Search results for: Tea Meta
427 The Effect of Undernutrition on Sputum Culture Conversion and Treatment Outcomes among People with Multidrug-Resistant Tuberculosis: A Systematic Review and Meta-Analysis
Authors: Fasil Wagnew, Kerri Viney, Kefyalew Addis Alene, Matthew Kelly, Darren Gray
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Background: Undernutrition is a risk factor for tuberculosis (TB), including poor treatment outcomes. However, evidence regarding the effect of undernutrition on TB treatment outcomes is not well understood. We aimed to evaluate the effect of undernutrition on sputum culture conversion and treatment outcomes among people with multi-drug resistance (MDR)-TB. Methods: We searched for publications in the Medline, Embase, Scopus, and Web of Science databases without restrictions on geography or year of publication. We conducted a random-effect meta-analysis to estimate the effects of undernutrition on sputum culture conversion and treatment outcomes. Two reviewers independently assessed the study eligibility, extracted the necessary information, and assessed the risk of bias. Depending on the nature of the data, odds ratio (OR) and hazard ratio (HR) with 95% confidence intervals (CIs) were used to summarize the effect estimates. Potential publication bias was checked using funnel plots and Egger’s tests. Results: Of 2358 records screened, 59 studies comprising a total of 31,254 people with MDR-TB were included. Undernutrition was significantly associated with a lower sputum culture conversion rate (HR 0·7, 95% CI 0·6–0·9, I2=67·1%) and a higher rate of mortality (OR 2·9, 95%CI 2·1–3·8, I2=23·7%) and unfavourable treatment outcomes (OR 1·8, 95%CI 1·5–2·0, I2=72·7%). There was no statistically significant publication bias in the included studies. Three studies were low, forty-two studies were moderate, and fourteen studies were high quality. Interpretations: Undernutrition was significantly associated with unfavourable treatment outcomes, including mortality and lower sputum culture conversion among people with MDR-TB. These findings have implications for supporting targeted nutritional interventions alongside standardised second-line TB drugs.Keywords: undernutrition, MDR-TB, sputum culture conversion, treatment outcomes, meta-analysis
Procedia PDF Downloads 156426 Aquatic Therapy Improving Balance Function of Individuals with Stroke: A Systematic Review with Meta-Analysis
Authors: Wei-Po Wu, Wen-Yu Liu, Wei−Ting Lin, Hen-Yu Lien
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Introduction: Improving balance function for individuals after stroke is a crucial target in physiotherapy. Aquatic therapy which challenges individual’s postural control in an unstable fluid environment may be beneficial in enhancing balance functions. The purposes of the systematic review with meta-analyses were to validate the effects of aquatic therapy in improving balance functions for individuals with strokes in contrast to conventional physiotherapy. Method: Available studies were explored from three electronic databases: PubMed, Scopus, and Web of Science. During literature search, the published date of studies was not limited. The study design of the included studies should be randomized controlled trials (RCTs) and the studies should contain at least one outcome measurement of balance function. The PEDro scale was adopted to assess the quality of included studies, while the 'Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence' was used to evaluate the level of evidence. After the data extraction, studies with same outcome measures were pooled together for meta-analysis. Result: Ten studies with 282 participants were included in analyses. The research qualities of the studies were ranged from fair to good (4 to 8 points). Levels of evidence of the included studies were graded as level 2 and 3. Finally, scores of Berg Balance Scale (BBS), Eye closed force plate center of pressure velocity (anterior-posterior, medial-lateral axis) and Timed up and Go test were pooled and analyzed separately. The pooled results shown improvement in balance function (BBS mean difference (MD): 1.39 points; 95% confidence interval (CI): 0.05-2.29; p=0.002) (Eye closed force plate center of pressure velocity (anterior-posterior axis) MD: 1.39 mm/s; 95% confidence interval (CI): 0.93-1.86; p<0.001) (Eye closed force plate center of pressure velocity (medial-lateral) MD: 1.48 mm/s; 95% confidence interval (CI): 0.15-2.82; p=0.03) and mobility (MD: 0.9 seconds; 95% CI: 0.07-1.73; p=0.03) of stroke individuals after aquatic therapy compared to conventional therapy. Although there were significant differences between two treatment groups, the differences in improvement were relatively small. Conclusion: The aquatic therapy improved general balance function and mobility in the individuals with stroke better than conventional physiotherapy.Keywords: aquatic therapy, balance function, meta-analysis, stroke, systematic review
Procedia PDF Downloads 202425 Enteropathogenic Viruses Associated with Acute Gastroenteritis among Under 5-Years Children in Africa: A Systematic Review and Meta-Analysis
Authors: Cornelius Arome Omatola, Ropo Ebenezer Ogunsakin, Anyebe Bernard Onoja, Martin-Luther Oseni Okolo, Joseph Abraham-Oyiguh, Kehinde Charles Mofolorunso, Phoebe Queen Akoh, Omebije Patience Adejo, Joshua Idakwo, Therisa Ojomideju Okeme, Danjuma Muhammed, David Moses Adaji, Sunday Ocholi Samson, Ruth Aminu, Monday Eneojo Akor
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Gastroenteritis viruses are the leading etiologic agents of diarrhea in children worldwide. We present data from thirty-three (33) eligible studies published between 2003 and 2023 from African countries bearing the brunt of the virus-associated diarrheal mortality. Random effects meta-analysis with proportion, subgroups, and meta-regression analyses were employed. Overall, rotavirus with estimated pooled prevalence of 31.0% (95% CI 24.0–39.0) predominated in all primary care visits and hospitalizations, followed by norovirus, adenovirus, sapovirus, astrovirus, and aichivirus with pooled prevalence estimated at 15.0% (95% CI 12.0–20.0), 10% (95% CI 6-15), 4.0% (95% CI 2.0–6.0), 4% (95% CI 3-6), and 2.3% (95% CI 1-3), respectively. Predominant rotavirus genotype was G1P[8] (38%), followed by G3P[8] (11.7%), G9P[8] (8.7%), and G2P[4] (7.1%); although, unusual genotypes were also observed, including G3P[6] (2.7%), G8P[6] (1.7%), G1P[6] (1.5%), G10P[8] (0.9%), G8P[4] (0.5%), and G4P[8] (0.4%). The genogroup II norovirus predominated over the genogroup I-associated infections (84.6%, 613/725 vs 14.9%, 108/725), with the GII.4 (79.3%) being the most prevalent circulating genotype. In conclusion, this review showed that rotavirus remains the leading driver of viral diarrhea requiring health care visits and hospitalization among under-five years children in Africa. Thus, improved rotavirus vaccination in the region and surveillance to determine the residual burden of rotavirus and the evolving trend of other enteric viruses are needed for effective control and management of cases.Keywords: enteric viruses, rotavirus, norovirus, adenovirus, astrovirus, gastroenteritis
Procedia PDF Downloads 98424 The Relationship between Sexual Minority Stress and Sexual Satisfaction: A Meta-Analytic Review
Authors: Terri A. Croteau, Todd G. Morrison
