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Rapid internet penetration and technological advancements have facilitated accessibility to internet-enabled devices globally. Since Asia lacks comprehensive data on internet addiction among college students, this review aims to estimate its pooled prevalence. This was a systematic review and meta-analysis. Searches were conducted in PubMed, Scopus, CINAHL, and MEDLINE from their inception through August 2022 using terms appropriate to internet addiction and Asian countries/territorial for publications in English peer-reviewed journals. The studies included those done on current college students and provided unambiguous indicators of the threshold of internet addiction. The pooled prevalence was calculated through a random-effects meta-analysis by RStudio software, and I 2 statistic was used to assess heterogeneity. The Joanna Briggs Institute critical appraisal checklist was used for quality assessment. Overall, between 2007 and 2021, 39 papers comprising 45 effect sizes and totaling 58,058 participants met the inclusion criteria. The pooled prevalence of internet addiction among Asian college students was 24.3% (95% confidence interval: 19.8%–29.5%, Q = 6234, df = 44, τ2 = 0.79, I 2 = 99.29%), and strikingly, this percentage increased over time. A high degree of heterogeneity was seen, and no publication bias was found. To our knowledge, this is the first comprehensive review report on Asian college students, which found that one-fifth suffer from internet addiction. The findings emphasize the significance of multidisciplinary prevention and management strategies to mitigate the harmful effects of internet addiction. Further research is warranted to develop a standardized diagnostic tool for a more precise estimation of internet addiction among this population. [ABSTRACT FROM AUTHOR]

It is an updated systematic review with meta-analysis that compared supervised exercise therapy (SET) vs non-supervised exercise therapy (NSET) programs for patients with distal radius fracture. The purpose of this systematic review is to appraise the current literature to determine if SET program is more effective than a NSET program for pain relief, improvement of range of movement, function and grip strength, both in the short or medium term for patients following distal radius fractures. Systematic review. The following electronic databases were searched: Medline/Pubmed, PEDro, Cinahl, Embase, CENTRAL, and Lilacs. PICOT strategy was used for trial selection. The searches were conducted on August 22, 2021, and May 26, 2022. Two researchers performed an independent search for papers from the references of the chosen trials. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used for assessing the quality of evidence. The search strategy identified 2786 potentially eligible studies and 15 studies met our inclusion criteria. The results did not show that the SET program was more effective than the NSET program for all outcomes, in both terms for patients after distal radius fractures. GRADE showed that all analyses presented very low-quality evidence. Even the results showing there was no difference between the two programs analyzed, the available evidence for randomized controlled trials was insufficient to support these results. • The trials selected have very low methodological quality. • It was not possible to conclude that there is no difference between the programs. • Future clinical trials are needed to conclude the effectiveness of the programs. • The non-supervised programs used very different methods. • Instructions, videos, booklets and advice were used as methods. [ABSTRACT FROM AUTHOR]

• Sex differences: females had lower MMOS than males among healthy elderly individuals. • Age impact: MMOS decreases with age, indicating reduced mouth-opening strength. • Dysphagia impact: dysphagic individuals showed significantly lower MMOS compared to healthy elderly. • Data insufficiency : limited reliable data on mouth-opening strength across populations. • Research need: further studies are needed to understand mouth-opening performance. To characterize mouth-opening muscular performance (MOMP) in adults and elderly individuals with dysphagia and healthy controls. We searched the PubMed, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science databases from inception to Jan. 26, 2023. Two independent researchers considered the titles, abstracts, and full texts of potentially eligible papers from 1451 search results. Twenty-five studies that evaluated mouth-opening maximal strength (MOMS) in healthy adults, elderly individuals, and patients with dysphagia met the inclusion criteria. We found comparable, reliable values with significant sex differences in maximal mouth opening strength (MMOS) in the meta-analysis for healthy elderly patients (females 5.31 ± 0.47 kg vs. males 7.04 ± 0.70 kg; mean difference of 0.84 kg). Age has also emerged as an essential factor in reducing strength. There was a significant reduction in the MMOS score in the only study that compared dysphagic individuals to healthy elderly individuals. In another study, the MMOS score was comparable to the meta-analysis of healthy elderly individuals. Both sex and age play significant roles in the MMOS. There is no reliable data on the normal mouth-opening strength and endurance of healthy adults, patients with dysphagia, or individuals with other relevant clinical problems. [ABSTRACT FROM AUTHOR]

