scholarly journals A systematic review and meta-analysis of non-workplace interventions to reduce time spent sedentary in adults

Author(s):  
Jessica Faye Hall ◽  
Rekesh Corepal ◽  
Thomas Frederick Crocker ◽  
Natalie Lam ◽  
Louisa-Jane Burton ◽  
...  

Background: Sedentary behaviour has been the focus of considerable clinical, policy and research interest due to its detrimental effects on health and wellbeing. This systematic review aims to (1) develop a more precise description of different categories of interventions that aim to reduce sedentary time in adults by identifying specific components that form an intervention; (2) explore the effect of different categories of interventions in reducing time spent sedentary in adults. Methods: Ten electronic databases, websites of relevant organisations (e.g. the Sedentary Behaviour Research Network), and relevant reviews were searched. Inclusion criteria: Randomised controlled trials (RCTs), including cluster and randomised cross-over trials, in the adult population (clinical and non-clinical). Any study including a measure of sedentary behaviour was included even if reducing sedentary behaviour was not the primary aim. Exclusion criteria: Interventions delivered in schools, colleges, or workplaces; studies investigating the immediate effects of breaking up sitting time as part of a supervised (usually laboratory-based) intervention. Two review authors conducted data extraction and quality assessment (GRADE approach). Results: Searches identified 39,223 records, of which 85 studies met the inclusion criteria and were included in the review. Interventions shown to significantly reduce time spent sedentary were those which incorporated the provision of information, education, or support (advice/recommendations), in conjunction with either counselling (mean difference: -52.24 minutes/day; 95% CI: -85.37 to -19.10) or a form of structured/prescribed physical activity (standardised mean difference: -0.15; 95% CI: -0.23 to -0.07). However, this positive effect was not maintained at follow-up. No interventions were shown to break up prolonged sitting. Conclusions: This review presents a novel way of categorising interventions according to the types of components they comprised. There is evidence that interventions might be effective in reducing time spent sedentary immediately post-intervention. There were limited studies measuring sustained behaviour change.

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043122
Author(s):  
Bhageerathy Reshmi ◽  
Bhaskaran Unnikrishnan ◽  
Shradha S Parsekar ◽  
Eti Rajwar ◽  
Ratheebhai Vijayamma ◽  
...  

IntroductionHealth insurance is one of the important approaches that can help in boosting universal healthcare coverage through improved healthcare utilisation and financial protection. This objectives of this review are to identify various interventions implemented in India to promote awareness of health insurance, and to provide evidence for the effectiveness of such interventions on the awareness and uptake of health insurance by the resident Indian population.Methods and analysisA systematic review will be carried out based on the Cochrane handbook for systematic reviews of interventions. The review will include experimental and analytical observational studies that have included adult population (>18 years) in India. We will include any intervention, policy or programme that directly or indirectly affects awareness or uptake of health insurance. The following outcomes will be eligible to be included: awareness or health insurance literacy, attitude such as readiness to buy health insurance or decision making, uptake of health insurance, demand-side and supply-side factors for awareness of health insurance, and awareness as a factor for uptake and re-enrolment in health insurance. Databases such as MEDLINE (PubMed), Web of Science, Scopus, 3ie impact evaluation repository and Social Science Research Network will be searched from January 2010 to 15 July 2020. Additionally, important government websites and references of the included studies will be scanned to identify potential records. Three authors, independently, will carry out screening and data extraction. Studies will be categorised into quantitative and qualitative, and mixed-methods synthesis will be employed to analyse the findings.Ethics and disseminationThis review will be based on published studies and will not recruit human participants directly, therefore, ethical clearance is not applicable. We will disseminate the final review findings in a national or international conference and publish in a peer-reviewed journal.


2016 ◽  
Vol 52 (5) ◽  
pp. 314-321 ◽  
Author(s):  
Katherine L Downing ◽  
Jill A Hnatiuk ◽  
Trina Hinkley ◽  
Jo Salmon ◽  
Kylie D Hesketh

