Effect of Bright Light Therapy on Perinatal Depression: A Systematic Review and Meta-Analysis: Effet de la luminothérapie sur la dépression périnatale: une revue systématique et une méta-analyse.

OBJECTIVE: This study represents the inaugural attempt to systematically review and analyse the efficacy of bright light therapy on depression among women experiencing major depressive disorder or depressive symptoms during the perinatal period, encompassing its efficacy on depression scores, remission rates, and response rates. METHODS: We searched 10 databases for randomized controlled trials examining bright light therapy's efficacy on perinatal depression up to January 2024. Data extraction was performed independently by 2 investigators. The Cochrane Handbook guidelines appraised the study quality, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach assessed evidence certainty. RESULTS: We incorporated 6 studies, encompassing 151 participants. When contrasted with dim light therapy, bright light therapy did not significantly alter depression scores (standard mean difference = -0.29, 95% confidence interval [CI], -0.62 to 0.04, P = 0.08, I² = 34%) or response rates (risk ratio [RR] = 1.56, 95% CI, 0.98 to 2.49, P = 0.06, I² = 0%) in women experiencing perinatal depression. Conversely, bright light therapy was associated with a substantial increase in remission rates (RR = 2.63, 95% CI, 1.29 to 5.38, P = 0.008, I² = 2%). CONCLUSION: Bright light therapy did not show efficacy in treating perinatal depression in terms of depression scores and response rates. However, regarding the remission rate, bright light did show efficacy compared to control conditions. Due to the limited sample size in the included studies, type II err or may occur. To obtain more conclusive evidence, future studies must employ larger sample sizes.

Clip or staple in laparoscopic live donor nephrectomy? A systematic literature review.

INTRODUCTION: Ligation of the renal pedicle is a crucial step in laparoscopic renal harvesting. Currently, two devices are widely used: Hem-o-Lok® clips and staplers. Each has its advantages and disadvantages. METHODS: A systematic literature review was conducted following the PRISMA methodology on PubMed, EMBASE, and Cochrane databases with no time restrictions. Registered in the PROSPERO database (CRD42023460585), the study's primary outcome measures include the failure rate of the ligation tool, conversion to open surgery, rate of severe bleeding, and device-related death. Other secondary variables are also explored. An assessment of the quality of included comparative studies was performed using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool. RESULTS: Out of 393 articles identified using our keywords, 32 were included. Overall, clips have a lower failure rate during application, elongate graft vessel length, and are more cost-effective. Staples are associated with a shorter warm ischemia time and lower blood loss. There is no significant difference between the two devices in terms of conversion, severe bleeding, death, and blood transfusion. CONCLUSION: There is no perfect modality for renal pedicle control during laparoscopic harvesting, as each instrument has its pros and cons. Hem-o-Lok® clips are a safe and cost-effective option, particularly suitable for right-sided harvesting or in cases of vascular variations. However, they are still associated with a risk of secondary displacement with potentially serious consequences. Certain technical tricks can mitigate this risk.

[Effectiveness of psychotherapy on dissociative symptoms in adult populations: A PRISMA systematic review]. / Efficacité des psychothérapies sur les symptômes dissociatifs en population adulte : une revue de la littérature PRISMA.

INTRODUCTION: Dissociation is a psychological process in reaction to threat which can be found in many psychiatric conditions. Dissociative symptoms can become very disabling, whether in daily life or in care. Nevertheless, few studies seem to have examined the efficacy of psychotherapy on the latter and its relevance as a therapeutic target. METHOD: A systematic review of the literature (PRISMA) on the efficacy of psychotherapy on dissociative symptoms in adults with mental disorders was conducted. Effectiveness was considered in terms of reduction in dissociative symptomatology. The search was conducted on Scopus, PubMed and PsycInfo. Overall, 50 full-text articles were evaluated. RESULTS: Fourteen studies were included in the review. In all, 711 adult subjects with post-traumatic stress disorder, borderline personality disorder or dissociative disorder were included. Overall, this systematic review reports a reduction in dissociative symptoms associated with a variety of psychotherapeutic interventions, without allowing any conclusions to be drawn on the superiority of one psychotherapy over another. DISCUSSION: The conclusions of this work highlight three possible therapeutic orientations for reducing dissociative symptoms: (i) by reintegrating the dynamic subsystems, (ii) by treating the cognitive processes underlying dissociation, and (iii) by acting on the processes identified as common to the effectiveness of psychotherapy.

[Prevalence of mental disorders in French prisons: A systematic review]. / Prévalence des troubles psychiatriques en population carcérale française : une revue systématique de la littérature.

