-
Journal of the American Medical... May 2020Serious health games might have the potential to prevent tobacco smoking and its health consequences, depending on the inclusion of specific game elements. This review...
OBJECTIVE
Serious health games might have the potential to prevent tobacco smoking and its health consequences, depending on the inclusion of specific game elements. This review aimed to assess the composition of serious games and their effects on smoking initiation prevention and cessation and behavioral determinants.
MATERIALS AND METHODS
We systematically searched MEDLINE, Embase, PsycINFO, and Web of Science for publications that evaluated serious games aimed at changing smoking behavior or behavioral determinants. A taxonomy by King et al was used to classify game elements.
RESULTS
We identified 15 studies, evaluating 14 unique serious games. All games combined multiple game elements (mean 5.5; range, 3-10). Most frequently used were general and intermittent rewards, theme and genre features, and punishments. Six studies on smoking prevention together assessed 20 determinants and found statistically significant positive effects for 8 determinants (eg, attitude, knowledge, intention). Of 7 studies on smoking cessation, 5 found positive, statistically significant effects on smoking cessation or status. These studies found statistically significant positive effects for 6 of 12 determinants (eg, self-efficacy, attitude, intention). The majority of included studies had poor or fair methodological quality, lacked follow-up measures, and had fixed (as opposed to free, on-demand) play sessions.
CONCLUSIONS
Serious games included multiple types of game elements. The evidence from a number of studies suggests that games may have positive effects on smoking-related outcomes, particularly smoking cessation. However, as most studies had important methodological limitations, stronger designs are needed to demonstrate, quantify, and understand the effects of serious games.
Topics: Humans; Medical Informatics; Smoking Cessation; Smoking Prevention; Video Games
PubMed: 32330255
DOI: 10.1093/jamia/ocaa013 -
BMC Health Services Research Apr 2024The growing adoption of continuous quality improvement (CQI) initiatives in healthcare has generated a surge in research interest to gain a deeper understanding of CQI.... (Review)
Review
BACKGROUND
The growing adoption of continuous quality improvement (CQI) initiatives in healthcare has generated a surge in research interest to gain a deeper understanding of CQI. However, comprehensive evidence regarding the diverse facets of CQI in healthcare has been limited. Our review sought to comprehensively grasp the conceptualization and principles of CQI, explore existing models and tools, analyze barriers and facilitators, and investigate its overall impacts.
METHODS
This qualitative scoping review was conducted using Arksey and O'Malley's methodological framework. We searched articles in PubMed, Web of Science, Scopus, and EMBASE databases. In addition, we accessed articles from Google Scholar. We used mixed-method analysis, including qualitative content analysis and quantitative descriptive for quantitative findings to summarize findings and PRISMA extension for scoping reviews (PRISMA-ScR) framework to report the overall works.
RESULTS
A total of 87 articles, which covered 14 CQI models, were included in the review. While 19 tools were used for CQI models and initiatives, Plan-Do-Study/Check-Act cycle was the commonly employed model to understand the CQI implementation process. The main reported purposes of using CQI, as its positive impact, are to improve the structure of the health system (e.g., leadership, health workforce, health technology use, supplies, and costs), enhance healthcare delivery processes and outputs (e.g., care coordination and linkages, satisfaction, accessibility, continuity of care, safety, and efficiency), and improve treatment outcome (reduce morbidity and mortality). The implementation of CQI is not without challenges. There are cultural (i.e., resistance/reluctance to quality-focused culture and fear of blame or punishment), technical, structural (related to organizational structure, processes, and systems), and strategic (inadequate planning and inappropriate goals) related barriers that were commonly reported during the implementation of CQI.
CONCLUSIONS
Implementing CQI initiatives necessitates thoroughly comprehending key principles such as teamwork and timeline. To effectively address challenges, it's crucial to identify obstacles and implement optimal interventions proactively. Healthcare professionals and leaders need to be mentally equipped and cognizant of the significant role CQI initiatives play in achieving purposes for quality of care.
