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Critical Reviews in Food Science and... 2021To examine the relation between the consumption or avoidance of meat and psychological health and well-being. A systematic search of online databases (PubMed, PsycINFO,...
To examine the relation between the consumption or avoidance of meat and psychological health and well-being. A systematic search of online databases (PubMed, PsycINFO, CINAHL Plus, Medline, and Cochrane Library) was conducted for primary research examining psychological health in meat-consumers and meat-abstainers. Inclusion criteria were the provision of a clear distinction between meat-consumers and meat-abstainers, and data on factors related to psychological health. Studies examining meat consumption as a continuous or multi-level variable were excluded. Summary data were compiled, and qualitative analyses of methodologic rigor were conducted. The main outcome was the disparity in the prevalence of depression, anxiety, and related conditions in meat-consumers versus meat-abstainers. Secondary outcomes included mood and self-harm behaviors. Eighteen studies met the inclusion/exclusion criteria; representing 160,257 participants (85,843 females and 73,232 males) with 149,559 meat-consumers and 8584 meat-abstainers (11 to 96 years) from multiple geographic regions. Analysis of methodologic rigor revealed that the studies ranged from low to severe risk of bias with high to very low confidence in results. Eleven of the 18 studies demonstrated that meat-abstention was associated with poorer psychological health, four studies were equivocal, and three showed that meat-abstainers had better outcomes. The most rigorous studies demonstrated that the prevalence or risk of depression and/or anxiety were significantly greater in participants who avoided meat consumption. Studies examining the relation between the consumption or avoidance of meat and psychological health varied substantially in methodologic rigor, validity of interpretation, and confidence in results. The majority of studies, and especially the higher quality studies, showed that those who avoided meat consumption had significantly higher rates or risk of depression, anxiety, and/or self-harm behaviors. There was mixed evidence for temporal relations, but study designs and a lack of rigor precluded inferences of causal relations. Our study does not support meat avoidance as a strategy to benefit psychological health.
Topics: Anxiety; Depression; Diet, Vegetarian; Female; Humans; Male; Meat; Mental Health
PubMed: 32308009
DOI: 10.1080/10408398.2020.1741505 -
Pain Research & Management 2022Cognitive-behavioral therapy (CBT) is commonly adopted in pain management programs for patients with chronic low back pain (CLBP). However, the benefits of CBT are still... (Meta-Analysis)
Meta-Analysis
Evaluation of Cognitive Behavioral Therapy on Improving Pain, Fear Avoidance, and Self-Efficacy in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis.
BACKGROUND
Cognitive-behavioral therapy (CBT) is commonly adopted in pain management programs for patients with chronic low back pain (CLBP). However, the benefits of CBT are still unclear.
OBJECTIVES
This review investigated the effectiveness of CBT on pain, disability, fear avoidance, and self-efficacy in patients with CLBP.
METHODS
Databases including PubMed, EMBASE, Web of Science, Cochrane Library, and PsycINFO were searched. RCTs examining the effects of CBT in adults with CLBP were included. The data about the outcome of pain, disability, fear avoidance, and self-efficacy were retained. Subgroup analysis about the effects of CBT on posttreatment was conducted according to CBT versus control groups (waiting list/usual care, active therapy) and concurrent CBT versus CBT alone. A random-effects model was used, and statistical heterogeneity was explored.
RESULTS
22 articles were included. The results indicated that CBT was superior to other therapies in improving disability (SMD -0.44, 95% CI -0.71 to -0.17, < 0.05), pain (SMD -0.32, 95% CI -0.57 to -0.06, < 0.05), fear avoidance (SMD -1.24, 95% CI -2.25 to -0.23, < 0.05), and self-efficacy (SMD 0.27, 95% CI 0.15 to 0.40, < 0.05) after intervention. No different effect was observed between CBT and other therapies in all the follow-up terms. Subgroup analysis suggested that CBT in conjunction with other interventions was in favor of other interventions alone to reduce pain and disability ( < 0.05).
