Preferred Items For Systematic Reviews And Meta-Analyses Research Articles

The Circular Economy: Recent debates and research trends

The Circular Economy is one of the most prominent cross-disciplinary and cross-sectoral concepts to emerge in recent decades. It has permeated academia, policymaking, business, NGOs, and the general public, leading to numerous applications of the concept, some of which only partially overlap. In this article, we review recent debates and research trends in the Circular Economy, outlining the ten most common groups of its conceptualizations using the PRISMA (Preferred Items for Systematic Reviews and Meta-Analysis) method. We then propose a post disciplinary and transnational research program on the Circular Economy that would not only combine hard and soft sciences in unprecedented ways but also have important practical applications, such as developing tools to embed the Circular Economy in natural, technical, economic, and socio-cultural settings.

Women in Disaster Policy: A Bibliometric Mapping of the Research Literature 2015-2023

The research regarding women in disaster policy discourse received attention from scholars and policymakers as the current leading international disaster policy had a shortfall in mentioning women’s rights. Although many studies have deliberated how women engage with disaster, research that systematically maps how the literature regarding women in disaster policy develops has not yet been conducted. Per the result through the bibliometric mapping, the 58 pieces of literature included by the PRISMA (Preferred Items for Systematic Reviews and Meta-Analyses) framework are clustered into health, environment, economic, and socio-political contexts. The discourse discussion revolves around women’s vulnerability, capacity and capability, and strategy and policy initiatives. The study contributes to the literature by mapping the research trajectory regarding women in the disaster risk reduction policy framework following the Sendai Framework for Disaster Risk Reduction 2015-2030 establishment. A recommendation model of the disaster policy framework and prospective research agenda is developed through the study.

Systematic Literature Review: The Role of Character-Based Digital Literacy in 21st Century Learning in Elementary Schools

Education in the 21st Century has experienced various changes in various lines of life, such as the rapid progress of science and technology that can be used to meet educational needs. 21st-century education directs students to improve different skills and shape the morale and character of students through the use of the role of digital literacy in education. This study aims to systematically examine the scope of research in digital literacy, character, and the 21st Century using the PRISMA (Preferred Items for Systematic Reviews and Meta-Analysis) design, which consists of three steps: identification, screening, and inclusion. The number of articles found was 472 from 2016 to 2022. This study reviewed 25 items based on three systematic literature review analysis steps. This research concludes that digital literacy is essential in strengthening students' character. The application of digital literacy is expected to support 21st-century skills, including critical thinking, communication, collaboration, and creativity.

A SYSTEMATIC REVIEW: DIGITAL LITERACY FOR STRENGTHENING CHARACTER IN FACING THE ERA OF SOCIETY 5.0

<p>Era Society 5.0 is a concept to solve various social problems in the Industrial Revolution 4.0 era, such as a moral crisis and a decline in character values. Digital literacy is a solution to strengthen students' character values. This article aims to present information about the role of digital literacy in supporting character in the era of Society 5.0. The method used in this study was PRISMA (Preferred Items for Systematic Reviews and Meta-Analysis), which consisted of three steps: identification, screening, and inclusion. The number of articles found is 512 from 2018 to 2022. This study decided to review 17 items based on three systematic literature review analysis steps. The results showed that (1) the most frequently used method is the qualitative method with data collection techniques such as interviews, observation, and documentation, (2) technological capabilities and digital literacy competencies must be balanced, (3) schools need to apply digital literacy competencies to strengthen the value of the character to avoid negative impact from using technology to remain competitive in the international arena while remaining polite and of good character.</p>

Prevalence of fatigue in adolescents and adults with cerebral palsy: a systematic review and meta-analysis

