Medication-related adverse events in health care-what have we learned? A narrative overview of the current knowledge.

PURPOSE: Although medication-related adverse events (MRAEs) in health care are vastly studied, high heterogeneity in study results complicates the interpretations of the current situation. The main objective of this study was to form an up-to-date overview of the current knowledge of the prevalence, risk factors, and surveillance of MRAEs in health care. METHODS: Electronic databases (PubMed, MEDLINE, Web of Science, and Scopus) were searched with applicable search terms to collect information on medication-related adverse events. In order to obtain an up-to-date view of MRAEs, only studies published after 2000 were accepted. RESULTS: The prevalence rates of different MRAEs vary greatly between individual studies and meta-analyses. Study setting, patient population, and detection methods play an important role in determining detection rates, which should be regarded while interpreting the results. Medication-related adverse events are more common in elderly patients and patients with lowered liver or kidney function, polypharmacy, and a large number of additional comorbidities. However, the risk of MRAEs is also significantly increased by the use of high-risk medicines but also in certain care situations. Preventing MRAEs is important as it will decrease patient mortality and morbidity but also reduce costs and functional challenges related to them. CONCLUSIONS: Medication-related adverse events are highly common and have both immediate and long-term effects to patients and healthcare systems worldwide. Conclusive solutions for prevention of all medication-related harm are impossible to create. In the future, however, the development of efficient real-time detection methods can provide significant improvements for event prevention and forecasting.

Effects of school-based physical activity on mathematics performance in children: a systematic review.

BACKGROUND: The benefits of physical activity (PA) on children's health and wellbeing are well established. However, the benefits of PA on academic performance and particularly on mathematics performance warrant systematic analysis. Mathematics is one of the core subjects in school education globally. METHODS: We systematically searched, analysed and synthesized the literature on the effects of school-based PA interventions on mathematics performance in children aged 4-16. A total of 29 studies consisting of randomised trials and other interventions with control groups were identified through a systematic search, and 11 of them provided sufficient data and appropriate design for a meta-analysis. RESULTS: Of the 29 studies involving 11,264 participants, positive overall effects of a PA intervention on mathematics performance were found in 13 studies (45%) and neutral overall effects in 15 studies (52%). Only one study reported a significant negative result for a subgroup of children in the first half of the intervention. In a risk-of-bias assessment, 12 studies had low, 17 moderate, and none had a high risk of bias. The meta-analysis of 11 studies suggested an overall small positive effect (ES = 0.23) of the interventions. Only one study in the meta-analysis indicated a negative effect in one of the intervention groups. CONCLUSIONS: Adding PA to the school day may enhance children's mathematics performance or has no negative effects on performance. Several types of PA interventions can be recommended to be added to the school day.

The prevalence of medication-related adverse events in inpatients-a systematic review and meta-analysis.

PURPOSE: Adverse drug events (ADEs) have been internationally recognized as a major threat to patient safety. The purpose of this study was to conduct a meta-analysis focusing on inpatient ADEs in the Western World to provide better estimate of the current state of medication safety in these countries. METHODS: The studies for meta-analysis were identified through electronic search in Cochrane, Scopus, Medline, and Web of science databases. Included articles focused on adult inpatient ADEs, had commonly accepted definition for ADE, and were conducted between 2000 and 2016. Disease or ADE-specific studies were excluded. Meta-analysis was conducted on the prevalence of inpatient ADEs and fatal adverse drug reactions (FADRs). RESULTS: The pooled estimate of the prevalence of inpatient ADEs was formed by 46,626 patient records included in 9 articles. Inpatient ADE prevalence was 19 and 32.3% of these ADEs were assessed preventable (MD 28.6%, SD 22.6%). Three articles including 3385 patients focused on inpatient FADRs, but the pooled estimate of this was disregarded due to low number and high heterogeneity of the included studies. CONCLUSIONS: ADEs are estimated to affect 19% of inpatients during hospitalization. Most of the ADEs are moderate in severity causing no permanent harm to the patient. Only a small amount of ADEs cause inpatient deaths, but in this meta-analysis, however, we were unable to give direct estimate of the prevalence.