ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring: A systematic review and meta-analysis

Background: Allergic diseases have increased worldwide in the last 2 decades, with children suffering the highest burden of the condition. The ω-3 long-chain poly-unsaturated fatty acid (LCPUFA) possesses anti-inflammatory properties that could lead to a reduction in inflammatory mediators in allergies. Objective: A systematic review and meta-analysis of the most recent follow-ups of randomized clinical trials (RCTs) was conducted to assess the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on allergic outcomes in offspring. Methods: The RCTs with a minimum of 1-month follow-up post gestation were eligible for inclusion. The CENTRAL, MEDLINE, SCOPUS, WHO's International Clinical Trials Register, E-theses, and Web of Science databases were searched. Study quality was evaluated using the Cochrane Collaboration's risk of bias tool. Results: Ten RCTs (3,637 children), from 9 unique trials, examined the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on the development of allergic outcomes in offspring. Heterogeneities were seen between the trials in terms of their sample, type, and duration of intervention and follow-up. Pooled estimates showed a significant reduction in childhood “sensitization to egg” (relative risk [RR] = 0.54, 95% confidence interval [CI] = 0.32-0.90), and “sensitization to peanut” (RR = 0.62, 95% CI = 0.40-0.96). No statistical differences were found for other allergic outcomes (eg, eczema, asthma/wheeze). Conclusion: These results suggest that intake of ω-3 LCPUFA started during pregnancy can reduce the risk of sensitization to egg and peanut; however, the evidence is limited because of the small number of studies that contributed to the meta-analyses. The current evidence on the association between supplementation with ω-3 LCPUFA started during pregnancy and allergic outcomes is weak, because of the risk of bias and heterogeneities between studies

Prenatal intake of vitamins and allergic outcomes in the offspring: a systematic review and meta-analysis

Background - Allergic diseases have seen a rise worldwide with children suffering the highest burden. Thus early prevention of allergic diseases is a public health priority. Objective - To synthesise the evidence from randomised controlled trials (RCTs) assessing the efficacy of vitamin interventions during pregnancy on developing allergic diseases in offspring. Methods - We searched CENTRAL, MEDLINE, SCOPUS, WHO’s Int. Clin. Trials Reg., E-theses and Web of Science. Study quality was evaluated using the Cochrane’s risk of bias tool. Included RCTs had a minimum of 1-month follow-up post gestation.Results - A total of five RCTs met the inclusion criteria, including 2456 children that used vitamins C+E (one study), vitamin C (one study) and vitamin D (three studies) compared with placebo/control. Two studies were judged to have a high risk of bias for performance bias or high rate of loss to follow-up. All were rated as low risk of bias for blinding of outcome assessment. We did not perform meta-analysis with vitamin C or C+E studies due to high heterogeneity between the two included studies. However we did conduct a meta-analysis with trials on vitamin D (including 1493 children) and the results showed an association between prenatal intake of vitamin D and the risk of developing recurrent wheeze in offspring (RR=0.812, 95 % CI=0.67-0.98). Conclusion - The current evidence suggests that prenatal supplementation of vitamin D, might have a beneficial effect on recurrent wheezing in children. Longer-term follow-up of these studies are needed to ascertain whether this observed effect is a sustained. There is lack of evidence on the effect of other vitamins for prevention of respiratory and/or allergic outcomes

An exploratory investigation of food choice behavior of teenagers with and without food allergies

Background - Understanding food choice behavior in adolescence is important because many core eating habits may be tracked into adulthood. The food choices of at least 2.3% of teenagers living in the United Kingdom are determined by food allergies. However, the effect of food allergies on eating habits in teenagers has not yet been studied.Objective - To provide an understanding of how teenagers with food allergies make food choice decisions and how these differ from those of non–food-allergic teenagers.Methods - One focus group discussion with non–food-allergic teenagers (n = 11) and 14 semistructured interviewers (7 with food-allergic and 7 with non–food-allergic teenagers) were performed (age range, 12-18 years). The focus group discussion and interviews were audiorecorded, transcribed verbatim, and analyzed using thematic content analysis.Results - Teenagers from both groups (food-allergic and non–food-allergic) named sensory characteristics of foods as the main reason for choosing them. Some food-allergic teenagers downplayed their allergy and frequently engaged in risk-taking behavior in terms of their food choices. However, they reported difficulties in trying new foods, especially when away from home. Parental control was experienced as protective by those with food allergies, whereas non–food-allergic teenagers felt the opposite. Most teenagers, including food-allergic ones, expressed the wish to eat similar foods to their friends. Other themes did not vary between the 2 groups.Conclusion - Food-allergic teenagers strive to be able to make similar food choices to their friends, although differences to non–food-allergic teenagers exist. It is important to address these differences to improve their dietary management

