scholarly journals Home-Based Interventions to Treat and Prevent Childhood Obesity: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 9 (4) ◽  
pp. 38 ◽  
Author(s):  
Pamungkas ◽  
Chamroonsawasdi
Keyword(s):  
Systematic Review ◽  
Childhood Obesity ◽  
Meta Analysis ◽  
Premature Mortality ◽  
Risk Groups ◽  
The Body ◽  
Chi Square ◽  
Mortality And Morbidity ◽  
Home Based ◽  
Home Based Intervention

Childhood obesity has adverse impacts on premature mortality and morbidity. Managing obesity could prevent premature mortality and several types of complications among high-risk groups. This study aimed to review and examine the effects of home-based interventions to treat and prevent childhood obesity. Three databases, i.e., PubMed, Scopus, and Science Direct, were included to extract articles related to the topic. The terms “childhood obesity”, “home-based intervention”, “parental program”, and “parental involvement” were used as the primary keywords. Appraisal of the systematic review was based on PRISMA formats. Of 1556 publications identified, 22 studies fulfilled the inclusion criteria and were appropriate to conduct a meta-analysis. Overall, the home-based interventions reduced the body mass index (BMI) z-score by 36.99% (z = 36.99, p = 0.00). The data analysis indicated considerable heterogeneity among all interventions (Chi-square = 926.41, df = 22 (p <0.000001), I2 = 98%). The home-based intervention positively reduced BMI. Our findings could guide future meaningful home-based interventions to treat and prevent childhood obesity.

Vaccination against Japanese encephalitis with IC51: systematic review on immunogenicity, duration of protection and safety

2020 ◽  
Vol 27 (2) ◽  
Author(s):  
Kerstin Kling ◽  
Thomas Harder ◽  
Zane Younger ◽  
Gerd Burchard ◽  
Jonas Schmidt-Chanasit ◽  
...  
Keyword(s):  
Systematic Review ◽  
Japanese Encephalitis ◽  
Meta Analysis ◽  
Age Groups ◽  
Risk Groups ◽  
The Body ◽  
Trial Methodology ◽  
Serious Adverse Events ◽  
Clinical Trial Methodology ◽  
Randomized Studies

Abstract Japanese encephalitis is a disease caused by a flavivirus which is transmitted by mosquitos in endemic countries. Considering the potentially severe outcomes of the disease, vaccination is recommended for those at risk of exposure. During recent years, IC51 (IXIARO®, JESPECT®, JEVAL®) has increasingly been used to protect travellers from Europe and the USA. However, no systematic review exists that summarizes the currently available evidence on the immunogenicity and safety of this vaccine. We conducted a systematic review on the immunogenicity and safety of IC51, using the databases PubMed, MEDLINE, EMBASE and ClinicalTrials.gov (search date: 31 August 2019). Data extracted from included studies were grouped by outcomes and stratified by population and setting. Risk of bias (ROB) was assessed using the RoB 2 tool for randomized controlled trials (RCTs) and ROBINS-I for non-randomized studies. Due to high heterogeneity, meta-analysis was not performed. A total of 32 studies from 16 countries met the inclusion criteria (15 RCTs, 17 non-randomized studies). ROB was serious or high in the majority of studies. Seroprotection rates ranged from 93 to 100% in adults (seven studies) and from 91 to 100% in children (four studies). In the study involving adults aged 64 years and older, seroprotection was 65% with higher rates in persons who were previously vaccinated against tick-borne encephalitis virus. Safety was investigated in 27 studies. Rates of serious adverse events were below 5% in all age groups, with the majority not being causally related to the vaccine. IC51 is a safe vaccine with good seroprotective abilities in persons aged &gt;2 months to &lt;64 years. The body of evidence, however, is weakened by a large amount of heterogeneity in study and clinical trial methodology. Further well-designed RCTs with special risk groups are needed.

