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The Journal of Allergy and Clinical... Jun 2024Cow's milk and egg allergy affect approximately 1.9% and 0.9% of children, respectively. Dietary advancement therapies (DAT), including milk (ML) and egg (EL) ladders,...
BACKGROUND
Cow's milk and egg allergy affect approximately 1.9% and 0.9% of children, respectively. Dietary advancement therapies (DAT), including milk (ML) and egg (EL) ladders, baked milk (BM-OIT) and baked egg (BE-OIT) oral immunotherapy are potential therapeutic options for these patients.
OBJECTIVE
To perform systematic review and meta-analysis of the safety and efficacy of DAT in children with IgE-mediated milk or egg allergy.
METHODS
A systematic literature review was conducted, exploring 22 potential outcomes, with meta-analysis performed where >3 studies reported data. The GRADE approach was used to determine the certainty of evidence for each outcome, and the Johanna Briggs Institute tools for determining risk of bias.
RESULTS
Twenty-nine studies met inclusion criteria among 9946 titles screened. Tolerance occurred in 69% of EL, 58% of ML, 49% of BE-OIT and 29% of BM-OIT patients. All-severity allergic reactions occurred in 21% of EL, 25% of ML, 20% of BE-OIT and 61% of BM-OIT patients, with epinephrine use in 3% of EL, 2% of ML, and 9% of BM-OIT patients. At-home reactions occurred in 19% of BE-OIT and 10% of BM-OIT patients. Discontinuation occurred in 14% of EL, 17% of ML, 17% of BE-OIT and 20% of BM-OIT patients. Mean time to BE egg and BE-OIT tolerance was 13.25 months (4 studies) and 19.1 months (3 studies). Certainty of evidence was very low, and risk of bias high. Study heterogeneity was high, attributable to multiple factors.
CONCLUSIONS
There is very low certainty of evidence supporting DAT safety and efficacy. We cannot conclude DAT accelerates tolerance development.
PubMed: 38901613
DOI: 10.1016/j.jaip.2024.06.016 -
Maxillofacial Plastic and... Jun 2024Focal and florid cemento-osseous dysplasia are benign fibro-osseous lesions affecting the quality and quantity of the jawbones. This study aimed to determine the... (Review)
Review
BACKGROUND
Focal and florid cemento-osseous dysplasia are benign fibro-osseous lesions affecting the quality and quantity of the jawbones. This study aimed to determine the viability of implant-based approaches in the affected patients.
MAIN TEXT
Different scientific databases, including PubMed/MEDLINE, Scopus, Web of Science, Embase, the Cochrane Library, and Google Scholar, were searched until October 8, 2023, using a pre-determined search strategy. Two reviewers screened the retrieved reports and extracted the required information from the included studies. The eligibility criteria included English-language case reports/series or clinical trials. The JBI critical appraisal checklist for case reports was used to assess the methodological quality of the included studies. Three studies were deemed eligible to be included in this study out of the initial 202 records found. Five implants were placed in three patients, positioned in the proximity of the lesion area, without any additional treatment to remove the pathology. The mandibular posterior area was the affected site in all patients. Only one implant failed in one patient after 16 years, which was attributed to peri-implantitis and not the lesion. Other implants demonstrated successful maintenance over follow-up periods.
CONCLUSIONS
Although the number of the included records was relatively low to draw firm conclusions, it seems that implant-based treatments in patients with focal/florid cemento-osseous dysplasia could be viable, considering a conservative and well-planned approach.
PubMed: 38900334
DOI: 10.1186/s40902-024-00432-x -
BMC Oral Health Jun 2024Biosurfactants are amphiphilic compounds produced by various microorganisms. Current research evaluates diverse types of biosurfactants against a range of oral pathogens.
BACKGROUND
Biosurfactants are amphiphilic compounds produced by various microorganisms. Current research evaluates diverse types of biosurfactants against a range of oral pathogens.
OBJECTIVES
This systematic review aims to explore the potential of microbial-derived biosurfactants for oral applications.
