A comprehensive systematic review and meta-analysis of pharmacological and dietary supplement interventions in paediatric autism: moderators of treatment response and recommendations for future research

2017 ◽  
Vol 47 (7) ◽  
pp. 1323-1334 ◽  
Author(s):  
A. Masi ◽  
A. Lampit ◽  
M. M. DeMayo ◽  
N. Glozier ◽  
I. B. Hickie ◽  
...  
Keyword(s):  
Treatment Response ◽  
Biological Markers ◽  
Meta Analysis ◽  
Geographical Location ◽  
Autism Spectrum ◽  
Qualitative Assessment ◽  
Response To Treatment ◽  
Future Research ◽  
Qualitative Synthesis ◽  
Baseline Characteristics

BackgroundAutism spectrum disorders (ASDs) are pervasive and multifactorial neurodevelopmental conditions, characterized by impairments in social communication and interaction, and restricted, repetitive patterns of behaviour, interests or activities. Treatment options to ameliorate symptoms of ASDs are limited. Heterogeneity complicates the quest for personalized medicine in this population. Our aim was to investigate if there are baseline characteristics of patients that moderate response or trial design features that impede the identification of efficacious interventions for ASDs.MethodLiterature searches of EMBASE, MEDLINE and PsycINFO identified 43 studies for qualitative assessment of baseline characterization of participants and 37 studies for quantitative analysis of moderators of treatment response. Criteria included blinded randomized controlled trials (RCTs) in paediatric ASD, with at least 10 participants per arm or 20 overall, of oral treatments, including pharmacological interventions and dietary supplements.ResultsRandom-effects meta-analysis of 1997 participants (81% male) identified three moderators associated with an increase in treatment response: trials located in Europe and the Middle-East; outcome measures designated primary status; and the type of outcome measure. Inconsistent reporting of baseline symptom severity and intellectual functioning prevented analysis of these variables. Qualitative synthesis of baseline characteristics identified at least 31 variables, with only age and gender reported in all trials. Biological markers were included in six RCTs.ConclusionsFew trials reported adequate baseline characteristics to permit detailed analysis of response to treatment. Consideration of geographical location, baseline severity and intellectual function is required to ensure generalizability of results. The use of biological markers and correlates in ASD trials remains in its infancy. There is great need to improve the application of baseline characterization and incorporation of biological markers and correlates to permit selection of participants into homogeneous subgroups and to inform response to treatment in ASD.

scholarly journals An integrative systematic review of creative arts interventions for older informal caregivers of people with neurological conditions

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243461
Author(s):  
J. Yoon Irons ◽  
Gulcan Garip ◽  
Ainslea J. Cross ◽  
David Sheffield ◽  
Jamie Bird
Keyword(s):  
Meta Analysis ◽  
Informal Caregivers ◽  
Small Sample ◽  
Cochrane Library ◽  
Future Research ◽  
Creative Arts ◽  
Qualitative Synthesis ◽  
Current Review ◽  
Neurological Conditions ◽  
Creative Interventions

Objective We aimed to assess and synthesise the current state of quantitative and qualitative research concerning creative arts interventions for older informal caregivers of people with neurological conditions. Methods A systematic search was employed to identify studies that examined creative arts interventions for older informal caregivers, which were synthesised in this integrative review. We searched the following databases: MEDLINE, PubMed, EBSCO, CINAHL, EMBASE, PsycINFO, Cochrane Library, Scopus, Web of Science, and Google Scholar. We also backwards searched references of all relevant studies and inspected trials registers. Results Of the 516 studies identified, 17 were included: one was quantitative, nine were qualitative and seven used mixed methods. All included quantitative studies were pilot or feasibility studies employing pre- and post-test design with small sample sizes. Studies varied in relation to the type of creative intervention and evaluation methods, which precluded meta-analysis. Large effect sizes were detected in wellbeing measures following singing and art interventions. The qualitative synthesis highlighted that interventions created space for caregivers to make sense of, accept and adapt to their identity as a caregiver. Personal developments, such as learning new skills, were viewed positively by caregivers as well as welcoming the opportunity to gain cognitive and behavioural skills, and having opportunities to unload emotions in a safe space were important to caregivers. Group creative interventions were particularly helpful in creating social connections with their care-recipients and other caregivers. Conclusions The current review revealed all creative interventions focused on caregivers of people living with dementia; subsequently, this identified gaps in the evidence of creative interventions for informal caregivers of other neurological conditions. There are encouraging preliminary data on music and art interventions, however, little data exists on other art forms, e.g., drama, dance. Creative interventions may appeal to many caregivers, offering a range of psycho-social benefits. The findings of the current review open the way for future research to develop appropriate and creative arts programmes and to test their efficacy with robust tools.