Aim or objectiveTo evaluate the effectiveness of behavioural interventions that report sedentary behaviour outcomes during early childhood.DesignSystematic review and meta-analysis.Data sourcesAcademic Search Complete, CINAHL Complete, Global Health, MEDLINE Complete, PsycINFO, SPORTDiscus with Full Text and EMBASE electronic databases were searched in March 2016.Eligibility criteria for selecting studiesInclusion criteria were: (1) published in a peer-reviewed English language journal; (2) sedentary behaviour outcomes reported; (3) randomised controlled trial (RCT) study design; and (4) participants were children with a mean age of ≤5.9 years and not yet attending primary/elementary school at postintervention.Results31 studies were included in the systematic review and 17 studies in the meta-analysis. The overall mean difference in screen time outcomes between groups was −17.12 (95% CI −28.82 to −5.42) min/day with a significant overall intervention effect (Z=2.87, p=0.004). The overall mean difference in sedentary time between groups was −18.91 (95% CI −33.31 to −4.51) min/day with a significant overall intervention effect (Z=2.57, p=0.01). Subgroup analyses suggest that for screen time, interventions of ≥6 months duration and those conducted in a community-based setting are most effective. For sedentary time, interventions targeting physical activity (and reporting changes in sedentary time) are more effective than those directly targeting sedentary time.Summary/conclusionsDespite heterogeneity in study methods and results, overall interventions to reduce sedentary behaviour in early childhood show significant reductions, suggesting that this may be an opportune time to intervene.Trial registration numberCRD42015017090.


2021 ◽  
pp. 219256822110668
Author(s):  
Kenney K. L. Lau ◽  
Karlen K. P. Law ◽  
Kenny Y. H. Kwan ◽  
Jason P. Y. Cheung ◽  
Kenneth M. C. Cheung ◽  
...  

Study Design Systematic review and meta-analysis Objectives The present review aimed to summarize the evidence regarding differences in proprioception between children with and without adolescent idiopathic scoliosis (AIS). Methods Seven electronic databases were searched from their inception to April 10, 2021. Articles were included if they involved: (1) AIS patients aged between 10 and 18 years, (2) measurements of proprioceptive abilities, and (3) comparisons with non-AIS controls. Animal studies, case reports, commentaries, conference proceedings, research protocols, and reviews were excluded. Two reviewers independently conducted literature screening, data extraction, risks of bias assessments, and quality of evidence evaluations. Relevant information was pooled for meta-analyses. Results From 432 identified citations, 11 case-control studies comprising 1121 participants were included. The meta-analyses showed that AIS participants displayed proprioceptive deficits as compared to non-AIS controls. Moderate evidence supported that AIS participants showed significantly larger repositioning errors than healthy controls (pooled mean difference = 1.27 degrees, P < .01). Low evidence substantiated that AIS participants had significantly greater motion detection threshold (pooled mean difference = 1.60 degrees, P < .01) and abnormal somatosensory evoked potentials (pooled mean difference = .36 milliseconds, P = .01) than non-AIS counterparts. Conclusions Consistent findings revealed that proprioceptive deficits occurred in AIS patients. Further investigations on the causal relationship between AIS and proprioception, and the identification of the subgroup of AIS patients with proprioceptive deficit are needed.


Author(s):  
Raquel Arruda ◽  
Claudia Takano ◽  
Manoel Girão ◽  
Jorge Haddad ◽  
Gabriel Aleixo ◽  
...  

AbstractWe performed a systematic review and meta-analysis of randomized placebo-controlled trials that studied non-neurogenic overactive bladder patients who were treated with 100 units of onabotulinumtoxinA or placebo. The primary purpose of our study was to evaluate the clinical effectiveness with regard to urinary urgency, urinary frequency, nocturia, and incontinence episodes. Our secondary purpose consisted of evaluating the adverse effects. Our initial search yielded 532 entries. Of these, seven studies met all the inclusion criteria (prospective, randomized, placebo-controlled studies, ≥ 3 points on the Jadad scale) and were selected for analysis. For all primary endpoints, the toxin was more effective than placebo (p < 0.0001; 95% confidence interval [95CI]), namely: urgency (mean difference = -2.07; 95CI = [-2.55–1.58]), voiding frequency (mean difference = -1.64; 95CI = [-2.10–1.18]), nocturia (mean difference = -0.25; 95CI = [-0.39–0.11]) and incontinence episodes (mean difference = -2.06; 95CI= [-2.60–1.52]). The need for intermittent catheterization and the occurrence of urinary tract infection (UTI) were more frequent in patients treated with onabotulinumtoxinA than in patients treated with placebo (p < 0.0001). Compared with placebo, onabotulinumtoxinA had significantly and clinically relevant reductions in overactive bladder symptoms and is associated with higher incidence of intermittent catheterization and UTI.


