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Acta Physiologica (Oxford, England) Aug 2023The immune system plays an important role in mediating exercise responses and adaptations. However, whether fluctuating hormone concentrations across the menstrual cycle... (Meta-Analysis)
Meta-Analysis Review
The immune system plays an important role in mediating exercise responses and adaptations. However, whether fluctuating hormone concentrations across the menstrual cycle may impact these processes remains unknown. The aim of this systematic review with meta-analysis was to compare baseline concentrations as well as exercise-induced changes in immune and inflammatory parameters between menstrual cycle phases. A systematic literature search was conducted according to the PRISMA guidelines using Pubmed/MEDLINE, ISI Web of Science, and SPORTDiscus. Of the 159 studies included in the qualitative synthesis, 110 studies were used for meta-analysis. Due to the designs of the included studies, only the follicular and luteal phase could be compared. The estimated standardized mean differences based on the random-effects model revealed higher numbers of leukocytes (-0.48 [-0.73; -0.23], p < 0.001), monocytes (-0.73 [-1.37; -0.10], p = 0.023), granulocytes (-0.85 [-0.1.48; -0.21], p = 0.009), neutrophils (-0.32 [-0.52; -0.12], p = 0.001), and leptin concentrations (-0.37 [-0.5; -0.23], p = 0.003) in the luteal compared to the follicular phase at rest. Other parameters (adaptive immune cells, cytokines, chemokines, and cell adhesion molecules) showed no systematic baseline differences. Seventeen studies investigated the exercise-induced response of these parameters, providing some indications for a higher pro-inflammatory response in the luteal phase. In conclusion, parameters of innate immunity showed cycle-dependent regulation at rest, while little is known on the exercise responses. Due to a large heterogeneity and a lack of cycle phase standardization among the included studies, future research should focus on comparing at least three distinct hormonal profiles to derive more specific recommendations for exercise prescription.
Topics: Female; Humans; Menstrual Cycle; Follicular Phase; Exercise; Inflammation; Immunity
PubMed: 37309068
DOI: 10.1111/apha.14013 -
Pediatric Critical Care Medicine : a... Sep 2023This systematic review investigates the use of adaptive designs in randomized controlled trials (RCTs) in pediatric critical care.
OBJECTIVES
This systematic review investigates the use of adaptive designs in randomized controlled trials (RCTs) in pediatric critical care.
DATA SOURCES
PICU RCTs, published between 1986 and 2020, stored in the www.PICUtrials.net database and MEDLINE, EMBASE, CENTRAL, and LILACS databases were searched (March 9, 2022) to identify RCTs published in 2021. PICU RCTs using adaptive designs were identified through an automated full-text screening algorithm.
STUDY SELECTION
All RCTs involving children (< 18 yr old) cared for in a PICU were included. There were no restrictions to disease cohort, intervention, or outcome. Interim monitoring by a Data and Safety Monitoring Board that was not prespecified to change the trial design or implementation of the study was not considered adaptive.
DATA EXTRACTION
We extracted the type of adaptive design, the justification for the design, and the stopping rule used. Characteristics of the trial were also extracted, and the results summarized through narrative synthesis. Risk of bias was assessed using the Cochrane Risk of Bias Tool 2.
DATA SYNTHESIS
Sixteen of 528 PICU RCTs (3%) used adaptive designs with two types of adaptations used; group sequential design and sample size reestimation. Of the 11 trials that used a group sequential adaptive design, seven stopped early due to futility and one stopped early due to efficacy. Of the seven trials that performed a sample size reestimation, the estimated sample size decreased in three trials and increased in one trial.
CONCLUSIONS
Little evidence of the use of adaptive designs was found, with only 3% of PICU RCTs incorporating an adaptive design and only two types of adaptations used. Identifying the barriers to adoption of more complex adaptive trial designs is needed.
