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Journal of Evidence-based Medicine Nov 2019To systematically evaluate evidence against male circumcision (MC).
OBJECTIVE
To systematically evaluate evidence against male circumcision (MC).
METHODS
We searched PubMed, Google Scholar, EMBASE and Cochrane databases.
RESULTS
Database searches retrieved 297 publications for inclusion. Bibliographies of these yielded 101 more. After evaluation we found: Claims that MC carries high risk were contradicted by low frequency of adverse events that were virtually all minor and easily treated with complete resolution. Claims that MC causes psychological harm were contradicted by studies finding no such harm. Claims that MC impairs sexual function and pleasure were contradicted by high-quality studies finding no adverse effect. Claims disputing the medical benefits of MC were contradicted by a large body of high-quality evidence indicating protection against a wide range of infections, dermatological conditions, and genital cancers in males and the female sexual partners of men. Risk-benefit analyses reported that benefits exceed risks by 100-200 to 1. To maximize benefits and minimize risks, the evidence supported early infant MC rather than arguments that the procedure should be delayed until males are old enough to decide for themselves. Claims that MC of minors is unethical were contradicted by balanced evaluations of ethical issues supporting the rights of children to be provided with low-risk, high-benefit interventions such as MC for better health. Expert evaluations of case-law supported the legality of MC of minors. Other data demonstrated that early infant MC is cost-saving to health systems.
CONCLUSIONS
Arguments opposing MC are supported mostly by low-quality evidence and opinion, and are contradicted by strong scientific evidence.
Topics: Circumcision, Male; Evidence-Based Medicine; Humans; Male
PubMed: 31496128
DOI: 10.1111/jebm.12361 -
PloS One 2019Despite the relationship between physical activity (PA) and learning outcomes, the school system has not been able to support the inclusion of PA throughout the day. A... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Despite the relationship between physical activity (PA) and learning outcomes, the school system has not been able to support the inclusion of PA throughout the day. A solution to this problem integrates PA into the academic classroom. The objective of this review is to determine the impact of active classrooms compared to traditional sedentary classrooms on educational outcomes of school-aged children.
DESIGN
We searched ERIC, PubMed, PsychINFO, and Web of Science, reference lists of included studies for randomised controlled studies. Independent reviewers screened the texts of potentially eligible studies and assessed the risk of bias. Data were pooled using random-effects models on standardized mean differences.
RESULTS
This review identified 25 studies examining educational outcomes, including approximately 6,181 students. Risk of bias was assessed as either some or high risk of bias for most of the studies and outcomes. Pooled data from 20 studies and 842 participants measuring academic performance shows a small positive effect of active classrooms compared with traditional, sedentary classrooms (SMD = 0.28, 95% CI: 0.09 to 0.47).
CONCLUSIONS
Physically active classrooms may slightly improve academic achievement compared to the traditional sedentary lessons. Future research is needed to ensure that studies are adequately powered, employ appropriate methods of randomization, and measure a wide range of important student outcomes across the full spectrum of the school-age.
Topics: Academic Success; Adolescent; Child; Exercise; Female; Humans; Male; Pleasure; Randomized Controlled Trials as Topic; Schools
PubMed: 31237913
DOI: 10.1371/journal.pone.0218633 -
Revista Da Associacao Medica Brasileira... Jun 2019The term meditation can be used in many different ways, according to the technique to which it refers. Transcendental Meditation (MT) is one of these techniques. TM...
The term meditation can be used in many different ways, according to the technique to which it refers. Transcendental Meditation (MT) is one of these techniques. TM could serve as a model for research on spiritual meditation, unlike the meditation techniques based on secular knowledge. The purpose of the present study is to conduct a bibliographic review to organize scientific evidence on the effects of TM on neurophysiology, neurochemistry, and cognitive and behavioral aspects of its practitioners. To conduct this critical narrative review of the literature, we searched for scientific papers on the PubMed database of the National Center for Biotechnology Information. The keywords used in the search were Transcendental Meditation, Neuroscience of meditation e Meditation and behavior. We selected 21 papers that analyzed different aspects that could be altered through meditation practice. We concluded that TM has positive and significant documentable neurochemical, neurophysiological, and cognitive-behavioral effects. Among the main effects are the reduction of anxiety and stress (due to the reduction of cortisol and norepinephrine levels), increase of the feeling of pleasure and well-being (due to the increase of the synthesis and release of dopamine and serotonin), and influence on memory recall and possible consolidation. Further studies are needed using creative and innovative methodological designs that analyze different neural circuitry and verify the clinical impact on practitioners.