An exploratory investigation of food choice behavior of teenagers with and without food allergies

Background - Understanding food choice behavior in adolescence is important because many core eating habits may be tracked into adulthood. The food choices of at least 2.3% of teenagers living in the United Kingdom are determined by food allergies. However, the effect of food allergies on eating habits in teenagers has not yet been studied.Objective - To provide an understanding of how teenagers with food allergies make food choice decisions and how these differ from those of non–food-allergic teenagers.Methods - One focus group discussion with non–food-allergic teenagers (n = 11) and 14 semistructured interviewers (7 with food-allergic and 7 with non–food-allergic teenagers) were performed (age range, 12-18 years). The focus group discussion and interviews were audiorecorded, transcribed verbatim, and analyzed using thematic content analysis.Results - Teenagers from both groups (food-allergic and non–food-allergic) named sensory characteristics of foods as the main reason for choosing them. Some food-allergic teenagers downplayed their allergy and frequently engaged in risk-taking behavior in terms of their food choices. However, they reported difficulties in trying new foods, especially when away from home. Parental control was experienced as protective by those with food allergies, whereas non–food-allergic teenagers felt the opposite. Most teenagers, including food-allergic ones, expressed the wish to eat similar foods to their friends. Other themes did not vary between the 2 groups.Conclusion - Food-allergic teenagers strive to be able to make similar food choices to their friends, although differences to non–food-allergic teenagers exist. It is important to address these differences to improve their dietary management

Relationship between maternal and child behaviors in pediatric food allergy: an exploratory study

Parents play an important role in developing young children's food choices. They influence children's eating environments through the foods they make available, their own eating behavior, and the quality of their interactions with children in eating contexts

Literature searches and reviews related to the prevalence of food allergy in Europe

In 2011, the European Food Safety Authority (EFSA) received a mandate from the Food Safety Authority of Ireland (FSAI) to review the available scientific data on the prevalence of each food allergy in Europe, to derive threshold concentrations for each allergen in foods when possible, and to review the analytical methods available for the detection/quantification of food allergens. This report presents the findings of a series of systematic reviews of the literature related to these aims. Systematic searches of relevant bibliographic databases and the grey literature were conducted, studies were selected for inclusion according to pre-specified criteria, relevant data was extracted from all included studies, and the quality of included studies assessed. The first systematic review examined the literature on the prevalence of food allergy (IgE-mediated and non-IgE mediated) in different regions of the World and in individual European countries for different age groups in relation to each of the following food allergens: milk/dairy, eggs, cereals, peanuts, nuts, celery, crustaceans, fish, molluscs, soy, lupin, mustard and sesame. For each of these allergens changes in prevalence trends over time were also examined. Additionally, emerging food allergens in different European countries were identified. Of the 7333 articles identified by the searches, data from 92 studies was included, 52 of which reported on studies conducted within Europe. The second systematic review examined the effects of food processing on the allergenicity of foods in relation to each of the following food allergens: milk/dairy, eggs, cereals, peanuts, nuts, celery, crustaceans, fish, molluscs, soy, lupin, mustard and sesame. From 1040 articles identified by the searches, 25 studies were included in this review. The final systematic review examined the evidence regarding the new analytical methods available to analyse/detect the food allergens considered in the previous systematic reviews in processed foods. From 1475 articles identified by the searches, 84 studies were included

