Videogames and Health Improvement: A Literature Review of Randomized Controlled Trials. A systematic review of neuropsychological studies involving young binge drinkers Effects of case management in community aged care on client and carer outcomes: a systematic review of randomized trials and comparative observational studies Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations. Effect of long-term nutraceutical and dietary supplement use on cognition in the elderly: a 10-year systematic review of randomised controlled trials. Does Cognitive Training Prevent Cognitive Decline? Effectiveness of workplace interventions in rehabilitating musculoskeletal disorders and preventing its consequences among workers with physical and sedentary employment: systematic review protocol Interventions to improve benzodiazepine tapering success in the elderly: a systematic review Using Virtual Reality and Videogames for Traumatic Brain Injury Rehabilitation: A Structured Literature Review. Structural brain alterations following adult non-CNS cancers: a systematic review of the neuroimaging literature Rehabilitation in rheumatoid arthritis: a critical review. A randomised control trial of the cognitive effects of working in a seated as opposed to a standing position in office workers Indicators Used to Assess the Impact of Specialized Pediatric Palliative Care: A Scoping Review. Methodological developments in searching for studies for systematic reviews: past, present and future? Psychosocial effects of workplace exercise - A systematic review. Risk Factors Associated with Falls in Older Adults with Dementia: A Systematic Review. Psychological interventions for needle-related procedural pain and distress in children and adolescents. Technology-adaptable interventions for treating depression in adults with cognitive impairments: protocol for a systematic review Effect of Standing or Walking at a Workstation on Cognitive Function Determinants of weight loss maintenance: a systematic review. Nutritional Intervention as a Preventive Approach for Cognitive-Related Outcomes in Cognitively Healthy Older Adults: A Systematic Review. Impact of aerobic exercise on neurobehavioral outcomes. Improving mental health among people living with HIV: a review of intervention trials in low- and middle-income countries
OBJECTIVE There are potential benefits of playing videogames for health improvement such as increasing knowledge about health-related issues by playing educational games and fighting a sedentary lifestyle by playing exergames . The number of systematic review articles about " videogames " and " health improvement " is limited . Therefore , the purpose of this study is to review those r and omized controlled trials ( RCTs ) with the topic of " videogames " and " health improvement . " MATERIAL S AND METHODS Several electronic data bases were search ed for RCTs testing  videogames on health outcomes that were published in English between January 2000 and April 2012 . RESULTS Forty-five articles met the eligibility criteria and were categorized into five groups : ( 1 ) videogames and patient pain and stress reduction ( nine articles ) , ( 2 ) videogames and  patient behavioral change  ( 19 articles ) , ( 3 ) videogames and patient rehabilitation  ( eight articles ) , ( 4 ) videogames as diagnostic tools ( three articles ) , and ( 5 ) videogames and cognitive ability ( six articles ) . CONCLUSIONS Most of the articles have shown promising results in using videogames within various fields of healthcare . Although exergames are the most prominent choice regarding health improvement , videogames have the potential to be used as a pain management tool , diagnostic tool , or educational tool . They also can be used as a facilitator in physical rehabilitation or cognitive loss prevention . More RCTs are needed to fully uncover the benefits of using videogames for improving patients ' health HighlightsBinge drinking ( BD ) is associated with verbal memory and executive deficits ( principally inhibition).Potential deficits in prospect i ve memory and decision‐making require further study .Attention , speed , short‐term memory and visuospatial construction seem unaffected . Female BDs does not seem to show greater vulnerability than male BDs . Recovery deficits and the cumulative effects of BD have scarcely been explored . & NA ; Binge drinking ( BD ) is a public health concern with serious implication s for brain development . This review is the first in which neuropsychological studies of healthy young BDs are synthesized following PRISMA guidelines . We conducted a literature search in PsycINFO , Web of Science , and PubMed . Articles were screened using strict inclusion criteria . Two authors independently assessed the method ological quality . Of the 27 studies included , 14 ( 52 % ) were of intermediate quality , 7 ( 26 % ) of poor quality and 6 ( 22 % ) of high quality . BD is associated with deficits in verbal memory and executive functions , principally poor inhibitory control . Tentatively , BD may be related to deficits in cognitive flexibility and monitoring of information in working memory . Further studies are needed to determine potential impairments in prospect i ve memory and decision‐making . BDs do not seem to show difficulties in planning , short‐term memory , attention , processing speed or visuospatial construction . The evidence does not seem to support greater vulnerability in females . Future longitudinal studies should identify the characteristics of extreme trajectories , explore recovery deficits and design intervention programs Background Case management has been applied in community aged care to meet frail older people ’s holistic needs and promote cost-effectiveness . This systematic review aims to evaluate the effects of case management in community aged care on client and carer outcomes . Methods We search ed Web of Science , Scopus , Medline , CINAHL ( EBSCO ) and PsycINFO ( CSA ) from inception to 2011 July . Inclusion criteria were : no restriction on date , English language , community-dwelling older people and /or carers , case management in community aged care , published in refereed journals , r and omized control trials ( RCTs ) or comparative observational studies , examining client or carer outcomes . Quality of studies was assessed by using such indicators as quality control , r and omization , comparability , follow-up rate , dropout , blinding assessors , and intention-to-treat analysis . Two review ers independently screened potentially relevant studies , extracted information and assessed study quality . A narrative summary of findings were presented . Results Ten RCTs and five comparative observational studies were identified . One RCT was rated high quality . Client outcomes included mortality ( 7 studies ) , physical or cognitive functioning ( 6 studies ) , medical conditions ( 2 studies ) , behavioral problems ( 2 studies ) , unmet service needs ( 3 studies ) , psychological health or well-being ( 7 studies ) , and satisfaction with care ( 4 studies ) , while carer outcomes included stress or burden ( 6 studies ) , satisfaction with care ( 2 studies ) , psychological health or well-being ( 5 studies ) , and social consequences ( such as social support and relationships with clients ) ( 2 studies ) . Five of the seven studies reported that case management in community aged care interventions significantly improved psychological health or well-being in the intervention group , while all the three studies consistently reported fewer unmet service needs among the intervention participants . In contrast , available studies reported mixed results regarding client physical or cognitive functioning and carer stress or burden . There was also limited evidence indicating significant effects of the interventions on the other client and carer outcomes as described above . Conclusions Available evidence showed that case management in community aged care can improve client psychological health or well-being and unmet service needs . Future studies should investigate what specific components of case management are crucial in improving clients and their carers ’ outcomes BACKGROUND There is currently no disease-modifying treatment available to halt or delay the progression of the disease pathology in dementia . An agreed core set of the best-available and most appropriate outcomes for disease modification would facilitate the design of trials and ensure consistency across disease modification trials , as well as making results comparable and meta-analysable in future trials . OBJECTIVES To agree a set of core outcomes for disease modification trials for mild to moderate dementia with the UK dementia research community and patient and public involvement ( PPI ) . DATA SOURCES We included disease modification trials with quantitative outcomes of efficacy from ( 1 ) references from related systematic review s in workstream 1 ; ( 2 ) search es of the Cochrane Dementia and Cognitive Improvement Group study register , Cochrane Central Register of Controlled Trials , Cumulative Index to Nursing and Allied Health Literature , EMBASE , Latin American and Caribbean Health Sciences Literature and PsycINFO on 11 December 2015 , and clinical trial registries [ International St and ard R and omised Controlled Trial Number ( IS RCT N ) and clinical trials.gov ] on 22 and 29 January 2016 ; and ( 3 ) h and - search es of reference lists of relevant systematic review s from data base search es . REVIEW METHODS The project consisted of four workstreams . ( 1 ) We obtained related core outcome sets and work from co-applicants . ( 2 ) We systematic ally review ed published and ongoing disease modification trials to identify the outcomes used in different domains . We extracted outcomes used in each trial , recording how many used each outcome and with how many participants . We divided outcomes into the domains measured and search ed for validation data . ( 3 ) We consulted with PPI participants about recommended outcomes . ( 4 ) We presented all the synthesis ed information at a conference attended by the wider body of National Institute for Health Research ( NIHR ) dementia research ers to reach consensus on a core set of outcomes . RESULTS We included 149 papers from the 22,918 papers screened , referring to 125 individual trials . Eighty-one outcomes were used across trials , including 72 scales [ 31 cognitive , 12 activities of daily living ( ADLs ) , 10 global , 16 neuropsychiatric and three quality of life ] and nine biological techniques . We consulted with 18 people for PPI . The conference decided that only cognition and biological markers are core measures of disease modification . Cognition should be measured by the Mini Mental State Examination ( MMSE ) or the Alzheimer 's Disease Assessment Scale - Cognitive subscale ( ADAS-Cog ) , and brain changes through structural magnetic resonance imaging ( MRI ) in a subset of participants . All other domains are important but not core . We recommend using the Neuropsychiatric Inventory for neuropsychiatric symptoms : the Disability Assessment for Dementia for ADLs , the Dementia Quality of Life Measure for quality of life and the Clinical Dementia Rating scale to measure dementia globally . LIMITATIONS Most of the trials included participants with Alzheimer 's disease , so recommendations may not apply to other types of dementia . We did not conduct economic analyses . The PPI consultation was limited to members of the Alzheimer 's Society Research Network . CONCLUSIONS Cognitive outcomes and biological markers form the core outcome set for future disease modification trials , measured by the  MMSE or ADAS-Cog , and structural MRI in a subset of participants . FUTURE WORK We envisage that the core set may be superseded in the future , particularly for other types of dementia . There is a need to develop an algorithm to compare scores on the MMSE and ADAS-Cog . STUDY REGISTRATION The project was registered with Core Outcome Measures in Effectiveness Trials [ www.comet-initiative.org/ studies /details/819 ? result = true ( accessed 7 April 2016 ) ] . The systematic review protocol is registered as PROSPERO CRD42015027346 . FUNDING The National Institute for Health Research Health Technology Assessment programme Nutraceuticals have generated interest as a way to mitigate the cognitive decline in older adults . The aim of this systematic review was to determine the evidence for these cl aims from the scientific literature in r and omised , double-blinded , controlled trials ( duration : ≥1 year ; participants : n≥100 ; age(mean ) : ≥65 years ) . Following Preferred Reporting Items for Systematic Review s and Meta-Analyses ( PRISMA ) guidelines , we search ed four electronic data bases ( PubMed , Scopus , CINAHL and Web of Science ) and identified twenty-five studies published between the 15·June·2006 and 14·June·2016 . Interventions included B-vitamins , n-3 fatty acids , antioxidant vitamins and herbs . Of the B-vitamin studies , four found benefits to cognition with supplementation . The first of these B-vitamin studies , in individuals with mild cognitive impairment ( n 266 ; duration = 2 years ) , included benefit to executive function ( P=0·015 ) and improvements in the Mini-Mental State Examination ( MMSE ) among participants with baseline homocysteine above 11·3 µmol/l ( P<0·001 ) . In the same sample , the second study found cognitive benefits  of B-vitamins dependent on the higher baseline plasma n-3 fatty acid status . The third B-vitamin study ( n 900 ; duration = 2 years ) reported improved performance in immediate ( P=0·046 ) and delayed recall ( P=0·013 ) , whereas the fourth study ( n 856 ; duration = 2 years ) reported slower rate of cognitive decline in the MMSE ( P=0·05 ) . One study investigating DHA treatment ( n 402 ; duration = 1·5 years ) revealed the slower rate of cognitive change in apoE e4 non-carriers ( P=0·03 ) . As only five included studies revealed notable benefits , presently based on the specific compounds explored here , there is not compelling evidence to support the use nutraceuticals to improve cognition in the elderly . Future long-term trials of nutraceuticals should investigate interactions with lifestyle , blood biomarkers and genetic risk factors Fear of losing one 's cognitive ability to Alzheimer disease and related dementias ( ADRD ) and ultimately declining to a state considered by many to be worse than death ( 1 ) is driving a growing brain-training industry . Cognitive training programs , marketed to otherwise healthy adults and persons with a recent diagnosis of mild cognitive impairment ( MCI ) , make bold cl aims for reversing brain aging . Such cl aims include the ability to boost cognitive reserve in midlife ( with cognitive reserve referring to both the mismatch between clinical symptoms of dementia and pathologic brain lesion load at death and the repeatedly demonstrated association between educational achievement and dementia risk ) . However , few studies have evaluated the effect of cognitive training programs on cognitive decline or the onset of dementia , which is the outcome of interest for most people