Topics: Cognition; Humans; Meditation; Nervous System; Nervous System Physiological Phenomena; Neurotransmitter Agents
PubMed: 31166449
DOI: 10.1590/1806-9282.65.5.706 -
Healthcare (Basel, Switzerland) May 2019Although technology has the potential to promote aging in place, the use of technology remains scarce among community-living older adults with dementia. A reason might...
Although technology has the potential to promote aging in place, the use of technology remains scarce among community-living older adults with dementia. A reason might be that many stakeholders are involved who all have a different perspective on technology use (i.e., needs, wishes, attitudes, possibilities, and difficulties). We systematically searched the literature in order to provide an overview of perspectives of different stakeholders on technology use among community-living older adults with dementia. After selection, 46 studies were included. We mainly found perspectives of informal caregivers and, to a lesser extent, of persons with dementia and formal caregivers. Perspectives of suppliers of technology were not present. Shared perspectives among persons with dementia and informal and formal caregivers were, among other things, ease of use, stability and flexibility of technology, importance of privacy, and confidentiality. We also found that among older persons, fun and pleasure, in addition to enhancing freedom and independence, facilitates technology use. Informal caregivers' peace of mind and relief of burden also appeared to be important in using technologies. Formal caregivers value the potential of technologies to improve monitoring and communication. Insight in shared, and conflicting perspectives of stakeholders are essential to enhance the use of technology.
PubMed: 31141999
DOI: 10.3390/healthcare7020073 -
European Journal of Orthodontics Jun 2020Social media are one of the most common and easily accessible ways of gaining information about orthodontic treatment.
BACKGROUND
Social media are one of the most common and easily accessible ways of gaining information about orthodontic treatment.
OBJECTIVE
The main objective of this study was to systematically search the literature and determine the various aspects of the interrelationship between social media and orthodontics from the patient's perspective.
SEARCH METHODS
Electronic database searches of published and unpublished literature were performed. The reference lists of all eligible articles were hand-searched for additional studies.
SELECTION CRITERIA
Randomized clinical trials (RCTs), prospective, retrospective, and cross-sectional studies were included.
DATA COLLECTION AND ANALYSIS
Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate by the first two authors.
RESULTS
One RCT, three retrospective, and four cross-sectional studies were deemed as eligible for inclusion in this review. The studies included patient's statements in social media or results from questionnaires given to patients. The social media reported were with order of frequency: Twitter, YouTube, Facebook, Google+, Pinterest, and Instagram. The feelings the patients expressed seemed to be more positive than negative: enthusiasm, self-esteem and pleasure, excitement about the aesthetic result, excitement after braces removal but also antipathy, annoyances, reduced self-esteem, and impatience for removing mechanisms. In addition, one study referred to bullying through Twitter.
LIMITATIONS
The high amount of heterogeneity precluded a valid interpretation of the results through pooled estimates.
CONCLUSIONS AND IMPLICATIONS
This systematic review demonstrated that information about orthodontics, how the patient feels, and other psychosocial facets are spread through social media. It is intuitive that research relating to the effects and impact of orthodontic interventions should account not only for the physical impacts of treatment but also to encompass patient-centered outcomes.
REGISTRATION
The protocol of this study was not registered in publicly assessable database.
CONFLICTS OF INTEREST
None to declare.
Topics: Dental Care; Esthetics, Dental; Humans; Orthodontics; Retrospective Studies; Social Media
PubMed: 31107943
DOI: 10.1093/ejo/cjz029 -
Sexual Medicine Jun 2019Women's choices for a sexual partner are influenced by numerous personal, cultural, social, political and religious factors, and may also include aspects of penile... (Review)
Review
INTRODUCTION
Women's choices for a sexual partner are influenced by numerous personal, cultural, social, political and religious factors, and may also include aspects of penile anatomy such as male circumcision (MC) status.