INTRODUCTION: The prevalence of psychiatric disorders among prisoners remains a major public health issue worldwide. In France, despite the increasing number of persons who are incarcerated (+30% between 1992 and 2002 with a 120% prison overcrowding), and a historical concern about the mental health of persons in detention and its management, no systematic review has been published on this subject. The aim of this article is to present the results of a systematic review of the literature on the prevalence of psychiatric disorders in French prisons. METHOD: The reporting of this systematic review conforms to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) checklist. We searched the PubMed and Web of Science databases. We used combinations of keywords relating to prison (prison*, jail*, inmate*), to psychiatry ("mental health", psychiatr*), and to France (France, French). This work was completed with a search through the digital libraries of the École des Hautes Études en Santé Publique (EHESP) and of the Système Universitaire de Documentation (Sudoc) to obtain data from academic works and the gray literature. References cited in studies included in this review were also examined. All references published up to September 2022, written in English or French, presenting the results of original quantitative studies on the prevalence of psychiatric disorders in correctional settings were included. Two researchers independently extracted data from included references according to a pre-established protocol. RESULTS: Among 501 records identified, a total of 35 papers based on 24 epidemiological studies met the eligibility criteria for inclusion in this review: 16 were cross-sectional, 7 retrospective and 1 both cross-sectional and retrospective. All papers were published between 1999 and 2022. We found one European study, 5 international studies, 18 regional or local studies. Of these, 21 studies had all-male or mixed gender samples (but when the sample was mixed gender, it was always at least 92% male). Almost half of the studies (n=11) involved a small sample of fewer than 500 persons. Half of the studies involved a sample of recently incarcerated persons: 6 involved a random sample of persons in detention, and 1 involved a sample of people incarcerated for more than 5 years. The last 5 studies focused on persons aged over 50 years and incarcerated for more than one year (n=1), incarcerated for sexual offences (n=2), placed in disciplinary cells (n=1) or in a special wing for radicalized or suspected radicalized individuals (n=1). Nine studies used standardized and validated diagnostic tools. According to the 4 studies involving representative samples and using standardized and validated diagnostic tools, the prevalence of the following psychiatric disorders was: 29.4-44.4% for anxiety disorders, 5-14.2% for PTSD, 28-31.2% for mood disorders, 6.9-17% for psychotic disorders, 32% for personality disorders and 11% for ADHD. CONCLUSION: This systematic review of the literature highlights the high prevalence of psychiatric disorders in French prisons. The data collected are in line with international studies. The great methodological heterogeneity of the papers included in this review calls for further rigorous research to better understand the rates of mental disorders in French prisons and to explore their determinants.

Prevalence of prolonged grief disorder in bereaved children and adolescents: A systematic review.

PURPOSE: Prolonged Grief Disorder (PGD) is a condition recently introduced in international classifications of mental disorders. Although PGD is associated with significant distress and impairment that may have developmental consequences, to date, little is known about its prevalence and associated factors in children and adolescents. The present systematic review registered in PROSPERO (CRD42021236026) aimed to: (i) review existing data on the prevalence of PGD in bereaved children and adolescents; and (ii) identify factors associated with PGD in this population. METHODS: Six electronic databases, grey literature and a manually searched journal identified 1,716 articles with no backward limit to September 2021. Epidemiological studies were included if they reported the prevalence of PGD in bereaved children and adolescents. Study characteristics, diagnostic and assessment tools, population, loss-related characteristics and prevalence of PGD were reviewed. RESULTS: Five studies met our inclusion criteria. The reported prevalences of PGD ranged from 10.4% to 32%. Female gender, cognitive avoidance, chronic stressors such as economic hardship, exposure to trauma or other losses appear to be associated with more severe symptoms or even a higher risk of PGD. Conversely, data suggest social support may be protective. CONCLUSION: This first systematic review found a relatively high prevalence of PGD in bereaved children and adolescents. While further large epidemiological studies are needed, this review highlights the importance of evaluating PGD in current clinical practice and suggests that further research into diagnostic and therapeutic approaches targeting this disorder is warranted.

Proximal row carpectomy versus four-corner arthrodesis in the treatment of SLAC and SNAC wrist: meta-analysis and literature review.

A systematic literature review was performed on 84 articles from 2000 to 2020 on proximal row carpectomy (PRC) or four-corner arthrodesis (FCA) in patients with posttraumatic wrist osteoarthritis. Qualitative assessment was conducted on 14 articles. Pain, range of motion (ROM), grip strength and complications were analyzed using weighted average means. Meta-analysis with a random effects model was performed for the flexion-extension arc and grip strength. A total of 1,066 PRCs and 2,771 FCAs were analyzed, with a mean follow-up of 9 and 7 years respectively. Mean flexion after PRC and FCA respectively was 36.2 ° and 31.1 °, mean extension 41.4 ° and 32.4 °, and mean grip strength 26.4 kg and 27.5 kg. PRC had a larger flexion-extension arc than FCA, with a standard mean difference (SMD) of 0.41 (range, 0.02-0.81). No significant difference was found for grip strength. Osteoarthritis occurred in 42.2% of PRC cases, independently of capitate shape. Conversion to wrist arthrodesis was performed in 10.1% of failed PRCs. Revision was chosen in 4.7% of FCAs and conversion to wrist arthrodesis in 4.6%. We conclude that the functional results of both techniques are similar, but prefer PRC to FCA because of the lower complications rate.

Updating the evidence: A systematic review of a decade of Infant and Early Childhood Mental Health Consultation (IECMHC) research.

