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Sleep Medicine Reviews Oct 2022Naps are increasingly considered a means to boost cognitive performance. We quantified the cognitive effects of napping in 60 samples from 54 studies. 52 samples... (Meta-Analysis)
Meta-Analysis Review
Naps are increasingly considered a means to boost cognitive performance. We quantified the cognitive effects of napping in 60 samples from 54 studies. 52 samples evaluated memory. We first evaluated effect sizes for all tests together, before separately assessing their effects on memory, vigilance, speed of processing and executive function. We next examined whether nap effects were moderated by study features of age, nap length, nap start time, habituality and prior sleep restriction. Naps showed significant benefits for the total aggregate of cognitive tests (Cohen's d = 0.379, CI = 0.296-0.462). Significant domain specific effects were present for declarative (Cohen's d = 0.376, CI = 0.269-0.482) and procedural memory (Cohen's d = 0.494, CI = 0.301-0.686), vigilance (Cohen's d = 0.610, CI = 0.291-0.929) and speed of processing (Cohen's d = 0.211, CI = 0.052-0.369). There were no significant moderation effects of any of the study features. Nap effects were of comparable magnitude across subgroups of each of the 5 moderators (Q values = 0.009 to 8.572, p values > 0.116). Afternoon naps have a small to medium benefit over multiple cognitive tests. These effects transcend age, nap duration and tentatively, habituality and prior nocturnal sleep.
Topics: Humans; Cognition; Executive Function; Sleep; Wakefulness
PubMed: 36041284
DOI: 10.1016/j.smrv.2022.101666 -
Epilepsy & Behavior : E&B Sep 2021The epilepsy surgery treatment gap is well defined and secondary to a broad range of issues, including healthcare professionals' (HCPs') knowledge, attitude, and... (Review)
Review
OBJECTIVE
The epilepsy surgery treatment gap is well defined and secondary to a broad range of issues, including healthcare professionals' (HCPs') knowledge, attitude, and perception (KAP) toward epilepsy surgery. However, no previous systematic reviews investigated this important topic.
METHODS
The systematic review was conducted according to Preferred Reporting Items for the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We identified a total of 652 articles from multiple databases using database-specific queries and included 65 articles for full-text review after screening the titles and abstracts of the articles. Finally, we selected 11 papers for qualitative analysis. We critically appraised the quality of the studies using the Joanna Briggs critical appraisal tool.
RESULTS
The qualitative analysis of the content identified several key reasons causing healthcare professional-related barriers to epilepsy surgery: inadequate knowledge and awareness about the role of epilepsy surgery in drug-resistant epilepsy (DRE), poor identification and referral of patients with DRE, insufficient selection of candidates for presurgical workup, negative or ambivalent attitudes and perceptions regarding epilepsy surgery, deficient communication practices with patients regarding risk-benefit analysis of epilepsy surgery, and challenging coordination issues with the surgical referral. Neurologists with formal instruction in epilepsy, surgical exposure during training, participation in high volume epilepsy practice, or prior experience in surgical referral may refer more patients for surgical evaluation.
CONCLUSIONS
While significant work has been conducted in a limited number of studies to explore HCPs' knowledge gap and educational need regarding epilepsy surgery, further research is needed in defining the learning goals, assessing and validating specific learning gaps among providers, defining the learning outcomes, optimizing the educational format, content, and outcome measures, and appraising the achieved results following the educational intervention.
Topics: Epilepsy; Health Knowledge, Attitudes, Practice; Health Personnel; Humans; Learning; Perception
PubMed: 34273740
DOI: 10.1016/j.yebeh.2021.108199 -
BMJ Open Aug 2022Decision aids (DAs) for clients in home and community care can support shared decision-making (SDM) with patients, healthcare teams and informal caregivers. We aimed to...
OBJECTIVES
Decision aids (DAs) for clients in home and community care can support shared decision-making (SDM) with patients, healthcare teams and informal caregivers. We aimed to identify DAs developed for home and community care, verify their adherence to international DA criteria and explore the involvement of interprofessional teams in their development and use.
DESIGN
Systematic review reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
DATA SOURCES
Six electronic bibliographic databases (MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO and the Cochrane Library) from inception to November 2019, social media and grey literature websites up to January 2021.
ELIGIBILITY CRITERIA
DAs designed for home and community care settings or including home care or community services as options.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently reviewed citations. Analysis consisted of a narrative synthesis of outcomes and a thematic analysis. DAs were appraised using the International Patient Decision Aid Standards (IPDAS). We collected information on the involvement of interprofessional teams, including nurses, in their development and use.
RESULTS
After reviewing 10 337 database citations and 924 grey literature citations, we extracted characteristics of 33 included DAs. DAs addressed a variety of decision points. Nearly half (42%) were relevant to older adults. Several DAs did not meet IPDAS criteria. Involvement of nurses and interprofessional teams in the development and use of DAs was minimal (33.3% of DAs).
