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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 -
Brain : a Journal of Neurology Dec 2007Anosognosia is the lack of awareness or the underestimation of a specific deficit in sensory, perceptual, motor, affective or cognitive functioning due to a brain... (Review)
Review
Anosognosia is the lack of awareness or the underestimation of a specific deficit in sensory, perceptual, motor, affective or cognitive functioning due to a brain lesion. This self-awareness deficit has been studied mainly in stroke hemiplegic patients, who may report no deficit, overestimate their abilities or deny that they are unable to move a paretic limb. In this review, a detailed search of the literature was conducted to illustrate clinical manifestations, pathogenetic models, diagnostic procedures and unresolved issues in anosognosia for motor impairment after stroke. English and French language papers spanning the period January 1990-January 2007 were selected using PubMed Services and utilizing research words stroke, anosognosia, awareness, denial, unawareness, hemiplegia. Papers reporting sign-based definitions, neurological and neuropsychological data and the results of clinical trials or historical trends in diagnosis were chosen. As a result, a very complex and multifaceted phenomenon emerges, whose variable behavioural manifestations often produce uncertainties in conceptual definitions and diagnostic procedures. Although a number of questionnaires and diagnostic methods have been developed to assess anosognosia following stroke in the last 30 years, they are often limited by insufficient discriminative power or a narrow focus on specific deficits. As a consequence, epidemiological estimates are variable and incidence rates have ranged from 7 to 77% in stroke. In addition, the pathogenesis of anosognosia is widely debated. The most recent neuropsychological models have suggested a defect in the feedforward system, while neuro-anatomical studies have consistently reported on the involvement of the right cerebral hemisphere, particularly the prefrontal and parieto-temporal cortex, as well as insula and thalamus. We highlight the need for a multidimensional assessment procedure and suggest some potentially productive directions for future research about unawareness of illness.
Topics: Agnosia; Awareness; Brain; Brain Mapping; Denial, Psychological; Hemiplegia; Humans; Stroke
PubMed: 17533170
DOI: 10.1093/brain/awm106 -
JBI Library of Systematic Reviews 2012The objective of this review is to describe and synthesize the experiences and perspectives of illness for patients living with both hemophilia and human...
REVIEW QUESTION/OBJECTIVE
The objective of this review is to describe and synthesize the experiences and perspectives of illness for patients living with both hemophilia and human immunodeficiency virus (HIV).
BACKGROUND
Hemophilia is an inherited bleeding disorder caused by low concentrations of specific coagulation factors. There are two major types of this condition characterized by deficiencies of factor VIII (hemophilia A) and factor IX (hemophilia B). Bleeding occurs in hemophilia owing to failure of secondary hemostasis. The bleeding tendency is related to the measured concentration of the factor and is classified as mild, moderate, or severe. Severe hemophilia A and B is classified as repeated (as often as weekly) bleeds into joints and muscles. The main treatment is to arrest spontaneous and traumatic bleeds by prophylactic injection of factor concentrates or to prevent injury by restriction of exercise. Most people with severe hemophilia are on therapy at home with intravenous infusion of the relevant missing factor. Joint bleeds are painful, and the build up of blood is irritating to the synovial lining and damages joint tissue, so that adherence to hemophilia therapy is important.Global research in 18 countries reported that compliance with therapy by patients with hemophilia was low with self-injection adherence under 75% with as few as 53-65% of adults complying with therapy. Some of the most frequently cited factors affecting patients' compliance to therapy are as follows; inability to understand potential benefits (75%); denial (67%); interference with life style (62%); and lack of time (42%).The self-injection method of administering coagulation products became popular in the 1970s. In the early 1980s, 1,432 patients with hemophilia in Japan were infected with HIV (human immunodeficiency virus) because of the use of untreated blood products contaminated with the HIV virus. In addition commercial factor concentrates, which are prepared from pools of 2 to 6000 liters of plasma obtained by plasmapheresis from paid donors, carries a much higher risk of transmission of hepatitis B or C or HIV. Acquired autoimmune disease or AIDS, which is caused by HIV was once an incurable and fatal disease. However the anti-retro virus therapy, from the commencement of protease inhibitor based therapy in 1996, has increased the life expectancy of HIV patients. Nevertheless, adherence to highly active anti-retroviral therapy (HAART) medication by patients with hemophilia (66%-84%) is lower than that of patients with only HIV (98%) in Japan.Although the causes of low adherence of hemophilia therapy or HAART medication are considered to be associated with patient values, qualitative evidence of previous studies have not been synthesized We searched previous reviews and review protocols in the Cochrane Library, Joanna Briggs Institute Library (JBI), MEDLINE, CINAHL, PsycINFO, JBI