scholarly journals Associations between lifestyle interventions during pregnancy and childhood weight and growth: a systematic review and meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Roxana Raab ◽  
Sophie Michel ◽  
Julia Günther ◽  
Julia Hoffmann ◽  
Lynne Stecher ◽  
...  
Keyword(s):  
Systematic Review ◽  
Childhood Obesity ◽  
Healthy Lifestyle ◽  
Meta Analysis ◽  
The Body ◽  
Analytical Models ◽  
Lifestyle Interventions ◽  
Childhood Weight ◽  
Z Scores ◽  
Meta Analyses

Abstract Background Maternal health and lifestyle during pregnancy may be critical for the onset and progression of childhood obesity. Prenatal lifestyle interventions have been shown to positively affect maternal behaviors, gestational weight gain, and anthropometric outcomes in infants at birth. The influence of such interventions on child weight or growth beyond birth is unknown. We therefore examined the association between lifestyle interventions during pregnancy and anthropometric outcomes during childhood. Methods A systematic literature search was conducted in three electronic databases, two clinical trial registers and further sources, without language or publication status restrictions. Additionally, 110 study authors were contacted to obtain unpublished data. Randomized controlled trials comparing any antenatal lifestyle or behavioral intervention to standard prenatal care, in women of any body mass index (BMI), with offspring anthropometric data at 1 month of age or older, were considered. Two reviewers independently extracted data and assessed the risk of bias using the Cochrane Collaboration’s updated tool. Data on weight, length, and BMI, and corresponding z-scores, were stratified into six age ranges and weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated in univariate and multivariate random-effects meta-analytical models. Results Twenty trials comprising 11,385 women were included in this systematic review, of which 19 were combined in meta-analyses. Overall, lifestyle interventions during pregnancy were not associated with differences in weight, length, BMI, or corresponding z-scores, in children aged 1 month to 7 years (e.g. weight in 5 to 6 month old children, WMD: 0.02 kg; 95% CI: − 0.05 to 0.10 kg, I2 = 38%; 13 studies, 6667 participants). Findings remained consistent when studies were stratified by maternal baseline BMI or other risk factors, and intervention content and duration. Based on the GRADE criteria, the strength of the body of evidence was considered moderate. Conclusion Prenatal lifestyle interventions were not shown to influence childhood weight or growth. Nevertheless, women should be encouraged to pursue a healthy lifestyle during pregnancy. Further efforts to establish early prevention strategies for childhood obesity are urgently needed. Thus, large, high-quality studies with pre-planned, long-term follow-ups are warranted. Trial registration PROSPERO CRD42018118678.

scholarly journals Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Eleni Papoutsi ◽  
Vassilis G. Giannakoulis ◽  
Eleni Xourgia ◽  
Christina Routsi ◽  
Anastasia Kotanidou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Meta Analysis ◽  
Mortality And Morbidity ◽  
Icu Admission ◽  
All Cause Mortality ◽  
Detectable Difference

Abstract Background Although several international guidelines recommend early over late intubation of patients with severe coronavirus disease 2019 (COVID-19), this issue is still controversial. We aimed to investigate the effect (if any) of timing of intubation on clinical outcomes of critically ill patients with COVID-19 by carrying out a systematic review and meta-analysis. Methods PubMed and Scopus were systematically searched, while references and preprint servers were explored, for relevant articles up to December 26, 2020, to identify studies which reported on mortality and/or morbidity of patients with COVID-19 undergoing early versus late intubation. “Early” was defined as intubation within 24 h from intensive care unit (ICU) admission, while “late” as intubation at any time after 24 h of ICU admission. All-cause mortality and duration of mechanical ventilation (MV) were the primary outcomes of the meta-analysis. Pooled risk ratio (RR), pooled mean difference (MD) and 95% confidence intervals (CI) were calculated using a random effects model. The meta-analysis was registered with PROSPERO (CRD42020222147). Results A total of 12 studies, involving 8944 critically ill patients with COVID-19, were included. There was no statistically detectable difference on all-cause mortality between patients undergoing early versus late intubation (3981 deaths; 45.4% versus 39.1%; RR 1.07, 95% CI 0.99–1.15, p = 0.08). This was also the case for duration of MV (1892 patients; MD − 0.58 days, 95% CI − 3.06 to 1.89 days, p = 0.65). In a sensitivity analysis using an alternate definition of early/late intubation, intubation without versus with a prior trial of high-flow nasal cannula or noninvasive mechanical ventilation was still not associated with a statistically detectable difference on all-cause mortality (1128 deaths; 48.9% versus 42.5%; RR 1.11, 95% CI 0.99–1.25, p = 0.08). Conclusions The synthesized evidence suggests that timing of intubation may have no effect on mortality and morbidity of critically ill patients with COVID-19. These results might justify a wait-and-see approach, which may lead to fewer intubations. Relevant guidelines may therefore need to be updated.

