Landscapes of becoming social: A systematic review of evidence for associations and pathways between interactions with nature and socioemotional development in children

Background. Existing research indicates that spending time in nature is associated with diverse aspects of children’s health and wellbeing. Although fundamental to later life chances and health, no systematic reviews, to our knowledge, have focused specifically on the effects of interaction with nature on socioemotional functioning in childhood. Objectives. Amongst children, what is the consistency of associations between the availability of or spending time in nature on socioemotional function and development? Furthermore, which child behaviours and states independently associate with socioemotional function and availability of or spending time in nature, and what is the consistency of associations between these behaviours and states and contact with nature?Data sources. Embase, Environment Complete, MEDLINE, and APA PsycINFO. Eligible studies were backward and forward snowball-searched. Study eligibility criteria. Studies investigating effects of, or associations between, availability of or interaction with nature on socioemotional or proximal outcomes in children under the age of 12 years were included in this review. Study appraisal and synthesis methods. The internal validity of studies investigating socioemotional outcomes were based on assessments of elements of study design, conduct, and reporting to identify potential issues related to confounding or other biases. The number of analyses indicating positive, negative, and non-significant associations between availability or interaction with green space and the outcomes were summed.Results. A total of 223 eligible full-texts, of which 43 pertained to socioemotional outcomes and 180 to proximal outcomes, met eligibility criteria. Positive associations between availability of and spending time in green space were found with children’s intra- and interpersonal socioemotional function and development. Proportions of positive findings ranged from 13.9% to 55% across experimental and observational research, exposures, populations, and contexts. Modifying and mediating factors were identified. We found consistent evidence for improved aspects of cognition and, for children over six years, reduced risk of obesity and overweight in association with green space; consistent links between movement behaviours in the experimental, but not observational research; tentative trends suggesting associations with play, motor skills, language, screen time, and communication skills; little evidence for positive associations between green space and mood, physical wellbeing, and stress; some evidence for associations with healthy birth outcomes, and little evidence for direct associations between availability of green space and asthma and allergy prevalence, however, mediation via, for example, air pollution was likely.Limitations. We identified few studies without either probable or severe risk of bias in at least one item. Improved study quality may therefore result in different results. Restricting analyses to include only studies considered at low risk of bias indicated similar or slightly lower proportions of positive findings. Risk of bias in proximal outcomes was not assessed.Conclusions. The empirical evidence for benefits of availability of and interaction green space for child socioemotional function and development must currently be considered limited. A number of proximal indicators were identified. Systematic review registration number. PROSPERO ID: CRD42019135016.

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Hallux valgus orthosis characteristics and effectiveness: a systematic review with meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-047273 ◽

2021 ◽

Vol 11 (8) ◽

pp. e047273

Author(s):

Mei-Ying Kwan ◽

Kit-Lun Yick ◽

Joanne Yip ◽

Chi-Yung Tse

Keyword(s):

Systematic Review ◽

Hallux Valgus ◽

Outcome Measurement ◽

Meta Analysis ◽

Outcome Data ◽

Risk Of Bias ◽

Eligibility Criteria ◽

Systematic Analysis ◽

Registration Number ◽

Mean Differences

ObjectiveThe treatment effect of orthoses for hallux valgus (HV) is unclear with little interventional studies, the design involves multiple complex factors, and therefore a systematic analysis with meta-analysis is necessary. The objective of this systematic review and meta-analysis is to determine whether current foot orthoses are effective in treating HV.DesignSystematic review with meta-analysis.Data sourcesElectronic databases (PubMed, Scopus, Cinahl and Medline) are searched up to February 2020.Eligibility criteria for selecting studiesInterventional studies with content focus on HV orthosis design and any of the outcomes related to effectiveness for treating HV are included. The standardised mean differences are calculated. The risk of bias in included studies is assessed using the Cochrane Collaboration’s risk of bias tools.ResultsIn total, 2066 articles are identified. Among them, nine are selected and quality rated, and data are extracted and closely examined. A meta-analysis is conducted, where appropriate. The main causes of potential bias are missing outcome data and outcome measurement error. The results show that orthosis with a toe separator has the best effect of correcting the HV angle (standardised mean difference: 0.50, 95% CI: 0.189 to 0.803).ConclusionThe orthoses design with a toe separator or an element that allows for the foot anatomic alignment is critical for reducing the HV angle and relieving foot pain. The results contribute to a better selection of treatment for patients.PROSPERO registration numberCRD42021260403.

