A systematic review with meta-analysis and meta-regression. Eight databases, including Cochrane Library, ProQuest, PubMed, EMBASE, EBSCO, Web of Science, Ovid Medline and Physiotherapy Evidence Database (PEDro), were searched up to January 2017. Eligible studies were classified by intervention and accessed for quality using the Quality Assessment Tool for quantitative studies. Sixteen research articles were eligible in the final review; 10 randomize control trail studies were included in the analysis. The meta-analysis revealed that the use of physical restraint was significantly less often in the experimental (education) group (OR = 0.55, 95% CI: 0.39 to 0.78, p < 0.001) compared to the control group. Meta-regression revealed the period of post education would have decreased the effect of the restraint educational program (β: 0.08, p = 0.002); instead, the longer education period and more times of education would have a stronger effect of reducing the use of physical restraint (β: -0.07, p < 0.001; β: -0.04, p = 0.056). The educational program had an effect on the reduced use of physical restraint. The results of meta-regression suggest that long-term care facilities should provide a continuous education program of physical restraint for caregivers.

Background and Objectives Dementia and central nervous system degeneration are common problems in aging societies with regard to the number of people affected and total medical expenses. Socially assistive robotic (SAR) technology has gradually matured; currently, most scholars believe it can be used as companions in long-term care facilities and worked as caregivers alongside staffs to improve the social interaction and mental state of older adults and patients with dementia. Therefore, this study measured the effect of the duration of exposure to SAR in older adults with dementia. Research Design and Methods Seven databases were searched up to February 2019 through the consultation of appropriate Internet sites and use of criteria lists recommended by relevant experts. Randomized controlled trials comparing SAR use with a control group in older adults with dementia and using at least one of the primary outcomes of agitation, depression, and quality of life were included. Results Thirteen RCTs were identified from 873 articles, 7 of which were included in the meta-analysis. The pooled effect estimate from 3 trials with 214 participants revealed that the pet-type robot improved patients’ agitation level, with a standardized mean difference of −0.37 (95% CI: −0.64 to −0.10, P &lt; .01) and no heterogeneity (I 2 = 0%). The results also revealed that length of each session and pet-type robot exposure time per week were associated with reduced depression levels (β = −0.06, Q = 21.213, df = 1, P = &lt; .001 and β = −0.019, Q = 7.532, df = 1, P &lt; .01, respectively). However, the results for quality of life were nonsignificant. Discussion and Implications Pet-type robot systems seem to be a potential activity in long-term care facilities for dementia care. Further research is warranted to establish a comprehensive intervention plan related to the use of pet-type robots.

Background: World Health Organization has communicated that dementia as a public health priority in 2012. Behavioral and psychological symptoms of dementia are the main reason results in hospitalization of dementia patients. Horticulture is one of the favorite activity for many peoples to relax their minds. Objectives: To investigate psychological health benefits of horticulture intervention in dementia patients. Methods: The databases including Cochrane Library, ProQuest, PubMed, EMBASE, EBSCO, Web of Science, and Ovid Medline were searched up to August 2017. Results: Twenty-three articles for systematic review, whereas 8 articles were included in meta-analysis. Meta-analysis verified the beneficial effect of horticultural therapy (HT) on agitation level (standard mean difference: −0.59; P < .00001); increase time spent on activity engagement (mean differences [MD]: 45.10%, P < .00001); decrease time for doing nothing (MD: −29.36%, P = .02). Conclusions: Patients with dementia benefit from horticultural by alleviating their degrees of agitate behaviors, increasing time of engaging in activities and decrease time of doing nothing.

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this meta-analysis assessed the association between vitamin D supplementation and the outcomes of critically ill adult patients. A literature search was conducted using the PubMed, Web of Science, EBSCO, Cochrane Library, Ovid MEDLINE, and Embase databases until March 21, 2020. We only included randomized controlled trials (RCTs) comparing the efficacy of vitamin D supplementation with placebo in critically ill adult patients. The primary outcome was their 28-day mortality. Overall, 9 RCTs with 1867 patients were included. In the pooled analysis of the 9 RCTs, no significant difference was observed in 28-day mortality between the vitamin D supplementation and placebo groups (20.4% vs 21.7%, OR, 0.73; 95% CI, 0.46-1.15; I 2 = 51%). This result did not change as per the method of vitamin D supplementation (enteral route only: 19.9% vs 18.2%, OR, 1.19; 95% CI, 0.88-1.57; I 2 = 10%; intramuscular or intravenous injection route: 25.6% vs 40.8%, OR, 0.48; 95% CI, 0.21-1.06; I 2 = 19%) or daily dose (high dose: 20.9% vs 19.8%, OR, 0.83; 95% CI, 0.51-1.36; I 2 = 53%; low dose: 15.6% vs 21.3%, OR, 0.74; 95% CI, 0.32-1.68; I 2 = 0%). No significant difference was observed between the vitamin D supplementation and placebo groups regarding the length of ICU stay (standard mean difference [SMD], − 0.30; 95% CI, − 0.61 to 0.01; I 2 = 60%), length of hospital stay (SMD, − 0.17; 95% CI, − 041 to 0.08; I 2 = 65%), and duration of mechanical ventilation (SMD, − 0.41; 95% CI, − 081 to 0.00; I 2 = 72%). In conclusion, this meta-analysis suggested that the administration of vitamin D did not provide additional advantages over placebo for critically ill patients. However, additional studies are needed to confirm our findings. Vitamin D, a fat-soluble vitamin, is an essential nutrient in bone metabolism and calcium and phosphorus homeostasis. However, the system of vitamin D is complex, in which some novel pathways have been found for host response to vitamin D treatment including non-canonical pathways of vitamin D activation 1,2 leading to production of non-or low-calcemic analogs 3 and of lumisterol activation 4. In clinical practice, vitamin D is used for the treatment of hyperproliferative skin diseases, hyperparathyroidism, and osteoporosis. Vitamin D also exhibits other non-skeletal pleiotropic properties, such as immunomodulatory, antimicrobial, cardiovascular, and muscular effects. Therefore, vitamin D deficiency is associated with many diseases including tuberculosis, nonalcoholic fatty liver disease, cardiovascular disease, and metabolic syndrome 5-7. In the United States, adults aged 20-39 years are at the highest risk of vitamin D deficiency