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Journal of Geriatric Psychiatry and... Sep 2021Awareness of the diagnosis or related changes in functioning varies in people with dementia (PwD), with implications for the well-being of PwD and their carers....
BACKGROUND
Awareness of the diagnosis or related changes in functioning varies in people with dementia (PwD), with implications for the well-being of PwD and their carers. Measuring awareness in a clinical setting could facilitate tailored support and optimize involvement in personal health and care decisions. This scoping review aimed to identify validated methods of assessing awareness in dementia and appraise their clinical utility.
METHOD
A systematic search was conducted of English-language publications that measured awareness in PwD, in 6 electronic databases. Search terms included dement*, Alzheimer*, Pick disease, and awareness, unawareness, anosognosia, insight, denial, metacognit*, or discrepanc*.
RESULTS
We screened 30,634 articles, finding 345 articles that met our inclusion criteria. We identified 76 measures, most commonly using a discrepancy questionnaire comparing evaluations of function by PwD and an informant. There were 30 awareness measures developed and validated for use in dementia populations but few designed for general clinical use.
CONCLUSIONS
Although we found a range of clinical indications for measuring awareness, there were few studies investigating clinical applications and few tools designed for clinical purposes. Further investigation and development of a person-centered tool could facilitate health and care choices in mild-to-moderate dementia.
Topics: Agnosia; Caregivers; Dementia; Humans; Surveys and Questionnaires
PubMed: 32400259
DOI: 10.1177/0891988720924717 -
Journal of Medical Systems Nov 2014Wireless Body Area Networks (WBANs) have emerged as a promising technology that has shown enormous potential in improving the quality of healthcare, and has thus found a... (Review)
Review
Wireless Body Area Networks (WBANs) have emerged as a promising technology that has shown enormous potential in improving the quality of healthcare, and has thus found a broad range of medical applications from ubiquitous health monitoring to emergency medical response systems. The huge amount of highly sensitive data collected and generated by WBAN nodes requires an ascendable and secure storage and processing infrastructure. Given the limited resources of WBAN nodes for storage and processing, the integration of WBANs and cloud computing may provide a powerful solution. However, despite the benefits of cloud-assisted WBAN, several security issues and challenges remain. Among these, data availability is the most nagging security issue. The most serious threat to data availability is a distributed denial of service (DDoS) attack that directly affects the all-time availability of a patient's data. The existing solutions for standalone WBANs and sensor networks are not applicable in the cloud. The purpose of this review paper is to identify the most threatening types of DDoS attacks affecting the availability of a cloud-assisted WBAN and review the state-of-the-art detection mechanisms for the identified DDoS attacks.
Topics: Computer Communication Networks; Humans; Information Systems; Wireless Technology
PubMed: 25218122
DOI: 10.1007/s10916-014-0128-8 -
Diabetic Medicine : a Journal of the... Jan 2017To identify the reasons why those offered a place on diabetes education programmes declined the opportunity. (Meta-Analysis)
Meta-Analysis Review
AIMS
To identify the reasons why those offered a place on diabetes education programmes declined the opportunity.
BACKGROUND
It is well established that diabetes education is critical to optimum diabetes care; it improves metabolic control, prevents complications, improves quality of life and empowers people to make informed choices to manage their condition. Despite the significant clinical and personal rewards offered by diabetes education, programmes are underused, with a significant proportion of patients choosing not to attend.
METHODS
A systematic search of the following databases was conducted for the period from 2005-2015: Medline; EMBASE; Scopus; CINAHL; and PsycINFO. Studies that met the inclusion criteria focusing on patient-reported reasons for non-attendance at structured diabetes education were selected.
RESULTS
A total of 12 studies spanning quantitative and qualitative methodologies were included. The selected studies were published in Europe, USA, Pakistan, Canada and India, with a total sample size of 2260 people. Two broad categories of non-attender were identified: 1) those who could not attend for logistical, medical or financial reasons (e.g. timing, costs or existing comorbidities) and 2) those who would not attend because they perceived no benefit from doing so, felt they had sufficient knowledge already or had emotional and cultural reasons (e.g. no perceived problem, denial or negative feelings towards education). Diabetes education was declined for many reasons, and the range of expressed reasons was more diverse and complex than anticipated.