scholarly journals Asthma in Competitive Cross-Country Skiers: A Systematic Review and Meta-analysis

2020 ◽  
Vol 50 (11) ◽  
pp. 1963-1981
Author(s):  
Rikhard Mäki-Heikkilä ◽  
Jussi Karjalainen ◽  
Jari Parkkari ◽  
Maarit Valtonen ◽  
Lauri Lehtimäki
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Medication Use ◽  
Asthma Medication ◽  
Future Research ◽  
Bronchial Biopsy ◽  
Qualitative Synthesis ◽  
Eosinophilic Asthma ◽  
Airway Infections ◽  
Cross Country

Abstract Introduction In cross-country skiing, the repetitive ventilation of large amounts of cold and dry air strains the airways. The aim of this systematic review was to establish an overview of the current literature on asthma in cross-country skiers, biathletes and ski-orienteers. Methods Six databases were searched on August 29, 2019. The search yielded 2161 articles. Thirty articles fulfilled the search criteria and were pooled together for a qualitative synthesis. Eight articles were included in the meta-analysis on the prevalence of asthma and the use of asthma medication. Results According to the meta-analysis, the prevalence of self-reported physician-diagnosed asthma in skiers was 21% (95% CI 14–28%). The onset age of asthma was higher in skiers than in non-skiers with asthma. The prevalence of asthma medication use was on average 23% (CI 95% 19–26%). Several studies reported that asthma was underdiagnosed in skiers, as previously healthy skiers without a prior asthma diagnosis or medication use were frequently found to fulfill diagnostic criteria for asthma according to lung function tests. Studies using bronchial biopsy demonstrated that eosinophilic asthma is not detected in skiers with asthma as often as it is in non-skiers with asthma and that there are signs of airway inflammation even in non-asthmatic skiers. Conclusion Our findings suggest that the accuracy and coverage of diagnosing asthma in skiers has improved over the recent decades. However, the optimal treatment and natural course of asthma in this population remain unclear. Future research should investigate how the intensity of training, airway infections and their treatment affect the development of asthma among skiers. PRD registration number CRD42017070940.

scholarly journals Defining the core components of Family Navigation for autism spectrum disorder

Autism ◽  
2019 ◽  
Vol 24 (2) ◽  
pp. 526-530 ◽  
Author(s):  
Sarabeth Broder-Fingert ◽  
Nicole A Stadnick ◽  
Emily Hickey ◽  
Julia Goupil ◽  
Yaminette Diaz Lindhart ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Future Research ◽  
Qualitative Synthesis ◽  
Intervention Component ◽  
The Core ◽  
Training And Supervision ◽  
Core Components ◽  
Intervention Description

This study aimed to define the core components of Family Navigation for autism spectrum disorder, a promising intervention to reduce disparities in care for this population. Teams from four trials of Family Navigation for autism spectrum disorder completed the Template for Intervention Description and Replication checklist to outline intervention components. Through intervention component analysis and qualitative synthesis, we identified 11 core components across three domains: Training and Supervision, Navigator Tools, and Navigator Activities. We discuss the importance of identifying these core components and implications for future research and practice.

scholarly journals 15 years of introgression studies: quantifying gene flow across Eukaryotes

2021 ◽  
Author(s):  
Andrius J Dagilis ◽  
David Peede ◽  
Jenn M Coughlan ◽  
Gaston I Jofre ◽  
Emmanuel R R D'Agostino ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Divergence Time ◽  
Taxonomic Group ◽  
Qualitative Assessment ◽  
Future Research ◽  
Unified Approach ◽  
Sequencing Technology ◽  
Next Generation Sequencing Technology ◽  
Comprehensive Survey ◽  
Generation Sequencing