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Despite increased scholarly attention paid to minority stress and sexual satisfaction among sexual minorities, to the authors’ knowledge, no researchers, to date, have attempted to synthesize this literature. To address this omission, the authors conducted a meta-analytic review of the association between sexual minority stress (i.e., sexual identity stigma, internalized sexual identity stigma, and sexual identity concealment) and sexual satisfaction. Twenty-seven articles containing 58 effect sizes were analyzed (N = 183,582). Findings indicated a small, inverse relationship between these constructs, indicating that minority stress may lead to diminished sexual satisfaction among gay/lesbian and bisexual individuals. Further, the overall effect size varied as a function of minority stress type, such that the effect for internalized stigma was significantly larger than the effects for stigma or concealment. Age also moderated the relationship between minority stress and sexual satisfaction; specifically, older age was associated with a smaller effect, suggesting that older adults may be better at coping with minority stress than younger adults. Limitations, implications, and directions for future research are discussed.Keywords: minority stress, stigma, sexual satisfaction, sexual minorities
Procedia PDF Downloads 133423 Comparison of Quality of Life One Year after Bariatric Intervention: Systematic Review of the Literature with Bayesian Network Meta-Analysis
Authors: Piotr Tylec, Alicja Dudek, Grzegorz Torbicz, Magdalena Mizera, Natalia Gajewska, Michael Su, Tanawat Vongsurbchart, Tomasz Stefura, Magdalena Pisarska, Mateusz Rubinkiewicz, Piotr Malczak, Piotr Major, Michal Pedziwiatr
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Introduction: Quality of life after bariatric surgery is an important factor when evaluating the final result of the treatment. Considering the vast surgical options, we tried to globally compare available methods in terms of quality of following the surgery. The aim of the study is to compare the quality of life a year after bariatric intervention using network meta-analysis methods. Material and Methods: We performed a systematic review according to PRISMA guidelines with Bayesian network meta-analysis. Inclusion criteria were: studies comparing at least two methods of weight loss treatment of which at least one is surgical, assessment of the quality of life one year after surgery by validated questionnaires. Primary outcomes were quality of life one year after bariatric procedure. The following aspects of quality of life were analyzed: physical, emotional, general health, vitality, role physical, social, mental, and bodily pain. All questionnaires were standardized and pooled to a single scale. Lifestyle intervention was considered as a referenced point. Results: An initial reference search yielded 5636 articles. 18 studies were evaluated. In comparison of total score of quality of life, we observed that laparoscopic sleeve gastrectomy (LSG) (median (M): 3.606, Credible Interval 97.5% (CrI): 1.039; 6.191), laparoscopic Roux en-Y gastric by-pass (LRYGB) (M: 4.973, CrI: 2.627; 7.317) and open Roux en-Y gastric by-pass (RYGB) (M: 9.735, CrI: 6.708; 12.760) had better results than other bariatric intervention in relation to lifestyle interventions. In the analysis of the physical aspects of quality of life, we notice better results in LSG (M: 3.348, CrI: 0.548; 6.147) and in LRYGB procedure (M: 5.070, CrI: 2.896; 7.208) than control intervention, and worst results in open RYGB (M: -9.212, CrI: -11.610; -6.844). Analyzing emotional aspects, we found better results than control intervention in LSG, in LRYGB, in open RYGB, and laparoscopic gastric plication. In general health better results were in LSG (M: 9.144, CrI: 4.704; 13.470), in LRYGB (M: 6.451, CrI: 10.240; 13.830) and in single-anastomosis gastric by-pass (M: 8.671, CrI: 1.986; 15.310), and worst results in open RYGB (M: -4.048, CrI: -7.984; -0.305). In social and vital aspects of quality of life, better results were observed in LSG and LRYGB than control intervention. We did not find any differences between bariatric interventions in physical role, mental and bodily aspects of quality of life. Conclusion: The network meta-analysis revealed that better quality of life in total score one year after bariatric interventions were after LSG, LRYGB, open RYGB. In physical and general health aspects worst quality of life was in open RYGB procedure. Other interventions did not significantly affect the quality of life after a year compared to dietary intervention.Keywords: bariatric surgery, network meta-analysis, quality of life, one year follow-up
Procedia PDF Downloads 159422 The Potential of 48V HEV in Real Driving
Authors: Mark Schudeleit, Christian Sieg, Ferit Küçükay
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This paper describes how to dimension the electric components of a 48V hybrid system considering real customer use. Furthermore, it provides information about savings in energy and CO2 emissions by a customer-tailored 48V hybrid. Based on measured customer profiles, the electric units such as the electric motor and the energy storage are dimensioned. Furthermore, the CO2 reduction potential in real customer use is determined compared to conventional vehicles. Finally, investigations are carried out to specify the topology design and preliminary considerations in order to hybridize a conventional vehicle with a 48V hybrid system. The emission model results from an empiric approach also taking into account the effects of engine dynamics on emissions. We analyzed transient engine emissions during representative customer driving profiles and created emission meta models. The investigation showed a significant difference in emissions when simulating realistic customer driving profiles using the created verified meta models compared to static approaches which are commonly used for vehicle simulation.Keywords: customer use, dimensioning, hybrid electric vehicles, vehicle simulation, 48V hybrid system
Procedia PDF Downloads 510421 Evidence-Based Investigation of the Phonology of Nigerian Instant Messaging
Authors: Emmanuel Uba, Lily Chimuanya, Maryam Tar
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Orthographic engineering is no longer the preserve of the Short Messaging Service (SMS), which is characterised by limited space. Such stylistic creativity or deviation is fast creeping into real-time messaging, popularly known as Instant Messaging (IM), despite the large number of characters allowed. This occurs at various linguistic levels: phonology, morphology, syntax, etc. Nigerians are not immune to this linguistic stylisation. This study investigates the phonological and meta-phonological conventions of the messages sent and received via WhatsApp by Nigerian graduates. This is ontological study of 250 instant messages collected from 98 graduates from different ethnic groups in Nigeria. The selection and analysis of the messages are based on figure and ground principle. The results reveal the use of accent stylisation, phoneme substitution, blending, consonantisation (a specialised form of deletion targeting vowels), numerophony (using a figure/number, usually 1-10, to represent a word or syllable that has the same sound) and phonetic respelling in the IMs sent by Nigerians. The study confirms the existence of linguistic creativity.Keywords: figure and ground principle, instant messaging, linguistic stylisation, meta-phonology
Procedia PDF Downloads 397420 Solving Weighted Number of Operation Plus Processing Time Due-Date Assignment, Weighted Scheduling and Process Planning Integration Problem Using Genetic and Simulated Annealing Search Methods
