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Mindfulness 2022This study includes a systematic review of cost-effectiveness analyses (CEAs) and cost-benefit analyses (CBAs) of mindfulness-based interventions (MBIs). (Review)
Review
OBJECTIVES
This study includes a systematic review of cost-effectiveness analyses (CEAs) and cost-benefit analyses (CBAs) of mindfulness-based interventions (MBIs).
METHODS
A literature search was conducted using PubMed, Web of Science, JSTOR, and CINAHL for studies published between January 1985 and September 2021, including an original cost-related evaluation of an MBI. A qualitative assessment of bias was performed using the Drummond checklist.
RESULTS
Twenty-eight mindfulness-based intervention studies (18 CEAs and 10 CBAs) were included in this review. Mindfulness-based stress reduction (MBSR) was less costly and more effective when compared with the usual care of cognitive behavioral therapy among patients with chronic lower back pain, fibromyalgia, and breast cancer. MBSR among patients with various physical/mental conditions was associated with reductions in healthcare costs. Mindfulness-based cognitive therapy (MBCT) was also less costly and more effective than the comparison group among patients with depression, medically unexplained symptoms, and multiple sclerosis. MBCT's cost-effectiveness advantage was also identified among breast cancer patients with persistent pain, non-depressed adults with a history of major depressive disorder episodes, adults diagnosed with ADHD, and all cancer patients. From a societal perspective, the cost-saving property of mindfulness training was evident when used as the treatment of aggressive behaviors among persons with intellectual/developmental disabilities in mental health facilities.
CONCLUSIONS
Based on this review, more standardized MBI protocols such as MBSR and MBCT compare favorably with usual care in terms of health outcomes and cost-effectiveness. Other MBIs may result in cost savings from both healthcare and societal perspectives among high-risk patient populations.
PubMed: 36061089
DOI: 10.1007/s12671-022-01960-1 -
Frontiers in Psychiatry 2022Individuals with developmental disabilities present with perceptuo-motor, social communication, and cognitive impairments that often relate to underlying atypical brain...
Individuals with developmental disabilities present with perceptuo-motor, social communication, and cognitive impairments that often relate to underlying atypical brain structure and functioning. Physical activity/movement interventions improve behavioral performance of individuals with and without developmental disabilities. Majority of the evidence on potential neural mechanisms explaining the impact of physical activity/movement interventions is based on studies in individuals with typical development; there is a dearth of systematic reviews synthesizing the neural effects of physical activity/movement interventions in individuals with developmental disabilities. In this systematic review, we have gathered evidence on the neural effects of physical activity/movement interventions from 32 papers reporting substantial neural effects and behavioral improvements in individuals with developmental disabilities. Chronic intervention effects (multiple sessions) were greater than acute intervention effects (single session). Specifically, using electroencephalogram, functional magnetic resonance imaging, diffusion tensor imaging, and functional near-infrared spectroscopy, studies found physical activity/movement intervention-related changes in neural activity, indicating normalization of cortical arousal in individuals with attention-deficit /hyperactivity disorder (ADHD), increased social brain connectivity in individuals with autism spectrum disorder (ASD), and more efficient executive functioning processes in individuals with a wide range of other developmental disabilities. Despite promising results, more research is clearly needed in this area with larger sample sizes, using standardized neuroimaging tools/variables, and across multiple diagnoses to further explore the neural mechanisms underlying physical activity/movement interventions and to replicate findings from the present review.
PubMed: 35242063
DOI: 10.3389/fpsyt.2022.794652 -
Current Rheumatology Reports Mar 2020The purpose of this report is to review recent research findings on APS in children and neonates.
PURPOSE OF REVIEW
The purpose of this report is to review recent research findings on APS in children and neonates.