CONCLUSION
New and innovative methods of delivering diabetes education are required which address the needs of people with diabetes whilst maintaining quality and efficiency.
Topics: Activities of Daily Living; Adult; Appointments and Schedules; Child; Combined Modality Therapy; Cost of Illness; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Health Care Costs; Health Knowledge, Attitudes, Practice; Humans; Insurance, Health, Reimbursement; Patient Acceptance of Health Care; Patient Education as Topic; Referral and Consultation
PubMed: 26996982
DOI: 10.1111/dme.13120 -
The Cochrane Database of Systematic... 2002Eating disorders represent an extremely difficult condition to treat and patients consume an enormous amount of mental health energy and resources. Being young, female,... (Review)
Review
BACKGROUND
Eating disorders represent an extremely difficult condition to treat and patients consume an enormous amount of mental health energy and resources. Being young, female, and dieting are some of the few identified risk factors that have been reliably linked to the development of eating disorders, and several prevention eating disorder prevention programs have been developed and trialed with children and adolescents. The purpose of this systematic review is to evaluate the effectiveness of eating disorder prevention programs for children and adolescents both in the general population and those determined to be at risk.
OBJECTIVES
1. To determine if eating disorder prevention programs are effective in promoting healthy eating attitudes and behaviours in children and adolescents; 2. To determine if eating disorder prevention programs are effective in promoting psychological factors that protect children and adolescents from developing eating disorders; 3. To determine if eating disorder prevention programs are effective in promoting satisfactory physical health in children and adolescents; 4. To determine if eating disorder prevention programs have a long-term, sustainable, and positive impact on the mental and physical health of children and adolescents; and, 5. To determine the safety of eating disorder prevention programs in terms of possible harmful consequences on the mental or physical health of children and adolescents.
SEARCH STRATEGY
Relevant trials are identified through searching the Cochrane Controlled Trial Register (CCTR) and relevant biomedical and social science databases. All terms necessary to detect prevention programs and the participant groups are used. A strategy to locate randomised controlled trials is used. Other sources of information are the bibliographies of systematic and non-systematic reviews and reference lists from articles identified through the search strategy. In order to identify unpublished studies, experts in the field are contacted by letter and/or electronic mail.
SELECTION CRITERIA
Randomised controlled trials (RCT) with a major focus on eating disorder prevention programs for children and adolescents, where there is no known DSM-IV diagnosis of an eating disorder, are eligible for inclusion in the review. Trials must include a control group and at least one objective outcome measure (eg. BMI) or a standardised psychological measure used with the intervention and control group, pre- and post-intervention.
DATA COLLECTION AND ANALYSIS
A total of 1379 titles have been identified through the search to date. 13 studies were located that reported use of a randomised controlled trial methodology and were critically appraised by two independent reviewers. Five (5) studies were excluded as data were not reported in a useable form or useable data could not be obtained from the trial authors, one dissertation could not be obtained, one study had no "true" no-treatment or usual treatment control group, and one study did not use a pre-test outcome measure. Eight (8) studies met the selection criteria outlined above.
MAIN RESULTS
Only one of eight pooled comparisons of two or more studies using similar outcome measures and similar intervention types demonstrated the statistically significant effect of a particular type of eating disorder prevention program for children and adolescents. Combined data from two eating disorder prevention programs based on a media literacy and advocacy approach indicate a reduction in the internalisation or acceptance of societal ideals relating to appearance at a 3- to 6-month follow-up (Kusel, unpublished; Neumark-Sztainer2000) [SMD -0.28, -0.51 to -0.05, 95% CI]. However, there is insufficient evidence to conclude that this approach also demonstrated a significant impact on awareness of societal standards relating to appearance. There is insufficient evidence to support the effect of four programs designed to address eating attitudes and behaviours and other adolescent issues on body weight, eating disorder symptoms, associated eating disorder psychopathology or general psychological and physical well-being in the general sample or those classified as being at high risk for eating disorder (Buddeberg-F 1998; Killen 1993/1996; Santonastaso 1999; Zanetti 1999). Given only one program used a psychoeducation approach to prevent bulimia nervosa (Jerome, unpublished) and only one program adopted a focus on self-esteem (O'Dea 2000), the effect of these approaches could not be evaluated via meta-analyses. In relation to potential harmful effects, there is not sufficient evidence to suggest that harm resulted from any of the prevention programs included in the review.
