Understanding Families’ Experiences Raising Young Children With Challenging Behavior Through an Ecological Lens: A Qualitative Meta-Synthesis

Raising a young child with challenging behavior can have a significant impact on families’ well-being and family functioning. Despite advancements in the field, there is a paucity of research focused on effective ways to address their unique experiences. This qualitative meta-synthesis aims to identify the needs of families with young children who exhibit challenging behavior to inform more robust and responsive family-centered practices. Using a constant comparative approach, we used axial coding to examine six studies involving 49 families and a critical appraisal approach to evaluate their strengths and weaknesses, based on recommendations articulated by the Cochrane Collaboration. We determined that six major themes were most salient: (a) the family system, (b) families’ self-concept, (c) families’ capacity, (d) families’ social and emotional needs, (e) families’ experiences with professionals, and (f) families’ initial concerns. Our findings indicate that studies were conducted with acceptable rigor and all studies established credibility and trustworthiness of their results. The importance of family-centered practices, parenting interventions, and addressing the mental health needs of families are discussed.

Efficacy and safety of treatments for REM sleep behaviour disorder in Parkinson’s disease: a systematic review and Bayesian network meta-analysis protocol

IntroductionSleep disorders are the main non-motor characteristics of Parkinson’s disease (PD). The quality of life is significantly impacted by rapid eye movement sleep behaviour disorder (RBD). It is not clearly evidenced in the literature that some medications can reduce the dream activities of patients with PD and RBD and improve sleep quality. And, they have side effects that may increase the severity of this disease. To further understand which medication has better efficacy and fewer adverse effects for patients with PD and RBD, it is necessary to perform a network meta-analysis.Methods and analysisThis protocol is performed accordingly to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the Cochrane Collaboration Handbook.A thorough literature selection will be conducted up to September 2021 using PubMed, Cochrane Library (The Cochrane Database of Systematic Reviews) and Embase. We will not only include randomised controlled trials, but prospective, retrospective cohort, case–control, nested case–control, case–cohort, cross-sectional and case series. We will use the Cochrane Collaboration tool to assess the risk of bias. Pairwise and network meta-analyses will be conducted using the R netmeta package and Stata V.14.0. The relative ranking probability of the best intervention will be estimated using the surface under the cumulative ranking curve. Additionally, sensitivity analysis, subgroup analysis, quality assessment and publication bias analysis will be performed.Ethics and disseminationNo research ethics approval is required for this systematic review, as no confidential patient data will be used. We will disseminate our findings through publication in a peer-reviewed journal and conference presentations, and our review will support development of a BMJ Rapid Recommendations providing contextualised clinical guidance based on this body of evidence.PROSPERO registration numberCRD42020206958.

Physical functionality of alternative communication resources on people with cerebral palsy: A systematic review

BACKGROUND: Augmentative and Alternative Communication (AAC) systems are used by people with motor disabilities, such as those with cerebral palsy (CP). The assessment of physical functional skills is crucial for appropriately choosing the computer access tool. OBJECTIVE: This study aimed to do a systematic literature review addressing the importance of the analysis of physical functional performance for the construction of specific tools to support communication. METHODS: The review followed PRISMA guidelines. We searched articles from 2009 to 2021 using three databases (PubMed, Lilacs in Portuguese, and SciELO). Three reviewers extracted the data. Registration was made to PROSPERO. The risk of bias was assessed using the Cochrane Collaboration tool. RESULTS: We found 132 articles in the databases. First, we excluded 31 articles because they did not provide evidence for the use of alternative communication in people with CP and did not use high technology resources. We also excluded 57 duplicated articles. At the end of this first step, 44 articles were left, 38 of them were excluded because they are not clinical trials. We selected 6 articles for the final analysis. CONCLUSIONS: The systematic review had a positive impact on the precise dissemination of knowledge ensuring comparisons of interventions and articles such as assistive technology programs.

