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International Journal For Equity in... Aug 2017Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective... (Review)
Review
BACKGROUND
Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting.
METHODS
A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines.
RESULTS
Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4-20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children's negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children's substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes.
CONCLUSIONS
Quantitative research investigating Indigenous children's mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children's familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children.
Topics: Child; Developed Countries; Humans; Mental Disorders; Population Groups; Psychology
PubMed: 28830449
DOI: 10.1186/s12939-017-0652-5 -
Frontiers in Medicine 2023Glioblastoma is the most common and malignant primary brain tumour with median survival of 14.6 months. Personalised medicine aims to improve survival by targeting...
INTRODUCTION
Glioblastoma is the most common and malignant primary brain tumour with median survival of 14.6 months. Personalised medicine aims to improve survival by targeting individualised patient characteristics. However, a major limitation has been application of targeted therapies in a non-personalised manner without biomarker enrichment. This has risked therapies being discounted without fair and rigorous evaluation. The objective was therefore to synthesise the current evidence on survival efficacy of personalised therapies in glioblastoma.
METHODS
Studies reporting a survival outcome in human adults with supratentorial glioblastoma were eligible. PRISMA guidelines were followed. MEDLINE, Embase, Scopus, Web of Science and the Cochrane Library were searched to 5th May 2022. Clinicaltrials.gov was searched to 25th May 2022. Reference lists were hand-searched. Duplicate title/abstract screening, data extraction and risk of bias assessments were conducted. A quantitative synthesis is presented.
RESULTS
A total of 102 trials were included: 16 were randomised and 41 studied newly diagnosed patients. Of 5,527 included patients, 59.4% were male and mean age was 53.7 years. More than 20 types of personalised therapy were included: targeted molecular therapies were the most studied (33.3%, 34/102), followed by autologous dendritic cell vaccines (32.4%, 33/102) and autologous tumour vaccines (10.8%, 11/102). There was no consistent evidence for survival efficacy of any personalised therapy.
CONCLUSION
Personalised glioblastoma therapies remain of unproven survival benefit. Evidence is inconsistent with high risk of bias. Nonetheless, encouraging results in some trials provide reason for optimism. Future focus should address target-enriched trials, combination therapies, longitudinal biomarker monitoring and standardised reporting.
PubMed: 37122327
DOI: 10.3389/fmed.2023.1166104 -
MedEdPublish (2016) 2020This article was migrated. The article was not marked as recommended. Trust is an essential component of developing bonds and, in particular, the relationship between...
This article was migrated. The article was not marked as recommended. Trust is an essential component of developing bonds and, in particular, the relationship between teacher and learner. The cumulative effects of pedagogy, curriculum, content, and delivery in teaching and learning of medical students (MS) are well established and the importance of the relationship between student and teachers, with particular reference to the concept of trust is reviewed, addressing aspects of intention, capability, character, and integrity. Trust is often perceived as a soft quality with respect to education, however trust actually provides an environment of hope and inspirational optimism. In such an environment teachers and learners can be authentic about their 'best selves', developing good character with high emotional intelligence (EI), where honest reflection is the key to enhanced integrity with transparent intentions in their relationships. Trusting relationships in education instil mutual respect, enhance collaboration, and promote the independent thinking that results from transparent and kind mutual interactions. Indeed, loyalty and commitment to values and goals ensures the success of the learning environment. Neuroscience and psychology experiments demonstrate recent evidence to support the importance of trust in relationships that can be considered relevant to teaching and learning. The expression of hormones and brain function, associated with trusting relationships and interpersonal bonding is explored.
PubMed: 38476829
DOI: 10.15694/mep.2020.000184.1 -
Journal of Occupational Health Jan 2021Gratitude intervention, which requires participants to engage regularly in brief activities designed to cultivate a sense of gratefulness, is known as one of the most...