Topics: Child; Humans; Research Design; Adaptive Clinical Trials as Topic; Pediatrics; Critical Care
PubMed: 37195182
DOI: 10.1097/PCC.0000000000003273 -
Pediatric Cardiology Apr 2015Families of children with congenital heart disease (CHD) cope differently depending on individual and familial factors beyond the severity of the child's condition.... (Review)
Review
Families of children with congenital heart disease (CHD) cope differently depending on individual and familial factors beyond the severity of the child's condition. Recent research has shifted from an emphasis on the psychopathology of family functioning to a focus on the resilience of families in coping with the challenges presented by a young child's condition. The increasing number of studies on the relationship between psychological adaptation, parental coping and parenting practices and quality of life in families of children with CHD necessitates an in-depth re-exploration. The present study reviews published literature in this area over the past 25 years to generate evidence to inform clinical practice, particularly to better target parent and family interventions designed to enhance family coping. Twenty-five studies were selected for inclusion, using the PRISMA guidelines. Thematic analysis identified a number of themes including psychological distress and well-being, gender differences in parental coping, and variable parenting practices and a number of subthemes. There is general agreement in the literature that families who have fewer psychosocial resources and lower levels of support may be at risk of higher psychological distress and lower well-being over time, for both parent and the child. Moreover, familial factors such as cohesiveness and adaptive parental coping strategies are necessary for successful parental adaptation to CHD in their child. The experiences, needs and ways of coping in families of children with CHD are diverse and multi-faceted. A holistic approach to early psychosocial intervention should target improved adaptive coping and enhanced productive parenting practices in this population. This should lay a strong foundation for these families to successfully cope with future uncertainties and challenges at various phases in the trajectory of the child's condition.
Topics: Adaptation, Psychological; Child; Child, Preschool; Family; Female; Heart Diseases; Humans; Male; Parents; Psychotherapy; Quality of Life
PubMed: 25618163
DOI: 10.1007/s00246-015-1121-9 -
Journal of Clinical Medicine Dec 2022Current lung cancer clinical research focuses on biomarkers and personalized treatment strategies. Adaptive clinical trial designs have gained significant ground due to... (Review)
Review
Current lung cancer clinical research focuses on biomarkers and personalized treatment strategies. Adaptive clinical trial designs have gained significant ground due to their increased flexibility, compared to the conventional model of drug development from phase I to phase IV trials. One such adaptive approach is the seamless phase II/III design, which has been used to reduce the total sample size and drug development time. In this context, an algorithmic systematic search was conducted in MEDLINE (PUBMED), SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials until 31 June 2022 in order to identify lung cancer trials of systematic treatments that have employed the seamless phase II/III methodology and to describe their characteristics. The search strategy yielded a total of 1420 records that were screened through their title and abstract; 28 eligible trials were included in the systematic review. Based on the study endpoints, the most common subtype included phase II/III trials with inefficacy/futility analyses (61%; 17/28), followed by dose escalation phase II/III trials (18%; 5/28), one multi-arm multi stage trial and 5 trials with other design (18%). Most eligible trials were open-label (71%; 20/27), included patients with non-small cell lung cancer (82%; 23/28), evaluated targeted therapies and/or immunotherapies (82%; 23/28) and recruited patients with advanced disease (89.3%; 25/28). In conclusion, the seamless phase II/III design is a feasible and suitable approach in lung cancer research, with distinct design subcategories according to study endpoints.
PubMed: 36498749
DOI: 10.3390/jcm11237176 -
IEEE Transactions on Visualization and... Apr 2022In the era of 'information overload', effective information provision is essential for enabling rapid response and critical decision making. In making sense of diverse...
In the era of 'information overload', effective information provision is essential for enabling rapid response and critical decision making. In making sense of diverse information sources, dashboards have become an indispensable tool, providing fast, effective, adaptable, and personalized access to information for professionals and the general public alike. However, these objectives place heavy requirements on dashboards as information systems in usability and effective design. Understanding these issues is challenging given the absence of consistent and comprehensive approaches to dashboard evaluation. In this article we systematically review literature on dashboard implementation in healthcare, where dashboards have been employed widely, and where there is widespread interest for improving the current state of the art, and subsequently analyse approaches taken towards evaluation. We draw upon consolidated dashboard literature and our own observations to introduce a general definition of dashboards which is more relevant to current trends, together with seven evaluation scenarios - task performance, behaviour change, interaction workflow, perceived engagement, potential utility, algorithm performance and system implementation. These scenarios distinguish different evaluation purposes which we illustrate through measurements, example studies, and common challenges in evaluation study design. We provide a breakdown of each evaluation scenario, and highlight some of the more subtle questions. We demonstrate the use of the proposed framework by a design study guided by this framework. We conclude by comparing this framework with existing literature, outlining a number of active discussion points and a set of dashboard evaluation best practices for the academic, clinical and software development communities alike.
