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Neuroscience and Biobehavioral Reviews Jun 2020Research into the basic effects and therapeutic applications of psychedelic drugs has grown considerably in recent years. Yet, pressing questions remain regarding the... (Review)
Review
Research into the basic effects and therapeutic applications of psychedelic drugs has grown considerably in recent years. Yet, pressing questions remain regarding the substances' lasting effects. Although individual studies have begun monitoring sustained changes, no study to-date has synthesized this information. Therefore, this systematic review aims to fill this important gap in the literature by synthesizing results from 34 contemporary experimental studies which included classic psychedelics, human subjects, and follow-up latencies of at least two weeks. The bulk of this work was published in the last five years, with psilocybin being the most frequently administered drug. Enduring changes in personality/attitudes, depression, spirituality, anxiety, wellbeing, substance misuse, meditative practices, and mindfulness were documented. Mystical experiences, connectedness, emotional breakthrough, and increased neural entropy were related to these long-term changes in psychological functioning. Finally, with proper screening, preparation, supervision, and integration, limited aversive side effects were noted by study participants. Future researchers should focus on including larger and more diverse samples, lengthier longitudinal designs, stronger control conditions, and standardized dosages.
Topics: Anxiety; Emotions; Hallucinogens; Humans; Pharmaceutical Preparations; Psilocybin
PubMed: 32194129
DOI: 10.1016/j.neubiorev.2020.03.017 -
The Cochrane Database of Systematic... Jul 2020Resilience can be defined as maintaining or regaining mental health during or after significant adversities such as a potentially traumatising event, challenging life... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Resilience can be defined as maintaining or regaining mental health during or after significant adversities such as a potentially traumatising event, challenging life circumstances, a critical life transition or physical illness. Healthcare students, such as medical, nursing, psychology and social work students, are exposed to various study- and work-related stressors, the latter particularly during later phases of health professional education. They are at increased risk of developing symptoms of burnout or mental disorders. This population may benefit from resilience-promoting training programmes.
OBJECTIVES
To assess the effects of interventions to foster resilience in healthcare students, that is, students in training for health professions delivering direct medical care (e.g. medical, nursing, midwifery or paramedic students), and those in training for allied health professions, as distinct from medical care (e.g. psychology, physical therapy or social work students).
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results.
SELECTION CRITERIA
Randomised controlled trials (RCTs) comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, waiting list, usual care, and active or attention control, in adults (18 years and older), who are healthcare students. Primary outcomes were resilience, anxiety, depression, stress or stress perception, and well-being or quality of life. Secondary outcomes were resilience factors.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only).
MAIN RESULTS
We included 30 RCTs, of which 24 were set in high-income countries and six in (upper- to lower-) middle-income countries. Twenty-two studies focused solely on healthcare students (1315 participants; number randomised not specified for two studies), including both students in health professions delivering direct medical care and those in allied health professions, such as psychology and physical therapy. Half of the studies were conducted in a university or school setting, including nursing/midwifery students or medical students. Eight studies investigated mixed samples (1365 participants), with healthcare students and participants outside of a health professional study field. Participants mainly included women (63.3% to 67.3% in mixed samples) from young adulthood (mean age range, if reported: 19.5 to 26.83 years; 19.35 to 38.14 years in mixed samples). Seventeen of the studies investigated group interventions of high training intensity (11 studies; > 12 hours/sessions), that were delivered face-to-face (17 studies). Of the included studies, eight compared a resilience training based on mindfulness versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. universities, foundations), or a combination of various sources (four studies). Seven studies did not specify a potential funder, and three studies received no funding support. Risk of bias was high or unclear, with main flaws in performance, detection, attrition and reporting bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare students receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.43, 95% confidence interval (CI) 0.07 to 0.78; 9 studies, 561 participants), lower levels of anxiety (SMD -0.45, 95% CI -0.84 to -0.06; 7 studies, 362 participants), and lower levels of stress or stress perception (SMD -0.28, 95% CI -0.48 to -0.09; 7 studies, 420 participants). Effect sizes varied between small and moderate. There was little or no evidence of any effect of resilience training on depression (SMD -0.20, 95% CI -0.52 to 0.11; 6 studies, 332 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.15, 95% CI -0.14 to 0.43; 4 studies, 251 participants; very-low certainty evidence). Adverse effects were measured in four studies, but data were only reported for three of them. None of the three studies reported any adverse events occurring during the study (very-low certainty of evidence).