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Tibetan Medicine: A Systematic Review of the Clinical Research Available in the West

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/213407 ◽

2013 ◽

Vol 2013 ◽

pp. 1-16 ◽

Cited By ~ 7

Author(s):

K. Philip Reuter ◽

Thorolf E. R. Weißhuhn ◽

Claudia M. Witt

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Tibetan Medicine ◽

Synthesis Methods ◽

Industrialized Countries ◽

The West ◽

Eligibility Criteria ◽

Registration Number ◽

Clinical Trial Results ◽

Study Type

Background. Little is known about Tibetan medicine (TM), in Western industrialized countries.Objectives. To provide a systematic review of the clinical studies on TM available in the West.Data Sources. Seven literature databases, published literature lists, citation tracking, and contacts to experts and institutions.Study Eligibility Criteria. Studies in English, German, French, or Spanish presenting clinical trial results.Participants. All patients of the included studies.Interventions. Tibetan medicine treatment.Study Appraisal and Synthesis Methods. Included studies were described quantitatively; their quality was assessed with the DIMDI HTA checklist; for RCTs the Jadad score was used.Results. 40 studies from 39 publications were included. They were very heterogeneous regarding study type and size, treated conditions, treatments, measured outcomes, and quality.Limitations. No Russian, Tibetan, or Chinese publications were included. Possible publication bias.Conclusions. The number of clinical trials on TM available in the West is small; methods and results are heterogeneous.Implications of Key Findings. Higher quality larger trials are needed, as is a general overview of traditional usage to inform future clinical trials.Systematic Review Registration Number. None.

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The Effects of Agility Ladders on Performance: A Systematic Review

International Journal of Sports Medicine ◽

10.1055/a-1157-9078 ◽

2020 ◽

Author(s):

José Afonso ◽

Israel Teoldo da Costa ◽

Miguel Camões ◽

Ana Silva ◽

Ricardo Franco Lima ◽

...

Keyword(s):

Systematic Review ◽

Randomized Trials ◽

Risk Of Bias ◽

Cochrane Library ◽

Synthesis Methods ◽

Qualitative Synthesis ◽

Eligibility Criteria ◽

Healthy Humans ◽

Physical Skills

AbstractThe goal of this systematic review was to evaluate the effects of exercise programs using agility ladders and to assess the quality of available evidence. Search was conducted in October of 2019 using the following databases: Cochrane Library, PEDro, PubMed, Scopus and Web of Science. Study eligibility criteria included randomized trials or randomized controlled trials using agility ladders drills. Participants were healthy humans of any health status. The study appraisal and synthesis methods followed the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and a qualitative synthesis of the main results of each study were applied. Only five studies met our criteria, lasting between 4 and 8 weeks. Only two studies evaluated the effects of ladder drills on more than one dimension. Lack of description of the specific exercises that were used limits reproducibility of current studies. With one exception, the articles had low risk of bias for most domains. Despite the widespread popularity of agility ladder drills, research is scarce and problematic, with poorly described protocols and mostly unidimensional performance measures. Claims that agility ladders improve agility and other physical skills is premature, given the nature and quality of existing research.

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Oral Myofunctional and Articulation Disorders in Children with Malocclusions: A Systematic Review

Folia Phoniatrica et Logopaedica ◽

10.1159/000516414 ◽

2021 ◽

pp. 1-16

Author(s):

Zoë Thijs ◽

Laura Bruneel ◽

Guy De Pauw ◽

Kristiane M. Van Lierde

Keyword(s):

Systematic Review ◽

Risk Of Bias ◽

Open Bite ◽

Anterior Open Bite ◽

Eligibility Criteria ◽

High Prevalence ◽

Tongue Position ◽

Articulation Disorders ◽

Level 2 ◽

Unclear Risk

Background: Relationships between malocclusion and orofacial myofunctional disorders (OMD), as well as malocclusions and articulation disorders (AD) have been described, though the exact relationships remain unclear. Given the high prevalence of these disorders in children, more clarity is needed. Summary: The purpose of this study was to determine the association between OMD (specifically, bruxism, deviate swallowing, caudal resting tongue posture, and biting habits), AD, and malocclusions in children and adolescents aged between 3 and 18 years. To conduct a systematic review, 4 databases were searched (MEDLINE, Embase, Web of Science, and Scopus). The identified articles were screened for the eligibility criteria. Data were extracted from the selected articles and quality assessment was performed using the tool of Munn et al. [Int J Health Policy Manag. 2014;3:123–81] in consensus. Using the search strategy, the authors identified 2,652 articles after the removal of duplicates. After reviewing the eligibility criteria, 17 articles were included in this study. One of the included articles was deemed to have an unclear risk of bias, whereas all other articles were considered to have a low risk of bias. The articles showed a relationship between anterior open bite and apico-alveolar articulatory distortions, as well as between anterior open bite and deviate swallowing. For the biting habits, bruxism, and low tongue position no clear conclusions could be drawn. Key Messages: The current review suggests a link between specific types of malocclusion and OMD and AD. However, more high-quality evidence (level 1 and level 2, Oxford Levels of Evidence) is needed to clarify the cooccurrence of other OMD, AD, and malocclusions.