COnNECT+ protocols. Regarding hemophilia or HIV, there were 11 systematic reviews, 7 protocols, and 128 other reviews. We excluded the reviews that were randomized controlled trials (RCTs) of treatment effects or therapies, and quantitative research of quality of life (QOL). We also excluded children as they are supervised by their parents to maintain high adherence. After the title and abstract review, 15 reviews remained and upon reading the full articles, one protocol and nine narrative reviews were identified.The systematic review protocol of Shaibu et al. investigated HIV positive adult patients on HAART focusing on the experience of HIV positive patients with patients' lifestyles and beliefs about HIV/AIDS and HAART effectiveness, and the role these play in adherence. However, the review differs from this one in terms of classification of HIV positive adults by the route of infection such as iatrogenic and sexually transmitted infection. Taking the deferent rate of adherence of HAART in Japan into consideration, we will focus on the experience of hemophilic patients with HIV.There were also narrative reviews that were concerned with management and treatment of hemophilia; recommendations for assessment and follow-up for patients and caregivers and for health providers, co-morbidity and QOL in the aging patient, and psychosocial issues of hemophilic patients. However, these reviews did not describe the methods in detail such as search engines, inclusion and exclusion criteria, and number of studies included. Furthermore, there was a lack of patients' voice as evidence that composed each category. Strictly speaking, these were not systematic reviews but a narrative review or study related to sociology of knowledge.The systematic review of Cassis et al. is the most similar to our proposed systematic review. They identified studies evaluating psychological stressors in hemophilic patients to address psychological needs and to improve QOL. They mainly evaluated methodologies. The psychosocial stressors synthesized findings from 22 quantitative studies as well as 2 qualitative ones. However, the review differs from this one as they excluded studies related to the HIV epidemic. Additionally, the review was limited as only one search engine, PubMed, was used.The illness which patients with hemophilia and HIV experience has changed from incurable disease to a manageable one by the progress of medicine. A similar scenario might exist for young patients with other incurable diseases at this time. Therefore, synthesizing the patients' experiences of living with both hemophilia and HIV will help not only this patient group but also young patients with other incurable diseases. Furthermore, there are few studies of hemophilia patients as hemophilia is a rare disease. Thus, synthesis of qualitative evidence is critical to understand patient values.
PubMed: 27820530
DOI: 10.11124/jbisrir-2012-435 -
Journal of Reproductive and Infant... Nov 2018Given the prevalence of antenatal anxiety and its consistent associations with adverse pregnancy and child outcomes, early detection and management of anxiety are...
BACKGROUND
Given the prevalence of antenatal anxiety and its consistent associations with adverse pregnancy and child outcomes, early detection and management of anxiety are essential.
OBJECTIVE
The aim was to identify risk factors for anxiety among pregnant women by systematically reviewing original research.
METHODS
Cross-sectional, case-control and cohort studies that examined associations between antenatal anxiety and at least one potential risk factor prospectively or retrospectively and measured anxiety independent from other mental health conditions were included. Studies rated strong/moderate in methodological quality appraisal were used to synthesise the evidence.
RESULTS
Factors associated with greater risk of anxiety included previous pregnancy loss, medical complications, childhood abuse, intimate partner violence, denial/acceptance coping styles, personality traits, inadequate social support, history of mental health problems, high perceived stress and adverse life events.
CONCLUSIONS
Several risk factors identified in this review are detectable in routine prenatal care visits (e.g. previous pregnancy loss, pregnancy complications), potentially modifiable (e.g. coping styles, social support, partner factors) and can be identified prior to pregnancy (e.g. psychosocial factors), underlining the significance of pre-conception mental health screening.
Topics: Adaptation, Psychological; Anxiety; Female; Humans; Pregnancy; Pregnancy Complications; Prenatal Care; Prevalence; Risk Factors; Social Support; Surveys and Questionnaires
PubMed: 30293441
DOI: 10.1080/02646838.2018.1492097 -
BMC Medical Research Methodology Feb 2013Research suggests that there are a number of factors which can be associated with delay in a patient seeking professional help following chest pain, including... (Review)
Review
BACKGROUND
Research suggests that there are a number of factors which can be associated with delay in a patient seeking professional help following chest pain, including demographic and social factors. These factors may have an adverse impact on the efficacy of interventions which to date have had limited success in improving patient action times. Theory-based methods of review are becoming increasingly recognised as important additions to conventional systematic review methods. They can be useful to gain additional insights into the characteristics of effective interventions by uncovering complex underlying mechanisms.