Authors: Halil Ibrahim Demir, Caner Erden, Mumtaz Ipek, Ozer Uygun
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Traditionally, the three important manufacturing functions, which are process planning, scheduling and due-date assignment, are performed separately and sequentially. For couple of decades, hundreds of studies are done on integrated process planning and scheduling problems and numerous researches are performed on scheduling with due date assignment problem, but unfortunately the integration of these three important functions are not adequately addressed. Here, the integration of these three important functions is studied by using genetic, random-genetic hybrid, simulated annealing, random-simulated annealing hybrid and random search techniques. As well, the importance of the integration of these three functions and the power of meta-heuristics and of hybrid heuristics are studied.Keywords: process planning, weighted scheduling, weighted due-date assignment, genetic search, simulated annealing, hybrid meta-heuristics
Procedia PDF Downloads 469419 Effect of Bonded and Removable Retainers on Occlusal Settling after Orthodontic Treatment: A Systematic Review and Meta-Analysis
Authors: Umair Shoukat Ali, Kamil Zafar, Rashna Hoshang Sukhia, Mubassar Fida, Aqeel Ahmed
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Objective: This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (Hawley and Essix retainer) in terms of improvement in occlusal settling (occlusal contact points/areas) after orthodontic treatment. Search Method: We searched the Cochrane Library, CINAHL Plus, PubMed, Web of Science, Orthodontic journals, and Google scholar for eligible studies. We included randomized control trials (RCT) along with Cohort studies. Studies that reported occlusal contacts/areas during retention with fixed bonded and removable retainers were included. To assess the quality of the RCTs Cochrane risk of bias tool was utilized, whereas Newcastle-Ottawa Scale was used for assessing the quality of cohort studies. Data analysis: The data analysis was limited to reporting mean values of occlusal contact points/areas with different retention methods. By utilizing the RevMan software V.5.3, a meta-analysis was performed for all the studies with the quantitative data. For the computation of the summary effect, a random effect model was utilized in case of high heterogeneity. I2 statistics were utilized to assess the heterogeneity among the selected studies. Results: We included 6 articles in our systematic review after scrutinizing 219 articles and eliminating them based on duplication, titles, and objectives. We found significant differences between fixed and removable retainers in terms of occlusal settling within the included studies. Bonded retainer (BR) allowed faster and better posterior tooth settling as compared to Hawley retainer (HR). However, HR showed good occlusal settling in the anterior dental arch. Essix retainer showed a decrease in occlusal contact during the retention phase. Meta-analysis showed no statistically significant difference between BR and removable retainers. Conclusions: HR allowed better overall occlusal settling as compared to other retainers in comparison. However, BR allowed faster settling in the posterior teeth region. Overall, there are insufficient high-quality RCTs to provide additional evidence, and further high-quality RCTs research is needed.Keywords: orthodontic retainers, occlusal contact, Hawley, fixed, vacuum-formed
Procedia PDF Downloads 126418 Effectiveness of the Bundle Care to Relieve the Thirst for Intensive Care Unit Patients: Meta-Analysis
Authors: Wen Hsin Hsu, Pin Lin
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Objective: Thirst discomfort is the most common yet often overlooked symptom in patients in the intensive care unit (ICU), with an incidence rate of 69.8%. If not properly cared for, it can easily lead to irritability, affect sleep quality, and increase the incidence of delirium, thereby extending the length of hospital stay. Research points out that the sensation of coldness is an effective strategy to alleviate thirst. Using a combined care approach for thirst can prolong the sensation of coldness in the mouth and reduce thirst discomfort. Therefore, it needs to be further analyzed and its effectiveness reviewed. Methods: This study uses systematic literature review and meta-analysis methodologies and searched databases including PubMed, MEDLINE, EMBASE, Cochrane, CINAHL, and two Chinese databases (CEPS and CJTD) based on keywords. JBI was used to appraise the quality of the literature. RevMen 5.4 software package was used, and Fix Effect Model was applied for data analysis. We selected experimental articles, including those in English and Chinese, that met the inclusion and exclusion criteria. Three research articles were included in total, with a sample size of 416 people. Two were randomized controlled trials, and one was a quasi-experimental design. Results: The results show that the combined care for thirst, which includes ice water spray or oral swab wipes, menthol mouthwash, and lip balm, can significantly relieve thirst intensity MD=-1.36 (3 studies, 95% CI (-1.77, -0.95), p <0.001) and thirst distress MD=-0.71 (2 studies, 95% CI (-1.32, -0.10), p =0.02). Therefore, it is recommended that medical staff identify high-risk groups for thirst early on. Implications for Practice: For patients who cannot eat orally, providing combined care for thirst can increase oral comfort and improve the quality of care.Keywords: thirst bundle care, intensive care units, meta-analysis, ice water spray, menthol
Procedia PDF Downloads 77417 Conditions Required for New Sector Emergence: Results from a Systematic Literature Review
Authors: Laurie Prange-Martin, Romeo Turcan, Norman Fraser
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The aim of this study is to identify the conditions required and describe the process of emergence for a new economic sector created from new or established businesses. A systematic literature review of English-language studies published from 1983 to 2016 was conducted using the following databases: ABI/INFORM Complete; Business Source Premiere; Google Scholar; Scopus; and Web of Science. The two main terms of business sector and emergence were used in the systematic literature search, along with another seventeen synonyms for each these main terms. From the search results, 65 publications met the requirements of an empirical study discussing and reporting the conditions of new sector emergence. A meta-analysis of the literature examined suggest that there are six favourable conditions and five key individuals or groups required for new sector emergence. In addition, the results from the meta-analysis showed that there are eighteen theories used in the literature to explain the phenomenon of new sector emergence, which can be grouped in three study disciplines. With such diversity in theoretical frameworks used in the 65 empirical studies, the authors of this paper propose the development of a new theory of sector emergence.Keywords: economic geography, new sector emergence, economic diversification, regional economies
Procedia PDF Downloads 271416 Synthesis and Gas Transport Properties of Polynorbornene Dicarboximides Bearing Trifluoromethyl Isomer Moieties
Authors: Jorge A. Cruz-Morales, Joel Vargas, Arlette A. Santiago, Mikhail A. Tlenkopatchev