OBJECTIVES
Gratitude intervention, which requires participants to engage regularly in brief activities designed to cultivate a sense of gratefulness, is known as one of the most effective positive psychological interventions. Although numerous meta-analyses and systematic reviews have been conducted on gratitude intervention, no studies have focused on the working population. This study aimed to systematically summarize the effectiveness of gratitude interventions on workers' mental health and well-being.
METHODS
Systematic search was conducted in February 2021 using five databases. Eligible studies included randomized controlled trials implementing gratitude activities among healthy workers and measuring mental health or well-being indicators and original articles or thesis in English.
RESULTS
Nine out of 1957 articles met the inclusion criteria. Eight studies adopted gratitude list interventions, showing a significant improvement in perceived stress and depression; however, the effects on well-being were inconsistent. Interventions with gratitude list four times or less did not report significant changes in any outcomes.
CONCLUSIONS
Most gratitude interventions incorporated a gratitude list, and some studies included gratitude activities as a part of the combined program. On the other hand, no studies focused on only behavioral gratitude expression among workers. Gratitude interventions might be effective in improving mental health, but their effects on well-being remain unclear. The total number of gratitude lists and reflections might influence the effect on mental health and well-being; however, due to the high heterogeneity of the studies, further studies are needed.
Topics: Emotions; Health Promotion; Humans; Mental Health; Optimism; Personal Satisfaction; Psychology, Positive; Randomized Controlled Trials as Topic; Workplace
PubMed: 34762326
DOI: 10.1002/1348-9585.12290 -
International Journal of Molecular... Oct 2020Leveraging the immune system to thwart cancer is not a novel strategy and has been explored via cancer vaccines and use of immunomodulators like interferons. However, it... (Meta-Analysis)
Meta-Analysis
Leveraging the immune system to thwart cancer is not a novel strategy and has been explored via cancer vaccines and use of immunomodulators like interferons. However, it was not until the introduction of immune checkpoint inhibitors that we realized the true potential of immunotherapy in combating cancer. Oncolytic viruses are one such immunotherapeutic tool that is currently being explored in cancer therapeutics. We present the most comprehensive systematic review of all oncolytic viruses in Phase 1, 2, and 3 clinical trials published to date. We performed a systematic review of all published clinical trials indexed in PubMed that utilized oncolytic viruses. Trials were reviewed for type of oncolytic virus used, method of administration, study design, disease type, primary outcome, and relevant adverse effects. A total of 120 trials were found; 86 trials were available for our review. Included were 60 phase I trials, five phase I/II combination trials, 19 phase II trials, and two phase III clinical trials. Oncolytic viruses are feverously being evaluated in oncology with over 30 different types of oncolytic viruses being explored either as a single agent or in combination with other antitumor agents. To date, only one oncolytic virus therapy has received an FDA approval but advances in bioengineering techniques and our understanding of immunomodulation to heighten oncolytic virus replication and improve tumor kill raises optimism for its future drug development.
Topics: Clinical Trials as Topic; Combined Modality Therapy; Disease Management; Gene Transfer Techniques; Genetic Vectors; Humans; Neoplasms; Oncolytic Virotherapy; Oncolytic Viruses; Treatment Outcome
PubMed: 33053757
DOI: 10.3390/ijms21207505 -
Age and Ageing Oct 2023to examine the measurement properties of instruments that have been used to measure aspects of psychological capacity in adults aged 60 years and over.
OBJECTIVE
to examine the measurement properties of instruments that have been used to measure aspects of psychological capacity in adults aged 60 years and over.
METHODS
the databases PsycINFO, MEDLINE, EMCARE and Scopus from 2010 were searched using search terms related to psychological capacity, older persons and measurement properties. Both data extraction and risk-of-bias assessment were conducted using the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria using Covidence software.
RESULTS
the full text of 326 articles were reviewed and a total of 30 studies were included, plus two further articles identified from reference lists (n = 32). No single instrument measuring psychological capacity was identified. Twenty (n = 20) instruments were identified that measure seven constructs of psychological capacity: Resilience; Sense of coherence; Hope; Mindfulness; Optimism; Attachment to life; Emotional regulation.
