-
Technology and Health Care : Official... Jun 2024About 186 million people in the world suffer from infertility, and there is one infertile couple in every 4-6 couples. It is thus essential to find effective... (Review)
Review
BACKGROUND
About 186 million people in the world suffer from infertility, and there is one infertile couple in every 4-6 couples. It is thus essential to find effective psychological treatment.
OBJECTIVE
To conduct a systematic review of previous meta-analyses on mindfulness-based therapy outcomes in infertile female patients and a meta-analysis of studies nested within these meta-analyses.
METHODS
Randomized controlled trials (RCTS) on the efficacy of mindset-based interventions in infertile female patients were retrieved from PubMed, The Cochrane Library, Embase, Web of Science, CNI, VIP Database, and Wanfang Database until March 1, 2023. Two researchers screened the literature, extracted data according to inclusion and exclusion criteria, and conducted quality control according to Cochrane Handbook 5.1.0. When there was ambiguity, a third party determined it. The meta-analysis was performed using RevMan 5.3 software.
RESULT
14 randomized controlled trials involving 1784 patients were included. Meta-analysis showed that compared with conventional care, mindfulness-based intervention can effectively relieve anxiety in female infertility patients [SMD =-2.25, 95% CI (-2.90, -1.60), P< 0.00001], depression [SMD =-2.25, 95% CI (-2.99, -1.52), P< 0.00001], perceived stress [SMD =-0.99, 95% CI (-1.27, -0.71), P< 0.00001], improved quality of life, physiological function [MD = 14.03, 95% CI (11.98, 16.07), P< 0.00001], Role limitations due to physical problems [MD = 11.30, 95% CI (5.71, 16.90), P< 0.0001], vitality [MD = 11.55, 95% CI (9.46, 13.65), P< 0.00001], mental health [MD = 17.32, 95% CI (15.29, 19.35), P< 0.00001].
CONCLUSION
Existing evidence shows that mindfulness therapy can effectively relieve the anxiety and depression of infertile women, reduce the level of stress, and improve the quality of life and sleep quality. However, due to the limited quantity and quality of the literature, multi-center, large-sample, and high-quality randomized controlled studies should be conducted in the future.
PubMed: 38943413
DOI: 10.3233/THC-240174 -
JMIR Formative Research Jun 2024Conduct disorder increases risks of educational dropout, future mental illness, and incarceration if untreated. First-line treatment of conduct disorder involves...
BACKGROUND
Conduct disorder increases risks of educational dropout, future mental illness, and incarceration if untreated. First-line treatment of conduct disorder involves evidence-based parenting skills programs. Time-outs, a frequent tool in these programs, can be effective at improving behavior, and recent apps have been developed to aid this process. However, these apps promote the use of time-outs in inconsistent or developmentally inappropriate ways, potentially worsening behavior problems. Digital microinterventions like these apps could guide parents through high-quality time-outs in the moment, but current time-out apps lack features promoting adherence to the evidence-based best practice. Agile scrum is a respected approach in the software development industry.
OBJECTIVE
We aimed to explore the feasibility of using the agile scrum approach to build a digital microintervention to help parents deliver an evidence-based time-out.
METHODS
The agile scrum methodology was used. Four sprints were conducted. Figma software was used for app design and wireframing. Insights from 42 expert stakeholders were used during 3 sprint reviews. We consulted experts who were identified from councils around the Midlands region of the United Kingdom and charities through personal contacts and a snowballing approach.
RESULTS
Over 4 development sprints from August 2022 to March 2023, the app was iteratively designed and refined based on consultation with a diverse group of 42 experts who shared their knowledge about the content of common parenting programs and the challenges parents commonly face. Modifications made throughout the process resulted in significant app enhancements, including tailored timer algorithms and enhanced readability, as well as an onboarding zone, mindfulness module, and pictorial information to increase inclusivity. By the end of the fourth sprint, the app was deemed ready for home use by stakeholders, demonstrating the effectiveness of our agile scrum development approach.
CONCLUSIONS
We developed an app to support parents to use the evidence-based time-out technique. We recommend the agile scrum approach to create mobile health apps. Our experience highlights the valuable role that frontline health and social care professionals, particularly those working with vulnerable families, can play as experts in scrum reviews. There is a need for research to both evaluate the impact of digital microinterventions on child behavioral change and also create digital microinterventions that cater to non-English speakers and individuals who participate in parenting programs in settings outside the United Kingdom.
PubMed: 38941594
DOI: 10.2196/54892 -
Journal of General Internal Medicine Jun 2024Electronic consultations (eConsults) enable asynchronous consultation between primary care providers (PCPs) and specialists. eConsults have been used successfully to...
BACKGROUND
Electronic consultations (eConsults) enable asynchronous consultation between primary care providers (PCPs) and specialists. eConsults have been used successfully to manage a variety of conditions and have the potential to help PCPs manage polypharmacy and promote deprescribing.
OBJECTIVE
To elicit clinician perspectives on barriers/facilitators of using eConsults for deprescribing among older adults within a university health network.
DESIGN
Semi-structured interviews.
