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Journal of Medical Ethics and History... 2021One important part of a nurse's job is to create and help maintain a safe work environment. Evidence shows that negative behaviors such as incivility are not uncommon in... (Review)
Review
One important part of a nurse's job is to create and help maintain a safe work environment. Evidence shows that negative behaviors such as incivility are not uncommon in the nursing profession. This systematic review and meta-analysis aimed to examine the prevalence of incivility toward nurses. For this purpose, all observational studies that primarily investigated the rate of incivility toward nurses were selected. The electronic databases PubMed, Embase, Web of Sciences, Magiran, IranDoc, and Scopus were searched for studies published during the period of January 1, 1996 to December 31, 2019. The quality of studies was assessed using Hoy's Critical Assessment Checklist. The study was undertaken using the random effects model, and data were analyzed using STATA14. Data on 60 articles, including data on 30801 individuals, published between 1997 and 2019, entered the study. The findings showed the prevalence of incivility to be 55.10% (95%, CI: 48.05, 62.06). Due to the high prevalence of uncivil behavior, especially of the verbal type, nursing managers should identify risk factors in the workplace. Planners should develop programs to increase workplace safety, especially in centers that are most exposed to these behaviors. It is also recommended that future studies focus on implementation of effective evidence-based interventions based on organizational culture.
PubMed: 35035802
DOI: 10.18502/jmehm.v14i15.7670 -
Journal of Neurodevelopmental Disorders Aug 2023Subtle abnormalities in children's intelligence, motor skills, and psychology from various assisted reproductive treatments (ARTs) might be underdiagnosed. Understanding... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Subtle abnormalities in children's intelligence, motor skills, and psychology from various assisted reproductive treatments (ARTs) might be underdiagnosed. Understanding the prognosis of intelligence, motor skills, and psychology in children from ART would provide parents with reasonable expectations and enable them to plan relevant support to achieve the optimum potential in ART children.
METHODS
We searched PubMed, EMBASE, Ovid, Google Scholar, and Scopus databases until April 13, 2021, to identify relevant studies. Thirty-four studies met the inclusion and exclusion criteria. The meta-analysis employed a standardized mean difference model. The outcome of this study is to compare intelligence quotient (IQ), motoric ability, and behavioral problems between all ARTs, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) to naturally conceived (NC) children. Subdomains of intelligence based on the Cattell, Horn, and Carroll Model (CHC Model) of cognitive architecture, including fluid reasoning, short-term and working memory, processing speed, visual-spatial ability, long-term memory retrieval, and crystalized intelligence (knowledge), were evaluated and summarized in details. Motor skill was stratified into two domains: gross motoric and fine motoric. Behavioral problem was categorized as externalizing and internalizing behavior.
RESULTS
Meta-analysis showed that verbal intelligence score in IVF toddlers is significantly lower than NC toddlers (p = 0.02); conversely, ICSI toddlers scored significantly higher verbal intelligence score compared to NC toddlers (p = 0.005). Toddlers born after ART had significantly lower non-verbal intelligence score (p = 0.047). IVF toddlers scored significantly lower fine motor score (p = 0.01) compared to naturally conceived toddlers. Based on parent's CBCL, NC toddlers had higher total (p = 0.01) and externalizing behavior (p = 0.001) scores compared to ART toddlers. Evaluation of full scale IQ and all domains of intelligence in preschool and primary school children revealed that no significant differences exist between ART and NC children. Based on preschool and primary school parents' CBCL, IVF children had significantly lower externalizing behavior score compared to NC children (p = 0.04). Meta-analyses of studies on young adolescents revealed that ART young adolescents scored higher academically than their NC counterparts, including on mathematics (p < 0.00001) and reading or language (p < 0.00001).
CONCLUSIONS
Despite differences in certain aspects, this finding suggests that ART is unlikely to cause negative impacts on children's neurodevelopment.
Topics: Adolescent; Humans; Male; Child, Preschool; Child; Semen; Intelligence; Problem Behavior; Language; Memory, Short-Term
PubMed: 37608302
DOI: 10.1186/s11689-023-09490-0 -
Journal of Medical Internet Research May 2017Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal... (Review)
Review
BACKGROUND
Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal behavior. In Internet-based eHealth interventions, ECAs may be used for the delivery of automated human support factors.
OBJECTIVE
We aim to provide an overview of the technological and clinical possibilities, as well as the evidence base for ECA applications in clinical psychology, to inform health professionals about the activity in this field of research.
METHODS
Given the large variety of applied methodologies, types of applications, and scientific disciplines involved in ECA research, we conducted a systematic scoping review. Scoping reviews aim to map key concepts and types of evidence underlying an area of research, and answer less-specific questions than traditional systematic reviews. Systematic searches for ECA applications in the treatment of mood, anxiety, psychotic, autism spectrum, and substance use disorders were conducted in databases in the fields of psychology and computer science, as well as in interdisciplinary databases. Studies were included if they conveyed primary research findings on an ECA application that targeted one of the disorders. We mapped each study's background information, how the different disorders were addressed, how ECAs and users could interact with one another, methodological aspects, and the study's aims and outcomes.
