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American Journal of Speech-language... May 2018The Language Environment Analysis (LENA®) represents a breakthrough in automatic speech detection because it makes one's language environment, what adults and children...
PURPOSE
The Language Environment Analysis (LENA®) represents a breakthrough in automatic speech detection because it makes one's language environment, what adults and children actually hear and say, efficiently measurable. The purpose of this article was to examine (a) current dimensions of LENA research, (b) LENA's sensitivity to differences in populations and language environments, and (c) what has been achieved in closing the Word Gap.
METHOD
From electronic and human searches, 83 peer-reviewed articles using LENA were identified, and 53 met inclusionary criteria and were included in a systematic literature review. Each article reported results of 1 study.
RESULTS
Originally developed to make natural language research more efficient and feasible, systematic review identified a broad landscape of relevant LENA findings focused primarily on the environments and communications of young children but also older adults and teachers. LENA's automated speech indicators (adult input, adult-child interaction, and child production) and the audio environment were shown to meet high validity standards, including accuracy, sensitivity to individual differences, and differences in populations, settings, contexts within settings, speakers, and languages. Researchers' own analyses of LENA audio recordings have extended our knowledge of microlevel processes in adult-child interaction. To date, intervention research using LENA has consisted of small pilot experiments, primarily on the effects of brief parent education plus quantitative linguistic feedback to parents.
CONCLUSION
Evidence showed that automated analysis has made a place in the repertoire of language research and practice. Implications, limitations, and future research are discussed.
Topics: Acoustics; Adult; Automation; Child; Child Behavior; Child Language; Child, Preschool; Environment; Environmental Monitoring; Female; Humans; Male; Pattern Recognition, Automated; Signal Processing, Computer-Assisted; Speech; Speech Production Measurement; Time Factors; Transducers
PubMed: 29594313
DOI: 10.1044/2017_AJSLP-17-0033 -
Advances in Nutrition (Bethesda, Md.) May 2017The use of mobile and wireless technologies and wearable devices for improving health care processes and outcomes (mHealth) is promising for health promotion among... (Review)
Review
The use of mobile and wireless technologies and wearable devices for improving health care processes and outcomes (mHealth) is promising for health promotion among patients with chronic diseases such as obesity and diabetes. This study comprehensively examined published mHealth intervention studies for obesity and diabetes treatment and management to assess their effectiveness and provide recommendations for future research. We systematically searched PubMed for mHealth-related studies on diabetes and obesity treatment and management published during 2000-2016. Relevant information was extracted and analyzed. Twenty-four studies met inclusion criteria and varied in terms of sample size, ethnicity, gender, and age of the participating patients and length of follow-up. The mHealth interventions were categorized into 3 types: mobile phone text messaging, wearable or portable monitoring devices, and applications running on smartphones. Primary outcomes included weight loss (an average loss ranging from -1.97 kg in 16 wk to -7.1 kg in 5 wk) or maintenance and blood glucose reduction (an average decrease of glycated hemoglobin ranging from -0.4% in 10 mo to -1.9% in 12 mo); main secondary outcomes included behavior changes and patient perceptions such as self-efficacy and acceptability of the intervention programs. More than 50% of studies reported positive effects of interventions based on primary outcomes. The duration or length of intervention ranged from 1 wk to 24 mo. However, most studies included small samples and short intervention periods and did not use rigorous data collection or analytic approaches. Although some studies suggest that mHealth interventions are effective and promising, most are pilot studies or have limitations in their study designs. There is an essential need for future studies that use larger study samples, longer intervention (≥ 6 mo) and follow-up periods (≥ 6 mo), and integrative and personalized innovative mobile technologies to provide comprehensive and sustainable support for patients and health service providers.
Topics: Blood Glucose; Cell Phone; Diabetes Mellitus; Health Promotion; Humans; Mobile Applications; Monitoring, Ambulatory; Obesity; Self-Management; Telemedicine; Text Messaging; Weight Loss
PubMed: 28507010
DOI: 10.3945/an.116.014100 -
Rheumatology (Oxford, England) May 2021To investigate the reliability of durometry in systemic sclerosis (SSc), by means of a systematic review and additional pilot study. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To investigate the reliability of durometry in systemic sclerosis (SSc), by means of a systematic review and additional pilot study.
