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JMIR Mental Health Dec 2023During the COVID-19 pandemic, the Oxford Precision Psychiatry Lab (OxPPL) developed open-access web-based summaries of mental health care guidelines (OxPPL guidance) in... (Review)
Review
BACKGROUND
During the COVID-19 pandemic, the Oxford Precision Psychiatry Lab (OxPPL) developed open-access web-based summaries of mental health care guidelines (OxPPL guidance) in key areas such as digital approaches and telepsychiatry, suicide and self-harm, domestic violence and abuse, perinatal care, and vaccine hesitancy and prioritization in the context of mental illness, to inform timely clinical decision-making.
OBJECTIVE
This study aimed to evaluate the practice of creating evidence-based health guidelines during health emergencies using the OxPPL guidance as an example. An international network of clinical sites and colleagues (in Australia, New Zealand, and the United Kingdom) including clinicians, researchers, and experts by experience aimed to (1) evaluate the clinical impact of the OxPPL guidance, as an example of an evidence-based summary of guidelines; (2) review the literature for other evidence-based summaries of COVID-19 guidelines regarding mental health care; and (3) produce a framework for response to future global health emergencies.
METHODS
The impact and clinical utility of the OxPPL guidance were assessed using clinicians' feedback via an international survey and focus groups. A systematic review (protocol registered on Open Science Framework) identified summaries or syntheses of guidelines for mental health care during and after the COVID-19 pandemic and assessed the accuracy of the methods used in the OxPPL guidance by identifying any resources that the guidance had not included.
RESULTS
Overall, 80.2% (146/182) of the clinicians agreed or strongly agreed that the OxPPL guidance answered important clinical questions, 73.1% (133/182) stated that the guidance was relevant to their service, 59.3% (108/182) said that the guidelines had or would have a positive impact on their clinical practice, 42.9% (78/182) that they had shared or would share the guidance, and 80.2% (146/182) stated that the methodology could be used during future health crises. The focus groups found that the combination of evidence-based knowledge, clinical viewpoint, and visibility was crucial for clinical implementation. The systematic review identified 2543 records, of which 2 syntheses of guidelines met all the inclusion criteria, but only 1 (the OxPPL guidance) used evidence-based methodology. The review showed that the OxPPL guidance had included the majority of eligible guidelines, but 6 were identified that had not been included.
CONCLUSIONS
The study identified an unmet need for web-based, evidence-based mental health care guidance during the COVID-19 pandemic. The OxPPL guidance was evaluated by clinicians as having a real-world clinical impact. Robust evidence-based methodology and expertise in mental health are necessary, but easy accessibility is also needed, and digital technology can materially help. Further health emergencies are inevitable and now is the ideal time to prepare, including addressing the training needs of clinicians, patients, and carers, especially in areas such as telepsychiatry and digital mental health. For future planning, guidance should be widely disseminated on an international platform, with allocated resources to support adaptive updates.
Topics: Humans; COVID-19; Mental Health; Pandemics; Psychiatry; Emergencies; Telemedicine
PubMed: 38133912
DOI: 10.2196/52901 -
European Journal of Psychotraumatology 2023Adverse childhood experiences (ACEs) have been shown to negatively affect health in adulthood. Estimates of associations between ACEs and chronic painful conditions are... (Meta-Analysis)
Meta-Analysis Review
Adverse childhood experiences (ACEs) have been shown to negatively affect health in adulthood. Estimates of associations between ACEs and chronic painful conditions are lacking. This systematic review and meta-analysis aimed to evaluate associations between exposure to ACEs and chronic pain and pain-related disability in adults. We searched 10 electronic databases from inception to February 2023. We included observational studies assessing associations between direct ACEs (childhood sexual, physical, emotional abuse, or neglect) alone or in combination with indirect ACEs (witnessing domestic violence, household mental illness), and adult chronic pain (≥3 months duration) and pain-related disability (daily activities limited by chronic pain). Pairs of reviewers independently extracted data and assessed study risks of bias. Random-effect models were used to calculate pooled adjusted odds ratios [aOR]. Tau square [T], 95% prediction intervals [95%PI] and I expressed the amount of heterogeneity, and meta-regressions and subgroup meta-analyses investigated sources of heterogeneity (PROSPERO: CRD42020150230). We identified 85 studies including 826,452 adults of which 57 studies were included in meta-analyses. Study quality was generally good or fair ( = 70). The odds of reporting chronic pain in adulthood were significantly higher among individuals exposed to a direct ACE (aOR, 1.45, 95%CI, 1.38-1.53). Individuals reporting childhood physical abuse were significantly more likely to report both chronic pain (aOR, 1.50, 95CI, 1.39-1.64) and pain-related disability (1.46, 95CI, 1.03-2.08) during adulthood. Exposure to any ACEs alone or combined with indirect ACEs significantly increase the odds of adult chronic painful conditions (aOR, 1.53, 95%CI, 1.42-1.65) and pain-related disability (aOR, 1.29; 95%CI, 1.01-1.66). The risk of chronic pain in adulthood significantly increased from one ACE (aOR, 1.29, 95%CI, 1.22-1.37) to four or more ACEs (1.95, 95%CI, 1.73-2.19). Single and cumulative ACEs are significantly associated with reporting of chronic pain and pain-related disability as an adult.