CONCLUSION
CBT is beneficial in patients with CLBP for improving pain, disability, fear avoidance, and self-efficacy in CLBP patients. Further study is recommended to investigate the long-term benefits of CBT. This meta-analysis is registered with Prospero (registration number CRD42021224837).
Topics: Adult; Cognitive Behavioral Therapy; Fear; Humans; Low Back Pain; Pain Management; Self Efficacy
PubMed: 35345623
DOI: 10.1155/2022/4276175 -
Physiotherapy Sep 2022Studies consistently suggest that work as a physical therapist is associated with burnout, yet no review of the contributing factors has been conducted. (Review)
Review
BACKGROUND
Studies consistently suggest that work as a physical therapist is associated with burnout, yet no review of the contributing factors has been conducted.
OBJECTIVE
To identify and examine the risk factors associated with physical therapist burnout.
DATA SOURCES
PubMed, Embase, CINAHL, and the Cochrane Library were searched from inception to May 2020.
ELIGIBILITY CRITERIA
Quantitative studies of physical therapists in clinical practice who experience burnout symptoms or syndrome.
DATA EXTRACTION AND DATA SYNTHESIS
Risk factors such as characteristics of the participant, environment, structures, and experiences that demonstrate a significant predisposition to burnout were extracted. The modified Downs and Black checklist was used to identify risk of bias.
RESULTS
Forty-six studies (8717 participants) were included. The risk of bias assessment determined all were of fair or poor quality. Fifty-three risk factors were identified, with four being classified as unavoidable and forty-nine determined as avoidable. The avoidable risk factors were further categorized as either structural/organizational (32%), psychological/emotional (19%), environmental (19%), or sociodemographic (13%).
LIMITATIONS
A risk factor's importance may not correlate with its prevalence, and the low-quality studies limit the ability to make definitive conclusions.
CONCLUSION
A significant amount of literature has identified a wide variety of risk factors. The majority are avoidable, and the effect and degree to which each risk factor contributes to burnout varies. The identified risk factors can help develop targeted prevention and intervention strategies for the benefit of physical therapists, organizations, and policymakers.
FUNDING
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
SYSTEMATIC REVIEW REGISTRATION NUMBER
PROSPERO CRD42020136356.
Topics: Burnout, Professional; Humans; Physical Therapists; Qualitative Research; Risk Factors
PubMed: 35569408
DOI: 10.1016/j.physio.2022.01.005 -
International Journal of Environmental... Dec 2021Chronic low back pain (CLBP) is the most common cause of disability worldwide, affecting about 12% to 30% of the adult population. Psychological factors play an... (Meta-Analysis)
Meta-Analysis Review
Chronic low back pain (CLBP) is the most common cause of disability worldwide, affecting about 12% to 30% of the adult population. Psychological factors play an important role in the experience of pain, and may be predictive of pain persistence, disability, and long-term sick leave. The aim of this meta-analysis was to identify and to describe the most common psychological approaches used to treat patients who suffer from CLBP. A systematic search was performed on PubMed/MEDLINE and Cochrane Central. Overall, 16 studies with a total of 1058 patients were included in the analysis. Our results suggest that cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) interventions are both associated with an improvement in terms of pain intensity and quality of life when singularly compared to usual care. Disability also improved in both groups when compared to usual care. Significant differences in fear-avoidance beliefs were noted in the CBT group compared to usual care. Therefore, psychological factors are related to and influence CLBP. It is crucial to develop curative approaches that take these variables into account. Our findings suggest that CBT and MBSR modify pain-related outcomes and that they could be implemented in clinical practice.
Topics: Adult; Chronic Pain; Cognitive Behavioral Therapy; Humans; Low Back Pain; Mindfulness; Quality of Life
PubMed: 35010319
DOI: 10.3390/ijerph19010060 -
European Eating Disorders Review : the... Mar 2023Avoidant/restrictive food intake disorder (ARFID) was a new diagnosis in DSM-5. This systematic review explores what is known to date about the epidemiology of ARFID in... (Review)
Review
BACKGROUND
Avoidant/restrictive food intake disorder (ARFID) was a new diagnosis in DSM-5. This systematic review explores what is known to date about the epidemiology of ARFID in children and adolescents.
