-
Archives of Suicide Research : Official... 2020This study aimed to systemically review the literature regarding self-harm, emotion regulation, and experiential avoidance. Articles were identified through systematic...
This study aimed to systemically review the literature regarding self-harm, emotion regulation, and experiential avoidance. Articles were identified through systematic searches of several databases using combinations of the phrases "emotion regulation" AND "experiential avoidance" AND "self-harm," or "self-injury," and "BPD" or "Borderline Personality Disorder." Additional searches were conducted inclusive of terms related to experiential avoidance and emotion regulation, as well as other disorders related to self-harm. 17 articles were identified and reviewed. Results tentatively support the role of experiential avoidance in self-harm; some studies described phenomena similar to experiential avoidance without using the term. Poor emotion regulation was often cited as a reason for engagement in self-harm. Several gaps in the literature were identified and discussed.
Topics: Avoidance Learning; Borderline Personality Disorder; Emotional Regulation; Humans; Self-Injurious Behavior
PubMed: 30636566
DOI: 10.1080/13811118.2018.1563575 -
Sensors (Basel, Switzerland) Oct 2022The Internet of Things (IoT) is a complete ecosystem encompassing various communication technologies, sensors, hardware, and software. IoT cutting-edge technologies and... (Review)
Review
The Internet of Things (IoT) is a complete ecosystem encompassing various communication technologies, sensors, hardware, and software. IoT cutting-edge technologies and Artificial Intelligence (AI) have enhanced the traditional healthcare system considerably. The conventional healthcare system faces many challenges, including avoidable long wait times, high costs, a conventional method of payment, unnecessary long travel to medical centers, and mandatory periodic doctor visits. A Smart healthcare system, Internet of Things (IoT), and AI are arguably the best-suited tailor-made solutions for all the flaws related to traditional healthcare systems. The primary goal of this study is to determine the impact of IoT, AI, various communication technologies, sensor networks, and disease detection/diagnosis in Cardiac healthcare through a systematic analysis of scholarly articles. Hence, a total of 104 fundamental studies are analyzed for the research questions purposefully defined for this systematic study. The review results show that deep learning emerges as a promising technology along with the combination of IoT in the domain of E-Cardiac care with enhanced accuracy and real-time clinical monitoring. This study also pins down the key benefits and significant challenges for E-Cardiology in the domains of IoT and AI. It further identifies the gaps and future research directions related to E-Cardiology, monitoring various Cardiac parameters, and diagnosis patterns.
Topics: Artificial Intelligence; Ecosystem; Wireless Technology; Delivery of Health Care; Technology
PubMed: 36298423
DOI: 10.3390/s22208073 -
International Journal of Environmental... Aug 2022It is well established that access to preventative care, such as breast or cervical cancer screening, can reduce morbidity and mortality. Certain groups may be missed... (Meta-Analysis)
Meta-Analysis Review
It is well established that access to preventative care, such as breast or cervical cancer screening, can reduce morbidity and mortality. Certain groups may be missed out of these healthcare services, such as women with disabilities, as they face many access barriers due to underlying inequalities and negative attitudes. However, the data have not been reviewed on whether women with disabilities face inequalities in the uptake of these services. A systematic review and meta-analysis were conducted to compare the uptake of breast and cervical cancer screening in women with and without disabilities. A search was conducted in July 2021 across four databases: PubMed, MEDLINE, Global Health, and CINAHL. Quantitative studies comparing the uptake of breast or cervical cancer screening between women with and without disabilities were eligible. Twenty-nine studies were included, all from high-income settings. One third of the 29 studies (34.5%, 10) were deemed to have a high risk of bias, and the remainder a low risk of bias. The pooled estimates showed that women with disabilities have 0.78 (95% CI: 0.72-0.84) lower odds of attending breast cancer screening and have 0.63 (95% CI: 0.45-0.88) lower odds of attending cervical cancer screening, compared to women without disabilities. In conclusion, women with disabilities face disparities in receipt of preventative cancer care. There is consequently an urgent need to evaluate and improve the inclusivity of cancer screening programs and thereby prevent avoidable morbidity and mortality.
