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BMC Geriatrics Feb 2021The theme of young family caregivers of older relatives is still partially uncovered, although the phenomenon is increasing worldwide. This Systematic Literature Review... (Review)
Review
BACKGROUND
The theme of young family caregivers of older relatives is still partially uncovered, although the phenomenon is increasing worldwide. This Systematic Literature Review discusses methodological and content issues of ten articles covering this topic, in order to contribute to increase the knowledge and provide suggestions for designing effective support services for adolescent young caregivers. To this purpose, the findings of this review are framed within the caregiving stress appraisal model (renamed CSA model) elaborated by Yates' and collegues, in order to highlight differences between young caregivers and the older ones.
METHODS
Multiple databases including PubMed, Web of Science, Scopus, ProQuest - Psychology Database, CINAHL Complete - EBSCOHost were used to carry out a systematic review of the literature. Additional references were retrieved from experts contacted and research knowledge. The selected articles underwent both methodological appraisal and contents analysis: for every article an appraisal score was calculated and themes and sub-themes were identified.
RESULTS
Out of the ten included studies three were mixed methods, six qualitative and one quantitative. Nine reached a high quality methodological score and one medium. Four main themes emerged from the content analysis: aspects of the caregiving relationship; effects of caregiving; coping strategies; recommendations for services, policy and research.
CONCLUSIONS
Selected studies explored practical features of the relationship between young caregivers and older family members (tasks performed, motivations, coping strategies) and highlighted both positive and negative outcomes on young people's everyday life condition and future development. Nevertheless, these evidences were often limited to small samples that did not allow to make generalizations. More studies are needed including large samples in order to deepen the different aspects of caregiving and design tailored support services.
Topics: Adaptation, Psychological; Adolescent; Aged; Aged, 80 and over; Caregivers; Family; Humans
PubMed: 33546605
DOI: 10.1186/s12877-020-01976-z -
Child and Adolescent Mental Health Nov 2023Youth and children's lived experiences are rarely considered in studies seeking to improve or evaluate their mental health care. We conducted a scoping review to... (Review)
Review
BACKGROUND
Youth and children's lived experiences are rarely considered in studies seeking to improve or evaluate their mental health care. We conducted a scoping review to identify approaches to child, adolescent, and youth engagement in mental health studies as well as study-reported barriers, constraints, and facilitators to engagement.
METHOD
We systematically searched six electronic databases for literature. We included studies of mental health care service design, development, or evaluation that involved engagement of children, adolescents, and/or youth with mental disorders or who intentionally self-harm. Studies could be of any design as long as patient engagement was used at any point during its design and/or conduct. Engagement could include co-designing health services/interventions and/or participating as a co-researcher. We assessed the reporting of patient engagement using the Guidance for Reporting Involvement of Patients and the Public 2 Long-Form (GRIPP2-LF) checklist and used the Experience Based Co-design (EBCD) framework to guide data extraction and analysis.
RESULTS
Sixteen articles were included in the review. Most studies used engagement to develop or adapt a mental health service (75%) and utilized a participatory or co-design approach (69%). Participants were namely adolescents and youth (aged 10-24 years) with some studies including young adults (up to 29 years old). Most studies followed less than 50% of the EBCD framework, and the commonly reported study barriers were related to aspects addressed in EBCD: time restrictions, recruitment, and generalizability. Frequently reported study facilitators included study methodology, youth engagement, and having a diverse participant sample.
CONCLUSIONS
Findings from this review suggest that the EBCD framework is not commonly used to guide patient engagement in studies of mental health care services. Future initiatives should consider following the framework to ensure meaningful evaluation and improvements to youth and children's mental health care services.
Topics: Young Adult; Humans; Adolescent; Child; Patient Participation; Mental Disorders; Mental Health; Mental Health Services; Health Services Research
PubMed: 36494910
DOI: 10.1111/camh.12615 -
Journal of Intellectual Disability... Jan 2021According to several comprehensive systematic and narrative reviews, interventions based on applied behaviour analysis principles, or behaviour analytic interventions,... (Review)
Review
BACKGROUND
According to several comprehensive systematic and narrative reviews, interventions based on applied behaviour analysis principles, or behaviour analytic interventions, are considered evidence based for children with autism spectrum disorder (ASD). However, no comprehensive review of the literature related to behaviour analytic interventions for children with intellectual disability (ID) currently exists.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (registration ID: CRD42018099317), the purpose of this study was to conduct a systematic review of the relevant published literature on the use of behaviour analytic interventions to develop skills in young children (0-8 years) with ID (and without ASD). A preliminary search of the literature identified 1209 potential studies published between January 2000 and April 2020. The review process resulted in 48 articles consisting of 49 studies (i.e. one paper contained two studies) that met the inclusion criteria. Most used single-case research designs. Studies were evaluated on five dimensions of methodological quality based on the Scientific Merit Rating Scale developed by the National Autism Center (NAC). The NAC definitions were also used for the quantity and quality of research evidence required for interventions to be considered established or emerging.