Topics: Adult; Humans; Adverse Childhood Experiences; Chronic Pain; Mental Disorders; Sex Offenses
PubMed: 38111090
DOI: 10.1080/20008066.2023.2284025 -
BMC Geriatrics Dec 2023Many studies have investigated the relationship between social support and the prevention of elder abuse; however, their results are somehow inconsistent in terms of the... (Meta-Analysis)
Meta-Analysis
INTRODUCTION AND AIMS
Many studies have investigated the relationship between social support and the prevention of elder abuse; however, their results are somehow inconsistent in terms of the association. This systematic review and meta-analysis aimed to investigate the published studies on the relationship between social support and the prevention of elder maltreatment.
MATERIALS AND METHODS
An electronic search was conducted until January 2023, using such databases as PubMed, Scopus, and Web of Science. The present research included cross-sectional, longitudinal, and case-control studies. Study selection, data extraction, and risk of bias assessment were conducted by two researchers independently. The Newcastle-Ottawa checklist was utilized to evaluate the quality of studies. The random effects model was employed to perform a meta-analysis.
RESULTS
In total, 32 studies were included in this systematic review, out of which 26 articles were eligible for meta-analysis. The results showed that 68.75% of the studies were of high quality, and there is a significant relationship between social support and elder maltreatment. Accordingly, the lack of social support increased overall maltreatment (odds ratio: 1.24, 95% confidence interval: 1.16-1.33; I = 92.3%, p = 0.000)). Moreover, lack of social support had an increasing effect on the level of psychological abuse (1.55, 1.18-2.04; 88.7%, p = 0.000), physical abuse (1.31, 0.42-4.11; 76.3%, p = 0.005), and neglect (2.02, 0.86-4.72; 87.9%, p = 0.000), which shows heterogeneities among the results of the included studies. On the contrary, the lack of social support showed a decreasing effect on financial abuse (0.92, 0.70-1.21; 62.1%, p = 0.022).
CONCLUSION
This systematic review provides evidence that social support in the form of structural or functional support may plays an important role in improving the quality of life of the elderly.
Topics: Humans; Aged; Quality of Life; Cross-Sectional Studies; Elder Abuse; Social Support; Case-Control Studies
PubMed: 38110874
DOI: 10.1186/s12877-023-04541-6 -
Journal of Elder Abuse & Neglect 2023Resident-to-resident aggression (RRA) is an important issue in congregate residential facilities (CRFs) for older adults and has devastating effects. This study aimed to... (Review)
Review
Resident-to-resident aggression (RRA) is an important issue in congregate residential facilities (CRFs) for older adults and has devastating effects. This study aimed to provide an inventory and content analysis of the practices used to counter RRA and promote wellness care for older adults in CRFs. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, original, peer-reviewed research and systematic reviews published in 14 electronic databases and two gray literature sources were examined. Of the 6196 articles identified, 28 met the inclusion criteria. Practices aimed to prevent, track or intervene in RRA, mostly in long-term care centers, but few were evidence-based and ready for widespread implementation. It emerges that continuous training of staff is necessary and that it should prioritize a person-centered approach. CRFs' managers must promote a culture of wellness care and policymakers should consider the prevention practices to improve the quality of life of older adults in CRFs.
Topics: Aged; Humans; Aggression; Nursing Homes; Quality of Life; Elder Abuse; Residential Facilities
PubMed: 38073175
DOI: 10.1080/08946566.2023.2283746 -
Child Abuse & Neglect Jan 2024Disclosure of CSA is key to victims having access to support and protection, but the current understanding of what factors play a key role is still limited. The present...
