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The American Journal of Drug and... Jan 2023Tools predicting individual relapse risk would invaluably inform clinical decision-making (e.g. level-of-care) in substance use treatment. Studies of neuroprediction -...
Tools predicting individual relapse risk would invaluably inform clinical decision-making (e.g. level-of-care) in substance use treatment. Studies of neuroprediction - use of neuromarkers to predict individual outcomes - have the dual potential to create such tools and inform etiological models leading to new treatments. However, financial limitations, statistical power demands, and related factors encourage restrictive selection criteria, yielding samples that do not fully represent the target population. This problem may be further compounded by a lack of statistical optimism correction in neuroprediction research, resulting in predictive models that are overfit to already-restricted samples. This systematic review aims to identify potential threats to external validity related to restrictive selection criteria and underutilization of optimism correction in the existing neuroprediction literature targeting substance use treatment outcomes. Sixty-seven studies of neuroprediction in substance use treatment were identified and details of sample selection criteria and statistical optimism correction were extracted. Most publications were found to report restrictive selection criteria (e.g. excluding psychiatric (94% of publications) and substance use comorbidities (69% of publications)) that would rule-out a considerable portion of the treatment population. Furthermore, only 21% of publications reported optimism correction. Restrictive selection criteria and underutilization of optimism correction are common in the existing literature and may limit the generalizability of identified neural predictors to the target population whose treatment they would ultimately inform. Greater attention to the inclusivity and generalizability of addiction neuroprediction research, as well as new opportunities provided through open science initiatives, have the potential to address this issue.
Topics: Humans; Substance-Related Disorders; Behavior, Addictive; Patient Selection; Research Design; Treatment Outcome
PubMed: 36099534
DOI: 10.1080/00952990.2022.2116712 -
International Journal of Mental Health... Dec 2022Mental and substance use disorders are leading contributing factors for the Australian non-fatal burden of disease. These disorders frequently co-occur in the mental... (Review)
Review
Mental and substance use disorders are leading contributing factors for the Australian non-fatal burden of disease. These disorders frequently co-occur in the mental health population, and mental health nurses are the largest group of professionals treating dual diagnosis. A comprehensive understanding of mental health nurses' attitudes and perceptions is required to inform future implementation of dual diagnosis training programs. A systematic literature review of sources derived from electronic databases including Medline, CINAHL, SCOPUS review, and PsychINFO, along with Connected Papers. Selection criteria included a focus on mental health nurses' attitudes towards dual diagnosis of mental illness and substance use. Extracted data was qualitatively synthesized. Of the 5232 articles retrieved initially, 12 were included in the review. Four themes emerged from the synthesis: drug and alcohol use among mental health consumers (seven studies), caring for dual diagnosis consumers (eight studies), role perception (six studies), and treatment optimism (five studies). Salient beliefs included substance use as a self-inflicted choice (71%) or a form of 'self-medication' (29%); a lack of willingness to provide care (75%), or a strong commitment to care (25%); greater comfort with screening and acute medical management rather than ongoing management (83%); and pessimism about treatment effectiveness (100%). Mental health nurses' beliefs and attitudes towards dual diagnosis were often negative, which is likely to result in poor quality care and treatment outcomes. However, the lack of recent studies in this research area indicates the need for up-to-date knowledge that can inform the development of training programs.
Topics: Humans; Mental Health; Australia; Psychiatric Nursing; Substance-Related Disorders; Attitude of Health Personnel
PubMed: 35909095
DOI: 10.1111/inm.13043 -
Journal of Psychopharmacology (Oxford,... Mar 2023Major depressive disorder (MDD) is a highly burdensome health condition, for which there are numerous accepted pharmacological and psychological interventions.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Major depressive disorder (MDD) is a highly burdensome health condition, for which there are numerous accepted pharmacological and psychological interventions. Adjunctive treatment (augmentation/combination) is recommended for the ~50% of MDD patients who do not adequately respond to first-line treatment. We aimed to evaluate the current evidence for concomitant approaches for people with early-stage treatment-resistant depression (TRD; defined below).
METHODS
We systematically searched Medline and Institute for Scientific Information Web of Science to identify randomised controlled trials of adjunctive treatment of ⩾10 adults with MDD who had not responded to ⩾1 adequate antidepressant. The cochrane risk of bias (RoB) tool was used to assess study quality. Pre-post treatment meta-analyses were performed, allowing for comparison across heterogeneous study designs independent of comparator interventions.
