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Journal of the International AIDS... Mar 2023Couple HIV testing and counselling (CHTC) is associated with measurable benefits for HIV prevention and treatment. However, the uptake remains limited in much of... (Review)
Review
INTRODUCTION
Couple HIV testing and counselling (CHTC) is associated with measurable benefits for HIV prevention and treatment. However, the uptake remains limited in much of sub-Saharan Africa, despite an expanded range of strategies designed to promote access.
METHODS
Following PRIMSA guidelines, we conducted a systematic review to characterize CHTC uptake strategies. Five databases were searched. Full-text articles were included if they were: conducted in sub-Saharan Africa during the study period (1980-2019), targeted heterosexual couples, reported at least one strategy to promote CHTC and provided a quantifiable measure of CHTC uptake. After the initial and full-text screening, key features of the studies were abstracted and synthesized.
RESULTS
Of the 6188 unique records found in our search, 365 underwent full-text review with 29 distinct studies included and synthesized. Most studies recruited couples through antenatal care (n = 11) or community venues (n = 8) and used provider-based HIV testing (n = 25). The primary demand creation strategies included home-based CHTC (n = 7); integration of CHTC into clinical settings (n = 4); distribution of HIV self-testing kits (n = 4); verbal or written invitations (n = 4); community recruiters (n = 3); partner tracing (n = 2); relationship counselling (n = 2); financial incentives (n = 1); group education with CHTC coupons (n = 1); and HIV testing at other community venues (n = 1). CHTC uptake ranged from negligible to nearly universal.
DISCUSSION
We thematically categorized a diverse range of strategies with varying levels of intensity and resources used across sub-Saharan Africa to promote CHTC. Offering CHTC within couples' homes was the most common approach, followed by the integration of CHTC into clinical settings. Due to heterogeneity in study characteristics, we were unable to compare the effectiveness across studies, but several trends were observed, including the high prevalence of CHTC promotion strategies in antenatal settings and the promising effects of home-based CHTC, distribution of HIV self-tests and integration of CHTC into routine health services. Since 2019, an updated literature search found that combining partner notification and secondary distribution of HIV self-test kits may be an additionally effective CHTC strategy.
CONCLUSIONS
There are many effective, feasible and scalable approaches to promote CHTC that should be considered by national programmes according to local needs, cultural context and available resources.
Topics: Humans; Female; Pregnancy; Sexual Partners; HIV Infections; Counseling; HIV Testing; Africa South of the Sahara
PubMed: 36929284
DOI: 10.1002/jia2.26075 -
International Journal of Environmental... Feb 2023Autism spectrum disorder (ASD) has become a critical public health issue that affects more than 78 million people. In many recent studies, the authors have demonstrated... (Meta-Analysis)
Meta-Analysis Review
Autism spectrum disorder (ASD) has become a critical public health issue that affects more than 78 million people. In many recent studies, the authors have demonstrated that equine-assisted activities and therapies (EAATs) can substantially improve the social and behavioral skills of children with ASD. However, the qualities of the studies differ, and some authors reached opposite conclusions. In this review, we systematically and objectively examined the effectiveness of EAATs for people with ASD, combining both qualitative and quantitative methods. We searched five databases (PubMed, Scopus, ERIC, ProQuest, and MEDLINE) and added relevant references, and we identified 25 articles for data extraction and analysis. According to our results, EAAT programs can substantially improve the social and behavioral functioning and language abilities of children with ASD. However, among the subdomains, the results were inconsistent. According to the meta-analyses, there were considerable improvements in the social cognition, communication, irritability, and hyperactivity domains, but not in the domains of social awareness, mannerisms, motivation, lethargy, stereotypy, or inappropriate speech. Moreover, there was a lack of sufficient comparative data to conclude that EAAT programs lead to substantial improvements in motor and sensory functioning. In addition, among the included studies, we noted the indicator of whether EAAT programs decreased parental stress and improved family functioning, and although there were four articles in which the researchers considered this aspect, we were unable to draw any conclusions because of the insufficient data and conflicting descriptive evidence. However, we need to consider the improvement in parental mental health as a factor in the effectiveness of this complementary intervention. We hope that in future studies, researchers will focus on family functioning and conduct more randomized controlled trials (RCTs) with blinded assessments using different scales and measures.
