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Palliative Medicine Jul 2023Medical Aid in Dying is an end-of-life option that allows a physician to provide a patient with a prescription to end their life. Though Medical Aid in Dying intends to... (Review)
Review
An examination and proposed theoretical model of risk and protective factors for bereavement outcomes for family members of individuals who engaged in medical aid in dying: A systematic review.
BACKGROUND
Medical Aid in Dying is an end-of-life option that allows a physician to provide a patient with a prescription to end their life. Though Medical Aid in Dying intends to reduce suffering for a patient, opponents argue Medical Aid in Dying may increase suffering for the family members during bereavement. To better understand the bereavement outcomes for family members/friends following Medical Aid in Dying, an exhaustive review of the risk and protective factors for bereavement outcomes is warranted.
AIM
This systemic review aimed to identify studies that examined bereavement outcomes of family members of individuals who engage in Medial Aid in Dying, identify risk and protective factors for bereavement outcomes, and propose a theoretical model to enhance conceptual clarity.
DESIGN
A mixed-method systematic review.
DATA SOURCES
Ten databases were searched on June 16, 2021 and later conducted two updates (latest April 25, 2022).
RESULTS
Thirteen articles met inclusion criteria. Risk and protective factors were identified pre-Medical Aid in Dying and risk factors post-Medical Aid in Dying. Few studies compared bereavement outcomes for family members of individuals utilizing Medical Aid in Dying to family members who lost someone to natural loss.
CONCLUSIONS
This study provides equivocal results about the effects of Medical Aid in Dying on family members following the loss. The theoretical model outlines potential risk and protective factors. This model provides a greater understanding of possible universal risk and protective factors for family members of individuals who engaged in Medical Aid in Dying.
Topics: Humans; Suicide, Assisted; Protective Factors; Bereavement; Grief; Family
PubMed: 37129287
DOI: 10.1177/02692163231172242 -
Infant Behavior & Development Aug 2021Early self-regulation is a foundation for lifelong wellness and can be shaped by the interplay among several vital exposures. In this study, we examined the emergence of...
Early self-regulation is a foundation for lifelong wellness and can be shaped by the interplay among several vital exposures. In this study, we examined the emergence of reliable profiles based upon exposure to risk and protective factors in infancy, determined if sociodemographic resources predict profile membership, and determined if these profiles predict early regulatory behaviors in a sample of infants reared in low-income homes. Data were collected from a sample of primarily Black or White mother-infant dyads living in low-income homes in the Midwest (n = 222) during the infants' first year of life (mean maternal age at enrollment: 26.29 years; range 18-43 years). Exposures included mother-infant interactions; father support; maternal depression, stress, and self-efficacy; home environment; food security; and breastfeeding duration. Sociodemographic resources included poverty status; economic hardship; maternal education, employment, and age; parental marital status; and infant race and sex. Infant regulatory behaviors were measured with the Infant Behavior Questionnaire-Revised Very Short Form effortful control subscale (mean age 11 months; range 8.5-14.3 months). Latent profile analysis was used to profile infants by risk and protective exposures. Regression was used to differentiate profiles by sociodemographic resources and to predict infant regulatory behavior from profiles. Three profiles emerged: low father support, good maternal mental health, and poor maternal mental health. A married mother, less economic hardship, and working mothers predicted infant exposure to good maternal mental health. Infant regulatory behavior was best when the infant was exposed to the good maternal mental health profile. Implications for future research are discussed.
Topics: Adolescent; Adult; Breast Feeding; Female; Humans; Infant; Mother-Child Relations; Mothers; Poverty; Protective Factors; Young Adult
PubMed: 34118651
DOI: 10.1016/j.infbeh.2021.101598 -
BMC Public Health Jun 2021Coronavirus Disease 2019 (COVID-19) is a global pandemic and an anxiety-provoking event. There are few studies to identify potential risk and protective factors related...
BACKGROUND
Coronavirus Disease 2019 (COVID-19) is a global pandemic and an anxiety-provoking event. There are few studies to identify potential risk and protective factors related to anxiety during COVID-19 pandemic.
METHODS
We collected information on demographic data and lifestyles by a web-based survey of 19,802 participants from 34 provinces in China during COVID-19 pandemic. Level of anxiety was evaluated using the Self-Rating Anxiety Scale. We used ordinal multivariable logistic regression to estimate the associations of anxiety level with potential risk and protective factors. We further developed a new score to simplify the assessment of anxiety during COVID-19 crisis.