who buy these programs . This review systematic ally evaluates the existing literature on the effectiveness of cognitive training in preventing cognitive decline and ADRD . It is part of a larger systematic review commissioned by the National Institute on Aging to address a range of potential interventions to slow cognitive decline and prevent or delay dementia . Methods We developed and followed a st and ard protocol that was posted on the Agency for Healthcare Research and Quality ( AHRQ ) Web site ( www.effectivehealthcare.ahrq.gov ) . Full details of the methods , including literature search es , findings , and evidence tables , are available in the final report ( 2 ) . Data Sources and Search es We search ed Ovid MEDLINE , PsycINFO , EMBASE , and the Cochrane Central Register of Controlled Trials for relevant literature published between January 2009 and July 2017 ( see Part A of the Supplement , for search es ) and h and - search ed reference lists of selected articles . We identified studies published before 2009 by review ing studies included and excluded from the 2010 AHRQ review on preventing Alzheimer disease and cognitive decline ( 3 ) . Supplement . Cognitive Training Supplement Study Selection Two investigators independently review ed titles and abstract s of search results and screened the full text of potentially eligible references . We included r and omized trials of cognitive training interventions enrolling adults with either normal cognition or MCI if the studies followed participants for at least 6 months , provided cognitive performance or incident dementia outcomes , and were published in English . We excluded studies that enrolled only persons diagnosed with dementia . The final health outcome of interest was incident ADRD . Intermediate health outcomes of interest included performance on cognitive testing , biomarker protein levels , brain matter volume , and brain cell activity level . No restrictions were placed on sample size or comparator type . Data Extraction and Quality Assessment One review er extracted study , population , intervention , comparator , and setting characteristics as well as the funding source from all eligible studies . Risk of bias was assessed independently from full texts by 2 investigators using an instrument based on AHRQ guidance ( 4 ) . Risk of bias was individually review ed overall and for each outcome and time point , and was summarized as low , medium , or high on the basis of a summary of bias risk across risk-of-bias domains and confidence that results were credible given the study 's limitations . Outcomes and adverse events were extracted from studies with low to medium risk of bias . A second review er checked the quality of all data . Data Synthesis and Analysis Only studies with low or medium risk of bias were summarized , because we judged findings from studies with high risk of bias to lack validity , have little meaning , or be easily misinterpreted . Because studies used a highly varied set of outcome measures , neuropsychological tests were categorized by the following specific cognitive domains to facilitate analysis : executive function , attention , and processing speed ; memory ; language ; and visuospatial abilities ( Supplement Table A1 ) . The domains of executive function , attention , and processing speed were grouped together because cognitive tests frequently measure all 3 of these related domains . Because studies analyzed and reported cognitive test results in many different ways , making it difficult or impossible to determine effect size or to assess whether between-group differences in scores or subscores were clinical ly meaningful ( Supplement Table A2 ) , we analyzed and reported cognitive test results by direction of effect and statistical significance . When we identified at least 2 studies or 1 large study ( > 500 participants ) for a treatment comparison , 2 review ers grade d strength of evidence for each outcome on the basis of study limitations , directness , consistency , and precision ; otherwise , strength of evidence was grade d as insufficient . Assessment s were confirmed by consensus . Role of the Funding Source The National Institute on Aging of the National Institutes of Health requested this report from the AHRQ Evidence -based Practice Center Program . The funding agencies provided comments on draft reports but had no role in data collection , analysis , interpretation , or manuscript development . Results We identified 35 publications of 34 unique r and omized controlled trials of cognitive training interventions , 11 of which had medium or low risk of bias ( 516 ) . Only 1 trial was industry funded ( 8) , whereas in 3 cases , trial funding was not reported ( 9 , 15 , 16 ) . ( See the Supplement Figure and Supplement Tables C1 to C4 for the literature flow diagram , evidence tables , and risk-of-bias assessment s. ) The Table summarizes the overall strength-of- evidence findings . For cognitively normal adults , moderate-strength evidence suggests that cognitive training in a particular domain improves performance in that domain compared with inactive or attention control population s. These results are driven largely by the results from the ACTIVE ( Advanced Cognitive Training for Independent and Vital Elderly ) trial . Low-strength evidence suggests that for persons with MCI , cognitive training in a particular domain does not improve performance in that domain compared with controls . The MCI trials have more limitations and are less precise than the studies conducted with cognitively normal participants . Evidence is insufficient for incident MCI or ADRD outcomes . Table . Summary of Conclusions and Strength of Evidence for Cognitive Training in Adults With Normal Cognition or MCI * Studies in Cognitively Normal Population s Six trials with low to medium risk of bias tested training interventions in cognitively normal older adults ( 510 ) . Sample sizes for the selected studies ranged from 40 to 2832 participants . Interventions lasted from 2 weeks to 6 months ; follow-up ranged from 6 months to 2 years . Three of the 6 trials used only computer-based interventions ( 68 ) , 2 used a combination of computer and noncomputer ( paper- and -pencil ) interventions ( 5 , 9 ) , and 1 used group-based competition to increase divergent thinking ( 10 ) . Three of the computer-based interventions were design ed to increase performance on a specific cognitive domain ( such as processing speed ) ( 5 , 6 , 9 ) , 1 used computers for cognitive stimulation more generally ( 7 ) , and 1 used a computer program design ed to train several cognitive domains ( 8) . Comparators included both inactive ( 5 , 7 , 8 , 10 ) and attention controls ( 6 , 9 ) . No studies reported adverse effects . The largest trial of cognitive training , ACTIVE , r and omly assigned 2832 older adults ( mean age , 74 years ) without clinical ly significant cognitive impairment to 1 of 3 training groups or a no-contact control group ( 5 ) . In each training group , a different cognitive domain was targeted : memory , reasoning , or processing speed . Participants in the intervention groups received 10 trainings of 60 to 70 minutes over 6 weeks . Cognitive testing outcomes included measuring changes in domain-specific test performance . Patient-centered cognitive outcomes included measuring changes in everyday problem solving ( such as the ability to identify information on medication bottles ) , everyday speed ( such as the time required to find food items on a grocery shelf ) , driving , and degree of dependency in completing activities