METHODOLOGY
A systematic literature search was performed utilizing PubMed-MEDLINE, Scopus, and Web of Science databases with designated keywords. The results were registered in the PROSPERO database and conducted following the PRISMA checklist. Criteria for eligibility, guided by the PICOS framework, were established for both inclusion and exclusion criteria. The QUIN tool was used to assess the bias risk for in vitro dentistry studies.
RESULTS
Among the initial 357 findings, ten studies were selected for further analysis. The outcomes of this systematic review reveal that both crude and purified forms of biosurfactants exhibit antimicrobial and antibiofilm properties against various oral pathogens. Noteworthy applications of biosurfactants in oral products include mouthwash, toothpaste, and implant coating.
CONCLUSION
Biosurfactants have garnered considerable interest and demonstrated their potential for application in oral health. This is attributed to their surface-active properties, antiadhesive activity, biodegradability, and antimicrobial effectiveness against a variety of oral microorganisms, including bacteria and fungi.
Topics: Surface-Active Agents; Humans; Anti-Infective Agents; Biofilms; Mouth; Mouthwashes; Toothpastes
PubMed: 38898470
DOI: 10.1186/s12903-024-04479-0 -
The Science of the Total Environment Jun 2024Chronic exposure to indoor volatile organic compounds (VOCs) can result in several adverse effects including cancers. We review reports of levels of VOCs in offices and...
Exposure to volatile organic compounds in offices and in residential and educational buildings in the European Union between 2010 and 2023: A systematic review and health risk assessment.
Chronic exposure to indoor volatile organic compounds (VOCs) can result in several adverse effects including cancers. We review reports of levels of VOCs in offices and in residential and educational buildings in the member states of the European Union (EU) published between 2010 and 2023. We use these data to assess the risk to population health by estimating lifetime exposure to indoor VOCs and resulting non-cancer and cancer risks and, from that, the burden of cancer attributable to VOC exposure and associated economic losses. Our systematic review identified 1783 articles, of which 184 were examined in detail, with 58 yielding relevant data. After combining data on VOC concentrations separately for EU countries and building types, non-cancer and cancer risks were assessed in terms of hazard quotient and lifetime excess cancer risk (LECR) using probabilistic Monte Carlo Simulations. The LECR was used to estimate disability adjusted life years (DALYs) from VOC-related cancers and associated costs. We find that the LECR associated with formaldehyde exposure was above the acceptable risk level (ARL) in France and Germany and that of from exposure to benzene was also above the ARL in Spanish females. The sum of DALYs and related costs/1,000,000 population/year from exposure to acetaldehyde, benzene, formaldehyde, tetrachloroethylene, and trichloroethylene were 4.02 and €41,010, respectively, in France, those from exposure to acetaldehyde, benzene, carbon tetrachloride, formaldehyde, and trichloroethylene were 3.91 and €39,590 in Germany, and those from exposure to benzene were 0.1 and €1030 in Spain. Taken as a whole, these findings show that indoor exposure to VOCs remains a public health concern in the EU. Although the EU has set limits for certain VOCs, further measures are needed to restrict the use of these chemicals in consumer products.
PubMed: 38897460
DOI: 10.1016/j.scitotenv.2024.173965 -
Frontiers in Neuroscience 2024Single-pulse transcranial magnetic stimulation (spTMS) applied to the Early Visual Cortex (EVC) has demonstrated the ability to suppress the perception on visual...
BACKGROUND
Single-pulse transcranial magnetic stimulation (spTMS) applied to the Early Visual Cortex (EVC) has demonstrated the ability to suppress the perception on visual targets, akin to the effect of visual masking. However, the reported spTMS suppression effects across various studies have displayed inconsistency.
OBJECTIVE
We aim to test if the heterogeneity of the spTMS effects can be attributable to variations in experimental factors.
