Psychological and Behavioral Impact of Lockdown and Quarantine Measures for COVID-19 Pandemic on Children, Adolescents and Caregivers: A Systematic Review and Meta-Analysis

Abstract Background During the current ongoing COVID-19 pandemic, psychological problems like anxiety, depression, irritability, mood swings, inattention and sleep disturbance are fairly common among quarantined children in several studies. A systematic review of these publications to provide an accurate burden of these psychiatric/behavioral problems is needed for planning mitigating measures by the health authorities. Methods Different electronic databases (MEDLINE, EMBASE, Web of Science, CENTRAL, medRxiv and bioRxiv) were searched for articles describing psychological/behavioral complications in children/adolescents with/without pre-existing behavioral abnormalities and their caregivers related to the COVID-19 pandemic. Only original articles with/without comparator arms and a minimum sample size of 50 were included in the analysis. The pooled estimate of various psychological/behavioral problems was calculated using a random-effect meta-analysis. Results Fifteen studies describing 22 996 children/adolescents fulfilled the eligibility criteria from a total of 219 records. Overall, 34.5%, 41.7%, 42.3% and 30.8% of children were found to be suffering from anxiety, depression, irritability and inattention. Although the behavior/psychological state of a total of 79.4% of children was affected negatively by the pandemic and quarantine, at least 22.5% of children had a significant fear of COVID-19, and 35.2% and 21.3% of children had boredom and sleep disturbance. Similarly, 52.3% and 27.4% of caregivers developed anxiety and depression, respectively, while being in isolation with children. Conclusion Anxiety, depression, irritability, boredom, inattention and fear of COVID-19 are predominant new-onset psychological problems in children during the COVID-19 pandemic. Children with pre-existing behavioral problems like autism and attention deficit hyperactivity disorder have a high probability of worsening of their behavioral symptoms.

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Burden of predominant psychological reactions among the healthcare workers and general during COVID-19 pandemic phase: a systematic review and meta-analysis

10.1101/2021.01.02.21249126 ◽

2021 ◽

Author(s):

Bhaskar Thakur ◽

Mona Pathak

Keyword(s):

Mental Health ◽

Systematic Review ◽

Healthcare Workers ◽

Global Mental Health ◽

Meta Analysis ◽

Random Effect ◽

Anxiety And Depression ◽

Psychological Reactions ◽

Frontline Healthcare Workers ◽

Anxiety Depression

ABSTRACTAimPresent systematic review and meta-analysis examined the burden of psychological reactions predominantly anxiety, depression, stress and insomnia during novel COVID-19 pandemic phase among the frontline healthcare, non-frontline healthcare and general.MethodologyPubMed, EMBASE and SCOPUS were searched for studies between Jan 1, 2020 to May 25, 2020. Brief protocol of the systematic review was registered with the PROSPERO database, (CRD42020186229).Any study that reported the burden of at least one of psychological reactions including anxiety or depression or stress or insomnia was eligible. Heterogeneity was assessed using I2 statistic and results were synthesized using random effect meta-analysis.ResultsOut of 52eligible studies, 43 reported anxiety, 43 reported depression, 20 reported stress and 11 reported insomnia. Overall prevalence for anxiety, depression, stress and insomnia were 26.6%, 26.2%,26.2% and 34.4% respectively. Anxiety and depression were found highest among the COVID-19 patients (43.3% and 51.75 respectively). Apart from COVID-19 patients, prevalence of anxiety, depression, stress and insomnia were found highest among the frontline healthcare (27.2%, 32.1%,55.6% and 34.4% respectively) as compared to general healthcare workers (26.9%, 15.7%, 7.0% and 34.0% respectively) and general population (25.9%, 25.9%,25.4% and 29.4% respectively).ConclusionAnxiety and depression were found highest among the COVID-19 patients. Apart from COVID-19 patients, the anxiety, depression, stress and insomnia were more prevalent among frontline healthcare workers compared to general. Such increased prevalence is prompting towards the global mental health emergency. Therefore a call of urgent attention and pan-region effective mental-health intervention are required to mitigate these psychological reactions.

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Effect of pragmatic versus explanatory interventions on medication adherence in people with cardiometabolic conditions: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-036575 ◽

2020 ◽

Vol 10 (7) ◽

pp. e036575

Author(s):

Claire Fitzpatrick ◽

Clare Gillies ◽

Samuel Seidu ◽

Debasish Kar ◽

Ekaterini Ioannidou ◽

...

