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Journal of the American Heart... Jun 2024Sinus venosus atrial septal defect (SVASD) is a rare congenital cardiac anomaly comprising 5% to 10% of all atrial septal defects. Although surgical closure is the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Sinus venosus atrial septal defect (SVASD) is a rare congenital cardiac anomaly comprising 5% to 10% of all atrial septal defects. Although surgical closure is the standard treatment for SVASD, data on outcomes have been confined to small cohorts. Thus, we conducted a systematic review of the outcomes of SVASD repair.
METHODS AND RESULTS
The primary outcome was death. Secondary outcomes encompassed atrial fibrillation, sinus node dysfunction, pacemaker insertion, cerebrovascular accident, reoperation, residual septal defect, superior vena cava obstruction, and reimplanted pulmonary vein obstruction. Pooled incidences of outcomes were calculated using a random-effects model. Forty studies involving 1320 patients who underwent SVASD repair were included. The majority were male patients (55.4%), with 88.0% presenting with associated anomalous pulmonary venous connection. The weighted mean age was 18.6±12.5 years, and the overall weighted mean follow-up period was 8.6±10.4 years. The in-hospital mortality rate was 0.24%, with a 30-day mortality rate of 0.5% reported in 780 patients. Incidences of atrial fibrillation, sinus node dysfunction, pacemaker insertion, and cerebrovascular accident over the long-term follow-up were 3.3% (2.18%-4.93%), 6.5% (5.09%-8.2%), 2.23% (1.34%-3.57%), and 2.03% (0.89%-2.46%) respectively. Reoperation occurred in 1.36% (0.68%-2.42%) of surgeries, residual septal defect in 1.34% (0.69%-2.42%), superior vena cava obstruction in 1.76% (1.02%-2.9%), and reimplanted pulmonary vein obstruction in 1.4% (0.7%-2.49%).
CONCLUSIONS
This is the first comprehensive analysis of outcomes following surgical repair of SVASD. The findings affirm the safety and effectiveness of surgery, establishing a reference point for evaluating emerging transcatheter therapies. Safety and efficacy profiles comparable to surgical repair are essential for widespread adoption of transcatheter treatments.
Topics: Humans; Heart Septal Defects, Atrial; Treatment Outcome; Cardiac Surgical Procedures; Postoperative Complications; Male; Adolescent; Young Adult; Female; Child; Hospital Mortality; Adult
PubMed: 38874063
DOI: 10.1161/JAHA.123.033686 -
Cureus May 2024Human Papillomavirus (HPV) infection is the most common sexually transmitted infection, affecting both men and women globally. Men and women are at risk of type HPV16... (Review)
Review
A Systematic Review of Knowledge, Attitudes, and Factors Influencing HPV Vaccine Acceptance Among Adolescents, Parents, Teachers, and Healthcare Professionals in the Middle East and North Africa (MENA) Region.
Human Papillomavirus (HPV) infection is the most common sexually transmitted infection, affecting both men and women globally. Men and women are at risk of type HPV16 and HPV18 viruses leading to cervical, anal, vulvar, and oropharyngeal cancers. The HPV vaccines are highly effective in preventing various strains of HPV infection, and effective vaccines are available only in the Middle East and North Africa (MENA) region. Hence, this systematic review explored knowledge and attitudes toward HPV infection and HPV vaccination and factors influencing HPV vaccination uptake among the MENA populations. Various databases, such as Medline, Science Direct, CINHAL, EBSCO, PsycINFO, and PubMed, were systematically searched to include English studies assessing knowledge, attitudes toward HPV infection, and factors influencing HPV vaccination acceptance in the MENA region. Twenty-two papers met the inclusion criteria. The number of participants ranged from 99 to 7223. While knowledge, attitude, and vaccine hesitancy association factors were generally reported in cross-sectional studies, the HPV vaccine acceptancy over time from longitudinal studies was mixed and inconclusive due to inadequate information on HPV infection and vaccination, the cost of the vaccine, cultural beliefs, and safety concerns. Results demonstrated that low HPV vaccine acceptance is due to a lack of HPV understanding among the MENA population, coupled with access issues. Factors such as awareness, confidence in vaccination, and involvement in decision-making positively influence vaccine uptake. Therefore, tailored programs addressing vaccine hesitancy in the MENA communities are necessary.
PubMed: 38872638
DOI: 10.7759/cureus.60293 -
PloS One 2024Obesity and physical inactivity among children and young people are public health concerns. Despite the wide variety of interventions available to promote physical...