Topics: Humans; Quality Improvement; Concept Formation; Delivery of Health Care; Health Personnel; Health Facilities
PubMed: 38641786
DOI: 10.1186/s12913-024-10828-0 -
PloS One 2019Adherence to antiretroviral therapy (ART) and long-term uninterrupted engagement in HIV care is difficult for HIV-positive people, and randomized trials of specific...
BACKGROUND
Adherence to antiretroviral therapy (ART) and long-term uninterrupted engagement in HIV care is difficult for HIV-positive people, and randomized trials of specific techniques to promote adherence often show small or negligible effects. Understanding what influences decision-making in HIV-positive people in Africa may help researchers and policy makers in the development of broader, more effective interventions and policies.
METHODS
We used thematic synthesis and a grounded theory approach to generate a detailed narrative and theoretical model reflecting life with HIV in Africa, and how this influences ART adherence and engagement decisions. We included qualitative primary studies that explored perspectives, perceptions and experiences of HIV-positive people, caregivers and healthcare service providers. We searched databases from 1 January 2013 to 9 December 2016, screened all studies, and selected those for inclusion using purposeful sampling methods. Included studies were coded with Atlas.ti, and we assessed methodological quality across five domains.
RESULTS
We included 59 studies from Africa in the synthesis. Nine themes emerged which we grouped under three main headings. First, people who are HIV-positive live in a complicated world where they must navigate the challenges presented by poverty, competing priorities, unpredictable life events, social identity, gender norms, stigma, and medical pluralism-these influences can make initiating and maintaining ART difficult. Second, the health system is generally seen as punishing and uninviting and this can drive HIV-positive people out of care. Third, long-term engagement and adherence requires adaptation and incorporation of ART into daily life, a process which is facilitated by: inherent self-efficacy, social responsibilities, previous HIV-related illnesses and emotional, practical or financial support. These factors together can lead to a "tipping point", a point in time when patients choose to either engage or disengage from care. HIV-positive people may cycle in and out of these care states in response to fluctuations in influences over time.
CONCLUSION
This analysis provides a practical theory, arising from thematic synthesis of research, to help understand the dynamics of adherence to ART and engagement in HIV care. This can contribute to the design of service delivery approaches, and informed thinking and action on the part of policy makers, providers, and society: to understand what it is to be HIV-positive in Africa and how attitudes and the health service need to shift to help those with HIV lead 'normal' lives.
Topics: Africa; Anti-Retroviral Agents; HIV Infections; Humans; Patient Compliance; Patient Dropouts; Poverty; Socioeconomic Factors
PubMed: 30629648
DOI: 10.1371/journal.pone.0210408 -
Addictive Behaviors Jul 2017To provide a systematic overview of longitudinal studies on different smoking-specific parenting practices (i.e., perceived parental norms and influences,... (Review)
Review
AIM
To provide a systematic overview of longitudinal studies on different smoking-specific parenting practices (i.e., perceived parental norms and influences, smoking-specific monitoring, availability of cigarettes at home, household smoking rules, non-smoking agreements, smoking-specific communication, and parental reactions) as useful tools in the prevention of youth smoking.
METHOD
MEDLINE and PsychINFO search identified 986 studies published from 1990 to December 2016. Two independent researchers identified eligible studies. Study quality was assessed using Newcastle Ottawa Scale (NOS).
RESULTS
The systematic search resulted in 1 to 14 longitudinal studies per parenting practice. Studies scored between 4 and 9 on the NOS, indicating an overall moderate quality. The results of complete smoking house rules showed a preventive effect on smoking onset. Furthermore, availability of cigarettes, frequency and quality of communication, parental reaction (i.e., conflict engagement) and norms showed significant and non-significant effects. Significant results were in line with expectations: availability of cigarettes and frequent communication about smoking predicted smoking, whereas a high quality of communication, negative reactions or punishments and setting norms by parents showed a preventive effect. No effects were found for non-smoking agreements. The number of studies was too limited to draw conclusions about other parenting strategies. More research on (1) reliable and valid instruments, (2) other stages of smoking in addition to onset, and (3) potential moderators and mediators is warranted.
CONCLUSION
While evidence supports the effectiveness of smoking-specific parenting, further research is required.