Keyword(s):

Systematic Review ◽

Medication Adherence ◽

Real World ◽

Meta Analysis ◽

Random Effect ◽

Routine Care ◽

Outcome Data ◽

Eligibility Criteria ◽

Novel Approach ◽

Explanatory Trials

ObjectiveTo synthesise findings from randomised controlled trials (RCTs) of interventions aimed at increasing medication adherence in individuals with type 2 diabetes (T2DM) and/or cardiovascular disease (CVD). And, in a novel approach, to compare the intervention effect of studies which were categorised as being more pragmatic or more explanatory using the Pragmatic-Explanatory Continuum Indicator Summary-2 (PRECIS-2) tool, to identify whether study design affects outcomes. As explanatory trials are typically held under controlled conditions, findings from such trials may not be relatable to real-world clinical practice. In comparison, pragmatic trials are designed to replicate real-world conditions and therefore findings are more likely to represent those found if the intervention were to be implemented in routine care.DesignSystematic review and meta-analysis.Data sourcesOvid Medline, Ovid Embase, Web of Science and CINAHL from 1 January 2013 to 31 December 2018.Eligibility criteria for selecting studiesRCTs lasting ≥3 months (90 days), involving ≥200 patients in the analysis, with either established CVD and/or T2DM and which measured medication adherence. From 4403 citations, 103 proceeded to full text review. Studies published in any language other than English and conference abstracts were excluded.Main outcome measureChange in medication adherence.ResultsOf 4403 records identified, 34 studies were considered eligible, of which 28, including 30 861 participants, contained comparable outcome data for inclusion in the meta-analysis. Overall interventions were associated with an increase in medication adherence (OR 1.57 (95% CI: 1.33 to 1.84), p<0.001; standardised mean difference 0.24 (95% CI: −0.10 to 0.59) p=0.101). The effectiveness of interventions did not differ significantly between studies considered pragmatic versus explanatory (p=0.598), but did differ by intervention type, with studies that included a multifaceted rather than a single-faceted intervention having a more significant effect (p=0.010). The analysis used random effect models and used the revised Cochrane Risk of Bias Tool to assess study quality.ConclusionsIn this meta-analysis, interventions were associated with a significant increase in medication adherence. Overall multifaceted interventions which included an element of education alongside regular patient contact or follow-up showed the most promise. Effectiveness of interventions between pragmatic and explanatory trials was comparable, suggesting that findings can be transferred from idealised to real-word conditions.PROSPERO registration numberCRD42017059460.

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How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-028280 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028280 ◽

Cited By ~ 20

Author(s):

Jan B. Schmutz ◽

Laurenz L. Meier ◽

Tanja Manser

Keyword(s):

Systematic Review ◽

Clinical Performance ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Performance Measure ◽

Task Type ◽

Eligibility Criteria ◽

Expert Rating ◽

The Relationship

ObjectivesTo investigate the relationship between teamwork and clinical performance and potential moderating variables of this relationship.DesignSystematic review and meta-analysis.Data sourcePubMed was searched in June 2018 without a limit on the date of publication. Additional literature was selected through a manual backward search of relevant reviews, manual backward and forward search of studies included in the meta-analysis and contacting of selected authors via email.Eligibility criteriaStudies were included if they reported a relationship between a teamwork process (eg, coordination, non-technical skills) and a performance measure (eg, checklist based expert rating, errors) in an acute care setting.Data extraction and synthesisModerator variables (ie, professional composition, team familiarity, average team size, task type, patient realism and type of performance measure) were coded and random-effect models were estimated. Two investigators independently extracted information on study characteristics in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsThe review identified 2002 articles of which 31 were included in the meta-analysis comprising 1390 teams. The sample-sized weighted mean correlation wasr=0.28 (corresponding to an OR of 2.8), indicating that teamwork is positively related to performance. The test of moderators was not significant, suggesting that the examined factors did not influence the average effect of teamwork on performance.ConclusionTeamwork has a medium-sized effect on performance. The analysis of moderators illustrated that teamwork relates to performance regardless of characteristics of the team or task. Therefore, healthcare organisations should recognise the value of teamwork and emphasise approaches that maintain and improve teamwork for the benefit of their patients.

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A Systematic Review and Meta-analysis on the Epidemiology of the Muscular Dystrophies

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2015.311 ◽

2015 ◽

Vol 43 (1) ◽

pp. 163-177 ◽

Cited By ~ 53

Author(s):

Jean K. Mah ◽

Lawrence Korngut ◽

Kirsten M. Fiest ◽

Jonathan Dykeman ◽

Lundy J. Day ◽

...