The aim of this study was to conduct a meta-analysis of clinical trials on the effect of nonpharmaceutical treatments on outcomes for multiple sclerosis (MS). The CINAHL, Mantis, Medline, PEDro, PubMed, and Scopus databases were searched. Final papers meeting inclusion criteria were scored with the Physiotherapy Evidence Database for quality and included in a meta-analysis. Forty papers in the meta-analysis totaled 1673 participants. The interventions were grouped into 6 subcategories: physical activity, technology, rehabilitation, alternative, resistance training, and psychological. The combined effect of interventions produced a large overall effect size for the outcome fatigue; medium effect sizes for functionality, balance, and quality of life; and no effect on pain or spasticity. Physical activity had the greatest effect, improving fatigue, function, and balance. Rehabilitation and resistance training had a large effect on functionality. Comparatively, psychological approaches had only a small effect on improving quality of life. Sample sizes of included papers tended to be small with large variability in design. Therefore, results should be interpreted cautiously. Our results suggest there may be effective nonpharmaceutical treatment options available that can improve the symptoms of fatigue, poor functionality, balance, and quality of life. We found that physical activity, alternative approaches, rehabilitation, and resistance training were effective for improving the management of a number of MS symptoms. [ABSTRACT FROM AUTHOR]

• High prevalence of involuntary treatment among community-dwelling older persons with dementia. • Specific caregiver and care recipient factors associated with involuntary treatment. • Urgent need for proactive measures and targeted interventions to enhance care quality. This systematic review and meta-analysis aimed to ascertain the prevalence of involuntary treatment among community-living older persons with dementia and explore associated factors. We comprehensively searched seven electronic databases (PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, and Scopus) from their inception to October 17, 2023, with an update conducted on April 1, 2024. Meta-analysis synthesized prevalence estimates of involuntary treatment and its three subcategories, with 95% confidence intervals. This study included 11 research papers involving 12,136 community-dwelling individuals with cognitive impairment and dementia from 19 countries. The pooled prevalence of involuntary treatment among community-dwelling older persons with dementia was 45.2% (95% CI: 33.7−60.5%). Subcategories included physical restraints (9.8%, 95% CI: 5.1−18.8%), psychotropic medication (19.1%, 95% CI: 13.6−26.9%), and non-consensual care (34.3%, 27.6−42.7%). Factors influencing involuntary treatment were categorized as caregiver-related and care recipient-related. This study underscores the prevalent use of involuntary treatment among community-dwelling older persons with dementia, emphasizing its association with specific caregiver and care recipient factors. Addressing these findings underscores the importance of proactive measures and targeted interventions to improve the quality of care for this vulnerable population. [ABSTRACT FROM AUTHOR]

This paper aims to systematically review the illness perceptions of stroke patients and to examine the association between illness representation and psychological distress in empirical research studies. Patients' perceptions of health threats determine their coping behavior. Several recent studies have focused on illness belief and distress in stroke patients. This information is suitable for a meta-analysis to further understand stroke patients' illness perceptions. Systematic review and meta-analysis. An electronic literature search was conducted using the CINAHL, MEDLINE, PubMed, Cochrane library, and Google Scholar databases. Search strategies were title (stroke or cerebrovascular accident or CVA or cerebral vascular event or transient ischemic attack or TIA) and keyword (disease or illness) and keyword (perceptions or attitudes or opinion or experience or view or reflection or beliefs). The literature search covers the period of January 1990 to October 2018. Seven articles were included in the meta-analysis and Fisher's z was calculated with correlation coefficient or regression coefficient values for eight illness representation dimensions and psychological distress. All statistical analyses were performed using Comprehensive Meta-Analysis (CMA) version 3.0 software. A total of 49 studies were reviewed, and seven studies with a total of 507 participants were eligible for the meta-analysis. For patients' perceived anxiety and depression, six of seven studies, with 285 to 461 participants, were examined in terms of the average corrected correlation coefficient across the studies. It was found that stroke patients' perception of a strong illness identity, timeline-acute/chronic, timeline-cyclical, consequences, and emotional responses were significantly and positively related to anxiety and depression. The pooled z -value ranged from 0.189 to 0.460. Conversely, for protective-related factors, such as stroke patients' perceived personal control, treatment control, and illness coherence, only perceived illness coherence was significantly negatively associated with depression (z -value, -0.122; 95% CI: -0.241, -0.002). For patients' perceived overall distress, three of seven studies with 173 participants showed that there were significant and positive associations between identity, consequence, emotions, and distress (z -value ranges = 0.493–0.711) as well as a significant and negative association between illness coherence and overall distress (z -value, -0.226; 95% CI: -0.379, -0.073). An association between illness representation and distress exists in stroke patients. Risk factors are the most significant in terms of this relationship, and protective factors do not have a protective health impact. Protection factors need to be promoted to reduce patient distress. [ABSTRACT FROM AUTHOR]