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Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-045343 ◽

2021 ◽

Vol 11 (3) ◽

pp. e045343

Author(s):

Ray Moynihan ◽

Sharon Sanders ◽

Zoe A Michaleff ◽

Anna Mae Scott ◽

Justin Clark ◽

...

Keyword(s):

Systematic Review ◽

Primary Outcome ◽

Unmet Need ◽

Healthcare Utilisation ◽

Healthcare Services ◽

Risk Of Bias ◽

Secondary Outcome ◽

Severe Illness ◽

Service Utilisation ◽

Registration Number

ObjectivesTo determine the extent and nature of changes in utilisation of healthcare services during COVID-19 pandemic.DesignSystematic review.EligibilityEligible studies compared utilisation of services during COVID-19 pandemic to at least one comparable period in prior years. Services included visits, admissions, diagnostics and therapeutics. Studies were excluded if from single centres or studied only patients with COVID-19.Data sourcesPubMed, Embase, Cochrane COVID-19 Study Register and preprints were searched, without language restrictions, until 10 August, using detailed searches with key concepts including COVID-19, health services and impact.Data analysisRisk of bias was assessed by adapting the Risk of Bias in Non-randomised Studies of Interventions tool, and a Cochrane Effective Practice and Organization of Care tool. Results were analysed using descriptive statistics, graphical figures and narrative synthesis.Outcome measuresPrimary outcome was change in service utilisation between prepandemic and pandemic periods. Secondary outcome was the change in proportions of users of healthcare services with milder or more severe illness (eg, triage scores).Results3097 unique references were identified, and 81 studies across 20 countries included, reporting on >11 million services prepandemic and 6.9 million during pandemic. For the primary outcome, there were 143 estimates of changes, with a median 37% reduction in services overall (IQR −51% to −20%), comprising median reductions for visits of 42% (−53% to −32%), admissions 28% (−40% to −17%), diagnostics 31% (−53% to −24%) and for therapeutics 30% (−57% to −19%). Among 35 studies reporting secondary outcomes, there were 60 estimates, with 27 (45%) reporting larger reductions in utilisation among people with a milder spectrum of illness, and 33 (55%) reporting no difference.ConclusionsHealthcare utilisation decreased by about a third during the pandemic, with considerable variation, and with greater reductions among people with less severe illness. While addressing unmet need remains a priority, studies of health impacts of reductions may help health systems reduce unnecessary care in the postpandemic recovery.PROSPERO registration numberCRD42020203729.

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The use of eHealth to promote physical activity in people living with Parkinson’s disease: A systematic review

Physiotherapy Practice and Research ◽

10.3233/ppr-200474 ◽

2021 ◽

pp. 1-14

Author(s):

Adam McDermott ◽

Ciaran Haberlin ◽

Jonathan Moran

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Risk Of Bias ◽

Attrition Rate ◽

Medical Subject Headings ◽

Eligibility Criteria ◽

Ehealth Intervention ◽

High Level

BACKGROUND: People living with Parkinson’s disease (PD) are less active than healthy individuals. Ehealth is an emerging concept in healthcare which presents opportunities to promote physical activity (PA) in people with PD. The aim of this systematic review was to explore the effectiveness of ehealth in the promotion of PA in people living with PD. METHODS: Suitable articles were searched for using EMBASE, PsychInfo, Web of Science and OVID Medline databases using a combination of keywords and medical subject headings. Articles were included if they described an ehealth intervention designed to promote PA in people living with PD. Two reviewers screened studies for suitability and extracted data. Risk of bias was assessed using the Cochrane risk of bias 2 tool and the Downs and Black risk of bias checklist. Due to the heterogeneity of studies, a narrative synthesis of study interventions and results was completed rather than a quantitative analysis. RESULTS: 1449 articles were screened. Four studies met the eligibility criteria which included 652 participants. Web and mobile applications were used to design the PA interventions. PA levels were measured using self-reported questionnaires, Fitbits, activity monitors and accelerometers. Three of the studies reported improvements in aspects of PA. However, this was not consistently reported in all study participants. No adverse effects, a high level of enjoyment and a relatively low attrition rate (∼12.5%) were reported. CONCLUSION: Ehealth is a safe and feasible intervention to promote PA in this population. It is unclear whether ehealth is effective at promoting PA in people with PD. Keywords:

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Mortality Benefit From the Passive Leg Raise Maneuver in Guiding Resuscitation of Septic Shock Patients: A Systematic Review and Meta-Analysis of Randomized Trials

Journal of Intensive Care Medicine ◽

10.1177/08850666211019713 ◽

2021 ◽

pp. 088506662110197

Author(s):