of daily living and instrumental activities of daily living . Incident MCI or ADRD was not a prespecified outcome . Although 5- and 10-year outcomes from the ACTIVE trial have been published ( 17 , 18 ) , only the results from the 2-year study had a medium risk of bias ( 5 ) . At 2 years , ACTIVE participants showed improvement in the cognitive domains in which they were trained ( for example , those who received memory training improved on memory-related tasks compared with control participants ) , but no statistically significant differences were found among groups with regard to other cognitive outcomes ( for example , persons who received training in memory did not do better than control participants on reasoning tasks ) . Intervention and control groups did not differ in other patient-centered cognitive outcomes at 2-year follow-up . Modeled on the visual process and speed training group of the ACTIVE trial , IHAMS ( the Iowa Healthy and Active Minds Study ) ( n= 681 ) ( 6 ) r and omly assigned adults by age group ( 50 to 64 years vs. 65 years ) to visual processing speed training at the study center , visual processing speed training on the participant 's home computer , or computerized crossword puzzles ( attention control group ) . Two-hour training sessions were held once a week for 5 weeks . Participants assigned to the intervention at the training center also received a booster training at 11 months . One year after training , both intervention groups showed statistically significant improvement in the primary outcome of the Useful Field of View test compared with the attention control group . The IHAMS participants also were administered 8 secondary cognitive tests on which they had not been Background Musculoskeletal disorders ( MSDs ) are the leading cause of work disability and sickness absence worldwide . The prevalence of MSDs increases with age , consequently challenging sustainable employability among the growing ageing workforce . Knowledge of feasible and efficient workplace-based interventions to rehabilitate MSD or prevent its consequences is therefore warranted . This systematic review will evaluate the effectiveness of workplace-based interventions on MSDs and its consequences among adult workers with physical and sedentary work tasks , respectively . Methods We will search the following bibliographic data bases : PubMed ( including the data base ‘ MEDLINE ’ ) and Web of Science Core Collection ( including the data bases ‘ Science Citation Index Exp and ed ’ , ‘ Social Sciences Citation Index ’ and ‘ Arts & Humanities Citation Index ’ ) . Manual search es will also be performed . We will include r and omised controlled trials ( RCTs ) and non- RCTs reported in English in which ( 1 ) participants are adult workers with MSD , ( 2 ) interventions are aim ing at rehabilitating pain symptoms of MSD or preventing the consequences of MSD and ( 3 ) interventions are initiated and /or carried out at the workplace . The review will adhere to the ‘ Preferred Reporting Items for Systematic review s and Meta-Analyses ’ ( PRISMA ) guidelines for reporting systematic review s and the Institute for Work and Health ( IWH ) guidelines for workplace-based interventions . For the primary evaluation of the review , the quality assessment and evidence synthesis will conform to the IWH guidelines . Secondary evaluation will include a meta- analysis ( unless the included studies do not allow this due to heterogeneity ) and employ the risk of bias domains recommended by Cochrane along with the Grading of Recommendations , Assessment , Development and Evaluations ( GRADE ) approach on the studies with pain intensity as an outcome . Discussion This systematic review will provide knowledge on effective workplace-based interventions among physical and sedentary workers with MSD . RCTs are considered the most powerful experimental design in clinical trials , but solely including these may be too restrictive to underst and effective workplace-based interventions where r and omised and carefully controlled trials ( RCTs ) are not always possible . In order to maximize practical relevance , the selection process will , therefore , include both RCTs and non- RCTs and the quality assessment and evidence synthesis will conform to IWH guidelines focusing on developing practical guidelines for stakeholders . The result of this work will form the basis for industry-specific evidence -based recommendations on effective workplace-based interventions for rehabilitation of MSDs and its consequences that will later be operationalised into concrete and user-friendly practical tools for workplaces . Systematic review registration International Prospect i ve Register of Systematic Review s ( PROSPERO ) number CRD42018116752 ABSTRACT Background : Long-term benzodiazepine use in the elderly population is a significant public health problem that leads to impaired cognitive functioning , medication dependence and increased risks for adverse drug reactions . The aim of this review was to examine r and omized controlled trials ( RCTs ) on the efficacy of different methods for tapering and discontinuing benzodiazepines . Method : We used four data bases ( Ovid , PubMed , Academic Search Complete , Web of Science ) to retrieve r and omized controlled trials published in peer- review ed journals that explored different methods for tapering benzodiazepine use in a primarily geriatric population . Results : Eleven papers met the inclusion criteria . Methods to assist in benzodiazepine tapering included patient education , cognitive behavioural therapy ( CBT ) , and pharmaceutical adjuvants ( SSRIs , melatonin , progesterone ) . Patient education was consistently effective in increasing benzodiazepine discontinuation success while CBT had mixed but promising results . The use of medications to help improve tapering success was inconclusive . Conclusions : Patient education is a successful , time- and cost-effective intervention that can significantly help with benzodiazepine discontinuation success .  CBT may also be an effective approach . However , cost can be an issue since public healthcare coverage in Canada does not cover psychotherapy . More research is needed in looking at pharmaceutical adjuvants and their role in assisting with benzodiazepine discontinuation OBJECTIVE This article review s the available literature about the use of novel methods of rehabilitation using virtual reality interventions for people living with posttraumatic brain injuries . MATERIAL S AND METHODS The MEDLINE , EMBASE , SCOPUS , and Cochrane Library data bases were search ed using the terms " virtual reality " OR " video games " AND " traumatic brain injury . " Included studies investigated therapeutic use of virtual reality in adults with a brain trauma result ing from acquired closed head injury , reported outcomes that included measures of motor or cognitive functionality , and were published in a peer- review ed journal written in English . RESULTS Eighteen articles fulfilled inclusion criteria . Eight were case studies , five studies had a quasi-experimental design with a pre-post comparison , and five were pilot r and omized control trials or comparative studies . The virtual reality systems used were commercial or custom design ed for the study and ranged from expensive , fully immersive systems to cheap online games or videogames . In before-after comparisons , improvements in balance were seen in four case studies and two small r and omized control trials . Between-group comparisons in these r and omized control trials showed no difference