RECENT FINDINGS
European evidence-based recommendations for diagnosis and treatment of pediatric APS has recently been published by the SHARE Initiative. Recent studies have shown a high prevalence of non-thrombotic manifestations in children with aPL, domains 4/5 specificity of 'innocent' anti-β2GPI antibodies in infants, and a higher risk for developmental delays and learning disabilities, hence, the need for neurodevelopmental monitoring in children born to mothers with APS. An International effort on creating a new diagnostic criteria for APS is underway. Pediatric APS is a rare disease with significant differences from the APS in adults. Majority of the children with persistently positive aPL do not develop thrombotic events; however, relatively higher proportion of thrombosis in children is related to aPL positivity compared to adults; this may partly be due to the absence of common pro-thrombotic "second-hit" risk factors of adults such as atherosclerosis and cigarette smoking. Diagnosis of APS in children may be delayed or missed when adult APS criteria are used, because in pediatric APS, non-thrombotic clinical manifestations such as thrombocytopenia, hemolytic anemia, and neurological disorders such as migraine, epilepsy, and chorea may precede thrombotic manifestations. Around 20% of the children initially diagnosed with primary APS eventually develop SLE. Neonatal APS is rare; however, the offspring of mothers with APS are at a higher risk for developmental delays and learning disabilities; prematurity and IUGR may increase this risk. Regular assessment of neurodevelopmental status of these children should be performed. Thrombosis is a rare event in the offspring of mothers with APS; anticoagulation of such infants is not recommended. An international effort to create a new diagnostic criteria for APS is underway.
Topics: Antiphospholipid Syndrome; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Registries
PubMed: 32124078
DOI: 10.1007/s11926-020-0887-9 -
Journal of Psychosocial Rehabilitation... Mar 2023Psychiatric rehabilitation is a therapeutic approach that encourages people with mental illness and intellectual disabilities to develop their inherent capacities... (Review)
Review
Psychiatric rehabilitation is a therapeutic approach that encourages people with mental illness and intellectual disabilities to develop their inherent capacities through learning and environmental support. Psychiatric treatment (pharmacological and psychological) controls psychiatric symptoms; psychiatric rehabilitation focuses on functioning and role outcomes. The review aimed to explore the end-user's perception of facilitators and barriers in accessing psychiatric tele-rehabilitation services. Various electronic databases like Web of Science, Scopus, PubMed, Research Gate, Science Direct, ProQuest, Springer, Wolters-Taylors, Elsevier, PsycINFO, and Wiley online library were searched using Google scholar. Inclusion criteria were studies including psychiatric rehabilitation, web-based interventions, and facilitators and barriers in accessing psychiatric tele-rehabilitation services. A systematic search identified 13 studies, including quantitative, qualitative, and mixed-method approaches. The results identified were based on the facilitators and barriers in accessing telerehabilitation. The common themes identified in this review are (1) facilitators of telerehabilitation, (2) barriers of tele-rehabilitation, and (3) expectations in tele-rehabilitation. The facilitating factors include an internet-enabled device, cost/financial benefits, ehealthcare knowledge, technology as a valuable and accessible tool, motivational factors, satisfaction and willingness. The barriers include affordability to the internetenabled device, network connectivity, lack of technical skills, and digital literacy. Expectations include some modifications needed to carry out effective practices of psychiatric tele-rehabilitation. Effective tele-rehabilitation helps people with mental illness and intellectual developmental disorders for their optimal functioning/quality of life.
PubMed: 37360916
DOI: 10.1007/s40737-023-00333-8 -
Journal of Intellectual Disabilities :... Jun 2023This review synthesizes the available literature regarding factors which facilitate a sense of belonging in people with intellectual and developmental disabilities, and...
This review synthesizes the available literature regarding factors which facilitate a sense of belonging in people with intellectual and developmental disabilities, and provide a comprehensive integrative view of the subject. Four electronic databases were searched, and 13 studies met inclusion criteria for review. The "standard quality assessment criteria for evaluating primary research papers from a variety of fields" indicated satisfactory quality. Factors which facilitate a sense of belonging in people with intellectual and developmental disabilities were analyzed into themes. Sense of belonging is enhanced by feeling respected, accepted, and valued (Subjectivity). These experiences are more likely to be achieved in a familiar and safe environment (Dynamism), and with access to platforms for social interactions (Groundedness), where a sense of relatedness and connectedness achieved by shared experiences with others (Reciprocity). Sense of belonging is associated with committed action of people with disability, taking assertive action or being agentic (Self-determination). Sense of belonging is a unique concept that should be addressed in disability research and practice.