RESULTS
In total, 115 trials investigating 48 treatments were synthesised. The mean intervention duration was 9 weeks (range 5 days to 18 months) with most studies assessed to have low ( = 57) or moderate ( = 51) RoB. The highest effect sizes (ESs) were from cognitive behavioural therapy (ES = 1.58, 95% confidence interval (CI): 1.09-2.07), (es)ketamine (ES = 1.48, 95% CI: 1.23-1.73) and risperidone (ES = 1.42, 95% CI: 1.29-1.61). Only aripiprazole and lithium were examined in ⩾10 studies. Pill placebo (ES = 0.89, 95% CI: 0.81-0.98) had a not inconsiderable ES, and only six treatments' 95% CIs did not overlap with pill placebo's (aripiprazole, (es)ketamine, mirtazapine, olanzapine, quetiapine and risperidone). We report marked heterogeneity between studies for almost all analyses.
CONCLUSIONS
Our findings support cautious optimism for several augmentation strategies; although considering the high prevalence of TRD, evidence remains inadequate for each treatment option.
Topics: Adult; Humans; Aripiprazole; Risperidone; Depression; Depressive Disorder, Major; Ketamine
PubMed: 35861202
DOI: 10.1177/02698811221104058 -
Journal of Education and Health... 2022The present study aims to systematically review the women's knowledge, attitude, and practice (KAP) of breast cancer (BC) screening methods to get enough information for... (Review)
Review
The present study aims to systematically review the women's knowledge, attitude, and practice (KAP) of breast cancer (BC) screening methods to get enough information for policymakers to orient the screening strategies. All English KAP studies on BC screening methods in five databases up to January 2021 were included. The quality of the final articles was assessed using the STROBE checklist. The qualitative synthesis was performed. Out of 5574 retrieved articles, 28 were included. About 64% of the articles were of high quality. Overall, there were poor knowledge, negative attitude, and low practice between women. The educational programs and cultural plans can encourage regular screening. Women's excessive optimism to their BC risk should be eliminated by focusing on the risk of the disease, more.
PubMed: 35847154
DOI: 10.4103/jehp.jehp_634_21 -
The British Journal of General Practice... Aug 2022Antibiotics are overused in patients with acute rhinosinusitis (ARS) as it is difficult to identify those who benefit from antibiotic treatment. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Antibiotics are overused in patients with acute rhinosinusitis (ARS) as it is difficult to identify those who benefit from antibiotic treatment.
AIM
To develop prediction models for computed tomography (CT)-confirmed ARS and culture-confirmed acute bacterial rhinosinusitis (ABRS) in adults presenting to primary care with symptoms suggestive of ARS.
DESIGN AND SETTING
This was a systematic review and individual participant data meta-analysis.
METHOD
CT-confirmed ARS was defined as the presence of fluid level or total opacification in any maxillary sinuses, whereas culture-confirmed ABRS was defined by culture of fluid from antral puncture. Prediction models were derived using logistic regression modelling.
RESULTS
Among 426 patients from three studies, 140 patients (32.9%) had CT-confirmed ARS. A model consisting of seven variables: previous diagnosis of ARS, preceding upper respiratory tract infection, anosmia, double sickening, purulent nasal discharge on examination, need for antibiotics as judged by a physician, and C-reactive protein (CRP) showed an optimism-corrected c-statistic of 0.73 (95% confidence interval [CI] = 0.69 to 0.78) and a calibration slope of 0.99 (95% CI = 0.72 to 1.19). Among 225 patients from two studies, 68 patients (30.2%) had culture-confirmed ABRS. A model consisting of three variables: pain in teeth, purulent nasal discharge, and CRP showed an optimism-corrected c-statistic of 0.70 (95% CI = 0.63 to 0.77) and a calibration slope of 1.00 (95% CI = 0.66 to 1.52). Clinical utility analysis showed that both models could be useful to rule out the target condition.
CONCLUSION
Simple prediction models for CT-confirmed ARS and culture-confirmed ABRS can be useful to safely reduce antibiotic use in adults with ARS in high-prescribing countries.
Topics: Acute Disease; Adult; Anti-Bacterial Agents; C-Reactive Protein; Humans; Primary Health Care; Rhinitis; Sinusitis; Tomography, X-Ray Computed
PubMed: 35817585
DOI: 10.3399/BJGP.2021.0585 -
Arthroscopy, Sports Medicine, and... Jun 2022To investigate whether psychological factors, such as avoidance behavior, fear, pain catastrophization, kinesiophobia, anxiety, depression, optimism, and expectation are... (Review)
Review
PURPOSE
To investigate whether psychological factors, such as avoidance behavior, fear, pain catastrophization, kinesiophobia, anxiety, depression, optimism, and expectation are associated with different subjective and functional baseline scores in patients with frozen shoulder contracture syndrome (FSCS).