between virtual reality and traditional therapy . Post-training improvements were also seen for upper extremity functions ( five small studies ) and for various cognitive function measures ( four case studies and one pilot r and omized control trial ) . Attitudes of participants toward virtual reality interventions was more positive than for traditional therapy ( three studies ) . CONCLUSIONS The evidence that the use of virtual reality in rehabilitation of traumatic brain injury improves motor and cognitive functionality is currently very limited . However , this approach has the potential to provide alternative , possibly more affordable and available rehabilitation therapy for traumatic brain injury in setting s where access to therapy is limited by geographical or financial constraints Abstract Background : Cancer and cancer treatments may impact the brain through several pathways leading to cognitive impairment . Neuroimaging evidence has begun to eluci date the neurobiological underpinnings of cancer-related cognitive impairment . The aim of this paper was to systematic ally review available literature on structural brain alterations following adult non- central nervous system ( CNS ) cancers and associated treatments . Methods : This review followed PRISMA guidelines and was registered in PROSPERO ( ID#107387 ) . Comprehensive search es were conducted in June 2018 using PubMed and Web of Science . Inclusion criteria were English peer- review ed journal articles of formal , controlled studies that examined structural neuroimaging outcomes in adult non-CNS cancer patients and survivors . Selected articles were assessed for quality and risk of bias using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies . Results : Thirty-six publications of prospect i ve and cross-sectional studies met inclusion criteria and were included . Structural brain alterations following cancer and its treatment were reported in a majority of the publications as evidence d by reduced global and local gray matter volumes , impaired white matter microstructural integrity , and brain network alterations . Structural alterations were most often evident when cancer-treated groups were compared with healthy controls , and more subtle when compared with cancer controls . Regarding the existence of pretreatment impairments , the evidence was equivocal . There was significant between- study heterogeneity in imaging analytical approaches and use of statistical adjustments . Over half reported associations with cognitive outcomes , though regions and associated cognitive domains were heterogeneous . Conclusions : Structural brain alterations following cancer and cancer treatments were reported in a majority of the review ed studies . However , the extent of observed alterations depended on the choice of comparison groups . Method ological issues exist that will need to be addressed systematic ally to ensure the validity of findings . Large-scale prospect i ve studies with extended assessment points are warranted to replicate and build upon initial findings This article considers the evidence for effectiveness and timing of rehabilitation  for people with rheumatoid arthritis ( RA ) . The Cochrane Library , DARE , Medline , Embase , CINAHL and AMED were search ed to identify systematic review s and r and omized controlled trials evaluating rehabilitation interventions for people with rheumatoid arthritis . Many trials identified had method ological limitations ( e.g. short follow-up periods , small sample sizes ) . Evidence to date is that symptomatic relief results from thermotherapy , laser therapy , acupuncture and assistive devices . In the short-term , comprehensive occupational therapy ( in established rheumatoid arthritis ) , orthoses , and mind-body approaches can help maintain function . Over at least a one-year period , the following are effective in reducing pain and maintaining function :  patient education and joint protection training using behavioural approaches ; dynamic exercise therapy , h and exercises and hydrotherapy ; and cognitive-behavioural therapy ( in people with poorer psychological status ) . Many trials have recruited people with moderate to severe , established RA and relatively little is known about the long-term effectiveness of early rehabilitation , although this is becoming much more common in practice . Despite the increased availability of guidelines and systematic review s , most conclude there is insufficient evidence for many areas of rheumatology rehabilitation . Further well- design ed clinical trials are needed recruiting people with early disease using patient-centred outcomes Abstract Sedentary behaviour is increasing and has been identified as a potential significant health risk , particularly for desk-based employees . The development of sit-st and workstations in the workplace is one approach to reduce sedentary behaviour . However , there is uncertainty about the effects of sit-st and workstations on cognitive functioning .  A sample of 36 university staff participated in a within-subjects r and omised control trial examining the effect of sitting vs. st and ing for one hour per day for five consecutive days on attention , information processing speed , short-term memory , working memory and task efficiency . The results of the study showed no statistically significant difference in cognitive performance or work efficiency between the sitting and st and ing conditions , with all effect sizes being small to very small ( all ds < .2 ) . This result suggests that the use of sit-st and workstations is not associated with a reduction in cognitive performance . Practitioner Summary : Although it has been reported that the use of sit-st and desks may help offset adverse health effects of prolonged sitting , there is scant evidence about changes in productivity . This r and omised control study showed that there was no difference between sitting and st and ing for one hour on cognitive function or task efficiency in university staff BACKGROUND  Specialized pediatric palliative care programs  aim to improve quality of life and ease distress of patients and their families across the illness trajectory . These programs require further development , which should be based on how they improve outcomes for patients , families , health care professionals , and the health care system . OBJECTIVE To identify and compare definitions of indicators used to assess the impact of  specialized pediatric palliative care programs .  DESIGN The scoping review protocol was prospect ively registered on PROSPERO 2017 ( CRD42017074090 ) . DATE SOURCES MEDLINE , PsycINFO , Cochrane Central Register of Controlled Trials , Web of Science , CINAHL , Scopus , and Embase data bases were search ed from January 2000 to September 2018 . Eligible studies included r and omized controlled trials , experimental studies , or observational studies that compared specialized programs with usual care .  