Objective: To explore patient and health professional views and experiences of antidepressant treatment with particular focus on barriers and facilitators to discontinuing use.Design: Systematic review with thematic synthesis DATA SOURCES: MEDLINE, PubMed, Embase, PsycINFO, CINAHL, AMED, Health Management Information Consortium, OpenGrey, and the Networked Digital Library of Theses and Dissertations from inception until February 2017. Updated searches were carried out in July 2018.Eligibility Criteria: Primary studies, published in English, that used qualitative data collection and analysis, and had data on attitudes, beliefs, feelings, perceptions on continuing or discontinuing antidepressant use, of patients (aged 18 or above, who received treatment with antidepressants for at least 6 months) or any health professionals.Data Extraction: One reviewer extracted data and assessed study quality, which was checked by a second reviewer.Findings: Twenty two papers were included in the review. A thematic synthesis was performed for patient perspectives only, due to insufficient data from a health professional perspective. The thematic synthesis yielded nine themes: (1) psychological and physical capabilities; (2) perception of antidepressants; (3) fears; (4) intrinsic motivators and goals; (5) the Doctor as a navigator to maintenance or discontinuation; (6) perceived cause of depression; (7) aspects of information that support decision-making; (8) significant others - a help or a hindrance; and (9) support from other health professionals.Limitations: Coding and development of subthemes and themes was performed by one researcher and further developed through discussion between two researchers.Conclusions: Barriers and facilitators to discontinuing antidepressant use are numerous and complex, and likely to require detailed conversations between patients and their general practitioners (GPs). These conversations are more likely to happen if GPs raise the issue of discontinuation. Further research from a health professional perspective including, but not limited to GPs, is needed. [ABSTRACT FROM AUTHOR]

Intensive-care-unit (ICU) patients exhibit disturbed sleeping patterns, often attributed to environmental noise, although the relative contribution of noise compared to other potentially disrupting factors is often debated. We therefore systematically reviewed studies of the effects of ICU noise on the quality of sleep to determine to what extent noise explains the observed sleep disruption, using the Cochrane Collaboration method for non-randomized studies. Searches in Scopus, PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library were conducted until May 2017. Twenty papers from 18 studies assessing sleep of adult patients and healthy volunteers in the ICU environment, whilst recording sound levels, were included and independently reviewed by two reviewers. We found that the numbers of arousals between the baseline and the ICU noise condition in healthy subjects differed significantly (mean difference 9.59; 95% confidence interval 2.48-16.70). However, there was considerable heterogeneity between studies (I2 94%, P < 0.00001), and all studies suffered from a considerable risk of bias. The meta-analysis of results was hampered by widely varying definitions of sound parameters between studies and a general lack of detailed description of methods used. It is, therefore, currently impossible to quantify the extent to which noise contributes to sleep disruption among ICU patients, and thus, the potential benefit from noise reduction remains unclear. Regardless, the majority of the observed sleep disturbances remain unexplained. Future studies should, therefore, also focus on more intrinsic sleep-disrupting factors in the ICU environment. [ABSTRACT FROM AUTHOR]

Background: Physical exercise has been used to mitigate the metabolic effects of diabetes mellitus. Objective: To evaluate the effect of resistance exercise when compared to aerobic exercise without insulin therapy on metabolic and clinical outcomes in patients with type 2 diabetes mellitus. Methods: Papers were searched on the databases MEDLINE/PubMed, CINAHL, SPORTDiscus, LILACS, and SCIELO, without language or date of publication limits. Clinical trials that compared resistance exercise to aerobic exercise in adults with type 2 diabetes mellitus who did not use insulin therapy were included. The quality of evidence and risk of bias were assessed using the GRADE system and the Cochrane Risk of Bias tool, respectively. Meta-analysis was also used, whenever possible. Two reviewers extracted the data independently. Eight eligible articles were included in this study, with a total of 336 individuals, with a mean age of 48-58 years. The protocols of aerobic and resistance exercise varied in duration from eight to 22 weeks, 30-60 min/day, three to five times/week. Results: Overall the available evidence came from a very low quality of evidence and there was an increase in Maximal oxygen consumption (mean difference: -2.86; 95% CI: -3.90 to -1.81; random effect) for the resistance exercise and no difference was found in Glycated hemoglobin, Body mass index, High-density lipoprotein cholesterol, Low-density lipoprotein cholesterol, triglycerides, and total cholesterol. Conclusions: Resistance exercise appears to be more effective in promoting an increase in Maximal oxygen consumption in protocols longer than 12 weeks and there is no difference in the control of glycemic and lipid levels between the two types of exercise. [ABSTRACT FROM AUTHOR]

