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Canadian Journal of Pain = Revue... 2023Graded Motor Imagery (GMI) is a non-invasive and inexpensive therapy used to treat Phantom Limb Pain (PLP) by sequentially activating motor networks in such a way that... (Review)
Review
INTRODUCTION
Graded Motor Imagery (GMI) is a non-invasive and inexpensive therapy used to treat Phantom Limb Pain (PLP) by sequentially activating motor networks in such a way that movement and pain are unpaired. The objective of this systematic review was to critically appraise relevant data on the efficacy of GMI and its components for reducing PLP and disability in amputees.
METHODS
We searched 11 electronic databases for controlled trials investigating GMI and its components in amputees with PLP from inception until February 2023. Two reviewers independently screened studies and extracted relevant data. Study-level data were entered using the inverse variance function of the Review Manager 5 and pooled with the random effects model.
RESULTS
Eleven studies with varying risk of bias were eligible. No eligible study considered left/right judgement tasks in isolation. Studies showed no effect for imagined movements, but positive effects were seen for GMI [weighted mean difference: -21.29 (95%CI: -31.55, -11.02), I= 0%] and mirror therapy [weighted mean difference: -8.55 (95%CI: -14.74, -2.35, I= 61%]. A comparison of mirror therapy versus sham showed no difference [weighted mean difference: -4.43 (95%CI: -16.03, 7.16), I= 51%].
CONCLUSION
Our findings suggest that GMI and mirror therapy may be effective for reducing PLP. However, this conclusion was drawn from a limited body of evidence, and the certainty of the evidence was very low. Therefore, rigorous, high-quality trials are needed to address the gap in the literature and inform practice.
PubMed: 37214633
DOI: 10.1080/24740527.2023.2188899 -
Journal of Market Access & Health Policy 2022Deliberative processes in Health Technologies Assessment (HTA) result in recommendations that determine the reimbursement of medicines, diagnostics or devices. These... (Review)
Review
OBJECTIVES
Deliberative processes in Health Technologies Assessment (HTA) result in recommendations that determine the reimbursement of medicines, diagnostics or devices. These processes are governed by explicit criteria, but are also influenced by implicit factors. The objective of this work was to identify the implicit factors influencing HTA deliberative processes in five European countries (France, Germany, Italy, Spain and the UK).
METHODS
A systematic review of literature published between 2009 and 2019 was conducted. The search was performed in Pubmed, The Cochrane Database of Systematic Reviews, Google Scholar and Center for Reviews and Dissemination. The ISPOR database was searched manually.
RESULTS
Out of 100 eligible publications, eight articles were selected for data extraction and analysis. The implicit factors in the HTA deliberative process most frequently mentioned in the identified literature are value judgments, biases, preferences and subjectivity. Five out of the eight articles highlight the need to further improve the transparency of the process, and three provide recommendations on how to address the influence of implicit factors on the HTA deliberative process through a framework.
CONCLUSION
Even in countries with a long HTA history, evidence on implicit factors is scarce. Some methods have been recommended for addressing these factors. Further research is required to characterize the implicit factors in the HTA deliberative process at a country level and explore potential ways to mitigate the influence of these factors on the HTA deliberative process.
PubMed: 35811835
DOI: 10.1080/20016689.2022.2094047 -
International Journal of Nursing Studies Jun 2022The incidence of prostate cancer is increasing across the world, with over 1.2 million men diagnosed in 2018. Survival rates have increased significantly however the... (Review)
Review
BACKGROUND
The incidence of prostate cancer is increasing across the world, with over 1.2 million men diagnosed in 2018. Survival rates have increased significantly however the morbidity remains high. Men do report unmet sexual health needs post prostatectomy, despite this, many do not pursue treatment.
OBJECTIVES
To explore men's perceptions of the education and support they receive surrounding post-prostatectomy erectile dysfunction and penile rehabilitation.
DESIGN
Systematic review and qualitative analysis based on Joanna Briggs Institute's methodology for conducting synthesis.
METHODS
Based on the protocol registered with PROSPERO, data were collected from the following electronic databases: MEDLINE, Web of Science, CINAHL, Psycinfo, The Cochrane Library and Embase. Titles and abstracts were screened against the inclusion and exclusion criteria, full texts were then screened, and the methodological quality of included studies was assessed using the Joanna Briggs Institutes Critical Appraisal Checklist for Qualitative Research by two independent reviewers.
RESULTS
Synthesised findings were extracted from 13 articles; four synthesised findings were identified from nine categories with 57 findings and 108 illustrations. The findings related to a perceived lack of education and support regarding all aspects of sexuality post prostatectomy. Practitioners' knowledge of gay, bisexual and single men's needs was particularly lacking. Nurses and nurse practitioners were considered to contribute positively to educational needs.