METHODS
This paper describes the further analysis of research papers identified in a conventional systematic review of published evidence. The aim of this work was to investigate the theoretical frameworks underpinning studies exploring the issue of why people having a heart attack delay seeking professional medical help. The study used standard review methods to identify papers meeting the inclusion criterion, and carried out a synthesis of data relating to theoretical underpinnings.
RESULTS
Thirty six papers from the 53 in the original systematic review referred to a particular theoretical perspective, or contained data which related to theoretical assumptions. The most frequently mentioned theory was the self-regulatory model of illness behaviour. Papers reported the potential significance of aspects of this model including different coping mechanisms, strategies of denial and varying models of treatment seeking. Studies also drew attention to the potential role of belief systems, applied elements of attachment theory, and referred to models of maintaining integrity, ways of knowing, and the influence of gender.
CONCLUSIONS
The review highlights the need to examine an individual's subjective experience of and response to health threats, and confirms the gap between knowledge and changed behaviour. Interventions face key challenges if they are to influence patient perceptions regarding seriousness of symptoms; varying processes of coping; and obstacles created by patient perceptions of their role and responsibilities. A theoretical approach to review of these papers provides additional insight into the assumptions underpinning interventions, and illuminates factors which may impact on their efficacy. The method thus offers a useful supplement to conventional systematic review methods.
Topics: Chest Pain; Delayed Diagnosis; Evidence-Based Medicine; Humans; Models, Theoretical; Patient Acceptance of Health Care
PubMed: 23388093
DOI: 10.1186/1471-2288-13-15 -
Behavior Modification Jan 2023Chained and tandem schedules are a common method for thinning schedules of reinforcement following functional communication training (FCT) in the treatment of problem... (Meta-Analysis)
Meta-Analysis
Chained and tandem schedules are a common method for thinning schedules of reinforcement following functional communication training (FCT) in the treatment of problem behavior. We conducted a systematic literature review and meta-analysis of chained and tandem schedules following FCT to describe treatment characteristics and evaluate effects. We identified 38 articles and found reductions in problem behavior across four measures. Results of a random-effects multilevel meta-analysis of rigorous evaluations showed a significant effect of chained or tandem schedules + FCT on problem behavior relative to baseline. We observed resurgence in 77% of cases and 31% of schedule-thinning transitions. Results showed chained schedules resulted in greater reductions in problem behavior relative to tandem schedules. Exploratory moderator analyses suggested extinction, combined reinforcement, and delay and denial tolerance training procedures were associated with greater reductions in problem behavior relative to other treatment characteristics. Implications for practice and future research are discussed.
Topics: Humans; Reinforcement Schedule; Behavior Therapy; Communication; Reinforcement, Psychology; Problem Behavior; Extinction, Psychological
PubMed: 35164521
DOI: 10.1177/01454455221077420 -
Issues in Law & Medicine 2018South Asia, a historically low-incidence region for breast cancer, has produced many recent studies examining reproductive factors. We compiled these studies to confirm... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
South Asia, a historically low-incidence region for breast cancer, has produced many recent studies examining reproductive factors. We compiled these studies to confirm the reality of the significant association reported in the first, 1996 review of induced abortion as a risk factor, independent of abortion's known effect in abrogating the protection afforded by full-term pregnancy.
METHODS
We searched the medical literature for English language studies on breast cancer incidence in women in South Asia published from 1 January, 2000 through 30 June, 2017, using Pubmed, Scholar-Google, and bibliographic searches. Studies were included which reported overall data on induced abortion and/or abortion non-specifically. All 20 eligible studies were of retrospective, case-control design. Data from individual studies were combined using random effects modeling, following the determination of significant heterogeneity.
RESULTS
Cumulative OR for all 20 studies was 2.51 (95%CI: 1.67-3.75) and 3.91 (95%CI: 1.02-14.97) for the five studies which reported specific data on induced abortion. Significant dose-dependence was observed among all 5 studies which stratified by number of abortions. Meta-regression of OR v. abortion prevalence among controls was statistically significant, as observed in a 2013 meta-analysis in China.
CONCLUSION
The moderately strong association identified between abortion and breast cancer explains in part the spread of the breast cancer epidemic to South Asia as it has become Westernized. Continuing denial of the abortion-breast cancer association can only ensure that the acknowledged worldwide breast cancer epidemic will continue to worsen, costing many millions of women their lives over the next several decades.