RESULTS
Among 19,802 participants, we found that those who were front-line medical personnel, suffered from chronic disease, with present symptoms of SARS-CoV-2 infection or contact history had 112, 93, 40 and 15% increased risk of higher anxiety level; while those with knowledge about personal protective measures or wore masks had 75 and 29% lower risk of higher anxiety level respectively. We developed a risk score by calculating the sum of single score of 17 factors. Each one increase of the risk score was associated with a 297% increase in anxiety index score. In categorical analysis, low risk (the risk score between 1 to 2), the moderate risk group (the risk score of 3) and high risk group (the risk score ≥ 4) had - 0.40 (95% CI: - 1.55, 0.76), 1.44 (95% CI: 0.27, 2.61) and 9.18 (95% CI: 8.04, 10.33) increase in anxiety index score, and 26% (95% CI: - 7, 72%), 172% (95% CI: 100, 270%), and 733% (95% CI: 516, 1026%) higher risk of anxiety respectively, when compared with the very low risk group (the risk score of 0). The AUC was 0.73 (95% CI, 0.72, 0.74) for the model fitted the developed risk score, with the cut-off point of 3.5.
CONCLUSIONS
These findings revealed protective and risk factors associated with anxiety, and developed a simple method of identifying people who are at an increased risk of anxiety during COVID-19 pandemic.
Topics: Anxiety; COVID-19; China; Cross-Sectional Studies; Depression; Humans; Pandemics; Protective Factors; Risk Factors; SARS-CoV-2; Surveys and Questionnaires
PubMed: 34088290
DOI: 10.1186/s12889-021-11118-8 -
International Journal of Environmental... Jan 2023Since the outbreak of the COVID-19 pandemic in December 2019 and the associated restrictions, mental health in children and adolescents has been increasingly discussed...
Since the outbreak of the COVID-19 pandemic in December 2019 and the associated restrictions, mental health in children and adolescents has been increasingly discussed in the media. Negative impacts of the pandemic, including a sharp increase in psychopathology and, consequently, reduced quality of life, appear to have particularly affected children and young people, who may be especially vulnerable to the adverse effects of isolation. Nevertheless, many children and adolescents have managed to cope well with the restrictions, without deterioration of their mental health. The present study therefore explored the links between COVID-19 infection (in oneself or a family member, as well as the death of a family member due to the virus), protective factors such as self-efficacy, resilience, self-esteem, and health-related quality of life, and measures of psychopathology such as depression scores, internalizing/externalizing problems, emotion dysregulation, and victimization. For this purpose, we examined data from 2129 adolescents (mean age = 12.31, SD = 0.67; 51% male; 6% born outside of Germany) using a structural equation model. We found medium to high loadings of the manifest variables with the latent variables (COVID-19, protective factors, and psychopathology). Protective factors showed a significant negative correlation with psychopathology. However, COVID-19 had a weak connection with psychopathology in our sample. External pandemic-related factors (e.g., restrictions) and their interaction with existing psychopathology or individual protective factors appear to have a greater influence on young people's mental health than the impact of the virus per se. Sociopolitical efforts should be undertaken to foster prevention and promote individual resilience, especially in adolescence.
Topics: Child; Humans; Male; Adolescent; Female; Mental Disorders; Protective Factors; Pandemics; Quality of Life; COVID-19
PubMed: 36767859
DOI: 10.3390/ijerph20032493 -
Cultural Diversity & Ethnic Minority... Oct 2022Indigenous knowledge and practices promote American Indian/Alaska Native (AI/AN; Native) communities' health and well-being. Historical losses and continued oppression... (Review)
Review
OBJECTIVE
Indigenous knowledge and practices promote American Indian/Alaska Native (AI/AN; Native) communities' health and well-being. Historical losses and continued oppression have resulted in disproportionately higher AI/AN youth suicide rates. This article describes the development of a new national resource guide titled "CULTURE FORWARD" for tribal leaders and stakeholders to support youth suicide prevention efforts through cultural strengths.
METHOD
The CULTURE FORWARD guide was developed over 6 months through a community-engaged process. We conducted nine roundtables and eight interviews with a wide variety of community members, leaders, and providers representing 36 diverse tribal communities and geographic regions. Participants discussed AI/AN youth risk and protective factors, successful community efforts to prevent suicide, and content and dissemination ideas. A comprehensive literature review complemented qualitative findings. A diverse and representative National Advisory Editorial Board guided content and design throughout development.