CONCLUSIONS
The synthesised findings demonstrated that men do not receive sufficient education and support to initiate penile rehabilitation post-prostatectomy. Men need a holistic approach to altered sexuality and practitioners should facilitate education and treatment in a non-judgmental and all-inclusive approach.
Topics: Erectile Dysfunction; Humans; Male; Prostatectomy; Qualitative Research; Sexual Behavior; Sexuality
PubMed: 35395575
DOI: 10.1016/j.ijnurstu.2022.104212 -
Journal of Geriatric Psychiatry and... Nov 2021The syndromes of mild cognitive impairment (MCI) or mild neurocognitive disorder (MiND), often prodromal to dementia (Major Neurocognitive Disorder), are characterized...
INTRODUCTION
The syndromes of mild cognitive impairment (MCI) or mild neurocognitive disorder (MiND), often prodromal to dementia (Major Neurocognitive Disorder), are characterized by acquired clinically significant changes in one or more cognitive domains despite preserved independence. Mild impairment has significant medicolegal consequences for an affected person and their care system. We review the more common etiologies of MiND and provide a systematic review of its medicolegal implications.
METHODS
We conducted a systematic review of the peer-reviewed English literature on medicolegal aspects of MCI or MiND using comprehensive search terms and expanding our review to include sources cited by these reports.
RESULTS
Impairment of memory, executive function, social cognition, judgment, insight or abstraction can alter an individual's abilities in a variety of areas that include decision making, informed consent, designation of a surrogate decision-maker such as a health care proxy, understanding and management of financial affairs, execution of a will, or safe driving.
CONCLUSION
Even mild cognitive impairment can have significant behavioral consequences. Clinicians can assist care partners and persons with MCI or MiND by alerting them to the medicolegal concerns that often accompany cognitive decline. Early recognition and discussion can help a care system manage medicolegal risk more effectively and promote thoughtful advance planning.
Topics: Cognitive Dysfunction; Executive Function; Humans; Neuropsychological Tests
PubMed: 32935606
DOI: 10.1177/0891988720957092 -
Schizophrenia Research Feb 2020Voice atypicalities have been a characteristic feature of schizophrenia since its first definitions. They are often associated with core negative symptoms such as flat... (Meta-Analysis)
Meta-Analysis Review
Voice atypicalities have been a characteristic feature of schizophrenia since its first definitions. They are often associated with core negative symptoms such as flat affect and alogia, and with the social impairments seen in the disorder. This suggests that voice atypicalities may represent a marker of clinical features and social functioning in schizophrenia. We systematically reviewed and meta-analyzed the evidence for distinctive acoustic patterns in schizophrenia, as well as their relation to clinical features. We identified 46 articles, including 55 studies with a total of 1254 patients with schizophrenia and 699 healthy controls. Summary effect sizes (Hedges'g and Pearson's r) estimates were calculated using multilevel Bayesian modeling. We identified weak atypicalities in pitch variability (g = -0.55) related to flat affect, and stronger atypicalities in proportion of spoken time, speech rate, and pauses (g's between -0.75 and -1.89) related to alogia and flat affect. However, the effects were mostly modest (with the important exception of pause duration) compared to perceptual and clinical judgments, and characterized by large heterogeneity between studies. Moderator analyses revealed that tasks with a more demanding cognitive and social component showed larger effects both in contrasting patients and controls and in assessing symptomatology. In conclusion, studies of acoustic patterns are a promising but, yet unsystematic avenue for establishing markers of schizophrenia. We outline recommendations towards more cumulative, open, and theory-driven research.
Topics: Aphasia; Bayes Theorem; Humans; Schizophrenia; Speech; Voice
PubMed: 31839552
DOI: 10.1016/j.schres.2019.11.031 -
Journal of Oral Rehabilitation Jul 2022The evidence on the relationship between anxiety and depression and patients with distinct subtypes of temporomandibular disorder (TMD) is uncertain, so a thorough... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The evidence on the relationship between anxiety and depression and patients with distinct subtypes of temporomandibular disorder (TMD) is uncertain, so a thorough review study on the topic is still missing.
OBJECTIVES
This systematic review investigated the distribution and severity of anxiety and depression in patients diagnosed with different subtypes of TMD.
METHODS
The study is registered in PROSPERO (CRD42020150562) and it followed the PRISMA 2020 Statement. We searched in PubMed, Web of Science, Scopus and SciELO databases (last search: 12 March 2021) and the reference list from the included studies. Study eligibility criteria consisted of: (i) patients diagnosed with TMD using the Research Diagnostic Criteria (RDC/TMD) or Diagnostic Criteria (DC/TMD) instruments; (ii) assessment of anxiety and/or depression with validated psychological instruments and (iii) allocation of patients into a minimum of two distinct TMD subtypes with at least one group having myofascial pain (comparison group). Analyses were carried out using RevMan 5.3.5 statistical package and random- or fixed-effects models (α = 0.05). The quality of evidence was assessed based on review authors' judgment derived from a 10-item appraisal tool for prevalence studies and with the Newcastle-Ottawa scale.