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In industrial processes such as oil extraction and refining, products are handled or generated in the gas phase, which represents a challenge in terms of treatment and purification. During the past three decades, new scientific findings and technological advances in separation based on the use of membranes have led to simpler and more efficient gas separation processes, optimizing the use of energy and generating less pollution. This work reports the synthesis and ring-opening metathesis polymerization (ROMP) of new structural isomers based on norbornene dicarboximides bearing trifluoromethyl moieties, specifically N-2-trifluoromethylphenyl-exo,endo-norbornene-5,6-dicarboximide (2a) and N-3-trifluoromethylphenyl-exo,endo-norbornene-5,6-dicarboximide (2b), using tricyclohexylphosphine [1,3-bis(2,4,6-trimethylphenyl)-4,5-dihydroimidazol-2-ylidene][benzylidene] ruthenium dichloride (I), bis(tricyclohexylphosphine) benzylidene ruthenium (IV) dichloride (II), and bis(tricyclohexylphosphine) p-fluorophenylvinylidene ruthenium (II) dichloride (III). It was observed that the -CF3 moiety attached at the ortho position of the aromatic ring increases thermal and mechanical properties of the polymer, whereas meta substitution has the opposite effect. A comparative study of gas transportation in membranes, based on these fluorinated polynorbornenes, showed that -CF3 ortho substitution increases permeability of the polymer membrane as a consequence of the increase in both gas solubility and gas diffusion. In contrast, gas permeability coefficients of the meta-substituted polymer membrane are rather similar to those of that which is non-fluorinated; this can be attributed to a lower fractional free volume. The meta-substituted polymer membrane, besides showing the largest permselectivity coefficients of all the isomers studied here, was also found to have one of the largest permselectivity coefficients for separating H2/C3H6 into glassy polynorbornene dicarboximides.Keywords: gas transport membranes, polynorbornene dicarboximide, ROMP, structural isomers
Procedia PDF Downloads 256415 Comparative Efficacy of Vasodilators on Internal Mammary Artery Flow in Coronary Artery Bypass Grafting (CABG): A Systematic Review and Network Meta-Analysis
Authors: Umm E. Aimen Minhas, Sameen Tahira, Haneen Kamran, Syed Saad Ul Hassan, Haris Bin Khalid, Hadia Nadeem, Ahmed Sanan
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In coronary artery bypass grafting (CABG) patients, vasodilators play a key role in optimizing graft patency by preventing vasospasm and enhancing blood flow. Limited literature is available comparing the effectiveness of various vasodilators on IMA flow in CABG patients. Thus, the rationale for conducting this Network-meta-analysis is to identify the most efficacious vasodilator for increasing IMA flow in CABG patients. A systematic search of 3 databases yielded 357 studies, with 19 meeting inclusion criteria (18 RCTs, 1 observational study). The primary outcome was IMA flow, with secondary outcomes including central venous pressure (CVP) and mean arterial pressure (MAP). Analyses were conducted on an intention-to-treat basis using the net meta package in R. A frequentist random-effects model was employed, with consistency assessed via node-splitting and heterogeneity evaluated. The risk of bias was assessed using RoB 2 and ROBINS-I tools. Out of 92 possible pairwise comparisons, 11 were direct, and 3 included both direct and indirect evidence. Network ranking identified milrinone as the most effective vasodilator for improving IMA flow (SMD: 1.12; 95% CI: 0.36–1.87), followed by nitroglycerin (SMD: 0.51; 95% CI: 0.01–1.00). On the contrary, CO₂ insufflation significantly reduced IMA flow (SMD: -1.17; 95% CI: -2.28 to -0.06). Dobutamine significantly increased CVP, favoring placebo, with no notable differences in MAP across interventions. This analysis positions milrinone as a potentially superior agent for enhancing IMA flow in CABG, warranting its consideration as a first-line therapy. However, moderate to high heterogeneity and limited direct evidence highlight the need for more head-to-head trials.Keywords: IMA flow, vasodilators, CABG, milrinone, cardiac outcomes
Procedia PDF Downloads 3414 Effect of Innovation and Its Determinants on the Performance of Small and Medium-Sized Enterprises
Authors: Rihab Hentati, Younes Boujelbene
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Nowadays we realize more and more than the value of a company is not only a function of its means of production but depends essentially on the managerial aptitude and orientation to implement the material and human means for generating profitability. Indeed, a productive R&D activity, a good strategy, and innovation are originally supplementary benefits that increase the value of the business. Is this ‘value-added’ closely linked to innovation? The purpose of our research is to Meta-analyze the results of 56 empirical studies in order to explain the overall effect of innovation on performance of small and medium-sized enterprises. In order to justify the differences in the results, we look for the moderating factors that may affect the innovation-performance relationship. We find a positive and significant relationship between innovation and performance in small and medium-sized enterprises. The results also note a positive relationship between entrepreneurial orientation, research and development (R&D), and performance in SMEs. In addition, innovation has a strong impact on performance measured both with accounting and market index. The originality of the article is based on a rigorous synthesis, based on several statistical tools, of an important subject of research in finance.Keywords: innovation, performance, entrepreneurial orientation, meta-analysis, moderator variables
Procedia PDF Downloads 287413 The Impact of Social Support on Anxiety and Depression under the Context of COVID-19 Pandemic: A Scoping Review and Meta-Analysis
Authors: Meng Wu, Atif Rahman, Eng Gee, Lim, Jeong Jin Yu, Rong Yan
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Context: The COVID-19 pandemic has had a profound impact on mental health, with increased rates of anxiety and depression observed. Social support, a critical factor in mental well-being, has also undergone significant changes during the pandemic. This study aims to explore the relationship between social support, anxiety, and depression during COVID-19, taking into account various demographic and contextual factors. Research Aim: The main objective of this study is to conduct a comprehensive systematic review and meta-analysis to examine the impact of social support on anxiety and depression during the COVID-19 pandemic. The study aims to determine the consistency of these relationships across different age groups, occupations, regions, and research paradigms. Methodology: A scoping review and meta-analytic approach were employed in this study. A search was conducted across six databases from 2020 to 2022 to identify relevant studies. The selected studies were then subjected to random effects models, with pooled correlations (r and ρ) estimated. Homogeneity was assessed using Q and I² tests. Subgroup analyses were conducted to explore variations across different demographic and contextual factors. Findings: The meta-analysis of both cross-sectional and longitudinal studies revealed significant correlations between social support, anxiety, and depression during COVID-19. The pooled correlations (ρ) indicated a negative relationship between social support and anxiety (ρ = -0.30, 95% CI = [-0.333, -0.255]) as well as depression (ρ = -0.27, 95% CI = [-0.370, -0.281]). However, further investigation is required to validate these