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The Gerontologist May 2024The poor mental health of adults living in aged care needs addressing. Improvements to nutrition and exercise are important, but mental health requires a psychological... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
The poor mental health of adults living in aged care needs addressing. Improvements to nutrition and exercise are important, but mental health requires a psychological approach. Self-determination theory finds that autonomy is essential to wellbeing while experiences of being controlled undermine it. A review of existing quantitative data could underscore the importance of autonomy in aged care, and a review of the qualitative literature could inform ways to promote autonomy and avoid control. Testing these possibilities was the objective of this research.
RESEARCH DESIGN AND METHODS
We conducted a mixed-methods systematic review of studies investigating autonomy, control, and indices of optimal functioning in aged care settings. The search identified 30 eligible reports (19 quantitative, 11 qualitative), including 141 quantitative effect sizes, 84 qualitative data items, and N = 2,668. Quantitative effects were pooled using three-level meta-analytic structural equation models, and the qualitative data were meta-synthesized using a grounded theory approach.
RESULTS
As predicted, the meta-analysis showed a positive effect of aged care residents' autonomy and their wellness, r = 0.33 [95% CI: 0.27, 0.39], and a negative effect of control, r = -0.16 [95% CI: -0.27, -0.06]. The meta-synthesis revealed seven primary and three sub-themes describing the nuanced ways autonomy, control, and help seeking are manifest in residential aged care settings.
DISCUSSION AND IMPLICATIONS
The results suggest that autonomy should be supported, and unnecessary external control should be minimized in residential aged care, and we discuss ways the sector could strive for both aims.
Topics: Humans; Aged; Exercise; Mental Health; Personal Autonomy; Nutritional Status; Qualitative Research
PubMed: 37798134
DOI: 10.1093/geront/gnad135 -
Journal of Medical Internet Research Oct 2023YouTube has become a popular source of health care information, reaching an estimated 81% of adults in 2021; approximately 35% of adults in the United States have used...
BACKGROUND
YouTube has become a popular source of health care information, reaching an estimated 81% of adults in 2021; approximately 35% of adults in the United States have used the internet to self-diagnose a condition. Public health researchers are therefore incorporating YouTube data into their research, but guidelines for best practices around research ethics using social media data, such as YouTube, are unclear.
OBJECTIVE
This study aims to describe approaches to research ethics for public health research implemented using YouTube data.
METHODS
We implemented a systematic review of articles found in PubMed, SocINDEX, Web of Science, and PsycINFO following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. To be eligible to be included, studies needed to be published in peer-reviewed journals in English between January 1, 2006, and October 31, 2019, and include analyses on publicly available YouTube data on health or public health topics; studies using primary data collection, such as using YouTube for study recruitment, interventions, or dissemination evaluations, were not included. We extracted data on the presence of user identifying information, institutional review board (IRB) review, and informed consent processes, as well as research topic and methodology.
RESULTS
This review includes 119 articles from 88 journals. The most common health and public health topics studied were in the categories of chronic diseases (44/119, 37%), mental health and substance use (26/119, 21.8%), and infectious diseases (20/119, 16.8%). The majority (82/119, 68.9%) of articles made no mention of ethical considerations or stated that the study did not meet the definition of human participant research (16/119, 13.4%). Of those that sought IRB review (15/119, 12.6%), 12 out of 15 (80%) were determined to not meet the definition of human participant research and were therefore exempt from IRB review, and 3 out of 15 (20%) received IRB approval. None of the 3 IRB-approved studies contained identifying information; one was explicitly told not to include identifying information by their ethics committee. Only 1 study sought informed consent from YouTube users. Of 119 articles, 33 (27.7%) contained identifying information about content creators or video commenters, one of which attempted to anonymize direct quotes by not including user information.
CONCLUSIONS
Given the variation in practice, concrete guidelines on research ethics for social media research are needed, especially around anonymizing and seeking consent when using identifying information.
TRIAL REGISTRATION
PROSPERO CRD42020148170; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=148170.