RESULTS
There were a number of limitations to the quality of the body of research. Nevertheless, various behaviour analytic interventions met criteria for being established interventions when used for targeting communication, adaptive and pre-academic skills in young children with ID. Behaviour analytic interventions targeting academic skills met criteria for emerging interventions.
CONCLUSIONS
Although the current literature is limited, results indicate that behaviour analytic interventions may be effectively used to support skill development in children with ID.
Topics: Applied Behavior Analysis; Behavior Therapy; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Intellectual Disability; Male
PubMed: 32974933
DOI: 10.1111/jir.12780 -
Sports Medicine (Auckland, N.Z.) Jul 2023Heat adaptation regimes are used to prepare athletes for exercise in hot conditions to limit a decrement in exercise performance. However, the heat adaptation literature... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Heat adaptation regimes are used to prepare athletes for exercise in hot conditions to limit a decrement in exercise performance. However, the heat adaptation literature mostly focuses on males, and consequently, current heat adaptation guidelines may not be optimal for females when accounting for the biological and phenotypical differences between sexes.
OBJECTIVES
We aimed to examine: (1) the effects of heat adaptation on physiological adaptations in females; (2) the impact of heat adaptation on performance test outcomes in the heat; and (3) the impact of various moderators, including duration (minutes and/or days), total heat dose (°Cmin), exercise intensity (kcalmin), total energy expended (kcal), frequency of heat exposures and training status on the physiological adaptations in the heat.
METHODS
SPORTDiscus, MEDLINE Complete and Embase databases were searched to December 2022. Random-effects meta-analyses for resting and exercise core temperature, skin temperature, heart rate, sweat rate, plasma volume and performance tests in the heat were completed using Stata Statistical Software: Release 17. Sub-group meta-analyses were performed to explore the effect of duration, total heat dose, exercise intensity, total energy expended, frequency of heat exposure and training status on resting and exercise core temperature, skin temperature, heart rate and sweat rate. An explorative meta-regression was conducted to determine the effects of physiological adaptations on performance test outcomes in the heat following heat adaptation.
RESULTS
Thirty studies were included in the systematic review; 22 studies were meta-analysed. After heat adaptation, a reduction in resting core temperature (effect size [ES] = - 0.45; 95% confidence interval [CI] - 0.69, - 0.22; p < 0.001), exercise core temperature (ES = - 0.81; 95% CI - 1.01, - 0.60; p < 0.001), skin temperature (ES = - 0.64; 95% CI - 0.79, - 0.48; p < 0.001), heart rate (ES = - 0.60; 95% CI - 0.74, - 0.45; p < 0.001) and an increase in sweat rate (ES = 0.53; 95% CI 0.21, 0.85; p = 0.001) were identified in females. There was no change in plasma volume (ES = - 0.03; 95% CI - 0.31, 0.25; p = 0.835), whilst performance test outcomes were improved following heat adaptation (ES = 1.00; 95% CI 0.56, 1.45; p < 0.001). Across all moderators, physiological adaptations were more consistently observed following durations of 451-900 min and/or 8-14 days, exercise intensity ≥ 3.5 kcalmin, total energy expended ≥ 3038 kcal, consecutive (daily) frequency and total heat dose ≥ 23,000 °Cmin. The magnitude of change in performance test outcomes in the heat was associated with a reduction in heart rate following heat adaptation (standardised mean difference = - 10 beatsmin; 95% CI - 19, - 1; p = 0.031).
CONCLUSIONS
Heat adaptation regimes induce physiological adaptations beneficial to thermoregulation and performance test outcomes in the heat in females. Sport coaches and applied sport practitioners can utilise the framework developed in this review to design and implement heat adaptation strategies for females.
Topics: Male; Humans; Female; Hot Temperature; Thermotolerance; Adaptation, Physiological; Exercise; Body Temperature Regulation
PubMed: 37222863
DOI: 10.1007/s40279-023-01831-2 -
Journal of Advanced Nursing Apr 2015To evaluate the effectiveness of interventions to support caregivers of people with selected chronic conditions. (Review)
Review
AIM
To evaluate the effectiveness of interventions to support caregivers of people with selected chronic conditions.
BACKGROUND
Informal caregivers provide millions of care hours each week contributing to significant healthcare savings. Despite much research evaluating a range of interventions for caregivers, their impact remains unclear.
DESIGN
A systematic review of systematic reviews of interventions to support caregivers of people with selected chronic conditions.