results across different age groups, occupations, and regions. Theoretical Importance: This study emphasizes the multifaceted role of social support in mental health during the COVID-19 pandemic. It highlights the need to reevaluate and expand our understanding of social support's impact on anxiety and depression. The findings contribute to the existing literature by shedding light on the associations and complexities involved in these relationships. Data Collection and Analysis Procedures: The data collection involved an extensive search across six databases to identify relevant studies. The selected studies were then subjected to rigorous analysis using random effects models and subgroup analyses. Pooled correlations were estimated, and homogeneity was assessed using Q and I² tests. Question Addressed: This study aimed to address the question of the impact of social support on anxiety and depression during the COVID-19 pandemic. It sought to determine the consistency of these relationships across different demographic and contextual factors. Conclusion: The findings of this study highlight the significant association between social support, anxiety, and depression during the COVID-19 pandemic. However, further research is needed to validate these findings across different age groups, occupations, and regions. The study emphasizes the need for a comprehensive understanding of social support's multifaceted role in mental health and the importance of considering various contextual and demographic factors in future investigations.Keywords: social support, anxiety, depression, COVID-19, meta-analysis
Procedia PDF Downloads 63412 Comparing Perceived Restorativeness in Natural and Urban Environment: A Meta-Analysis
Authors: Elisa Menardo, Margherita Pasini, Margherita Brondino
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A growing body of empirical research from different areas of inquiry suggests that brief contact with natural environment restore mental resources. The Attention Restoration Theory (ART) is the widespread used and empirical founded theory developed to explain why exposure to nature helps people to recovery cognitive resources. It assumes that contact with nature allows people to free (and then recovery) voluntary attention resources and thus allows them to recover from a cognitive fatigue situation. However, it was suggested that some people could have more cognitive benefit after exposure to urban environment. The objective of this study is to report the results of a meta-analysis on studies (peer-reviewed articles) comparing the restorativeness (the quality to be restorative) perceived in natural environments than those perceived in urban environments. This meta-analysis intended to estimate how much nature environments (forests, parks, boulevards) are perceived to be more restorativeness than urban ones (i.e., the magnitude of the perceived restorativeness’ difference). Moreover, given the methodological difference between study, it studied the potential role of moderator variables as participants (student or other), instrument used (Perceived Restorativeness Scale or other), and procedure (in laboratory or in situ). PsycINFO, PsycARTICLES, Scopus, SpringerLINK, Web of Science online database were used to identify all peer-review articles on restorativeness published to date (k = 167). Reference sections of obtained papers were examined for additional studies. Only 22 independent studies (with a total of 1371 participants) met inclusion criteria (direct exposure to environment, comparison between one outdoor environment with natural element and one without natural element, and restorativeness measured by self-report scale) and were included in meta-analysis. To estimate the average effect size, a random effect model (Restricted Maximum-likelihood estimator) was used because the studies included in the meta-analysis were conducted independently and using different methods in different populations, so no common effect-size was expected. The presence of publication bias was checked using trim and fill approach. Univariate moderator analysis (mixed effect model) were run to determine whether the variable coded moderated the perceived restorativeness difference. Results show that natural environments are perceived to be more restorativeness than urban environments, confirming from an empirical point of view what is now considered a knowledge gained in environmental psychology. The relevant information emerging from this study is the magnitude of the estimated average effect size, which is particularly high (d = 1.99) compared to those that are commonly observed in psychology. Significant heterogeneity between study was found (Q(19) = 503.16, p < 0.001;) and studies’ variability was very high (I2[C.I.] = 96.97% [94.61 - 98.62]). Subsequent univariate moderator analyses were not significant. Methodological difference (participants, instrument, and procedure) did not explain variability between study. Other methodological difference (e.g., research design, environment’s characteristics, light’s condition) could explain this variability between study. In the mine while, studies’ variability could be not due to methodological difference but to individual difference (age, gender, education level) and characteristics (connection to nature, environmental attitude). Furthers moderator analysis are working in progress.Keywords: meta-analysis, natural environments, perceived restorativeness, urban environments
Procedia PDF Downloads 170411 Maternal Smoking and Risk of Childhood Overweight and Obesity: A Meta-Analysis
Authors: Martina Kanciruk, Jac J. W. Andrews, Tyrone Donnon
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The purpose of this study was to determine the significance of maternal smoking for the development of childhood overweight and/or obesity. Accordingly, a systematic literature review of English-language studies published from 1980 to 2012 using the following data bases: MEDLINE, PsychINFO, Cochrane Database of Systematic Reviews, and Dissertation Abstracts International was conducted. The following terms were used in the search: pregnancy, overweight, obesity, smoking, parents, childhood, risk factors. Eighteen studies of maternal smoking during pregnancy and obesity conducted in Europe, Asia, North America, and South America met the inclusion criteria. A meta-analysis of these studies indicated that maternal smoking during pregnancy is a significant risk factor for overweight and obesity; mothers who smoke during pregnancy are at a greater risk for developing obesity or overweight; the quantity of cigarettes consumed by the mother during pregnancy influenced the odds of offspring overweight and/or obesity. In addition, the results from moderator analyses suggest that part of the heterogeneity discovered between the studies can be explained by the region of world that the study occurred in and the age of the child at the time of weight assessment.Keywords: childhood obesity, overweight, smoking, parents, risk factors
Procedia PDF Downloads 523410 Physical Activity Interventions and Maternal Health Outcomes in Nigeria: A Meta-Analysis of Randomized Controlled Trials
Authors: Jamilu Lawal Ajiya
