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Objective To synthesize current knowledge of the modifiable psychosocial constructs associated with physical activity (PA) participation in people with multiple sclerosis. Data Sources A search was conducted through October 2015 in 8 electronic databases: CINAHL, PubMed, SPORTDiscus, Web of Knowledge, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and PsycINFO. Study Selection Cohort and intervention studies were included if they (1) included an objective or subjective measure of PA; (2) measured at least 1 modifiable psychosocial construct; and (3) reported bivariate correlations (or these could be extracted) between the PA and psychosocial construct measures. A total of 13,867 articles were screened for inclusion, and 26 were included in the final analysis. Data Extraction Meta-analyses of correlations were conducted using the Hedges-Olkin method. Where a meta-analysis was not possible, results were reported descriptively. Data Synthesis Meta-analyses indicated a pooled correlation coefficient between (1) objective PA and self-efficacy (n=7) of r =.30 ( P <.0001), indicating a moderate, positive association; (2) subjective PA and self-efficacy (n=7) of r =.34 ( P <.0001), indicating a moderate, positive association; (3) subjective PA and goal-setting (n=5) of r =.44 ( P <.0001), indicating a moderate-to-large positive association; and 4) subjective PA and outcome expectancies (n=4) (physical: r =.13, P =.11; social: r =.19, P <.0001; self-evaluative: r =.27, P <.0001), indicating small-moderate positive associations. Other constructs such as measures of health beliefs, enjoyment, social support, and perceived benefits and barriers were reported to be significantly correlated with PA in individual studies, but the number of studies was not sufficient for a meta-analysis. Conclusions Future PA interventions should continue to focus on the psychosocial constructs of self-efficacy and goal-setting. However, there is a need to explore the associations between other constructs outside those reported in this review. [ABSTRACT FROM AUTHOR]

Background This study assesses the outcomes of surgical vs. conservative management in the treatment of the Jones fracture. Materials and methods A systematic review using four databases from their inception until September 2014 was undertaken. Six studies were found evaluating operative therapy compared to conservative treatment. Results Six relevant studies were included, with a total of 237 patients. Of these, 51% were treated non-operatively, and 49% had surgical intervention. Those in the non-operative group were found to have a significantly higher odds ratio (OR) of fracture non-union (OR 5.74, 95% confidence interval (CI) 2.65–12.40, P < 0.001). Studies also reported a prolonged healing time and a longer time to return to sports. Of the trials with time to union as an outcome measure, 3 of 4 trials found favourable results in the operative cohort. Conclusions Surgical intervention is recommended for patients presenting with a Jones fracture as it is found to result in a lesser non-union rate and an improved time to union. [ABSTRACT FROM AUTHOR]

Epidemiological evidence suggests that obesity and depression are highly co-morbid. In a national cohort study, we examined whether parents caring for children with disabilities were more likely to be classified as obese compared to parents of children without disabilities and if obesity was associated with depressive symptoms or child behaviour characteristics. Using data from the Growing Up in Ireland National Longitudinal Study of Children (2006 to date), 627 parents of children with developmental disabilities were compared with 7941 parents of typically developing children on objectively measured levels of obesity (body mass index ≥30kg/m2), depression, health behaviours, chronic health conditions, socio-demographic and child behavioural characteristics. Parents of children with disabilities were more likely to be classified as obese compared to control parents (24.5% vs. 19.6%, p=0.005, Cramer's V<0.1). Depression was not associated with obesity. However, the odds of obesity increased with increasing child problem behaviour (OR 1.05, 95% CI 1.03-1.06). Over half (57%) of obese parents caring for children with disabilities reported trying to lose weight often or very often. This study has confirmed, in a population-based sample, the high risk of obesity in parents caring for children with disabilities after adjusting for the presence of depression and other health behaviours; increasing child problem behaviours were predictive of obesity. Importantly, given the negative health correlates of obesity, it is imperative that health professionals pay attention to weight issues in these parents and support their efforts in managing these issues. [ABSTRACT FROM AUTHOR]

Highlights: [•] Parents of children with disabilities are at an increased risk of depression. [•] The excess risk was independent of their physical health status. [•] Depression was most likely to manifest after the birth of the child. [Copyright &y& Elsevier]