RESULTS
This study included N=54 publications (N=49 studies). More than half of the studies (n=26) focused on autism treatment, and ECAs were used most often for social skills training (n=23). Applications ranged from simple reinforcement of social behaviors through emotional expressions to sophisticated multimodal conversational systems. Most applications (n=43) were still in the development and piloting phase, that is, not yet ready for routine practice evaluation or application. Few studies conducted controlled research into clinical effects of ECAs, such as a reduction in symptom severity.
CONCLUSIONS
ECAs for mental disorders are emerging. State-of-the-art techniques, involving, for example, communication through natural language or nonverbal behavior, are increasingly being considered and adopted for psychotherapeutic interventions in ECA research with promising results. However, evidence on their clinical application remains scarce. At present, their value to clinical practice lies mostly in the experimental determination of critical human support factors. In the context of using ECAs as an adjunct to existing interventions with the aim of supporting users, important questions remain with regard to the personalization of ECAs' interaction with users, and the optimal timing and manner of providing support. To increase the evidence base with regard to Internet interventions, we propose an additional focus on low-tech ECA solutions that can be rapidly developed, tested, and applied in routine practice.
Topics: Communication; Humans; Psychology, Clinical; Telemedicine
PubMed: 28487267
DOI: 10.2196/jmir.6553 -
International Journal of Environmental... Jan 2021Rett Syndrome is an x linked developmental disorder which becomes apparent in females after 6 to 18 months of age. It leads to severe impairments including loss of... (Review)
Review
Rett Syndrome is an x linked developmental disorder which becomes apparent in females after 6 to 18 months of age. It leads to severe impairments including loss of speech, loss of hand movements/manual dexterity, characteristic hand movements such as hang wringing and intellectual disability/learning problems. This systematic review was carried out to identify the dental manifestation of Rett syndrome and to shed light on treatment options available for oral health problems associated with Rett syndrome. A systematic literature search was conducted on the PubMed, Scopus, Biomed, Web of Science, Embase, Google Scholars, Cochrane and CINAHL using the following entries: Rett syndrome ( = 3790), Oral health and Rett syndrome ( = 17), dental health of Rett syndrome patients ( = 13), and the MeSH terms listed below: Rett syndrome and Oral Health ( = 17), Rett syndrome and dentistry ( = 29). The final review included 22 search articles. The most common oral findings was bruxism. Masseteric hypertrophy was also reported. Anterior open bite and non-physiological tooth wear was observed. Other oral manifestations of Rett syndrome included mouth breathing, tongue thrusting, digit/thumb sucking, high arch palate. Increased awareness and dental education amongst dentists and assistants regarding the dental manifestations of Rett syndrome and similar neurodevelopmental disorders is required to improve the level of care and empathy they can provide to these differently able patients. Research on dental aspects of Rett is scarce and this remains a neglected topic.
Topics: Bruxism; Female; Hand; Humans; Rett Syndrome; Speech
PubMed: 33525609
DOI: 10.3390/ijerph18031162 -
Journal of General Internal Medicine Dec 2021Many health providers and communicators who are concerned that patients will not understand numbers instead use verbal probabilities (e.g., terms such as "rare" or...
INTRODUCTION
Many health providers and communicators who are concerned that patients will not understand numbers instead use verbal probabilities (e.g., terms such as "rare" or "common") to convey the gist of a health message.
OBJECTIVE
To assess patient interpretation of and preferences for verbal probability information in health contexts.
METHODS
We conducted a systematic review of literature published through September 2020. Original studies conducted in English with samples representative of lay populations were included if they assessed health-related information and elicited either (a) numerical estimates of verbal probability terms or (b) preferences for verbal vs. quantitative risk information.
RESULTS
We identified 33 original studies that referenced 145 verbal probability terms, 45 of which were included in at least two studies and 19 in three or more. Numerical interpretations of each verbal term were extremely variable. For example, average interpretations of the term "rare" ranged from 7 to 21%, and for "common," the range was 34 to 71%. In a subset of 9 studies, lay estimates of verbal probability terms were far higher than the standard interpretations established by the European Commission for drug labels. In 10 of 12 samples where preferences were elicited, most participants preferred numerical information, alone or in combination with verbal labels.
CONCLUSION
Numerical interpretation of verbal probabilities is extremely variable and does not correspond well to the numerical probabilities established by expert panels. Most patients appear to prefer quantitative risk information, alone or in combination with verbal labels. Health professionals should be aware that avoiding numeric information to describe risks may not match patient preferences, and that patients interpret verbal risk terms in a highly variable way.