Studies were excluded if most care recipients were older than 19 years or the article was not available in English , French , German , or Spanish . RESULTS Forty-six studies were included ; one was a r and omized controlled trial . We identified 82 different indicators grouped into 14 domains . The most common indicators included the following : location of death , length of stay in hospital , and number of hospital admissions . Only 22 indicators were defined identically in at least 2 studies . Only one study included children 's perspectives in assessing indicators . CONCLUSIONS Many indicators were used to assess program outcomes with little definition consensus across studies . Development of a set of agreed-upon indicators to assess program impact concurrent with family and patient input is essential to advance research and practice in pediatric palliative care The Cochrane Collaboration was established in 1993 , following the opening of the UK Cochrane Centre in 1992 , at a time when search ing for studies for inclusion in systematic review s was not well-developed . Review authors largely conducted their own search es or depended on medical librarians , who often possessed limited awareness and experience of systematic review s. Guidance on the conduct and reporting of search es was limited . When work began to identify reports of r and omized controlled trials ( RCTs ) for inclusion in Cochrane Review s in 1992 , there were only approximately 20,000 reports indexed as RCTs in MEDLINE and none indexed as RCTs in Embase . No search filters had been developed with the aim of identifying all RCTs in MEDLINE or other major data bases . This presented The Cochrane Collaboration with a considerable challenge in identifying relevant studies .Over time , the number of studies indexed as RCTs in the major data bases has grown considerably and the Cochrane Central Register of Controlled Trials ( CENTRAL ) has become the best single source of published controlled trials , with approximately 700,000 records , including records identified by the Collaboration from Embase and MEDLINE . Search filters for various study types , including systematic review s and the Cochrane Highly Sensitive Search Strategies for RCTs , have been developed . There have been considerable advances in the evidence base for method ological aspects of information retrieval . The Cochrane H and book for Systematic Review s of Interventions now provides detailed guidance on the conduct and reporting of search es . Initiatives across The Cochrane Collaboration to improve the quality inter alia of information retrieval include : the recently introduced Method ological Expectations for Cochrane Intervention Review s ( MECIR ) programme , which stipulates ' m and atory ’ and ' highly desirable ’ st and ards for various aspects of review conduct and reporting including search ing , the development of St and ard Training Material s for Cochrane Review s and work on peer review of electronic search strategies . Almost all Cochrane Review Groups and some Cochrane Centres and Fields now have a Trials Search Co-ordinator responsible for study identification and medical librarians and other information specialists are increasingly experienced in search ing for studies for systematic review s. Prospect i ve registration of clinical trials is increasing and search ing trials registers is now m and atory for Cochrane Review s , where relevant . Portals such as the WHO International Clinical Trials Registry Platform ( ICTRP ) are likely to become increasingly attractive , given concerns about the number of trials which may not be registered and /or published . The importance of access to information from regulatory and reimbursement agencies is likely to increase . Cross- data base search ing , gateways or portals and improved access to full-text data bases will impact on how search es are conducted and reported , as will services such as Google Scholar , Scopus and Web of Science . Technologies such as textual analysis , semantic analysis , text mining and data linkage will have a major impact on the search process but efficient and effective updating of review s may remain a challenge . In twenty years ’ time , we envisage that the impact of universal social networking , as well as national and international legislation , will mean that all trials involving humans will be registered at inception and detailed trial results will be routinely available to all . Challenges will remain , however , to ensure the discoverability of relevant information in diverse and often complex sources and the availability of meta data to provide the most efficient access to information . We envisage an ongoing role for information professionals as experts in identifying new re sources , research ing efficient ways to link or mine them for relevant data and managing their content for the efficient production of systematic review Objectives Workplace exercise interventions are known to reduce musculoskeletal complaints and are widely offered to promote employee`s health . The psychosocial effects of such interventions are not clear . This review evaluates the effects of workplace exercise interventions on the psychosocial work environment and mental health . Methods A systematic review was performed by screening four scientific data bases ( Pubmed , Cochrane Data base , PsycINFO and Web of Science ) for published r and omized controlled trials in English from 1998 - 2018 . The review followed the PRISMA statement guidelines using the Cochrane tool for assessing risk of bias and the GRADE approach for assessment of quality . Two research ers independently performed data base search , study screening , and evaluation . Results Twenty two r and omized controlled trials met the inclusion criteria . Substantial heterogenicity in the studies included was found in study population s , types of intervention , and outcome measures performed . Quality assessment revealed a generally low level of quality in the studies included . This was partly the result of the limited possibilities for blinding and the self-reported outcome measures . Conclusion Workplace exercise interventions seem to have limited effects on mental health and the psychosocial work environment . Future studies should incorporate blinding and independent outcome measures Purpose : People with dementia fall more often than cognitively healthy older adults , but their risk factors are not well understood . A review is needed to determine a fall risk profile for this population . The objective was to critically evaluate the literature and identify the factors associated with fall risk in older adults with dementia . Methods : Articles published between January 1988 and October 2014 in EMBASE , PubMed , PsycINFO , and CINAHL were search ed . Inclusion criteria were participants aged 55 years or older with dementia or cognitive impairment , prospect i ve cohort design , detailed fall definition , falls as the primary outcome , and multi-variable regression analysis . Two authors independently review ed and extracted data on study characteristics , quality assessment , and outcomes . Adjusted risk estimates were extracted from the articles . Results : A total of 17 studies met the inclusion criteria . Risk factors were categorized into demographic , balance , gait , vision , functional status , medications , psychosocial , severity of dementia , and other . Risk factors varied with living setting and were not consistent across all studies within a setting . Conclusion : Falls in older adults with dementia are associated with multiple intrinsic and extrinsic risk factors , some shared with older adults in general and others unique to the disease . Risk factors vary between community- and institution-dwelling sample s of adults with dementia or cognitive impairment For the current issue of the Journal , we asked Drs Anna Taddio and C Meghan McMurtry to comment on and put into context the Cochrane Review on psychological interventions for needle-related procedural pain and distress in children and adolescents ( 1 ) . Background This review is an up date d version of the original Cochrane review published in Issue 4 , 2006 . Needle-related procedures