Vocational Interventions to Improve Employment Participation of People with Psychosocial Disability, Autism and/or Intellectual Disability: A Systematic Review

Objective: To systematically review interventions aimed at improving employment participation of people with psychosocial disability, autism, and intellectual disability. Methods: We searched MEDLINE, Embase, PsycINFO, Web of Science, Scopus, CINAHL, ERIC, and ERC for studies published from 2010 to July 2020. Randomized controlled trials (RCTs) of interventions aimed at increasing participation in open/competitive or non-competitive employment were eligible for inclusion. We included studies with adults with psychosocial disability autism and/or intellectual disability. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias II Tool. Data were qualitatively synthesized. Our review was registered with PROSPERO (CRD42020219192). Results: We included 26 RCTs: 23 targeted people with psychosocial disabilities (n = 2465), 3 included people with autism (n = 214), and none included people with intellectual disability. Risk of bias was high in 8 studies, moderate for 18, and low for none. There was evidence for a beneficial effect of Individual Placement and Support compared to control conditions in 10/11 studies. Among young adults with autism, there was some evidence for the benefit of Project SEARCH and ASD supports on open employment. Discussion: Gaps in the availability of high-quality evidence remain, undermining comparability and investment decisions in vocational interventions. Future studies should focus on improving quality and consistent measurement, especially for interventions targeting people with autism and/or intellectual disability.

Personality Factors in Colorectal Cancer: A Systematic Review

Background: The role of personality in cancer incidence and development has been studied for a long time. As colorectal cancer (CRC) is one of the most prevalent cancer types and linked with lifestyle habits, it is important to better understand its psychological correlates, in order to design a more specific prevention and intervention plan. The aim of this systematic review is to analyze all the studies investigating the role of personality in CRC incidence.Methods: All studies on CRC and personality up to November 2020 were scrutinized according to the Cochrane Collaboration and the PRISMA statements. Selected studies were additionally evaluated for the Risk of Bias according to the Newcastle-Ottawa Scale (NOS).Results: Eight studies met the inclusion criteria and were eventually included in this review. Two main constructs have been identified as potential contributors of CRC incidence: emotional regulation (anger) and relational style (egoism).Conclusion: Strong conclusions regarding the influence of personality traits on the incidence of CRC are not possible, because of the small number and the heterogeneity of the selected studies. Further research is needed to understand the complexity of personality and its role in the incidence of CRC and the interaction with other valuable risk factors.

Evaluation of Industry Relationships Among Authors of Systematic Reviews and Meta-analyses Regarding Ménières Disease

Objectives: To quantify the presence of conflicts of interest (COI) in SRs and MAs of Ménières disease treatment and identify any related secondary characteristics of these articles. Methods: A search was conducted on May 28, 2020 to search MEDLINE and Embase databases for SRs or MAs pertaining to Ménières disease published between September 1, 2016 and June 2, 2020. A risk of bias assessment was performed using the Cochrane Collaboration risk of bias assessment criteria. Results: A total of 13 systematic reviews conducted by 49 authors met the inclusion criteria. Of the 49 authors, 7 (14.3%) were found to have some form of COI. Of these 7 authors, 1 (14.3%) completely disclosed all COI within the SR, 1 (14.3%) disclosed one or more COI but were found to have an additional undisclosed COI, and 5 (71.4%) were found to have only undisclosed COI. One of 2 industry funded SRs (50%) had a high risk of bias, and 1 (50%) of the non-industry sponsored SRs were found to have a high risk of bias. Conclusions: Overall authors of SRs pertaining to Ménières disease appear to be properly disclosing COI at higher rates than other fields of medicine; however, further room for improvement has been noted.

Use of biomaterials in the surgical regenerative treatment of peri-implantitis: systematic review

The aim of this study was to review the scientific literature regarding the effectiveness of different biomaterials in the regenerative treatment of peri-implantitis. A systematic literature search was performed in PubMed/Medline, Web of Science, Science Direct, Embase, and the Cochrane Collaboration Library. Studies on the use of biomaterials in the regenerative treatment of peri-implantitis were selected. The search strategy retrieved 253 articles. After selection, six articles met all inclusion criteria and were included in the present systematic review. The studies showed that an initial therapeutic approach consisting of plaque control and implant surface decontamination and subsequent surgery for biomaterial placement were essential for the successful regenerative treatment of peri-implantitis defects. Analysis of all biomaterials used in surgical regenerative treatment showed that bovine bone grafts provided superior outcomes in terms of new bone formation compared to autogenous grafts and nanocrystalline hydroxyapatite. It is important to note that porous titanium granules have emerged as a promising biomaterial for the regenerative treatment of peri-implantitis. In conclusion, biomaterials are promising for the treatment of peri-implant bone defects and the number of in silico biomaterials that can provide treatment of excellence to patients with this condition is expected to increase in the near future.