AIM
To perform a systematic review examining (i) whether MC status influences women's preference for sexual activity and the reasons for this, and (ii) whether women prefer MC for their sons.
METHODS
PRISMA-compliant searches were conducted of PubMed, Google Scholar, Embase, and the Cochrane Database of Systematic Reviews. Articles that met the inclusion criteria were rated for quality using the SIGN system.
RESULTS
Database searches identified 29 publications with original data for inclusion, including 22 for aim (i) and 4 of these and 7 others pertaining to aim (ii). In the overwhelming majority of studies, women expressed a preference for the circumcised penis. The main reasons given for this preference were better appearance, better hygiene, reduced risk of infection, and enhanced sexual activity, including vaginal intercourse, manual stimulation, and fellatio. In studies that assessed mothers' preference for MC of sons, health, disease prevention, and hygiene were cited as major reasons for this preference. Cultural differences in preference were evident among some of the studies examined. Nevertheless, a preference for a circumcised penis was seen in most populations regardless of the frequency of MC in the study setting.
CONCLUSION
Women's preferences generally favor the circumcised penis for sexual activity, hygiene, and lower risk of infection. The findings add to the already well-established health benefits favoring MC and provide important sociosexual information on an issue of widespread interest. Morris BJ, Hankins CA, Lumbers ER, et al. Sex and Male Circumcision: Women's Preferences Across Different Cultures and Countries: A Systematic Review. Sex Med 2019;7:145-161.
PubMed: 31031121
DOI: 10.1016/j.esxm.2019.03.003 -
Nicotine & Tobacco Research : Official... Jan 2020When animals undergo nicotine deprivation, rewards become less rewarding (ie, anhedonia occurs). We searched for tests of whether anhedonia occurs in abstinent smokers.
INTRODUCTION
When animals undergo nicotine deprivation, rewards become less rewarding (ie, anhedonia occurs). We searched for tests of whether anhedonia occurs in abstinent smokers.
METHODS
The major inclusion criterion was a within-participants comparison of behavioral measures of reward sensitivity or self-reported anhedonia during smoking versus during abstinence among daily smokers. A computerized search of PubMed, PsychInfo, and Cochrane databases and other methods located 13 studies. All but one were laboratory studies.
RESULTS
The number of studies and participants were small and the results mixed. In terms of anticipatory anhedonia (ie, wanting a reward), abstinence appeared to decrease willingness to work for immediately available rewards, but did not appear to influence how much adding rewards to a task increased responding. Abstinence also appeared to produce small increases in self-reported anticipatory anhedonia. In terms of consummatory anhedonia (ie, liking a reward), self-report measures found anhedonia decreased pleasure from rewards in some but not all tests. In terms of learning (ie, learning to choose a more frequent reward), abstinence did not reliably decrease allocating responding to high versus low frequency reward options.
CONCLUSIONS
Although results were mixed, abstinence appears to increase anticipatory anhedonia. It is unclear if abstinence increases consummatory or reward learning-based anhedonia. Further studies of anhedonia in clinical settings are needed (1) to estimate the reliability and clinical significance of anhedonia as a symptom of tobacco withdrawal, (2) to assess if effects represent withdrawal versus offset processes, and (3) to assess if anhedonia interferes with the ability to stop smoking.
IMPLICATIONS
Anticipatory anhedonia appears to be a symptom of tobacco withdrawal and should be added to tobacco withdrawal checklists and diagnostic criteria. Further study of consummatory and learning-based anhedonia is warranted.
Topics: Anhedonia; Humans; Inhibition, Psychological; Smokers; Smoking Cessation; Substance Withdrawal Syndrome; Tobacco Use Disorder
PubMed: 30726957
DOI: 10.1093/ntr/nty171 -
Frontiers in Psychology 2018Depression experienced by older adults is proving an increasing global health burden, with rates generally 7% and as high as 27% in the USA. This is likely to...