Nurses work in stressful and demanding settings and often suffer from depression and burnout. Despite overlapping symptoms, research has been inconclusive regarding the discriminant validity of measures of burnout with regard to measures of depression. Such inconclusive discriminant validity might cause clinicians to fail to recognize and manage depression separately from burnout. This meta-analysis aimed to clarify the distinctiveness of burnout as a separate construct by examining the size of the relationship between burnout and depression among nurses as well as potential moderators. A stepwise method was used by searching 4 databases (PubMed, CINAHL, PsycINFO, and EMBASE) to retrieve published papers in English examining the relationship between burnout and depression among nurses and reporting the effect sizes of their findings. We identified a total of 37 eligible studies. The pooled estimate showed a positive association between burnout and depression among nurses (r = 0.403, 95% CI [0.327, 0.474], p < 0.0001) and a slightly higher correlation coefficient for the Emotional Exhaustion subscale of the Maslach Burnout Inventory (MBI) measure (0.494, 95% CI [0.41, 0.57]). This review confirms a large burnout - depression correlation in nursing samples, adding to existing literature encompassing a variety of occupations. Future studies should focus on path analysis to assess the causal relationship as well as investigate potential moderators. [ABSTRACT FROM AUTHOR]

• Internet-based prenatal interventions had a small effect on depression. • Websites and mobile devices were the most common internet-based prenatal education. • Promoting communications and social support enabled the bridge of online-based education. This study investigated the effect of internet-based prenatal interventions among pregnant women. Articles regarding randomized controlled trials of internet-based prenatal education interventions were investigated through a systematic review. A literature search was conducted in PubMed, CINAHL, Cochrane Library, Embase, ERIC, and RISS on material published between 1985 and 2020. The inclusion criteria were peer-reviewed papers in English regarding randomized controlled trials of internet-based prenatal education interventions. The exclusion criteria were studies in which high-risk pregnant women participated, interventions that were conducted face-to-face or only involved telephone contact, and studies that reported outcomes related to the baby's health. The quality of the included studies was evaluated using the Risk of Bias 2.0 methodology checklist. Heterogeneity testing suggested a homogeneous sample (I2 = 0%, p =.45). Meta-analysis through standardized mean differences showed that six studies had an effect on postpartum depression, with an effect size of −0.16 (95% CI, −0.26 to −0.05). Conclusion : This study demonstrated that internet-based prenatal interventions had an impact on maternal depression during the postpartum period. Therefore, antenatal care involving mobile-, web-, and internet-based materials may reduce maternal depressive symptoms. [ABSTRACT FROM AUTHOR]

Sexual and reproductive health of young people is an international concern with the increasing interest in healthy pregnancy and childbirth. mHealth interventions involve the use of mobile technologies for health support, have wide applications in clinical nursing practice, and play an increasingly important role in disseminating sexual and reproductive health-related information in emerging adulthood. However, there is a lack of evidence on the effects of mHealth intervention programs. This meta-analysis systematically assessed the effects of mHealth interventions on contraceptive use and pregnancy occurrence in emerging adulthood to identify the characteristics of a successful mHealth intervention program. We conducted a systematic review and meta-analysis of randomized controlled trials. Four central electronic databases (PubMed, Embase, CINAHL complete, and the Cochrane Library) were searched for relevant articles published from inception to May 2020. Data extraction and quality appraisal were performed independently by two reviewers. Eleven papers on the effects of mHealth interventions on sexual and reproductive health in emerging adulthood were selected. The included studies were assessed for the risk of bias with the Risk of Bias 2 (RoB 2) tool. Overall and subgroup meta-analyses were conducted using STATA 16.0. Heterogeneity within studies was calculated using I2. We tested the effect of mHealth interventions on contraceptive use and pregnancy occurrence to identify the impact of sexual and reproductive health. mHealth interventions improved the use of contraception (OR 1.21; 95% CI: 1.02–1.43, I 2 = 20.7%; p = 0.234) although the effect on pregnancy occurrence was not significant (OR 0.80, 95% CI: 0.61–1.05, I 2 = 0.0%, p = 0.950). In subgroup analysis, mHealth interventions especially improved oral contraceptive use (OR 1.43, 95% CI: 1.15–1.77, I 2 = 0.0%, p = 0.784). Regarding the communication type, two-way communication showed statistically significant results with the mHealth intervention in the experimental group (OR 1.28, 95% CI: 1.06–1.54, I 2 = 0.0%, p = 0.872). This meta-analysis found a positive effect of mHealth intervention on contraception, whereas the impact on pregnancy occurrences was limited. We also confirmed the factors underlying effective mHealth interventions from the results of our review. Our findings demonstrate that mHealth interventions may be suggested as a useful strategy to promote sexual and reproductive health in emerging adulthood. [ABSTRACT FROM AUTHOR]