BACKGROUND
Obesity and physical inactivity among children and young people are public health concerns. Despite the wide variety of interventions available to promote physical activity, little is known about which interventions are most effective. This review aimed to evaluate the existing literature on school-based interventions that aim to increase physical activity among children and young people aged 6 to 18 years.
METHODS
A systematic review of reviews was undertaken. We searched for systematic reviews and meta-analyses published between December 2017 and January 2024 using databases such as PubMed, Scopus, and CINAHL. Titles and abstracts were independently screened by two reviewers, who also conducted data extraction and quality assessments. We focused on outcomes like changes in physical activity levels and body mass index to assess the effectiveness of the interventions.
RESULTS
A total of 23 reviews examining school-based physical activity interventions met the inclusion criteria, comprising 15 systematic reviews and 8 meta-analyses. All reviews (N = 23) were implemented in the school setting: three in primary schools, seven in secondary schools, and thirteen targeted both primary and secondary schools. The findings demonstrated that six reviews reported a statistical increase in physical activity levels among the target population, and one review found a decrease in body mass index. The most promising interventions focused on physical activity included within the school curriculum and were characterised as long-term interventions. 20 out of 23 reviews assessed the quality of primary studies.
CONCLUSION
Some interventions were promising in promoting physical activity among school-aged children and young people such as Daily Mile, Active Break, and Active transport while multi-component interventions seem to be positively effective in reducing BMI. Future efforts should focus on long-term, theory-driven programmes to ensure sustainable increases in physical activity.
Topics: Humans; Exercise; Child; Adolescent; Schools; Health Promotion; Body Mass Index; School Health Services
PubMed: 38870155
DOI: 10.1371/journal.pone.0304513 -
Digital Health 2024Wearable technology is used in healthcare to monitor the health of individuals. This study presents an updated systematic literature review of the use of wearable... (Review)
Review
BACKGROUND
Wearable technology is used in healthcare to monitor the health of individuals. This study presents an updated systematic literature review of the use of wearable technology in promoting child and adolescent health, accompanied by recommendations for future research.
METHODS
This review focuses on studies involving children and adolescents aged between 2 and 18 years, regardless of their health condition or disabilities. Studies that were published from 2016 to 2024, and which met the inclusion criteria, were extracted from four academic databases (i.e. PubMed, Cochrane, Embase, and Web of Science) using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) protocol. Data on intervention purposes, interventions deployed, intervention duration, measurements, and the main outcomes of the studies were collected.
RESULTS
A total of 53 studies involving 14,852 participants were reviewed. They focused on various aspects, including the ownership and use of wearable devices ( = 3), the feasibility ( = 22), effectiveness ( = 4), and adherence ( = 2) of intervention strategies, or a combination of multiple aspects ( = 22). Among the interventions deployed, Fitbit was the most frequently used, featuring in 26 studies, followed by ActiGraph ( = 11). In intervention studies, the majority of studies focused on pre-morbidity prevention ( = 26) and the treatment of illnesses ( = 20), with limited attention given to postoperative monitoring ( = 4).
CONCLUSIONS
The use of wearable technology by children and adolescents has proven to be both feasible and effective for health promotion. This systematic review summarizes existing research by exploring the use of wearable technology in promoting health across diverse youth populations, including healthy and unhealthy individuals. It examines health promotion at various stages of the disease continuum, including pre-disease prevention, in-disease treatment, and postoperative monitoring. Additionally, the review provides directions for future research.
PubMed: 38868368
DOI: 10.1177/20552076241260507 -
Frontiers in Public Health 2024Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children.
METHODS
A comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique.
RESULT
A total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14-1.35) with extreme heterogeneity ( = 81%, < 0.001). Exposure to pesticides increased the odds of developing wheezing among children by 34% (OR = 1.34, 95% CI: 1.14-1.57), with high heterogeneity ( = 79%, < 0.001) and also increased the risk of developing lower respiratory tract infection by 79% (OR = 1.79, 95% CI: 1.45-2.21) with nonsignificant low heterogeneity ( = 30%, -value = 0.18).
CONCLUSION
This meta-analysis provided valuable evidence supporting the association between childhood asthma, wheezing, and lower respiratory tract infection with pesticide exposure. The findings would contribute to a better understanding of the estimate of the effect of pesticide exposure on respiratory health in children and inform evidence-based preventive strategies and public health interventions.