CONCLUSION
DAs concerned a variety of decisions, especially those related to older people. This reflects the complexity of decisions and need for better support in this sector. There is little evidence about the involvement of interprofessional teams in the development and use of DAs in home and community care settings. An interprofessional approach to designing DAs for home care could facilitate SDM with people being cared for by teams.
PROSPERO REGISTRATION NUMBER
CRD42020169450.
Topics: Aged; Decision Making; Decision Making, Shared; Decision Support Techniques; Home Care Services; Humans; Patient Care Team; Patient Participation
PubMed: 36129731
DOI: 10.1136/bmjopen-2022-061215 -
Body Image Mar 2024Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing... (Review)
Review
Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing literature that has explored the relationship between weight stigma and disordered eating cognitions and behaviors. We specifically examined three dimensions of weight stigma - experienced, anticipated, and internalized - and adopted an inclusive conceptualization of outcomes related to disordered eating (including constructs such as binge eating, body dissatisfaction, and other cognitions and behaviors such as dietary restraint, unhealthy weight control behaviors, and drive for thinness). We searched PubMed, Embase, CINAHL, Web of Science, Sociological Abstracts, and PsycINFO for English-language, peer-reviewed articles and dissertations with quantitative methodology published through October 2023. The search resulted in 242 articles meeting inclusion criteria. A narrative review found a consistent relationship between greater weight stigma and more disordered eating cognitions and behaviors. Methodological and theoretical limitations are discussed, as are critical avenues for future research and potential clinical implications stemming from this body of research. Given the widespread nature and impact of weight stigma on disordered eating, it is imperative that we intervene to address weight stigma at all levels, from the structural to the intrapersonal.
Topics: Humans; Body Image; Weight Prejudice; Feeding and Eating Disorders; Thinness; Cognition
PubMed: 38278088
DOI: 10.1016/j.bodyim.2023.101678 -
Clinical Psychology Review Jun 2024In this systematic review, we aimed to synthesise existing research on the phenomenology of mental imagery among high worriers compared to healthy individuals, and to... (Review)
Review
BACKGROUND
In this systematic review, we aimed to synthesise existing research on the phenomenology of mental imagery among high worriers compared to healthy individuals, and to characterise the nature and effectiveness of existing imagery-related interventions in treatment of worry.
METHODS
PsycInfo, CENTRAL, EMBASE, Medline, Medline Epub, and PubMed were searched for studies examining the relationship between worry/GAD and mental imagery, or interventions using imagery in treatment of worry/GAD. We assessed study quality and used qualitative narrative synthesis to comprehensively map study results.
RESULTS
The search yielded 2589 abstracts that were assessed for eligibility independently by two authors. From this, 183 full texts were screened and 50 qualitatively synthesised. Twenty-seven reported an association between worry/GAD and an aspect of mental imagery. Here, overactive negative and worry imagery, and diminished positive future imagining, were associated with worry/GAD. Twenty-three studies reported an intervention. This literature suggested mixed findings regarding efficacy, including for imaginal exposure as an independent technique for GAD.
CONCLUSIONS
Findings support dysfunctional negative imagining and diminished positive prospective imagery in GAD. General imagining abilities remain intact, which is promising for efforts to utilise imagery in treatment. Further research is warranted to develop innovative clinical applications of imagery in treatment of GAD.
Topics: Humans; Imagery, Psychotherapy; Anxiety Disorders; Imagination; Anxiety
PubMed: 38640775
DOI: 10.1016/j.cpr.2024.102427 -
Addiction (Abingdon, England) May 2023Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training...
AIMS
Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions.
DESIGN, SETTING AND PARTICIPANTS
We used a Delphi approach with two sequential phases: survey development and iterative surveying of experts. This was an on-line study. During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n = 54) identified via recommendations from the Steering Committee and a systematic review.
MEASUREMENTS
Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients and modes of delivery.
FINDINGS
Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias modification, goal-setting, strategy learning and meta-awareness as active ingredients; and (iv) both addiction treatment work-force and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities.
CONCLUSIONS
Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options.
Topics: Humans; Delphi Technique; Cognitive Training; Substance-Related Disorders; Behavior, Addictive; Consensus
PubMed: 36508168
DOI: 10.1111/add.16109 -
Neuroscience and Biobehavioral Reviews Sep 2022Anxiety is often conceptualised as the prototypical disorder of interoception (one's perception of bodily states). Whilst theoretical models predict an association... (Meta-Analysis)
Meta-Analysis Review
Anxiety is often conceptualised as the prototypical disorder of interoception (one's perception of bodily states). Whilst theoretical models predict an association between interoceptive accuracy and anxiety, empirical work has produced mixed results. This manuscript presents a pre-registered systematic review (https://osf.io/2h5xz) and meta-analysis of 55 studies, obtained via a Pubmed search on 9th November 2020, examining the relationship between state and trait anxiety and objectively measured cardiac interoceptive accuracy as assessed by heartbeat counting and discrimination tasks. Potential moderators of this relationship - the age, gender and clinical diagnoses of participants, the anxiety measures used and the study design - were also explored. Overall, we found no evidence for an association between cardiac interoceptive accuracy and anxiety, with none of the factors examined moderating this finding. We discuss the implications these findings have for future research, with a particular focus on the need for further investigation of the relationship between anxiety and other facets of interoception.