METHOD
Embase, Medline and PsycInfo were used to identify studies meeting inclusion criteria. PRISMA guidelines were followed.
RESULTS
Thirty studies met inclusion criteria, with most coming from specialised eating disorder services where prevalence rates were 5%-22.5%. Three studies from specialist feeding clinics showed the highest prevalence rates, ranging from 32% to 64%. Studies from non-clinical samples reported ARFID prevalence estimates ranging from 0.3% to 15.5%. One study, using national surveillance methodology, reported the incidence of ARFID in children and adolescents reaching clinical care to be 2.02 per 100,000 patients. Psychiatric comorbidity was common, especially anxiety disorders (9.1%-72%) and autism spectrum disorder (8.2%-54.75%).
CONCLUSION
The current literature on the epidemiology of ARFID in children and adolescents is limited. Studies are heterogeneous with regard to setting and sample characteristics, with a wide range of prevalence estimates. Further studies, especially using surveillance methodology, will help to better understand the nature of this disorder and estimate clinical service needs.
Topics: Humans; Child; Adolescent; Avoidant Restrictive Food Intake Disorder; Feeding and Eating Disorders; Autism Spectrum Disorder; Retrospective Studies; Eating
PubMed: 36527163
DOI: 10.1002/erv.2964 -
Sports Medicine (Auckland, N.Z.) Dec 2022To improve the understanding of the psychological impacts of anterior cruciate ligament (ACL) injury, a systematic review synthesizing the evidence on knee... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To improve the understanding of the psychological impacts of anterior cruciate ligament (ACL) injury, a systematic review synthesizing the evidence on knee self-efficacy, fear avoidance beliefs and kinesiophobia following ACL injury is needed.
OBJECTIVE
The aim of this systematic review was to investigate knee self-efficacy, fear avoidance beliefs and kinesiophobia following ACL injury, and compare these outcomes following management with rehabilitation alone, early and delayed ACL reconstruction (ACLR).
METHODS
Seven databases were searched from inception to April 14, 2022. Articles were included if they assessed Tampa Scale of Kinesiophobia (TSK), Knee Self-Efficacy Scale (KSES), or Fear Avoidance Beliefs Questionnaire (FABQ). Risk of bias (RoB) was assessed using domain-based RoB tools (ROBINS-1, RoB 2, RoBANS), and GRADE-assessed certainty of evidence. Random-effects meta-analyses pooled outcomes, stratified by time post-injury (pre-operative, 3-6 months, 7-12 months, > 1-2 years, > 2-5 years, > 5 years).
RESULTS
Seventy-three studies (70% high RoB) were included (study outcomes: TSK: 55; KSES: 22; FABQ: 5). Meta-analysis demonstrated worse kinesiophobia and self-efficacy pre-operatively (pooled mean [95% CI], TSK-11: 23.8 [22.2-25.3]; KSES: 5.0 [4.4-5.5]) compared with 3-6 months following ACLR (TSK-11: 19.6 [18.7-20.6]; KSES: 19.6 [18.6-20.6]). Meta-analysis suggests similar kinesiophobia > 3-6 months following early ACLR (19.8 [4.9]) versus delayed ACLR (17.2 [5.0]). Only one study assessed outcomes comparing ACLR with rehabilitation only.
CONCLUSIONS
Knee self-efficacy and kinesiophobia improved from pre-ACLR to 3-6 months following ACLR, with similar outcomes after 6 months. Since the overall evidence was weak, there is a need for high-quality observational and intervention studies focusing on psychological outcomes following ACL injury.