Topics: Humans; Asthma; Respiratory Sounds; Pesticides; Respiratory Tract Infections; Child; Environmental Exposure; Child, Preschool; Adolescent; Infant
PubMed: 38868160
DOI: 10.3389/fpubh.2024.1402908 -
PCN Reports : Psychiatry and Clinical... Jun 2023The current systematic review and meta-analysis aimed to explore the evidence base to date for exercise interventions/interventions that aim to increase physical... (Review)
Review
BACKGROUND
The current systematic review and meta-analysis aimed to explore the evidence base to date for exercise interventions/interventions that aim to increase physical activity using a modality that can be accessed from home (i.e., online or video-based programs), and its effects on anxiety and depression in children and adolescents.
METHODS
A broad search was conducted using six databases (PubMed, Web of Science, CINAHL, PsychINFO, ERIC and Scopus) on February 23, 2022. Studies with children or adolescents between the ages 5 and 18 years were included. Of the 2527 records that were identified, nine studies met the full-inclusion criteria. Their quality was assessed by two independent researchers using the Cochrane risk-of-bias tool for randomized trials (RoB 2) and Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. Meta analyses were conducted for studies that specifically assessed anxiety and depression.
RESULTS
The overall results indicated that there is some evidence suggesting the positive effects of exercise interventions delivered online in reducing children's and adolescents' anxiety ( = -0.99, 95% confidence interval [CI]: -1.12 to -0.86). Meanwhile, there seems to be insufficient evidence for its efficacy in reducing low mood ( = -0.42; 95% CI: -0.84 to 0.01). Motivational and coaching based interventions to increase levels of physical activity may be limited in their efficacy, whilst having children exercise along with a video or live sessions online appears promising.
CONCLUSION
The current preliminary review revealed potential benefits of at-home interventions that had children and adolescents exercise along with a video in improving anxiety.
PubMed: 38868129
DOI: 10.1002/pcn5.103 -
PCN Reports : Psychiatry and Clinical... Jun 2024This study systematically reviewed and listed support groups that are currently active in accepting people with eating disorders in Japan. The characteristics of the 50...
This study systematically reviewed and listed support groups that are currently active in accepting people with eating disorders in Japan. The characteristics of the 50 support groups for eating disorders approved for publication are listed in Table 1 in Supplementary Materials.
PubMed: 38868086
DOI: 10.1002/pcn5.183 -
BMC Medicine Jun 2024Home treatment in child and adolescent psychiatry offers an alternative to conventional inpatient treatment by involving the patient's family, school, and peers more... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Home treatment in child and adolescent psychiatry offers an alternative to conventional inpatient treatment by involving the patient's family, school, and peers more directly in therapy. Although several reviews have summarised existing home treatment programmes, evidence of their effectiveness remains limited and data synthesis is lacking.
METHODS
We conducted a meta-analysis on the effectiveness of home treatment compared with inpatient treatment in child and adolescent psychiatry, based on a systematic search of four databases (PubMed, CINAHL, PsychINFO, Embase). Primary outcomes were psychosocial functioning and psychopathology. Additional outcomes included treatment satisfaction, duration, costs, and readmission rates. Group differences were expressed as standardised mean differences (SMD) in change scores. We used three-level random-effects meta-analysis and meta-regression and conducted both superiority and non-inferiority testing.
RESULTS
We included 30 studies from 13 non-overlapping samples, providing data from 1795 individuals (mean age: 11.95 ± 2.33 years; 42.5% female). We found no significant differences between home and inpatient treatment for postline psychosocial functioning (SMD = 0.05 [- 0.18; 0.30], p = 0.68, I = 98.0%) and psychopathology (SMD = 0.10 [- 0.17; 0.37], p = 0.44, I = 98.3%). Similar results were observed from follow-up data and non-inferiority testing. Meta-regression showed better outcomes for patient groups with higher levels of psychopathology at baseline and favoured home treatment over inpatient treatment when only randomised controlled trials were considered.
CONCLUSIONS
This meta-analysis found no evidence that home treatment is less effective than conventional inpatient treatment, highlighting its potential as an effective alternative in child and adolescent psychiatry. The generalisability of these findings is reduced by limitations in the existing literature, and further research is needed to better understand which patients benefit most from home treatment.
TRIAL REGISTRATION
Registered at PROSPERO (CRD42020177558), July 5, 2020.
Topics: Humans; Mental Disorders; Adolescent; Child; Home Care Services; Treatment Outcome; Female; Male
PubMed: 38867231
DOI: 10.1186/s12916-024-03448-2 -
PloS One 2024Core strength training (CST) has been shown to improve performance in several sports disciplines. CST is recognized as one of the crucial elements that enhance athletic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Core strength training (CST) has been shown to improve performance in several sports disciplines. CST is recognized as one of the crucial elements that enhance athletic performance, particularly impacting badminton skills. Despite its popularity as a strength training method among badminton players, there is a lack of comprehensive studies examining the effectiveness of CST on the performance of these athletes.
