms, otitis media with effusion, obstructive sleep apnea, and quality of life at the basal level. There was also no significant difference in the number of patients with different symptoms at the basal level. After the administration of mometasone, there were significant improvements in grades of nasal obstruction, 0.8±0.5 versus 2.0±0.6, WMD -1.16 [-2.09, -0.23], snoring 0.3±0.4 versus 1.6±0.6, WMD -1.07 [-2.09, -0.05], total nasal symptoms 2.9±1.3 versus 6.9±1.5, WMD -4.09 [-6.64, -1.53], obstructive sleep apnea, 0.6±0.3 versus 1.4±0.4, WMD -0.95 [-1.74, -0.16], as well as the percentage of patients with nasal obstruction, snoring, obstructive sleep apnea, compared to control. There was tendency of improvement in rhinorrhea, and cough with mometasone. Compared to control, mometasone nasal spray significantly improved adenoid size or adenoid/choana ratio 50.9±8.8 versus 74.2±12.6, WMD -21.2 [-34.0, -8.4], change in adenoid/choana obstruction from the basal level (p=0.01), and percentage of patients with adenoid hypertrophy, 26% versus 92%, RR 0.29 [0.18, 0.48]. There was improvement in otitis media with effusion, 40% versus 72%, pure tone audiometry 5.2±11 versus 11.6±11dB, WMD -6.40dB [-12.65, -0.15], and quality of life with mometasone. Subgroup analyses showed that RCTs that followed blinding showed significantly less response compared to RCTs that did not follow it for most of the outcomes.
CONCLUSIONS
Mometasone caused improvements in outcomes of nasal obstruction, snoring, total nasal symptoms, pure tune audiometry, otitis media with effusion, adenoid size, and quality of life. The data is based on meta-analysis of RCTs of poor methodological quality. A high methodological quality, placebo controlled RCT of different doses and duration of administration of mometasone is required to evaluate its clear efficacy and safety in children with adenoid hypertrophy.
Topics: Adenoids; Anti-Inflammatory Agents; Child; Child, Preschool; Humans; Hypertrophy; Mometasone Furoate; Nasal Obstruction; Quality of Life; Treatment Outcome
PubMed: 26235732
DOI: 10.1016/j.ijporl.2015.07.009 -
Archives of Psychiatric Nursing Oct 2016Adolescents and young people are known to hold negative views about mental illness. There is less known about their beliefs about mental health services and care. (Review)
Review
BACKGROUND
Adolescents and young people are known to hold negative views about mental illness. There is less known about their beliefs about mental health services and care.
OBJECTIVE
The aim of this study was to systematically examine literature on the beliefs of adolescents and young people from the general population about mental health services and care. Factors that positively and negatively influence these beliefs are also explored.
METHODS
Relevant electronic databases were searched for papers published in the English language between January 2004 and October 2015.
RESULTS
Culture seemed to influence how adolescents and young adults perceived mental health interventions. This was particularly evident in countries such as Palestine and South Africa where prayer was highly valued. Adolescents and young people were uninformed about psychiatric medication. They believed that accessing mental health care was a sign of weakness. Furthermore, they viewed psychiatric hospitals and various mental health professionals negatively. Film was found to have a negative impact on how adolescents and young people perceived mental health services, whereas open communication with family members was found to have a positive impact.
CONCLUSION
Adolescents and young adults hold uninformed and stigmatizing beliefs about mental health treatments, mental health professionals, and access to care. The sources of these beliefs remain unclear although some at least seem influenced by culture. Further research, (particularly qualitative research) in this area is recommended in order to address current gaps in knowledge.
Topics: Adolescent; Culture; Global Health; Health Personnel; Hospitals, Psychiatric; Humans; Mental Disorders; Mental Health Services; Qualitative Research; Religion; Stereotyping; Young Adult
PubMed: 27654250
DOI: 10.1016/j.apnu.2016.04.004 -
BioMed Research International 2021Temporomandibular disorders (TMD) have been traditionally associated with psychosocial factors; however, occupational stress as a factor related to TMD has not been...
