Active commuting to school (ACS) is an important source of physical activity among children. Recent research has focused on ACS and its benefits on cognition and academic achievement (AA), factors important for success in school. This review aims to synthesize literature on the relationship between ACS and cognition or AA among children and adolescents. Peer-reviewed articles in PubMed, Web of Science, PsycINFO and Cochrane Library assessing ACS with cognition and/or AA among children, until February 2019, were selected. Twelve studies across nine countries (age range 4-18.5 years) were included. One study used accelerometers, whereas all others used self-report measures of ACS. A wide range of objective assessments of cognitive functioning and AA domains were used. Five among eight studies, and four among six found a positive relationship between ACS and cognitive or AA measure, respectively. Four studies found dose-response relationships, and some studies found sex differences. The quantitative analysis found that ACS was not significantly associated with mathematics score (odds ratio = 1.18; CI = 0.40, 3.48). Findings are discussed in terms of methodological issues, potential confounders, and the strength of the evidence. Future studies should conduct longitudinal studies and use objective measures of ACS to understand this relationship further.
<b><i>Introduction:</i></b> Hemodialysis (HD) patients are often prescribed salt and fluid-restricted diets to reduce their interdialytic weight gain (IDWG) and prevent chronic volume overload and hypertension. However, adherence to fluid restrictions is poor, which may be due to HD patients’ excessive thirst. The purpose of the review is to explore the association between HD patients’ subjective thirst and IDWG, which may inform strategies to manage chronic volume overload. <b><i>Methods:</i></b> We conducted the literature search in Web of Science, Cumulative Index to Nursing and Allied Health Literature, PubMed, and the Cochrane Library, until February 25, 2019. Studies performing statistical tests to assess the association between patients’ subjective thirst and IDWG were included. <b><i>Results:</i></b> A total of eighteen studies were included in the systematic review, which measured the relationship between patients’ subjective thirst and IDWG. Among them, 14 studies found that different domains of thirst and different units of IDWG are positively associated. Therefore, there is a positive association between the patients’ subjective thirst and IDWG. However, the findings should be interpreted cautiously as there was variability in thirst and IDWG measurement techniques, which might influence the estimated relationship in these studies. <b><i>Discussion/Conclusion:</i></b> These data suggest that strategies are needed to reduce thirst to control IDWG in HD patients.
The current increase in global dementia prevalence deserves public health intervention. While limited access to health care and a shortage of health care workers are significant shortcomings, utilizing community health workers (CHWs) could be a promising way to improve dementia care through cost-effective approaches. This scoping review synthesizes existing research on roles of CHWs in dementia-related services. PubMed, CINAHL, Scopus, CABI Global Health, Web of Science, PsycINFO, and Cochrane Library were searched from inception to October 2, 2019, and yielded 1,594 articles. Five broad areas emerged as potential roles of CHWs from 10 eligible articles: educational and community awareness, screening for dementia, screening for HIV-associated dementia, utilization of health care systems and other dementia-related resources by patients, and services to dementia caregivers. This scoping review sheds light on important contributions of CHWs in addressing dementia among vulnerable communities/groups around the world.
<b><i>Background:</i></b> Clonidine is a frequently prescribed long-term antihypertensive medication in hemodialysis (HD) patients in the USA, but its safety and efficacy has not been clearly established in the HD population. <b><i>Objective:</i></b> To evaluate, we conducted a systematic review and meta-analysis on the safety and efficacy of clonidine in HD patients. <b><i>Methods:</i></b> Keyword search of “clonidine” and “dialysis” was conducted through April 2021 in PubMed, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov databases. Inclusion criteria were as follows – study design: randomized controlled trials, cohort studies, prospective studies, retrospective studies, or case series; subjects: adult HD patients; main outcome: blood pressure (BP) and safety; language: English; and article type: peer-reviewed publications. Studies that examined the effects of clonidine in populations other than adult HD patients were excluded. Meta-analysis was performed on BP reduction outcomes. <b><i>Results:</i></b> Eight studies met the inclusion criteria for the systematic review, including prospective pre-post studies (2), double-blind controlled trial (1), single-blinded placebo-controlled trial (1), crossover open-label clinical trial (1), retrospective analysis (1), and case report series (2). Three studies included in the meta-analysis ranged from 2 to 12 weeks duration, with a collective sample size of 24 (ages 12–77 years). Risk of bias, assessed using the ROBINS-1 tool, was high for all included studies. Significant adverse effects reported included hypotension, light-headedness, drowsiness, dry mouth, rebound hypertension, and contact dermatitis from patch application. Short-term clonidine use was associated with significant improvement in systolic BP (pooled effect: −12.985 mm Hg, 95% CI [−7.878, −18.092], <i>p</i> < 0.001), while changes in diastolic BP were not statistically significant (−11.119 mm Hg, 95% CI [−22.725, 0.487], <i>p</i> = 0.060). No data currently support the long-term efficacy of clonidine in HD patients. This study was unfunded and was developed using PRISMA guidelines and registered on PROSPERO (CRD42018112042). <b><i>Conclusions:</i></b> There is no evidence supporting the long-term use of clonidine in the HD population and a significant side-effect profile. There is low-quality evidence demonstrating the efficacy of clonidine in lowering BP in HD patients in short-term use, but significant safety concerns remain. Fluid removal strategies and other antihypertensives should be used over clonidine for long-term BP control in the HD population.
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