Objectives: This study describes the pitfalls for commonly used statistical techniques in dental research and gives some recommendations for avoiding them. It also explores the potential of some of the newer statistical techniques for dental research. Methods: Each of the commonly used techniques e.g. descriptive statistics, correlation and regression, hypothesis tests (parametric and non-parametric) and survival analysis are explored with examples and recommendations for their use are provided. Common sources of error including those of study design, insufficient information, ignoring the impact of clustering and underuse of confidence intervals are outlined. The potential of statistical techniques such as multivariate survival models, generalized estimating equations and multilevel models are also explored. Conclusions: Reviews of published dental research repeatedly identify statistical errors in the design, analysis and conclusions of the study. Educating researchers on common pitfalls and giving recommendations for avoiding them may help researchers to eliminate statistical errors. Developments in statistical methodology should be routinely monitored to ensure the most appropriate statistical methods are used in dental research. [ABSTRACT FROM AUTHOR]

Predictors of depression over time were examined in parental carers of children with developmental disabilities (DD) and parents of typically developing children (controls) who participated in the Growing up in Ireland Study. Parents completed measures of depression, the Centre for Epidemiological Depression Scale (CES-D) and child problem behaviours, the Strength and Difficulties Questionnaire when the children were aged 9 (Wave 1) and 13 (Wave 2). Using CES-D cut-off scores to indicate probable depression, caregivers were more likely to be depressed at both waves compared to controls with a Wave 1 rate of depression of 14.6% vs. 7.9% (p < 0.001, Cramer`s V = 0.059) and Wave 2 (14.8% vs. 10%, p = 0.003, Cramer`s V = 0.038). While overall rates of depression were stable for caregivers, a shifting pattern emerged; 59.6% of those who were depressed at Wave 1, were not at Wave 2; similarly, 10.9% who were not depressed at Wave 1, were at Wave 2. Parents of children with DD were also more likely to report greater problem behaviours in their children compared to controls at both waves. Depression in caregivers at Wave 1 and persistent child problem behaviours were significant predictors of depression at Wave 2. In conclusion, while overall rates of depression remain stable in caregivers, there are shifting patterns evident with prior depression and persistent behaviour problems predictive of ongoing depression. [ABSTRACT FROM AUTHOR]

Previous research has investigated the endocrinological consequences of unemployment as a likely pathway behind chronic stress and negative health outcomes. Despite these early attempts at delineating the neuroendocrine consequences of the chronic stress experienced by the unemployed, identifying a consistent and stable effect has remained elusive. Here we sought to strengthen existing knowledge into the effect of the stress of employment status on cortisol by improving on the methodological weaknesses of earlier studies and extend this line of enquiry by measuring the steroid hormone Dehydroepiandrosterone-Sulfate (DHEAS). Saliva samples were collected from unemployed and employed participants at four time points across two days. As expected, unemployed people reported higher stress, lower social support and lower self-esteem. Unexpectedly, the unemployed showed lower overall cortisol output, a likely consequence of a higher cortisol awakening response (CAR) in the employed. However, they also had a higher DHEA output across the day, albeit the diurnal pattern across the day was more dysregulated compared to that seen in those employed with a blunted response evident in the evening; the cortisol:DHEAS ratio was also lower in the unemployed group. Further, these hormone differences were correlated with self-esteem and stress. Taken together these results suggest that the relationship between employment status and endocrine responses is far more complicated than previously thought. We have shown for the first time that unemployed people have a lower CAR, but also show a blunted DHEA response relative to those employed and we suggest that this may be a feature of chronic stress exposure or perhaps dependent on the prevailing socio-economic context. [ABSTRACT FROM AUTHOR]

BACKGROUND: We undertook a systematic review and meta-analysis to compare surgeon-performed ultrasound (SPUS) for suspected appendicitis or gallstone disease to the "gold standard" of pathological examination or radiologist-performed ultrasound (RPUS). DATA SOURCES: MEDLINE, Embase, trial registries, conference proceedings, and article reference lists were searched to identify trials and/or studies comparing SPUS with pathology or RPUS as the reference standard. Data were abstracted from eligible studies to produce 2 x 2 contingency tables, permitting the calculation of pooled sensitivity and specificity values. RESULTS: Eight studies (1,268 patients) evaluated SPUS for appendicitis. For appendicitis, SPUS had a pooled sensitivity of .92 (95% confidence interval [CI], .887-.939) and a pooled specificity of .96 (95% CI, .946 -.974). SPUS for gallstones was evaluated in 8 studies (1,019 patients). The pooled sensitivity was .96 (95% CI, .934 -.979), and the specificity was .99 (95% CI .983-.998). CONCLUSIONS: SPUS achieves acceptable sensitivity and specificity for both gallstones and appendicitis. However, there was some evidence of heterogeneity. Data regarding cost-effectiveness are lacking. [ABSTRACT FROM AUTHOR]