With the rise of affordable next generation sequencing technology, introgression - or the exchange of genetic materials between taxa - is widely perceived to be a ubiquitous phenomenon in nature. Although this claim is supported by several keystone studies, no thorough assessment on the frequency of introgression in nature has been performed to date. In this manuscript, we aim to address this knowledge gap by providing a meta-analysis of the most comprehensive survey of introgression studies in Eukaryotes to date (724 papers with claims of introgression). We first examined the evidence given to support introgression, and if/how the lines of evidence have changed across time. We then collated a single statistic, Patterson's D, that quantifies the strength of introgression across 123 studies to further assess how taxonomic group, divergence time, and aspects of life history influence introgression. We find three main results. Studies on introgression are much more frequent in plants and mammals than any other taxonomic group. The study of introgression has shifted from a largely qualitative assessment of whether introgression happens, to a focus on when and how much introgression has occurred across taxa. The most-often used introgression statistic, Patterson's D, shows several intriguing patterns suggesting introgression reports may be biased by both differences in reporting criteria and sequencing technology, but may also differ across taxonomic systems and throughout the process of speciation. Together, these results suggest the need for a unified approach to quantifying introgression in natural communities, and highlight important areas of future research that can be better assessed once this unified approach is met.

scholarly journals Rates of Attrition and Dropout in App-Based Interventions for Chronic Disease: Systematic Review and Meta-Analysis (Preprint)

2020 ◽  
Author(s):  
Gideon Meyerowitz-Katz ◽  
Sumathy Ravi ◽  
Leonard Arnolda ◽  
Xiaoqi Feng ◽  
Glen Maberly ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Meta Analysis ◽  
Dropout Rate ◽  
Dropout Rates ◽  
Dropping Out ◽  
Future Research ◽  
Controlled Trials ◽  
Qualitative Synthesis ◽  
Attrition Rates ◽  
Central Register

BACKGROUND Chronic disease represents a large and growing burden to the health care system worldwide. One method of managing this burden is the use of app-based interventions; however attrition, defined as lack of patient use of the intervention, is an issue for these interventions. While many apps have been developed, there is some evidence that they have significant issues with sustained use, with up to 98% of people only using the app for a short time before dropping out and/or dropping use down to the point where the app is no longer effective at helping to manage disease. OBJECTIVE Our objectives are to systematically appraise and perform a meta-analysis on dropout rates in apps for chronic disease and to qualitatively synthesize possible reasons for these dropout rates that could be addressed in future interventions. METHODS MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed, Cochrane CENTRAL (Central Register of Controlled Trials), and Embase were searched from 2003 to the present to look at mobile health (mHealth) and attrition or dropout. Studies, either randomized controlled trials (RCTs) or observational trials, looking at chronic disease with measures of dropout were included. Meta-analysis of attrition rates was conducted in Stata, version 15.1 (StataCorp LLC). Included studies were also qualitatively synthesized to examine reasons for dropout and avenues for future research. RESULTS Of 833 studies identified in the literature search, 17 were included in the review and meta-analysis. Out of 17 studies, 9 (53%) were RCTs and 8 (47%) were observational trials, with both types covering a range of chronic diseases. The pooled dropout rate was 43% (95% CI 29-57), with observational studies having a higher dropout rate (49%, 95% CI 27-70) than RCTs in more controlled scenarios, which only had a 40% dropout rate (95% CI 16-63). The studies were extremely varied, which is represented statistically in the high degree of heterogeneity (I<sup>2</sup>&gt;99%). Qualitative synthesis revealed a range of reasons relating to attrition from app-based interventions, including social, demographic, and behavioral factors that could be addressed. CONCLUSIONS Dropout rates in mHealth interventions are high, but possible areas to minimize attrition exist. Reducing dropout rates will make these apps more effective for disease management in the long term. CLINICALTRIAL International Prospective Register of Systematic Reviews (PROSPERO) CRD42019128737; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019128737

scholarly journals The Impact of Maternal Obesity on Human Milk Macronutrient Composition: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 773-773
Author(s):  
Gabriela Leghi ◽  
Merryn J Netting ◽  
Philippa F Middleton ◽  
Mary E Wlodek ◽  
Donna T Geddes ◽  
...  
Keyword(s):  
Human Milk ◽  
Maternal Obesity ◽  
Meta Analysis ◽  
Overweight And Obesity ◽  
Qualitative Assessment ◽  
Cochrane Library ◽  
Qualitative Synthesis ◽  
Lactating Women ◽  
Maternal Overweight ◽  
The Impact