METHODS
Literature was systematically reviewed according to the PRISMA guidelines to identify all original studies assessing the reliability of durometry in SSc. Additionally, in the pilot study, intra-rater reliability was evaluated in a first cohort of 74 SSc patients (61 female, 13 LSSc/53 LcSSc/8 DcSSc). In a second separate set of 30 SSc patients (21 female, 4 LSSc/20 LcSSc/6 DcSSc), intra- and inter-rater reliability were evaluated.
RESULTS
Only two unique records identified through the systematic review were qualified to generate conclusions. Regarding intra-rater reliability, Kissin reported excellent intra-class correlation coefficient values (ICC, 0.86-0.94) for measurements at nine skin sites in two DcSSc patients. Merkel and Kissin described, both in five DcSSc patients, good to excellent inter-rater reliability (ICC, 0.82-0.96 and 0.61-0.85) for measurements at respectively, six and nine skin sites. In our pilot study, ICC for intra-rater reliability at 17 standardized skin sites were excellent in both cohorts, ranging 0.93-0.99 and 0.78-0.98, respectively. ICC for inter-rater reliability at 17 standardized skin sites were good to excellent 0.63-0.93, except for the feet (0.48 and 0.52).
CONCLUSION
The preliminary findings in the literature are supported by our pilot study in which we have attested the reliability of durometry in SSc patients. However, prior to including durometry as an (additional) outcome measure in SSc clinical trials, its validation status in the assessment of skin fibrosis needs to be completely attested.
Topics: Cross-Sectional Studies; Fibrosis; Humans; Pilot Projects; Scleroderma, Systemic; Skin
PubMed: 33493286
DOI: 10.1093/rheumatology/keab028 -
The Oncologist Feb 2023Patient decision aids (PDAs) are tools designed to facilitate decision-making. In this systematic review, we summarized existing studies on the development and...
BACKGROUND
Patient decision aids (PDAs) are tools designed to facilitate decision-making. In this systematic review, we summarized existing studies on the development and evaluation of PDAs for patients with hematologic malignancies.
PATIENTS AND METHODS
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched for articles in PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. We included studies, abstracts, and clinical trial protocols available in English involving PDAs for patients age ≥18 diagnosed with a hematologic malignancy and/or their caregivers. Data were summarized using descriptive statistics.
RESULTS
Of the 5281 titles/abstracts screened, 15 were included: 1 protocol, 7 abstracts, and 7 full-texts. Six were PDA developmental studies, 6 were pilot studies, and 3 were randomized trials. PDA formats included electronic with web content, videos, and/or audio, questionnaires, bedside instruments, and a combination of various formats. Average participant age ranged from 36.0 to 62.4 years. Patients and caregivers identified efficacy, adverse effects, cost, and quality of life as important decision-making factors. PDAs were associated with increased knowledge and patient satisfaction as well as decreased decisional conflict and attitudinal barriers. Research on PDAs for adult patients with hematologic malignancies and their caregivers is limited. Among the studies, PDAs appear to support patients in shared decision-making.
CONCLUSION
While current literature examining the use of PDAs for adults with hematologic malignancies is limited, the positive impact of PDAs on shared decision-making and patient outcomes warrants additional research in this field.
Topics: Adult; Humans; Middle Aged; Decision Support Techniques; Quality of Life; Patient Satisfaction; Decision Making, Shared; Pilot Projects
PubMed: 36342114
DOI: 10.1093/oncolo/oyac231 -
The American Journal of Tropical... Dec 2018Leishmaniasis is a major neglected tropical disease associated with high rates of disability and death. This disease is associated with poverty, which can be reflected...