Topics: Anxiety; Anxiety Disorders; Awareness; Heart; Heart Rate; Humans; Interoception
PubMed: 35798125
DOI: 10.1016/j.neubiorev.2022.104754 -
Journal of General Internal Medicine Sep 2023Improving access to evidence-based psychotherapies (EBPs) is a Veterans Health Administration (VHA) priority. Cognitive behavioral therapy (CBT), acceptance and...
Evaluation of Implementation Strategies for Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness-Based Stress Reduction (MBSR): a Systematic Review.
BACKGROUND
Improving access to evidence-based psychotherapies (EBPs) is a Veterans Health Administration (VHA) priority. Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based stress reduction (MBSR) are effective for chronic pain and several mental health conditions. We synthesized evidence on implementation strategies to increase EBP access and use.
METHODS
We searched MEDLINE, Embase, PsycINFO, and CINAHL from inception until March 2021 for articles on EBP implementation within integrated health systems to treat chronic pain or chronic mental health conditions. Reviewers independently screened articles, extracted results, coded qualitative findings, and rated quality using modified criteria from Newcastle-Ottawa (quantitative results) or Critical Appraisal Skills Programme (qualitative results). We categorized implementation strategies using the Expert Recommendations for Implementing Change (ERIC) framework and classified outcomes using RE-AIM domains (Reach, Effectiveness, Adoption, Implementation, Maintenance).
RESULTS
Twelve articles (reporting results from 10 studies) evaluated CBT (k = 11) and ACT (k = 1) implementation strategies in large integrated healthcare systems. No studies evaluated MBSR implementation. Eight articles evaluated strategies within VHA. Six articles reported on national VHA EBP implementation programs; all involved training/education, facilitation, and audit/feedback. CBT and ACT implementation demonstrated moderate to large improvements in patient symptoms and quality of life. Trainings increased mental health provider self-efficacy in delivering EBPs, improved provider EBP perceptions, and increased provider EBP use during programs, but had unclear impacts on Reach. It was unclear whether external facilitation added benefit. Provider EBP maintenance was modest; barriers included competing professional time demands and patient barriers.
DISCUSSION
Multi-faceted CBT and ACT implementation programs increased provider EBP Adoption but had unclear impacts on Reach. Future implementation efforts should further evaluate Reach, Adoption, and Maintenance; assess the added value of external facilitation; and consider strategies targeting patient barriers. Future work should use implementation frameworks to guide evaluations of barriers and facilitators, processes of change, and outcomes.
REGISTRATION
PROSPERO registration number CRD42021252038.
Topics: Humans; Acceptance and Commitment Therapy; Mindfulness; Chronic Pain; Quality of Life; Cognitive Behavioral Therapy
PubMed: 37012538
DOI: 10.1007/s11606-023-08140-4 -
International Journal of Environmental... Oct 2022A growing body of research suggests disinhibited eating and weaker executive function (EF) are two risk factors for pediatric obesity. Emerging brain imaging and... (Meta-Analysis)
Meta-Analysis Review
A growing body of research suggests disinhibited eating and weaker executive function (EF) are two risk factors for pediatric obesity. Emerging brain imaging and behavioral findings support the notion that EF skills impact eating regulation. However, a major gap in the current literature is a synthesis of the association between various EF skills and disinhibited eating patterns across child development. To address this gap, a systematic review and meta-analysis was conducted to examine the effect of EF skills on disinhibited eating behaviors among youth ages 3-18 years old. PubMed and PsychINFO databases were utilized and data from 15 studies with a total sample of 4909 youth were included. A random effects meta-analysis revealed a small negative effect of overall EF skills on disinhibited eating behavior, = -0.14, < 0.01. Analysis of individual EF skills found working memory had an overall medium negative effect on disinhibited eating behavior, = -0.25, < 0.05. Taken together, findings from this meta-analysis support an inverse relationship between EF abilities and disinhibited eating patterns in children and adolescents, such that poorer EF abilities are associated with higher levels of disinhibited eating. Given the effect on eating behavior, future research is needed to assess whether EF difficulties may be a barrier to effective weight management in youth. Specifically, research is needed to examine whether EF skills may be a key target to consider for effective obesity prevention and treatment in children and adolescents.
Topics: Child; Humans; Adolescent; Child, Preschool; Executive Function; Pediatric Obesity; Feeding Behavior; Memory, Short-Term; Problem Behavior
PubMed: 36293963
DOI: 10.3390/ijerph192013384 -
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