BACKGROUND AND OBJECTIVE
Disclosure of CSA is key to victims having access to support and protection, but the current understanding of what factors play a key role is still limited. The present review aims to understand a range of socio-ecological factors that can either facilitate or obstruct the disclosure of CSA.
METHODS AND RESULTS
Through a systematic review of 27 quantitative studies published from 2000 to 2022, the current review identified 17 significant predictors of CSA disclosure. Facilitators of disclosure included older age, being female, higher IQ, recent abuse, resistance during abuse, clergy perpetrator, non-offending caregiver support, and acculturation. Barriers to disclosure included intellectual disability, avoidant coping, romantic relationships with the perpetrator, family criminality, domestic violence, adherence to traditional Asian values, and ethnic minority identity. The findings also suggested that the relationship between predictors and disclosure tends to be mixed, contradictory, or indirect/interactional, emphasizing the importance of situating the findings in specific social-ecological contexts.
CONCLUSIONS
The findings can inform future research and practice by providing a comprehensive understanding of the predictors of CSA disclosure and highlighting the importance of considering the socio-ecological context when interpreting findings. Moreover, the review provides a valuable resource for professionals who work with victims of CSA, helping them better identify factors that may facilitate or hinder disclosure and allowing for tailored interventions.
Topics: Child; Female; Humans; Male; Child Abuse, Sexual; Disclosure; Ethnicity; Minority Groups; Self Disclosure
PubMed: 38056036
DOI: 10.1016/j.chiabu.2023.106564 -
Sao Paulo Medical Journal = Revista... 2023Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas.
BACKGROUND
Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas.
OBJECTIVE
This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women.
DESIGN AND SETTING
Systematic review developed at Universidade Federal de Uberlândia.
METHODS
We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool.
RESULTS
Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%.
CONCLUSIONS
The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice.
SYSTEMATIC REVIEW REGISTRATION
This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.
Topics: Humans; Female; Domestic Violence; Health Personnel; Sexual Behavior
PubMed: 38055422
DOI: 10.1590/1516-3180.2022.0682.R1.180723 -
Heliyon Nov 2023Child sexual abuse (CSA) is a substantial public health issue that is challenging to measure epidemiologically due to the "pact of silence" among those involved.... (Review)
Review
Child sexual abuse (CSA) is a substantial public health issue that is challenging to measure epidemiologically due to the "pact of silence" among those involved. Validated tools could contribute to early recognition or risk detection for CSA. We aimed to systematically assess self-report tools' measurement properties and methodological quality that detect risk or exposure to CSA for children under twelve. The search strategy, selection criteria, data extraction, data analysis, and synthesis followed the COSMIN methodology for systematic reviews (2018). PROSPERO 2021 registration CRD42021278465. MEDLINE, COCHRANE, EMBASE, CINAHL, SCOPUS, and ERIC were searched until August 2021, with an updated search on September 23, 2021, and unlimited by language. The inclusion criteria were: to assess risk or exposure to CSA under twelve years old by objective items and self-report tools; sexual violence risk or exposure in the domestic context; the application context should include health facilities (such as hospital emergency rooms, outpatient clinics, pediatric wards, psychology centers, social services), education (such as schools) and community; no language or date restriction. The exclusion criteria were: non-self-report tools studies, comprehensive articles, comments, editorials, expert opinions, and studies of projective techniques. The COSMIN risk of bias checklist was used to evaluate the methodological quality of the included studies. Feasibility aspects were assessed. This study had no funding source; 29 studies describing eight tools met eligibility criteria. No single instrument reported all nine measurement properties outlined by the COSMIN methodology. The strength of the evidence was moderate to high for six out of eight instruments. ICAST-C and JVQ were the tools that obtained the highest number of rated measurement properties and strength of evidence.