Topics: Child; Humans; Intellectual Disability; Developmental Disabilities; Disabled Persons; Social Interaction; Personal Autonomy
PubMed: 35271785
DOI: 10.1177/17446295211068424 -
Journal of Applied Research in... May 2022Positive behavioural support (PBS) can be effective in supporting children and young people (CYP) with developmental disabilities. This systematic review focused on... (Review)
Review
BACKGROUND
Positive behavioural support (PBS) can be effective in supporting children and young people (CYP) with developmental disabilities. This systematic review focused on describing the components and nine characteristics of PBS that have been used with CYP with developmental disabilities in special education settings, and the evidence for PBS effectiveness in these settings. Additionally, facilitators and barriers to PBS implementation, and experiences of stakeholders, were investigated.
METHOD
Systematic searches followed a registered protocol, and 30 studies were identified, narratively synthesised, and critically appraised.
RESULTS
From the 30 studies included, 10 reported the presence of all 9 PBS characteristics, 17 reported on 8 PBS characteristics, and 3 reported on 7 characteristics. Overall, 28 studies demonstrated significant decreases in behaviours that challenge and increases in alternative behaviours, if increasing alternative behaviours was part of the interventions.
CONCLUSIONS
There was a lack of evidence on facilitators and barriers, and a lack of qualitative studies exploring experiences of stakeholders with PBS in special education settings. The available evidence suggested that not all studies reported on all PBS characteristics when describing the approach followed. In addition, available evidence suggested that most studies demonstrated effectiveness of PBS regarding the measured outcomes. Implications and future directions are discussed.
Topics: Adolescent; Child; Developmental Disabilities; Education, Special; Humans; Intellectual Disability; Qualitative Research
PubMed: 35199433
DOI: 10.1111/jar.12989 -
Autism : the International Journal of... Oct 2022In sub-Saharan Africa, there are few services for children with developmental disabilities such as autism and intellectual disability. One way to support these children... (Review)
Review
Stakeholder experiences, attitudes and perspectives on inclusive education for children with developmental disabilities in sub-Saharan Africa: A systematic review of qualitative studies.
In sub-Saharan Africa, there are few services for children with developmental disabilities such as autism and intellectual disability. One way to support these children is to include them in mainstream schools. However, currently, African children with developmental disabilities are often excluded from mainstream education opportunities. People involved (e.g. teachers, families and children) can offer information on factors that could ease or interfere with inclusion. This article discusses the findings of published studies that explored the views of relevant groups on including children with developmental disabilities in mainstream schools in sub-Saharan Africa. We systematically searched the literature and identified 32 relevant articles from seven countries in sub-Saharan Africa. We found that unclear policies and insufficient training, resources and support for teachers often blocked the implementation of inclusive education. Factors in favour of inclusive education were the commitment of many teachers to include pupils with developmental disabilities and the work of non-governmental organisations (NGOs), which provided resources and training. This review suggests that motivated teachers should be provided with appropriate training, resources and support for inclusive education, directly and by promoting the work of NGOs.
Topics: Africa South of the Sahara; Autism Spectrum Disorder; Child; Developmental Disabilities; Humans; Mainstreaming, Education; Qualitative Research
PubMed: 35635316
DOI: 10.1177/13623613221096208 -
Journal of Applied Research in... May 2022Quality participation, defined as satisfying and enjoyable involvement, is one of the most valued life outcomes for children with intellectual and developmental... (Review)
Review
Exploring experiential elements, strategies and outcomes of quality participation for children with intellectual and developmental disabilities: A systematic scoping review.
OBJECTIVE
Quality participation, defined as satisfying and enjoyable involvement, is one of the most valued life outcomes for children with intellectual and developmental disabilities. To broaden understandings of quality participation, our review explored participation experiences of children with intellectual and developmental disabilities.