Topics: Adolescent; Adolescent Behavior; Humans; Longitudinal Studies; Parent-Child Relations; Parenting; Parents; Smoking Prevention
PubMed: 28237717
DOI: 10.1016/j.addbeh.2017.02.003 -
Frontiers in Psychology 2021Deterrence by punishment aims to prevent a crime; however, it is not always successful. Restrictive deterrence explains the continuous criminal activities that occur...
Deterrence by punishment aims to prevent a crime; however, it is not always successful. Restrictive deterrence explains the continuous criminal activities that occur despite deterrence; offenders enact various strategies to avoid detection, which is more typical among drug offenders given that they have a high frequency of offending and exposure to punishment. This systematic review provides an in-depth understanding of restrictive deterrence of drug offenders. Two prominent themes, "restrictive deterrence strategy" and "deterrability and restrictive deterrence," depict drug offenders' restrictive deterrence and effectively fit within the certainty-severity framework of punishment. Future studies should investigate restrictive deterrence strategies in the after-arrest context, the facilitative effect of perception of risk on strategy development, and facilitators or inhibitors affecting the diffusion of restrictive deterrence strategies.
PubMed: 34512482
DOI: 10.3389/fpsyg.2021.727142 -
European Journal of Investigation in... May 2024The prevalence of diagnosed cases of autism has increased rapidly, which has raised interest in studying the variables related to the well-being of these families. The... (Review)
Review
The prevalence of diagnosed cases of autism has increased rapidly, which has raised interest in studying the variables related to the well-being of these families. The purpose of this paper is to review the recent literature on other variables related to family well-being, such as parenting styles. We conducted a systematic review using the PRISMA check list and bias assessment with the aim of analyzing if the concepts of autism, well-being and parenting style are related. We screened 755 references from relevant databases like Scopus, Pubmed, PscyInfo EBSCO, Web of Science and Dialnet, updated on May 2024. Sixteen full text articles and abstracts were read. It was identified that the authoritative parenting style, as well as those based on warmth, establishing relationships and emotional bonding, and low expressed emotion were positively related to family well-being. On the other hand, authoritarian, permissive and overprotective styles, as well as critical, punishing and training-based, were negatively associated with well-being and quality of family life.
PubMed: 38921067
DOI: 10.3390/ejihpe14060101 -
Campbell Systematic Reviews Jun 2021In spite of the large number of anti-corruption reforms implemented in different countries, there has been little research that empirically and systematically assesses... (Review)
Review
BACKGROUND
In spite of the large number of anti-corruption reforms implemented in different countries, there has been little research that empirically and systematically assesses the impact of these efforts.
OBJECTIVES
The main objective of this review is to identify what works in curbing corruption in the public sector, by meta-analyzing the findings of published and unpublished evaluations of different types of anti-corruption interventions in different countries. The focus of this review is administrative corruption, namely corrupt acts involving civil servants in their dealings with their superiors, during the implementation of public policies, or while interacting with the public for service delivery. Political corruption (in the adoption of laws, regulations, and policies), and private-to-private corruption (involving only private actors) are excluded from this review.
SEARCH METHODS
The literature search was conducted by querying three widely recognized electronic databases: RePEc, SSRN, and Web of Science. These databases are considered the most comprehensive in the socio-economic field of research. The main grey literature repositories were also queried. Both published and unpublished studies were searched on the basis of specific combinations of keywords. The terms used to define queries were based on the "types of corruption", "types of interventions/policies/reforms" and "study design" search strings. Specific conventions were used to "explode" or "truncate" keywords as appropriate. Screening of the references (i.e., snowballing) of the identified studies was also performed, and a reverse snowballing approach on Google Scholar was used. In order to ensure replicability, all searches were stored into Covidence, an online software developed by the Cochrane community for screening studies and extracting data for systematic reviews.
SELECTION CRITERIA
Any study that included experimental evaluations (randomized controlled trials) of interventions developed for use in the public sector (e.g., public administration, education, health, etc.) to curb administrative corruption has been included in this review without any geographical or temporal limitations. Only studies written in or translated into English have been considered.