RESULTS
Of the 4086 records identified in total, 24 were eligible for inclusion; meta-analyses were conducted with 20 studies. In total, 3678 subjects were included in the review. Most of the studies found that patients with myofascial pain showed similar occurrence and severity of anxiety/depression as compared to other subtypes of TMD, although the average prevalence seemed to be higher among the diagnoses consisting of myofascial pain (muscular TMD). Despite the moderate-to-high heterogeneity, anxiety and depression were more frequently distributed within patients with myofascial pain (p = .001). TMD patients without myofascial pain presented less severe levels of anxiety and depression than patients with only myofascial pain (p ≤ .01). The type of psychological instrument seems to affect the assessment of both anxiety and depression emotional states.
CONCLUSION
The findings of this review suggest that patients with myofascial pain are more anxious and more depressed than patients with other subtypes of TMD.
IMPLICATIONS
Considering that anxiety and depression are differently distributed within the TMD population, a proper assessment of the psychological state of patients seems essential to offer an adequate treatment and management of each specific subtype of TMD.
Topics: Anxiety; Depression; Humans; Myofascial Pain Syndromes; Pain; Temporomandibular Joint Disorders
PubMed: 35398904
DOI: 10.1111/joor.13331 -
Journal of Cutaneous Medicine and... 2022Cutaneous drug eruptions are a significant source of morbidity, mortality, and cost to the healthcare system. Identifying the culprit drug is essential; however, despite... (Review)
Review
BACKGROUND
Cutaneous drug eruptions are a significant source of morbidity, mortality, and cost to the healthcare system. Identifying the culprit drug is essential; however, despite numerous methods being published, there are no consensus guidelines.
OBJECTIVES
Conduct a scoping review to identify all published methods of culprit drug identification for cutaneous drug eruptions, compare the methods, and generate hypotheses for future causality assessment studies.
ELIGIBILITY CRITERIA
Peer-reviewed publications involving culprit drug identification methods.
SOURCES OF EVIDENCE
Medline, Embase, and Cochrane Central Register of Controlled Trials.
CHARTING METHODS
Registered PRISMA-ScR format protocol on Open Science Forum.
RESULTS
In total, 109 studies and 26 reviews were included comprising 656,635 adverse drug events, most of which were cutaneous. There were 54 methods of culprit drug identification published, categorized as algorithms, probabilistic approaches, and expert judgment. Algorithms had higher sensitivity and positive predictive value, but lower specificity and negative predictive value. Probabilistic approaches had lower sensitivity and positive predictive value, but higher specificity and negative predictive value. Expert judgment was subjective, less reproducible, but the most frequently used to validate other methods. Studies suggest that greater accuracy may be achieved by specifically assessing cutaneous drug eruptions and using combinations of causality assessment categories.
CONCLUSIONS
Culprit drug identification for adverse drug reactions remains a challenge. Many methods have been published, but there are no consensus guidelines. Using causality assessment methods specifically for cutaneous drug eruptions and combining aspects of the different causality assessment categories may improve efficacy. Further studies are needed to validate this hypothesis.
Topics: Algorithms; Consensus; Drug Eruptions; Drug-Related Side Effects and Adverse Reactions; Exanthema; Humans
PubMed: 34798794
DOI: 10.1177/12034754211027509 -
Law and Human Behavior Apr 2022Cognitive biases can impact experts' judgments and decisions. We offer a broad descriptive model of how bias affects human judgment. Although studies have explored the... (Review)
Review
OBJECTIVE
Cognitive biases can impact experts' judgments and decisions. We offer a broad descriptive model of how bias affects human judgment. Although studies have explored the role of cognitive biases and debiasing techniques in forensic mental health, we conducted the first systematic review to identify, evaluate, and summarize the findings.
HYPOTHESES
Given the exploratory nature of this review, we did not test formal hypotheses. General research questions included the proportion of studies focusing on cognitive biases and/or debiasing, the research methods applied, the cognitive biases and debiasing strategies empirically studied in the forensic context, their effects on forensic mental health decisions, and effect sizes.
METHOD
A systematic search of PsycINFO and Google Scholar resulted in 22 records comprising 23 studies in the United States, Canada, Finland, Italy, the Netherlands, and the United Kingdom. We extracted data on participants, context, methods, and results.
