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Neurological Sciences : Official... Feb 2022Telerehabilitation (TR) seems to be an encouraging solution for the delivery of cognitive treatments in patients with neurological disorders. This study was aimed to... (Meta-Analysis)
Meta-Analysis Review
Telerehabilitation (TR) seems to be an encouraging solution for the delivery of cognitive treatments in patients with neurological disorders. This study was aimed to analyze and synthesize the evidence on the efficacy of cognitive TR interventions in patients with neurological diseases, compared with conventional face-to-face rehabilitation. From a total of 4485 records, 9 studies met the inclusion criteria for qualitative analysis. At the end of the process, 7 studies remained for quantitative analysis. By comparing TR with face-to-face treatments for cognitive impairments, we assessed improvements in global cognitive domain (Mini Mental State Exam) (MD = -0.86; 95% CI -2.43, 0.72, I = 0%), in learning and memory domains (SMD = 0.26, 95% CI -0.22, 0.74, I = 24%), in verbal fluency (SMD = 0.08, 95% CI -0.47, 0.62, I = 0%), and in executive functions (i.e., problem-solving, central processing speed and working memory) (SMD = 0.38, 95% CI 0.06, 0.71, I = 0%). In all the included studies, improvement in the performance of the TR groups was comparable to that achieved through face-to-face intervention. Significant differences between those two modalities of providing treatments were observed for working memory and total executive function comparison, in favor of TR. The results of this study can sustain the efficacy of TR and its application for the treatment of neurological patients, especially when treated for executive function impairments.
Topics: Cognition; Cognitive Dysfunction; Executive Function; Humans; Telerehabilitation
PubMed: 34822030
DOI: 10.1007/s10072-021-05770-6 -
Journal of Medical Internet Research Aug 2022Acceptance and commitment therapy (ACT) is based on a psychological flexibility model that encompasses 6 processes: acceptance, cognitive defusion, self-as-context,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Acceptance and commitment therapy (ACT) is based on a psychological flexibility model that encompasses 6 processes: acceptance, cognitive defusion, self-as-context, being present, values, and committed action.
OBJECTIVE
This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to examine the effects of internet-based ACT (iACT) on process measures.
METHODS
A comprehensive search was conducted using 4 databases. The quality of the included RCTs was assessed using the Cochrane Collaboration Risk of Bias Tool. A random-effects or fixed-effects model was used. Subgroup analyses for each outcome were conducted according to the type of control group, use of therapist guidance, delivery modes, and use of targeted participants, when applicable.
RESULTS
A total of 34 RCTs met the inclusion criteria. This meta-analysis found that iACT had a medium effect on psychological flexibility and small effects on mindfulness, valued living, and cognitive defusion at the immediate posttest. In addition, iACT had a small effect on psychological flexibility at follow-up. The overall risk of bias across studies was unclear.
CONCLUSIONS
Relatively few studies have compared the effects of iACT with active control groups and measured the effects on mindfulness, valued living, and cognitive defusion. These findings support the processes of change in iACT, which mental health practitioners can use to support the use of iACT.
Topics: Acceptance and Commitment Therapy; Humans; Internet; Mental Health; Mindfulness; Models, Psychological
PubMed: 36040783
DOI: 10.2196/39182 -
Nurse Education in Practice Oct 2023This study aimed to evaluate the effects of blended learning on nursing students. The primary outcomes include knowledge and skills, and the secondary outcomes include... (Meta-Analysis)
Meta-Analysis Review
AIM
This study aimed to evaluate the effects of blended learning on nursing students. The primary outcomes include knowledge and skills, and the secondary outcomes include critical thinking ability, mental health, blended learning design, and nursing students' attitudes toward blended learning.
BACKGROUND
Blended learning combines the advantages of online learning and traditional face-to-face learning, and makes up for the disadvantages of simple online learning or traditional learning. The effects of blended learning on the knowledge, skills, critical thinking ability, and mental health of nursing students were unknown.
DESIGN
Systematic review and meta-analysis.
METHODS
The present systematic review and meta-analysis was applied according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Publications were searched in PubMed, Web of Science, EMBASE, ERIC, CINAHL and the Cochrane's Library before February 2023. Two researchers independently retrieved articles and evaluated quality. The meta-analysis was performed using Stata 12.0 software according to PRISMA guidelines. The risk of bias in the selected studies was evaluated using the Revised Cochrane risk-of-bias tool for randomized trials. Heterogeneity was assessed by I and P statistics. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were used as effective indicators.
RESULTS
A total of 26 studies involving 2823 nursing students were included in the present study. The results showed that blended learning courses were designed based on learning theory. Blended learning was more effective on the knowledge (SMD = 0.73, 95%CI [0.37, 1.09]) and skills (SMD = 0.86, 95% CI [0.35, 1.37]) compared with non-blended learning for nursing students. Critical thinking ability improved significantly through BL (SMD = 2.23, 95% CI [0.85, 3.61]). In addition, blended learning had a positive impact on nursing students' mental health. Nursing students were very satisfied with blended learning.