Topics: Humans; Probability
PubMed: 34357577
DOI: 10.1007/s11606-021-07050-7 -
Brain Sciences Jul 2021Interpersonal distance (IPD) plays a critical role in a human being's social life, especially during interpersonal interaction, and IPD is non-verbal social information... (Review)
Review
BACKGROUND
Interpersonal distance (IPD) plays a critical role in a human being's social life, especially during interpersonal interaction, and IPD is non-verbal social information and not only provides silent cues but also provides a secure space for personal relationships. IPD has been a research field of neural studies from the recent decade, researches had provided behavior and neural correlates of IPD.
OBJECTIVES
This review aims to summarize the experimental paradigms of IPD-neural research, to reveal the neural activity processes associated with it, and to explore the correlation between IPD-neural activity and IPD-behavior.
METHODS
We conducted a standardized systematic review procedure, including the formal search method be adopted to seek out any type of studies related to IPD and brain, then devised them into categories to make a systematic review.
RESULTS
17 articles met the inclusion criteria of the review, 5 event-related potential (ERP) studies measured the amplitude and latencies of ERPs, and 12 functional magnetic resonance imaging (fMRI) studies provided the neural activation during IPD tasks. In addition, the passive IPD experimental paradigm is the main experimental paradigm for exploring neural activity in IPD cognition, with the parietal lobe, motor areas, prefrontal lobe, and amygdala being the main brain areas involved. Functional connections between the identified brain regions were found and have a moderate correlation with IPD behavior.
CONCLUSIONS
This review provides the neural activity of the IPD interaction process. However, the insufficient ecological validity of IPD tasks and ignore the initiative of people in IPD interaction. Therefore, there is a large research space on this topic. The work of the current systematic review contributed to linking the external performance and inner neural activities of IPD.
PubMed: 34439634
DOI: 10.3390/brainsci11081015 -
Journal of Medical Internet Research Jan 2024Embodied conversational agents (ECAs) are computer-generated animated humanlike characters that interact with users through verbal and nonverbal behavioral cues. They... (Review)
Review
BACKGROUND
Embodied conversational agents (ECAs) are computer-generated animated humanlike characters that interact with users through verbal and nonverbal behavioral cues. They are increasingly used in a range of fields, including health care.
OBJECTIVE
This scoping review aims to identify the current practice in the development and evaluation of ECAs for chronic diseases.
METHODS
We applied a methodological framework in this review. A total of 6 databases (ie, PubMed, Embase, CINAHL, ACM Digital Library, IEEE Xplore Digital Library, and Web of Science) were searched using a combination of terms related to ECAs and health in October 2023. Two independent reviewers selected the studies and extracted the data. This review followed the PRISMA-ScR (Preferred Reporting Items of Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) statement.
RESULTS
The literature search found 6332 papers, of which 36 (0.57%) met the inclusion criteria. Among the 36 studies, 27 (75%) originated from the United States, and 28 (78%) were published from 2020 onward. The reported ECAs covered a wide range of chronic diseases, with a focus on cancers, atrial fibrillation, and type 2 diabetes, primarily to promote screening and self-management. Most ECAs were depicted as middle-aged women based on screenshots and communicated with users through voice and nonverbal behavior. The most frequently reported evaluation outcomes were acceptability and effectiveness.
CONCLUSIONS
This scoping review provides valuable insights for technology developers and health care professionals regarding the development and implementation of ECAs. It emphasizes the importance of technological advances in the embodiment, personalized strategy, and communication modality and requires in-depth knowledge of user preferences regarding appearance, animation, and intervention content. Future studies should incorporate measures of cost, efficiency, and productivity to provide a comprehensive evaluation of the benefits of using ECAs in health care.
Topics: Middle Aged; Humans; Female; Diabetes Mellitus, Type 2; Communication; Chronic Disease; Voice; Atrial Fibrillation
PubMed: 38194260
DOI: 10.2196/47134 -
Systematic Reviews Jul 2023We systematically reviewed the literature and performed a meta-analysis on the effects of speech therapy and phonosurgery, for transgender women, in relation to the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
We systematically reviewed the literature and performed a meta-analysis on the effects of speech therapy and phonosurgery, for transgender women, in relation to the fundamental frequency gain of the voice, regarding the type of vocal sample collected, and we compared the effectiveness of the treatments. In addition, the study design, year, country, types of techniques used, total therapy time, and vocal assessment protocols were analyzed.
METHODS
We searched the PubMed, Lilacs, and SciELO databases for observational studies and clinical trials, published in English, Portuguese, or Spanish, between January 2010 and January 2023. The selection of studies was carried out according to Prisma 2020. The quality of selected studies was assessed using the Newcastle-Ottawa scale.