Topics: Computer Graphics; Delivery of Health Care; Research Design; Software
PubMed: 35213306
DOI: 10.1109/TVCG.2022.3147154 -
Korean Journal of Family Medicine Mar 2021Different scales have attempted to assess various aspects of family dynamics and structures. Good family function seems to allow for better prognoses for basic diseases...
BACKGROUND
Different scales have attempted to assess various aspects of family dynamics and structures. Good family function seems to allow for better prognoses for basic diseases and appears to be a predictor of depression. The aim of this study was to determine the association between family functionality and depression.
METHODS
This is a systematic review and meta-analysis including cross-sectional, cohort, and case-control studies using validated instruments such as the Family APGAR (Adaptability, Partnership, Growth, Affection, and Resolve) and Family Adaptability and Cohesion Evaluation Scale III. A search strategy was designed for the MEDLINE, Embase, Central, and LILACS databases along with data saturation through a search of unpublished literature from the onset of the databases to the present. The categorical variables are expressed in terms of odds ratios (OR), and the statistical analysis was carried out using Review Manager ver. 5.31 (The Cochrane Collaboration, Oxford, UK) using forest plots with corresponding 95% confidence intervals (CI). A fixed-effect model was used according to the expected heterogeneity, expressed in terms of I2 . The risk of bias was evaluated using the MINORS (methodological index for non-randomized studies) tool.
RESULTS
A total of 1,519 studies were found, of which 10 were selected for the qualitative synthesis and four were chosen for the meta-analysis. The result for the association between family dysfunction and depression yielded an OR (95% CI) of 3.72 (2.70 to 5.12) and I2 of 24%.
CONCLUSION
Family dysfunction and depression are strongly associated.
PubMed: 32521579
DOI: 10.4082/kjfm.19.0166 -
Heliyon Sep 2019This article reviews evaluation studies of interventions aimed at preventing and reducing incidents of suicide and self-harm among incarcerated individuals. Study... (Review)
Review
This article reviews evaluation studies of interventions aimed at preventing and reducing incidents of suicide and self-harm among incarcerated individuals. Study design, sample characteristics, intervention procedures, study measures, and relevant results of each study are reviewed. The outcomes of interest include severity and frequency of self-harm episodes and suicidal ideation, scores on adaptive coping methods, scoring on the Beck Hopelessness scale and risk scores. The six evaluated studies are peer-reviewed, published between 1990 and 2015, and took place in the United States, the United Kingdom, and Pakistan. Treatment modalities widely vary across studies and include cognitive behavioral therapy, dialectical behavioral therapy, peer programming, staff intervention training, and uniquely-designed courses that incorporate various aspects from other treatment modalities. Due to the nature of the studies, only one multi-randomized controlled trial was identified. All identified studies had a pre- and post-treatment design either lacking a comparison group or containing 1-2 comparison groups and conduct follow-up of varying times. While Cognitive Behavioral Therapy (CBT) interventions and uniquely-tailored intervention programs suggest promising results, the general absence of comparison groups, the shortage of relevant evaluation studies and the inconsistency of behavioral outcome measurements compromise the capacity of this review. Further, definitional variances, particularly for self-injury (self-harm, non-suicidal self-injury [NSSI], deliberate self-harm, suicidal behavior, etc.) affect the ability to synthesize study results. This article aims to synthesize the literature results to identify the most effective interventions that would benefit from additional research.