Keyword(s):

Systematic Review ◽

Full Text ◽

Meta Analysis ◽

Random Effect ◽

Final Analysis ◽

Muscular Dystrophies ◽

Multiple Sources ◽

Eligibility Criteria ◽

Case Ascertainment ◽

Prevalence Estimates

AbstractBackground: The muscular dystrophies are a heterogeneous group of genetic muscle diseases with variable distribution of weakness and mode of inheritance.Methods: We previously performed a systematic review of worldwide population-based studies on Duchenne and Becker muscular dystrophies; the current study focused on the epidemiology of other muscular dystrophies using Medline and EMBASE databases. Two reviewers independently reviewed all abstracts, full-text articles, and abstracted data from 1985 to 2011. Pooling of prevalence estimates was performed using random-effect models.Results: A total of 1104 abstracts and 167 full-text articles were reviewed. Thirty-one studies met all eligibility criteria and were included in the final analysis. The overall pooled prevalence of combined muscular dystrophies was 16.14 (confidence interval [CI], 11.21-23.23) per 100,000. The prevalence estimates per 100,000 were 8.26 (CI, 4.99-13.68) for myotonic dystrophy, 3.95 (CI, 2.89-5.40) for facioscapulohumeral dystrophy, 1.63 (CI, 0.94-2.81) for limb girdle muscular dystrophy, and 0.99 (CI, 0.62-1.57) for congenital muscular dystrophies.Conclusions: The studies differed widely in their approaches to case ascertainment, and substantial gaps remain in the global estimates of many other types of muscular dystrophies. Additional epidemiological studies using standardized diagnostic criteria as well as multiple sources of case ascertainment will help address the economic impact and health care burden of muscular dystrophies worldwide.

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Olfactory and gustatory dysfunction in 2019 novel coronavirus: An updated systematic review and meta-analysis

10.21203/rs.3.rs-44648/v1 ◽

2020 ◽

Author(s):

Marzieh Esmaeili ◽

Fatemeh Abdi ◽

Gita Shafiee ◽

Hadis Rastad ◽

Hamid Asayesh ◽

...

Keyword(s):

Systematic Review ◽

English Language ◽

Meta Analysis ◽

Random Effect ◽

Eligibility Criteria ◽

Language Studies ◽

Pooled Prevalence ◽

Comprehensive Search ◽

Novel Coronavirus

Abstract BackgroundEvidence showed that partial or complete loss of smell and taste might be a possible primary symptom of the 2019 novel coronavirus (COVID-19). This study aimed to systematically review and pool all available evidence on the olfactory and gustatory dysfunction in COVID-19 patients. MethodsIn this systematic review, a comprehensive search was carried out systematically through e-databases including PubMed, EMBASE, Scopus, and Web of Science (WoS); that was limited to English-language studies published from 2019 up to 6th May 2020. Afterward, all studies reported the taste and smell dysfunction in the COVID-19 patients were included. The quality of the studies was assessed by the Mixed Methods Appraisal Tool (MMAT). The pooled prevalence of olfactory and gustatory dysfunction was estimated using the random effects meta-analysis method.ResultsAmong 28 eligible included studies in this systematic review, finally, 22 studies met the eligibility criteria and were included in the meta-analysis. According to the random effect meta-analysis, the global pooled prevalence (95% confidence interval) of any olfactory dysfunction, anosmia, and hyposmia was 55% (40%-70%), 40% (22%-57%), and 40% (20%-61%) respectively. The pooled estimated prevalence of any gustatory dysfunction, ageusia, and dysgeusia was 41% (23%-59%), 31% (3%-59%), and 34% (19%-48%) respectively. ConclusionOlfactory and gustatory dysfunction is prevalent among COVID-19 patients. Therefore, olfactory and gustatory dysfunction seems to be part of important symptoms and notify for the diagnosis of COVID-19, especially in the early phase of the infection.