Topics: Humans; Animals; Horses; Autism Spectrum Disorder; Irritable Mood; Communication; Speech; Equine-Assisted Therapy
PubMed: 36767996
DOI: 10.3390/ijerph20032630 -
Frontiers in Psychology 2022Advances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will...
BACKGROUND
Advances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will affect healthcare systems worldwide. Compassion is essential for high-quality healthcare and research shows how prosocial caring behaviors benefit human health and societies. However, the possible association between AI technologies and compassion is under conceptualized and underexplored.
OBJECTIVES
The aim of this scoping review is to provide a comprehensive depth and a balanced perspective of the emerging topic of AI technologies and compassion, to inform future research and practice. The review questions were: How is compassion discussed in relation to AI technologies in healthcare? How are AI technologies being used to enhance compassion in healthcare? What are the gaps in current knowledge and unexplored potential? What are the key areas where AI technologies could support compassion in healthcare?
MATERIALS AND METHODS
A systematic scoping review following five steps of Joanna Briggs Institute methodology. Presentation of the scoping review conforms with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Eligibility criteria were defined according to 3 concept constructs (AI technologies, compassion, healthcare) developed from the literature and informed by medical subject headings (MeSH) and key words for the electronic searches. Sources of evidence were Web of Science and PubMed databases, articles published in English language 2011-2022. Articles were screened by title/abstract using inclusion/exclusion criteria. Data extracted (author, date of publication, type of article, aim/context of healthcare, key relevant findings, country) was charted using data tables. Thematic analysis used an inductive-deductive approach to generate code categories from the review questions and the data. A multidisciplinary team assessed themes for resonance and relevance to research and practice.
RESULTS
Searches identified 3,124 articles. A total of 197 were included after screening. The number of articles has increased over 10 years (2011, = 1 to 2021, = 47 and from Jan-Aug 2022 = 35 articles). Overarching themes related to the review questions were: (1) (7 themes) Concerns about AI ethics, healthcare jobs, and loss of empathy; Human-centered design of AI technologies for healthcare; Optimistic speculation AI technologies will address care gaps; Interrogation of what it means to be human and to care; Recognition of future potential for patient monitoring, virtual proximity, and access to healthcare; Calls for curricula development and healthcare professional education; Implementation of AI applications to enhance health and wellbeing of the healthcare workforce. (2) (10 themes) Empathetic awareness; Empathetic response and relational behavior; Communication skills; Health coaching; Therapeutic interventions; Moral development learning; Clinical knowledge and clinical assessment; Healthcare quality assessment; Therapeutic bond and therapeutic alliance; Providing health information and advice. (3) (4 themes) Educational effectiveness of AI-assisted learning; Patient diversity and AI technologies; Implementation of AI technologies in education and practice settings; Safety and clinical effectiveness of AI technologies. (4) (3 themes) Enriching education, learning and clinical practice; Extending healing spaces; Enhancing healing relationships.
CONCLUSION
There is an association between AI technologies and compassion in healthcare and interest in this association has grown internationally over the last decade. In a range of healthcare contexts, AI technologies are being used to enhance empathetic awareness; empathetic response and relational behavior; communication skills; health coaching; therapeutic interventions; moral development learning; clinical knowledge and clinical assessment; healthcare quality assessment; therapeutic bond and therapeutic alliance; and to provide health information and advice. The findings inform a reconceptualization of compassion as a comprising six elements: (1) Awareness of suffering (e.g., pain, distress, risk, disadvantage); (2) Understanding the suffering (significance, context, rights, responsibilities etc.); (3) Connecting with the suffering (e.g., verbal, physical, signs and symbols); (4) Making a judgment about the suffering (the need to act); (5) Responding with an intention to alleviate the suffering; (6) Attention to the effect and outcomes of the response. These elements can operate at an individual (human or machine) and collective systems level (healthcare organizations or systems) as a cyclical system to alleviate different types of suffering. New and novel approaches to human-AI intelligent caring could enrich education, learning, and clinical practice; extend healing spaces; and enhance healing relationships.