ABSTRACT Background Fatigue is a common problem for adults with cerebral palsy (CP) and may be related to the decline in physical function, including the loss of the ability to walk. Objective To estimate the overall prevalence of fatigue in adolescents and adults with cerebral palsy. Methods MEDLINE (OVID), EMBASE (OVID), CINAHL, PsycINFO, and Web of Science electronic databases were searched in September 2021. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration CRD42021275596. Two authors independently screened studies according to Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the methodological quality of included studies was assessed using the Joanna Briggs Institute (JBI) Prevalence Critical Appraisal Checklist. Results Of the 1022 studies identified, fifteen met the inclusion criteria. Study quality assessment was performed using the Joanna Briggs Institute (JBI) Prevalence Critical Appraisal Checklist, with scores ranging from 4 out of 10 to 10 out of 10. Pooled prevalence estimates for twelve studies were 52.9% (95% confidence interval [CI]40.9–64.6). Fatigue was higher in people with bilateral CP than unilateral CP, and higher in people classified as Gross Motor Function Classification System (GMFCS) levels III-V. Conclusion More than half of the adults with CP (52.9%) reported living with fatigue. Adults with CP frequently reported fatigue that may lead to activity limitations and/or restrictions. Fatigue was strongly correlated with pain, depression, and reduced quality of life. Assessment and appropriate fatigue management techniques are necessary to enhance capacity for everyday functioning and quality of life.

The Potential Threat of Vertical Transmission in Methicillin-Resistant Staphylococcus Aureus Infection: A Systematic Review 2022.

This systematic review paper aimed to assess and analyze the prevalence of maternal colonization of Staphylococcus aureus (S. aureus) also known as methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) in the peripartum period and its significance on vertical transmission to the neonate and if it is a potential threat to the health of newborns. For this, multiple databases, such as PubMed, MEDLINE, ScienceDirect, and the database of Elsevier, were used to scout for relevant articles, and results were reported adhering to the principles set by Preferred Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines 2020. A specific medical subject headings (MeSH) criterion was designed to search for relevant publications on PubMed. A total of 26 articles were finally selected after a meticulous screening process, including detailed inclusion and exclusion criteria, manual reading of titles and abstracts, and availability of accessible full-text articles. A few articles were also selected after going through the citations section of the initially selected papers. Quality appraisal was done on the selected publications. Maternal colonization of S. aureus is determined to be highly prevalentwith the hypothesis that nasal colonization had higher rates than recto-vaginal sites. Increasing maternal age, history of vaginitis, and multiparity were the most common risk factors for MRSA and MSSA colonization. Premature babies were at the highest risk of MRSA colonization. Breast milk is also a risk factor for neonatal MRSA transmission. Through this systematic review, we concluded that although the rate of vertical transmission of MRSA is lower than that of MSSA, we felt that it held significance as neonates with the bug have poor outcomes due to skin and soft tissue infections and there is spread of MRSA to other neonates in the wardsand spread to siblings in cases of triplets and quadruplets and even death due to potential MRSA sepsis. Women in Africa and China had high prevalence rates of MRSA and S. aureus which can probably be attributed to a lack of access to adequate healthcare facilities. We recommend screening with regular recto-vaginal swabs and nasal swabs especially in regions with a high burden of MRSA to be performed at regular intervals after confirmation of pregnancy, as prevention and screening are effective to avoid serious complications.

Effectiveness of integrated care for elderly patients with hip fractures: A systematic review and meta-analysis

Hip fractures in the elderly often cause many complications after surgery. Although ample evidence shows that integrated care can effectively improve postoperative conditions, the effectiveness of specific interventions remains inconsistent across studies. This study was conducted following the Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The database was from November 1998 to July 2022. Twelve studies (3,010 participants) implemented integrated care for elderly patients with hip fractures. Overall, integrated care improved Activities of Daily Living (ADL) levels within 6 months, at 12 months, Quality of Life (QoL) at 6 months, and decreased Length of Stay (LOS) and mortality rate at 3 months. At least 3 months of integrated care intervention for hip fractures in the elderly to reduce patient complications and medical costs, can be used as a reference for future policies and clinical care.