Author(s):  
Bradley MacDonald ◽  
Xanne Janssen ◽  
Alison Kirk ◽  
Mhairi Patience ◽  
Ann-Marie Gibson

Sedentary behaviour is associated with poor health outcomes, and office-based workers are at significant health risk, as they accumulate large proportions of their overall sitting time at work. The aim of this integrated systematic review was to collate and synthesize published research on sedentary behaviour interventions in the workplace that have reported on at least one an aspect of the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. Studies were included if they involved adult office workers, were conducted in an office setting, and changes in sedentary behaviour had been measured as a primary outcome. Five electronic databases were searched yielding 7234 articles, with 75 articles (61 individual interventions) meeting the inclusion criteria. Reach indicators were the most frequently reported RE-AIM dimensions, which were reported on average 59% of the time. Efficacy/effectiveness was the second most reported dimension at 49% reporting across all of the indicators. Implementation indicators were reported an average of 44% of the time, with indicators of adoption and maintenance reported as the lowest of all indicators at 13% and 8%, respectively. Recommendations are provided to improve reporting across all RE-AIM dimensions, which is an important first step to enable the effective translation of interventions into real world settings.


Author(s):  
Arshid Yousefi Avarvand ◽  
Mehrdad Halaji ◽  
Donya Zare ◽  
Meysam Hasannejad-Bibalan ◽  
Hadi Sedigh Ebrahim-Saraie

Background: Streptococcus pneumoniae is an important pathogen of children, mostly in developing countries. We aimed to investigate the prevalence of invasive S. pneumoniae among Iranian children using a systematic review and meta-analysis. Methods: A systematic search was carried out to identify papers published by Iranian authors in the Web of Science, PubMed, Scopus, and Google Scholar electronic databases from January of 2010 to December of 2017. Then, seven publications that met our inclusion criteria were selected for data extraction and analysis. Results: Totally, one study was multicenter, and six were single-center based studies. Meanwhile, all of the included studied performed among hospitalized patients. Seven studies reported the prevalence of invasive S. pneumoniae isolated from children, of these the pooled prevalence of S. pneumoniae was 2.5% (95% CI: 0.7%-9.1%). Conclusion: The overall prevalence of invasive S. pneumoniae infections among Iranian children is low (2.5%). However, further clinical studies are required to elucidate the burden of infections among Iranian children, especially in eastern regions.


2021 ◽  
pp. 002203452110503
Author(s):  
X. Shu ◽  
S. He ◽  
E.C.M. Lo ◽  
K.C.M. Leung

The aim of the current systematic review was to summarize and to evaluate the available information on the effectiveness of oral exercise in improving the masticatory function of people ≥18 y. Electronic databases (Medline, Embase, CENTRAL) and gray literatures were searched (up to December 2020) for relevant randomized and nonrandomized controlled clinical trials. Two reviewers independently conducted the study selection, data extraction, and quality assessments. Meta-analysis was conducted for the comparison of bite force and masticatory performance using mean difference (MD) and standardized mean difference (SMD), respectively. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment was adopted for collective grading of the overall body of evidence. Of the 1,576 records identified, 18 studies (21 articles) were included in the analysis. Results of meta-analysis indicated that oral exercise could significantly improve the mean bite force of the participants (parallel comparison: MD, 41.2; 95% CI, 11.6–70.7, P = 0.006; longitudinal comparison: MD, 126.5; 95% CI, 105.2–144.9, P < 0.001). However, the improvement in masticatory performance was not significant (parallel comparison: SMD, 0.11; 95% CI, –0.20 to 0.42, P = 0.48; longitudinal comparison: SMD, 0.4; 95% CI, –0.11 to 0.91, P = 0.13). Results of meta-regression showed that greater improvements in bite force can be achieved among younger adults and with more intensive exercise. Chewing exercise is the most effective oral exercise, followed by clenching exercise, while simple oral exercise may not have a significant effect. Based on the results of the meta-analysis and GRADE assessment, a weak recommendation for people with declined masticatory function to practice oral exercise is made.


2020 ◽  
Vol 49 (5) ◽  
pp. 531-539
Author(s):  
Shogo Shima ◽  
Yasunari Niimi ◽  
Yosuke Moteki ◽  
Osamu Takahashi ◽  
Shinsuke Sato ◽  
...  