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Background: Physical activity is essential for improving maternal health outcomes, particularly in low- and middle-income countries like Nigeria. Objective: The aim is to evaluate the effectiveness of physical activity interventions on maternal health outcomes among Nigerian pregnant women. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) conducted in Nigeria, published in English, and focusing on physical activity and maternal health outcomes. Results: Ten RCTs (N=1,200) were included. Physical activity interventions significantly reduced the risk of gestational diabetes, hypertension and preterm birth. Also, the study found that brisk walking and aerobic exercise were more effective than yoga. Conclusion: Physical activity interventions improve maternal health outcomes among Nigerian pregnant women. Policy changes and public health programs should prioritize physical activity promotion during pregnancy. This study informs healthcare providers, policymakers, and researchers on the effectiveness of physical activity interventions in improving maternal health outcomes in Nigeria.Keywords: physical activity, maternal health, Nigeria, randomized controlled trials
Procedia PDF Downloads 29409 Optimal Allocation of Distributed Generation Sources for Loss Reduction and Voltage Profile Improvement by Using Particle Swarm Optimization
Authors: Muhammad Zaheer Babar, Amer Kashif, Muhammad Rizwan Javed
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Nowadays distributed generation integration is best way to overcome the increasing load demand. Optimal allocation of distributed generation plays a vital role in reducing system losses and improves voltage profile. In this paper, a Meta heuristic technique is proposed for allocation of DG in order to reduce power losses and improve voltage profile. The proposed technique is based on Multi Objective Particle Swarm optimization. Fewer control parameters are needed in this algorithm. Modification is made in search space of PSO. The effectiveness of proposed technique is tested on IEEE 33 bus test system. Single DG as well as multiple DG scenario is adopted for proposed method. Proposed method is more effective as compared to other Meta heuristic techniques and gives better results regarding system losses and voltage profile.Keywords: Distributed generation (DG), Multi Objective Particle Swarm Optimization (MOPSO), particle swarm optimization (PSO), IEEE standard Test System
Procedia PDF Downloads 455408 Prevalence of Depression among Post Stroke Survivors in South Asian Region: A Systematic Review and Meta-Analysis
Authors: Roseminu Varghese, Laveena Anitha Barboza, Jyothi Chakrabarty, Ravishankar
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Depression among post-stroke survivors is prevalent, but it is unidentified. The purpose of this review was to determine the pooled prevalence of depression among post-stroke survivors in the South Asian region from all published health sciences research articles. The review also aimed to analyze the disparities in the prevalence of depression among the post-stroke survivors from different study locations. Data search to identify the relevant research articles published from 2005 to 2016 was done by using mesh terms and keywords in Web of Science, PubMed Medline, CINAHL, Scopus, J gate, IndMED databases. The final analysis comprised of 9 studies, including a population of 1,520 men and women. Meta-analysis was performed in STATA version 13.0. The overall pooled post-stroke depression prevalence was 0.46, 95% (CI), (0.3- 0.62). The prevalence rate in this systematic review is evident of depression among post-stroke survivors in the South Asian Region. Identifying the prevalence of post-stroke depression at an early stage is important to improve outcomes of the rehabilitative process of stroke survivors and for its early intervention.Keywords: depression, post stroke survivors, prevalence, systematic review
Procedia PDF Downloads 159407 Mobile Phones and Language Learning: A Qualitative Meta-Analysis of Studies Published between 2008 and 2012 in the Proceedings of the International Conference on Mobile Learning
Authors: Lucia Silveira Alda
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This research aims to analyze critically a set of studies published in the Proceedings of the International Conference on Mobile Learning of IADIS, from 2008 until 2012, which addresses the issue of foreign language learning mediated by mobile phones. The theoretical review of this study is based on the Vygotskian assumptions about tools and mediated learning and the concepts of mobile learning, CALL and MALL. In addition, the diffusion rates of the mobile phone and especially its potential are considered. Through systematic review and meta-analysis, this research intended to identify similarities and differences between the identified characteristics in the studies on the subject of language learning and mobile phone. From the analysis of the results, this study verifies that the mobile phone stands out for its mobility and portability. Furthermore, this device presented positive aspects towards student motivation in language learning. The studies were favorable to mobile phone use for learning. It was also found that the challenges in using this tool are not technical, but didactic and methodological, including the need to reflect on practical proposals. The findings of this study may direct further research in the area of language learning mediated by mobile phones.Keywords: language learning, mobile learning, mobile phones, technology
Procedia PDF Downloads 283406 Mycophenolate Versus Methotrexate in Non-Infectious Ocular Inflammatory Disease: A Systematic Review and Meta-Analysis
Authors: Mohammad Karam, Abdulmalik Alsaif, Abdulrahman Al-Naseem, Amrit Hayre, Abdurrahman Al Jabbouri, Ahmad Aldubaikhi, Narvair Kahlar, Salem Al-Mutairi
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Purpose: To compare the outcomes of mycophenolate mofetil (MMF) versus methotrexate (MTX) in non-infectious ocular inflammatory disease (NIOID). Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify all comparative studies of MMF versus MTX in NIOID. Treatment results and side effects were primary outcome measures. Secondary outcome measures included visual acuity and resolution of macular oedema. Fixed and random-effects models were used for the analysis. Results: Four studies enrolling 905 patients were identified. There was no significant difference between MMF and MTX groups in overall treatment success (Odds Ratio [OR] = 0.97, P = 0.96) and failure (OR = 0.86, P = 0.85) of NIOID. Although treatment success of uveitis showed no significant difference for anterior and intermediate uveitis cases (OR = 2.33, P = 0.14), MTX showed a significantly improved effect in cases involving posterior uveitis and panuveitis (OR = 0.41, P = 0.003). However, the median dose required for treatment success was lower for MTX whereas MMF was associated with a faster median time to treatment success. Further to this, MMF showed a reduced rate of side effects when compared to MTX, but MTX failed to reach statistical significance, most notably for liver enzyme elevation (OR = 0.65, P = 0.16), fatigue (OR = 0.84, P = 0.49) and headache (OR = 0.81, P = 0.37). For secondary outcomes, no significant difference was noted in visual acuity and resolution of macular edema. Conclusions: MMF is comparable to MTX in the treatment of NIOID as there was no significant difference in the outcome of treatment success and side effect profiles.Keywords: Mycophenolate mofetil, methotrexate, non-infectious ocular inflammation, uveitis, scleritis
Procedia PDF Downloads 152405 Scheduling Flexibility and Employee Health Outcomes: A Meta-Analytic Review
Authors: Nicole V. Shifrin