Topics: Abortion, Induced; Breast Neoplasms; Female; Humans; Pregnancy; Retrospective Studies; Risk Factors
PubMed: 30831018
DOI: No ID Found -
Soft Computing Jan 2022In today's world, technology has become an inevitable part of human life. In fact, during the Covid-19 pandemic, everything from the corporate world to educational...
In today's world, technology has become an inevitable part of human life. In fact, during the Covid-19 pandemic, everything from the corporate world to educational institutes has shifted from offline to online. It leads to exponential increase in intrusions and attacks over the Internet-based technologies. One of the lethal threat surfacing is the Distributed Denial of Service (DDoS) attack that can cripple down Internet-based services and applications in no time. The attackers are updating their skill strategies continuously and hence elude the existing detection mechanisms. Since the volume of data generated and stored has increased manifolds, the traditional detection mechanisms are not appropriate for detecting novel DDoS attacks. This paper systematically reviews the prominent literature specifically in deep learning to detect DDoS. The authors have explored four extensively used digital libraries (IEEE, ACM, ScienceDirect, Springer) and one scholarly search engine (Google scholar) for searching the recent literature. We have analyzed the relevant studies and the results of the SLR are categorized into five main research areas: (i) the different types of DDoS attack detection deep learning approaches, (ii) the methodologies, strengths, and weaknesses of existing deep learning approaches for DDoS attacks detection (iii) benchmarked datasets and classes of attacks in datasets used in the existing literature, and (iv) the preprocessing strategies, hyperparameter values, experimental setups, and performance metrics used in the existing literature (v) the research gaps, and future directions.
PubMed: 35103047
DOI: 10.1007/s00500-021-06608-1 -
Health Education Research Oct 2011We conducted a systematic review of qualitative evidence relating to the views and attitudes of men who have sex with men (MSM) concerning testing for HIV. Studies... (Review)
Review
We conducted a systematic review of qualitative evidence relating to the views and attitudes of men who have sex with men (MSM) concerning testing for HIV. Studies conducted in high-income countries (Organisation for Economic Co-operation and Development members) since 1996 were included. Seventeen studies were identified, most of gay or bisexual men. Data were analysed using a thematic analysis methodology. The uncertainty of unknown HIV status is an important motive for testing; however, denial is also a common response to uncertainty. Fear of the consequences of a positive HIV test is widespread and may take several forms. A sense of responsibility towards oneself or one's partner may be a motive for testing. The perception of stigma, from other gay men or from the wider culture, is a barrier to testing. Gay and other MSM have clear preferences regarding testing services, particularly for those that are community based, include non-judgemental and gay-positive service providers, and offer a high degree of confidentiality.
Topics: AIDS Serodiagnosis; HIV Infections; Health Knowledge, Attitudes, Practice; Homosexuality, Male; Humans; Male; Qualitative Research; Social Responsibility; Social Stigma
PubMed: 21873612
DOI: 10.1093/her/cyr064 -
Epidemiologic Reviews Jun 2018Transgender people experience a disproportionate burden of human immunodeficiency virus (HIV) and incarceration. Discrimination, victimization, poverty, and poor mental...
Transgender people experience a disproportionate burden of human immunodeficiency virus (HIV) and incarceration. Discrimination, victimization, poverty, and poor mental health drive vulnerability to HIV and related infections, as well as risk of arrest, detention, and incarceration. In this paper, we systematically review published data on HIV, sexually transmitted infections, viral hepatitis, and tuberculosis among incarcerated transgender people; describe potential structural determinants of HIV risk and transmission; identify gaps in the literature; and make recommendations for research and interventions to address this neglected population. We found that HIV and related infections among incarcerated transgender people have received little attention in the epidemiologic literature. The limited data available, which date from 1992, demonstrate high prevalence of HIV and sexually transmitted infections in this population internationally. Transgender people who had not had genital surgery were typically placed in jails and prisons corresponding to birth-assigned sex rather than gender identity. Once incarcerated, they routinely faced harassment, physical abuse, and sexual violence from inmates and staff and denial of access to medically necessary gender-affirming therapies. More HIV research with incarcerated transgender populations is urgently needed to inform correctional policy change that centers human rights and structural interventions, such as stigma reduction, pre-arrest diversion, and access to HIV prevention methods and gender-affirming care during incarceration.
Topics: Crime Victims; Female; Global Health; HIV Infections; Health Status Disparities; Hepatitis, Viral, Human; Humans; Male; Prevalence; Prisoners; Risk Factors; Sexually Transmitted Diseases; Transgender Persons; Tuberculosis
PubMed: 29554240
DOI: 10.1093/epirev/mxx012