• Seven studies with 770 randomized patients with dementia were included, which compared valproic acid with placebo. • Valproic acid is generally well-tolerated in patients with dementia, even in long-term therapy for 24 months. • Insufficient evidences are found to support valproic acid in the treatment of dementia for symptoms or disease-modifying. • The anticipations for a success in the trial of valproic acid for dementia in the future look not optimistic. The neuroprotective effect of valproic acid has been observed in the animal models of neurodegeneration, which suggests it as a potential candidate for clinical trials. In this paper, we aimed to systematically analyze the efficacy and safety of valproic acid in the treatment of dementia. We searched the electronic databases PubMed, EMBASE, CINAHL, Cochrane Library and China National Knowledge Infrastructure until March 2020 for the eligible randomized controlled trials, as well as the unpublished and ongoing trials. We pooled the results using a random-effects model. We included seven studies with 770 randomized patients with dementia, which compared valproic acid with placebo. Indeed, there were no significant differences found in the scores of Mini–mental State Examination, Cohen-Mansfield Agitation Inventory and number of patients with adverse events. Valproic acid is generally well-tolerated in patients with dementia, even in long-term therapy for 24 months. Insufficient evidences are found to support valproic acid in the treatment of dementia for cognitive, psychiatric symptoms or disease-modifying. The anticipations for a success in the trial of valproic acid for dementia in the future look not optimistic based on the available evidence. [ABSTRACT FROM AUTHOR]

Objective: Existing evidence of predictors of repeated teenage pregnancy has not been assessed rigorously. This systematic review provides a comprehensive evaluation of protective and risk factors that are associated with repeated teenage pregnancy through a metaanalytical consensus.Data Sources: We used PubMed, EMBASE, CINAHL, ProQuest, PsychINFO, ScienceDirect, Scopus, and Web of Science databases from 1997-2015 and the reference list of other relevant research papers and related reviews.Study Eligibility Criteria: Eligibility criteria included (1) epidemiologic studies that analyzed factors associated with repeated pregnancy or birth among adolescents <20 years of age who were nulliparous or experienced at least 1 pregnancy, and (2) experimental studies with an observational component that was adjusted for the intervention.Study Appraisal and Synthesis Methods: We performed narrative synthesis of study characteristics, participant characteristics, study results, and quality assessment. We also conducted random-effects and quality-effects metaanalyses with meta-regression to obtain pooled odds ratios of identified factors and to determine sources of between-study heterogeneity.Results: Twenty-six eligible epidemiologic studies, most from the United States (n=24), showed >47 factors with no evidence of publication bias for each metaanalysis. Use of contraception (pooled odds ratio, 0.60; 95% confidence interval, 0.35-1.02), particularly long-acting reversible contraceptives (pooled odds ratio, 0.19; 95% confidence interval, 0.08-0.45), considerably reduced repeated teenage pregnancy risk. Among studies about contraception, the number of follow-up visits (adjusted coefficient, 0.72; P=.102) and country of study (unadjusted coefficient, 2.57; permuted P=.071) explained between-study heterogeneity. Education-related factors, which included higher level of education (pooled odds ratio, 0.74; 95% confidence interval, 0.60-0.91) and school continuation (pooled odds ratio, 0.53; 95% confidence interval, 0.33-0.84), were found to be protective. Conversely, depression (pooled odds ratio, 1.46; 95% confidence interval, 1.14-1.87), history of abortion (pooled odds ratio, 1.66; 95% confidence interval, 1.08-2.54), and relationship factors, such as partner support, increased the repeated teenage pregnancy risk.Conclusion: Contraceptive use, educational factors, depression, and a history of abortion are the highly influential predictors of repeated teenage pregnancy. However, there is a lack of epidemiologic studies in low- and middle-income countries to measure the extent and characteristics of repeated teenage pregnancy across more varied settings. [ABSTRACT FROM AUTHOR]