DATA SOURCES
The electronic databases of PubMed, CINAHL, British Nursing Index, PsycINFO, Social Science Index (January 1990-May 2014) and The Cochrane Library (Issue 6, June 2014), were searched using Medical Subject Heading and index term combinations of the keywords caregiver, systematic review, intervention and named chronic conditions.
REVIEW METHODS
Papers were included if they reported a systematic review of interventions for caregivers of people with chronic conditions. The methodological quality of the included reviews was independently assessed by two reviewers using R-AMSTAR. Data were independently extracted by two reviewers using a pre-designed data extraction form. Narrative synthesis of review findings was used to present the results.
RESULTS
Eight systematic reviews were included. There was evidence that education and support programme interventions improved caregiver quality of life. Information-giving interventions improved caregiver knowledge for stroke caregivers.
CONCLUSION
Education, support and information-giving interventions warrant further investigation across caregiver groups. A large-scale funded programme for caregiver research is required to ensure that studies are of high quality to inform service development across settings.
Topics: Adaptation, Psychological; Caregivers; Chronic Disease; Humans; Quality of Life; Review Literature as Topic; Stress, Psychological; Stroke
PubMed: 25223528
DOI: 10.1111/jan.12523 -
Annals of the New York Academy of... Jun 2016Research on the efficacy of yoga for improving mental, emotional, physical, and behavioral health characteristics in school settings is a recent but growing field of... (Review)
Review
Research on the efficacy of yoga for improving mental, emotional, physical, and behavioral health characteristics in school settings is a recent but growing field of inquiry. This systematic review of research on school-based yoga interventions published in peer-reviewed journals offers a bibliometric analysis that identified 47 publications. The studies from these publications have been conducted primarily in the United States (n = 30) and India (n = 15) since 2005, with the majority of studies (n = 41) conducted from 2010 onward. About half of the publications were of studies at elementary schools; most (85%) were conducted within the school curriculum, and most (62%) also implemented a formal school-based yoga program. There was a high degree of variability in yoga intervention characteristics, including overall duration, and the number and duration of sessions. Most of these published research trials are preliminary in nature, with numerous study design limitations, including limited sample sizes (median = 74; range = 20-660) and relatively weak research designs (57% randomized controlled trials, 19% uncontrolled trials), as would be expected in an infant research field. Nevertheless, these publications suggest that yoga in the school setting is a viable and potentially efficacious strategy for improving child and adolescent health and therefore worthy of continued research.
Topics: Adaptation, Psychological; Adolescent; Adolescent Behavior; Child; Child Behavior; Humans; Meditation; Schools; Self-Control; Students; Yoga
PubMed: 26919395
DOI: 10.1111/nyas.13025 -
Journal For Immunotherapy of Cancer Jul 2021With rapid advances in our understanding of cancer, there is an expanding number of potential novel combination therapies, including novel-novel combinations.... (Review)
Review
With rapid advances in our understanding of cancer, there is an expanding number of potential novel combination therapies, including novel-novel combinations. Identifying which combinations are appropriate and in which subpopulations are among the most difficult questions in medical research. We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review of trials of novel-novel combination therapies involving immunotherapies or molecular targeted therapies in advanced solid tumors. A MEDLINE search was conducted using a modified Cochrane Highly Sensitive Search Strategy for published clinical trials between July 1, 2017, and June 30, 2020, in the top-ranked medical and oncology journals. Trials were evaluated according to a criterion adapted from previously published Food and Drug Administration guidance and other key considerations in designing trials of combinations. This included the presence of a strong biological rationale, the use of a new established or emerging predictive biomarker prospectively incorporated into the clinical trial design, appropriate comparator arms of monotherapy or supportive external data sources and a primary endpoint demonstrating a clinically meaningful benefit. Of 32 identified trials, there were 11 (34%) trials of the novel-novel combination of anti-programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) and anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) therapy, and 10 (31%) trials of anti-PD-1/PD-L1 and anti-vascular endothelial growth factor (VEGF) combination therapy. 20 (62.5%) trials were phase II trials, while 12 (37.5%) were phase III trials. Most (72%) trials lacked significant preclinical evidence supporting the development of the combination in the given indication. A majority of trials (69%) were conducted in biomarker unselected populations or used pre-existing biomarkers within the given indication for patient selection. Most studies (66%) were considered to have appropriate comparator arms or had supportive external data sources such as prior studies of monotherapy. All studies were evaluated as selecting a clinically meaningful primary endpoint. In conclusion, designing trials to evaluate novel-novel combination therapies presents numerous challenges to demonstrate efficacy in a comprehensive manner. A greater understanding of biological rationale for combinations and incorporating predictive biomarkers may improve effective evaluation of combination therapies. Innovative statistical methods and increasing use of external data to support combination approaches are potential strategies that may improve the efficiency of trial design. Designing trials to evaluate novel-novel combination therapies presents numerous challenges to demonstrate efficacy in a comprehensive manner. A greater understanding of biological rationale for combinations and incorporating predictive biomarkers may improve effective evaluation of combination therapies. Innovative statistical methods and increasing use of external data to support combination approaches are potential strategies that may improve the efficiency of trial design.