Topics: Humans; Anterior Cruciate Ligament Injuries; Self Efficacy; Knee Joint; Fear; Anterior Cruciate Ligament Reconstruction
PubMed: 35963980
DOI: 10.1007/s40279-022-01739-3 -
Psychiatry Research Mar 2020Anxiety disorders are highly prevalent in the general population and associated with high rates of impairment and disability. This burden highlights the need to identify...
Anxiety disorders are highly prevalent in the general population and associated with high rates of impairment and disability. This burden highlights the need to identify risk factors that individuals can modify without professional intervention. A systematic review was conducted to identify studies that examined modifiable risk and protective factors for anxiety disorders among adults in the general population. Searches were conducted in PubMed, PsycINFO and MEDLINE using medical subject headings and text words related to risk factors, protective factors, and each anxiety disorder. Screening, data extraction, and quality assessment were performed by three study authors. Modifiable risk and protective factors from 19 studies across seven countries were identified. Risk factors identified included cigarette smoking, alcohol use, cannabis use, negative appraisals of life events, avoidance, and occupational factors. Protective factors included social support, coping, and physical activity. Cigarette smoking was the most studied risk factor. Support was found for cigarette smoking as a risk factor for agoraphobia and panic disorder. Mixed results were found for generalized anxiety disorder and specific phobia. Across disorders, smoking frequency was associated with greater risk. Results indicate an important gap in the literature in that few studies have examined modifiable risk factors for anxiety disorders.
Topics: Adult; Agoraphobia; Anxiety Disorders; Avoidance Learning; Cigarette Smoking; Cross-Sectional Studies; Female; Humans; Male; Occupational Health; Panic Disorder; Prevalence; Protective Factors; Retrospective Studies; Risk Factors; Substance-Related Disorders
PubMed: 31839417
DOI: 10.1016/j.psychres.2019.112705 -
Preventing food allergy in infancy and childhood: Systematic review of randomised controlled trials.Pediatric Allergy and Immunology :... Oct 2020This systematic review of ways to prevent immediate-onset/IgE-mediated food allergy will inform guidelines by the European Academy of Allergy and Immunology (EAACI).
BACKGROUND
This systematic review of ways to prevent immediate-onset/IgE-mediated food allergy will inform guidelines by the European Academy of Allergy and Immunology (EAACI).
METHODS
The GRADE approach was used. Eleven databases were searched from 1946 to October 2019 for randomized controlled trials (and large prospective cohort studies in the case of breastfeeding). The studies included heterogeneous interventions, populations, and outcomes and so were summarized narratively.
RESULTS
Forty-six studies examined interventions to reduce the risk of food allergy in infancy (up to 1 year) or early childhood. The following interventions for pregnant or breastfeeding women and/or infants may have little to no effect on preventing food allergy, but the evidence is very uncertain: dietary avoidance of food allergens, vitamin supplements, fish oil, probiotics, prebiotics, synbiotics, and emollients. Breastfeeding, hydrolyzed formulas, and avoiding cow's milk formula may not reduce the risk of cow's milk protein allergy; however, temporary supplementation with cow's milk formula in the first week of life may increase the risk of cow's milk allergy. Introducing well-cooked egg, but not pasteurized raw egg, from 4 to 6 months probably reduces the risk of hen's egg allergy. Introducing regular peanut consumption into the diet of an infant at increased risk beginning from 4 to 11 months probably results in a large reduction in peanut allergy in countries with a high prevalence. These conclusions about introducing peanut are based on moderate certainty evidence, from single trials in high-income countries.
CONCLUSIONS
Sixty percent of the included studies were published in the last 10 years, but much still remains to be understood about preventing food allergy. In particular, there is a need to validate the potential benefits of early introduction of food allergens in a wider range of populations.