Leishmaniasis is a major neglected tropical disease associated with high rates of disability and death. This disease is associated with poverty, which can be reflected in housing quality, especially in rural areas. This systematic review found that mud walls with cracks and holes, damp, and dark houses were risk factors for transmission of leishmaniasis. These characteristics create favorable conditions for sand fly breeding and resting as sand flies prefer humidity, warmth, and protection from sunlight during the day. Housing interventions might be a promising research area with a special focus on education as individual and collective protection for the effective control of leishmaniasis.
Topics: Africa; Animals; Architecture; Asia; Construction Materials; Housing; Humans; Insect Control; Insect Vectors; Latin America; Leishmania; Leishmaniasis, Visceral; Neglected Diseases; Pilot Projects; Population Density; Poverty; Psychodidae
PubMed: 30382013
DOI: 10.4269/ajtmh.18-0037 -
BMJ Supportive & Palliative Care Jan 2024Family and friend caregivers often feel overwhelmed by and ill-prepared for their responsibilities. Many feel helpless living with uncertainty about the outcome of the...
OBJECTIVES
Family and friend caregivers often feel overwhelmed by and ill-prepared for their responsibilities. Many feel helpless living with uncertainty about the outcome of the patient's illness, which leads to existential distress. Supportive care interventions that address existential distress by promoting meaning and purpose buffer the negative effects of caregiver burden and promote resilience and growth. The purpose of this scoping review is to describe the depth and breadth of available interventions targeting caregiver existential distress.
METHODS
We followed the Joanna Briggs Institute's scoping review methods and applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension checklist. SCOPUS, Ovid MEDLINE and PsycINFO databases were searched for interventions that targeted existential distress by promoting meaning-making, spiritual well-being, post-traumatic growth and/or benefit finding for caregivers of seriously ill adult patients.
RESULTS
We screened 1377 titles/abstracts and 42 full-text articles. Thirty-one articles (28 unique studies) met inclusion criteria. Most interventions were designed for caregivers supporting patients with cancer (n=14) or patients receiving palliative care (n=9). Promising interventions included Meaning-Centered Psychotherapy for Cancer Caregivers, Meaning-Based Intervention for Patients and their Partners, Legacy Intervention for Family Enactment, Family Participatory Dignity Therapy and Existential Behavioural Therapy. More than half of the studies (n=20, 64%) were in the feasibility/acceptability/pilot stage of intervention testing.
CONCLUSION
Large randomised controlled trials with more diverse samples of caregivers are needed. Future research should explore the impact of delivering meaning-making interventions to caregivers throughout the illness trajectory. Developing strategies for scaling up and conducting cost analyses will narrow the research and practice gap for meaning-making interventions.
Topics: Humans; Caregivers; Emotions; Neoplasms; Palliative Care; Stress, Psychological
PubMed: 37604657
DOI: 10.1136/spcare-2023-004448 -
The Cochrane Database of Systematic... May 2017Approximately 20% of stroke patients experience clinically significant levels of anxiety at some point after stroke. Physicians can treat these patients with... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Approximately 20% of stroke patients experience clinically significant levels of anxiety at some point after stroke. Physicians can treat these patients with antidepressants or other anxiety-reducing drugs, or both, or they can provide psychological therapy. This review looks at available evidence for these interventions. This is an update of the review first published in October 2011.
OBJECTIVES
The primary objective was to assess the effectiveness of pharmaceutical, psychological, complementary, or alternative therapeutic interventions in treating stroke patients with anxiety disorders or symptoms. The secondary objective was to identify whether any of these interventions for anxiety had an effect on quality of life, disability, depression, social participation, caregiver burden, or risk of death.
SEARCH METHODS
We searched the trials register of the Cochrane Stroke Group (January 2017). We also searched the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library; 2017, Issue 1: searched January 2017); MEDLINE (1966 to January 2017) in Ovid; Embase (1980 to January 2017) in Ovid; the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1937 to January 2017) in EBSCO; and PsycINFO (1800 to January 2017) in Ovid. We conducted backward citation searches of reviews identified through database searches and forward citation searches of included studies. We contacted researchers known to be involved in related trials, and we searched clinical trials registers for ongoing studies.