Abstract Objectives This article aimed to provide a synthesis of studies evaluating the effects of maternal overweight and obesity, including body mass index (BMI) and other measures of adiposity, on the concentrations of macronutrients (fat, protein and lactose) in human milk (HM). Methods EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science and ProQuest databases were searched for relevant articles. Two authors conducted screening, data extraction and quality assessment independently. Meta-analyses of eligible studies were conducted using Review Manager software version 5.3. Results A total of 31 studies (5078 lactating women) were included in the qualitative synthesis and 9 studies (872 lactating women) in the quantitative synthesis. The meta-analysis indicated that maternal overweight and obesity were associated with higher concentrations of fat in mature HM (p = 0.01) and lactose in colostrum (p = 0.002). While the qualitative analyses broadly supported the findings of the meta-analysis, the qualitative assessment identified considerable variability in the results between studies and low quality of many of the included studies, making it difficult to draw robust conclusions. Conclusions Overall, maternal BMI and adiposity measurements were associated with differences in the concentrations of fat and lactose in HM, however the direction of change was dependent on the stage of lactation, whereas protein concentration in HM did not appear to differ between overweight and/or obese and normal weight women. This is particularly relevant considering potential implications of higher HM fat concentration on both growth and fat deposition during the first few months of infancy and long-term risk of obesity. Funding Sources GEL was supported by a FOODplus Early Life Nutrition Scholarship, The University of Adelaide. BSM received a Career Development Award from the National Health and Medical Research Council of Australia (NHMRC).

A Meta-Analysis of Paraprofessional-Delivered Interventions to Address Challenging Behavior Among Students With Disabilities

2020 ◽  
pp. 109830072091114
Author(s):  
Virginia L. Walker ◽  
Megan E. Carpenter ◽  
Kristin J. Lyon ◽  
Lindsey Button
Keyword(s):  
Students With Disabilities ◽  
Challenging Behavior ◽  
Behavioral Interventions ◽  
Single Case ◽  
Meta Analysis ◽  
Challenging Behaviors ◽  
Autism Spectrum ◽  
Future Research ◽  
School Environments ◽  
Wide Range

Paraprofessionals report spending a substantial amount of time addressing challenging behavior in a range of school environments, yet identify behavioral intervention as a high-priority training area. The purpose of this meta-analysis was to systematically review and summarize single-case intervention studies involving paraprofessional-delivered behavioral interventions for students with disabilities. Descriptive findings suggest that, among the reviewed studies, paraprofessionals primarily provided behavioral support to students with autism spectrum disorder, intellectual disability, and multiple disabilities who engage in a wide range of challenging behaviors in both inclusive and noninclusive school environments. Overall, training largely was delivered by researchers and resulted in positive paraprofessional implementation outcomes. Likewise, paraprofessional-implemented behavioral interventions contributed to desirable changes in student challenging and appropriate behavior, with effect size estimates significantly higher for interventions delivered to early childhood–age students and within inclusive school settings. Implications for practice, limitations, and future research directions are described.

scholarly journals A Systematic Review and Meta-Analysis of the Incidence Rate of Takayasu Arteritis

2020 ◽  
Author(s):  
Megan Rutter ◽  
Jonathan Bowley ◽  
Peter C. Lanyon ◽  
Matthew J. Grainge ◽  
Fiona A. Pearce
Keyword(s):  
Incidence Rate ◽  
Takayasu Arteritis ◽  
Meta Analysis ◽  
Geographical Location ◽  
Incidence Rates ◽  
Future Research ◽  
Autoimmune Rheumatic Disease ◽  
Global Epidemiology ◽  
Newcastle Ottawa Scale ◽  
Different Populations

AbstractObjectivesTakayasu arteritis (TAK), is a rare autoimmune rheumatic disease causing large vessel vasculitis. Onset is typically between the ages of 20-30. It is associated with substantial morbidity and mortality, notably due to its effects on the cardiovascular system. It has a poorly understood global epidemiology. Our objective was to systematically review the available evidence in order to calculate the incidence rate of TAK.MethodsThree databases (Medline, PubMed and Embase) were searched in November 2019 and the results were screened by two reviewers. A random effects meta-analysis was then conducted in R to calculate the overall incidence rate. Heterogeneity was assessed using I2. The quality of the studies was assessed using an adapted Newcastle-Ottawa scale. Further sub-group analyses were performed by quality, sex, research setting and geographical location. Publication bias was assessed using a Begg’s funnel plot.ResultsThe incidence rate for TAK per million person-years with 95% confidence intervals was 1.11 per million person years (95% CI 0.75 – 1.65). The heterogeneity in the data was extremely high in all analyses, which suggests that there was considerable variation in incidence rates across the different populations studied. TAK was found to be more common in women (incidence rate 2.01 per million person-years, 95% CI 1.39-2.90).ConclusionsTAK is an extremely rare disease. It affects women more commonly than men. There is considerable variation in the incidence rate between populations. We suggest that future research should focus on discrete populations in order to better identify genetic and environmental risk factors.