PubMed: 38027830
DOI: 10.1016/j.heliyon.2023.e21027 -
Global Mental Health (Cambridge,... 2023Most family violence research has been conducted in high-income countries, although family violence rates are higher in low- and middle-income countries (LMICs), and... (Review)
Review
Most family violence research has been conducted in high-income countries, although family violence rates are higher in low- and middle-income countries (LMICs), and outcomes more severe. Given the strong associations of family violence with substance use and mental illness, the aim of this systematic review was to examine interventions that targeted familial violence and at least one other condition of substance use or mental illness to determine effective treatments in LMICs. We conducted a systematic review of interventions that addressed family violence and mental illness or substance use. A committee of three researchers independently screened titles and abstracts and conducted full-text eligibility assessments. Two researchers conducted a risk of bias assessment. Data were extracted using a structured spreadsheet and narratively synthesized. Our search identified 29 articles produced from 19 studies conducted in 13 LMICs. Most ( = 15) studies randomized to study condition. Lack of blinding was the most common threat. The external validity of studies was generally poor. Fourteen studies had a primary intervention target of family violence, mental health, substance use, economic improvement, or HIV. None of the studies showed improvements in all intervention areas. Child maltreatment was less likely to be addressed than intimate partner violence (IPV). Targeted interventions for substance and mental health mostly improved primary outcomes, although they were less effective in reducing IPV. Evidence-based treatments must be rigorously evaluated before innovations in implementation can occur. Interventions overwhelmingly addressed IPV victimization and should consider how to work with couples and include men and children.
PubMed: 38024805
DOI: 10.1017/gmh.2023.62 -
Journal of Affective Disorders Feb 2024Profound negative implications of adverse childhood experiences (ACEs) have raised public health concern worldwide. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Profound negative implications of adverse childhood experiences (ACEs) have raised public health concern worldwide.
METHOD
This systematic review and meta-analysis examined associations of three types of ACEs (abuse, neglect, and household dysfunctions) with experiential (emotional quality of momentary and everyday experiences) and reflective (judgments about life satisfaction, sense of meaning, and ability to pursue goals that can include and extend beyond the self) facets of emotional well-being (EWB) and educational achievement. The systematic review yielded 100 studies with 176 effect sizes that met criteria for inclusion in the meta-analysis.
RESULTS
ACEs were related particularly strongly to lower EWB, r = -0.32, p < .001; [95 % CI: -0.44 to 0.01], but also to lower educational achievement, r = -0.18, p < .001; [95 % CI: -0.21 to -0.05]. Associations were stronger for abuse and composite indicators of ACEs than for household dysfunctions. Associations of ACEs with EWB and educational achievement were stronger in childhood and adolescence than in emerging or later adulthood. Associations did not differ for males and females or for Eastern versus Western cultural groups. Analyses provided evidence for the causal role of ACEs in the development of lower EWB and academic achievement as well as their reciprocal associations.
LIMITATIONS
There is no standard conceptualization of well-being and studies are not always clear about the types of ACEs examined, with limited research on educational achievement.
CONCLUSION
Findings have important implications for mental health professionals, policy makers and social service agencies in developing resources and intervention services that target ACEs to protect individuals and promote well-being and academic achievement.
Topics: Male; Female; Adolescent; Humans; Child; Adult; Adverse Childhood Experiences; Academic Success; Child Abuse; Educational Status; Emotions
PubMed: 38000469
DOI: 10.1016/j.jad.2023.11.083 -
Trauma, Violence & Abuse Jul 2024To perform a systematic search of instruments for the early identification of risk of sexual exploitation in children (CSE) and appraise their metric properties.... (Review)
Review
To perform a systematic search of instruments for the early identification of risk of sexual exploitation in children (CSE) and appraise their metric properties. Searches were conducted in four electronic databases to identify instruments that only evaluated child sexual exploitation with no restrictions of date or language. Two reviewers independently carried out the initial selection of titles and abstracts, appraisal of the methodological quality, compliance with the entry criteria in the analysis, and extraction of data necessary to systematize the information available. Twenty-three articles were found that used 15 CSE detection instruments. The instruments varied with regard to number of questions, ease of administration, sources of information, rating methods, and the training information provided. What they had in common is that most were designed and used in the English-speaking world, basically in the United States, with few instruments providing solid proof of their validity and reliability in the scores derived thereof. Although instruments were obtained with significant similarities in their conceptualization, differences in multiple characteristics made it difficult to draw clear conclusions regarding their greater or lesser suitability. What did become clear was the need to keep working on obtaining rigorous empirical psychometric evidence.
Topics: Humans; Child Abuse, Sexual; Child; Psychometrics; Reproducibility of Results; Female; Male; Surveys and Questionnaires
PubMed: 37997288
DOI: 10.1177/15248380231207898