DATA COLLECTION AND ANALYSIS
Two review authors read the titles and abstracts of identified studies in order to determine their eligibility against the inclusion/exclusion criteria. When a title or abstract could not be included or rejected with certainty, the full text of the article was reviewed. In case of disagreement about whether or not a study should be included, the lead author (Giulia Mugellini), together with Martin Killias acted as arbitrator. The relevant information from identified studies was extracted independently by two review authors, following the guidelines of the Campbell Collaboration. The studies were assessed using the Cochrane Risk of Bias checklist as a basis.The effect size selected for the analysis was the Fisher's z-score transformation of the partial correlation coefficient. For the meta-analysis, random effect(s) models were estimated. Meta-regression analysis models were then used to investigate the determinants behind the observed between- and within-study heterogeneity. Ten different covariates were included in the meta-regression models in order to control for the type of intervention, the type of corruption, the level of national income, the quality of the study and the type of participants involved in laboratory experiments.
RESULTS
The initial literature search led to the identification of 70 studies. Approximately one-third of the studies were excluded at the title/abstract stage because they either did not evaluate any anti-corruption intervention but simply assessed the relationship between corruption and other phenomena, or because the study design was not based on randomized controlled trials. Another 14 studies were excluded only after a full-text assessment. At this stage, the main reasons for exclusion were related to an unsuitable type of corruption (e.g., when the focus of the paper was political corruption, or private-to-private corruption instead of administrative corruption), the lack of regression output, or an unsuitable study design. At the end of the selection process, 29 studies resulted as eligible for inclusion.All the selected studies were written in English. The publication years ranged from 2007 to 2018. The majority of the selected studies (20) investigates the effect of anti-corruption interventions in high- and upper-middle income countries (Austria, Brazil, Canada, China, Germany, Italy, Mexico, the Netherlands, Thailand, the United Kingdom, and the United States). Nine studies focused on low- and low-middle income countries (Burkina Faso, Burundi, Ethiopia, India, Indonesia, Pakistan, Tanzania, and Uganda). All of them were randomized experiments. Twenty-five of these experiments were conducted in a laboratory, while four of them were field experiments.As to the type of outcome, the majority (18) of the selected studies addressed bribery (either active or passive), while 11 studies considered misappropriation of public resources (embezzlement). In terms of anti-corruption interventions, 19 studies tested the effect of deterrence interventions, while 10 studies focused on policies based on organizational and cultural change.Overall, the meta-analysis' findings indicate that the identified interventions decrease the level of corruption. Results are statistically significant (p < 0.01) and robust to different heterogeneity estimators-that is, (restricted) maximum likelihood and method of moment estimators. The observed high level of heterogeneity- is equal to 92.36%, of which 43.78% is due to between-study heterogeneity and 48.57% to within-study heterogeneity-albeit in line with other meta-analyses in economics, suggests the need for meta-regression analyses.To investigate the determinants behind the between- and within-study heterogeneity of the observed effect, both a random effect model and a multilevel model were adopted.The results of the multilevel model show that: 1)Control and deterrence interventions are more effective than organizational and cultural reforms in reducing corruption in the public sector.2)Combining different interventions reduces corruption more than single interventions.3)Interventions are more effective in preventing misappropriation of public resources (embezzlement) than passive or active bribery. Finally, the Funnel Asymmetry Test (FAT), conducted with both additive and multiplicative dispersion terms, shows no evidence of a strong publication bias in the literature.