Infant and Early Childhood Mental Health Consultation (IECMHC) is a preventative, capacity-building intervention in which mental health professionals partner with early childhood professionals to indirectly improve the environments and relationships that young children experience. Prior research has demonstrated that IECMHC is associated with positive outcomes for children, teachers, and classrooms. Over the past decade, IECMHC implementation and research have expanded, warranting an updated review. The current paper provides an update of the IECMHC evidence base. Included studies (n = 16) were systematically gathered, screened, and coded for context, intervention characteristics, methods and measures, outcomes across ecological levels, and alignment with the IDEAS Impact Framework's guiding questions. Our analysis replicates prior reviews, describing the positive impact of IECMHC on outcomes such as child externalizing behavior, teacher self-efficacy, and teacher-child interactions. Beyond updating prior reviews, this analysis describes emerging, nuanced findings regarding the mechanisms of change and the differential impact of IECMHC. We augment our review with descriptions of evaluations that did not meet our inclusion criteria (e.g., IECMHC in the home visiting context, unpublished evaluation reports) to provide context for our findings. Finally, we provide policy and practice implications and articulate an agenda for future research.

Cervical cancer in Morocco: A systematic review.

BACKGROUND: This systematic review aims to determine the epidemiological profile, etiology and risk factors, prevention, diagnosis, treatment, cost-effectiveness, survival, and quality of life related to cervical cancer in Morocco. METHODS: This study was conducted according to the recommendations of the "preferred reporting items for systematic reviews and meta-analysis." The PubMed, ScienceDirect, Springer, Web of Science data bases were used, as was Google Scholar for the grey literature. The review protocol was registered in the PROSPERO register (CRD42021235241). RESULTS: Fifty studies were selected. The mean age was 49.31 ±6.3 years. HPV infection prevalence ranged from 13.30% to 76%, with a peak in HIV-positive women. Acceptability of the HPV vaccine was higher among parents (35% and 82%) than among adolescents (16.9% to 46.6%). Knowledge of the vaccine and its price are two key factors related to vaccine acceptability among parents. This systematic review highlights that the fact that few eligible women (not more than 11%) were participating in the cervical cancer screening program. Moroccan women's level of knowledge and awareness regarding cervical cancer screening was low, negatively impacting their use of such screening tools, as illustrated by the high percentage (mean 76.32% ± 17.21) of women who had never been screened for cervical cancer. Treatment was the most significant component of the global care budget (95.87%), with an annual cost of $13,027,609. Five-year overall survival ranged from 41.3% to 73.6%, with higher survival rates for patients diagnosed at an earlier stage (77.3-85% for stage I). Lastly, low quality of life was observed in women with tumors at an advanced stage who had received brachytherapy and lacked social support. CONCLUSIONS: Subjects that require further investigation include Moroccan women's knowledge, attitudes, and awareness, especially among those at high risk of developing cervical cancer, and its impact on their quality of life and survival.

Effects of caffeinated energy drinks on cardiovascular responses during exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials.

The impact of caffeinated energy drinks (CEDs) on the cardiovascular (CV) response to exercise has not been well described. A systematic review and meta-analysis was conducted on the acute effects of CEDs on CV responses during dynamic, aerobic exercise in 296 healthy adult males (224) and females (72) in 21 randomized controlled trials. During exercise, there was an increase in heart rate (HR) (mean difference (MD), 2.86 bpm, 95% CI, 2.39-3.34 bpm, I2 = 0%, p < 0.00001), and systolic blood pressure (SBP) (MD, 9.02 mm Hg, 95% CI, 4.25-13.79 mm Hg, I2 = 0%, p = 0.0002) with consumption of CEDs, compared with controls, but diastolic blood pressure was similar. Insufficient data were available to evaluate rate pressure product (HR × SBP) and exercise-induced arrhythmia. Though changes to HR during exercise were modest, the significant increase in exercise SBP highlights the importance of directly assessing CV effects of CEDs with exercise, especially in individuals prone to hypertension. Novelty: Exercise SBP in healthy adults is significantly increased during exercise with the consumption of CEDs compared with controls, despite limited data. The direct assessment of CV effects of CEDs with exercise highlights the particular relevance to individuals prone to hypertension.

[The efficacy of esketamine in resistant major depressive disorder: A systematic review of the literature]. / L'efficacité de l'eskétamine dans le trouble dépressif majeur résistant : une revue systématique de la littérature.

OBJECTIVE: Major depression is a significant public health problem since its lifetime prevalence is estimated at 15-18 %. Its standard treatment is based on the use of antidepressant medications but their effectiveness is limited. Indeed, only two thirds of patients with a major depressive episode will reach remission after two lines of conventional treatment. In major depression, there are arguments in favour of disturbances in neuronal glutamatergic transmission. Esketamine appears to have an antidepressant action through modulation of the NMDA receptors involved in this glutamatergic neurotransmission. The aim of this review to systematically investigate the efficacy of esketamine combined with an SSRI or SNRI for major depressive disorder resistant to treatment. METHOD: A systematic review on the efficacy of esketamine in combination with an SSRI or SNRI for resistant major depressive disorder was performed in July 2021 in the PUBMED database according to the PRISMA criteria. The key words used are: "depressed" [All Fields] OR "depression" [MeSH Terms] OR "depression" [All Fields] OR "depressions" [All Fields] OR "depression s" [All Fields] OR "depressive disorder"[MeSH Terms] OR ("depressive"[All Fields] AND"disorder"[All Fields]) OR"depressive disorder"[All Fields] OR"depressivity"[All Fields] OR"depressive"[All Fields] OR "depressively" [All Fields] OR "depressiveness" [All Fields] OR "depressives" [All Fields]) AND ("esketamine" [Supplementary Concept] OR "esketamine" [All Fields] OR "esketamine" [All Fields]. The inclusion criteria were: efficacy on depressive symptoms of intranasal esketamine combined with an SSRI or an SNRI for major depressive disorder resistant to at least two lines of treatment, RCT and meta-analysis, individual≥18 years, articles in English and French. RESULTS: Four randomized double-blind studies were selected on the basis of these criteria. The included studies are of grade A and B which leads to a high level of scientific evidence. CONCLUSIONS: Intranasal esketamine in combination with sertraline, escitalopram, duloxetine or venlafaxine prolonged release is more effective than the monotherapy use of these four molecules for the treatment of resistant depression. It has been shown to be effective for a population aged between 18 and 74 years at doses between 28mg and 84mg. Currently, based on these results, intranasal esketamine should be proposed as a second level of treatment after an unsuccessful trial of two antidepressants. It is nevertheless advisable to be careful in its use in a clinical psychiatric population: exclusion of suicidal ideation or antecedent of suicidal acting, absence of psychotic depression, use exclusively for unipolar major depressive disorder. The different conditions of use are also notified in the product characteristics of the European Medicines Agency. Finally, further comparative studies are needed in the future, in the absence of funding from the pharmaceutical company producing esketamine.