<b><i>Objective:</i></b> Hyponatremia is a common electrolyte disorder in patients with stroke, which leads to various fatal complications. We performed a systematic review and meta-analysis to investigate the outcomes of acute stroke patients with hyponatremia. <b><i>Methods:</i></b> We searched MEDLINE, EMBASE, and the Cochrane Library databases for relevant literature in English published up to March 2020. Two review authors independently screened and selected the studies by assessing the eligibility and validity based on the inclusion criteria. Mortality at 90 days was set as the primary end point, and in-hospital mortality and length of hospital stay were set as the secondary end points. We conducted the data synthesis and analyzed the outcomes by calculating the odds ratio (OR) and mean difference. <b><i>Results:</i></b> Of 835 studies, 15 studies met the inclusion criteria (<i>n</i> = 10,745). The prevalence rate of stroke patients with hyponatremia was 7.0–59.2%. They had significantly higher 90-day mortality (OR, 1.73; 95% confidence interval (CI), 1.24–2.42) and longer length of hospital stay (mean difference, 10.68 days; 95% CI, 7.14–14.22) than patients without hyponatremia. Patients with hyponatremia had a higher tendency of in-hospital mortality than those without hyponatremia (OR, 1.61; 95% CI, 0.97–2.69). <b><i>Conclusions:</i></b> The development of hyponatremia in the clinical course of stroke is associated with higher short-term mortality and a longer hospital stay. Although the causal relationship is unclear, hyponatremia could be a significant predictor of poor outcomes after stroke.


Author(s):  
Joao Toledo ◽  
Michelle M Haby ◽  
Ludovic Reveiz ◽  
Leopoldo Sosa Leon ◽  
Rodrigo Angerami ◽  
...  

Abstract Background Hantavirus is known to be transmitted from rodents to humans. However, some reports from Argentina and Chile have claimed that the hantavirus strain – Andes virus (ANDV) – can cause human-to-human transmission of the disease. The aim of this systematic review was to assess the evidence for human-to-human transmission of hantavirus. Methods We searched PubMed (inception to 28 February 2021), Cochrane CENTRAL, Embase, LILACS and SciELO (inception to 3 July 2020) and other sources. We included studies that assessed whether interpersonal contact with a person with laboratory-confirmed hantavirus infection led to human-to-human transmission. Two reviewers conducted screening, selection, data extraction, and risk of bias (RoB) assessment. Results Twenty-two studies met the inclusion criteria. Meta-analysis was not possible due to heterogeneity. With the exception of one prospective cohort study of ANDV in Chile with serious RoB, evidence from comparative studies (strongest level of evidence available) does not support human-to-human transmission of hantavirus infection. Non-comparative studies with a critical RoB suggest that human-to-human transmission of ANDV may be possible. Conclusions The balance of the evidence does not support the claim of human-to-human transmission of ANDV. Well-designed cohort and case-control studies that control for co-exposure to rodents are needed to inform public health recommendations.


2018 ◽  
pp. bjsports-2017-098968 ◽  
Author(s):  
Melissa M Peachey ◽  
Julie Richardson ◽  
Ada V Tang ◽  
Vanina Dal-Bello Haas ◽  
Janelle Gravesande

ObjectiveTo examine the overall effectiveness of interventions for reducing adult sedentary behaviour and to directly compare environmental, behavioural and multicomponent interventions.DesignIntervention systematic review with meta-analysis.Data sourcesOvid PsycINFO, Ovid MEDLINE, EBSCOHost CINAHL, EBSCOHost SPORTDiscus and PubMed were searched from inception to 26 July 2017.Eligibility criteriaTrials including randomised controlled trials, quasi-randomised, cluster-randomised, parallel group, prepost, factorial and crossover trials where the primary aim was to change the sedentary behaviour of healthy adults assessed by self-report (eg, questionnaires, logs) or objective measures (eg, accelerometry).ResultsThirty-eight trials of 5983 participants published between 2003 and 2017 were included in the qualitative synthesis; 35 studies were included in the quantitative analysis (meta-analysis). The pooled effect was a significant reduction in daily sitting time of −30.37 min/day (95% CI −40.86 to −19.89) favouring the intervention group. Reductions in sitting time were similar between workplace (−29.96 min/day; 95% CI −44.05 to –15.87) and other settings (−30.47 min/day; 95% CI −44.68 to –16.26), which included community, domestic and recreational environments. Environmental interventions had the largest reduction in daily sitting time (−40.59 min/day; 95% CI −61.65 to –19.53), followed by multicomponent (−35.53 min/day; 95% CI −57.27 to –13.79) and behavioural (−23.87 min/day; 95% CI −37.24 to –10.49) interventions.ConclusionInterventions targeting adult sedentary behaviour reduced daily sitting time by an average of 30 min/day, which was likely clinically meaningful.


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