IMPLICATIONS
In a complex adaptive system such as healthcare, human-AI intelligent caring will need to be implemented, not as an ideology, but through strategic choices, incentives, regulation, professional education, and training, as well as through joined up thinking about human-AI intelligent caring. Research funders can encourage research and development into the topic of AI technologies and compassion as a system of human-AI intelligent caring. Educators, technologists, and health professionals can inform themselves about the system of human-AI intelligent caring.
PubMed: 36733854
DOI: 10.3389/fpsyg.2022.971044 -
Localization patterns of speech and language errors during awake brain surgery: a systematic review.Neurosurgical Review Jan 2023Awake craniotomy with direct electrical stimulation (DES) is the standard treatment for patients with eloquent area gliomas. DES detects speech and language errors,... (Review)
Review
Awake craniotomy with direct electrical stimulation (DES) is the standard treatment for patients with eloquent area gliomas. DES detects speech and language errors, which indicate functional boundaries that must be maintained to preserve quality of life. During DES, traditional object naming or other linguistic tasks such as tasks from the Dutch Linguistic Intraoperative Protocol (DuLIP) can be used. It is not fully clear which speech and language errors occur in which brain locations. To provide an overview and to update DuLIP, a systematic review was conducted in which 102 studies were included, reporting on speech and language errors and the corresponding brain locations during awake craniotomy with DES in adult glioma patients up until 6 July 2020. The current findings provide a crude overview on language localization. Even though subcortical areas are in general less often investigated intraoperatively, still 40% out of all errors was reported at the subcortical level and almost 60% at the cortical level. Rudimentary localization patterns for different error types were observed and compared to the dual-stream model of language processing and the DuLIP model. While most patterns were similar compared to the models, additional locations were identified for articulation/motor speech, phonology, reading, and writing. Based on these patterns, we propose an updated DuLIP model. This model can be applied for a more adequate "location-to-function" language task selection to assess different linguistic functions during awake craniotomy, to possibly improve intraoperative language monitoring. This could result in a better postoperative language outcome in the future.
Topics: Adult; Humans; Brain Neoplasms; Speech; Wakefulness; Quality of Life; Magnetic Resonance Imaging; Brain Mapping; Glioma; Brain; Craniotomy; Electric Stimulation
PubMed: 36662312
DOI: 10.1007/s10143-022-01943-9 -
Sensors (Basel, Switzerland) Dec 2022Currently, not all children that need speech therapy have access to a therapist. With the current international shortage of speech-language pathologists (SLPs), there is... (Review)
Review
Currently, not all children that need speech therapy have access to a therapist. With the current international shortage of speech-language pathologists (SLPs), there is a demand for online tools to support SLPs with their daily tasks. Several online speech therapy (OST) systems have been designed and proposed in the literature; however, the implementation of these systems is lacking. The technical knowledge that is needed to use these programs is a challenge for SLPs. There has been limited effort to systematically identify, analyze and report the findings of prior studies. We provide the results of an extensive literature review of OST systems for childhood speech communication disorders. We systematically review OST systems that can be used in clinical settings or from home as part of a treatment program for children with speech communication disorders. Our search strategy found 4481 papers, of which 35 were identified as focusing on speech therapy programs for speech communication disorders. The features of these programs were examined, and the main findings are extracted and presented. Our analysis indicates that most systems which are designed mainly to support the SLPs adopt and use supervised machine learning approaches that are either desktop-based or mobile-phone-based applications. Our findings reveal that speech therapy systems can provide important benefits for childhood speech. A collaboration between computer programmers and SLPs can contribute to implementing useful automated programs, leading to more children having access to good speech therapy.