Patient-Reported Outcome and Experience Measures Administered by Dietitians in the Outpatient Setting: Systematic Review.

Understanding how patients perceive their health and the experience with the dietitian is fundamental to providing patient-centred care. The types of patient reported measures (PRMs) used by outpatient dietitians is unclear. Guidance about use of PRMs for dietitians is also lacking. The aim of this systematic review was to synthesise evidence regarding the use of PRMs by dietitians in the outpatient setting and evaluate the methodological quality of studies evaluating the psychometric properties of PRMs. Eight databases were searched systematically for studies of dietitians working in the outpatient setting and administering a PRM. Forty-four studies were evaluated and described 58 different PRMs. These included direct nutrition related (n = 12 studies), clinical (n = 21 studies), and health-related quality of life PRMs (n = 24 studies); 1 study documented use of a patient-reported experience measure. A large range of PRMs are used by outpatient dietitians. Of the most common PRMs, the majority are administered in similar populations to the original validation study. Dietitians should use a combination of 3 PRMs: a generic health-related quality of life tool, an experience measure, and at least 1 clinical or direct nutrition-related measure. This will enable dietitians to fully capture the impact of their care on patients.

Levetiracetam for Status Epilepticus in Adults: A Systematic Review.

BACKGROUND: Status epilepticus (SE) is a neurologic emergency with potential for substantial mortality and morbidity. Parenteral benzodiazepine is the established first-line treatment but fails to control SE in about one-third of patients. Levetiracetam may be used for SE that is refractory to benzodiazepine therapy. OBJECTIVE: To examine, by means of a systematic review, the role of IV levetiracetam for the treatment of SE in adults. DATA SOURCES: MEDLINE, Embase, CENTRAL, and CINAHL databases were searched, from inception to August 18, 2020. STUDY SELECTION AND DATA EXTRACTION: Included in this review were prospective randomized controlled trials comparing levetiracetam with another antiepileptic drug, given with or after a benzodiazepine, in adult patients with SE. The primary outcome was cessation of SE. Quality of evidence was assessed with the Cochrane risk-of-bias tool. Characteristics of the included studies were reported using descriptive statistics. DATA SYNTHESIS: Five studies compared IV levetiracetam with valproic acid, phenytoin (or its prodrug fosphenytoin), or both. All 5 studies found no statistically significant differences in efficacy or safety end points. There were numerically more cases of hypotension and respiratory failure with phenytoin, and more cases of psychiatric adverse effects (e.g., post-ictal psychosis) with levetiracetam. CONCLUSIONS: Available evidence suggests that levetiracetam is as effective as valproic acid or phenytoin for the cessation of SE in adults. Other factors should therefore dictate the choice of antiepileptic drug for patients with SE, such as adverse effect profile, logistics of administration, drug cost, inclusion on hospital formularies, and drug availability.

CONTEXTE: L'état de mal épileptique (EME) est une urgence neurologique qui s'accompagne d'un potentiel important de mortalité et de morbidité. La benzodiazépine parentérale est le traitement de première ligne établi, mais ne parvient pas à contrôler l'EME chez environ un tiers des patients. Le lévétiracétam peut s'utiliser pour les EME réfractaires au traitement par les benzodiazépines. OBJECTIF: Examiner, au moyen d'une revue systématique, le rôle du lévétiracétam IV pour le traitement de l'EME chez l'adulte. SOURCES DES DONNÉES: Les bases de données MEDLINE, Embase, CENTRAL et CINAHL ont fait l'objet d'une recherche, depuis leur création jusqu'au 18 août 2020. SÉLECTION DES ÉTUDES ET EXTRACTION DES DONNÉES: Cette revue comprenait des essais contrôlés randomisés prospectifs comparant le lévétiracétam à un autre médicament antiépileptique, administré avec ou après une benzodiazépine, chez des patients adultes atteints d'EME. Le critère de jugement principal était l'arrêt de l'EME. La qualité des preuves a été évaluée avec l'outil de risque de biais Cochrane. Les caractéristiques des études incluses ont été rapportées à l'aide de statistiques descriptives. SYNTHÈSE DES DONNÉES: Cinq études ont comparé le lévétiracétam IV avec l'acide valproïque, la phénytoïne (ou son promédicament, la fosphénytoïne), ou les deux. Les 5 études n'ont trouvé aucune différence statistiquement significative en termes d'efficacité ou d'innocuité. Numériquement, les cas d'hypotension et d'insuffisance respiratoire avec la phénytoïne étaient plus élevés, et les cas d'effets indésirables psychiatriques (par exemple, psychose post-critique) étaient plus élevés avec le lévétiracétam. CONCLUSIONS: Les preuves disponibles suggèrent que le lévétiracétam est aussi efficace que l'acide valproïque ou la phénytoïne pour l'arrêt de l'EME chez l'adulte. D'autres facteurs devraient donc dicter le choix du médicament antiépileptique pour les patients atteints d'EME, tels que le profil des effets indésirables, la logistique d'administration, le coût du médicament, l'inscription sur les formulaires hospitaliers et la disponibilité des médicaments.