RESULTS
Most studies focused only on cognitive biases ( = 16, 69.6%), with fewer investigating ways to address them ( = 7, 30.4%). Of the 17 studies that tested for biases, 10 found significant effects (58.8%), four found partial effects (23.5%), and three found no effects (17.6%). Foci included general perceptions of biases; adversarial allegiance; bias blind spot; hindsight and confirmation biases; moral disengagement; primacy and recency effects; interview suggestibility; and cross-cultural, racial, and gender biases. Of the seven debiasing-related studies, nearly all ( = 6) focused at least in part on the general perception of debiasing strategies, with three testing for specific effects (i.e., cognitive bias training, consider-the-opposite, and introspection caution), two of which yielded significant effects.
CONCLUSIONS
Considerable clinical and methodological heterogeneity limited quantitative comparability. Future research could build on the existing literature to develop or adapt effective debiasing strategies in collaboration with practitioners to improve the quality of forensic mental health decisions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Bias; Cognition; Humans; Judgment; Mental Health; United Kingdom
PubMed: 35191729
DOI: 10.1037/lhb0000482 -
Journal of Voice : Official Journal of... Aug 2022To analyze the prevalence of work-related voice disorders (WRVD) among the voice professionals. (Review)
Review
OBJECTIVE
To analyze the prevalence of work-related voice disorders (WRVD) among the voice professionals.
METHODS
The study protocol was registered in PROSPERO (CRD42021250121). The search was performed in the Embase, Lilacs, Medline, SCOPUS, and Web of Sciences databases. There were no limitations to the year of publication and the search included observational studies which reported data on the prevalence of dysphonia in voice professionals measured through vocal complaints, vocal self-assessment, the auditory-perceptual judgment of the voice, and laryngoscopy examinations. The critical appraisal instrument for studies reporting prevalence data was used to analyze the risk of bias of the studies. Data analysis was performed using Jamovi and R software with a significance level of 5%.
RESULTS
The initial search identified 561 articles, 73 of which were finally included and analyzed. The total number of participants was 63,126. Dysphonia was diagnosed in 45,996 participants based on a vocal complaint, 12,843 using vocal self-assessment, 1,254 using the auditory-perceptual judgment, and 1,683 using laryngoscopies. The prevalence of total dysphonia was 44.0 (95% CI 38.47; 49.69). The prevalence of vocal complaints was 43.9% (95% CI 37.37; 50.52), 42.5% (95% CI 28.57; 57.08) for self-assessment, 53.0% (95% CI 29.87; 77.19) for auditory-perceptual judgment, and 36.9% (95% CI 18.62; 57.08) for laryngoscopic examination. In the auditory-perceptual judgment, voice professionals in class 3 (moderate quality, high demand) had a higher prevalence of dysphonia than those in class 4 (moderate quality, moderate demand) (P = 0.04). In the auditory-perceptual judgment (P = 0.04), there was a higher prevalence of dysphonia in teachers than among other voice professionals non-teachers, and in the laryngeal evaluation, no differences were found between professionals (P = 0.8).
CONCLUSION
There was a high prevalence of dysphonia in voice professionals, especially in the detection by auditory-perceptual judgment. High vocal demand and being a teacher influenced the increase in the prevalence of WRVD.
PubMed: 36057482
DOI: 10.1016/j.jvoice.2022.07.030 -
Frontiers in Psychology 2022The literature suggests that the moral sense is based on innate abilities. In fact, it has been shown that children show the capacity for moral discernment, emotions and...
The literature suggests that the moral sense is based on innate abilities. In fact, it has been shown that children show the capacity for moral discernment, emotions and prosocial motivations from an early age. However, the moral sense is a complex construct of an evolutionary and social nature that evolves under the influence of interpersonal relationships. The emergence and development of moral sense is a challenge that has prompted many research studies with the aim of achieving a clear comprehension of moral development. However, success has been scarce, and studies relevant to this subject are limited. Thus, a systematic review of studies relevant to this topic was conducted to clearly establish how moral sense emerges and develops. An Ovid search was conducted to retrieve relevant items for this systematic review. The databases that were electronically visited are Cross-reference, Google Scholar and PubMed. Strict inclusion and exclusion criteria were imposed on the retrieved items to retain only relevant resources. Twenty-six studies were found valid for inclusion in this systematic review. The results of these studies were presented differently: In order to effectively analyze the selected papers and bring out the results more clearly, a categorization of the approaches adopted in the studies was carried out. The approaches identified were: "Natural Moral Sense," "Social Relationships and Moral Development," and "Environmental Factors and Moral Development." The evidence that emerged from the analysis of the papers was collected to produce a general basic model that explains moral development while also serving as a link between the various studies. First, moral sense is found to be innate in humans; individuals can naturally respond morally to various dilemmas. As seen among children and young infants, moral sense naturally exists. Second, it can be socially nurtured through social interactions and exposure to various environmental factors. Various research studies were reviewed in this systematic review to obtain a consensus on how moral sense emerges and develops. From the systematic review, the moral sense is found to be innate. However, moral development is fostered by social interactions and environmental factors.
PubMed: 35615195
DOI: 10.3389/fpsyg.2022.887537