Prevalence of Metabolic Syndrome in Polycystic Ovarian Syndrome

Metabolic Syndrome has High Prevalence in PCOS.Objective:This present study was conducted to evaluate the prevalence of MetS in PCOS patients using the related previously published data.Methods: The present systematic review was based on the Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was done using MeSH keywords in databases of PubMed, biomedcentral.com, Obgyn science and Google scholar search. We used Cochran's Q test and I2 Index to evaluate the relation among the studies and the random effects model was used to combine the results. Article review and discussion were precisely described with their refrences on the end of study.Results: 12 studies including 2600 plus patients with PCOS were included in the final analysis. Total heterogeneity was high . The prevalence of MetS in PCOS patients was estimated to about 70% in total patients with the history of pcos.Conclusion:Considering the prevalence of Metaboolic Syndrome in PCOS patients, diagnosis of Metabolic Syndrome in PCOS patients is necessary to reduce the causes and effects on the mortality rate.

Prevalence of Metabolic Syndrome in Polycystic Ovarian Syndrome

Metabolic Syndrome has High Prevalence in PCOS.Objective:This present study was conducted to evaluate the prevalence of MetS in PCOS patients using the related previously published data.Methods: The present systematic review was based on the Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was done using MeSH keywords in databases of PubMed, biomedcentral.com, Obgyn science and Google scholar search. We used Cochran's Q test and I2 Index to evaluate the relation among the studies and the random effects model was used to combine the results. Article review and discussion were precisely described with their refrences on the end of study.Results: 12 studies including 2600 plus patients with PCOS were included in the final analysis. Total heterogeneity was high . The prevalence of MetS in PCOS patients was estimated to about 70% in total patients with the history of pcos.Conclusion:Considering the prevalence of Metaboolic Syndrome in PCOS patients, diagnosis of Metabolic Syndrome in PCOS patients is necessary to reduce the causes and effects on the mortality rate.

Latihan Fisik terhadap Penurunan Cancer Related Fatigue pada Pasien Kanker Payudara

This study aims to identify and evaluate the effect of a physical exercise intervention on reducing cancer-related fatigue in breast cancer patients. The method used is Systematic Reviews using EBSCO, PubMed and ProQuest databases. The articles were selected using the PRISMA (Preferred Items for Systematic Reviews and Meta-Analyses) diagram, which found ten articles that matched the inclusion criteria. The results showed that physical exercise had a significant effect on reducing fatigue and could improve the quality of life of breast cancer patients. In conclusion, physical exercise intervention can help relieve symptoms and reduce cancer-related fatigue in breast cancer patients.
 Keywords: Cancer Related Fatigue, Breast Cancer, Physical Exercise

Efficacy of medication therapy for patients with chronic kidney disease and heart failure with preserved ejection fraction: a systematic review and meta-analysis

BackgroundThe prevalence and mortality of heart failure with preserved ejection fraction (HFpEF) are high in patients with chronic kidney disease (CKD). However, there is still a lack of recommendations for the medication therapy of these patients in the guideline so far.MethodsWe conducted a systematic review and meta-analysis of all the studies assessing medication therapy for patients with CKD and HFpEF by July 21, 2021. Pooled analysis was performed using a random-effect model and the quality assessment was performed. In our research, we followed to the Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The meta-analysis was registered on PROSPERO.ResultsWe finally identified six studies, three of which were randomized controlled trials and the others were retrospective cohort studies. The results of meta-analysis including three retrospective cohort studies showed that renin–angiotensin system inhibitors had significantly reduced all-cause mortality by 14% (3 studies, 3816 patients, HR 0.86; 95% CI 0.79–0.95; I2 = 49%; P = 0.003), and all-cause hospitalization by 11% (2 studies, 2350 patients, HR 0.89; 95% CI 0.85–0.94; I2 = 0%; P < 0.00001) in patients with CKD and HFpEF. However, there was no significant reduction in the risk of hospitalization for heart failure (3 studies, 3816 patients, HR 0.88; 95% CI 0.75–1.04; I2 = 75%; P = 0.13). One of the studies focused on the sacubitril–valsartan showed that sacubitril–valsartan was associated with a reduced risk of hospitalization for heart failure and cardiovascular death (RR 0.79, 95% CI 0.66–0.95). The study focused on the carvedilol did not show a significant reduction in the risk of hospitalization for heart failure and cardiovascular death (HR 0.917, 95% CI 0.501–1.678).ConclusionsFor patients with CKD and HFpEF, renin–angiotensin system inhibitors is associated with significant benefits in all-cause mortality and all-cause hospitalization but has no significant effect on hospitalization for heart failure. The subgroup analysis of one RCT study focused on ARNI showed that although long-term treatment with sacubitril–valsartan may reduce the risk of hospitalization for heart failure and cardiovascular death, more studies are needed to confirm that.