Topics: Adult; Humans; Data Collection; Ethics Committees, Research; Ethics, Research; Informed Consent; Social Media
PubMed: 37792443
DOI: 10.2196/43060 -
Journal of Fungi (Basel, Switzerland) Sep 2023Mucormycosis is a rare, opportunistic, and emerging fungal infection that can rapidly develop into a severe, highly fatal clinical picture. In most cases, it is caused... (Review)
Review
Mucormycosis is a rare, opportunistic, and emerging fungal infection that can rapidly develop into a severe, highly fatal clinical picture. In most cases, it is caused by fungi of the order Mucorales, which are usually avirulent but become pathogenic when the host's immune system is compromised. This systematic review was conducted according to PRISMA guidelines. The databases searched included PubMed, Scopus, and Web of Science. We chose articles that analyzed the oral manifestations of patients with mucormycosis, were published between 2018 and 2023, and met our search terms. The risk of bias in the articles was assessed using the CARE guideline for case reports and STROBE for a cross-sectional study. After the selection process, 20 articles were included in this review, all containing information about the different oral manifestations presented by people with mucormycosis. The most common oral manifestations are mainly bone exposures and oral ulcers, halitosis, pus discharge, gingival thickening, and periodontitis. However, despite the importance of recognizing these oral manifestations in the early stages of mucormycotic infection, providing early treatment, and reducing the high mortality rate of the infection, more studies are needed.
PubMed: 37755045
DOI: 10.3390/jof9090935 -
International Journal For Equity in... Sep 2023Recent years have seen record levels of migration to Europe. Female migrants are at heightened risk of developing mental health disorders, yet they face barriers to...
Barriers and facilitators to seeking and accessing mental health support in primary care and the community among female migrants in Europe: a "feminisms" systematic review.
BACKGROUND
Recent years have seen record levels of migration to Europe. Female migrants are at heightened risk of developing mental health disorders, yet they face barriers to accessing mental health services in their host countries. This systematic review aims to summarise the barriers and facilitators to accessing mental health support for female migrants in Europe.
METHODS
The review follows PRISMA guidelines, and the protocol was pre-published on PROSPERO. Six electronic databases were searched: CINAHL, Global Health Database, Medline, PsycARTICLES, PsycINFO and Web of Science. Thematic analysis was undertaken on the identified studies. A feminist quality appraisal tool was applied.
RESULTS
Eight qualitative, six quantitative and five mixed methods studies were identified. Barriers included a lack of information, stigma, religious and cultural practices and beliefs, and a lack of consideration of gender-specific needs within the health system. Gender-sensitive services, supportive general practitioners and religious leaders facilitated access.
CONCLUSIONS
The design of mental health research, services, policies, and commissioning of support for migrants must consider female migrant needs. Mental health support services must be culturally aware and gender sensitive.
REGISTRATION
The review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO, registration number CRD42021235571.
Topics: Female; Humans; Mental Health; Feminism; Transients and Migrants; Europe; Refugees; Primary Health Care; Health Services Accessibility
PubMed: 37752502
DOI: 10.1186/s12939-023-01990-8 -
JMIR MHealth and UHealth Sep 2023Mobile apps are fundamental tools in today's society for practical and social endeavors. However, these technologies are often not usable for older users. Given the... (Review)
Review
BACKGROUND
Mobile apps are fundamental tools in today's society for practical and social endeavors. However, these technologies are often not usable for older users. Given the increased use of mobile apps by this group of users and the impact that certain services may have on their quality of life, such as mobile health, personal finance, or online administrative procedures, a clear set of guidelines for mobile app designers is needed. Existing recommendations for older adults focus on investigations with certain groups of older adults or have not been extracted from experimental results.
OBJECTIVE
In this research work, we systematically reviewed the scientific literature that provided recommendations for the design of mobile apps based on usability testing with older adults and organized such recommendations into a meaningful set of design guidelines.
METHODS
We conducted a systematic literature review of journal and conference articles from 2010 to 2021. We included articles that carried out usability tests with populations aged >60 years and presented transferable guidelines on mobile software design, resulting in a final set of 40 articles. We then carried out a thematic analysis with 3 rounds of analysis to provide meaning to an otherwise diverse set of recommendations. At this stage, we discarded recommendations that were made by just 1 article, were based on a specific mobile app and were therefore nontransferrable, were based on other authors' literature (as opposed to recommendations based on the results of usability tests), or were not sufficiently argued. With the remaining recommendations, we identified commonalities, wrote a faithful statement for each guideline, used a common language for the entire set, and organized the guidelines into categories, thereby giving shape to an otherwise diverse set of recommendations.
RESULTS
Among the 27 resulting guidelines, the rules Simplify and Increase the size and distance between interactive controls were transversal and of the greatest significance. The rest of the guidelines were divided into 5 categories (Help & Training, Navigation, Visual Design, Cognitive Load, and Interaction) and consequent subcategories in Visual Design (Layout, Icons, and Appearance) and Interaction (Input and Output). The recommendations were structured, explained in detail, and illustrated with applied examples extracted from the selected studies, where appropriate. We discussed the design implications of applying these guidelines, contextualized with relevant studies. We also discussed the limitations of the approach followed, stressing the need for further experimentation to gain a better understanding of how older adults use mobile apps and how to better design such apps with these users in mind.