Temporomandibular disorders (TMD) have been traditionally associated with psychosocial factors; however, occupational stress as a factor related to TMD has not been adequately assessed in the literature. The aim was to investigate the association between stress at work and TMD on adult paid workers. An electronic search included PubMed, Scopus, Web of Science, Embase, and LILACS databases. Manual searches in the included articles' reference and gray literature were performed. There were no restrictions regarding language or publication period. The inclusion criteria comprised observational studies with paid workers of any category, of both sexes, above 18 years old, assessing occupational stress/stress or distress and TMD as diagnosis or isolated signs and symptoms. Methodological quality was evaluated using Joanna Briggs tools. We narratively assessed the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. We collected 12 studies. 50% reported a positive association between stress and TMD diagnostic across various job categories. On the other hand, TMJ sounds (a TMD sign) and work stress were associated only in a musicians' population. However, the shortage of eligible articles and the methodological limitations provided a very low certainty of the evidence; only 4 of the studies used validated tools for both stress and TMD (2 reporting positive association). The association between stress and TMD is inconclusive by the available data. In the future, we expect more robust epidemiologic studies addressing these relevant aspects.
Topics: Humans; Occupational Stress; Publications; Temporomandibular Joint Disorders
PubMed: 34307651
DOI: 10.1155/2021/2055513 -
BMC Nursing Apr 2022The Covid-19 pandemic has produced unprecedented challenges across all aspects of health and social care sectors globally. Nurses and healthcare workers in care homes...
BACKGROUND
The Covid-19 pandemic has produced unprecedented challenges across all aspects of health and social care sectors globally. Nurses and healthcare workers in care homes have been particularly impacted due to rapid and dramatic changes to their job roles, workloads, and working environments, and residents' multimorbidity. Developed by the World Health Organisation, Psychological First Aid (PFA) is a brief training course delivering social, emotional, supportive, and pragmatic support that can reduce the initial distress after disaster and foster future adaptive functioning.
OBJECTIVES
This review aimed to synthesise findings from studies exploring the usefulness of PFA for the well-being of nursing and residential care home staff.
METHODS
A systematic search was conducted across 15 databases (Social Care Online, Kings Fund Library, Prospero, Dynamed, BMJ Best Practice, SIGN, NICE, Ovid, Proquest, Campbell Library, Clinical Trials, Web of Knowledge, Scopus, Ebsco CINAHL, and Cochrane Library), identifying peer-reviewed articles published in English language from database inception to 20th June 2021.
RESULTS
Of the 1,159 articles screened, 1,146 were excluded at title and abstract; the remaining 13 articles were screened at full text, all of which were then excluded.
CONCLUSION
This review highlights that empirical evidence of the impact of PFA on the well-being of nursing and residential care home staff is absent. PFA has likely been recommended to healthcare staff during the Covid-19 pandemic. The lack of evidence found here reinforces the urgent need to conduct studies which evaluates the outcomes of PFA particularly in the care home staff population.
PubMed: 35468786
DOI: 10.1186/s12912-022-00866-6 -
Neurosurgery Sep 2014Currently, there is no evidence-based definition for concussion that is being uniformly applied in clinical and research settings. (Review)
Review
BACKGROUND
Currently, there is no evidence-based definition for concussion that is being uniformly applied in clinical and research settings.
OBJECTIVE
To conduct a systematic review of the highest-quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion. The goal was to establish an evidence-based foundation from which to derive, in future work, a definition, diagnostic criteria, and prognostic indicators for concussion.
METHODS
Key questions were developed, and an electronic literature search from 1980 to 2012 was conducted to acquire evidence about the prevalence of and associations among signs, symptoms, and neurologic and cognitive deficits in samples of individuals exposed to potential concussive events. Included studies were assessed for potential for bias and confound and rated as high, medium, or low potential for bias and confound. Those rated as high were excluded from the analysis. Studies were further triaged on the basis of whether the definition of a case of concussion was exclusive or inclusive; only those with wide, inclusive case definitions were used in the analysis. Finally, only studies reporting data collected at fixed time points were used. For a study to be included in the conclusions, it was required that the presence of any particular sign, symptom, or deficit be reported in at least 2 independent samples.
