A Meta-analysis of Sensitivity-related Factors of Child Care Teachers

Author(s):  
Eui-Yeon Na ◽  
Gwang-Yong Gim
BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051554
Author(s):  
Pascal Richard David Clephas ◽  
Sanne Elisabeth Hoeks ◽  
Marialena Trivella ◽  
Christian S Guay ◽  
Preet Mohinder Singh ◽  
...  

IntroductionChronic post-surgical pain (CPSP) after lung or pleural surgery is a common complication and associated with a decrease in quality of life, long-term use of pain medication and substantial economic costs. An abundant number of primary prognostic factor studies are published each year, but findings are often inconsistent, methods heterogeneous and the methodological quality questionable. Systematic reviews and meta-analyses are therefore needed to summarise the evidence.Methods and analysisThe reporting of this protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. We will include retrospective and prospective studies with a follow-up of at least 3 months reporting patient-related factors and surgery-related factors for any adult population. Randomised controlled trials will be included if they report on prognostic factors for CPSP after lung or pleural surgery. We will exclude case series, case reports, literature reviews, studies that do not report results for lung or pleural surgery separately and studies that modified the treatment or prognostic factor based on pain during the observation period. MEDLINE, Scopus, Web of Science, Embase, Cochrane, CINAHL, Google Scholar and relevant literature reviews will be searched. Independent pairs of two reviewers will assess studies in two stages based on the PICOTS criteria. We will use the Quality in Prognostic Studies tool for the quality assessment and the CHARMS-PF checklist for the data extraction of the included studies. The analyses will all be conducted separately for each identified prognostic factor. We will analyse adjusted and unadjusted estimated measures separately. When possible, evidence will be summarised with a meta-analysis and otherwise narratively. We will quantify heterogeneity by calculating the Q and I2 statistics. The heterogeneity will be further explored with meta-regression and subgroup analyses based on clinical knowledge. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guideline 28.Ethics and disseminationEthical approval will not be necessary, as all data are already in the public domain. Results will be published in a peer-reviewed scientific journal.PROSPERO registration numberCRD42021227888.


2021 ◽  
Vol 6 (4) ◽  
pp. e005413
Author(s):  
Valeria Raparelli ◽  
Colleen M. Norris ◽  
Uri Bender ◽  
Maria Trinidad Herrero ◽  
Alexandra Kautzky-Willer ◽  
...  

Gender refers to the socially constructed roles, behaviours, expressions and identities of girls, women, boys, men and gender diverse people. Gender-related factors are seldom assessed as determinants of health outcomes, despite their powerful contribution. The Gender Outcomes INternational Group: to Further Well-being Development (GOING-FWD) project developed a standard five-step methodology applicable to retrospectively identify gender-related factors and assess their relationship to outcomes across selected cohorts of non-communicable chronic diseases from Austria, Canada, Spain, Sweden. Step 1 (identification of gender-related variables): Based on the gender framework of the Women Health Research Network (ie, identity, role, relations and institutionalised gender), and available literature for a certain disease, an optimal ‘wish-list’ of gender-related variables was created and discussed by experts. Step 2 (definition of outcomes): Data dictionaries were screened for clinical and patient-relevant outcomes, using the International Consortium for Health Outcome Measurement framework. Step 3 (building of feasible final list): a cross-validation between variables per database and the ‘wish-list’ was performed. Step 4 (retrospective data harmonisation): The harmonisation potential of variables was evaluated. Step 5 (definition of data structure and analysis): The following analytic strategies were identified: (1) local analysis of data not transferable followed by a meta-analysis combining study-level estimates; (2) centrally performed federated analysis of data, with the individual-level participant data remaining on local servers; (3) synthesising the data locally and performing a pooled analysis on the synthetic data and (4) central analysis of pooled transferable data. The application of the GOING-FWD multistep approach can help guide investigators to analyse gender and its impact on outcomes in previously collected data.