AUTHORS' CONCLUSIONS
For healthcare students, there is very-low certainty evidence for the effect of resilience training on resilience, anxiety, and stress or stress perception at post-intervention. The heterogeneous interventions, the paucity of short-, medium- or long-term data, and the geographical distribution restricted to high-income countries limit the generalisability of results. Conclusions should therefore be drawn cautiously. Since the findings suggest positive effects of resilience training for healthcare students with very-low certainty evidence, high-quality replications and improved study designs (e.g. a consensus on the definition of resilience, the assessment of individual stressor exposure, more attention controls, and longer follow-up periods) are clearly needed.
Topics: Adult; Allied Health Occupations; Allied Health Personnel; Anxiety; Bias; Depression; Female; Humans; Male; Mental Health; Quality of Life; Randomized Controlled Trials as Topic; Resilience, Psychological; Stress, Psychological; Students, Health Occupations; Waiting Lists; Young Adult
PubMed: 32691879
DOI: 10.1002/14651858.CD013684 -
BMJ (Clinical Research Ed.) Nov 2023To examine the association between social media use and health risk behaviours in adolescents (defined as those 10-19 years). (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To examine the association between social media use and health risk behaviours in adolescents (defined as those 10-19 years).
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
EMBASE, Medline, APA PsycINFO, SocINDEX, CINAHL, SSRN, SocArXic, PsyArXiv, medRxiv, and Google Scholar (1 January 1997 to 6 June 2022).
METHODS
Health risk behaviours were defined as use of alcohol, drugs, tobacco, electronic nicotine delivery systems, unhealthy dietary behaviour, inadequate physical activity, gambling, and anti-social, sexual risk, and multiple risk behaviours. Included studies reported a social media variable (ie, time spent, frequency of use, exposure to health risk behaviour content, or other social media activities) and one or more relevant outcomes. Screening and risk of bias assessments were completed independently by two reviewers. Synthesis without meta-analysis based on effect direction and random-effects meta-analyses was used. Effect modification was explored using meta-regression and stratification. Certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluations).
RESULTS
Of 17 077 studies screened, 126 were included (73 included in meta-analyses). The final sample included 1 431 534 adolescents (mean age 15.0 years). Synthesis without meta-analysis indicated harmful associations between social media and all health risk behaviours in most included studies, except inadequate physical activity where beneficial associations were reported in 63.6% of studies. Frequent ( infrequent) social media use was associated with increased alcohol consumption (odds ratio 1.48 (95% confidence interval 1.35 to 1.62); n=383 068), drug use (1.28 (1.05 to 1.56); n=117 646), tobacco use (1.85, 1.49 to 2.30; n=424 326), sexual risk behaviours (1.77 (1.48 to 2.12); n=47 280), anti-social behaviour (1.73 (1.44 to 2.06); n=54 993), multiple risk behaviours (1.75 (1.30 to 2.35); n=43 571), and gambling (2.84 (2.04 to 3.97); n=26 537). Exposure to content showcasing health risk behaviours on social media ( no exposure) was associated with increased odds of use of electronic nicotine delivery systems (1.73 (1.34 to 2.23); n=721 322), unhealthy dietary behaviours (2.48 (2.08 to 2.97); n=9892), and alcohol consumption (2.43 (1.25 to 4.71); n=14 731). For alcohol consumption, stronger associations were identified for exposure to user generated content (3.21 (2.37 to 4.33)) versus marketer generated content (2.12 (1.06 to 4.24)). For time spent on social media, use for at least 2 h per day ( <2 h) increased odds of alcohol consumption (2.12 (1.53 to 2.95); n=12 390). GRADE certainty was moderate for unhealthy dietary behaviour, low for alcohol use, and very low for other investigated outcomes.
CONCLUSIONS
Social media use is associated with adverse health risk behaviours in young people, but further high quality research is needed to establish causality, understand effects on health inequalities, and determine which aspects of social media are most harmful.
STUDY REGISTRATION
PROSPERO, CRD42020179766.