RESULTS
Qualitative data were analyzed iteratively and thematically. Across all listening sessions, culture was identified as a key protective factor against AI/AN youth suicide. Five themes related to cultural strengths informed guide chapters. Each chapter includes an introduction; how that theme helps prevent Native youth suicide; a review of academic literature, community stories and programs; action steps; and additional resources.
CONCLUSIONS
CULTURE FORWARD honors and empowers communities by weaving strands of knowledge, stories, and practical resources highlighting Native communities' strengths to protect against Native youth suicide. The guide is free online and print copies are being distributed nationally. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Adolescent; Humans; Indians, North American; Alaska Natives; Protective Factors; Suicide Prevention
PubMed: 35771514
DOI: 10.1037/cdp0000546 -
International Journal of Environmental... Nov 2021Considerable research has been undertaken regarding the mental health inequalities experienced by lesbian, gay, bisexual, transgender and intersex (LGBTI+) youth as a... (Review)
Review
Considerable research has been undertaken regarding the mental health inequalities experienced by lesbian, gay, bisexual, transgender and intersex (LGBTI+) youth as a consequence of societal and individual prejudice, stigma and discrimination. Far less research has focussed on protective factors that promote wellbeing for this population. A scoping review was conducted using a six-stage methodological framework, and is reported in accordance with the PRISMA-ScR statement. This explored the extent, range and nature of the peer-reviewed, published, academic literature on what is known about the protective factors that promote LGBTI+ youth wellbeing. Six databases were systematically searched applying Population-Concept-Context key inclusion criteria, complemented by contact with authors to identify additional sources, reference checks and hand searches. Ninety-six individual research records were identified and analysed, drawing from Honneth's Recognition Theory. Interpersonal relations with parents ( = 40), peers ( = 32) and providers ( = 22) were associated with indicators of enhanced wellbeing, as were LGBTI+ community relations ( = 32). Importantly, online ( = 10), faith ( = 10) and cultural ( = 5) communities were potentially protective. Content and thematic analysis highlighted the importance of Gay-Straight Alliances (GSAs) ( = 23) offering powerful protective opportunities through intersecting interpersonal, community and legal forms of recognition. GSAs enhance allyship by peers and providers ( = 21), facilitate access to LGBTI+ community networks ( = 11) and co-exist alongside inclusive policies ( = 12), curricular ( = 5) and extracurricular activities ( = 1). This scoping review underscores the need to move beyond the predominant focus on risk factors for LGBTI+ youth, which subsequently inform protectionist approaches. It concludes with an appeal to develop mechanisms to apply recognitive justice to policy, practice and, importantly, future research directions. This emphasises the salience of enhanced understandings of inclusion, which is rights-based, universally available and of potential benefit to all.
Topics: Adolescent; Bisexuality; Female; Homosexuality, Female; Humans; Protective Factors; Sexual and Gender Minorities; Transgender Persons
PubMed: 34770199
DOI: 10.3390/ijerph182111682 -
International Journal of Environmental... Mar 2021This paper examines the association between media reporting on suicides and the subsequent suicides. Scientific papers from two online bibliographic sources Medline... (Review)
Review
This paper examines the association between media reporting on suicides and the subsequent suicides. Scientific papers from two online bibliographic sources Medline (PubMed) and PsycINFO were searched. The sample included 108 research papers examining the impact of different types of media stories on suicides. The review revealed that although the media can be a double-edged sword and serve both as a risk and a protective factor, the vast majority of research suggests that the relationship between the media reporting and the actual suicide rates is causal and real. Moreover, both the quantity and the quality of media reporting may trigger additional suicides in society. Simultaneously, research suggests that especially non-fictional presentations of celebrities' suicides in newspapers and on television news have the biggest influence on the subsequent suicides. Additionally, a strong modelling effect of media reporting on suicide is based on nationality, age, and gender. However, research shows that because a negative reporting style can be modifiable and improved, the media can also have an educative or preventive effect and can reduce the risk of contagion. Consequently, it is important to monitor the implementation of media recommendations for the reporting of suicide, and continuous education of reporters is needed.
Topics: Famous Persons; Humans; Mass Media; Protective Factors; Suicide; Television
PubMed: 33804527
DOI: 10.3390/ijerph18052396 -
Health Education Research Jul 2021Iceland has witnessed a dramatic decline in adolescent substance use that may be partly the result of efforts related to the Icelandic prevention model (IPM). We sought...