SELECTION CRITERIA
We included randomised trials including participants with a diagnosis of both stroke and anxiety for which treatment was intended to reduce anxiety. Two review authors independently screened and selected titles and abstracts for inclusion.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted data and assessed risk of bias. We performed a narrative review. We planned to do a meta-analysis but were unable to do so as included studies were not sufficiently comparable.
MAIN RESULTS
We included three trials (four interventions) involving 196 participants with stroke and co-morbid anxiety. One trial (described as a 'pilot study') randomised 21 community-dwelling stroke survivors to four-week use of a relaxation CD or to wait list control. This trial assessed anxiety using the Hospital Anxiety and Depression Scale and reported a reduction in anxiety at three months among participants who had used the relaxation CD (mean (standard deviation (SD) 6.9 (± 4.9) and 11.0 (± 3.9)), Cohen's d = 0.926, P value = 0.001; 19 participants analysed).The second trial randomised 81 participants with co-morbid anxiety and depression to paroxetine, paroxetine plus psychotherapy, or standard care. Mean levels of anxiety severity scores based on the Hamilton Anxiety Scale (HAM-A) at follow-up were 5.4 (SD ± 1.7), 3.8 (SD ± 1.8), and 12.8 (SD ± 1.9), respectively (P value < 0.01).The third trial randomised 94 stroke patients, also with co-morbid anxiety and depression, to receive buspirone hydrochloride or standard care. At follow-up, the mean levels of anxiety based on the HAM-A were 6.5 (SD ± 3.1) and 12.6 (SD ± 3.4) in the two groups, respectively, which represents a significant difference (P value < 0.01). Half of the participants receiving paroxetine experienced adverse events that included nausea, vomiting, or dizziness; however, only 14% of those receiving buspirone experienced nausea or palpitations. Trial authors provided no information about the duration of symptoms associated with adverse events. The trial of relaxation therapy reported no adverse events.The quality of the evidence was very low. Each study included a small number of participants, particularly the study of relaxation therapy. Studies of pharmacological agents presented details too limited to allow judgement of selection, performance, and detection bias and lack of placebo treatment in control groups. Although the study of relaxation therapy had allocated participants to treatment using an adequate method of randomisation, study recruitment methods might have introduced bias, and drop-outs in the intervention group may have influenced results.
AUTHORS' CONCLUSIONS
Evidence is insufficient to guide the treatment of anxiety after stroke. Further well-conducted randomised controlled trials (using placebo or attention controls) are required to assess pharmacological agents and psychological therapies.
Topics: Anti-Anxiety Agents; Antidepressive Agents; Anxiety; Buspirone; Depression; Humans; Middle Aged; Paroxetine; Pilot Projects; Psychotherapy; Randomized Controlled Trials as Topic; Relaxation Therapy; Stroke
PubMed: 28535332
DOI: 10.1002/14651858.CD008860.pub3 -
Occupational Medicine (Oxford, England) Oct 2021As work and health are closely interlinked, it is important to carefully monitor employees. However, limited resources restrict in-depth follow-up.
BACKGROUND
As work and health are closely interlinked, it is important to carefully monitor employees. However, limited resources restrict in-depth follow-up.
AIMS
This study was aimed to develop a low-cost screening instrument for employees' overall health status, that can be used across industries and that allows triaging workers to in-depth health surveillance in case of indications of health or functioning problems.
METHODS
We developed a new questionnaire-based algorithm built on multiple predictors to assess the need for further follow-up. We used a systematic review, Delphi panel (n = 9) and focus group (n = 5) to determine the predictors, tested for language pitfalls in a pilot study and evaluated the questionnaire's validity in two separate studies. Study 1 (n = 60) analysed the discriminatory power of the instrument by comparing it to the assessment of an occupational physician in a sample of employees from diverse occupational settings. Study 2 (n = 869) appraised the factor structure and internal consistency of the screening tool in a sample of employees from the hospital sector.