[Measuring adolescents' use of social media: A systematic review]. / La mesure de l'usage des réseaux sociaux chez les adolescents: une revue systématique de la littérature.

OBJECTIVE: The purpose of this review was to provide an overview of the methods used to measure social network site use among adolescents. Such a review is important given the number and diversity of sites and the prevalence of their use among adolescents. METHODS: A systematic review of the literature was conducted in line with PRISMA guidelines to arrive at an analysis of 58 peer-reviewed studies indexed in PubMed, PsychInfo, or Scopus. To be included in the review, articles had to be peer-reviewed, available in full text, and published in French or English. For inclusion, studies were required to pertain to adolescents aged between 11 and 18 years; to focus on social network site use and indicate how their use was estimated. Studies that simultaneously examined social network sites and general internet use or video games and only provided a combined analysis were excluded. The keywords for the search were: social media use, social media usage, social media misuse, measure, teen, and adolescents. RESULTS: In the literature, different methods were used to operationalize the use of social network sites: quantitative methods with the measurement of frequency and duration of use of social network sites, and qualitative methods to measure the different activities adolescents engage in on such sites. In this review, 28 articles investigated the use of social media through a measurement of frequency and 22 articles through a measurement of the duration of use. Most of the studies focused on social network sites in general, without specifying which sites in particular were considered by the respondents when answering the question. However, some articles provided cross measures of quantitative and qualitative measurements resulting in the examination of both the frequency of use and the time spent on specific activities on social network sites. CONCLUSIONS: The present review highlights the great diversity in the methods used to measure the use of social network sites among adolescents. The reliance on frequency-based measurements without taking into account the specificities of the activities or sites involved limits the investigation of their impact on adolescent functioning and behaviors. Given the observed discrepancies in the literature concerning the measurement of social network site use among adolescents and their associated biases, the development of specific instruments is needed to advance in this important field of research.

[Investigating the relationship between social media use and body image among adolescents: A systematic review]. / Lien entre usage des réseaux sociaux et image corporelle chez les adolescents : une revue systématique de la littérature.

OBJECTIVES: This study aimed to update the scientific knowledge concerning the relationship between the use of social networking sites and body image among adolescents. METHODS: A preregistered systematic review was conducted following PRISMA guidelines and allowed to include 30 peer-reviewed articles for qualitative analysis, consisting of 26 unique samples (n=31,331; Mage=14.89; SDage=1.07). The search was conducted on Pubmed, PsychInfo and Scopus focusing on studies that included any social network site use and body image measures while being based on general population adolescent samples. Social networking site use referred: 1) to any online activities such as browsing, posting, editing selfies, liking, commenting; 2) to any exposure to appearance-related content; or 3) to a measure of frequency use. The scope of social networking sites considered in the present review was extended to online video-sharing platforms and online dating applications due to their relationship with appearance. Body image as considered through MeSH terms referred to a wide range of possible outcomes including body and facial dissatisfaction, dysmorphophobia, body surveillance, self-objectification, body shame, weight concerns, self-monitoring. Any mental health outcome was extracted when available although its absence was not an exclusion criterion.. RESULTS: Among the 30 studies included in the review, 22 were cross-sectional, seven were longitudinal and one had an experimental design. Overall, among studies based on unique samples, 18 studies included both males and females (n=28,081; Mage 14.84; SDage=1.06), seven were based exclusively on female samples (n=2,507; Mage 14.87; SDage=1.19), while one study recruited only male adolescents (n=743; Mage 15.90; SDage=0.54). Only six studies were based on representative samples. These studies reported a robust association between frequency of social networking site use and negative body image among both females and males. In addition, exposure to appearance-related content was also deleterious to body image. The association between the use of social media and negative body image may involve negative mental health outcomes, such as depressive symptoms, low body esteem and problematic use of social media. Measuring specific activities on social network sites or exposure to appearance-related content (e.g. selfies editing; selfies posting) may be more accurate than using a frequency of overall use (e.g. during the past month) when predicting body image. Studies addressing underlying processes supported that the relationship between use of social media and body image may not be direct but rather involve intermediary steps on both cognitive and social levels, namely internalization of the thin ideal, self-objectification, peer appearance-related feedback, ascendant social comparison with peers and celebrities. Also, it remains unclear whether mental health mediates this relationship. CONCLUSIONS: The association between the use of social networking sites and negative body image is robustly supported in the literature. However, studies measuring frequency of overall use may instead be predicting negative body image with a nested measure of the use of social network sites, namely specific activities involving appearance-related content. Due to the observed discrepancies between self-reported frequency of social networking site use and actual use in methodological literature, future research may rather measure behaviors commonly encountered on a given platform. Furthermore, there is a need to distinguish specific site categories such as highly visual social media when focusing on body image outcomes. . Focusing on specific social media platforms may in turn lead to more targeted prevention regarding a safe utilization of social networking sites among adolescents. Despite the growing body of research concerning the association between social media and body image, the current review underlines that additional longitudinal and experimental studies are needed to investigate potential bidirectional effects, as well as studies based on representative samples to improve generalization to adolescent populations.