REVIEWER'S CONCLUSIONS
The one significant pooled effect in the current review does not allow for any firm conclusions to be made about the impact of prevention programs for eating disorders in children and adolescents, although none of the pooled comparisons indicated evidence of harm. From a clinical perspective, the development and refinement of prevention programs is complicated by a lack of knowledge about risk factors associated with eating disorders and the need to strike a balance between delivering preventive interventions for eating disorders and considering the potential to cause harm. From a research perspective, the idea of "thresholds" for identifying young people at risk of developing eating disorders has been raised, and denial of concern or denial of illness represents a further issue complicating early identification in relation to eating disorder symptomatology. Longer-term effects of the intervention approaches will need to be monitored across development in order to demonstrate a decline in the incidence of eating disorders and associated risk factors.
Topics: Adolescent; Child; Feeding and Eating Disorders; Humans; Program Evaluation; Psychotherapy
PubMed: 12076457
DOI: 10.1002/14651858.CD002891 -
International Journal of Psychiatry in... Jun 2019Cotard syndrome is a rare condition whose main feature is a nihilistic delusion ranging from the denial of body parts to that of the existence of one's own life or even...
Cotard syndrome is a rare condition whose main feature is a nihilistic delusion ranging from the denial of body parts to that of the existence of one's own life or even the entire universe. The aim of this article is to review the nosological significance of Cotard syndrome and to explore the disorder among patients with dementia. Medline and Google Scholar searches were conducted for relevant articles, chapters and books published before 2018. Search terms used included Cotard delusion, Cotard syndrome and dementia, nihilistic delusion. Publications found through this indexed search were reviewed for further relevant references. In this narrative review we emphasise the fact that cases of Cotard syndrome involving patients with dementia are reported quite infrequently. Published studies are limited to very short series or isolated cases. Clinicians are obliged to treat the disorder. They should be alert to the potential high risk inherent in this condition. Keypoints Cotard syndrome is a rare condition characterised by nihilistic delusions that may range from negation of existence of parts of the body to delusion of being dead. The prevalence and incidence of this rare syndrome are not known. Since Cotard's syndrome is conceptualised as part of an underlying disorder, several psychiatric and somatic diseases have been associated with the syndrome. The syndrome may occur in patients suffering from dementia.
Topics: Delusions; Dementia; Humans; Syndrome
PubMed: 30848970
DOI: 10.1080/13651501.2018.1529248 -
Sensors (Basel, Switzerland) Jun 2024Internet of Things (IoT) technology has become an inevitable part of our daily lives. With the increase in usage of IoT Devices, manufacturers continuously develop IoT... (Review)
Review
Internet of Things (IoT) technology has become an inevitable part of our daily lives. With the increase in usage of IoT Devices, manufacturers continuously develop IoT technology. However, the security of IoT devices is left behind in those developments due to cost, size, and computational power limitations. Since these IoT devices are connected to the Internet and have low security levels, one of the main risks of these devices is being compromised by malicious malware and becoming part of IoT botnets. IoT botnets are used for launching different types of large-scale attacks including Distributed Denial-of-Service (DDoS) attacks. These attacks are continuously evolving, and researchers have conducted numerous analyses and studies in this area to narrow security vulnerabilities. This paper systematically reviews the prominent literature on IoT botnet DDoS attacks and detection techniques. Architecture IoT botnet DDoS attacks, evaluations of those attacks, and systematically categorized detection techniques are discussed in detail. The paper presents current threats and detection techniques, and some open research questions are recommended for future studies in this field.