METHODS
We conducted a meta-analysis using data collected from the PubMed and Web of Science databases spanning from 1995 to March 2024. The meta-analysis encompassed a total of 40 independent experiments drawn from 33 original articles.
RESULTS
The findings unveiled an overall significant spTMS suppression effect on visual perception. Nevertheless, there existed substantial heterogeneity among the experiments. Univariate analysis elucidated that the spTMS effects could be significantly influenced by TMS intensity, visual angle of the stimulus, coil type, and TMS stimulators from different manufacturers. Reliable spTMS suppression effects were observed within the time windows of -80 to 0 ms and 50 to 150 ms. Multivariate linear regression analyses, which included SOA, TMS intensity, visual angle of the stimulus, and coil type, identified SOA as the key factor influencing the spTMS effects. Within the 50 to 150 ms time window, optimal SOAs were identified as 112 ms and 98 ms for objective and subjective performance, respectively. Collectively, multiple experimental factors accounted for 22.9% ( = 0.3353) and 39.9% ( = 0.3724) of the variance in objective and subjective performance, respectively. Comparing univariate and multivariate analyses, it was evident that experimental factors had different impacts on objective performance and subjective performance.
CONCLUSION
The present study provided quantitative recommendations for future experiments involving the spTMS effects on visual targets, offering guidance on how to configure experimental factors to achieve the optimal masking effect.
PubMed: 38894939
DOI: 10.3389/fnins.2024.1351399 -
Diagnostics (Basel, Switzerland) May 2024The study aimed to assess the prevalence of COVID-19 and spp. coinfection across continents. Conducted following PRISMA guidelines, a systematic review utilized PubMed,... (Review)
Review
The study aimed to assess the prevalence of COVID-19 and spp. coinfection across continents. Conducted following PRISMA guidelines, a systematic review utilized PubMed, Embase, SCOPUS, ScienceDirect, and Web of Science databases, searching for literature in English published from December 2019 to December 2022, using specific Health Sciences descriptors. A total of 408 records were identified, but only 50 were eligible, and of these, only 33 were included. Thirty-three references were analyzed to evaluate the correlation between COVID-19 and spp. infections. The tabulated data represented a sample group of 8741 coinfected patients. The findings revealed notable disparities in co-infection rates across continents. In Asia, 23% of individuals were infected with , while in Europe, the proportion of co-infected patients stood at 15%. Strikingly, on the African continent, 43% were found to be infected with , highlighting significant regional variations. Overall, the proportion of co-infections among COVID-positive individuals were determined to be 19%. Particularly concerning was the observation that 1 in 6 ICU coinfections was attributed to , indicating its substantial impact on patient outcomes and healthcare burden. The study underscores the alarming prevalence of co-infection between COVID-19 and , potentially exacerbating the clinical severity of patients and posing challenges to treatment strategies. These findings emphasize the importance of vigilant surveillance and targeted interventions to mitigate the adverse effects of bacterial coinfections in the context of the COVID-19 pandemic.
PubMed: 38893674
DOI: 10.3390/diagnostics14111149 -
BMC Medical Ethics Jun 2024The nursing profession considers conscience as the foundation and cornerstone of clinical practice, which significantly influences professional decision-making and...
BACKGROUND
The nursing profession considers conscience as the foundation and cornerstone of clinical practice, which significantly influences professional decision-making and elevates the level of patient care. However, a precise definition of conscience in the nursing field is lacking, making it challenging to measure. To address this issue, this study employed the hybrid approach of Schwartz Barcott and Kim to analyze the concept of conscience-based nursing care.
METHODS
This approach involves a three-phase process; theoretical, fieldwork, and analytical. A systematic literature review was conducted using electronic databases during the first phase to find relevant papers. The content of 42 articles that met the inclusion criteria was extracted to determine the attributes, antecedents, and consequences of consciousness care using thematic analysis. Based on the working definition as a product of this phase, the plan of doing the fieldwork phase was designed. During this phase, data were collected through interviews with nurses all of whom were responsible for patient care in hospitals. In this phase, 5 participants were chosen for in-depth interviewing by purposeful sampling. Data were analyzed using directed content analysis. The findings of the theoretical and fieldwork phases were integrated and the final definition was derived.