Topics: Breast Neoplasms; Disabled Persons; Early Detection of Cancer; Female; Humans; Mammography; Mass Screening; Uterine Cervical Neoplasms
PubMed: 35954824
DOI: 10.3390/ijerph19159465 -
Healthcare (Basel, Switzerland) Aug 2023Avoidant/Restrictive food intake disorder (ARFID) is a feeding disorder characterized by persistent difficulty eating, such as limited choices of preferred foods,... (Review)
Review
Avoidant/Restrictive food intake disorder (ARFID) is a feeding disorder characterized by persistent difficulty eating, such as limited choices of preferred foods, avoidance or restriction of certain foods or food groups, and negative emotions related to eating or meals. Although ARFID mainly affects children, it can also occur in adolescents and adults. ARFID can have serious physical and mental health consequences, including stunted growth, nutritional deficiencies, anxiety, and other psychiatric comorbidities. Despite its increasing importance, ARFID is relatively underrecognized and undertreated in clinical practice. Treatment consists of a multidisciplinary approach involving pediatric gastroenterologists, nutritionists, neuropsychiatrists, and psychologists. However, there are several gaps in the therapeutic approach for this condition, mainly due to the lack of interventional trials and the methodological variability of existing studies. Few studies have explored the nutritional management of ARFID, and no standardized guidelines exist to date. We performed a systematic literature review to describe the different nutritional interventions for children and adolescents diagnosed with ARFID and to assess their efficacy and tolerability. We identified seven retrospective cohort studies where patients with various eating and feeding disorders, including ARFID, underwent nutritional rehabilitation in hospital settings. In all studies, similar outcomes emerged in terms of efficacy and tolerability. According to our findings, the oral route should be the preferred way to start the refeeding protocol, and the enteral route should be generally considered a last resort for non-compliant patients or in cases of clinical instability. The initial caloric intake may be adapted to the initial nutritional status, but more aggressive refeeding regimens appear to be well tolerated and not associated with an increased risk of clinical refeeding syndrome (RS). In severely malnourished patients, however, phosphorus or magnesium supplementation may be considered to prevent the risk of electrolyte imbalance, or RS.
PubMed: 37628443
DOI: 10.3390/healthcare11162245 -
PloS One 2023Decision Avoidance (DA) strategies allow people to forego or abandon effortful deliberation by postponing, bypassing, or delegating a decision. DA is thought to reduce... (Meta-Analysis)
Meta-Analysis
Decision Avoidance (DA) strategies allow people to forego or abandon effortful deliberation by postponing, bypassing, or delegating a decision. DA is thought to reduce regret, primarily by allowing decision makers to evade personal responsibility for potential negative outcomes. We tested this relation between DA and post-decision regret in a multilevel meta-analysis of 59 effect estimates coming from 13 papers. Five DA strategies were considered: status quo preservation, action omission, inaction inertia, choice delegation and choice deferral. Across all effects and DA strategies, there was a non-significant trend toward DA reducing regret (Hedges' g = -0.23, p = 0.063). When assessing individual strategies, we found that only status quo preservation reduced regret reliably (Hedges' g = -0.45, p = 0.006). The relationship between DA and regret was unclear for the other DA strategies. We tested a number of moderators for the effect. Only 'previous experience' (i.e., the outcome of a previous decision) influenced the relation between DA and regret reliably. That is, if participants choose the DA option when the same choice previously led to a negative outcome, regret is actually enhanced. Overall, there is clear evidence that status quo preservation can reduce regret, but it is currently unclear whether the same holds for other DA strategies.