are a common source of pain and distress for children . Our previous review on this topic indicated that several psychological interventions were efficacious in managing paediatric needle pain including distraction , hypnosis and combined cognitive behavioural interventions . Considerable additional research in the area has been published since that time . Methods Search strategy Search es of the following data bases were conducted for relevant r and omized controlled trials ( RCTs ): Cochrane Central Register of Controlled Trials ( CENTRAL ) ; MEDLINE ; EMBASE ; PsycINFO ; the Cumulative Index to Nursing and Allied Health Literature ( CINAHL ) ; and Web of Science . Requests for relevant studies were also posted on various electronic list servers . An up date d search was conducted in March 2012 and again in March 2013 . Selection criteria Participants included children and adolescents two to 19 years of age undergoing needle-related procedures . Only RCTs with ≥5 participants in each study arm comparing a psychological intervention group with a control or comparison group were eligible for inclusion . Data analysis Two review authors extracted data and assessed trial quality , and a third author helped with data extraction and coding for one non-English study . Included studies were coded for quality using the Cochrane Risk of bias tool . St and ardized mean differences with 95 % CIs were calculated for all analyses using Review Manager version 5.2 . Results Thirty-nine trials with a total of 3394 participants were included . The most commonly studied needle-related procedures were veni-puncture , intravenous line insertion and immunization .  Studies included children two to 19 years of age , with the most evidence available for children < 12 years of age . Consistent with the original review , the most commonly studied psychological interventions for needle procedures were distraction , hypnosis and cognitive behavioural therapy ( CBT ) . The majority of included studies ( 19 of 39 ) examined distraction only . The additional studies from this review up date continued to provide strong evidence for the efficacy  of distraction and hypnosis . No evidence was available to support the efficacy of preparation and information , combined CBT ( ≥2 cognitive or behavioural strategies combined ) , parent coaching plus distraction , suggestion or virtual reality for reducing children ’s pain and distress . No conclusions could be drawn about interventions of memory alteration , parent positioning plus distraction , blowing out air or distraction plus suggestion because evidence was available from single studies only . In addition , the risk of bias scores indicated several domains with high or unclear bias scores ( eg , selection , detection and performance bias ) , suggesting that the method ological rigour and reporting of RCTs of psychological interventions continue to exhibit considerable room for improvement . Conclusions Overall , there is strong evidence supporting the efficacy of distraction and hypnosis for needle-related pain and distress in children and adolescents , with no evidence currently available for preparation and information or both , combined CBT , parent coaching plus distraction , suggestion or virtual reality . Additional research is needed to further assess interventions that have only been investigated in one RCT to date ( ie , memory alteration , parent positioning plus distraction , blowing out air and distraction plus suggestion ) . There are continuing issues with the quality of trials examining psychological interventions for needle-related pain and distress . The full text of the Cochrane Review is available in The Cochrane Library ( 1 ) Background Depression is a common comorbidity in individuals with cognitive impairment . Those with cognitive impairments face unique challenges in receiving the benefits of many conventional therapies for depression , and may have poorer outcomes in areas such as recovery and quality of life . However , the stigmatization of mental health disorders , cost barriers and physical disabilities may prevent these individuals from seeking mental health care . An online , self-help intervention specifically developed for adults with cognitive deficits and depression may be particularly beneficial to this population . We aim to inform the design of such an intervention through a systematic review by answering the following research question : among adults with cognitive impairment ( including those with acquired brain injuries or neurodegenerative diseases ) , which technology-amenable interventions have been shown to effectively decrease symptoms of depression ? Specifically , psychotherapeutic and /or behavioural interventions that could be delivered in a self-guided , online system will be included . Methods Comprehensive electronic search es will be conducted in MEDLINE , EMBASE , PsycINFO and CINAHL . Additional studies will be obtained through manually search ing the references of relevant systematic review s , contacting primary authors of select articles and tracking conference proceedings and trial registries . Article titles and abstract s will be screened using predefined eligibility criteria , and then judged for their amenability to the proposed self-help , technology-based intervention . The full text of those articles with selected interventions will then be screened to determine final eligibility for inclusion . Included articles will be categorized by intervention type and assessed for risk of bias using the Cochrane Effective Practice and Organization of Care Risk of Bias tool for non-r and omized trials , controlled before-after studies and interrupted time series . The primary outcome will be a change in score on a vali date d depression scale , and adverse events will be documented as a secondary outcome . After data extraction from selected articles , pooling of data and meta- analysis will be conducted if a sufficient pool of studies with comparable methodology and quality are identified . Alternatively , plain language summaries will be developed . The quality of evidence will be assessed using the Grading of Recommendations Assessment , Development and Evaluation ( GRADE ) system . Systematic review registration PROSPERO Objective : In the present study , we examined the effect of working while seated , while st and ing , or while walking on measures of short-term memory , working memory , selective and sustained attention , and information-processing speed . Background : The advent of computer-based technology has revolutionized the adult workplace , such that average adult full-time employees spend the majority of their working day seated . Prolonged sitting is associated with increasing obesity and chronic health conditions in children and adults . One possible intervention to reduce the negative health impacts of the modern office environment involves modifying the workplace to increase incidental activity and exercise during the workday . Although modifications , such as sit-st and desks , have been shown to improve physiological function , there is mixed information regarding the impact of such office modification on individual cognitive performance and thereby the efficiency of the work environment . Method : In a fully counterbalanced r and omized control trial , we assessed the cognitive performance of 45 undergraduate students for up to a 1-hr period in each condition . Results : The results indicate that there is no significant change in the measures used to assess cognitive performance associated with working while seated , while st and ing , or while walking at low intensity . Conclusion : These results indicate that cognitive performance is not de grade d with short-term use of alternate workstations BACKGROUND Discerning the determinants of weight loss maintenance is important in the planning of future interventions and policies regarding overweight and obesity . We have therefore systematic ally synthesized recent literature on determinants of weight loss maintenance for individuals with overweight and obesity . METHODS With the use of the Preferred Reporting Items for Systematic Review s and Meta-Analyses statement , prospect i ve studies were identified from search es in PubMed and PsycINFO from 2006 to 2016 . We included articles investigating adults with overweight and obesity undergoing weight loss without surgery or medication .  