Background: Self-esteem is a pivotal yet fragile factor influencing the learning and psychosocial outcomes of students with learning disabilities (LD). Although widely discussed, evidence has been inconsistent and dispersed across cultural and methodological contexts. Methods: This systematic review followed PRISMA 2020 guidelines. Databases search identified 54 records from Scopus and Web of Science, of which eight studies published between 2008 and 2023 met the inclusion criteria. The studies were synthesized into three domains, psychological dimensions, social support and educational interventions. Results: Findings revealed consistent psychological vulnerabilities. Students with LD reported lower academic self-concept than peers, while large-scale evidence showed overall moderate self-esteem with gender differences favoring males. Qualitative accounts from adults indicated ambivalent identities, blending positive traits such as independence with negative perceptions of anxiety and inadequacy. Social support emerged as a protective factor with friendships, parental involvement and teacher encouragement fostering resilience and buffering against stigma. Interventions demonstrated tangible benefits, educational therapy with 150 children improved self-esteem and reduced behavioral problems, while adapted cognitive-behavioral therapy enhanced emotional regulation and self-worth in adults. Conclusion: The evidence highlights the need for integrated, culturally responsive and gender-sensitive approaches that address both academic competence and psychosocial well-being. Future research should adopt larger, longitudinal and cross-cultural designs to better capture developmental trajectories across the lifespan.
Background: Poststroke insomnia (PSI) is a frequent complication for stroke patients. Acupuncture and related therapies demonstrate efficacy in PSI management. Despite their many types, the optimal strategy remains unclear. This network meta-analysis (NMA) compared the effectiveness of various acupuncture and related therapies. Methods: Seven databases were searched up to 1st February 2024. The primary outcome was a reduction in the Pittsburgh Sleep Quality Index (PSQI) score. The secondary outcomes were the response rate and adverse events. The treatment ranking probabilities were calculated using the surface under the cumulative ranking curve (SUCRA). Results: In total, 59 randomized controlled trials (RCTs) involving 4415 participants were included. Electroacupuncture (EA) provided the best result for PSQI reduction (SUCRA = 0.79), followed by warm acupuncture combined with auricular acupoint stimulation (WA+AAS) (0.68) and manual acupuncture combined with auricular acupoint stimulation (MA+AAS) (0.63). For the response rate, manual acupuncture combined with acupoint catgut embedding (MA+ACE) ranked highest (0.86), followed by EA (0.850) and manual acupuncture combined with moxibustion (MA+MOX) (0.83). A total of 96 adverse events were reported: 7 related to acupuncture interventions and 89 to conventional medicine (CM). Conclusion: Acupuncture and related therapies are effective and safe for PSI treatment. Among them, EA and MA+ACE are the most promising interventions for improving sleep quality poststroke
Background: We aimed to systematically examine the effects of Cochlear Implant Treatment (CIT) on quality of life and costs and to raise awareness of its economic and clinical value. Methods: A systematic scan was conducted for relevant published studies over Google Scholar, PubMed, ScienceDirect, Springer Link, and Web of Science electronic databases. The search covered studies published between January 2009 and December 2024. Literature search and data extraction were conducted by two researchers and the Drummond Checklist was used to assess the risk of bias and applicability of the included literature. The study was conducted following the PRISMA-2020 guidelines. Results: Overall, 11 studies were included in the study. When these studies were evaluated, it was found that most of them were conducted in 2021, children were the most preferred sample group, and these studies focused on unilateral Cochlear Implant Treatment. The lowest quality of life value was 0.452 and the highest was 0.93. Cost-effectiveness analyses were used in the studies to determine the cost-effectiveness of cochlear implants, and the Markov Model was preferred. The Incremental Cost-Effectiveness Ratio (ICER) was employed as the outcome measure highly cost-effective in lower-income settings such as Taiwan, while higher ICER values were observed in high-income countries such as the USA. Conclusion: Cochlear implant treatment improves quality of life and is generally cost-effective for both children and adults, as supported by the majority of studies.
Background: Patients with acute and chronic conditions often experience multiple symptoms known as symptom clusters. The Patient-Reported Outcomes Measurement Information System (PROMIS) is widely used to assess health status across various conditions, but its suitability for identifying symptom clusters remains unclear. Therefore, we examined the internal consistency reliability of PROMIS tools used to measure symptom clusters in adults through a systematic review and a reliability generalization meta-analysis. Methods: We searched four electronic databases (PubMed, CINAHL, ProQuest, and Embase) for relevant articles published through December 31, 2024, including studies that measured symptom clusters in adults using at least one PROMIS measure. Meta-regression using a random effects model was performed to assess study heterogeneity, and funnel plots were employed to evaluate publication bias. Results: The systematic review included 24 studies of 27,982 subjects with or without diseases in community, inpatient, and outpatient settings. Twenty PROMIS domains were used for symptom cluster research, and anxiety and depression were the most frequently used domains. In our reliability generalization meta-analysis of four studies, Cronbach’s alpha coefficients indicated good internal consistency reliability across five PROMIS domains (anxiety, depression, fatigue, pain, and sleep disturbance), with an average reliability of 0.91. Conclusion: PROMIS measures may be reliable for assessing symptom clusters in adults and could serve as valuable tools for researchers and clinicians in patient assessment and symptom management. Nevertheless, future research should rigorously examine the reliability and validity of PROMIS tools in this context.