Topics: Child; Humans; Speech; Speech Therapy; Speech-Language Pathology; Communication Disorders; Speech Disorders
PubMed: 36560082
DOI: 10.3390/s22249713 -
Child and Adolescent Psychiatry and... Nov 2022Attention Deficit/Hyperactivity disorder (ADHD) is one of the most common disorders in school-age children. In addition to learning difficulties associated with the... (Review)
Review
Attention Deficit/Hyperactivity disorder (ADHD) is one of the most common disorders in school-age children. In addition to learning difficulties associated with the disorder's core symptoms of inattention and hyperactivity, children with ADHD display substantial social impairments. Methylphenidate (MPH) in formulations such as Ritalin or Concerta mitigates inattention and hyperactivity, but the effects of the therapy on social behavior in children with ADHD are not clear. This review aims to determine the effectiveness of short term (up to 6 months) MPH treatment on three domains of social skills in children aged 6-14 with ADHD: (i) Recognition of nonverbal emotional expressions, which are a marker of inherent (unlearned) social understanding, (ii) theory of mind (ToM) components that relate to learned cognition and social communication, and (iii) social competence in everyday environments. 15 relevant studies were identified based on inclusion/exclusion criteria. The results show mixed effects: the overall social performance as evaluated by parents, teachers or peers, and some components of ToM, were found to improve following a weeks-long course of MPH treatment. However, the effects of the medication are less clear when evaluating momentary/nonverbal social responses such as reactions to emotional facial expressions. While the findings of this review indicate that an MPH medication regime of order weeks to months could improve, to a degree, social impairment in children with ADHD, more studies are required to identify the medications' mechanism and confirm such a conclusion.
PubMed: 36443766
DOI: 10.1186/s13034-022-00526-2 -
Medical Science Monitor : International... Nov 2022Changes in central auditory processing due to aging in normal-hearing elderly patients, as well as age-related hearing loss, are often associated with difficulties in...
Changes in central auditory processing due to aging in normal-hearing elderly patients, as well as age-related hearing loss, are often associated with difficulties in speech processing, especially in unfavorable acoustic environments. Speech processing depends on the perception of temporal and spectral features, and for this reason can be assessed by recordings of phase-locked neural activity when synchronized to transient and periodic sound stimuli frequency-following responses (FFRs). An electronic search of the PubMed and Web of Science databases was carried out in July 2019. Studies that evaluated the effects of age-related hearing loss on components of FFRs were included. Studies that were not in English, studies performed on animals, studies with cochlear implant users, literature reviews, letters to the editor, and case studies were excluded. Our search yielded 6 studies, each of which included 30 to 94 subjects aged between 18 and 80 years. Latency increases and significant amplitude reduction of the onset, offset, and sloop V/A components of FFRs were observed. Latency and amplitude impairment of the fundamental frequency, first formant, and high formants were related to peripheral sensorineural hearing loss in the elderly population. Conclusions: Temporal changes in FFR tracing were related to the aging process. Hearing loss also impacts the envelope fine structure, producing poorer speech comprehension in noisy environments. More research is needed to understand aspects related to hearing loss and cognitive aspects common to the elderly.
Topics: Aged; Animals; Humans; Speech; Speech Perception; Acoustic Stimulation; Hearing Loss, Sensorineural; Cochlear Implants
PubMed: 36397662
DOI: 10.12659/MSM.938089 -
Frontiers in Public Health 2022Despite numerous instruments existing to assist in the measurement of specific cyberbullying behaviors or cyberbullying in general, it is still unclear their purpose,...