2017 ◽  
Vol 14 (2) ◽  
pp. 1242 ◽  
Author(s):  
Filiz Kantek ◽  
Kamile Kabukcuoğlu

Burnout syndrome is still among the leading problems of nursing profession. Reduction and prevention of burnout will be possible with a better understanding of the relevant factors. The purpose of this study is to evaluate the effects of certain variables on burnout levels of nurses in Turkey with a meta analysis. The study was conducted with a meta analysis. A number of online databases were reviewed including Turkish Medical Index, Google scholar, National Thesis Center, Pubmed, EBSCO Host, and Web of Science by searching for certain keywords such as  “Emotional exhaustion”, “Depersonalization”, “personal accomplishment”, “burnout”, “nurse”, and “Turkey”  both in Turkish and English. The results of the review indicated that there were 11 studies for sex, 17 studies for marital status, 20 studies for educational status, 7 studies for the type of institution, and 8 studies for willingness to choose nursing and the work shift that were found eligible for the inclusion criteria. The study data were analyzed with CMA. The homogeneity of the studies was tested with Q and I2 values. The study bias was assessed with Orwin’s Fail-Safe N and Tau coefficients. The effect size was calculated with random effects and fixed effects models.  The study findings indicated that burnout was affected by sex, the type of institution, and the work shift at lower levels and by willingness to choose nursing at moderate levels. It was similarly found that depersonalization dimension was affected by the type of institution, the work shift, and willingness to choose nursing at lower levels. ÖzetTükenmişlik hemşireler için hala önemli problemlerden biridir. Tükenmişliğin azaltılması ve önlenmesi ilgili faktörlerin daha iyi anlaşılması ile mümkün olacaktır. Bu çalışmanın amacı, Meta analiz yöntemi kullanarak Türkiye’deki hemşirelerin tükenmişlik düzeyleri üzerine bazı değişkenlerin etkisini incelemektir. Çalışmada meta analiz yöntemi kullanıldı. İlgili çalışmalara ulaşmak için Türk Tıp Dizini, Google Akademik, YÖK tez merkezi, Pubmed,  EBSCO Host, Web of Science veri tabanları tarandı. Taramada “Tükenmişlik”, “duygusal tükenmişlik”, “Duyarsızlaşma”, “kişisel başarı” “hemşire” ve “Türkiye” anahtar sözcükleri Türkçe ve İngilizce olarak kullanıldı. Cinsiyet için 11, Medeni durum için 17, eğitim durumu için 20, kurum tipi için 7, mesleği isteyerek seçme durumu ve çalışma şekli için 8 çalışma dahil edilme kriterlerine uygundu. Verilerin analizinde CMA istatistik programı kullanıldı. Meta analize dahil edilen çalışmaların homojenliğini test etmek için Q ve I2 değerleri hesaplandı. Yayın yanlılığını test etmek için Orwin’s Fail-Safe N ve Tau-kare katsayısı hesaplaması yapıldı. Etki büyüklüğünün incelenmesinde rastgele etkiler ve sabit etkiler modeli kullanıldı. Bulgular duygusal tükenme üzerine cinsiyet, kurum tipi ve çalışma şeklinin düşük, mesleği isteyerek seçme durumunun orta düzeyde önemli etkiye sahip olduğunu ortaya koydu. Duyarsızlaşma boyutu üzerine kurum tipi, çalışma şekli ve mesleği isteyerek seçme durumu değişkenlerinin düşük düzeyde önemli etkiye sahip olduğu belirlendi.


2020 ◽  
Author(s):  
Valeria Raparelli Raparelli ◽  
Colleen M. Norris ◽  
Uri Bender ◽  
Maria Trinidad Herrero ◽  
Alexandra Kautzky-Willer ◽  
...  

Abstract Background: Gender refers to the socially constructed roles, behaviors, expressions, and identities of girls, women, boys, men, and gender diverse people. It influences self-perception, individual’s actions and interactions, as well as the distribution of power and resources in society. Gender-related factors are seldom assessed as determinants of health outcomes, despite their powerful contribution.Methods: Investigators of the GOING-FWD project developed a standard methodology applicable for observational studies to retrospectively identify gender-related factors to assess their relationship to outcomes and applied this method to selected cohorts of non-communicable chronic diseases from Austria, Canada, Spain, Sweden.Results: The following multistep process was applied. Step 1 (Identification of Gender-related Variables): Based on the gender framework of the Women Health Research Network (i.e. gender identity, role, relations, and institutionalized gender), and available literature for a certain disease, an optimal “wish-list” of gender-related variables/factors was created and discussed by experts. Step 2 (Definition of Outcomes): each of the cohort data dictionaries were screened for clinical and patient relevant outcomes, using the ICHOM framework. Step 3 (Building of Feasible Final List): A cross-validation between gender-related and outcome variables available per database and the “wish-list” was performed. Step 4 (Retrospective Data Harmonization): The harmonization potential of variables was evaluated. Step 5 (Definition of Data Structure and Analysis): Depending on the database data structure, the following analytic strategies were identified: (1) local analysis of data not transferable followed by a meta-analysis combining study-level estimates; (2) centrally performed federated analysis of anonymized data, with the individual-level participant data remaining on local servers; (3) synthesizing the data locally and performing a pooled analysis on the synthetic data; and (4) central analysis of pooled transferable data.Conclusion: The application of the GOING-FWD systematic multistep approach can help guide investigators to analyze gender and its impact on outcomes in previously collected data.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S284-S285
Author(s):  
Jemma Reid ◽  
Naomi A Fineberg ◽  
Lynne Drummond ◽  
Keith Laws ◽  
Matteo Vismara ◽  
...  