Sensory environment on health-related outcomes of hospital patients

Background: Hospital environments have recently received renewed interest, with considerable investments into building and renovating healthcare estates. Understanding the effectiveness of environmental interventions is important for resource utilisation and providing quality care. Objectives: To assess the effect of hospital environments on adult patient health-related outcomes. Search methods: We searched: the Cochrane Central Register of Controlled Trials (last searched January 2006); MEDLINE (1902 to December 2006); EMBASE (January 1980 to February 2006); 14 other databases covering health, psychology, and the built environment; reference lists; and organisation websites. This review is currently being updated (MEDLINE last search October 2010), see Studies awaiting classification. Selection criteria: Randomised and non-randomised controlled trials, controlled before-and-after studies, and interrupted times series of environmental interventions in adult hospital patients reporting health-related outcomes. Data collection and analysis: Two review authors independently undertook data extraction and 'Risk of bias' assessment. We contacted authors to obtain missing information. For continuous variables, we calculated a mean difference (MD) or standardized mean difference (SMD), and 95% confidence intervals (CI) for each study. For dichotomous variables, we calculated a risk ratio (RR) with 95% confidence intervals (95% CI). When appropriate, we used a random-effects model of meta-analysis. Heterogeneity was explored qualitatively and quantitatively based on risk of bias, case mix, hospital visit characteristics, and country of study. Main results: Overall, 102 studies have been included in this review. Interventions explored were: 'positive distracters', to include aromas (two studies), audiovisual distractions (five studies), decoration (one study), and music (85 studies); interventions to reduce environmental stressors through physical changes, to include air quality (three studies), bedroom type (one study), flooring (two studies), furniture and furnishings (one study), lighting (one study), and temperature (one study); and multifaceted interventions (two studies). We did not find any studies meeting the inclusion criteria to evaluate: art, access to nature for example, through hospital gardens, atriums, flowers, and plants, ceilings, interventions to reduce hospital noise, patient controls, technologies, way-finding aids, or the provision of windows. Overall, it appears that music may improve patient-reported outcomes such as anxiety; however, the benefit for physiological outcomes, and medication consumption has less support. There are few studies to support or refute the implementation of physical changes, and except for air quality, the included studies demonstrated that physical changes to the hospital environment at least did no harm. Authors' conclusions: Music may improve patient-reported outcomes in certain circumstances, so support for this relatively inexpensive intervention may be justified. For some environmental interventions, well designed research studies have yet to take place

What drives quality physical education? : a systematic review and meta-analysis of learning and development effects from physical education-based interventions

Objective: To determine the effects of learning interventions aimed at optimizing the quality of physical education (PE) on psychomotor, cognitive, affective and social learning outcomes in children and adolescents. Design: A systematic review and meta-analysis. Data Sources: After searching PsycInfo, ERIC, and SportDiscus electronic databases, we identified 135 eligible studies published between January 1, 1995 to May 1, 2021. Eligibility Criteria for Selecting Studies: We included randomized controlled trials, quasi-experimental studies, and controlled trials that assessed the effect of a PE-based intervention against one of the four identified learning domains in youth at school (aged 5-18 years). Results: One hundred and thirty five (135) studies with over 42,500 participants and 193 calculated effect sizes were included in the study. The mean effect across all the learning and development outcomes was small to medium (Cohen's d = 0.32, 95% confidence interval [CI] (0.27-0.37). When adjusted for publication bias using the Duval and Tweedie Trim and Fill Method, this mean effect size increased to d = 0.40 (CI = 0.34-0.46). Effect sizes varied significantly based on learning and development outcomes. Interventions that consistently report above or below the mean d = 0.40 effect are identified based on learning outcome. The greatest effects across interventions were witnessed in psychomotor learning outcomes (d = 0.52) followed by affective (d = 0.47), social (d = 0.32), and cognitive (d = 0.17) learning outcomes. A minority (< 10%) of PE interventions captured by this systematic review and meta-analysis reported having a negative effect on student learning and development. Conclusion: The interventions with the greatest effects on student learning and development were dependant on the learning domains. Some PE interventions with a pedagogical focus such as games-based approaches, TARGET/Mastery Teaching, and Sport Education were found to be strong investments across multiple domains. The evidence is limited however by consistency in intervention dosage, study design, and data collection instruments. The study received no internal or external funding and was not prospectively registered

What is the impact of contraceptive methods and mixes of contraceptive methods on contraceptive prevalence, unmet need for family planning, and unwanted and unintended pregnancies?