OBJECTIVE
This study aims to ascertain CST's effects on badminton players' performance.
METHOD
This study followed PRISMA principles and conducted comprehensive searches in well-known academic databases (SCOPUS, Pubmed, CNKI, Web of Science, Core Collection, and EBSCOhost) up to August 2023. The inclusive criteria were established using the PICOS framework. Following their inclusion based on PICOS criteria, the selected studies underwent literature review and meta-analysis. The methodological quality of the assessments was evaluated using Cochrane Collaboration's risk of bias tools bias risk tools and recommendations for a graded assessment, development, and evaluation.
RESULTS
The analysis included participants aged 10-19 years from 13 studies of moderate quality, totaling 208 individuals. The CST intervention s lasted between 4 to 16 weeks, with a frequency of 1 to 4 sessions per week and each session lasting 20 to 120 minutes. Sample sizes across these studies ranged from 8 to 34 participants. According to the meta-analysis, CST significantly influenced badminton performance, particularly in areas of explosive power (ES = 0.03 P = 0.04), front-court skill (ES = 2.53, P = 0.003), and back-court skill (ES = 2.33, P = 0.002).
CONCLUSION
CST enhances badminton players' fitness (strength, power, balance, and stability), in situ (front/back-court) skills, and movement position hitting. However, its effects on speed, endurance, agility, flexibility, and coordination are unclear, revealing a research gap. The precise benefits of CST, especially on flexibility and specific hitting skills (smashes, clears, drives, net shots, crosscourt, push, and lift shots), need more investigation. Additionally, research on CST's impact on female athletes is significantly lacking.
Topics: Humans; Athletes; Athletic Performance; Muscle Strength; Racquet Sports; Resistance Training; Child; Adolescent; Young Adult
PubMed: 38865415
DOI: 10.1371/journal.pone.0305116 -
Presentation of B-cell lymphoma in childhood and adolescence: a systematic review and meta-analysis.BMC Cancer Jun 2024The diagnosis of B-cell lymphoma, one of the commonest cancers seen in childhood and adolescence, is challenging. There is a crucial need to identify and delineate the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The diagnosis of B-cell lymphoma, one of the commonest cancers seen in childhood and adolescence, is challenging. There is a crucial need to identify and delineate the prevalence of associated symptoms in order to improve early diagnosis.
AIMS
To identify clinical presentations associated with childhood and adolescent B-cell lymphomas and estimate symptom prevalence.
METHODS
A systematic review of observational studies and meta-analysis of proportions was carried out. Medline and EMBASE were systematically searched, with no language restrictions, from inception to 1st August 2022. Observational studies with at least 10 participants, exploring clinical presentations of any childhood and adolescent lymphoma, were selected. Proportions from each study were inputted to determine the weighted average (pooled) proportion, through random-effects meta-analysis.
RESULTS
Studies reported on symptoms, signs and presentation sites at diagnosis of 12,207 children and adolescents up to the age of 20. Hodgkin's lymphoma most frequently presented with adenopathy in the head-and-neck region (79% [95% CI 58%-91%]), whilst non-Hodgkin's lymphoma presented abdominally (55% [95% CI 43%-68%]). Symptoms associated with lymphoma included cervical lymphadenopathy (48% [95% CI 20%-77%]), peripheral lymphadenopathy (51% [95% CI 37%-66%]), B-symptoms (40% [95% CI 34%-44%]), fever (43% [95% CI 34%-54%]), abdominal mass (46% [95% CI 29%-64%]), weight loss (53% [95% CI 39%-66%]), head-and-neck mass (21% [95% CI 6%-47%]), organomegaly (29% [95% CI 23%-37%]), night sweats (19% [95% CI 10%-32%]), abdominal pain (28% [95% CI 15%-47%]), bone pain (17% [95% CI 10%-28%]) and abnormal neurology (11% [95% CI 3%-28%]).
CONCLUSION
This systematic review and meta-analysis of proportions provides insight into the heterogeneous clinical presentations of B-cell lymphoma in childhood and adolescence and provides estimates of symptom prevalence. This information is likely to increase public and clinical awareness of lymphoma presentations and aid earlier diagnosis. This review further highlights the lack of studies exploring childhood and adolescent lymphoma presentations in primary care, where patients are likely to present at the earliest stages of their disease.
Topics: Humans; Adolescent; Child; Lymphoma, B-Cell; Lymphadenopathy; Observational Studies as Topic; Child, Preschool; Hodgkin Disease; Prevalence
PubMed: 38862882
DOI: 10.1186/s12885-024-12372-w