RESULTS
The integration of the theoretical and fieldwork phases resulted in identifying four key characteristics of conscience-based nursing care. Firstly, it involves providing professional care with a conscientious approach. Secondly, ethics is at the core of conscience-based care. Thirdly, external spirituality plays a significant role in shaping one's conscience in this context. Finally, conscience-based nursing care is both endogenous and exogenous, with professional commitment being the central focus of care.
CONCLUSION
Conscience-based nursing care is an essential component of ethical care, which elevates clinical practice to professional care. It requires the integration of individual and social values, influenced by personal beliefs and cultural backgrounds, and supported by professional competence, resources, and a conducive organizational atmosphere in the healthcare field. This approach leads to the provision of responsive care, moral integrity, and individual excellence, ultimately culminating in the development of professionalism in nursing.
Topics: Humans; Conscience; Nursing Care; Attitude of Health Personnel; Ethics, Nursing; Concept Formation
PubMed: 38890687
DOI: 10.1186/s12910-024-01070-8 -
Indian Journal of Otolaryngology and... Jun 2024In the 2022, World Health Organisation classification of odontogenic tumours, the clear cell odontogenic carcinoma is designated as a malignant odontogenic tumour with...
In the 2022, World Health Organisation classification of odontogenic tumours, the clear cell odontogenic carcinoma is designated as a malignant odontogenic tumour with high recurrence and aggressive behaviour. Deceptive behaviour in the context of a wide range of differentials presents a significant diagnostic problem. It is the fifth most commom type of malignant odontogenic tumor. A systematic assessment of published cases, case series, and retrospective investigations of diagnostic significance of EWSR1 gene in clear cell odontogenic carcinoma is presented to determine trends in presentation, diagnostic characteristics, treatment, and patient outcome. To locate papers reporting clear cell odontogenic carcinoma and EWSR1, extensive database searches were carried out. Demographics, tumour location, immunohistochemical and molecular tests, treatment, follow-up, and recurrence were the variables. 34 cases were detected; 52.9% (n = 18) of the cases were females. The average age was 62.5 years, with a range of 43-82 years. The average size ranged from 3.4 to 8 cm. The mandibular body was the most common location, followed by the maxilla. Maximum immunohistochemistry positivity revealed by CK 19, CKAE1/3, EMA and p63. Most common gene fusion detected was EWSR1-ATF1 in 62.4% of cases contributing to its diagnostic attributes. Surgical treatment was used in 97% of cases. The average follow-up period was 30.3 months, and recurrence was reported in 52.4% of the cases. CCOC can metastasize, and the prognosis is fair. This is first systematic review, where we have attempted to consolidate the mutational expression of EWSR1 in Clear cell odontogenic carcinoma. It is difficult to identify from other clear cell tumours of the head and neck region. It is crucial to distinguish it from other clear cell lesions because of its aggressiveness.
PubMed: 38883514
DOI: 10.1007/s12070-024-04543-9 -
Turkish Neurosurgery Feb 2024Extraventricular drainage (EVD) combined with fibrinolytics may prove effective in reducing morbidity and mortality rates associated with intraventricular cerebral...
INTRODUCTION
Extraventricular drainage (EVD) combined with fibrinolytics may prove effective in reducing morbidity and mortality rates associated with intraventricular cerebral hemorrhage (IVH). This efficacy is primarily attributed to increased drainage capacity and a decreased risk of EVD obstruction when fibrinolytics are employed. This systematic review and meta-analysis aimed to determine the effectiveness of thrombolytics in this context.
METHODS
A literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO registration number: CRD42022332152). Articles were selected from various sources, including PubMed, Trip Database, LILACS, Cochrane Library, and ScienceDirect. Clinical trials focusing on IVH treatment using EVD and/or fibrinolytics were considered. The Risk of Bias in Non-randomized Studies of Interventions (ROB 2) tool was employed for bias assessment. A fixed-effects regression model was used following heterogeneity analysis. Treatment effectiveness was evaluated based on mortality outcomes.