RESULTS
From 5437 abstracts, 1362 full-text publications were reviewed, of which 231 studies were included in the final library. Twenty-six met all criteria required to be used in the analysis, and of those, 11 independent samples from 8 publications directly contributed data to conclusions. Prevalent and consistent indicators of concussion are (1) observed and documented disorientation or confusion immediately after the event, (2) impaired balance within 1 day after injury, (3) slower reaction time within 2 days after injury, and/or (4) impaired verbal learning and memory within 2 days after injury.
CONCLUSION
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations, derived from the strongest evidence in the published literature. The product is an evidence-based foundation from which to develop diagnostic criteria and prognostic indicators.
Topics: Brain Concussion; Evidence-Based Medicine; Humans; Physical Examination; Practice Guidelines as Topic
PubMed: 25006974
DOI: 10.1227/NEU.0000000000000433 -
Ultrasound in Obstetrics & Gynecology :... Apr 2023To determine, by expert consensus through a modified Delphi process, the role of standardized and new ultrasound signs in the prenatal evaluation of patients at high...
OBJECTIVE
To determine, by expert consensus through a modified Delphi process, the role of standardized and new ultrasound signs in the prenatal evaluation of patients at high risk of placenta accreta spectrum (PAS).
METHODS
A systematic review of articles providing information on ultrasound imaging signs or markers associated with PAS was performed before the development of questionnaires for the first round of the Delphi process. Only peer-reviewed original research studies in the English language describing one or more new ultrasound sign(s) for the prenatal evaluation of PAS were included. A three-round consensus-building Delphi method was then conducted under the guidance of a steering group, which included nine experts who invited an international panel of experts in obstetric ultrasound imaging in the evaluation of patients at high risk for PAS. Consensus was defined as agreement of ≥ 70% between participants.
RESULTS
The systematic review identified 15 articles describing eight new ultrasound signs for the prenatal evaluation of PAS. A total of 35 external experts were approached, of whom 31 agreed and participated in the first round. Thirty external experts (97%) and seven experts from the steering group completed all three Delphi rounds. A consensus was reached that a prior history of at least one Cesarean delivery, myomectomy or PAS should be an indication for detailed PAS ultrasound assessment. The panelists also reached a consensus that seven of the 11 conventional signs of PAS should be included in the examination of high-risk patients and the routine mid-gestation scan report: (1) loss of the 'clear zone', (2) myometrial thinning, (3) bladder-wall interruption, (4) placental bulge, (5) uterovesical hypervascularity, (6) placental lacunae and (7) bridging vessels. A consensus was not reached for any of the eight new signs identified by the systematic review. With respect to other ultrasound features that are not specific to PAS but increase the probability of PAS at birth, the panelists reached a consensus for the finding of anterior placenta previa or placenta previa with cervical involvement. The experts were also asked to determine which PAS signs should be quantified and consensus was reached only for the quantification of placental lacunae using an existing score. For predicting surgical outcome in patients with a high probability of PAS at delivery, a consensus was obtained for loss of the clear zone, bladder-wall interruption, presence of placental lacunae and presence of placenta previa involving the cervix.
CONCLUSIONS
We have confirmed the continued importance of seven established standardized ultrasound signs of PAS, highlighted the role of transvaginal ultrasound in evaluating the placental position and anatomy of the cervix, and identified new ultrasound signs that may become useful in the future prenatal evaluation and management of patients at high risk for PAS at birth. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Placenta Accreta; Placenta; Placenta Previa; Delphi Technique; Ultrasonography; Ultrasonography, Prenatal; Retrospective Studies
PubMed: 36609827
DOI: 10.1002/uog.26155