[Efficacy of psychedelics in psychiatry, a systematic review of the literature]. / Efficacité des psychédéliques en psychiatrie, une revue systématique.

OBJECTIVES: Psychedelics are powerful psychoactive substances. Natural psychedelics have been used for millennia by human civilizations, in particular in Latin America, while synthetic psychedelics were discovered in the 50s, giving rise to a lot of research before they were prohibited. More recently, their therapeutic properties have been studied especially to help patients with psychiatric conditions, psychological distress or substance use disorders. This article is a systematic review of the literature which aims to provide an overview of all studies that assessed the efficacy of psychedelics, i.e. psilocybin, ayahuasca and lysergic acid diethylamide (LSD), on psychiatric diseases and addictions. METHODS: We conducted this literature review following the PRISMA recommendations. MEDLINE, PsycInfo, Web of Science and Scopus were searched from January 1990 to May 2020 with the following keywords "(ayahuasca OR psilocybin OR lysergic acid diethylamide) AND (depression OR anxiety OR major depressive disorder OR bipolar disorder OR anxiety disorder OR substance use disorder OR dependence)". RESULTS: Twenty-five articles met the inclusion criteria. Five articles studied psychedelic efficacy in the treatment of life-threatening diseases related to anxiety and depression: four were randomized controlled crossover trials (three with psilocybin for a total of 92 patients, and one with LSD, n=12), and one was a long-term follow-up study. Eleven articles explored the efficacy of psychedelics in the treatment of major depressive episodes: two were open-labeled trials (one with ayahuasca, n=17, one with psilocybin, n=20), one was a randomized controlled trial using ayahuasca against placebo (n=29), and the others were long-term follow-up studies or assessed more precise dimensions of the depressive disorder, such as suicidality, emotion processing or personality traits. Eight articles studied the efficacy of psychedelics in the treatment of addictions: two were open-labeled studies using psilocybin (one in alcohol use disorder, n=10, and one in tobacco use disorder, n=15), and the others were long-term follow-up studies or retrospective observational descriptive studies on alcohol, tobacco, opioids, cannabis, and psychostimulants. One study explored the efficacy of psilocybin in obsessional-compulsive disorder (n=9). Overall, these studies found a quick and important response after psychedelic administration that lasted for several months, even after a single dose. However most of these studies were descriptive or open-label studies conducted on small size samples. No severe adverse events occurred. CONCLUSIONS: Psychedelics are promising treatments for anxiety, depression and addiction, their efficacy is quick and sustainable, and they are well tolerated. These effects need to be confirmed in larger studies and compared to standard care.

[Current status of clinical practice guidelines on palliative sedation for adults in French-speaking countries]. / État des lieux des recommandations sur la sédation palliative chez l'adulte dans les pays francophones.

INTRODUCTION: Many clinical practice guidelines on palliative sedation have been developed. To date, studies on French-language guidelines are lacking, despite the specific and potentially influential end-of-life positions taken by some French-speaking countries. This study aimed to perform a systematic review of the guidelines related to palliative sedation for adults in French-speaking countries, taking a synchronic and diachronic approach (current and former guidelines). METHODS: Guidelines published in French since 2000 were searched for multiple databases. In addition, prominent palliative care experts in French-speaking countries were contacted individually. A content analysis of all guidelines was conducted. RESULTS: A total of 21 guidelines from 18 countries were identified. Among them, at the time of the data collection, 14 guidelines were effectively compiled in four countries or provinces: Belgium, France, Canada (Quebec) and Switzerland. No guidelines were found for African countries. The recommendations analyzed were very heterogeneous in form (simple proposals or formal guidelines) and in substance (i.e. different types of sedation). DISCUSSION AND CONCLUSION: The quantity and volume of the guidelines found and the heterogeneity of the terminology prevented a detailed analysis of the content of the texts. An analysis must be performed using a synchronic approach only and focusing on a specific element of one type of sedation.

Evidence from systematic reviews of randomized trials on enteral lactoferrin supplementation in preterm neonates.

In this commentary, we summarize the current evidence from randomized controlled trials on enteral lactoferrin supplementation in preterm neonates. Our recently completed systematic review includes 12 randomized controlled trials performed all over the world. Our meta-analysis suggests clinical benefit in decreasing late-onset sepsis, late-onset fungal sepsis, length of stay in the hospital and urinary tract infections. There were no adverse effects. There was no statistically significant decrease in necrotizing enterocolitis, mortality or neurodevelopmental impairment in lactoferrin supplemented preterm infants. There was significant statistical heterogeneity in the effects of lactoferrin on late-onset sepsis between larger and smaller studies, which may reflect either small study biases, differences in the effectiveness, dose or duration of supplemental lactoferrin products, or differences in underlying population risk, or any or all of these.