RESULTS
A total of 531 patients from four studies were included. The use of fibrinolytics significantly decreased IVH mortality compared with a placebo. The odds ratio (OR) for recombinant tissue plasminogen activator (rtPA) or alteplase was 0.54 [0.36; 0.82]. For urokinase (UK), the OR was 0.21 [0.03; 1.54], rendering it statistically non-significant. The overall OR was 0.52 [0.35; 0.78], and the heterogeneity I2 was 0% (indicating low heterogeneity).
CONCLUSION
While EVD alone is a common approach for managing hydrocephalus, its effectiveness is limited by potential blockages and infections. Combining EVD with UK or rtPA demonstrated improved patient outcomes. rtPA stands out as a reliable and effective option, while limited data are available regarding UK\'s effectiveness in reducing IVH mortality.
PubMed: 38874256
DOI: 10.5137/1019-5149.JTN.45919-23.1 -
Campbell Systematic Reviews Jun 2024Many intervention studies of summer programmes examine their impact on employment and education outcomes, however there is growing interest in their effect on young... (Review)
Review
REVIEW RATIONALE AND CONTEXT
Many intervention studies of summer programmes examine their impact on employment and education outcomes, however there is growing interest in their effect on young people's offending outcomes. Evidence on summer employment programmes shows promise on this but has not yet been synthesised. This report fills this evidence gap through a systematic review and meta-analysis, covering summer education and summer employment programmes as their contexts and mechanisms are often similar.
RESEARCH OBJECTIVE
The objective is to provide evidence on the extent to which summer programmes impact the outcomes of disadvantaged or 'at risk' young people.
METHODS
The review employs mixed methods: we synthesise quantitative information estimating the impact of summer programme allocation/participation across the outcome domains through meta-analysis using the random-effects model; and we synthesise qualitative information relating to contexts, features, mechanisms and implementation issues through thematic synthesis. Literature searches were largely conducted in January 2023. Databases searched include: Scopus; PsychInfo; ERIC; the YFF-EGM; EEF's and TASO's toolkits; RAND's summer programmes evidence review; key academic journals; and Google Scholar. The review employed PICOSS eligibility criteria: the was disadvantaged or 'at risk' young people aged 10-25; were either summer education or employment programmes; a valid group that did not experience a summer programme was required; studies had to estimate the summer programme's impact on violence and offending, education, employment, socio-emotional and/or health ; eligible were experimental and quasi-experimental; eligible were high-income countries. Other eligibility criteria included publication in English, between 2012 and 2022. Process/qualitative evaluations associated with eligible impact studies or of UK-based interventions were also included; the latter given the interests of the sponsors. We used standard methodological procedures expected by The Campbell Collaboration. The search identified 68 eligible studies; with 41 eligible for meta-analysis. Forty-nine studies evaluated 36 summer education programmes, and 19 studies evaluated six summer employment programmes. The number of participants within these studies ranged from less than 100 to nearly 300,000. The PICOSS criteria affects the external applicability of the body of evidence - allowances made regarding study design to prioritise evidence on UK-based interventions limits our ability to assess impact for some interventions. The risk of bias assessment categorised approximately 75% of the impact evaluations as low quality, due to attrition, losses to follow up, interventions having low take-up rates, or where allocation might introduce selection bias. As such, intention-to-treat analyses are prioritised. The quality assessment rated 93% of qualitative studies as low quality often due to not employing rigorous qualitative methodologies. These results highlight the need to improve the evidence.