Cholescintigraphy may have a role in selecting patients with biliary dyskinesia for cholecystectomy: a systematic review.

Patients with typical biliary pain, no gallstones on ultrasound and low gallbladder ejection fraction (GBEF) on cholescintigraphy (gallbladder dyskinesia) may be considered for a laparoscopic cholecystectomy. However, some studies have suggested that symptoms alone are an adequate indication for laparoscopic cholecystectomy. The aim was to determine the role of cholescintigraphy in predicting outcomes of cholecystectomy in patients with typical and atypical biliary symptoms and normal biliary ultrasound. Meta-analysis using Preferred Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines of published literature using several electronic databases. Twenty-four articles were selected with a total of 1710 patients. The majority (n = 1633, 94.4%) of patients had typical biliary symptoms. A total of 1047 patients with typical symptoms and a reduced GBEF had a cholecystectomy with 852 (81.4%) having complete resolution of symptoms. A total of 148 with typical symptoms and normal GBEF had a cholecystectomy with 103 (69.5%) having complete resolution, which was significantly less than those with a reduced GBEF (odds ratio 1.65, confidence interval 1.08-2.05, P = 0.01). Forty-five patients with atypical symptoms and a reduced GBEF had a cholecystectomy with 31 (68.9%) having complete resolution of symptoms, which is significantly lower than those with typical symptoms (odds ratio 1.97, confidence interval 0.95-3.90, P = 0.05). Cholescintigraphy improved the predication of outcome of cholecystectomy in biliary dyskinesia by 10%. However, the presence of typical symptoms does predict an effective response in 70% of patients. Atypical symptoms predict a poorer response.

Postoperative UFT-/Tegafur-based Chemotherapy Versus Postoperative Radiotherapy for Early-stage Non-small Cell Lung Cancer：A Systematic Review and Network Meta-analysis

Background: Both of UFT-/Tegafur-based postoperative chemotherapy and postoperative radiotherapy have made large progress in treatment of early-stage non-small cell lung cancer. While it is unclear that, whether UFT-/Tegafur-based postoperative chemotherapy is superior to postoperative radiotherapy for early-stage non-small cell lung cancer with no direct evidence. Methods: Electronic databases (Pubmed, embase, cochrane library and clinicaltrials.gov) were searched to obtain relevant studies. This systematic review and meta-analysis is reported in accordance with the Preferred Items for Systematic Reviews and Meta-analysis (PRISMA) Statement and was registered at International Prospective Register of Systematic Reviews (number CRD42018095979). Sensitive analysis was conducted by excluding overweight studies. Funnel plot and egger’s test were performed to conduct publication bias. Results: Twenty-one randomized control trials were included. Our results suggested UFT-/Tegafur-based postoperative chemotherapy could improve overall survival over postoperative radiotherapy [HR=0.69 (0.59-0.80), p=0.000]. But subgroup analysis about stage showed there was no significant difference between them, no matter of stageⅠ,Ⅱ and Ⅲ. As to chemotherapy regime, both UFT-/Tegafur + platinum+vinca alkaloid [HR=0.68 (0.56-0.82), p=0.000] and UFT-/Tegafur only [HR=0.66 (0.54-0.79), p=0.000] were superior to radiotherapy. Subgroup analysis about radiotherapy delivery method and dose showed, significant improvement of chemotherapy over radiotherapy for Cobalt-60 only [HR=0.54 (0.39-0.75), p=0.000], Cobalt-60 and linac [HR=0.69 (0.59-0.81), p=0.000] and ≥45 Gy [HR=0.64 (0.54-0.75), p=0.000], but not for linac only [HR=0.78 (0.60-1.03), p=0.081] and ＜45 Gy [HR=0.86 (0.67-1.11), p=0.241]. Conclusion: UFT-/Tegafur-based postoperative chemotherapy was superior to postoperative radiotherapy for improving overall survival of early-stage non-small cell lung cancer, but it is not always so under certain circumstance, such as RT delivery method and radiation dose. Of course, it is imperative to further explore differences in specific stage, such as ⅠA and ⅠB.