CONCLUSIONS
this systematic review identified potential measures of psychological capacity in older adults. The review will inform further work to develop a single comprehensive measure of psychological capacity in older adults.
Topics: Humans; Middle Aged; Aged; Aged, 80 and over; Consensus; Databases, Factual
PubMed: 37902524
DOI: 10.1093/ageing/afad100 -
JMIR Medical Informatics Mar 2024Generative artificial intelligence tools and applications (GenAI) are being increasingly used in health care. Physicians, specialists, and other providers have started... (Review)
Review
BACKGROUND
Generative artificial intelligence tools and applications (GenAI) are being increasingly used in health care. Physicians, specialists, and other providers have started primarily using GenAI as an aid or tool to gather knowledge, provide information, train, or generate suggestive dialogue between physicians and patients or between physicians and patients' families or friends. However, unless the use of GenAI is oriented to be helpful in clinical service encounters that can improve the accuracy of diagnosis, treatment, and patient outcomes, the expected potential will not be achieved. As adoption continues, it is essential to validate the effectiveness of the infusion of GenAI as an intelligent technology in service encounters to understand the gap in actual clinical service use of GenAI.
OBJECTIVE
This study synthesizes preliminary evidence on how GenAI assists, guides, and automates clinical service rendering and encounters in health care The review scope was limited to articles published in peer-reviewed medical journals.
METHODS
We screened and selected 0.38% (161/42,459) of articles published between January 1, 2020, and May 31, 2023, identified from PubMed. We followed the protocols outlined in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to select highly relevant studies with at least 1 element on clinical use, evaluation, and validation to provide evidence of GenAI use in clinical services. The articles were classified based on their relevance to clinical service functions or activities using the descriptive and analytical information presented in the articles.
RESULTS
Of 161 articles, 141 (87.6%) reported using GenAI to assist services through knowledge access, collation, and filtering. GenAI was used for disease detection (19/161, 11.8%), diagnosis (14/161, 8.7%), and screening processes (12/161, 7.5%) in the areas of radiology (17/161, 10.6%), cardiology (12/161, 7.5%), gastrointestinal medicine (4/161, 2.5%), and diabetes (6/161, 3.7%). The literature synthesis in this study suggests that GenAI is mainly used for diagnostic processes, improvement of diagnosis accuracy, and screening and diagnostic purposes using knowledge access. Although this solves the problem of knowledge access and may improve diagnostic accuracy, it is oriented toward higher value creation in health care.
CONCLUSIONS
GenAI informs rather than assisting or automating clinical service functions in health care. There is potential in clinical service, but it has yet to be actualized for GenAI. More clinical service-level evidence that GenAI is used to streamline some functions or provides more automated help than only information retrieval is needed. To transform health care as purported, more studies related to GenAI applications must automate and guide human-performed services and keep up with the optimism that forward-thinking health care organizations will take advantage of GenAI.
PubMed: 38506918
DOI: 10.2196/52073 -
Frontiers in Nutrition 2021Yogurt is known to be nutrient-rich and probiotic content, which gather optimism due to their potential role in preventing and managing cancers. The effect of yogurt...
Yogurt is known to be nutrient-rich and probiotic content, which gather optimism due to their potential role in preventing and managing cancers. The effect of yogurt consumption on colorectal cancer (CRC) is inconsistent. This study aims to investigate the association of yogurt consumption with the risk of CRC. Three databases, namely, PubMed, Web of Science, and Embase, were searched for all relevant studies from July 2021 on the association of yogurt consumption with CRC risk. We pooled the odds ratios (ORs) and their 95% CIs using a random-effects meta-analysis to assess the association. Finally, 16 studies met the inclusion criteria and were chosen in the meta-analysis. Yogurt consumption was significant with lower risk of CRC risk in the overall comparison (OR = 0.87, 95% CI: 0.81-0.94), in the cohort studies (OR = 0.91, 95% CI: 0.86-0.97), and case-control studies (OR = 0.75, 95% CI: 0.65-0.85). With regard to subgroup analyses by study region, cancer type, publication year, and sex, yogurt consumption significantly decreased overall CRC, colon cancer, and distal colon cancer risks. In stratified analyses, we observed significantly decreased CRC risk in Europe and Africa and published after 2010 and overall population. Sensitivity analysis indicated the result is stable and there is no publication bias in the meta-analysis. Overall, this study indicated that yogurt intake was related to a decreased risk of CRC.