RESULTS AND CONCLUSIONS
The quantitative synthesis examined impact estimates across 34 outcomes, through meta-analysis (22) or in narrative form (12). We summarise below the findings where meta-analysis was possible, along with the researchers' judgement of the security of the findings (high, moderate or low). This was based on the number and study-design quality of studies evaluating the outcome; the consistency of findings; the similarity in specific outcome measures used; and any other specific issues which might affect our confidence in the summary findings.Below we summarise the findings from the meta-analyses conducted to assess the impact of allocation to/participation in summer education and employment programmes (findings in relation to other outcomes are also discussed in the main body, but due to the low number of studies evaluating these, meta-analysis was not performed). We only cover the pooled results for the two programme types where there are not clear differences in findings between summer education and summer employment programmes, so as to avoid potentially attributing any impact to both summer programme types when this is not the case. We list the outcome measure, the average effect size type (i.e., whether a standardised mean difference (SMD) or log odds ratio), which programme type the finding is in relation to and then the average effect size along with its 95% confidence interval and the interpretation of the finding, that is, whether there appears to be a significant impact and in which direction (positive or negative, clarifying instances where a negative impact is beneficial). In some instances there may be a discrepancy between the 95% confidence interval and whether we determine there to be a significant impact, which will be due to the specifics of the process for constructing the effect sizes used in the meta-analysis. We then list the statistic and the -value from the homogeneity test as indications of the presence of heterogeneity. As the sample size used in the analysis are often small and the homogeneity test is known to be under-powered with small sample sizes, it may not detect statistically significant heterogeneity when it is in fact present. As such, a 90% confidence level threshold should generally be used when interpreting this with regard to the meta-analyses below. The presence of effect size heterogeneity affects the extent to which the average effects size is applicable to all interventions of that summer programme type. We also provide an assessment of the relative confidence we have in the generalisability of the overall finding (low, moderate or high) - some of the overall findings are based on a small sample of studies, the studies evaluating the outcome may be of low quality, there may be wide variation in findings among the studies evaluating the outcome, or there may be specific aspects of the impact estimates included or the effect sizes constructed that affect the generalisability of the headline finding. These issues are detailed in full in the main body of the review. -Engagement with/participation in/enjoyment of education (SMD):∘Summer education programmes: +0.12 (+0.03, +0.20); positive impact; = 48.76%, = 0.10; moderate confidence.-Secondary education attendance (SMD):∘Summer education programmes: +0.26 (+0.08, +0.44); positive impact; = N/A; = N/A; low confidence.∘Summer employment programmes: +0.02 (-0.03, +0.07); no impact; = 69.98%; = 0.03; low confidence.-Passing tests (log OR):∘Summer education programmes: +0.41 (-0.13, +0.96); no impact; = 95.05%; = 0.00; low confidence.∘Summer employment programmes: +0.02 (+0.00, +0.04); positive impact; = 0.01%; = 0.33; low confidence.-Reading test scores (SMD):∘Summer education programmes: +0.01 (-0.04, +0.05); no impact; = 0.40%; = 0.48; high confidence.-English test scores (SMD):∘Summer education programmes: +0.07 (+0.00, +0.13); positive impact; = 27.17%; = 0.33; moderate confidence.∘Summer employment programmes: -0.03 (-0.05, -0.01); negative impact; = 0.00%; = 0.76; low confidence.-Mathematics test scores (SMD):∘All summer programmes: +0.09 (-0.06, +0.25); no impact; = 94.53%; = 0.00; high confidence.∘Summer education programmes: +0.14 (-0.09, +0.36); no impact; = 94.15%; = 0.00; moderate confidence.∘Summer employment programmes: +0.00 (-0.04, +0.05); no impact; = 0.04%; = 0.92; moderate confidence.-Overall test scores (SMD):∘Summer employment programmes: -0.01 (-0.08, +0.05); no impact; = 32.39%; = 0.20; high confidence.-All test scores (SMD):∘Summer education programmes: +0.14 (+0.00, +0.27); positive impact; = 91.07%; = 0.00; moderate confidence.