Background - In many low-and middle-income countries, there is high maternal, infant and child mortality due in part to low contraceptive use and high unmet need for family planning. The aim of this overview of systematic reviews is to synthesise the findings of systematic reviews conducted in this area to assess the impact of various contraceptive methods and mixes of contraceptive methods on contraceptive prevalence, unwanted and unintended pregnancies, and unmet need (a desire to limit the number of children but not currently using any contraception) for family planning in developing countries/regions.Methods - Eight databases (Bioline international, The Cochrane Library, Latin American and Caribbean Health Sciences Literature - LILACS, Popline, PubMed, Turning Research Into Practice, World Health Organisation Reproductive Health Library and Zetoc) were searched from 28 October 2010 to 08 December 2010. Cochrane and non-Cochrane systematic reviews were included. Eligible reviews included studies whose participants were sexually active women or men from countries classified as ‘developing’, ‘low-income’ or ‘middle-income’. Systematic reviews of any intervention (or combination of interventions) designed to increase contraceptive prevalence, reduce fertility or both were eligible. Data were extracted and synthesised narratively. A Measurement Tool to Assess Systematic Reviews, AMSTAR, was used to evaluate the quality of the included systematic reviews, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of the body of evidence for each comparison. To aid the interpretation of the findings for a variety of settings, relevant contextual information was presented where possible.Results - There were 22 systematic reviews included in this overview of reviews. The overview examined a range of contraceptive methods, including modern (terminal and spacing) and traditional methods (such as withdrawal and periodic abstinence which do not require contraceptive substances or devices and also do not require clinical procedures). However, the systematic reviews included did not address all the objectives of the overview.The results of the review are summarised below according to the objectives.Objective 1: To assess the impact of various contraceptive methods and mixes ofcontraceptive methods on contraceptive prevalence in developing countries/regions. There was no systematic review that met this objective.Objective 2: To assess the impact of various contraceptive methods and mixes ofcontraceptive methods on unwanted and unintended pregnancies in developingcountries/regions.The body of evidence for the relative efficacy or effectiveness of a variety ofcontraceptive methods to prevent pregnancy in developing countries was generally rated as of low or moderate quality. There was, however, a number of comparisons (between different derivatives of the same contraceptive methods) for which the evidence was rated as of high or moderate quality. Evidence from systematic reviews is lacking on the acceptability of contraceptive methods and their impact on prevalence and on unmet needs for family planning. The evidence for the relative effectiveness of a variety of contraceptive methods to prevent pregnancy in developing countries is generally of low quality. There is some high-quality evidence comparing different derivatives of the same contraceptive methods, although this is more often evidence of efficacy than evidence of effectiveness.Objective 3: To assess the impact of various contraceptive methods and mixes ofcontraceptive methods on unmet need for family planning in developing countries/regions.There was no systematic review that met this objective

A Tale of Two Fractals: The Hofstadter Butterfly and The Integral Apollonian Gaskets

This paper unveils a mapping between a quantum fractal that describes a physical phenomena, and an abstract geometrical fractal. The quantum fractal is the Hofstadter butterfly discovered in 1976 in an iconic condensed matter problem of electrons moving in a two-dimensional lattice in a transverse magnetic field. The geometric fractal is the integer Apollonian gasket characterized in terms of a 300 BC problem of mutually tangent circles. Both of these fractals are made up of integers. In the Hofstadter butterfly, these integers encode the topological quantum numbers of quantum Hall conductivity. In the Apollonian gaskets an infinite number of mutually tangent circles are nested inside each other, where each circle has integer curvature. The mapping between these two fractals reveals a hidden threefold symmetry embedded in the kaleidoscopic images that describe the asymptotic scaling properties of the butterfly. This paper also serves as a mini review of these fractals, emphasizing their hierarchical aspects in terms of Farey fractions