METHOD
Utilising an established systematic scoping review methodology, data were collected using three search tools (peer-reviewed databases, grey literature databases and Google). Inclusion criteria required that children with intellectual and developmental disabilities and/or their proxies provided descriptions of quality participation experiences in any life domain.
RESULTS
A total of 35 articles met the inclusion criteria. Quality participation strategies (30 total) and outcomes (8 total) were categorised according to six experiential elements (autonomy, belongingness, challenge, engagement, mastery and meaning).
CONCLUSION
Findings provide novel insight for building quality experiences across current and future participation initiatives.
Topics: Child; Databases, Factual; Developmental Disabilities; Humans; Intellectual Disability
PubMed: 35174582
DOI: 10.1111/jar.12982 -
Research in Developmental Disabilities May 2023Psychological flexibility, a popular concept in clinical psychology, is still evolving in the context of studying parents of children with disabilities. This study... (Review)
Review
PURPOSE
Psychological flexibility, a popular concept in clinical psychology, is still evolving in the context of studying parents of children with disabilities. This study systematically reviewed the literature on the psychological flexibility of parents of children with disabilities to identify contributions of the literature and make recommendations for practice and future study.
MATERIALS AND METHODS
The systematic review was conducted according to the PRISMA guidelines and identified studies on the psychological flexibility of parents of children with disabilities using five electronic databases: PsychNet, PubMed, ERIC, Social Services Abstracts, and EBSCO. Twenty-six articles met the criteria and were included. A thematic analysis was conducted to extract major themes.
RESULTS
Three major themes emerged from the data: (1) psychological flexibility is associated with various aspects of mental health; (2) psychological flexibility is associated with parental functioning in caring for children with a disability; (3) acceptance and commitment therapy (ACT) based interventions effectively enhance the psychological flexibility of parents of children with disabilities.
CONCLUSIONS
The study concludes that psychological flexibility is extremely relevant to disability studies and should be further explored in relation to different parental well-being and functioning aspects. Professionals are encouraged to incorporate principles of acceptance and commitment therapy into their work with parents of children with disabilities.
Topics: Child; Humans; Disabled Children; Acceptance and Commitment Therapy; Parents; Mental Health; Stress, Psychological
PubMed: 36966545
DOI: 10.1016/j.ridd.2023.104490 -
Molecular Genetics and Metabolism Jun 2022Mevalonate kinase deficiency (MKD) is a monogenic auto-inflammatory disease. Its manifestations range from partial MKD to mevalonic aciduria (MVA). All patients display... (Review)
Review
INTRODUCTION
Mevalonate kinase deficiency (MKD) is a monogenic auto-inflammatory disease. Its manifestations range from partial MKD to mevalonic aciduria (MVA). All patients display a periodic fever, and MVA patients additionally exhibit severe neurological involvement. The objective of this work was to describe neurological manifestations of MKD.
METHODS
A systematic literature review was performed from January 1990 to January 2022. Forty-five patients from 18 case reports and five cohort studies were included in the analysis.
RESULTS
In cohort studies, the most-reported manifestations were headaches (41%) and fatigue (31%). Serious involvements including ataxia and developmental delay were described less than 1% of patients but 22-31% of case reports. They consistently appeared in the first years of life. Retinal dystrophy was frequently reported (31%) in case reports. Other manifestations, including uveitis, aseptic meningitis, and stroke remained rare.
DISCUSSION
Severe neurological manifestations are rare in MKD but are responsible for major functional disabilities. They are present at onset and never appear at follow-up of patients with mild MKD. Conversely, headaches and fatigue are frequent symptoms that should be investigated. Visual examinations should be performed on the appearance of visual symptoms. The efficacy of anti-IL-1β therapy on neurological manifestations should be further investigated.
Topics: Fatigue; Headache; Humans; Mevalonate Kinase Deficiency
PubMed: 35525811
DOI: 10.1016/j.ymgme.2022.04.006