∘Summer employment programmes: -0.01 (-0.04, +0.01); no impact; = 0.06%; = 0.73; high confidence.-Negative behavioural outcomes (log OR):∘Summer education programmes: -1.55 (-3.14, +0.03); negative impact; = N/A; = N/A; low confidence.∘Summer employment programmes: -0.07 (-0.33, +0.18); no impact; = 88.17%; = 0.00; moderate confidence.-Progression to HE (log OR):∘All summer programmes: +0.24 (-0.04, +0.52); no impact; = 97.37%; = 0.00; low confidence.∘Summer education programmes: +0.32 (-0.12, +0.76); no impact; = 96.58%; = 0.00; low confidence.∘Summer employment programmes: +0.10 (-0.07, +0.26); no impact; = 76.61%; = 0.02; moderate confidence.-Complete HE (log OR):∘Summer education programmes: +0.38 (+0.15, +0.62); positive impact; = 52.52%; = 0.06; high confidence.∘Summer employment programmes: +0.07 (-0.19, +0.33); no impact; = 70.54%; = 0.07; moderate confidence.-Entry to employment, short-term (log OR):∘Summer employment programmes: -0.19 (-0.45, +0.08); no impact; = 87.81%; = 0.00; low confidence.∘Entry to employment, full period (log OR)∘Summer employment programmes: -0.15 (-0.35, +0.05); no impact; = 78.88%; = 0.00; low confidence.-Likelihood of having a criminal justice outcome (log OR):∘Summer employment programmes: -0.05 (-0.15, +0.05); no impact; = 0.00%; = 0.76; low confidence.-Likelihood of having a drug-related criminal justice outcome (log OR):∘Summer employment programmes: +0.16 (-0.57, +0.89); no impact; = 65.97%; = 0.09; low confidence.-Likelihood of having a violence-related criminal justice outcome (log OR):∘Summer employment programmes: +0.03 (-0.02, +0.08); no impact; = 0.00%; = 0.22; moderate confidence.-Likelihood of having a property-related criminal justice outcome (log OR):∘Summer employment programmes: +0.09 (-0.17, +0.34); no impact; = 45.01%; = 0.18; low confidence.-Number of criminal justice outcomes, during programme (SMD):∘Summer employment programmes: -0.01 (-0.03, +0.00); no impact; = 2.17%; = 0.31; low confidence.-Number of criminal justice outcomes, post-programme (SMD):∘Summer employment programmes: -0.01 (-0.03, +0.00); no impact; = 23.57%; = 0.37; low confidence.-Number of drug-related criminal justice outcomes, post-programme (SMD):∘Summer employment programmes: -0.01 (-0.06, +0.06); no impact; = 55.19%; = 0.14; moderate confidence.-Number of violence-related criminal justice outcomes, post-programme (SMD):∘Summer employment programmes: -0.02 (-0.08, +0.03); no impact; = 44.48%; = 0.18; low confidence.-Number of property-related criminal justice outcomes, post-programme (SMD):∘Summer employment programmes: -0.02 (-0.10, +0.05); no impact; = 64.93%; = 0.09; low confidence. We re-express instances of significant impact by programme type where we have moderate or high confidence in the security of findings by translating this to a form used by one of the studies, to aid understanding of the findings. Allocation to a summer education programme results in approximately 60% of individuals moving from never reading for fun to doing so once or twice a month (engagement in/participation in/enjoyment of education), and an increase in the English Grade Point Average of 0.08. Participation in a summer education programme results in an increase in overall Grade Point Average of 0.14 and increases the likelihood of completing higher education by 1.5 times. Signs are positive for the effectiveness of summer education programmes in achieving some of the education outcomes considered (particularly on test scores (when pooled across types), completion of higher education and STEM-related higher education outcomes), but the evidence on which overall findings are based is often weak. Summer employment programmes appear to have a limited impact on employment outcomes, if anything, a negative impact on the likelihood of entering employment outside of employment related to the programme. The evidence base for impacts of summer employment programmes on young people's violence and offending type outcomes is currently limited - where impact is detected this largely results in substantial reductions in criminal justice outcomes, but the variation in findings across and within studies affects our ability to make any overarching assertions with confidence. In understanding the effectiveness of summer programmes, the order of outcomes also requires consideration - entries into education from a summer employment programme might be beneficial if this leads towards better quality employment in the future and a reduced propensity of criminal justice outcomes.