The Efficacy of Re-Warm-Up Practices during Half-Time: A Systematic Review

Background and Objectives: The passive nature of rest breaks in sport could reduce athletes’ performance and even increase their risk of injury. Re-warm-up activities could help avoid these problems, but there is a lack of research on their efficacy. This systematic review aimed at analyzing the results of those randomized controlled trials (RCTs) that provided information on the effects of re-warm-up strategies. Materials and Methods: Four electronic databases (Web of Science, Scopus, PubMed, and SPORTDiscus) were searched from their inception to January 2021, for RCTs on the effects of re-warm-up activities on sports performance. Interventions had to be implemented just after an exercise period or sports competition. Studies that proposed activities that were difficult to replicate in the sport context or performed in a hot environment were excluded. Data were synthesized following PRISMA guidelines, while the risk of bias was assessed following the recommendations of the Cochrane Collaboration. Results: A total of 14 studies (178 participants) reporting data on acute or short-term effects were analyzed. The main outcomes were grouped into four broad areas: physiological measures, conditional abilities, perceptual skills, and sport efficiency measures. The results obtained indicated that passive rest decreases physiological function in athletes, while re-warm-up activities could help to improve athletes’ conditional abilities and sporting efficiency, despite showing higher fatigue levels in comparison with passive rest. The re-warm-up exercise showed to be more effective than passive rest to improve match activities and passing ability. Conclusions: Performing re-warm-up activities is a valuable strategy to avoid reducing sports performance during prolonged breaks. However, given that the methodological quality of the studies was not high, these relationships need to be further explored in official or simulated competitions.

Effects of Training with Different Modes of Strength Intervention on Psychosocial Disorders in Adolescents: A Systematic Review and Meta-Analysis

Physical exercise has a positive impact on anxiety and depression. However, the evidence that associates strength training with a decrease in adolescents’ psychosocial disorders is scarce. Consequently, the objective was to analyze the effects of training with different modes of strength intervention on anxiety, stress, and depression in adolescents. The search was designed according to PRISMA®. We searched WoS, Scopus, SPORTDiscus, PubMed, and MEDLINE (2010–2020). Methodological quality and risk of bias were assessed with the Cochrane Collaboration. The analysis was carried out with a standardized mean difference (SMD) pooled using the Hedges g test (95% CI). The Main Outcome Measures were: anxiety, stress, and depression in adolescents post strength training. Nine studies were included in the systematic review and seven in the meta-analysis. These studies showed a large and significant effect of strength training on anxiety (SMD = −1.75; CI = 95%: −3.03, −0.48; p = 0.007) and depression (SMD = −1.61; CI = 95%: −2.54, −0.67, p = 0.0007). In conclusion, training with different modes of strength intervention have shown control over anxiety and depression in adolescents. However, conventional strength training seems to have better results than other modes of strength intervention.

Níveis plasmáticos do TNF-alfa em gestantes com infecção pelo Zika vírus (ZIKV) e sua relação com gravidade da síndrome congênita: revisão sistemática e metanálise

O processo patológico ocasionado pelo vírus Zika (ZIKV), que é transmitida por mosquitos do gênero Aedes, apresenta distintos sinais e sintomas, havendo uma certa dificuldade em achados de biomarcadores genéticos, bioquímicos ou imunológicos, indicando alterações a nível de tecidos alvos. Assim, o estudo tem como objetivo verificar se o aumento da expressão ou dos níveis plasmáticos de TNF-alfa em gestantes com infecção pelo ZIKV estão associados com a ocorrência/gravidade da Síndrome Congênita. Como processo metodológico, trata-se de uma revisão sistemática da literatura, seguindo as recomendações do protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) para revisões sistemáticas e metanálise. Os estudos foram pesquisados nas fontes de dados Scielo, Pubmed, LILACS e Scopus, onde todas as análises foram realizadas pelo software REVMAN 5.4 (The Cochrane Collaboration, 2020). Devido à heterogeneidade desses estudos incluídos na metanálise, foi selecionado o modelo de efeitos aleatórios (random-effects model), sendo utilizados sete trabalhos. Os resultados e discussão indicam que os achados nos estudos indicados valores de I2 elevado (95%; p<0,01) para o desfecho, mostrando heterogeneidade considerável, os resultados demonstram que há uma elevação considerável da citocina TNF- alfa na SCZ, sendo que o papel do TNF- alfa tanto nas doenças infecciosas quanto nas inflamações agudas e crônicas, vem sendo cada vez mais descrito, para tentar entender melhor a dinâmica da resposta de defesa do organismo as partículas invasoras que o acometem. Quando a produção de citocinas pró-inflamatórias, ficando evidente a presença de níveis plasmáticos de TNF- alfa em gestantes com infecção pelo ZIKV como marcadores biológicos.