scholarly journals Vaccine Research in COVID-19: A Living Scoping Review Protocol

2020 ◽  
Author(s):  
Jieyun Li ◽  
Lufang Feng ◽  
Haitong Zhao ◽  
Kehu Yang ◽  
Cuncun Lu
Keyword(s):  
Scoping Review ◽  
Meta Analysis ◽  
Effective Means ◽  
Reporting Quality ◽  
Cochrane Library ◽  
Future Research ◽  
Qualitative Synthesis ◽  
Research Activities ◽  
Review Protocol ◽  
Research Questions

Abstract Background: Coronavirus disease 2019 (COVID-19) has become a global public problem and a pandemic event. Since the epidemic outbreak, deaths and cumulative confirmed positive cases have continued rising rapidly worldwide. Vaccines are regarded as one of the most effective means of preventing and controlling an epidemic. With the spread of COVID-19, a large number amount of literature on vaccines has been published recently. There is a pressing need to map the research activities of COVID-19 vaccines.Methods: Following Arksey and O’Malley’s framework and Joanna Briggs Institute (JBI) methodological guidance, a scoping review is proposed to summarize the extent/breadth, range, and nature of evidence in research related to COVID-19 vaccines. Based on the research questions we have developed by ours, a comprehensive search will be performed in Cochrane Library, Embase, PubMed, Web of Science, CNKI, CBM, VIP, and WanFang databases by two independent reviewers. According to our predefined inclusion criteria, pairs of reviewers will independently assess the eligibility of identified studies from the databases. Following literature selection, pairs of reviewers will extract relevant information related to our research questions. The methodological quality and reporting quality of key evidence types (i.e., randomized controlled trials, systematic reviews and meta-analyses) will be evaluated using commonly used tools, if possible. Qualitative synthesis and descriptive statistics will be used to summarize and present the results. In addition, new or updated meta-analysis will be conducted to pool the data available in included primary studies where possible. To track the trends in COVID-19 vaccines research, we plan to update our results every 2~3 months. Preparation of this scoping review protocol referred to PRISMA-P checklist, and the reporting of the following full-text will be using PRISMA-ScR guidelines.Discussion: We believe the results of this scoping review on COVID-19 vaccine will contribute to provide foundational knowledge, and have significant value for the research and practice of COVID-19 vaccines. The findings will also allow us to identify research gaps on this topic and help to guide the future research of COVID-19 vaccines well.

Descriptive Analysis and Meta Analysis of Studies Investigating the Effectiveness of Simultaneous Prompting Procedure

2018 ◽  
Vol 85 (3) ◽  
pp. 309-328 ◽  
Author(s):  
Elif Tekin-Iftar ◽  
Seray Olcay-Gul ◽  
Belva C. Collins
Keyword(s):  
Single Case ◽  
Meta Analysis ◽  
Descriptive Analysis ◽  
Autism Spectrum ◽  
Effect Sizes ◽  
Future Research ◽  
Simultaneous Prompting ◽  
Case Methodology ◽  
Methodological Rigor ◽  
Present Systematic Review

Researchers have investigated the simultaneous prompting (SP) procedure across three decades; however, no meta-analysis has been conducted. In the present systematic review, we conducted both a descriptive and meta-analysis of SP studies from a seminal publication of an SP study through 2017. Our search resulted in 20 studies published in English in internationally disseminated peer-reviewed journals that used single-case methodology and also met criteria for methodological rigor. To analyze effect sizes, we used percentage of non-overlapping points and Tau- U, with both revealing highly consistent results. We concluded that there is a substantial body of evidence to support the SP procedure to teach a variety of skills to individuals with disabilities when consistent parameters of the procedure are employed; however, future research is needed to specifically validate the procedure as effective in regard to specific types of disability (e.g., autism spectrum disorder) and specific types of tasks.

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