CONCLUSIONS
The results of this study indicated that blended learning had a positive impact on nursing students. In the future, the optimal ratio of online to offline learning in blended learning should also be explored.
Topics: Humans; Education, Nursing, Baccalaureate; Mental Health; Students, Nursing; Learning; Thinking
PubMed: 37793247
DOI: 10.1016/j.nepr.2023.103786 -
International Ophthalmology Jul 2022To systematically review the published manuscripts on stereopsis after corneal refractive surgery. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To systematically review the published manuscripts on stereopsis after corneal refractive surgery.
METHODS
The Web of Science, PubMed, Scopus, ProQuest, Clinical Key, Embase, and Cochrane Library were searched for relevant articles published until August 2020. The fixed- or random-effects models were used to estimate the Weighted mean difference (WMD) or Relative risk (RR) and 95% Confidence interval (CI) for postoperative stereopsis changes and incidence when applicable. Meta-regression was conducted for adjusting the effects of potential confounders.
RESULTS
Seven studies (1266 eyes) in adults and ten studies in pediatrics (259 eyes) were included. In adults, stereopsis improved significantly compared to the preoperative state (WMD = - 27.4, 95% CI = - 40.0, - 14.7; I = 97.8%; P < 0.001). In pediatrics, proportion of patients with stereoacuity postoperatively was 2.18 times compared to preoperative evaluation. (RR = 2.18, 95% CI = 1.2, 3.9; I = 68.6%, P < 0.001).
CONCLUSIONS
Stereopsis improves after corneal refractive surgery in adults and pediatrics.
Topics: Adult; Child; Depth Perception; Humans; Refractive Surgical Procedures; Visual Acuity
PubMed: 35041131
DOI: 10.1007/s10792-021-02201-5 -
International Journal of Environmental... Dec 2022Environmental noise affects our daily functioning in many ways, and the cognitive, motivational, and emotional effects of noise are intertwined. Our task performance... (Review)
Review
Environmental noise affects our daily functioning in many ways, and the cognitive, motivational, and emotional effects of noise are intertwined. Our task performance under noisy conditions depends on our ability to cope with the noise and our cognitive resources. The process of (failed) coping may wear us out cognitively, lead to learned helplessness, and, consequently, alter the motivation to persist in a task. The direct effect of irrelevant sounds on cognitive functioning in children is relatively well-established, however, the research on the framework of learned helplessness is limited when it comes to children. Learned helplessness can give more insight into effects of environmental noise on learning and child development and how the effects of short-term and long-term exposure interact. A systematic literature review is performed to assess to what extent the current evidence addresses the (interaction) effects of the sound environment on cognition and learned helplessness as measured by motivation in children and young adults up to the age of 21. The search resulted in 8 included papers that addressed both cognition and learned helplessness in their research. The included papers study children between 8-13 years old and show evidence for a relation between environmental noise, cognition, and helplessness individually, but none study a possible interaction. Based on the individual study designs, it could be hypothesized that cognitive fatigue may play a role in the interaction. Studies that conducted motivation tasks after cognitive tasks found stronger effects than those that conducted tasks in a random order. More research is needed using the same methods in different age groups to further assess the interaction between cognition and learned helplessness in relation to the sound environment.
Topics: Child; Young Adult; Humans; Adolescent; Cognition; Motivation; Emotions; Helplessness, Learned; Learning
PubMed: 36612610
DOI: 10.3390/ijerph20010288 -
Psychiatric Services (Washington, D.C.) Nov 2023Shared decision making (SDM) is a health communication model to improve treatment decision making and is underused for people with mental health conditions and limited,... (Review)
Review
OBJECTIVE
Shared decision making (SDM) is a health communication model to improve treatment decision making and is underused for people with mental health conditions and limited, impaired, or fluctuating decisional capacity. SDM measures are essential to enhancing the adoption and implementation of SDM practices, yet no tools or research findings exist that explicitly focus on measuring SDM with such patients. The aim of this review was to identify instruments that measure SDM involving individuals with mental health conditions and limited decisional capacity, their family members, and their health and social care providers.
METHODS
A systematic review was performed by searching the PubMed, Embase, Web of Science, and PsycInfo databases. The authors included peer-reviewed, quantitative articles published in English during 2009-2022 that focused on adults (≥18 years old). All authors performed the screening independently.
RESULTS
A total of 7,956 records were identified, six of which met the inclusion criteria for full-text review and five of which were analyzed (one full-text article was not available). No instruments were identified that measured forms of SDM involving patients with mental health conditions and limited, impaired, or fluctuating decisional capacity.
CONCLUSIONS
Measurement instruments to address and assess SDM in health care-related communication processes involving individuals with a mental health condition and limited decisional capacity are needed.