CONCLUSIONS
The compiled guidelines support the design of mobile apps that cater to the needs of older adults because they are based on the results of actual usability tests with users aged >60 years.
Topics: Humans; Aged; Mobile Applications; Quality of Life; Language; Research Design; Software Design
PubMed: 37733401
DOI: 10.2196/43186 -
European Journal of Physical and... Oct 2023Rehabilitation is considered a key intervention in health care. Clinical registries, defined as an organized system that uses observational methods to collect...
INTRODUCTION
Rehabilitation is considered a key intervention in health care. Clinical registries, defined as an organized system that uses observational methods to collect information to assess specific outcomes in a defined population, can contribute to assessing the impact of the rehabilitation intervention. This review aims to identify and describe rehabilitation-specific registry systems with an emphasis on identifying outcomes that enable the assessment of vital areas and activities of daily living.
EVIDENCE ACQUISITION
A systematic scoping review was conducted. A systematic search was conducted up to August 2022 in MEDLINE/PubMed, Embase, Cochrane Library, Epistemonikos, and other search resources. Studies related to rehabilitation registries presented data on people with health problems that could limit their functioning were selected. The inclusion of studies/clinical registries was not limited by methodological design, year of publication, country, or language. The unit of analysis was rehabilitation registries. The measurement instruments used to assess the outcomes were explored to estimate the domain assessed from the vital areas related to functioning and disability as described by the International Classification of Functioning, Disability and Health (ICF). The vital areas were classified according to activities of daily living (ADLs).
EVIDENCE SYNTHESIS
Seventy-one registries in rehabilitation were identified. The registries included a median of 3 (IQR 2-5) assessment instruments designed to assess the impact of different rehabilitation programs. In total, 137 different assessment scales or instruments were identified. Each rehabilitation registry assessed 6 (IQR 2-8) domains of the ICF, and 15.4% of registries assessed all domains. The most assessed domain was "Mobility" (89.7%), and the least assessed was "General Tasks and Demands" (25.6%). In addition, 92.3% of rehabilitation registries assessed basic ADLs, 76.9% advanced ADLs, and 71.8% instrumental ADLs.
CONCLUSIONS
Although clinical registries do not claim to directly assess the impact of rehabilitation programs on people's functioning according to the ICF framework, it was identified that a low percentage of them assessed the nine vital areas through different outcome assessment instruments. However, most rehabilitation registries directly or indirectly assess some basic, instrumental, and advanced ADLs. The findings of this review highlight the need to improve the design of clinical registries focused on assessing the impact of rehabilitation programs to assess people in all areas of their lives.
Topics: Humans; Activities of Daily Living; Disabled Persons; Outcome Assessment, Health Care
PubMed: 37721783
DOI: 10.23736/S1973-9087.23.07895-4 -
JPMA. the Journal of the Pakistan... Aug 2023To map literature on research ethics committees, institutional review boards and ethics review framework in Pakistan to identify key insights during public health...
OBJECTIVE
To map literature on research ethics committees, institutional review boards and ethics review framework in Pakistan to identify key insights during public health emergencies and normal times.
METHOD
The systematic scoping review was conducted in April 2022, and comprised literature search on PubMed, World Health Organisation Global Index Medicus and Summons databases for articles published between January 2005 and February 2022. Information extracted included authors' names, year of publication, title, study methodology, and key insights under the heads of challenges and solutions. Due to data heterogeneity, key themes were identified and analysed.
RESULTS
Of the 2,190 studies initially identified, 21(0.95%) were subjected to full-text review, and, from among them, 9(45%) were analysed in detail. There were 4 key insights identified: research ethics committees and institutional review boards in Pakistan remain unregulated as they are currently not registered or accredited by a competent national-level authority; most members of such committees are not formally trained to implement the mandate; internal and external pressures hinder independent decision-making of such committees; and other issues hindering the functionality and performance of research ethics committees and institutional review boards.
CONCLUSIONS
Despite existing publications calling for urgent policy and regulatory reforms, there is a dearth of literature and minimal policy actions underlying the fact that ethics review remains a neglected area in Pakistan.