Topics: Adolescent; Humans; Health Risk Behaviors; Social Media; Alcohol Drinking; Diet; Exercise
PubMed: 38030217
DOI: 10.1136/bmj-2022-073552 -
Gerontology & Geriatric Medicine 2022Ageism may have harmful effects on the psychological well-being of older adults, leading to mental health issues, such as depression and anxiety. However, there are... (Review)
Review
Ageism may have harmful effects on the psychological well-being of older adults, leading to mental health issues, such as depression and anxiety. However, there are insufficient data to establish this hypothesis, and most work on the subject has appeared only in the form of conceptual or theoretical papers. This study reviewed quantitative studies of the relationship between ageism and psychological well-being of older adults. We conducted a comprehensive review using searches of academic databases, the grey literature, hand searches, and reference mining. A total of thirteen articles were selected using the inclusion criteria. All the reviewed studies showed a negative association between ageism and the psychological well-being of older adults. The study confirmed a negative association between ageism and older adults' psychological well-being, finding that older adults with a high level of psychological well-being may be less negatively affected by ageism, especially those who were proud of their age group, experienced less negative emotions, were more optimistic about aging and their future, were more self-confident about their bodies, and were flexible in setting goals. The identified mediators of the association can inform intervention development to the effects of ageism and improve older adults' psychological well-being.
PubMed: 35434202
DOI: 10.1177/23337214221087023 -
Sports Medicine (Auckland, N.Z.) Nov 2022Sleep loss may influence subsequent physical performance. Quantifying the impact of sleep loss on physical performance is critical for individuals involved in athletic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Sleep loss may influence subsequent physical performance. Quantifying the impact of sleep loss on physical performance is critical for individuals involved in athletic pursuits.
DESIGN
Systematic review and meta-analysis.
SEARCH AND INCLUSION
Studies were identified via the Web of Science, Scopus, and PsycINFO online databases. Investigations measuring exercise performance under 'control' (i.e., normal sleep, > 6 h in any 24 h period) and 'intervention' (i.e., sleep loss, ≤ 6 h sleep in any 24 h period) conditions were included. Performance tasks were classified into different exercise categories (anaerobic power, speed/power endurance, high-intensity interval exercise (HIIE), strength, endurance, strength-endurance, and skill). Multi-level random-effects meta-analyses and meta-regression analyses were conducted, including subgroup analyses to explore the influence of sleep-loss protocol (e.g., deprivation, restriction, early [delayed sleep onset] and late restriction [earlier than normal waking]), time of day the exercise task was performed (AM vs. PM) and body limb strength (upper vs. lower body).
RESULTS
Overall, 227 outcome measures (anaerobic power: n = 58; speed/power endurance: n = 32; HIIE: n = 27; strength: n = 66; endurance: n = 22; strength-endurance: n = 9; skill: n = 13) derived from 69 publications were included. Results indicated a negative impact of sleep loss on the percentage change (%) in exercise performance (n = 959 [89%] male; mean % = - 7.56%, 95% CI - 11.9 to - 3.13, p = 0.001, I = 98.1%). Effects were significant for all exercise categories. Subgroup analyses indicated that the pattern of sleep loss (i.e., deprivation, early and late restriction) preceding exercise is an important factor, with consistent negative effects only observed with deprivation and late-restriction protocols. A significant positive relationship was observed between time awake prior to the exercise task and % in performance for both deprivation and late-restriction protocols (~ 0.4% decrease for every hour awake prior to exercise). The negative effects of sleep loss on different exercise tasks performed in the PM were consistent, while tasks performed in the AM were largely unaffected.
CONCLUSIONS
Sleep loss appears to have a negative impact on exercise performance. If sleep loss is anticipated and unavoidable, individuals should avoid situations that lead to experiencing deprivation or late restriction, and prioritise morning exercise in an effort to maintain performance.
Topics: Humans; Male; Female; Physical Endurance; Exercise; Physical Functional Performance; Sleep
PubMed: 35708888
DOI: 10.1007/s40279-022-01706-y -
International Journal of Nursing Studies Mar 2024Peripheral intravenous catheters are the most frequently used invasive device in nursing practice, yet are commonly associated with complications. We performed a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Peripheral intravenous catheters are the most frequently used invasive device in nursing practice, yet are commonly associated with complications. We performed a systematic review to determine the prevalence of peripheral intravenous catheter infection and all-cause failure.
METHODS
The Cochrane Library, PubMed, CINAHL, and EMBASE were searched for observational studies and randomised controlled trials that reported peripheral intravenous catheter related infections or failure. The review was limited to English language and articles published from the year 2000. Pooled estimates were calculated with random-effects models. Meta-analysis of observation studies in epidemiology guidelines and the Cochrane process for randomised controlled trials were used to guide the review. Prospero registration number: CRD42022349956.