Topics: Humans; Decision Making; Emotions; Social Behavior; Apathy; Surveys and Questionnaires
PubMed: 37831709
DOI: 10.1371/journal.pone.0292857 -
International Journal For Quality in... Dec 2023Defensive medicine, characterized by physicians' inclination toward excessive diagnostic tests and procedures, has emerged as a significant concern in modern healthcare... (Meta-Analysis)
Meta-Analysis
Defensive medicine, characterized by physicians' inclination toward excessive diagnostic tests and procedures, has emerged as a significant concern in modern healthcare due to its high prevalence and detrimental effects. Despite the growing concerns among healthcare providers, policymakers, and physicians, comprehensive synthesis of the literature on the prevalence and determinants of defensive medicine among physicians has yet been reported. A comprehensive literature search was conducted to identify eligible studies published between 1 January 2000 and 31 December 2022, utilizing six databases (i.e. Web of Science, PubMed, Embase, Scopus, PsycINFO, and Cochrane Library). A meta-analysis was conducted to determine the prevalence and determinants of defensive medicine. Of the 8892 identified articles, 64 eligible studies involving 35.9 thousand physicians across 23 countries were included. The overall pooled prevalence of defense medications was 75.8%. Physicians engaged in both assurance and avoidance behaviors, with the most prevalent subitems being increasing follow-up and avoidance of high-complication treatment protocols. The prevalence of defensive medicine was higher in the African region [88.1%; 95% confidence interval (CI): 80.4%-95.8%] and lower-middle-income countries (89.0%; 95% CI: 78.2%-99.8%). Among the medical specialties, anesthesiologists (92.2%; 95% CI: 89.2%-95.3%) exhibited the highest prevalence. Further, the pooled odds ratios (ORs) of the nine factors at the individual, relational, and organizational levels were calculated, and the influence of previous experience in medical-legal litigation (OR: 1.65; 95% CI: 1.13-2.18) should be considered. The results of this study indicate a high global prevalence of defensive medicine among physicians, underscoring the necessity of implementing targeted interventions to reduce its use, especially in certain regions and specialties. Policymakers should implement measures to improve physicians' medical skills, enhance physician-patient communication, address physicians' medical-legal litigation fears, and reform the medical liability system. Future research should focus on devising and assessing interventions to reduce the use of defensive medicine and to improve the quality of patient care.
Topics: Humans; Defensive Medicine; Prevalence; Malpractice; Physicians; Physician-Patient Relations
PubMed: 38060672
DOI: 10.1093/intqhc/mzad096 -
Suicide & Life-threatening Behavior Oct 2021This systematic review and meta-analysis aimed to (i) examine the associations between experiential avoidance (EA), non-suicidal self-injury (NSSI), and suicide... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
This systematic review and meta-analysis aimed to (i) examine the associations between experiential avoidance (EA), non-suicidal self-injury (NSSI), and suicide experiences, and (ii) identify sample- and methodological-related variables affecting the strength of these associations.
METHOD
Medline, Embase, PsychINFO, Web of Science, and CINAHL were searched until April 2020. Random-effect meta-analyses were applied. The I statistic and the Egger's test assessed heterogeneity and publication bias. Meta-regression analyses were used to evaluate the impact of moderator variables on the strength of these associations.
RESULTS
Data from 19 independent studies based on n = 9900 participants were pooled. The analyses demonstrated a weak but significant association between EA and NSSI. None of the examined moderator variables influenced the strength of this relationship. There was an indication of publication bias, suggesting that this association may have been inflated. The associations between EA, and suicide ideation and behaviors were moderate to strong.
DISCUSSION
The current study concluded that (i) the EA model for NSSI should be revised by incorporating new evidence implicating feelings of relief in NSSI, and (ii) future studies should examine interactive factors between EA and key psychological components in the pathways to suicide experiences because these findings have direct clinical implications.
Topics: Emotions; Humans; Self-Injurious Behavior; Suicidal Ideation
PubMed: 34184775
DOI: 10.1111/sltb.12784 -
Clinical Psychology Review Apr 2023Intolerance of uncertainty, a transdiagnostic factor manifested across emotional disorders, has been associated with difficulties in regulating emotions. This... (Meta-Analysis)
Meta-Analysis
Intolerance of uncertainty, a transdiagnostic factor manifested across emotional disorders, has been associated with difficulties in regulating emotions. This meta-analysis addresses the lack of synthesis of this relationship. PsycInfo, PubMed, Scopus, and ProQuest were systematically searched for relevant articles published up to and during November 2022. We combined 161 effect sizes from 91 studies (N = 30,239), separating the analysis into maladaptive and adaptive emotion regulation strategies and their association with intolerance of uncertainty. We found a moderate positive relationship between maladaptive, and a moderate inverse relationship between adaptive emotion regulation and intolerance of uncertainty. Analysing the magnitude of relationships revealed that cognitive avoidance and mindfulness were the maladaptive and adaptive strategies respectively which had the largest effect sizes and thus strongest relationships with intolerance of uncertainty. Combining all strategies, cognitive avoidance remained the largest effect size, while expressive suppression had the smallest effect size and was non-significant in its relationship. Further analyses testing study sample, design, and age as moderators found no significant moderator for the relationships between intolerance of uncertainty and emotion regulation strategies. These findings have implications for future intolerance of uncertainty interventions, with emotion regulation as a potential target of change.