PubMed: 31517115
DOI: 10.1016/j.heliyon.2019.e02379 -
Psycho-oncology Dec 2010'Fighting spirit' in early-stage cancer comprises optimism about prognosis, a belief that the disease and/or its effects are controllable, and a determination to cope... (Review)
Review
'Fighting spirit' in early-stage cancer comprises optimism about prognosis, a belief that the disease and/or its effects are controllable, and a determination to cope with the situation using various active coping methods. It is associated with better adjustment. In advanced cancer, the usefulness of this coping style is contentious. This systematic review identified eight studies that investigated these qualities in advanced cancer. They provided some evidence that positive attitude and self-efficacy may be associated with better emotional adjustment; active, problem-focused coping appears to be adaptive and avoidant coping maladaptive. However, major methodological flaws make any conclusions highly speculative. Further research in this area using larger samples and longitudinal design is required.
Topics: Adaptation, Psychological; Affect; Attitude to Health; Humans; Neoplasms; Quality of Life; Self Efficacy
PubMed: 20200856
DOI: 10.1002/pon.1704 -
EXCLI Journal 2023Classic decision theory requires that rational agents show description invariance: which description is chosen should not matter for judgments, preferences, or choices... (Review)
Review
Classic decision theory requires that rational agents show description invariance: which description is chosen should not matter for judgments, preferences, or choices given the descriptions are co-extensive. Framing research has amply demonstrated a failure of description invariance by showing that the choice of the description has a systematic effect on judgments, preferences, and choices. Specifically, framing research has shown that linguistically different descriptions of seemingly equivalent options frequently lead to preference reversals. I summarize the research on framing in situations entailing risk. This includes the characterization of different research designs used, the size and robustness of the framing effects reported for those designs, and the theoretical accounts put forward to explain framing effects. The theoretical accounts are evaluated with respect to their merits, empirically and theoretically. I end by providing the implications of framing research. My central point is that the existence of framing effects points to the adaptiveness of the processes underlying human judgment and choice rather than simply showing human irrationality.
PubMed: 37927347
DOI: 10.17179/excli2023-6169 -
Nicotine & Tobacco Research : Official... Jun 2023Conversational agents (CAs; computer programs that use artificial intelligence to simulate a conversation with users through natural language) have evolved considerably... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Conversational agents (CAs; computer programs that use artificial intelligence to simulate a conversation with users through natural language) have evolved considerably in recent years to support healthcare by providing autonomous, interactive, and accessible services, making them potentially useful for supporting smoking cessation. We performed a systematic review and meta-analysis to provide an overarching evaluation of their effectiveness and acceptability to inform future development and adoption.
AIMS AND METHODS
PsycInfo, Web of Science, ACM Digital Library, IEEE Xplore, Medline, EMBASE, Communication and Mass Media Complete, and CINAHL Complete were searched for studies examining the use of CAs for smoking cessation. Data from eligible studies were extracted and used for random-effects meta-analyses.
RESULTS
The search yielded 1245 publications with 13 studies eligible for systematic review (total N = 8236) and six studies for random-effects meta-analyses. All studies reported positive effects on cessation-related outcomes. A meta-analysis with randomized controlled trials reporting on abstinence yielded a sample-weighted odds ratio of 1.66 (95% CI = 1.33% to 2.07%, p < .001), favoring CAs over comparison groups. A narrative synthesis of all included studies showed overall high acceptability, while some barriers were identified from user feedback. Overall, included studies were diverse in design with mixed quality, and evidence of publication bias was identified. A lack of theoretical foundations was noted, as well as a clear need for relational communication in future designs.
CONCLUSIONS
The effectiveness and acceptability of CAs for smoking cessation are promising. However, standardization of reporting and designing of the agents is warranted for a more comprehensive evaluation.
IMPLICATIONS
This is the first systematic review to provide insight into the use of CAs to support smoking cessation. Our findings demonstrated initial promise in the effectiveness and user acceptability of these agents. We also identified a lack of theoretical and methodological limitations to improve future study design and intervention delivery.
Topics: Humans; Smoking Cessation; Artificial Intelligence; Software; Delivery of Health Care; Communication
PubMed: 36507916
DOI: 10.1093/ntr/ntac281