Moosa Azadian ◽

Suyee Win ◽

Amir Abdipour ◽

Carolyn Krystal Kim ◽

H. Bryant Nguyen

Keyword(s):

Systematic Review ◽

Septic Shock ◽

Fluid Resuscitation ◽

Standard Care ◽

Meta Analysis ◽

Risk Of Bias ◽

Time Interval ◽

Eligibility Criteria ◽

Significant Difference ◽

Passive Leg Raise

Background: Fluid therapy plays a major role in the management of critically ill patients. Yet assessment of intravascular volume in these patients is challenging. Different invasive and non-invasive methods have been used with variable results. The passive leg raise (PLR) maneuver has been recommended by international guidelines as a means to determine appropriate fluid resuscitation. We performed this systematic review and meta-analysis to determine if using this method of volume assessment has an impact on mortality outcome in patients with septic shock. Methods: This study is a systematic review and meta-analysis. We searched available data in the MEDLINE, CINAHL, EMBASE, and CENTRAL databases from inception until October 2020 for prospective, randomized, controlled trials that compared PLR-guided fluid resuscitation to standard care in adult patients with septic shock. Our primary outcome was mortality at the longest duration of follow-up. Results: We screened 1,425 article titles and abstracts. Of the 23 full-text articles reviewed, 5 studies with 462 patients met our eligibility criteria. Odds ratios (ORs) and associated 95% confidence intervals (CIs) for mortality at the longest reported time interval were calculated for each study. Using random effects modeling, the pooled OR (95% CI) for mortality with a PLR-guided resuscitation strategy was 0.82 (0.52 -1.30). The included studies were not blinded and they ranged from having low to high risk of bias using the Cochrane Risk of Bias Tool. Conclusion: Our analysis showed there was no statistically significant difference in mortality among septic shock patients treated with PLR-guided resuscitation vs. those with standard care.

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A Systematic Review of the Cost-Effectiveness of Nurse Practitioners and Clinical Nurse Specialists: What Is the Quality of the Evidence?

Nursing Research and Practice ◽

10.1155/2014/896587 ◽

2014 ◽

Vol 2014 ◽

pp. 1-28 ◽

Cited By ~ 19

Author(s):

Faith Donald ◽

Kelley Kilpatrick ◽

Kim Reid ◽

Nancy Carter ◽

Ruth Martin-Misener ◽

...

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Nurse Practitioners ◽

Internal Validity ◽

Risk Of Bias ◽

Nurse Specialist ◽

Clinical Nurse ◽

Education Experience ◽

The Cost

Background. Improved quality of care and control of healthcare costs are important factors influencing decisions to implement nurse practitioner (NP) and clinical nurse specialist (CNS) roles.Objective. To assess the quality of randomized controlled trials (RCTs) evaluating NP and CNS cost-effectiveness (defined broadly to also include studies measuring health resource utilization).Design. Systematic review of RCTs of NP and CNS cost-effectiveness reported between 1980 and July 2012.Results. 4,397 unique records were reviewed. We included 43 RCTs in six groupings, NP-outpatient (n=11), NP-transition (n=5), NP-inpatient (n=2), CNS-outpatient (n=11), CNS-transition (n=13), and CNS-inpatient (n=1). Internal validity was assessed using the Cochrane risk of bias tool; 18 (42%) studies were at low, 17 (39%) were at moderate, and eight (19%) at high risk of bias. Few studies included detailed descriptions of the education, experience, or role of the NPs or CNSs, affecting external validity.Conclusions. We identified 43 RCTs evaluating the cost-effectiveness of NPs and CNSs using criteria that meet current definitions of the roles. Almost half the RCTs were at low risk of bias. Incomplete reporting of study methods and lack of details about NP or CNS education, experience, and role create challenges in consolidating the evidence of the cost-effectiveness of these roles.

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Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review

International Journal for Equity in Health ◽

10.1186/s12939-020-01375-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sara Lena Lueckmann ◽

Jens Hoebel ◽

Julia Roick ◽

Jenny Markert ◽

Jacob Spallek ◽

...

Keyword(s):

Systematic Review ◽

Primary Care ◽

Primary Care Physicians ◽

Web Of Science ◽

Adult Population ◽

Socioeconomic Inequalities ◽

Eligibility Criteria ◽

Physician Visits ◽

General Adult Population ◽

Registration Number

Abstract Background Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. Methods We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. Results Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. Conclusion This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare. PROSPERO registration number CRD42019123222.

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Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-017868 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017868

Author(s):

Joey S.W. Kwong ◽

Sheyu Li ◽

Wan-Jie Gu ◽

Hao Chen ◽

Chao Zhang ◽

...

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Meta Analysis ◽

Adverse Outcomes ◽

Coronary Revascularisation ◽

Eligibility Criteria ◽

Registration Number ◽

Collection Form ◽

Randomised Controlled ◽

Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

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