AUTHORS’ CONCLUSIONS
The results of this systematic review, based on a combination of laboratory and field experiments, demonstrate that increasing the expected monetary costs (e.g., sanctions) of corruption or the probability of detection (e.g., audit risk) is more effective than organizational, cultural and educational interventions in curbing administrative corruption, at least in the short term. However, this result might be due to the fact that the majority of selected studies are based on lab-experiments, where the assessment of the intervention is almost concurrent to its development. Short-term evaluations might fail to identify the effect of organizational and cultural interventions. Indeed, these interventions are based on structural changes in the organization of the system and the ethical and cultural education of public officials and might, thus, entail long periods to display their results on the level of corruption. Nevertheless, a combination of different interventions proves to be more effective than single interventions. For example, policies guaranteeing impunity to officials or citizens who report corrupt practices (principal witness/leniency treatment) are more effective if associated with a high probability of audit than leniency alone. A low probability of detection can be compensated by the threat of high fines in reducing both the amount and the likelihood of bribe demands. To the contrary, a high probability of detection had no effect in the absence of severe sanction threats.The importance of the organizational and cultural environment in which the intervention is implemented clearly emerged in the literature. When possible, the characteristics of the settings where the interventions were developed were included in the meta-regression analysis (such as the level of income of the countries). When it was not possible to measure contextual factors and their interaction with the main intervention, a qualitative analysis was performed to reveal the complexities of these interactions.This additional analysis shows that the impact of the interventions was found to be affected by the likelihood of the continued interactions between bribe takers and givers, the amount and probability of fines, and the size of the bribe, among others. For example, reporting mechanisms and leniency policies increase their potential in combination with interventions that limit agent's exposure to one another - such as staff rotation. The success of audit risk on corruption is strongly dependent on the seriousness of the potential sanction and the probability that a sanction is applied. Some differences also emerge between high- and low-corruption countries regarding the effectiveness of anti-corruption interventions. For example, measures tending to increase social blame of corrupt practices work in low-corruption countries. Adding punishments in environments where actors' behavior is tightly monitored increases compliance, but more so in environments where corruption is the exception rather than the rule.In terms of implications for research, the fact that control and deterrence turns out to be more effective than organizational and cultural interventions in curbing administrative corruption confirms the importance of economic theories (and cost-benefit analysis). However, the meta-analysis also demonstrates the effectiveness of combining different types of interventions.This is true not only when combining policies reinforcing control and deterrence (monitoring frequency, detection probability and amount of fines), but also when policies based on organizational and cultural change are added (e.g., staff rotation and leniency). In particular, the role of moral levers in preventing corruption emerges, and especially the importance of strengthening professional identity and values in order to avoid conflicts between an individual's private interests and his/her public role. These results highlight the importance of going beyond economic models for explaining corruption, and considering the moral and cultural mechanisms underlying this phenomenon.It also emerges the need to understand how different forms of corruption operate in practice at macro- (cross-country), meso- (country/nation-state) and micro- (individual) level. In particular, individual-level factors, such as the strive for power, low self-control, loss aversion and risk acceptance would need to be addressed.It would be interesting to distinguish, when more experimental studies will be available, between top-down (from supervisors to officials) and bottom-up (from citizens to officials) interventions.From a methodological point of view, it could be tested whether the results change according to the types of games used as a basis for the corruption experiments (e.g., behavioral game theory, trust game, etc.) and according to the setting in which the experiment was conducted (e.g., context-free versus in-context presentation of experimental tasks).Considering the effect of sensitization messages in reducing bribery demand, we would encourage researchers to develop other corruption experiments that explore the impact of interventions in fostering professional self-identity, as well as the impact of organizational family culture on corruption. Furthermore, this review highlights the need for a comprehensive classification of anti-corruption policies that distinguishes interventions by type of corruption, risk factors, type of policy tool and administrative sector.
PubMed: 37131927
DOI: 10.1002/cl2.1173 -
Neuroscience and Biobehavioral Reviews Aug 2019The comorbidity between discrete clinical diagnosis occurs in higher levels than prevalence rates, indicating that mental disorders are systematically overcategorized.... (Meta-Analysis)
Meta-Analysis
The comorbidity between discrete clinical diagnosis occurs in higher levels than prevalence rates, indicating that mental disorders are systematically overcategorized. Dimensional models - as the Internalizing-Externalizing Spectrum - claim for a common latent structure of psychopathology. The current meta-analysis aims to evaluate whether the externalizing and internalizing latent factors of the psychopathological spectrum display common and distinctive neurobiological substrates, as unveiled by Error-Related Negativity (ERN) modulation. A systematic search of the literature was conducted and a total of 99 articles (160 studies, N = 8123) were included in the quantitative analysis. A dissociable effect was found: reduced ERN amplitude was observed in externalizing, while increased ERN amplitude was reported in internalizing. Larger effects were documented in all the externalizing dimensions (except for alcohol abuse) and were moderated by frontal electrode sites and tasks requiring inhibition. In internalizing, the overall effect was less robust. Disorder severity and tasks with punishment contingencies moderated the findings, and anxiety and obsessive-compulsive traits were the unique dimensions of internalizing accounting for the ERN increased amplitude. Overall, our findings highlight that ERN reduction interacts with the multiple phenotypic expressions of externalizing at a general level, while more specific factors - such as differences in sensitivity and aversion to errors - may explain increased ERN amplitude in internalizing.