METHODS
Searches were conducted in MEDLINE, Cochrane Library (CENTRAL Database), PEDro, Pubpsych, and PsychNET.APA without restrictions applied to language, date, or status of publication. Two authors reviewed study titles, abstract, and full text based on the following inclusion criteria: adult population (≥ 30 < 70 years old) with FSCS.
RESULTS
Seven hundred and seventy-six records were included by the search strategies. After title final screening, 6 studies were included for the qualitative synthesis. Psychological features investigated were anxiety, depression, pain-related fear, pain catastrophizing, and pain self-efficacy; reported outcomes included pain, function, disability, quality of life, and range of motion. Data suggest that anxiety and depression impact self-assessed function, pain, and quality of life. There is no consensus on the correlation between psychological variables and range of motion. Associations were suggested between pain-related fear, pain-related beliefs, and pain-related behavior and perceived arm function; pain-related conditions showed no significant correlation with range of motion and with perceived stiffness at baseline.
CONCLUSION
Scores traditionally thought to assess physical dimensions like shoulder pain, disability, and function seem to be influenced by psychological variables. In FSCS patients, depression and anxiety were associated with increased pain perception and decreased function and quality of life at baseline. Moreover, pain-related fear and catastrophizing seem to be associated with perceived arm function.
PubMed: 35747628
DOI: 10.1016/j.asmr.2022.04.001 -
Gastroenterology Oct 2022Many studies have assessed risk factors of irritable bowel syndrome (IBS) and other abdominal pain-related disorders of gut-brain interaction (AP-DGBI); however, the... (Meta-Analysis)
Meta-Analysis
BACKGROUND & AIMS
Many studies have assessed risk factors of irritable bowel syndrome (IBS) and other abdominal pain-related disorders of gut-brain interaction (AP-DGBI); however, the role of these factors is unclear due to heterogeneous study designs. The aim of this systematic review was to extensively evaluate the literature and determine clinical risk and protective factors for the presence and persistence of AP-DGBI in children and adults.
METHODS
A PubMed search identified studies investigating potential risk and protective factors for AP-DGBI in adults and children. Inclusion criteria included fully published studies with a control group; exclusion criteria included poor-quality studies (using a validated scale). For each factor, the proportion of studies that found the factor to be a risk factor, protective factor, or neither was summarized. The number of studies, diagnostic criteria, number of subjects, and average study quality rating provided further context. Whenever possible, a meta-analysis generated pooled odds ratios or mean difference.
RESULTS
The systematic review included 348 studies. Female sex, gastroenteritis, abuse, stress, psychological disorders, somatic symptoms, and poor sleep were consistent risk factors for developing AP-DGBI in adults and children. In adults, additional risk factors included obesity, smoking, and increased use of medical resources. Protective AP-DGBI factors in adults included social support and optimism; no studies for protective factors were found for children.
CONCLUSIONS
There are multiple risk factors for AP-DGBI in adults and children. These include female sex, gastroenteritis, abuse, stress, poor sleep, obesity, psychological disorders, and somatic symptoms. Additional studies are needed in children, on protective factors, and on factors associated with persistence of AP-DGBI.
Topics: Abdominal Pain; Adult; Brain; Child; Female; Gastroenteritis; Gastrointestinal Diseases; Humans; Irritable Bowel Syndrome; Medically Unexplained Symptoms; Obesity; Risk Factors
PubMed: 35716771
DOI: 10.1053/j.gastro.2022.06.028 -
BMC Cancer Apr 2022Quality of life (QoL) is an important patient-reported outcome that has been studied extensively as an endpoint. There is a growing interest in factors that may...
BACKGROUND
Quality of life (QoL) is an important patient-reported outcome that has been studied extensively as an endpoint. There is a growing interest in factors that may influence QoL, such as personality. This descriptive systematic review examined the relationship between personality and QoL in women with non-metastatic breast cancer. METHODS: On November 24th, 2020, with a update on March 7th, 2022, PubMed, PsycINFO, CINAHL, Web of Science and Embase were systematically searched for studies that assessed the direct relationship between personality traits and QoL among adult women diagnosed with non-metastatic breast cancer. The National Institutes of Health Study Quality Assessment Tool was used to assess the quality and risk of bias of the included studies. Three reviewers independently extracted data regarding objectives, population, setting, design, method, outcome measurements and key results. The results are descriptively reported.
RESULTS
Twelve studies (6 cohort studies and 6 cross-sectional studies) were included. Three studies were rated as poor, one study was rated as good, and the remaining studies were rated as moderate. There was a small to moderate effect of personality on QoL as correlation coefficients ranged from 0.10 to 0.77, and the explained variance ranged from 4 to 43%. The (strength of the) relationship depended on the personality trait and QoL domain that was measured and was most apparent for the personality traits 'optimism' and 'trait anxiety' on psychosocial QoL domains. The results for the personality traits (unmitigated) agency, agreeableness, conscientiousness, novelty seeking, and self-efficacy indicated a smaller but statistically significant correlation between these personality traits and QoL.