Depression experienced by older adults is proving an increasing global health burden, with rates generally 7% and as high as 27% in the USA. This is likely to significantly increase in coming years as the number and proportion of older adults in the population rises all around the world. Therefore, it is imperative that the effectiveness of approaches to the prevention and treatment of depression are understood. Creative arts interventions, including art, dance movement, drama, and music modalities, are utilized internationally to target depression and depressive symptoms in older adults. This includes interventions led by trained arts therapists as well as other health and arts professionals. However, to date there has not been a systematic review that reports effects and examines the processes (why) and mechanisms (how) of creative arts interventions are used to address depression in this older age group. This systematic review of studies on creative arts interventions for older adults experiencing depression examined: outcomes of four creative arts modalities (art, dance movement, drama, and music); with particular attention paid to processes documented as contributing to change in each modality; and mechanisms considered to result from these processes. Our analysis of 75 articles (17 art, 13 dance, 4 drama, and 41 music) indicates mostly significant quantitative or positive qualitative findings, particularly for interventions led by creative arts therapists. Mechanisms of change gleaned from the studies that were common across modalities include physical (e.g., increased muscle strength; neurochemical effects, such as endorphin release), intra-personal (e.g., enhanced self-concept, strengthened agency and mastery; processing and communication of emotions), cultural (e.g., creative expression, aesthetic pleasure), cognitive (e.g., stimulation of memory), and social (e.g., increased social skills and connection), that were all considered to contribute to reduced depression and symptoms. Recommendations for future research includes stronger focus on testing of processes and mechanisms.
PubMed: 30671000
DOI: 10.3389/fpsyg.2018.02655 -
Current Treatment Options in Oncology Nov 2018Taste sensation is vital for a healthy body as it influences our food intake, acts as a defense mechanism and elicits pleasure. Majority of the head and neck cancer... (Review)
Review
Taste sensation is vital for a healthy body as it influences our food intake, acts as a defense mechanism and elicits pleasure. Majority of the head and neck cancer (HNC) patients undergoing radiotherapy suffer from altered taste function and often complain of inability to taste their food, reduced food intake, and weakness. However, there are not many studies conducted to assess this commonly reported side effect. Furthermore, clinical research on radiotherapy-induced taste alterations has proven to be difficult, considering a lack of reliable and validated study tools for assessing objective and subjective outcomes. Developing standardized tools for assessment of taste function and conducting prospective studies in larger population of HNC is the need of the hour. Taste sensation being critically important for sustenance, we need to focus on ways to preserve it. The physical properties of proton particle enable localization of the radiation dose precisely to the tumor and minimizing the exposure of the adjacent healthy tissues. By using Intensity-Modulated Proton Therapy in HNC patients, we anticipate preserving the taste sensation by reducing the dose of radiation to the taste buds.
Topics: Ageusia; Dysgeusia; Head and Neck Neoplasms; Humans; Quality of Life; Radiation Injuries; Taste
PubMed: 30411162
DOI: 10.1007/s11864-018-0580-7 -
Journal of Child Sexual Abuse 2018Sexual violence against children in sports receives little research attention. The aim of this Preferred Reporting Items for Systematic Reviews and Meta-Analyses-based... (Review)
Review
Sexual violence against children in sports receives little research attention. The aim of this Preferred Reporting Items for Systematic Reviews and Meta-Analyses-based systematic literature review was to synthesize the up-to-date knowledge and identify the already known and the still unknown information in this area. The literature search yielded seven eligible studies for inclusion. Their key outcomes suggest that sexual violence against children in sports is prevalent. Girls are more often the victims than boys, but gender appears to mediate the disclosure. Minority groups are at higher risk for sexual violence, and athletes at higher levels of competition seem to be more vulnerable for grooming. While the coach is often seen as the perpetrator, new research suggests that peer-athletes may precede the coach. Disclosure is a problem, due to personal and interpersonal concerns, which deters scholastic research in this area. In the final section of the review, a "what we know" and "what we need to know" list of highlights is offered as the concluding summary of the review. These factual points could raise the awareness of parents and/or guardians about the vulnerability of their children to sexual abuse if they are involved in sports. They could also attract the attention of the policy makers to the urgent need of developing and implementing preventive measures to make sports and exercise environments pleasurable and safe for children.
Topics: Adolescent; Athletes; Child; Child Abuse, Sexual; Female; Humans; Male; Sports
PubMed: 29877758
DOI: 10.1080/10538712.2018.1477222