Prevalence of enteric non‐typhoidal Salmonella in humans in the Middle East and North Africa: A systematic review and meta‐analysis

To enhance efforts related to controlling foodborne pathogens in the Middle East and North Africa (MENA), information on epidemiology of non-typhoidal Salmonella enterica (hereafter termed "Salmonella") is limited. We quantified the overall regional and country-specific Salmonella prevalence in different human populations and identified the most common serotypes. Published literature of Salmonella prevalence was systematically reviewed and reported following the Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Pooled Salmonella prevalence measures were estimated using a random-effects model. We identified 46 research reports that reported 84 Salmonella prevalence measures in 15 out of 24 countries in MENA. There were 252,831 tested humans with 6,356 Salmonella-positive cases. The pooled Salmonella prevalence in MENA was estimated at 6.6% (95% confidence interval (CI): 5.4%-7.9%). The highest pooled Salmonella prevalence measures were in Morocco (17.9%, 95% CI: 5.7%-34.8%, 1997-2012), Tunisia (10.2%, 95% CI: 4.3%-18.0%, 1988-2009) and Sudan (9.2%, 95% CI: 6.5%-12.2%, 2006-2008), while the lowest were in Jordan (1.1%, 95% CI: 0.1%-3.0%, 1993-2010), Oman (1.2%, 95% CI: 1.2%-1.3%, 1998-2002) and Palestine (1.2%, 95% CI: 0.4%-2.1%, 1999-2011). In MENA, Salmonella pooled prevalence in gastrointestinal symptomatic, gastrointestinal asymptomatic and food handlers population groups was 13.0% (95% CI: 7.6%-19.6%), 11.4% (95% CI: 2.2%-25.7%) and 3.8% (95% CI: 1.0%-8.0%), respectively. Salmonella prevalence was 14.5% (95% CI: 8.7%-26.1%) in studies tested <100 subjects, whereas 4.6% (95% CI: 3.6%-5.8%) in studies tested ≥100 subjects. Salmonella Enteritidis (29.8%) and Typhimurium (23.6%) were the most common serotypes. Salmonella was a common foodborne pathogen in MENA countries, particularly in North African countries. Findings inform the scientific community, the public and the decision-makers with Salmonella prevalence and gaps in evidence in MENA to support control and prevention strategies and could leverage more research studies.

Towards Guideline-Based Management of Tethered Cord Syndrome in Spina Bifida: A Global Health Paradigm Shift in the Era of Prenatal Surgery.

An estimated 60% of the world’s population lives in Asia, where the incidence of neural tube defects is high. Aware that tethered cord syndrome (TCS) is an important comorbidity, the purpose of this systematic review was to explore the treatment of TCS among individuals living with spina bifida (SB) in Asia. MEDLINE and Embase databases were searched for relevant studies published from January 2000 to June 2018. Search terms such as ‘spinal dysraphism,’ ‘spinabifida,’ ‘diastematomyelia,’ ‘lipomeningocele,’ ‘lypomyelomeningocele,’ ‘meningomyelocele,’ and ‘tethered cord syndrome’ were used in diverse combinations. Of the 1,290 articles that were identified in accordance with PRISMA (Preferred Items for Systematic Reviews and Meta-Analyses) guidelines, 15 Asia-based studies met the inclusion criteria. Significant differences in the diagnostic criteria and management of TCS were documented. As the surgical techniques for prenatal closure of the spinal defect continue to evolve, their adoption internationally is likely to continue. In this setting, a clear and evidence-based approach to the definition and management of TCS is essential. The recent publication by the Spina Bifida Association of America of their updated care guidelines may serve as a tool used to promote a systematized approach to diagnosing and treating TCS among individuals with SB in the region, as well as globally.