Topics: Behavioral Symptoms; Biomarkers; Cerebral Cortex; Evoked Potentials; Executive Function; Humans; Impulsive Behavior; Mental Disorders
PubMed: 31220503
DOI: 10.1016/j.neubiorev.2019.06.013 -
Frontiers in Public Health 2022Pharmacological neuroenhancement (PN) describes the use of divergent psychoactive substances to enhance mental performance (cognition) without medical need. This kind of...
Pharmacological neuroenhancement (PN) describes the use of divergent psychoactive substances to enhance mental performance (cognition) without medical need. This kind of substance abuse takes place predominantly in stressful situations. Users implicitly-or even explicitly-describe this kind of drug abuse to be a coping strategy. Regarding the decision making process whether to use PN drugs or not, users indicate that legal aspects to be decisive. However, the legal situation has been neglected so far. To elucidate the German legal situation, PN substances have to be divided into over-the-counter drugs, prescription drugs and illegal drugs. Amphetamines have the highest cognition-enhancing potential, followed by modafinil and caffeine-containing substances. It is pointed out that the use of both freely available and prescription PN substances and narcotics without medical indication have so far been largely exempt from punishment under German law. However, individuals (physicians, bus and truck drivers, etc.) taking PN substances may expose others at risk due to wrong decisions (driving or treatment), errors based on side effects of the used substances. Therefore, the protection of life and health of others could legitimize criminal regulation.
Topics: Humans; Criminals; Substance-Related Disorders; Illicit Drugs; Amphetamines; Adaptation, Psychological
PubMed: 36388290
DOI: 10.3389/fpubh.2022.1028654 -
PeerJ 2018Reward seeking and avoidance of punishment are key motivational processes. Brain-imaging studies often use the (MIDT) to evaluate motivational processes involved in...
BACKGROUND
Reward seeking and avoidance of punishment are key motivational processes. Brain-imaging studies often use the (MIDT) to evaluate motivational processes involved in maladaptive behavior. Although the bulk of research has been done on the MIDT reward events, little is known about the neural basis of avoidance of punishment. Therefore, we conducted a meta-analysis of brain activations during anticipation and receipt of monetary losses in healthy controls.
METHODS
All functional neuro-imaging studies using the MIDT in healthy controls were retrieved using PubMed, Google Scholar & EMBASE databases. Functional neuro-imaging data was analyzed using the Seed-based d Mapping Software.
RESULTS
Thirty-five studies met the inclusion criteria, comprising 699 healthy adults. In both anticipation and loss outcome phases, participants showed large and robust activations in the bilateral striatum, (anterior) insula, and anterior cingulate gyrus relatively to Loss > Neutral contrast. Although relatively similar activation patterns were observed during the two event types, they differed in the pattern of prefrontal activations: ventro-lateral prefrontal activations were observed during loss anticipation, while medial prefrontal activations were observed during loss receipt.
DISCUSSION
Considering that previous meta-analyses highlighted activations in the medial prefrontal cortex/anterior cingulate cortex, the anterior insula and the ventral striatum, the current meta-analysis highlighted the potential specificity of the ventro-lateral prefrontal regions, the median cingulate cortex and the amygdala in the loss events. Future studies can rely on these latter results to examine the neural correlates of loss processing in psychiatric populations characterized by harm avoidance or insensitivity to punishment.
PubMed: 29761060
DOI: 10.7717/peerj.4749