scholarly journals Influenza-associated disease burden in mainland China: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jing Li ◽  
Yinzi Chen ◽  
Xiling Wang ◽  
Hongjie Yu
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Fixed Effects ◽  
Disease Burden ◽  
Outpatient Visit ◽  
Meta Analysis ◽  
Age Groups ◽  
Mainland China ◽  
Mortality And Morbidity ◽  
All Cause Mortality

AbstractInfluenza causes substantial morbidity and mortality. Many original studies have been carried out to estimate disease burden of influenza in mainland China, while the full disease burden has not yet been systematically reviewed. We did a systematic review and meta-analysis to assess the burden of influenza-associated mortality, hospitalization, and outpatient visit in mainland China. We searched 3 English and 4 Chinese databases with studies published from 2005 to 2019. Studies reporting population-based rates of mortality, hospitalization, or outpatient visit attributed to seasonal influenza were included in the analysis. Fixed-effects or random-effects model was used to calculate pooled estimates of influenza-associated mortality depending on the degree of heterogeneity. Meta-regression was applied to explore the sources of heterogeneity. Publication bias was assessed by funnel plots and Egger’s test. We identified 30 studies eligible for inclusion with 17, 8, 5 studies reporting mortality, hospitalization, and outpatient visit associated with influenza, respectively. The pooled influenza-associated all-cause mortality rates were 14.33 and 122.79 per 100,000 persons for all ages and ≥ 65 years age groups, respectively. Studies were highly heterogeneous in aspects of age group, cause of death, statistical model, geographic location, and study period, and these factors could explain 60.14% of the heterogeneity in influenza-associated mortality. No significant publication bias existed in estimates of influenza-associated all-cause mortality. Children aged < 5 years were observed with the highest rates of influenza-associated hospitalizations and ILI outpatient visits. People aged ≥ 65 years and < 5 years contribute mostly to mortality and morbidity burden due to influenza, which calls for targeted vaccination policy for older adults and younger children in mainland China.

Association between early antibiotic exposure and risk of childhood weight gain and obesity: a systematic review and meta-analysis

2019 ◽  
Vol 32 (5) ◽  
pp. 439-445 ◽  
Author(s):  
Mohammad Aghaali ◽  
Seyed Saeed Hashemi-Nazari
Keyword(s):  
Systematic Review ◽  
Weight Gain ◽  
Childhood Obesity ◽  
Early Life ◽  
Meta Analysis ◽  
Healthy Children ◽  
Antibiotic Exposure ◽  
Statistical Estimates ◽  
Childhood Weight

Abstract Background Recent studies have shown that antibiotic exposure during infancy is associated with increased body mass in healthy children. This study was performed to investigate the association between early-life antibiotic exposure and risk of childhood obesity. Methods A systematic review and meta-analysis was performed to comprehensively and quantitatively determine the association between early antibiotic exposure and risk of childhood obesity. Various databases such as PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane and Google Scholar were searched. A random-effects meta-analysis was performed to pool the statistical estimates. Additionally, a subgroup analysis was performed based on the time of follow-up. Results Nineteen studies involving at least 671,681 participants were finally included. Antibiotic exposure in early life was significantly associated with risk of childhood weight gain and obesity (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.04–1.06). Conclusions Antibiotic exposure in early life significantly increases the risk of childhood weight gain and obesity.

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