Benefit and Risk from Paclitaxel-Coated Balloon Angioplasty for the Treatment of Femoropopliteal Artery Disease: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Background: Paclitaxel-coated balloons (DCB) are suitable to reduce the risk of restenosis after angioplasty of atherosclerotic femoropopliteal lesions. However, numerous types of DCBs are distinguished by drug density and coating. Conflicting evidence exists about the risk of all-cause death. Methods: Randomised trials published between Jan 1, 2005 and Feb 3, 2019 were identified by searching MEDLINE, CENTRAL, and Clinical.trials.gov. Studies on DCB versus plain old balloon angioplasty (POBA) for the treatment of femoropopliteal artery disease were included, and those focused on in-stent restenosis or critical limb ischemia were excluded. Random-effects meta-analysis was conducted to assess the main outcomes of freedom from target lesion revascularisation (FfTLR) and all-cause mortality. Findings: Of 552 identified records, 14 studies including 2504 patients were eligible. DCB significantly increased the probability of FfTLR with substantial heterogeneity (12-month: risk ratio [RR] 1·24 [95% CI 1·14- 2·27], I2 = 66%; 24-month RR 1·39 [95% CI 1·39-1·52], I2 = 21%). The risk of all-cause mortality was similar between groups at 12 months (RR 0·87 [95% CI 0·48-1·59]), and non-significantly increased after DCB angioplasty at 24 months (RR 1·53 [95% CI 0·94-2·50]). Interpretation: Efficacy of DCB for femoropopliteal angioplasty differs substantial across studies. Effect size depends on the type of DCB, treatment strategy, and lesion complexity. The risk of all-cause death at two years tended to be increased after DCB without evidence of causation. Trial Registration Number: This study is registered with ClinicalTrials.gov (NCT02927574). Funding Statement: The authors stated: There was no funding source for this study. Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: This systematic review and meta-analysis was conducted according to the Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Gefitinib Plus Chemotherapy Versus Cetuximab Plus Chemotherapy in Patients with Advanced Non-small Cell Lung Cancer: &amp;lt;i&amp;gt;A Network Meta-Analysis&amp;lt;/i&amp;gt;

Recent randomized control trials have revealed the efficacy and safety of gefitinib plus chemotherapy and cetuximab plus chemotherapy on the treatment of advanced non-small cell lung cancer, but little is known about the differences between them lacking of direct evidences. Randomized control trials were selected by formal search of electronic databases (PubMed, Embase, and Cochrane Library) and trials registers on the Internet. This systematic review and meta-analysis is reported in accordance with the Preferred Items for Systematic Reviews and Meta-analysis (PRISMA) Statement and was registered at International Prospective Register of Systematic Reviews. 14 trails were identified finally, with 8 studies about gefitinib plus chemotherapy vs chemotherapy alone and 6 studies about cetuximab plus chemotherapy plus vs chemotherapy alone. For overall survival and progression-free survival, the relative HRs of gefitinib plus chemotherapy vs cetuximab plus chemotherapy were 0.96 (0.81-1.13, p=0.583) and 0.69 (0.45-1.05, p=0.080) on first-line treatment and 1.60 (1.01-2.54, p=0.044) and 0.83 (0.61-1.15, p=0.267) on second-line treatment. For objective response rate and one-year survival rate on first-line treatment, the relative RRs of gefitinib plus chemotherapy vs cetuximab plus chemotherapy were 0.89 (0.69-1.15, p=0.395) and 0.84 (0.72-0.98, p=0.026). For adverse events, the risk of relative RR of leukopenia all grades was 0.73 (0.58-0.91, p=0.006), while other events didn’t exhibit significant differences. Subgroup analysis found that comparing to cetuximab plus chemotherapy, gefitinib plus chemotherapy appeared a better improvement in one-year survival rate of USA advanced NSCLC population [RR=0.83 (0.70-0.99, p=0.042)]. It concluded that, on the treatment of advanced NSCLC patients, the efficacy and safety of gefitinib plus chemotherapy are superior to cetuximab plus chemotherapy on first-line treatment, while the latter may be a better choice as well when it occurs to second-line treatment.

Prevalence and characteristics of pain in children and young adults with cerebral palsy: a systematic review.