PubMed: 38894365
DOI: 10.3390/s24113571 -
Neuropsychological Rehabilitation Sep 2022Self-awareness is an important consideration in cognitive rehabilitation for clinicians working with individuals following acquired brain injury (ABI), with impaired...
Self-awareness is an important consideration in cognitive rehabilitation for clinicians working with individuals following acquired brain injury (ABI), with impaired self-awareness linked to poor outcomes. To appropriately target assessment and intervention for self-awareness, its theoretical foundation and definition must be considered. The aim was to identify the definitions, theoretical models and conceptual frameworks of self-awareness in adults with ABI, and how self-awareness is conceptualized within those models. A qualitative systematic review was completed using search terms related to descriptions of models/frameworks, ABI and self-awareness. Data were analysed by narrative synthesis. Thirty-five papers were included in the review. Within these, 13 models, 12 conceptual frameworks and 2 theories were described. The main themes and subthemes conceptualized in the synthesis were: Clinical presentation of self-awareness (classifications and dimensions of self-awareness), development of self-awareness (knowledge, feedback mechanisms, temporal aspects, self-evaluation, enablers, barriers), understanding (dys)function (cognitive processing mechanisms, neurological foundations, causal factors), and practice guidance (assessment and intervention). This review identified an extensive theoretical basis to support conceptualization of self-awareness following ABI, underpinned by a distinction between intellectual awareness, on-line awareness, and psychological denial. Clinical application of an evaluation process that includes these elements would be beneficial to inform the rehabilitation process.
Topics: Adult; Awareness; Brain Injuries; Concept Formation; Humans; Perception; Self-Assessment
PubMed: 34008481
DOI: 10.1080/09602011.2021.1924794 -
Journal of Clinical Neuroscience :... Feb 2024Anosognosia, a neurological condition, involves a lack of awareness of one's neurological or psychiatric deficits. Anton Syndrome (AS), an unusual form of anosognosia,... (Review)
Review
INTRODUCTION
Anosognosia, a neurological condition, involves a lack of awareness of one's neurological or psychiatric deficits. Anton Syndrome (AS), an unusual form of anosognosia, manifests as bilateral vision loss coupled with denial of blindness. This systematic review delves into 64 studies encompassing 72 AS cases to explore demographics, clinical presentations, treatments, and outcomes.
MATERIALS AND METHODS
The study rigorously followed PRISMA guidelines, screening PubMed, Google Scholar, and Scopus databases without timeframe limitations. Only English human studies providing full text were included. Data underwent thorough assessment, examining patient demographics, etiological variables, and treatment modalities.
RESULTS
Sixty-four studies met the stringent inclusion criteria. Examining 72 AS cases showed a median age of 55 (6 to 96 years) with no gender preference. Hypertension (34.7 %) and visual anosognosia (90.3 %) were prevalent. Stroke (40.3 %) topped causes. Management included supportive (30.6 %) and causal approaches (30.6 %). Improvement was seen in 45.8 %, unchanged in 22.2 %, and deterioration in 11.1 %. Anticoagulation correlated with higher mortality (p < 0.05).
DISCUSSION
AS, an unusual manifestation of blindness, stems mainly from occipital lobe damage, often due to cerebrovascular incidents. The syndrome shares features with Dide-Botcazo syndrome and dates back to Roman times. Its causes range from strokes to rare conditions like multiple sclerosis exacerbation. Accurate diagnosis involves considering clinical presentations and imaging studies, distinguishing AS from similar conditions.
CONCLUSION
This comprehensive review sheds light on AS's complex landscape, emphasizing diverse etiologies, clinical features, and treatment options. Tailored treatments aligned with individual causes are crucial. The study's findings caution against blanket anticoagulation therapy, suggesting a nuanced approach. Further research is pivotal to refine diagnostics and optimize care for AS individuals.
Topics: Humans; Middle Aged; Aged; Aged, 80 and over; Blindness, Cortical; Brain; Stroke; Vision Disorders; Agnosia
PubMed: 38262263
DOI: 10.1016/j.jocn.2024.01.014 -
Health Psychology Open 2021Diabetes mellitus and its complications carry broad financial misfortune to the diabetic patients and their family, to the well-being frameworks, and to the public...