Enhancing parental reflective functioning through early dyadic interventions: A systematic review and meta-analysis.

Parental reflective functioning (PRF) is an important predictor of infant attachment, and interventions that target parent-infant/toddler dyads who are experiencing significant problems have the potential to improve PRF. A range of dyadic interventions have been developed over the past two decades, some of which explicitly target PRF as part of their theory of change, and some that do not explicitly target PRF, but that have measured it as an outcome. However, no meta-analytic review of the impact of these interventions has been carried out to date. The aim of this review was to evaluate the effectiveness of dyadic interventions targeting parents of infant and toddlers, in improving PRF and a number of secondary outcomes. A systematic review and meta-analysis was conducted in which key electronic databases were searched up to October 2018. Eligible studies were identified and data extracted. Data were synthesised using meta-analysis and expressed as both effect sizes and risk ratios. Six studies were identified providing a total of 521 participants. The results of six meta-analyses showed a nonsignificant moderate improvement in PRF in the intervention group (standardised mean difference [SMD]: -0.46; 95% confidence interval [CI] [-0.97, 0.04]) and a significant reduction in disorganised attachment (risk ratio: 0.50; 95% CI [0.27, 0.90]). There was no evidence for intervention effects on attachment security (odds ratio: 0.71; 95% CI [0.19, 2.64]), parent-infant interaction (SMD: -0.10; 95% CI [-0.46, 0.26]), parental depression (SMD: -1.55; 95% CI [-3.74, 0.64]) or parental global distress (SMD: -0.19, 95% CI [-3.04, 22.65]). There were insufficient data to conduct subgroup analysis (i.e. to compare the effectiveness of mentalisation-based treatment with non-mentalization-based treatment interventions). Relational early interventions may have important benefits in improving PRF and reducing the prevalence of attachment disorganisation. The implications for future research are discussed.

El funcionamiento de reflexión del progenitor (PRF) es un factor importante de predicción de la afectividad del infante, y las intervenciones que se enfocan en díadas progenitor/infante/niño pequeñito que experimentan problemas significativos tienen la posibilidad de mejorar el PRF. La meta de esta revisión fue evaluar la eficacia de las intervenciones diádicas que se enfocan en los progenitores de infantes y niños pequeñitos, para mejorar el PRF y un número de resultados secundarios. Se llevó a cabo una revisión sistemática y un meta-análisis en los que se investigaron bancos de información electrónica claves hasta octubre de 2018. Se identificaron estudios elegibles y se sacó de ellos la información. Se sintetizó esa información usando meta-análisis y la misma fue presentada tanto en términos de dimensión de efectos como la proporción de riesgo. Se identificaron seis estudios que aportaron un total de 521 participantes. Los resultados de seis meta-análisis mostraron un moderado, poco significativo y limítrofe mejoramiento en cuanto al PRF en el grupo de intervención (SMD: -0.46; 95% CI -0.97, 0.04), una reducción significativa en la afectividad desorganizada (RR: 0.50; 95% CI: 0.27, 0.90), pero no así en la afectividad segura (OR: 0.71; 95% CI: 0.19, 2.64), y ninguna evidencia de beneficio para la interacción progenitor-infante (SMD: -0.09; 95% CI: -0.51, 0.32). Se dio un mejoramiento grande no significativo en la depresión del progenitor (SMD: -1.55; 95% CI -3.74, 0.64), pero no hubo evidencia de beneficio en cuanto a la angustia total (SMD: -0.19; 95% CI: -3.04, 22.65). Se discuten las implicaciones para la futura investigación.

Le fonctionnement parental réfléchi (en anglais Parental Reflective Functioning, soit PRF) est un facteur de prédiction important de l'attachement du bébé, et les interventions qui ciblent les dyades parent-bébé/petit enfant qui font l'expérience de problèmes importants ont le potentiel d'améliorer le fonctionnement PRF. Le but de cette article était d'évaluer l'efficacité d'interventions dyadiques ciblant les parents de bébés et de petits enfants, en améliorant le fonctionnement PRF et un bon nombre de résultats secondaires. Une revue et une méta-analyse ont été faites, les bases de données électroniques clés ayant été passées au crible en octobre 2018. Les études pouvant être utilisées ont été identifiées et les données ont été extraites. Les données ont été synthétisées en utilisant une méta-analyse et exprimées sous forme d'ampleur de l'effet et de risque relatif. Six études ont été identifiées, pour un total de 521 participants. Les résultats de six méta-analyses ont montré une amélioration limite non importante modérée dans le PRF dans le groupe d'intervention (SMD: -0,46; 95% CI -0,97, 0,04), une réduction importante dans l'attachement désorganisé de l'enfant (RR: 0,50; 95% CI: 0,27, 0,90) mais non dans l'attachement sécure (OR: 0,71; 95% CI: 0,19, 2,64), ainsi qu'aucune preuve de bénéfice pour l'interaction parent-bébé (SMD: -0,09; 95% CI -0,51, 0,32). Il y avait une grande amélioration non-importante dans la dépression parentale (SMD: -1,55; 95% CI -3,74, 0,64) mais aucune preuve de bénéfice dans la détresse globale (SMD: -0,19; 95% CI: -3,04, 22,65. Les implications pour les recherches futures sont discutées.