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Scheduling flexibility is becoming an increasingly available option for employees struggling to balance their work and life responsibilities, allowing employees to coordinate work schedules with their additional roles. The goal of such opportunities is to help employees manage the demands they face across domains of life by allowing employees to work from home, design their own work hours, take time off when necessary, along with various other scheduling accommodations. Organizations are also turning to utilizing scheduling flexibility to facilitate employee health and wellbeing through the reduction of stress and maximization of efficiency. The purpose of the present study is to investigate the effects of scheduling flexibility on employee health-related behaviors and outcomes through a synthesis of research. The current meta-analytic review of 19 samples within 16 studies with a total sample size of 20,707 employees examines the relationship between the degree of scheduling flexibility available to employees and the resulting health outcomes and exercise habits. The results demonstrate that reduced scheduling flexibility is associated with poorer health status, suggesting that schedule inflexibility can hinder employees’ ability to maintain and support their health. These findings hold practical implications for developing work schedules to promote employee health and health-related behaviors, such as eating well and exercising. Additionally, there was a positive association between increased scheduling flexibility and engagement in exercise, suggesting that employees with more flexible schedules exercise more frequently than those with less flexible schedules. A potential explanation for the resulting relationship is that flexible schedules leave employees more time due to shorter work days, shorter or eliminated commutes, etc. with which they can use to engage in healthy behaviors. These findings stress the importance of promoting job designs that facilitate employee engagement in healthy behaviors, which directly impact their overall health status. Implications for practice are discussed as well as future directions in examining the link between job design and employee health and well-being.Keywords: exercise, health, meta-analysis, job design, scheduling flexibility
Procedia PDF Downloads 138404 Investigation the Impact of Flipped Learning on Developing Meta-Cognitive Ability in Chemistry Courses of Science Education Students
Authors: R. Herscu-Kluska
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The rise of the flipped or inverted classroom meet the conceptual needs of our time. The evidence of increased student satisfaction and course grades improvement promoted the flipped learning approach. Due to the successful outcomes of the inverted classroom, the flipped learning became a pedagogy and educational rising strategy among all education sciences. The aim of this study is to analyze the effect of flipped classroom on higher order learning in chemistry courses since it has been suggested that in higher education courses, class time should focus on knowledge application. The results of this study indicate improving meta-cognitive thinking and learning skills. The students showed better ability to cope with higher order learning assignments during the actual class time, using inverted classroom strategy. These results suggest that flipped learning can be used as an effective pedagogy and educational strategy for developing higher order thinking skills, proved to contribute to building lifelong learning.Keywords: chemistry education, flipped classroom, flipped learning, inverted classroom, science education
Procedia PDF Downloads 343403 Clinical Efficacy of Nivolumab and Ipilimumab Combination Therapy for the Treatment of Advanced Melanoma: A Systematic Review and Meta-Analysis of Clinical Trials
Authors: Zhipeng Yan, Janice Wing-Tung Kwong, Ching-Lung Lai
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Background: Advanced melanoma accounts for the majority of skin cancer death due to its poor prognosis. Nivolumab and ipilimumab are monoclonal antibodies targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocytes antigen 4 (CTLA-4). Nivolumab and ipilimumab combination therapy has been proven to be effective for advanced melanoma. This systematic review and meta-analysis are to evaluate its clinical efficacy and adverse events. Method: A systematic search was done on databases (Pubmed, Embase, Medline, Cochrane) on 21 June 2020. Search keywords were nivolumab, ipilimumab, melanoma, and randomised controlled trials. Clinical trials fulfilling the inclusion criteria were selected to evaluate the efficacy of combination therapy in terms of prolongation of progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The odd ratios and distributions of grade 3 or above adverse events were documented. Subgroup analysis was performed based on PD-L1 expression-status and BRAF-mutation status. Results: Compared with nivolumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR in combination therapy were 0.64 (95% CI, 0.48-0.85; p=0.002), 0.84 (95% CI, 0.74-0.95; p=0.007) and 1.76 (95% CI, 1.51-2.06; p < 0.001), respectively. Compared with ipilimumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR were 0.46 (95% CI, 0.37-0.57; p < 0.001), 0.54 (95% CI, 0.48-0.61; p < 0.001) and 6.18 (95% CI, 5.19-7.36; p < 0.001), respectively. In combination therapy, the odds ratios of grade 3 or above adverse events were 4.71 (95% CI, 3.57-6.22; p < 0.001) compared with nivolumab monotherapy, and 3.44 (95% CI, 2.49-4.74; p < 0.001) compared with ipilimumab monotherapy, respectively. High PD-L1 expression level and BRAF mutation were associated with better clinical outcomes in patients receiving combination therapy. Conclusion: Combination therapy is effective for the treatment of advanced melanoma. Adverse events were common but manageable. Better clinical outcomes were observed in patients with high PD-L1 expression levels and positive BRAF-mutation.Keywords: nivolumab, ipilimumab, advanced melanoma, systematic review, meta-analysis
Procedia PDF Downloads 138402 Socio-Cultural and Religious Contributions to Gender Wage Gap: A Meta-Analysis
Authors: R. Alothaim, T. Mishra
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Different researchers have reviewed the gender wage gap since early days between women and men to point out their difference to help bring about equality in production among them. Many fingers have been pointed out towards culture and religion as one of the major factors contributing to the gender wage gap throughout the years passed. Recent research has been done to give out equalization to this gap between men and women. The gender wage gap has raised serious concerns among nations and societies. Additionally, data, methodology and time periods have been affected by the gender wage gap, thus needing special decision making to help in the meta-study in the provision of quantitative review. Quality indicators have played a crucial role towards the education through stressing on enough consideration to help give a solution of equality and worth in the research study. The different research reviewed have given enough evidence and impact to point out that the major causes of this gender wage gap has resulted due to culture. On the other pedestal, religion may play a role to the issues of gender wage gap but with more emphasis on culture playing the bigger part. Furthermore, social status of individual has contributed to the wage gap difference between men and women. Labor market has played a vital role in empowering women, leading to the lower rate of the raw wage difference in the recent years.Keywords: culture, gender wage gap, social, religion