Despite numerous instruments existing to assist in the measurement of specific cyberbullying behaviors or cyberbullying in general, it is still unclear their purpose, corresponding scenarios, and their effectiveness. This study, therefore, aims to provide a comprehensive review of academic efforts on cyberbullying definitions, measurements, and their effectiveness in children and adolescents in the past two decades. A systematic review was performed using ASReview, an open source machine learning systematic review system. Three bibliographic citation databases, including Web of Science core collection, PubMed, and EBSCO were adopted for all relevant literature published from January 2001 to August 2021. In total, twenty-five studies, mentioning seventeen cyberbullying measurement scales, met the study collection criteria. The results found that most failed to provide a clear definition of cyberbullying, often providing unclear and inconsistent descriptions for the youth. Similarly, studies found it difficult to clearly reflect the three key elements of bullying, namely: harmfulness, repetitiveness, and the power imbalance between bullies and victims. With regard to cyberbullying types, most presented two or three categories, including victimization, perpetration, and bystanding, while some suggested four types based on the nature of the cyberbullying behavior, including written or verbal, visual or sexual, character impersonation, and exclusion. If characteristics are considered, cyberbullying becomes more specific with multiple categories being proposed, including flaming (or roasting), harassment, denigration, defamation, outing, jokes, online sexual harassment, and cyberstalking. With regard to measurements, many scales have been proposed and frequently refined to capture specific cyberbullying experience of the youth. This study emphasizes the value and importance of providing clear cyberbullying definitions and helps scholars in youth cyberbullying choose appropriate measurement scales.
Topics: Child; Adolescent; Humans; Cyberbullying; Bullying; Crime Victims
PubMed: 36388377
DOI: 10.3389/fpubh.2022.1000504 -
Frontiers in Psychiatry 2022Episodic memory impairments beyond the traumatic event might be a characteristic hallmark of post-traumatic stress disorder (PTSD). Although several studies support such...
Episodic memory impairments beyond the traumatic event might be a characteristic hallmark of post-traumatic stress disorder (PTSD). Although several studies support such a claim, empirical findings are inconsistent. Therefore, we performed a random-effects meta-analysis including data from a total of 47 studies and 3,062 subjects. As main finding, we can show that PTSD patients show episodic memory deficits compared to all controls. This effect was significantly stronger for PTSD vs. non-traumatized healthy controls as compared to PTSD vs. traumatized controls without PTSD. Finally, episodic memory impairments in PTSD were most pronounced in verbal memory tests as compared to non-verbal memory tests. Our results provide new evidence that PTSD is characterized by impaired episodic long-term memory beyond the traumatic event, and these deficits are particularly pronounced in verbal memory. We will discuss our findings in the context of physiological, psychological and trauma related memory models. From a broader perspective, our findings may have implications for the treatment of PTSD by suggesting that the assessment and, if necessary, training of memory deficits could be included as part of diagnostics and psychotherapeutic treatment.
PubMed: 36245884
DOI: 10.3389/fpsyt.2022.909442 -
Nursing Forum Nov 2022To identify the current research involving interprofessional collaboration between registered nurses (RNs) and speech language pathologists (SLPs) in healthcare and...
AIMS AND OBJECTIVE
To identify the current research involving interprofessional collaboration between registered nurses (RNs) and speech language pathologists (SLPs) in healthcare and educational settings.
BACKGROUND
As the complexity of healthcare increases, the need for active interprofessional collaboration between RNs and SLPs grows. A review of the literature revealed no systematic reviews currently exist about interprofessional collaborative studies between RNs and SLPs.
DESIGN
Researchers conducted a scoping review using PRISMA guidelines.
METHODS
Online databases were used to identify qualitative and quantitative research studies written in English and conducted between 2011 and 2020. Databases included Academic Search Ultimate, ASHA Wire, CINAHL, Cochrane Database of Systematic Reviews, ERIC, MEDLINE, PubMed, PsycINFO, and SEMANTIC SCHOLAR. The studies needed to focus on the interprofessional collaboration between RNs and SLPs or students in these professions.
FINDINGS
Of the 128 sources, only six studies met scoping review criteria. The primary focus of three studies was an evaluation of interprofessional education activities between nursing, speech language pathology, and other health profession students. One study explored interprofessional education in clinical practice between RNs and SLPs. Two studies explored interprofessional collaboration in the clinical setting.
CONCLUSION
More research is needed that investigates interprofessional collaboration and practice of RNs and SLPs in the healthcare setting.
RELEVANCE TO CLINICAL PRACTICE
This review identified the need for RNs and SLPs to work effectively as interprofessional teams are important in improving patient outcomes.
Topics: Humans; Pathologists; Speech; Speech-Language Pathology; Delivery of Health Care; Nurses
PubMed: 36161720
DOI: 10.1111/nuf.12802