RESULTS
Risk factors, current physical and mental health, functioning, absenteeism, job satisfaction and lifestyle were identified as the most relevant predictors. Study 1 showed the survey had good criterion validity (area under the curve = 0.72). Study 2 (N = 869, 28% response) demonstrated the internal consistency (Cronbach's α = 0.94), and a factor analysis confirmed a second-order factor structure with adequate model fit (comparative fit index = 0.96, root mean square error of approximation = 0.04 and standardized root mean square residual = 0.07).
CONCLUSIONS
This questionnaire can be used to triage workers for occupational health follow-up and can, additionally, be useful to describe the epidemiology of work-related illness.
Topics: Factor Analysis, Statistical; Humans; Occupational Health; Pilot Projects; Psychometrics; Reproducibility of Results; Surveys and Questionnaires; Triage
PubMed: 34415350
DOI: 10.1093/occmed/kqab101 -
The Lancet. Psychiatry Nov 2023Self-binding directives (SBDs) are an ethically controversial type of advance decision making involving advance requests for involuntary treatment. This study... (Review)
Review
Self-binding directives (SBDs) are an ethically controversial type of advance decision making involving advance requests for involuntary treatment. This study systematically reviewed the academic literature on psychiatric SBDs to elucidate reasons for and against their use in psychiatric practice. Full-text articles were thematically analysed within the international, interdisciplinary authorship team to produce a hierarchy of reasons. We found 50 eligible articles. Reasons for SBD use were promoting service user autonomy, promoting wellbeing and reducing harm, improving relationships, justifying coercion, stakeholder support, and reducing coercion. Reasons against SBD use were diminishing service user autonomy, unmanageable implementation problems, difficulties with assessing mental capacity, challenging personal identity, legislative issues, and causing harm. A secondary finding was a clarified concept of capacity-sensitive SBDs. Future pilot implementation projects that operationalise the clarified definition of capacity-sensitive SBDs with safeguards around informed consent, capacity assessment, support for drafting, and independent review are required.
PubMed: 37714174
DOI: 10.1016/S2215-0366(23)00221-3 -
The International Journal of Social... Nov 2022While employment programs were not created with the intent to improve common mental disorders (CMDs), they may have a positive impact on the prevalence, incidence, and... (Review)
Review
BACKGROUND
While employment programs were not created with the intent to improve common mental disorders (CMDs), they may have a positive impact on the prevalence, incidence, and severity of CMD by reducing poverty and increasing access to economic mobility.
AIM
To examine and synthesize the available quantitative evidence of the impact of employment programs on outcomes of CMD.
METHODS
Embase, Econlit, Global Health, MEDLINE, APA PsychINFO, and Social Policy and Practice were searched for experimental and quasi-experimental studies which investigated the impact of employment programs on primary and secondary outcomes of a CMD. A narrative synthesis according to Popay was conducted. The methodological quality of studies was assessed with the Cochrane Risk of Bias tool and the Newcastle-Ottawa Assessment Scale.
RESULTS
Of the 1,327 studies retrieved, two randomized controlled trials, one retrospective cohort, one pilot study with a non-randomized experimental design, and one randomized field experiment were included in the final review. Employment programs generally included multiple components such as skills-based training, and hands-on placements. Depression and anxiety were the CMDs measured as primary or secondary outcomes within included studies. Findings regarding the impact of employment programs on CMD were mixed with two studies reporting significantly positive effects, two reporting no effects, and one reporting mixed effects. The quality among included studies was good overall with some concerns regarding internal validity.
CONCLUSION
Employment programs may support a decrease in the prevalence, incidence, and severity of CMDs. However, there is high heterogeneity among study effects, designs, and contexts. More research is needed to gain further insight into the nature of this association and the mechanisms of impact. This review highlights the potential for employment programs and other poverty-reduction interventions to be utilized and integrated into the wider care, prevention, and treatment of common-mental disorders.
Topics: Humans; Employment; Mental Disorders; Pilot Projects; Poverty; Randomized Controlled Trials as Topic; Retrospective Studies
PubMed: 35796434
DOI: 10.1177/00207640221104684