Topics: Adolescent; Allergens; Animals; Breast Feeding; Child; Child, Preschool; Diet; Egg Hypersensitivity; Female; Food Hypersensitivity; Humans; Infant; Infant Formula; Male; Milk; Milk Hypersensitivity; Milk, Human; Peanut Hypersensitivity; Pregnancy; Probiotics; Protein Hydrolysates; Randomized Controlled Trials as Topic
PubMed: 32396244
DOI: 10.1111/pai.13273 -
European Radiology Nov 2022(1) To evaluate the diagnostic performance of radiomics in differentiating high-grade glioma from brain metastasis and how to improve the model. (2) To assess the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
(1) To evaluate the diagnostic performance of radiomics in differentiating high-grade glioma from brain metastasis and how to improve the model. (2) To assess the methodological quality of radiomics studies and explore ways of embracing the clinical application of radiomics.
METHODS
Studies using radiomics to differentiate high-grade glioma from brain metastasis published by 26 July 2021 were systematically reviewed. Methodological quality and risk of bias were assessed using the Radiomics Quality Score (RQS) system and Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool, respectively. Pooled sensitivity and specificity of the radiomics model were also calculated.
RESULTS
Seventeen studies combining 1,717 patients were included in the systematic review, of which 10 studies without data leakage suspicion were employed for the quantitative statistical analysis. The average RQS was 5.13 (14.25% of total), with substantial or almost perfect inter-rater agreements. The inclusion of clinical features in the radiomics model was only reported in one study, as was the case for publicly available algorithm code. The pooled sensitivity and specificity were 84% (95% CI, 80-88%) and 84% (95% CI, 81-87%), respectively. The performances of feature extraction from the volume of interest (VOI) or (semi) automatic segmentation in the radiomics models were superior to those of protocols employing region of interest (ROI) or manual segmentation.
CONCLUSION
Radiomics can accurately differentiate high-grade glioma from brain metastasis. The adoption of standardized workflow to avoid potential data leakage as well as the integration of clinical features and radiomics are advised to consider in future studies.
KEY POINTS
• The pooled sensitivity and specificity of radiomics for differentiating high-grade gliomas from brain metastasis were 84% and 84%, respectively. • Avoiding potential data leakage by adopting an intensive and standardized workflow is essential to improve the quality and generalizability of the radiomics model. • The application of radiomics in combination with clinical features in differentiating high-grade gliomas from brain metastasis needs further validation.
Topics: Humans; Magnetic Resonance Imaging; Glioma; Brain Neoplasms; Sensitivity and Specificity
PubMed: 35587827
DOI: 10.1007/s00330-022-08828-x -
Revista Paulista de Pediatria : Orgao... 2020To identify the factors associated with food neophobia in children through a systematic review.
OBJECTIVE
To identify the factors associated with food neophobia in children through a systematic review.
DATA SOURCES
This research was based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The research was carried out in the PubMed, Science Direct, and Scientific Electronic Library Online databases, with the combination of health descriptors in English and Portuguese: ("Food Neophobia" OR "Feeding Behavior" OR "Food Preferences" OR "Food Selectivity") AND Child, from 2000 to 2019. Studies that evaluated factors associated with food neophobia in children were included. The quality of the studies was assessed using the Effective Public Health Practice Project: Quality Assessment Tool for Quantitative Studies (QATQS).
DATA SYNTHESIS
19 studies were included in the systematic review. The prevalence of food neophobia ranged from 12.8 to 100%. The studies used three different scales to measure the level of food neophobia. The main factors associated with food neophobia were: parental influence on children's eating habits, children's innate preference for sweet and savory flavors, influence of the sensory aspect of the food, parents' pressure for the child to eat, parents' lack of encouragement and/or affection at mealtime, childhood anxiety, and diets with low variety and low nutritional quality.
CONCLUSIONS
The factors associated with food neophobia permeate several areas of the child's life, thus, interprofessional follow-up becomes essential in the intervention process.
Topics: Adolescent; Anxiety; Avoidant Restrictive Food Intake Disorder; Child; Child, Preschool; Feeding Behavior; Female; Food Preferences; Humans; Male; Parent-Child Relations; Parenting; Risk Factors; Severity of Illness Index
PubMed: 33175005
DOI: 10.1590/1984-0462/2021/39/2020089