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Association between Smoking and Risk of Primary Biliary Cholangitis: A Systematic Review and Meta-Analysis

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-181 ◽

2019 ◽

Vol 28 ◽

pp. 197-203

Author(s):

Karn Wijarnpreecha ◽

Monia Werlang ◽

Panadeekarn Panjawatanan ◽

Paul T Kroner ◽

Omar Y Mousa ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Statistical Significance ◽

Random Effect ◽

Primary Biliary Cholangitis ◽

Case Control Studies ◽

Eligibility Criteria ◽

Inverse Variance ◽

Increased Risk ◽

Former Smokers

Background & Aims: Studies have suggested that smokers may have a higher risk of primary biliary cholangitis (PBC) although the results have been inconsistent. This systematic review and meta-analysis aim to better characterize the risk of PBC among smokers by identifying all relevant studies and summarizing their results together. Methods: A comprehensive literature review was conducted using Embase and Pubmed/MEDLINE databases from inception to September 2018 to identify all studies which compared the risk of PBC among current, ever and former smokers to non-smokers. Effect estimates from each study were extracted and combined together using the random-effect, generic inverse variance method of DerSimonian and Laird. Results: Nine case-control studies with 21,577 participants met the eligibility criteria and were included in the meta-analysis. The risk of PBC among ever smokers was significantly higher than non-smokers with the pooled odds ratio (OR) of 1.31 (95% CI, 1.03-1.67; I 2 89%). Subgroup analysis found that the risk was higher in both former smokers (pooled OR 1.36; 95% CI, 1.01-1.84; I 2 75%) and current smokers (pooled OR 1.18; 95% CI, 0.94-1.50; I 2 79%), although the latter did not reach statistical significance. Immunomodulatory and cytotoxic effect of cigarettes were the possible mechanisms behind this increased risk. Conclusions: A significantly increased risk of PBC among individuals who ever smoked was observed in this study, adding to the already long list of harmful health consequences of smoking.

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Effectiveness of online interventions in preventing depression: a protocol for systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽

10.1136/bmjopen-2018-022012 ◽

2018 ◽

Vol 8 (11) ◽

pp. e022012 ◽

Cited By ~ 1

Author(s):

Alina Rigabert ◽

Emma Motrico ◽

Patricia Moreno-Peral ◽

Davinia M Resurrección ◽

Sonia Conejo-Cerón ◽

...

Keyword(s):

Systematic Review ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Random Effect ◽

Psychosocial Interventions ◽

Controlled Trials ◽

Cochrane Central Register ◽

Online Interventions ◽

Eligibility Criteria ◽

Randomised Controlled

IntroductionAlthough evidence exists for the efficacy of psychosocial interventions in preventing depression, little is known about its prevention through online interventions. The objective of this study is to conduct a systematic review and meta-analysis of randomised controlled trials assessing the effectiveness of online interventions in preventing depression in heterogeneous populations.Methods and analysisWe will conduct a systematic review and meta-analysis of randomised controlled trials that will be identified through searches of PubMed, PsycINFO, WOS, Scopus, OpenGrey, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Australia New Zealand Clinical Trials Register . We will also search the reference lists provided in relevant studies and reviews. Experts in the field will be contacted to obtain more references. Two independent reviewers will assess the eligibility criteria of all articles, extract data and determine their risk of bias (Cochrane Collaboration Tool). Baseline depression will be required to have been discarded through standardised interviews or validated self-reports with standard cut-off points. The outcomes will be the incidence of new cases of depression and/or the reduction of depressive symptoms as measured by validated instruments. Pooled standardised mean differences will be calculated using random-effect models. Heterogeneity and publication bias will be estimated. Predefined sensitivity and subgroup analyses will be performed. If heterogeneity is relevant, random-effect meta-regression will be performed.Ethics and disseminationThe results will be disseminated through peer-reviewed publication and will be presented at a professional conference. Ethical assessment is not required as we will search and assess existing sources of literature.Trial registration numberCRD42014014804; Results.

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Factors Influencing the Association Between Coach and Athlete Rating of Exertion: a Systematic Review and Meta-analysis

Sports Medicine - Open ◽

10.1186/s40798-020-00287-2 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Darren Paul ◽

Paul Read ◽

Abdulaziz Farooq ◽

Luke Jones

Keyword(s):