PubMed: 35047546
DOI: 10.3389/fnut.2021.789006 -
Journal of General Internal Medicine May 2023Physicians treating similar patients in similar care-delivery contexts vary in the intensity of life-extending care provided to their patients at the end-of-life.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Physicians treating similar patients in similar care-delivery contexts vary in the intensity of life-extending care provided to their patients at the end-of-life. Physician psychological propensities are an important potential determinant of this variability, but the pertinent literature has yet to be synthesized.
OBJECTIVE
Conduct a review of qualitative studies to explicate whether and how psychological propensities could result in some physicians providing more intensive treatment than others.
METHODS
Systematic searches were conducted in five major electronic databases-MEDLINE ALL (Ovid), Embase (Elsevier), CINAHL (EBSCO), PsycINFO (Ovid), and Cochrane CENTRAL (Wiley)-to identify eligible studies (earliest available date to August 2021). Eligibility criteria included examination of a physician psychological factor as relating to end-of-life care intensity in advanced life-limiting illness. Findings from individual studies were pooled and synthesized using thematic analysis, which identified common, prevalent themes across findings.
RESULTS
The search identified 5623 references, of which 28 were included in the final synthesis. Seven psychological propensities were identified as influencing physician judgments regarding whether and when to withhold or de-escalate life-extending treatments resulting in higher treatment intensity: (1) professional identity as someone who extends lifespan, (2) mortality aversion, (3) communication avoidance, (4) conflict avoidance, (5) personal values favoring life extension, (6) decisional avoidance, and (7) over-optimism.
CONCLUSIONS
Psychological propensities could influence physician judgments regarding whether and when to de-escalate life-extending treatments. Future work should examine how individual and environmental factors combine to create such propensities, and how addressing these propensities could reduce physician-attributed variation in end-of-life care intensity.
Topics: Humans; Communication; Death; Pharmaceutical Preparations; Physicians; Terminal Care
PubMed: 36732436
DOI: 10.1007/s11606-022-08011-4 -
Physical Therapy in Sport : Official... Jun 2024The aim of this review is to synthesise qualitative studies examining adolescents' experience with pain and injury arising from sports participation.
OBJECTIVE
The aim of this review is to synthesise qualitative studies examining adolescents' experience with pain and injury arising from sports participation.
METHODS
This review was registered on Open Science Framework prior to data extraction. A systematic search of PubMed, Embase, and SPORTDiscus was conducted. Studies were appraised using the CASP (critical appraisal skills programme) checklist. Data was synthesised using a meta aggregation.
STUDY SELECTION CRITERIA
Inclusion criteria included studies related to adolescents aged 14-19yrs with sports related pain/injury, employed a qualitative design, full text publications in English.
RESULTS
Sixteen studies of 216 participants were included. Studies investigated severe knee injuries, concussion, or other musculoskeletal injuries. Synthesised findings show that, regardless of injury type, adolescents experience a mix of positive (motivation to rehab and return to sport, optimism) and negative emotions (fear of re-injury, isolation, depressive responses) throughout recovery. Common coping strategies were to ignore symptoms, modify activity levels, or seek support.
CONCLUSION
Sports-related pain and injury has a multifaceted effect on the adolescent athlete. There is a pervasive fear of re-injury and social isolation, but the desire to return to sports is facilitated through motivation and support. Peer motivation effects the willingness of the adolescent to persist with rehabilitation.
PubMed: 38843686
DOI: 10.1016/j.ptsp.2024.05.003