Topics: Humans; Emotional Regulation; Emotions; Mood Disorders; Uncertainty
PubMed: 36965452
DOI: 10.1016/j.cpr.2023.102270 -
Waste Management (New York, N.Y.) Mar 2022Plastic waste, primarily from packaging, is a growing threat to nature and the environment and a waste of resources, calling for a greener, circular economy based on... (Review)
Review
Plastic waste, primarily from packaging, is a growing threat to nature and the environment and a waste of resources, calling for a greener, circular economy based on waste avoidance and recycling. This paper contributes to this goal by providing a systematic review of research, published in English between 2015 and 2020, on drivers and barriers of consumers' plastic packaging waste avoidance and recycling in private households. Focus is specifically on economically developed countries because they are responsible for the biggest share of plastic packaging waste and have implemented the most advanced and ambiguous legislation and regulation for plastic packaging waste prevention and recycling. Based on a search in Scopus, 36 peer-reviewed articles were identified that empirically address what motivates consumers to engage in these activities and what difficulties and hindrances they experience for doing so in an effective way. According to this research, the most important drivers of consumers' plastic packaging waste avoidance and recycling are environmental concern and task-specific benefits, and the most important barriers are lack of knowledge and understanding as well as lack of opportunities, inconvenience, and task difficulty. Moreover, there is some evidence that plastic packaging waste avoidance and recycling behaviours are interlinked, contingent on shared motives and understanding, which calls for an integrated approach considering potential positive and negative spill-over between plastic packaging waste behaviours.
PubMed: 35093857
DOI: 10.1016/j.wasman.2022.01.021 -
Cureus Dec 2023Psychotherapy has many forms, such as cognitive behavioral therapy (CBT), mindfulness therapy (MFT), and hypnotherapy, to name a few. Cognitive behavioral therapy is the... (Review)
Review
Psychotherapy has many forms, such as cognitive behavioral therapy (CBT), mindfulness therapy (MFT), and hypnotherapy, to name a few. Cognitive behavioral therapy is the gold standard in therapy-based treatment and is used for cognitive restructuring to reduce safety-seeking and avoidant behaviors. While the main application of psychotherapy is psychological disorders, recent studies have found that it is beneficial for somatic and physiological symptoms such as chronic pain or even irritable bowel syndrome (IBS). Irritable bowel syndrome is a common but debilitating gastrointestinal condition that has a prevalence of 12% in the United States and costs the average patient $9,776 annually in 2023. Irritatable bowel syndrome is a condition of exclusion but consists of abdominal discomfort or pain and must be associated with altered bowel habits as stated in the Rome IV criteria. At least half of these patients also exhibit extracolonic symptoms, most commonly psychological disorders like anxiety and stress. The true etiology of IBS is not understood, but ideas such as the brain-gut axis, stress response system, and gut microbiota have been evaluated. Treatment of IBS is extensive and heavily relies on the patient-physician interaction, but pharmacologic therapies have been employed and are sometimes unsuccessful. Irritable bowel syndrome impacts an individual as a whole, making them hesitate whether or not they eat a particular food or even go out to do an activity because of the unpredictable bowel pattern. Finding a better solution is essential to improving the patient's quality of life (QoL), especially by addressing how they perceive the illness, how they adjust to it, and even how they determine what foods to consume. This paper aims to evaluate whether or not psychotherapy can be employed to improve all aspects of IBS, as well as if it can reduce the cost of IBS treatment.
PubMed: 38259396
DOI: 10.7759/cureus.51003