Topics: Humans; Pakistan; Ethics Committees, Research; Learning; Databases, Factual
PubMed: 37697760
DOI: 10.47391/JPMA.8033 -
Ethical Decision Making in Disaster and Emergency Management: A Systematic Review of the Literature.Prehospital and Disaster Medicine Oct 2023Ethical decision making in disaster and emergency management requires more than good intentions; it also asks for careful consideration and an explicit, systematic... (Review)
Review
Ethical decision making in disaster and emergency management requires more than good intentions; it also asks for careful consideration and an explicit, systematic approach. The decisions made by leaders and the effects they have in a disaster must carry the confidence of the community to which they serve. Such decisions are critical in settings where resources are scarce; when decisions are perceived as unjust, the consequences may erode public trust, result in moral injury to staff, and cause community division. To understand how decisions in these settings are informed by ethics, a systematic literature review was conducted to determine what ethical guidance informs decision making in disaster and emergency management. This study found evidence of ethical guidance to inform decision making in disaster management in the humanitarian system, based on humanitarian principles. Evidence of the application of an ethical framework to guide or reference decision making was varied or absent in other emergency management agencies or systems. Development and validation of ethical frameworks to support decision making in disaster management practice is recommended.
Topics: Humans; Disasters; Decision Making
PubMed: 37675490
DOI: 10.1017/S1049023X23006325 -
Asia-Pacific Journal of Oncology Nursing Sep 2023Human papillomavirus (HPV) vaccination rates remain low among adolescent girls across ethnic minority groups that experience high incidences of HPV-related cervical... (Review)
Review
OBJECTIVE
Human papillomavirus (HPV) vaccination rates remain low among adolescent girls across ethnic minority groups that experience high incidences of HPV-related cervical cancer with poor outcomes. This systematic review aimed to synthesize the available evidence on the factors affecting HPV vaccination among ethnic minority adolescent girls.
METHODS
Six databases (PubMed, OVID MEDLINE, EMBASE, CINAHL, PsycINFO, and Scopus) were searched from inception to October 17, 2022. Guided by the conceptual model of vaccine hesitancy, the factors affecting HPV vaccine uptake were descriptively synthesized and analyzed using meta-analyses.
RESULTS
This review included 14 studies. The pooled uptake rate of at least one dose of HPV vaccine among ethnic minority adolescent girls was only 38% (95% confidence interval = 0.22, 0.39). At individual level, age of adolescent girls, knowledge of HPV, perceived importance of HPV vaccination, and perceived risk of HPV infection promoted the vaccine uptake. Beliefs in conspiracy theories and lack of trust in the government and HPV vaccine discouraged the utilization. At social and policy levels, health professionals' recommendations, subjective norms, sexuality-related communication, and vaccine policies such as insurance coverage facilitated HPV vaccination. The religious and moral convictions regarding abstinence from sex until marriage negatively influenced the vaccine acceptance.
CONCLUSIONS
HPV vaccination among ethnic minority adolescent girls was influenced by multi-level factors that highlighted a combined effort, including culturally sensitive health education programmes, sexuality-related communication skills training, collaboration with religious organizations, debunking conspiracy theories in HPV vaccine, and promoting school-based vaccination programs, to increase the coverage.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, CRD42022366805.
PubMed: 37661962
DOI: 10.1016/j.apjon.2023.100279 -
Scandinavian Journal of Medicine &... Jan 2024There has been an increase in the number of studies examining the effect of acute and chronic physical activity on academic outcomes in children and adolescents in the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There has been an increase in the number of studies examining the effect of acute and chronic physical activity on academic outcomes in children and adolescents in the last two decades. We aimed to systematically determine the acute effects of physical activity on academic outcomes in school-aged youth and to examine possible moderators.
METHODS
We conducted a systematic search using PubMed, Web of Science, SPORTDiscus, and PsycINFO databases (from inception to 11th January 2023) for studies assessing the acute effects of physical activity on academic performance-related outcomes in school-aged youth. A univariate and multivariate meta-analysis was conducted based on a random-effects model with restricted maximum likelihood used to pool the academic outcomes results (Hedge's g).
RESULTS
We included 11 articles (803 children and adolescents [range: 6-16 years]) in the systematic review. Overall, acute physical activity increased academic outcomes (Hedge's g = 0.35, 95% CI: 0.20-0.50). Multivariate meta-analyses revealed that physical activity increased academic performance in mathematics (Hedge's g = 0.29, 95% CI: 0.16-0.42) and language (Hedge's g = 0.28, 95% CI: 0.09-0.47). Only behavior change techniques (Hedge's g = 0.54, 95% CI, 0.18-0.90, p < 0.001) played a significant role in this relationship.
CONCLUSIONS
A single bout of physical activity can improve academic outcomes in school-aged youth, which may serve as a complementary tool for the educational field. However, the observed heterogeneity in the results indicates that we should interpret the findings obtained with caution.
Topics: Adolescent; Child; Humans; Academic Performance; Exercise
PubMed: 37632197
DOI: 10.1111/sms.14479