Topics: Adult; Humans; Adolescent; Decision Making, Shared; Decision Making; Patient Participation; Mental Disorders; Family
PubMed: 37194313
DOI: 10.1176/appi.ps.202200018 -
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 -
Trends in Psychiatry and Psychotherapy May 2022Mindfulness-based interventions (MBI) have been growing progressively as treatment options in the field of mental health. Aim: To assess the impact of mindfulness-based... (Review)
Review
INTRODUCTION
Mindfulness-based interventions (MBI) have been growing progressively as treatment options in the field of mental health. Aim: To assess the impact of mindfulness-based interventions for reducing suicidal thoughts and behaviors.
METHODS
A systematic review was performed in December 2020 using PubMed, PsycINFO, EMBASE, SciELO, Pepsic, and LILACS databases with no year restrictions. The search strategy included the terms ('mindfulness' OR 'mindfulness-based') AND ('suicide' OR 'suicidal' OR 'suicide risk' OR 'suicide attempt' OR 'suicide ideation' OR 'suicide behavior'). The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42020219514.
RESULTS
A total of 14 studies met all inclusion criteria and were included in this review. Most of the studies presented Mindfulness-Based Cognitive Therapy as the MBI assessed (n=10). An emerging and rapidly growing literature on MBI presents promising results in reduction of suicide risk, particularly in patients with MDD. Four studies assessing other MBI treatment protocols (Mindfulness-Based Stress Reduction; Daily Mindfulness Meditation Practice; Mind Body Awareness and Mindfulness-Based Cognitive Behavior Therapy) all demonstrated that MBI reduces factors associated with suicide risk.
CONCLUSION
MBI might target specific processes and contribute to suicide risk reduction.
Topics: Cognitive Behavioral Therapy; Humans; Mindfulness; Suicidal Ideation; Suicide, Attempted
PubMed: 34551465
DOI: 10.47626/2237-6089-2021-0316 -
Developmental Medicine and Child... May 2022To report on the results of the online international consensus process to develop the comprehensive and brief International Classification of Functioning, Disability and...
AIM
To report on the results of the online international consensus process to develop the comprehensive and brief International Classification of Functioning, Disability and Health (ICF) Core Sets for adults with cerebral palsy (CP).
METHOD
An online iterative decision-making and consensus process involved 25 experts, including clinicians and researchers working with adults with CP, an adult with CP, and the parents of adults with CP from all six regions of the World Health Organization. The most relevant categories were selected from a list of 154 unique second-level candidate categories to develop the ICF Core Sets for adults with CP. This list resulted from evidence gathered during four preparatory studies, that is, a systematic literature review, a qualitative study, an expert survey, and an empirical study.
RESULTS
The consensus process resulted in the comprehensive ICF Core Set containing 120 second-level ICF categories: 33 body functions; eight body structures; 50 activities and participation; and 29 environmental factors, from which the most essential categories, 33 in total, were selected for the brief ICF Core Set. For body functions, most of the categories were mental functions and neuromusculoskeletal and movement-related functions. Body structures were mostly related to movement. All the chapters of the activities and participation component were represented, with mobility and self-care as the most frequently covered chapters. For environmental factors, most of the categories addressed products and technology and services, systems, and policies.
INTERPRETATION
The comprehensive and brief ICF Core Sets for adults with CP were created using a new online version of an established ICF Core Set consensus process. These Core Sets complement the age-specific ICF Core Sets for children and young people with CP and will promote standardized data collection worldwide.
Topics: Activities of Daily Living; Adolescent; Adult; Cerebral Palsy; Child; Consensus; Disability Evaluation; Disabled Persons; Humans; World Health Organization
PubMed: 34800032
DOI: 10.1111/dmcn.15104 -
Preventive Medicine Feb 2022The present systematic review aimed to investigate the methodological quality and the effects of fundamental motor skills and physical activity interventions on... (Review)
Review
The present systematic review aimed to investigate the methodological quality and the effects of fundamental motor skills and physical activity interventions on cognitive and academic skills in typically developing 3 to 7-year-old children. The review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was carried out in April 2020 using seven electronic databases. The methodological quality of the studies was assessed with the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Cohen's d effect size calculations and post hoc power analyses were conducted for the included studies. A total of 35 studies, representing 2472 children met the inclusion criteria. Two of the studies demonstrated a strong methodological quality, while 24 were considered as methodologically weak. The majority (71%) of the included studies demonstrated the beneficial effects of the intervention on cognitive and academic skills. The most evidence was found for executive functions, language, and numeracy, and the effects were largest in enhancing memory. The effects were larger on cognitive and academic skills in the combined interventions compared to only fundamental motor skill and physical activity interventions, while fundamental motor skill interventions had larger effects than physical activity interventions. These findings indicate that it may be possible to support typically developing preschoolers' cognitive and academic learning with fundamental motor skill and physical activity interventions. However, most of the studies in this field have a weak methodological quality and thus, the presented evidence was considered weak in nature.
Topics: Child; Child, Preschool; Cognition; Executive Function; Exercise; Frailty; Humans; Motor Skills
PubMed: 34974071
DOI: 10.1016/j.ypmed.2021.106948