Topics: Combined Modality Therapy; Humans; Immunotherapy; Neoplasms
PubMed: 34215688
DOI: 10.1136/jitc-2021-002459 -
Midwifery Jun 2023Perinatal loss is a potentially painful event for parents and a grief that is often not recognised socially. Research has widely shown that grief responses can coexist... (Review)
Review
Perinatal loss is a potentially painful event for parents and a grief that is often not recognised socially. Research has widely shown that grief responses can coexist with posttraumatic growth responses. The aim of this systematic review was to assess the available evidence of studies investigating posttraumatic growth in people who have suffered a perinatal loss. A search was conducted in PROQUEST and Web of Science for articles published from 2011 to 2021. After reviewing 10 selected articles, it was found that the participants showed moderate levels of posttraumatic growth, mostly in the domains of personal strength, relationships with others, appreciation of life, and to a lesser extent in the perception of new possibilities and spiritual growth. Factors that facilitated the growth experience were finding meaning in the loss, changes in core beliefs, adaptive coping strategies, deliberate rumination, continued bonds with the deceased baby, and social support. It is expected that this systematic review will provide a basis for the design of future interventions aimed at promoting growth when facing perinatal loss.
Topics: Pregnancy; Female; Humans; Posttraumatic Growth, Psychological; Adaptation, Psychological; Grief; Social Support; Parents
PubMed: 36963142
DOI: 10.1016/j.midw.2023.103651 -
Clinical Psychology Review Jun 2021How fathers cope with stress may be critical to their mental health during the perinatal period. Using a sequential explanatory design for systematic review and... (Meta-Analysis)
Meta-Analysis Review
How fathers cope with stress may be critical to their mental health during the perinatal period. Using a sequential explanatory design for systematic review and meta-analysis, we aimed to identify associations and causal relations between higher- and lower-order avoidant and approach coping strategies and paternal psychopathology. We searched five electronic databases and grey literature, and used random-effects models to calculate pooled effects from 11 quantitative studies. Meta-analytic results were integrated with findings from 18 qualitative studies. Fathers' avoidant coping was positively associated with global psychopathology and depression. Approach-oriented coping, particularly problem-solving, was associated with positive affect but not psychopathology. Qualitative findings indicate distressed fathers employ avoidant coping strategies such as suppression, distraction, and social withdrawal. Approach-oriented coping strategies such as problem-solving and cognitive reappraisals appeared to be constructive components of men's coping repertoires supporting adaptation to fatherhood. Different coping strategies and approaches may reflect enactment of constrictive, moderate, or reinterpreted masculine norms. Study designs did not allow conclusions about causal relations between coping and psychopathology. Screening for, and targeting of, high avoidant coping among expectant and new fathers may help detect men at risk of or experiencing mental health difficulties and inform clinical response to psychopathology. Research examining whether different patterns of avoidant and approach coping are associated with psychopathology over time could inform interventions to support men's mental health and adaptation to fatherhood.
Topics: Adaptation, Psychological; Fathers; Female; Humans; Male; Men; Mental Disorders; Mental Health; Pregnancy
PubMed: 33975226
DOI: 10.1016/j.cpr.2021.102028 -
Brain Communications 2021Amyotrophic lateral sclerosis is a progressive and devastating neurodegenerative disease. Despite decades of clinical trials, effective disease-modifying drugs remain... (Review)
Review
Amyotrophic lateral sclerosis is a progressive and devastating neurodegenerative disease. Despite decades of clinical trials, effective disease-modifying drugs remain scarce. To understand the challenges of trial design and delivery, we performed a systematic review of Phase II, Phase II/III and Phase III amyotrophic lateral sclerosis clinical drug trials on trial registries and PubMed between 2008 and 2019. We identified 125 trials, investigating 76 drugs and recruiting more than 15 000 people with amyotrophic lateral sclerosis. About 90% of trials used traditional fixed designs. The limitations in understanding of disease biology, outcome measures, resources and barriers to trial participation in a rapidly progressive, disabling and heterogenous disease hindered timely and definitive evaluation of drugs in two-arm trials. Innovative trial designs, especially adaptive platform trials may offer significant efficiency gains to this end. We propose a flexible and scalable multi-arm, multi-stage trial platform where opportunities to participate in a clinical trial can become the default for people with amyotrophic lateral sclerosis.
PubMed: 34901853
DOI: 10.1093/braincomms/fcab242