QUALITATIVE SYNTHESIS
Various shared features among different summer education programmes emerged from the review, allowing us to cluster specific types of these interventions which then aided the structuring of the thematic synthesis. The three distinct clusters for summer education programmes were: catch-up programmes addressing attainment gaps, raising aspirations programmes inspiring young people to pursue the next stage of their education or career, and transition support programmes facilitating smooth transitions between educational levels. Depending on their aim, summer education programme tend to provide a combination of: additional instruction on core subjects (e.g., English, mathematics); academic classes including to enhance specialist subject knowledge (e.g., STEM-related); homework help; coaching and mentoring; arts and recreation electives; and social and enrichment activities. Summer employment programmes provide paid work placements or subsidised jobs typically in entry-level roles mostly in the third and public sectors, with some summer employment programmes also providing placements in the private sector. They usually include components of pre-work training and employability skills, coaching and mentoring. There are a number of mechanisms which act as facilitators or barriers to engagement in summer programmes. These include tailoring the summer programme to each young person and individualised attention; the presence of well-prepared staff who provide effective academic/workplace and socio-emotional support; incentives of a monetary (e.g., stipends and wages) or non-monetary (e.g., free transport and meals) nature; recruitment strategies, which are effective at identifying, targeting and engaging participants who can most benefit from the intervention; partnerships, with key actors who can help facilitate referrals and recruitment, such as schools, community action and workforce development agencies; format, including providing social activities and opportunities to support the formation of connections with peers; integration into the workplace, through pre-placement engagement, such as through orientation days, pre-work skills training, job fairs, and interactions with employers ahead of the beginning of the summer programme; and skill acquisition, such as improvements in social skills. In terms of the causal processes which lead from engagement in a summer programme to outcomes, these include: skill acquisition, including academic, social, emotional, and life skills; positive relationships with peers, including with older students as mentors in summer education programmes; personalised and positive relationships with staff; location, including accessibility and creating familiar environments; creating connections between the summer education programme and the students' learning at home to maintain continuity and reinforce learning; and providing purposeful and meaningful work through summer employment programmes (potentially facilitated through the provision of financial and/or non-financial incentives), which makes participants more likely to see the importance of education in achieving their life goals and this leads to raised aspirations. It is important to note that no single element of a summer programme can be identified as generating the causal process for impact, and impact results rather from a combination of elements. Finally, we investigated strengths and weaknesses in summer programmes at both the design and implementation stages. In summer education programmes, design strengths include interactive and alternative learning modes; iterative and progressive content building; incorporating confidence building activities; careful lesson planning; and teacher support which is tailored to each student. Design weaknesses include insufficient funding or poor funding governance (e.g., delays to funding); limited reach of the target population; and inadequate allocation of teacher and pupil groups (i.e., misalignment between the education stage of the pupils and the content taught by staff). Implementation strengths include clear programme delivery guidance and good governance; high quality academic instruction; mentoring support; and strong partnerships. Implementation weaknesses include insufficient planning and lead in time; recruitment challenges; and variability in teaching quality. In summer employment programmes, design strengths include use of employer orientation materials and supervisor handbooks; careful consideration of programme staff roles; a wide range of job opportunities; and building a network of engaged employers. Design weaknesses are uncertainty over funding and budget agreements; variation in delivery and quality of training between providers; challenges in recruitment of employers; and caseload size and management. Implementation strengths include effective job matching; supportive relationships with supervisors; pre-work training; and mitigating attrition (e.g., striving to increase take up of the intervention among the treatment group). Implementation weaknesses are insufficient monitors for the number of participants, and challenges around employer availability.
PubMed: 38873396
DOI: 10.1002/cl2.1406