[Efficacy of psychodynamic therapies: A systematic review of the recent literature]. / L'efficacité des psychothérapies inspirées par la psychanalyse : une revue systématique de la littérature scientifique récente.

AIM: A French governmental institute published, in February 2004, a report assessing the efficacy of psychotherapies in the light of the biomedical literature. It concluded that cognitive psychotherapies effectively cure common mental disorders, while the efficacy of psychodynamic therapies is not proven by scientific studies. Because many French mental health professionals are practicing with reference to psychoanalysis, this conclusion stirred up heated controversy. Since February 2004, numerous studies assessing psychodynamic therapies have been published in peer-reviewed biomedical journals. Moreover, these primary studies have been meta-analyzed in dozens of review articles. Here, we systematically review these meta-analysis articles. METHODS: A systematic search for meta-analyses assessing psychodynamic therapies was performed using PubMed and identified 71 articles published from January 2004 to December 2019. Among them, 25 articles were judged to be relevant because they reported meta-analyses assessing the symptoms of common mental disorders in at least three distinct cohorts of adult patients. Although the primary studies included in these 25 meta-analysis articles often overlap, the selection criteria, calculation methods and results always differ between them. Therefore, we reviewed all of them without further selection. From all the meta-analyses reported in these 25 articles, we systematically present here the most compelling ones, i.e. those calculated from the largest number of primary studies. Results were quantified in terms of effect size (i.e. standardized mean difference). Effect sizes below 0.25 were considered as without clinical significance, whereas those superior to 0.8 were regarded as robust. Because short-term psychodynamic therapies had been assessed in 20 meta-analysis articles published until 2017, we did not search for more recent primary studies. However, because the most recent meta-analysis article about long-term psychodynamic therapies was published in 2013, we also searched, using PubMed, for primary studies assessing psychodynamic therapies lasting for at least one year and published from January 2013 to December 2019. Among the 57 publications retrieved by PubMed, three were identified as randomized controlled trials not included in meta-analyses and were extensively described here. RESULTS: Eight meta-analysis articles have assessed symptom improvement at treatment termination by comparing with baseline symptoms. According to all of them, psychodynamic therapies alleviate symptoms and their effect sizes are always robust. Three meta-analysis articles compared psychodynamic therapies with inactive treatments (e.g. placebo medication, waiting list) and reported clinically significant differences in favor of psychodynamic therapies. Ten meta-analysis articles compared, at treatment termination, psychodynamic therapies to active treatments, including medication and cognitive psychotherapies. Nine of them reported no difference. Only one article concluded that psychodynamic therapies are clinically inferior to cognitive psychotherapies (d=-0.28). Seven meta-analysis articles compared psychodynamic therapies to active treatment at follow-up (i.e. months or years after treatment termination). Five of them reported no significant difference, one reported a medium effect size in favor of psychodynamic therapies over various active treatments (d=0.38), while the other reported a clinically significant difference in favor of cognitive psychotherapies (d=-0.55). Because short-term treatments are often insufficient to prevent relapse, investigations about long-term treatments (i.e. more than one year) are needed, but such published studies are still scarce. Five meta-analysis articles and three primary studies published since 2013 compared long-term psychodynamic therapies to various active treatments of similar duration. According to them, psychodynamic therapies were at least as effective as other active treatments. CONCLUSION: A systematic review about psychodynamic therapies, published in 2015 in Lancet Psychiatry, included 64 randomized controlled trials of which 37 were published after 2003. Therefore, most quality studies assessing psychodynamic therapies have been published since 2003 and have been reviewed in recent meta-analysis articles. All together, this recent literature leads to the conclusion that psychodynamic therapies are as effective as active treatments, including cognitive psychotherapies, to help patients suffering from common mental disorders (unipolar depression, anxiety disorders, eating disorders and personality disorders). Beside this overall conclusion, it appears that randomized controlled trials are not well suited for answering why psychotherapies work in some patients but not in others, and how they work in general. Other approaches are needed, including case studies.

Development and application of an outcome-centric approach for conducting overviews of reviews.

There are gaps in current guidance concerning how to conduct overviews of systematic reviews in an outcome-centric manner. Herein we summarize the methods and lessons learned from conducting 4 outcome-centric overviews to help inform the Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older on the topics of resistance training, balance and functional training, sedentary behaviour, sleep duration. We defined "critical" and "important" outcomes a priori. We used AMSTAR 2 to assess review quality and sought 1 systematic review per outcome. If multiple reviews were required to address subgroups for an outcome, we calculated the corrected covered area (CCA) to quantify overlap. We report our methodology in a PRISMA table. Across the 4 overviews, authors reviewed 1110 full texts; 45 were retained (low to high quality per AMSTAR 2), representing 950 primary studies, enrolling over 5 385 500 participants. Of 46 outcomes, we identified data for 35. Nineteen outcomes required >1 review (CCA range: 0% to 71.4%). Our outcome-centric overviews addressed unique aspects of overviews, including selection and quality assessment of included reviews, and overlap. Lessons learned included consistent application of methodological principles to minimize bias and optimize reporting transparency. Novelty Overviews of reviews synthesize systematic reviews in a rigorous and transparent manner. Outcome-centric systematic reviews assess the quality of evidence for primary studies contributing to an outcome. This manuscript describes the development and application of extending the concept of outcome-centric systematic reviews to the design and conduct of outcome-centric overviews.