Systematic Review ◽

Perceived Exertion ◽

Meta Analysis ◽

Random Effect ◽

Positive Association ◽

Rating Of Perceived Exertion ◽

Original Research ◽

Eligibility Criteria ◽

High Association ◽

The Relationship

Abstract Background Subjective monitoring of rate of perceived exertion is common practice in many sports. Typically, the information is used to understand the training load and at times modify forthcoming sessions. Identifying the relationship between the athlete and coach’s interpretation of training would likely further benefit understanding load management. The aim of this systematic review was to evaluate the relationship between coaches’ rating of intended exertion (RIE) and/or rating of observed exertion (ROE) and athletes’ reported rating of perceived exertion (RPE). Methods The review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted a search of Medline, Google Scholar, Science Direct, SPORTDiscus, and Web of Science databases. We assessed the correlation between coach-reported RIE and/or ROE and RPE. Assessment for risk of bias was undertaken using the Quality Appraisal for Reliability Studies (QAREL) checklist. Inclusion criteria were (1) male and/or female individuals, (2) individual and/or team sport active participants, and (3) original research article published in the English language. Results Data from 19 articles were found to meet the eligibility criteria. A random effect meta-analysis based on 11 studies demonstrated a positive association of player vs. coach rating of RIE (r = 0.62 [95% CI 0.5 to 0.7], p < 0.001). The pooled correlation from 7 studies of player vs. coach rating on ROE was r = 0.64 95% CI (0.5 to 0.7), p < 0.001. Conclusion There was a moderate to high association between coach RIE and/or ROE and athlete-reported RPE and this association seems to be influenced by many factors. The suggestions we present in this review are based on imploring practitioners to consider a multi-modal approach and the implications of monitoring when using RPE. Trial Registration CRD42020193387

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Psoriatic Arthritis and Risk of Vertebral Fracture: A Systematic Review and Meta-analysis

Current Rheumatology Reviews ◽

10.2174/1573397117666210908094349 ◽

2021 ◽

Vol 17 ◽

Author(s):

Nipith Charoenngam ◽

Ben Ponvilawan ◽

Jerapas Thongpiya ◽

Pitchaporn Yingchoncharoen ◽

Patompong Ungprasert

Keyword(s):

Systematic Review ◽

Psoriatic Arthritis ◽

Vertebral Fracture ◽

Cohort Studies ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Eligibility Criteria ◽

Inverse Variance ◽

Independent Review

Objective: This study was conducted in order to determine the association between psoriatic arthritis and risk of vertebral fracture by pooling the evidence from previous studies. Methods: Potentially eligible studies were identified from MEDLINE and EMBASE database from inception to March 2020 using search strategy that comprised of terms for “Psoriatic Arthritis” and “Vertebral Fracture”. Studies were eligible for the meta-analysis if they were cohort studies that included psoriatic arthritis and individuals without psoriasis and followed them for incident vertebral fracture. Studies were also required to report standardized incidence ration, hazard risk ratio or relative risk with related 95% confidence intervals (CI) comparing the incidence of vertebral fracture between the two cohorts. The retrieved point estimates with standard errors from each study were pooled into the final result by the random-effect model, generic inverse variance method. Results: A total of 26,090 articles were identified. After two rounds of independent review by three investigators, we included five cohort studies that met the eligibility criteria in the meta-analysis. PsA is significantly associated with VF the pooled odds ratio of 2.09 (95% CI, 1.11 – 3.96; I2 70%). The funnel plot was fairly asymmetric, thus, the publication bias in favor of studies may present. Conclusions: This systematic review and meta-analysis indicates that psoriatic arthritis patients have a significantly elevated risk of developing vertebral fracture.

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Statins and Risk of Cholangiocarcinoma: A Systematic Review and Meta-analysis

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-2990 ◽

2020 ◽

Vol 29 (4) ◽

pp. 629-635

Author(s):

Karn Wijarnpreecha ◽

Elizabeth S Aby ◽

Hassan Ghoz ◽

Wisit Cheungpasitporn ◽

Frank J Lukens ◽

...

Keyword(s):

Systematic Review ◽

Literature Review ◽

Odds Ratio ◽

Meta Analysis ◽

Random Effect ◽

Pooled Analysis ◽

Eligibility Criteria ◽

Comprehensive Literature Review ◽

Current Systematic Review ◽

Inverse Variance

Background and Aims: The use of statins has been shown to be associated with a decreased risk of cholangiocarcinoma (CCA) in many studies although the results have been inconsistent. We conducted this systematic review and meta-analysis to further investigate this possible association by identifying all relevant studies and combining their results together. Methods: A comprehensive literature review was conducted utilizing the MEDLINE and EMBASE databases through March 2020 to identify all studies that compared the risk of CCA among individuals who use statins with individuals who do not use statins. Effect estimates from each study were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird. Results: A total of seven studies with 6,251,187 participants fulfilled the eligibility criteria and were included in this meta-analysis. The pooled analysis found a significantly decreased risk of CCA among individuals who use statins compared with individuals who do not use statins with the pooled odds ratio of 0.68 (95% CI: 0.52-0.89; I 2 96%). Conclusions: The current systematic review and meta-analysis found a significant association between the use of statins and a decreased risk of CCA.

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