Diabetes mellitus and its complications carry broad financial misfortune to the diabetic patients and their family, to the well-being frameworks, and to the public economies through direct clinical expenses and decreased work efficiency. The present study systematically reviewed the possible factors that are influencing self-care behavior of disadvantaged diabetic patients that contribute heavily to the management of this chronic illness. Structured searches were conducted on PubMed, ScienceDirect, and manual searches on Google Scholar for articles published between the years 2000 and 2020. The review was limited to a particular time frame due to the change in WHO criteria for diagnosis and classification of abnormal glucose tolerance. Initially, 96858 articles were identified, and following the screening and full-text reading, 10 studies that met the inclusion criteria were chosen for systematic review. Seven studies had reported the factors influencing self-care behavior among disadvantaged diabetic population. Three studies had reported the importance of intervention strategies and its impact on self-care behavior among them. Findings show that self-care management of socio-economically disadvantaged people entails dimensions including diabetes knowledge, lack of physical activities, social support, lack of access to services, life disruptions, denial of illness, societal attitudes, responsibilities, and treatment costs. It was additionally discovered that diabetes self-management support mediations are successful in drawing in lower economy patients, tending to contending life needs and hindrances to self-care, and encouraging behavior change. Taken together, future methodologically efficacious studies that establish health promoting behaviors and explorations of the factors influencing self-care behaviors of disadvantaged diabetic patients are needed.
PubMed: 34552758
DOI: 10.1177/20551029211041427 -
Frontiers in Psychiatry 2022Receiving a child's autism diagnosis can be stressful; as such, parent resolution contributes to the wellbeing and development of healthy parent-child relationships. In...
BACKGROUND
Receiving a child's autism diagnosis can be stressful; as such, parent resolution contributes to the wellbeing and development of healthy parent-child relationships. In other significant childhood diagnoses (e.g., cerebral palsy, diabetes), the degree to which parents adjust to (a) their child's diagnosis and (b) their changes in expectations concerning their child's development and capacity (referred to as resolution to diagnosis), has been associated with improved outcomes including facilitating parent-child relationships and improved parental wellbeing. Given potential benefits to parent and child, and the heterogenous nature of autism, examining the unique factors associated with resolution to diagnosis is important. In this systematic review we identified factors that support or inhibit parental resolution to their child receiving a diagnosis of autism.
METHODS
We completed a systematic review following PRISMA guidelines of peer-reviewed studies from 2017 to 2022, that investigated parental resolution or acceptance of an autism diagnosis. Papers including "acceptance" needed to encompass both accepting the diagnosis and the implications regarding the child's abilities. We searched six databases (Scopus, Web of Science, MEDLINE, PsycINFO, ProQuest), with additional papers located following review of reference lists.
RESULTS
Fourteen papers with 592 participants that investigated parental resolution or acceptance of an autism diagnosis, were included. We identified six common factors that facilitate or inhibit parental resolution and acceptance of an autism diagnosis including: symptom severity; religion, belief, and culture; knowledge and uncertainty; negative emotions (i.e., denial, shame, guilt); positive emotions; and support. Greater resolution was associated with improved "attunement and insightfulness" in the parent-child relationship.
LIMITATION
The review was limited by the small number of studies meeting inclusion criteria. Second, the quality of included studies was mixed, with over half of the studies being qualitative and only one randomized control trial (RCT) identified.
CONCLUSION
Parental resolution can have an impact on parent's perception of their child's capabilities and impact the parent-child relationship. We identified six categories that aid in inhibiting or promoting resolution to diagnosis. Despite taking a broad approach on the definition of resolution, the low number of studies identified in the review indicates a need for more research in this area.
SYSTEMATIC REVIEW REGISTRATION
http://www.crd.york.ac.uk/PROSPERO/, PROSPERO [ID: CRD42022336283].
PubMed: 36683975
DOI: 10.3389/fpsyt.2022.1079371