FINDINGS
Our search retrieved 34,725 studies. Of these, 41 observational studies and 28 randomised controlled trials (478,586 peripheral intravenous catheters) met inclusion criteria. The pooled proportion of catheter-associated bloodstream infections was 0.028 % (95 % confidence interval (CI): 0.009-0.081; 38 studies), or 4.40 catheter-associated bloodstream infections per 100,000 catheter-days (20 studies, 95 % CI: 3.47-5.58). Local infection was reported in 0.150 % of peripheral intravenous catheters (95 % CI: 0.047-0.479, 30 studies) with an incidence rate of 65.1 per 100,000 catheter-days (16 studies; 95 % CI: 49.2-86.2). All cause peripheral intravenous catheter failure before treatment completion occurred in 36.4 % of catheters (95 % CI: 31.7-41.3, 53 studies) with an overall incidence rate of 4.42 per 100 catheter days (78,891 catheter days; 19 studies; 95 % CI: 4.27-4.57).
INTERPRETATION
Peripheral intravenous catheter failure is a significant worldwide problem, affecting one in three catheters. Per peripheral intravenous catheter, infection occurrence was low, however, with over two billion catheters used globally each year, the absolute number of infections and associated burden remains high. Substantial and systemwide efforts are needed to address peripheral intravenous catheter infection and failure and the sequelae of treatment disruption, increased health costs and poor patient outcomes.
Topics: Humans; Phlebitis; Catheter-Related Infections; Catheters; Catheterization, Peripheral; Sepsis
PubMed: 38142634
DOI: 10.1016/j.ijnurstu.2023.104673 -
BMC Public Health Nov 2019Youth often experience unique pathways into homelessness, such as family conflict, child abuse and neglect. Most research has focused on adult homeless populations, yet...
BACKGROUND
Youth often experience unique pathways into homelessness, such as family conflict, child abuse and neglect. Most research has focused on adult homeless populations, yet youth have specific needs that require adapted interventions. This review aims to synthesize evidence on interventions for youth and assess their impacts on health, social, and equity outcomes.
METHODS
We systematically searched Medline, Embase, PsycINFO, and other databases from inception until February 9, 2018 for systematic reviews and randomized controlled trials on youth interventions conducted in high income countries. We screened title and abstract and full text for inclusion, and data extraction were completed in duplicate, following the PRISMA-E (equity) review approach.
RESULTS
Our search identified 11,936 records. Four systematic reviews and 18 articles on randomized controlled trials met the inclusion criteria. Many studies reported on interventions including individual and family therapies, skill-building, case management, and structural interventions. Cognitive behavioural therapy led to improvements in depression and substance use, and studies of three family-based therapies reported decreases in substance use. Housing first, a structural intervention, led to improvements in housing stability. Many interventions showed inconsistent results compared to services as usual or other interventions, but often led to improvements over time in both the intervention and comparison group. The equity analysis showed that equity variables were inconsistently measured, but there was data to suggest differential outcomes based upon gender and ethnicity.
CONCLUSIONS
This review identified a variety of interventions for youth experiencing homelessness. Promising interventions include cognitive behavioural therapy for addressing depression, family-based therapy for substance use outcomes, and housing programs for housing stability. Youth pathways are often unique and thus prevention and treatment may benefit from a tailored and flexible approach.
Topics: Adolescent; Case Management; Child; Cognitive Behavioral Therapy; Depression; Ethnicity; Family Relations; Family Therapy; Ill-Housed Persons; Homeless Youth; Housing; Humans; Mental Health; Psychotherapy; Sex Factors; Social Work; Substance-Related Disorders
PubMed: 31727031
DOI: 10.1186/s12889-019-7856-0 -
Medicine Jan 2020Sedoanalgesia secondary iatrogenic withdrawal syndrome (IWS) in paediatric intensive units is frequent and its assessment is complex. Therapies are heterogeneous, and...
BACKGROUND
Sedoanalgesia secondary iatrogenic withdrawal syndrome (IWS) in paediatric intensive units is frequent and its assessment is complex. Therapies are heterogeneous, and there is currently no gold standard method for diagnosis. In addition, the assessment scales validated in children are scarce. This paper aims to identify and describe both the paediatric diagnostic and assessment tools for the IWS and the treatments for the IWS in critically ill paediatric patients.