Included articles were scored on their method ological quality , and a best- evidence synthesis was applied to summarize the results . RESULTS Our search result ed in 8,222 articles of which 67 articles were selected . In total , 124 determinants were identified of which 5 were demographic , 59 were behavioural , 51 were psychological/cognitive and 9 were social and physical environmental determinants . We found consistent evidence that demographic determinants were not predictive of weight loss maintenance . Behavioural and cognitive determinants that promote a reduction in energy intake , an increase in energy expenditure and monitoring of this balance are predictive determinants . CONCLUSION This review identifies key determinants in weight loss maintenance . However , more research regarding cognitive and environmental determinants of weight loss maintenance is needed to advance our knowledge on determinants of weight loss maintenance The link diet-cognitive function/dementia has been largely investigated in observational studies ; however , there was a lack of evidence from r and omized clinical trials ( RCTs ) on the prevention of late-life cognitive disorders though dietary intervention in cognitively healthy older adults . In the present article , we systematic ally review ed RCTs published in the last four years ( 2014 - 2017 ) exploring nutritional intervention efficacy in preventing the onset of late-life cognitive disorders and dementia in cognitively healthy subjects aged 60 years and older using different levels of investigation ( i.e. , dietary pattern changes/medical food/nutraceutical supplementation/multidomain approach and dietary macro- and micronutrient approaches ) as well as possible underlying mechanisms of nutritional prevention . From the 35 included RCTs , there was moderate evidence that intervention through dietary pattern changes , medical food/nutraceutical supplementation , and multidomain approach improved specific cognitive domains or cognitive-related blood biomarkers . There was high evidence that protein supplementation improved specific cognitive domains or functional status in prefrail older adults without effect on cognitive function . For fatty acid supplementation , mainly long-chain polyunsaturated fatty acids , there was emerging evidence suggesting an impact of this approach in improving specific cognitive domains , magnetic resonance imaging ( MRI ) findings , and /or cognitive-related biomarkers also in selected subgroups of older subjects , although some results were conflicting . There was convincing evidence of an impact of non-flavonoid polyphenol and flavonoid supplementations in improving specific cognitive domains and /or MRI findings . Finally , there was only low evidence suggesting efficacy of intervention with homocysteine-related and antioxidant vitamins in improving cognitive functions , dementia incidence , or cognitive-related biomarkers in cognitively healthy older subjects Numerous studies have examined the relationship between physical activity and cognitive function , demonstrating that greater physical activity is associated with lower incidence of cognitive impairment in later life . Due to an increasingly large number of older adults at risk for cognitive impairment , the relationship between physical activity and cognition has garnered increasing public health relevance and multiple r and omized trials have demonstrated that exercise interventions among sedentary adults improve cognitive performance in multiple domains of function . This article will examine the relationship between physical activity and cognitive function by review ing several different areas of literature , including the prevalence of cognitive impairment , assessment methods , observational studies examining physical activity and cognition , and intervention studies . The present review is intended to provide a historical tutorial of existing literature linking  physical activity , exercise , and cognitive function among both healthy and clinical population People living with HIV ( PLWH ) experience greater psychological distress than the general population . Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms , quality of life , and HIV care engagement . However , little is known about the effectiveness of mental health interventions for PLWH in low- and middle-income countries ( LMICs ) , where the large majority of PLWH reside . This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these setting s. A systematic search strategy was undertaken to identify peer- review ed published papers of intervention trials addressing negative psychological states or disorders ( e.g. depression , anxiety ) among PLWH in LMIC setting s. Search results were assessed against pre-established inclusion and exclusion criteria . Data from papers meeting criteria were extracted for synthesis . Twenty-six papers , published between 2000 and 2014 , describing 22 unique interventions were identified . Trials were implemented in sub-Saharan Africa ( n = 13 ) , Asia ( n = 7 ) , and the Middle East ( n = 2 ) , and addressed mental health using a variety of approaches , including cognitive-behavioral ( n = 18 ) , family-level ( n = 2 ) , and pharmacological ( n = 2 ) treatments . Four r and omized controlled trials reported significant intervention effects in mental health outcomes , and 11 preliminary studies demonstrated promising findings . Among the limited mental health intervention trials with PLWH in LMICs , few demonstrated efficacy .  Mental health interventions for PLWH in LMICs must be further developed and adapted for re source -limited setting s to improve effectiveness
Conclusion : These data suggest that sedentary behavior is not associated with changes in cognitive performance in interventions that intend to reduce sedentary behavior .
Background : It is now well-established that sedentarity has a negative impact on the physiological functioning and health of humans , whereas very little is known about the psychological repercussions , especially in cognitive functioning .
Yet , study ing the cognitive effects of the sedentary lifestyle is particularly relevant in the short term for productivity and in the long term for cognitive health ( accelerated aging ) .
This systematic review therefore aims to make an inventory of the potential cognitive effects of sedentarity at the workplace .
Methods : Pubmed , PsycINFO , Cochrane , Web of Science , and Scopus were search ed for English- language peer- review ed articles published between January 1 , 2000 and December 31 , 2017 to identify studies including sedentary behavior  and objective measures from cognitive domains ( cognitive inhibition , cognitive flexibility , working memory , etc . ) .