The primary aim of this review is to evaluate the evidence for pain prevalence in children and young adults with cerebral palsy. Secondary aims are to identify pain characteristics and types of pain measurement used in this population. Ovid MEDLINE, Embase, CINAHL Plus, and PubMed were searched in October 2016 and updated in November 2017. Two authors independently screened studies according to Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pain outcomes were categorized within a biopsychosocial pain framework, with pain prevalence extracted for all recall periods and measurement types. One hundred and six publications from 57 studies met inclusion criteria. Pain prevalence varied widely from 14 per cent to 76 per cent and was higher in females, older age groups, and those classified within Gross Motor Function Classification System level V. Pain was most frequent in the lower limbs, back, and abdomen and associated with reduced quality of life or health status. The influence of pain on psychological functioning, interference, and participation was inconclusive. Variation exists in reported pain prevalence because of sampling bias, inconsistent measurement, varying recall periods, and use of different participant age ranges. Pain prevalence varies from 14 per cent to 76 per cent in children and young adults with cerebral palsy. Pain is more prevalent in females, older age groups, and children in Gross Motor Function Classification System level V.

The analgesic efficacy of cyclooxygenase-2 selective inhibitors in paediatric adenotonsillectomy: a systematic review

Background: A systematic review of the analgesic efficacy of selective cyclooxygenase-2 (COX-2) inhibitors in paediatric adenotonsillectomy based on subjective pain scores, adjunct analgesic requirements and time to recovery was performed. Additional analysis was performed of side effects to treatment and patient satisfaction. Methods: A systematic search was performed using the PubMed, MEDLINE and EMBASE databases. The Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies that measured the efficacy of selective COX-2 inhibitors were included for qualitative analysis. Results: Eight studies (seven randomised controlled trials and one prospective cohort study) were included for analysis of rofecoxib, parecoxib and celecoxib. Rofecoxib and parecoxib were shown to be largely effective analgesic agents for post-adenotonsillectomy pain. Results were conflicting for celecoxib. Conclusions: The available evidence suggests that COX-2 inhibitors offer some benefit in post-adenotonsillectomy pain relief and are well tolerated. Paucity and heterogeneity of data make definitive conclusions difficult. Further research looking specifically at currently available oral agents in the post-operative setting will be of clinical relevance and potential benefit for this common paediatric procedure.

Memory Rehabilitation in Patients with Epilepsy: a Systematic Review.

Memory failure is a common clinical concern of patients with epilepsy and is associated with significant functional impairments. Thus, memory rehabilitation is of critical clinical importance. In this article, we aimed to systematically evaluate the efficacy of memory rehabilitation in patients with epilepsy. The Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to guide searches, extraction and reporting of data in this review. PsycINFO, Medline and PsychBITE searches yielded 95 studies. Twelve papers met inclusion criteria, reporting outcomes of cognitive or behavioural interventions that specifically targeted the rehabilitation of memory in patients with epilepsy. Methodological rigour was rated using the Single-Case Experimental Design (SCED) scale for single-case studies and a modified version of the Downs and Black checklist for group studies. Twelve prospective studies, nine group (six pre-post design, one waitlist crossover, two randomised controlled trials) and three single-case studies were identified. Eleven of the studies included adults, eight of which involved adults with temporal lobe epilepsy (TLE). One paediatric study was identified. The quality of group studies ranged from 36% (poor) to 72% (good), using the modified Downs and Black checklist. Single-case studies were assessed using the SCED scale and assessed to range in quality from four to seven out to 11. Overall, memory rehabilitation was associated with improved memory function in all studies. Verbal memory outcomes were most commonly examined and associated with improvements. This review found that the level of evidence available to support rehabilitation of memory in patients with epilepsy was generally weak and inconsistent. Nevertheless, studies conducted to date, albeit of limited methodological quality, offer preliminary evidence that memory rehabilitation is associated with improvements in verbal memory in patients with temporal lobe epilepsy. Little is known about the efficacy of memory rehabilitation in patients with non-TLE, children, and other aspects of memory difficulties. Guidelines for future research are proposed.