METHODS
A systematic review was conducted according to the PRISMA guidelines. This review included descriptive and observational studies published since 2000 that analyzed paediatric scales for the evaluation of the iatrogenic withdrawal syndrome and its treatments. The eligibility criteria included neonates, newborns, infants, pre-schoolers, and adolescents, up to age 18, who were admitted to the paediatric intensive care units with continuous infusion of hypnotics and/or opioid analgesics, and who presented signs or symptoms of deprivation related to withdrawal and prolonged infusion of sedoanalgesia.
RESULTS
Three assessment scales were identified: Withdrawal Assessment Tool-1, Sophia Observation Withdrawal Symptoms, and Opioid and Benzodiazepine Withdrawal Score. Dexmedetomidine, methadone and clonidine were revealed as options for the treatment and prevention of the iatrogenic withdrawal syndrome. Finally, the use of phenobarbital suppressed symptoms of deprivation that are resistant to other drugs.
CONCLUSIONS
The reviewed scales facilitate the assessment of the iatrogenic withdrawal syndrome and have a high diagnostic quality. However, its clinical use is very rare. The treatments identified in this review prevent and effectively treat this syndrome. The use of validated iatrogenic withdrawal syndrome assessment scales in paediatrics clinical practice facilitates assessment, have a high diagnostic quality, and should be encouraged, also ensuring nurses' training in their usage.
Topics: Child; Humans; Iatrogenic Disease; Intensive Care Units, Pediatric; Substance Withdrawal Syndrome
PubMed: 32000360
DOI: 10.1097/MD.0000000000018502 -
Journal of Evidence-based Social Work... Apr 2023This study identified the nature of social work practice in primary health care and described the reported patient outcomes, benefits, challenges, and enablers of social...
PURPOSE
This study identified the nature of social work practice in primary health care and described the reported patient outcomes, benefits, challenges, and enablers of social work in general practice [GP] settings.
METHOD
A systematic literature review applying the Prisma framework was conducted.
RESULTS
A total of 26 studies met the inclusion criteria. Social work practice in GP assists in delivering positive health outcomes for patients, improved patient care, offers value for money, and supports interdisciplinary teams. Identified challenges include funding impediments, organizational barriers, and a lack of understanding of and undervaluing the social work role.
DISCUSSION AND CONCLUSIONS
The review outlined the benefits of social work practice in GP practices; however, these must be further evidenced. Funding for social workers in primary health care was identified as a challenge when it was lacking, and as an enabler when it was available. Further research to evidence the patient outcomes and overall benefits, the fiscal value of social work and funding pathways in primary health care is recommended.
PubMed: 37264677
DOI: 10.1080/26408066.2023.2202665 -
International Journal of Environmental... Mar 2022Research has established the family as the predominant context for child labor practices. Decisions to involve children in child labor within the family or by a family... (Review)
Review
BACKGROUND
Research has established the family as the predominant context for child labor practices. Decisions to involve children in child labor within the family or by a family member (herein family child labor) is strongly motivated by cultural beliefs that normalize child labor. This systematic review sought to synthesize evidence on the social norms that support child labor practices, and the normative interpretation of international child labor legislation/standards.
METHODS
We followed the PRISMA procedure for systematic review by reviewing empirical articles published between 2000 to 2021 and contained within the four key databases: Scopus, ISI Web of Sciences, PubMed and Embase. Findings from 13 articles that met the inclusion criteria were analyzed thematically.
RESULTS
The review included studies from three continents: Africa, Asia and Europe. Gender norms, informal apprenticeship norm, norms on succession and sustenance as well as obedience, were key social norms that influenced child labor practices in the family. Parents' decision to involve children in child labor was strongly influenced by the collective acceptance of some occupations (e.g., cocoa farming and fishing) as family occupations, which need to be preserved, undertaken and passed on to children. Child rights and the UNCRC principle of children's participation were considered foreign to most non-western countries and interpreted as contravention to the cherished social norm of obedience. The findings underlie the link between social norms and the common social values of resilience, hard work, and respect.
CONCLUSION
The results provide foundations and target to develop normative change intervention programs to re-orient the negative interpretations of common social values and provide alternative pathways that prevent child labor within the social context.
Topics: Child; Child Labor; Family; Humans; Social Environment; Social Norms; Social Values
PubMed: 35409766
DOI: 10.3390/ijerph19074082