AimsSince the 1970s treatment for obsessive Compulsive Disorder (OCD) has consisted of the the application of drugs acting on the serotonin system of the brain or psychological treatments using graded exposure. Although there is a large number of studies on psychological treatments, they often are underpowered. Other major methodological issues include ignoring the effects of medication during the trial, using a variety of techniques and using waiting list data as controls.We decided to systematically review and perform a meta-analysis on randomised controlled trials (RCTs) of CBT with ERP (abbreviated to ERP)1.MethodThe study was preregistered in PROSPERO (CRD42019122311). RCTs incorporating ERP were examined. The primary outcome was the end-of-trial symptoms scores for OCD. In addition, factors which may have influenced the outcome including patient-related factors, type of control intervention, researcher allegiance and other potential forms of bias were examined. The moderating effects of patient-related and study-related factors including type of control intervention and risk of bias were also examined.ResultOverall, 36 studies were included in the analyses, involving 537 children/adolescents and 1483 adults (total 2020 subjects). A total of 1005 received ERP and the remainder a variety of control treatments. Initial results showed that ERP had a large effect size compared with placebo treatments. This was more marked in younger than older persons. However, whereas ERP was markedly more effective than waiting list or psychological control, this positive effect size disappeared when it was compared with other psychological treatments.When ERP was compared against psychopharmacological treatment it initially appeared significantly superior but this reduced to marginal benefit when compared with adequate doses of appropriate medication.The majority of studies were performed where there may be expected to be researcher allegiance to ERP and in these studies the effect size was large. In contrast, in the 8 studies considered to have low risk of researcher bias, ERP was found to be ineffective.ConclusionAlthough on initial sight CBT incorporating ERP seems to be highly efficacious in the treatment of OCD, further analysis revealed that this varied depending on the choice of comparator control. In addition there are considerable concerns about methodological rigour and reporting of studies using CBT with ERP. Further studies examining the role of researcher bias and allegiance are needed.Ref : 1 Jemma E Reid, Keith R Laws, Lynne Drummond, Matteo Vismara, Benedetta Grancini , Davis Mpavaenda, Naomi A Fineberg (2021) Cognitive Behavioural Therapy with Exposure and Response Prevention in the treatment of Obsessive-Compulsive Disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive Psychiatry , in press.


2018 ◽  
Vol 13 (9) ◽  
pp. 913-920 ◽  
Author(s):  
Jan-Dirk Vermeij ◽  
Willeke F Westendorp ◽  
Diederik van de Beek ◽  
Paul J Nederkoorn

This review provides an update of evidence on post-stroke infections and the use of preventive antibiotics in stroke. Infection is a common complication after stroke, affecting between 15% and 30% of the patients. The predictors for post-stroke infection can be divided into three categories: clinical factors, anatomical (stroke related) factors and immunological factors. The relation between the occurrence of a post-stroke infection and functional outcome remained subject of debate, but it seems likely that the occurrence of these infections has a causal relation with poor functional outcome and mortality. In the first meta-analysis on preventive antibiotic therapy, almost a decade ago, its beneficial effect on post-stroke infection rate was clear; however, the effect on functional outcome remained uncertain because included studies were small and heterogeneous. Afterwards, three large phase-3 RCTs were published and a Cochrane meta-analysis was performed. It has now become clear that, despite the finding that overall infections are reduced, preventive antibiotic therapy in the acute phase of stroke does neither improve functional outcome, nor decrease mortality rates. This does not yet mean that further research on preventive antibiotics in stroke is useless: the pathophysiology and etiology of post-stroke infections are unclear and the use of preventive antibiotics in specific subgroups of stroke patients could still be very effective. This is currently being studied. Besides, preventive antibiotic therapy might be cost-effective by increasing quality-adjusted life years. Thirdly, research for the upcoming years might put more emphasis on the effect of stroke on immunological alterations.