CONCLUSIONS
The results confirm that personality affects QoL in women with non-metastatic breast cancer and thus provides evidence that personality traits are indeed important influential factors of QoL. It is therefore strongly recommended for all future QoL research to measure personality traits and use these variables as predictive factors, as they are needed to accurately interpret QoL. Information regarding personality traits provide physicians and patients with an interpretation of low or deterioration of QoL, which could guide physicians to improve their patients' health outcomes and subsequently QoL using psycho-oncological support or treatment.
Topics: Adult; Anxiety; Breast Neoplasms; Cross-Sectional Studies; Female; Humans; Personality; Quality of Life
PubMed: 35439953
DOI: 10.1186/s12885-022-09408-4 -
Journal of Clinical Nursing Dec 2022To map the factors associated with nurses' positive attitudes towards families' involvement in nursing care and to identify any existing gaps in knowledge. (Review)
Review
AIM
To map the factors associated with nurses' positive attitudes towards families' involvement in nursing care and to identify any existing gaps in knowledge.
BACKGROUND
Several tools have been proposed to assess the attitudes, beliefs and practices of nurses towards families in different care contexts. However, there is a knowledge gap on how the results of these tools can identify the factors that are associated with more positive attitudes of nurses.
DESIGN
A scoping review based on the steps proposed by the Joanna Briggs Institute.
METHODS
Three independent reviewers searched the databases: PUBMED/Medline; LILACS; Virtual Health Library; PsycInfo; Google Scholar; SCOPUS and CINAHL, from 2006 to August 2021, guided by the question: What are the factors associated with nurses' positive attitudes towards families´ involvement in nursing care, in studies that used one or both of the following two scales 'Families' Importance in Nursing Care- Nurses' Attitudes' and 'Family Nursing Practice Scale'? This review was conducted in accordance with PRISMA-ScR.
RESULTS
Twenty-six primary studies were identified, in which 9,620 nurses participated. Positive attitudes were associated with three types of variables: (a) personal-longer working career (42.3%) and older age (26.9%); (b) educational-higher level of academic education (30.8%) and family nursing education (23.0%); and (c) workplace-working in primary health care and/or outpatient clinics (34.6%) or in a unit with philosophy/approach to families (23.0%).
CONCLUSIONS
Personal variables such as age and time of service are non-modifiable aspects, but educational and workplace variables are subject to intervention to improve nurses' attitudes towards families' involvement in nursing care. Continuing development programmes about family care can constitute important strategies to improve positive attitudes of nurses towards families in practice.
RELEVANCE TO CLINICAL PRACTICE
Recognising the characteristics associated with nurses´ positive attitudes towards families may enable the development of tailored interventions that promote family-focused care.
Topics: Humans; Attitude of Health Personnel; Optimism; Family Nursing; Nursing Care; Nurses
PubMed: 35083808
DOI: 10.1111/jocn.16226 -
Frontiers in Nutrition 2021Yogurt is known to be nutrient-rich and probiotic content, which gather optimism due to their potential role in preventing and managing cancers. The effect of yogurt...
Yogurt is known to be nutrient-rich and probiotic content, which gather optimism due to their potential role in preventing and managing cancers. The effect of yogurt consumption on colorectal cancer (CRC) is inconsistent. This study aims to investigate the association of yogurt consumption with the risk of CRC. Three databases, namely, PubMed, Web of Science, and Embase, were searched for all relevant studies from July 2021 on the association of yogurt consumption with CRC risk. We pooled the odds ratios (ORs) and their 95% CIs using a random-effects meta-analysis to assess the association. Finally, 16 studies met the inclusion criteria and were chosen in the meta-analysis. Yogurt consumption was significant with lower risk of CRC risk in the overall comparison (OR = 0.87, 95% CI: 0.81-0.94), in the cohort studies (OR = 0.91, 95% CI: 0.86-0.97), and case-control studies (OR = 0.75, 95% CI: 0.65-0.85). With regard to subgroup analyses by study region, cancer type, publication year, and sex, yogurt consumption significantly decreased overall CRC, colon cancer, and distal colon cancer risks. In stratified analyses, we observed significantly decreased CRC risk in Europe and Africa and published after 2010 and overall population. Sensitivity analysis indicated the result is stable and there is no publication bias in the meta-analysis. Overall, this study indicated that yogurt intake was related to a decreased risk of CRC.
PubMed: 35047546
DOI: 10.3389/fnut.2021.789006