RESULTS
Of 493 studies, 31 were deemed potentially eligible and retrieved for full-text review and 16 were included in the systematic review and meta-analysis. Six studies performed speech therapy and ten studies phonosurgery. The speech therapy time did not influence the post-treatment gain in voice fundamental frequency (p = 0.6254). The type of sample collected significantly influenced the post-treatment voice frequency gain (p < 0.01). When the vocal sample was collected through vowel (p < 0.01) and reading (p < 0.01), the gain was significantly more heterogeneous between the different types of treatment. Phonosurgery is significantly more effective in terms of fundamental frequency gain compared to speech therapy alone, regardless of the type of sample collected (p < 0.01). The average gain of fundamental frequency after speech therapy, in the /a/ vowel sample, was 27 Hz, 39.05 Hz in reading, and 25.42 Hz in spontaneous speech. In phonosurgery, there was a gain of 71.68 Hz for the vowel /a/, 41.07 Hz in reading, and 39.09 Hz in spontaneous speech. The study with the highest gain (110 Hz) collected vowels, and the study with the lowest gain (15 Hz), spontaneous speech. The major of the included studies received a score between 4 and 8 on the Newcastle-Ottawa Scale.
CONCLUSION
The type of vocal sample collected influences the gain result of the fundamental frequency after treatment. Speech therapy and phonosurgery increased the fundamental frequency and improved female voice perception and vocal satisfaction. However, phonosurgery yielded a greater fundamental frequency gain in the different samples collected. The study protocol was registered at Prospero (CRD42017078446).
Topics: Female; Humans; Speech Therapy; Transgender Persons; Speech; Voice; Databases, Factual
PubMed: 37481572
DOI: 10.1186/s13643-023-02267-5 -
Sensors (Basel, Switzerland) Feb 2022The automatic emotion recognition domain brings new methods and technologies that might be used to enhance therapy of children with autism. The paper aims at the... (Review)
Review
The automatic emotion recognition domain brings new methods and technologies that might be used to enhance therapy of children with autism. The paper aims at the exploration of methods and tools used to recognize emotions in children. It presents a literature review study that was performed using a systematic approach and PRISMA methodology for reporting quantitative and qualitative results. Diverse observation channels and modalities are used in the analyzed studies, including facial expressions, prosody of speech, and physiological signals. Regarding representation models, the basic emotions are the most frequently recognized, especially happiness, fear, and sadness. Both single-channel and multichannel approaches are applied, with a preference for the first one. For multimodal recognition, early fusion was the most frequently applied. SVM and neural networks were the most popular for building classifiers. Qualitative analysis revealed important clues on participant group construction and the most common combinations of modalities and methods. All channels are reported to be prone to some disturbance, and as a result, information on a specific symptoms of emotions might be temporarily or permanently unavailable. The challenges of proper stimuli, labelling methods, and the creation of open datasets were also identified.
Topics: Autistic Disorder; Child; Emotions; Facial Expression; Humans; Recognition, Psychology; Speech
PubMed: 35214551
DOI: 10.3390/s22041649 -
Journal of Alzheimer's Disease : JAD 2023Semantic and Phonological fluency (SF and PF) are routinely evaluated in patients with Alzheimer's disease (AD). There are disagreements in the literature regarding... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Semantic and Phonological fluency (SF and PF) are routinely evaluated in patients with Alzheimer's disease (AD). There are disagreements in the literature regarding which fluency task is more affected while developing AD. Most studies focus on SF assessment, given its connection with the temporoparietal amnesic system. PF is less reported, it is related to working memory, which is also impaired in probable and diagnosed AD. Differentiating between performance on these tasks might be informative in early AD diagnosis, providing an accurate linguistic profile.
OBJECTIVE
Compare SF and PF performance in healthy volunteers, volunteers with probable AD, and patients with AD diagnosis, considering the heterogeneity of age, gender, and educational level variables.
METHODS
A total of 8 studies were included for meta-analysis, reaching a sample size of 1,270 individuals (568 patients diagnosed with AD, 340 with probable AD diagnosis, and 362 healthy volunteers).
RESULTS
The three groups consistently performed better on SF than PF. When progressing to a diagnosis of AD, we observed a significant difference in SF and PF performance across our 3 groups of interest (p = 0.04). The age variable explained a proportion of this difference in task performance across the groups, and as age increases, both tasks equally worsen.
CONCLUSION
The performance of SF and PF might play a differential role in early AD diagnosis. These tasks rely on partially different neural bases of language processing. They are thus worth exploring independently in diagnosing normal aging and its transition to pathological stages, including probable and diagnosed AD.
Topics: Humans; Semantics; Alzheimer Disease; Verbal Behavior; Neuropsychological Tests; Linguistics
PubMed: 37482994
DOI: 10.3233/JAD-221272