2021 ◽  
pp. 1-26
Author(s):  
Sze Chung Yuen ◽  
Simon Ming-Yuen Lee ◽  
Siu-wai Leung

Background: Neuronal cell cycle re-entry (CCR) is a mechanism, along with amyloid-β (Aβ) oligomers and hyperphosphorylated tau proteins, contributing to toxicity in Alzheimer’s disease (AD). Objective: This study aimed to examine the putative factors in CCR based on evidence corroboration by combining meta-analysis and co-expression analysis of omic data. Methods: The differentially expressed genes (DEGs) and CCR-related modules were obtained through the differential analysis and co-expression of transcriptomic data, respectively. Differentially expressed microRNAs (DEmiRNAs) were extracted from the differential miRNA expression studies. The dysregulations of DEGs and DEmiRNAs as binary outcomes were independently analyzed by meta-analysis based on a random-effects model. The CCR-related modules were mapped to human protein-protein interaction databases to construct a network. The importance score of each node within the network was determined by the PageRank algorithm, and nodes that fit the pre-defined criteria were treated as putative CCR-related factors. Results: The meta-analysis identified 18,261 DEGs and 36 DEmiRNAs, including genes in the ubiquitination proteasome system, mitochondrial homeostasis, and CCR, and miRNAs associated with AD pathologies. The co-expression analysis identified 156 CCR-related modules to construct a protein-protein interaction network. Five genes, UBC, ESR1, EGFR, CUL3, and KRAS, were selected as putative CCR-related factors. Their functions suggested that the combined effects of cellular dyshomeostasis and receptors mediating Aβ toxicity from impaired ubiquitination proteasome system are involved in CCR. Conclusion: This study identified five genes as putative factors and revealed the significance of cellular dyshomeostasis in the CCR of AD.


2020 ◽  
Vol 116 ◽  
pp. 105205
Author(s):  
Andrea G. Eckhardt ◽  
Franziska Egert

2015 ◽  
Vol 113 (05) ◽  
pp. 958-967 ◽  
Author(s):  
Maria Elisa Mancuso ◽  
Elena Santagostino ◽  
Gili Kenet ◽  
Mohssen Elalfy ◽  
Susanne Holzhauer ◽  
...  

SummaryThe impact of treatment-related factors on inhibitor development in previously untreated patients (PUPs) with haemophilia A is still debated. We present the results of a collaborative, individual patient data meta-analytic project. Eligible data sources were published cohorts of PUPs for which patient-level data were available. The exposures of interest were factor (F)VIII type (recombinant [rFVIII] vs plasma-derived [pdFVIII]) and treatment intensity (≥ vs < 150 IU/kg/week) at first treatment. Family history of inhibitors, F8 mutations, age, treatment regimen (on-demand vs prophylaxis), secular trend and surgery were analysed as putative confounders using different statistical approaches (multivariable Cox regression, propensity score analyses, CART). Analyses accounted for the multi-centre origin of the data. We included 761 consecutive, unselected PUPs with moderate to severe haemophilia A from 10 centres in Egypt, Germany, Israel and Italy. A total of 27 % of patients developed inhibitors; 40 % and 22 % of patients treated with rFVIII and pdFVIII (unadjusted HR 2.2, 95 % CI 1.6–2.9), respectively; 51 % and 24 % of patients receiving high-and low-intensity treatment (unadjusted HR 2.9, 95 % CI 2.0–4.2), respectively. In adjusted analyses, only treatment intensity remained an independent predictor; the effect of FVIII type was largely due to confounding, but with a significant interaction between FVIII type and treatment intensity. This patient-level meta-analysis confirms, across different statistical approaches, that high-intensity treatment is a strong risk factor for inhibitor development. The possible role of FVIII type in subgroups is suggested by the test for interactions but could not be proven because of the limited subgroups sample sizes.


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