Procedia PDF Downloads 122401 Does Mirror Therapy Improve Motor Recovery After Stroke? A Meta-Analysis of Randomized Controlled Trials
Authors: Hassan Abo Salem, Guo Feng, Xiaolin Huang
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The objective of this study is to determine the effectiveness of mirror therapy on motor recovery and functional abilities after stroke. The following databases were searched from inception to May 2014: Cochrane Stroke, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, and PEDro. Two reviewers independently screened and selected all randomized controlled trials that evaluate the effect of mirror therapy in stroke rehabilitation.12 randomized controlled trials studies met the inclusion criteria; 10 studies utilized the effect of mirror therapy for the upper limb and 2 studies for the lower limb. Mirror therapy had a positive effect on motor recover and function; however, we found no consistent influence on activity of daily living, Spasticity and balance. This meta-analysis suggests that, Mirror therapy has additional effect on motor recovery but has a small positive effect on functional abilities after stroke. Further high-quality studies with greater statistical power are required in order to accurately determine the effectiveness of mirror therapy following stroke.Keywords: mirror therapy, motor recovery, stroke, balance
Procedia PDF Downloads 552400 Fuzzy Population-Based Meta-Heuristic Approaches for Attribute Reduction in Rough Set Theory
Authors: Mafarja Majdi, Salwani Abdullah, Najmeh S. Jaddi
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One of the global combinatorial optimization problems in machine learning is feature selection. It concerned with removing the irrelevant, noisy, and redundant data, along with keeping the original meaning of the original data. Attribute reduction in rough set theory is an important feature selection method. Since attribute reduction is an NP-hard problem, it is necessary to investigate fast and effective approximate algorithms. In this paper, we proposed two feature selection mechanisms based on memetic algorithms (MAs) which combine the genetic algorithm with a fuzzy record to record travel algorithm and a fuzzy controlled great deluge algorithm to identify a good balance between local search and genetic search. In order to verify the proposed approaches, numerical experiments are carried out on thirteen datasets. The results show that the MAs approaches are efficient in solving attribute reduction problems when compared with other meta-heuristic approaches.Keywords: rough set theory, attribute reduction, fuzzy logic, memetic algorithms, record to record algorithm, great deluge algorithm
Procedia PDF Downloads 456399 Approaching the Spatial Multi-Objective Land Use Planning Problems at Mountain Areas by a Hybrid Meta-Heuristic Optimization Technique
Authors: Konstantinos Tolidis
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The mountains are amongst the most fragile environments in the world. The world’s mountain areas cover 24% of the Earth’s land surface and are home to 12% of the global population. A further 14% of the global population is estimated to live in the vicinity of their surrounding areas. As urbanization continues to increase in the world, the mountains are also key centers for recreation and tourism; their attraction is often heightened by their remarkably high levels of biodiversity. Due to the fact that the features in mountain areas vary spatially (development degree, human geography, socio-economic reality, relations of dependency and interaction with other areas-regions), the spatial planning on these areas consists of a crucial process for preserving the natural, cultural and human environment and consists of one of the major processes of an integrated spatial policy. This research has been focused on the spatial decision problem of land use allocation optimization which is an ordinary planning problem on the mountain areas. It is a matter of fact that such decisions must be made not only on what to do, how much to do, but also on where to do, adding a whole extra class of decision variables to the problem when combined with the consideration of spatial optimization. The utility of optimization as a normative tool for spatial problem is widely recognized. However, it is very difficult for planners to quantify the weights of the objectives especially when these are related to mountain areas. Furthermore, the land use allocation optimization problems at mountain areas must be addressed not only by taking into account the general development objectives but also the spatial objectives (e.g. compactness, compatibility and accessibility, etc). Therefore, the main research’s objective was to approach the land use allocation problem by utilizing a hybrid meta-heuristic optimization technique tailored to the mountain areas’ spatial characteristics. The results indicates that the proposed methodological approach is very promising and useful for both generating land use alternatives for further consideration in land use allocation decision-making and supporting spatial management plans at mountain areas.Keywords: multiobjective land use allocation, mountain areas, spatial planning, spatial decision making, meta-heuristic methods
Procedia PDF Downloads 347398 Systematic Review and Meta-analysis Investigating the Efficacy of Walking-based Aerobic Exercise Interventions to Treat Postpartum Depression
Authors: V. Pentland, S. Spilsbury, A. Biswas, M. F. Mottola, S. Paplinskie, M. S. Mitchell
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Postpartum depression (PPD) is a form of major depressive disorder that afflicts 10–22% of mothers worldwide. Rising demands for traditional PPD treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. The objective of this review is to determine the impact of walking on PPD severity. A structured search of seven electronic databases for randomised controlled trials published between 2000 and July 29, 2021, was completed. Studies were included if walking was the sole or primary aerobic exercise modality. A random-effects meta-analysis was conducted for studies reporting PPD symptoms measured using a clinically validated tool. A simple count of positive/null effect studies was undertaken as part of a narrative summary. Five studies involving 242 participants were included (mean age=~28.9 years; 100% with mild-to-moderate depression). Interventions were 12 (n=4) and 24 (n=1) weeks long. Each assessed PPD severity using the Edinburgh Postnatal Depression Scale (EPDS) and was included in the meta-analysis. The pooled effect estimate suggests that relative to controls, walking yielded clinically significant decreases in mean EPDS scores from baseline to intervention end (pooled MD=-4.01; 95% CI:-7.18 to -0.84, I2=86%). The narrative summary provides preliminary evidence that walking-only, supervised, and group-based interventions, including 90-120+ minutes/week of moderate-intensity walking, may produce greater EPDS reductions. While limited by a relatively small number of included studies, pooled effect estimates suggest walking may help mothers manage PPD. This is the first time walking as a treatment for PPD, an exercise modality that uniquely addresses many barriers faced by mothers has been summarized in a systematic way. Trial registration: PROSPERO (CRD42020197521) on August 16th, 2020Keywords: postpartum, exercise, depression, walking
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