Iceland has witnessed a dramatic decline in adolescent substance use that may be partly the result of efforts related to the Icelandic prevention model (IPM). We sought to test risk and protective factor assumptions of the IPM using a prospective cohort study with 12 months separating baseline from follow-up. Participants were students in grades 8 and 9 in the national Icelandic school system enrolled in the spring of 2018 and 2019 (N=2165). Participants self-reported their experiences of cigarette smoking, alcohol consumption, and cannabis use and seven risk and protective factors. Analyses were conducted with generalized linear modeling with extension to general estimating equations with correlated outcomes data. Both individual main-effects models and collective models including all main-effects were tested. Out of 28 individual main-effects models, 23 produced findings consistent with study premises (P<0.05). Multiple main-effects models largely sustained the findings of the individual main-effects models. Findings support the assumption that the risk and protective factors commonly emphasized in the IPM are associated with the four different substance use outcomes in the hypothesized direction. Communities that plan to implement the IPM among adolescents might consider these factors in their work.
Topics: Adolescent; Adolescent Behavior; Humans; Iceland; Prospective Studies; Protective Factors; Substance-Related Disorders
PubMed: 33437995
DOI: 10.1093/her/cyaa052 -
International Journal of Environmental... Feb 2022Bullying is closely associated with suicide. This study validates mixed evidence on whether young bullies, victims, bully-victims, and those uninvolved in bullying...
Bullying is closely associated with suicide. This study validates mixed evidence on whether young bullies, victims, bully-victims, and those uninvolved in bullying differ in suicidality, risk, protective factor profiles, and predictors of suicide. A total of 2004 Hong Kong adolescents and young adults completed the Hong Kong Online Survey on Youth Mental Health and Internet Usage in 2018. Bullies, victims, and bully victims, as opposed to the uninvolved, were found to possess higher tendencies of suicidal thoughts and behaviors. They had more distinct rather than overlapping risk and protective factor profiles yet shared psychological distress and diagnosis of a psychiatric disorder as common predictors of suicide. The results indicate that suicide screening assessments and training to detect common suicide predictors can benefit youngsters regardless of their bullying involvement. From the discussion, group-specific interventions include restorative justice approaches to promote reintegration and help-seeking among bullies, peer, and professional support programs geared towards lowering victim isolation and equipping gatekeepers such as teachers with skills to connect with both bullies and victims.
Topics: Adolescent; Bullying; Crime Victims; Humans; Mental Disorders; Peer Group; Protective Factors; Suicidal Ideation
PubMed: 35270521
DOI: 10.3390/ijerph19052828 -
Reviews in Medical Virology Mar 2021Understanding Covid-19 pathophysiology is crucial for a better understanding of the disease and development of more effective treatments. Alpha-1-antitrypsin (A1AT) is a... (Review)
Review
Understanding Covid-19 pathophysiology is crucial for a better understanding of the disease and development of more effective treatments. Alpha-1-antitrypsin (A1AT) is a constitutive tissue protector with antiviral and anti-inflammatory properties. A1AT inhibits SARS-CoV-2 infection and two of the most important proteases in the pathophysiology of Covid-19: the transmembrane serine protease 2 (TMPRSS2) and the disintegrin and metalloproteinase 17 (ADAM17). It also inhibits the activity of inflammatory molecules, such as IL-8, TNF-α, and neutrophil elastase (NE). TMPRSS2 is essential for SARS-CoV-2-S protein priming and viral infection. ADAM17 mediates ACE2, IL-6R, and TNF-α shedding. ACE2 is the SARS-CoV-2 entry receptor and a key component for the balance of the renin-angiotensin system, inflammation, vascular permeability, and pulmonary homeostasis. In addition, clinical findings indicate that A1AT levels might be important in defining Covid-19 outcomes, potentially partially explaining associations with air pollution and with diabetes. In this review, we focused on the interplay between A1AT with TMPRSS2, ADAM17 and immune molecules, and the role of A1AT in the pathophysiology of Covid-19, opening new avenues for investigating effective treatments.
Topics: ADAM17 Protein; Animals; COVID-19; Humans; Protective Factors; Serine Endopeptidases; alpha 1-Antitrypsin
PubMed: 32844538
DOI: 10.1002/rmv.2157