PARTICIPANTS
PCPs, geriatricians, and pharmacists.
APPROACH
We used the COM-B (Capability, Opportunity, Motivation, and Behavior) model to structure the interview guide and qualitative analysis methods to identify barriers/facilitators of (1) deprescribing and (2) use of eConsults for deprescribing.
KEY RESULTS
Of 28 participants, 19 were PCPs (13 physicians, 4 residents, 2 nurse practitioners), 7 were geriatricians, and 2 were pharmacists. Barriers and facilitators to deprescribing: PCPs considered deprescribing important but identified myriad barriers (e.g., time constraints, fragmented clinical care, lack of pharmacist integration, and patient/family resistance). Use of eConsults for deprescribing: Both PCPs and geriatricians highlighted the limits of contextual information available through electronic health record (vs. face-to-face) to render specific and actionable eConsults (e.g., knowledge of prior deprescribing attempts). Participants from all groups expressed interest in a targeted process whereby eConsults could be offered for select patients based on key factors (e.g., polypharmacy or certain comorbidities) and accepted or declined by PCPs, with pithy recommendations delivered in a timely manner relative to patient appointments. This was encapsulated by one PCP: "they need to be crisp and to the point to be helpful, with specific suggestions of something that could be discontinued or switched…not, 'hey, did you know your patient is on over 12 medicines?'".
CONCLUSIONS
Clinicians identified multifaceted factors influencing the utility of eConsults for deprescribing among older adults in primary care. Deprescribing eConsult interventions should be timely, actionable, and mindful of limitations of electronic chart review.
PubMed: 38941059
DOI: 10.1007/s11606-024-08899-0 -
Frontiers in Psychology 2024Satisfaction with an intervention influences the uptake of behavior changes and the long-term efficacy of the intervention. Therefore, it is crucial to assess...
Satisfaction with an intervention influences the uptake of behavior changes and the long-term efficacy of the intervention. Therefore, it is crucial to assess satisfaction by participant profile when creating and adapting behavior interventions for minoritized populations. Qualitative and quantitative data on participant trauma symptom severity and intervention satisfaction were collected through self-report surveys from 54 women. The sample was 59.3% Hispanic, with an average age of 33.21 (SD = 10.42), who were in residential treatment for substance use disorders (SUDs) and participated in a 12-session mindfulness-based intervention. Qualitative responses were coded using thematic analysis, and an integrative mixed-methods approach was used to compare qualitative theme frequency between high-trauma ( = 28) and low-trauma ( = 26) groups at session 2 and session 11. High- and low-trauma groups were determined by interquartile ranges (bottom 25% = low; top 75% = high). In session 2, the low-trauma group reported significantly higher satisfaction ( = 4.20, SD = 0.55) than the high-trauma group ( = 3.77, SD = 0.89); (43) = 1.90, = 0.03. In session 11, there was no significant difference between groups. The mixed-methods analysis revealed that "trouble focusing" appeared more frequently in the high-trauma group than in the low-trauma group during session 2, but the theme was not present in either group at session 11, suggesting that this might pose an initial barrier for individuals with high trauma but subsides as the intervention progresses. This speaks to the importance of retention strategies tailored for participants with SUDs and high trauma while they adjust to the intervention. Assessing initial challenges with satisfaction may help facilitators intervene to increase participant satisfaction.
PubMed: 38939226
DOI: 10.3389/fpsyg.2024.1359174 -
Frontiers in Psychology 2024Are universal school-based mindfulness interventions an effective way to reduce risk for mental disorders and improve adolescents' lives? To answer this question, we...
Are universal school-based mindfulness interventions an effective way to reduce risk for mental disorders and improve adolescents' lives? To answer this question, we reanalyzed data from Dunning et al.'s (2022) meta-analysis of randomized controlled trials of mindfulness interventions delivered to children and adolescents. Though Dunning et al. (2022) reported some benefits of universal mindfulness interventions, their analysis did not examine adolescents separately from children. Consequently, their conclusions may not entirely reflect the effectiveness of universal mindfulness interventions specifically for adolescents, a developmental period when mental disorders are known to increase. Using their open-access data tables, we tested impacts of 22 randomized controlled trials ( = 16,558) on eight outcome categories-anxiety/stress, attention, depression, executive functioning, mindfulness, negative behavior, social behavior, and wellbeing-at immediate post-test and longest follow-up. Our reanalysis shows that when compared to passive controls, mindfulness interventions significantly reduced trait mindfulness ( = -0.10). When compared to active controls, mindfulness interventions significantly improved anxiety/stress ( = 0.17) and wellbeing ( = 0.10). When compared to all controls combined, mindfulness interventions did not significantly improve any outcome (s = 0.01 to 0.26). No effects of mindfulness interventions were observed at follow-up assessment. Overall, results of our analysis cast doubt about the value of existing school-based mindfulness interventions as a universal prevention strategy for adolescents.
PubMed: 38939220
DOI: 10.3389/fpsyg.2024.1384531 -
Frontiers in Psychology 2024To explore the intervention effect of mindfulness training on athletes' performance using meta-analysis method.
OBJECTIVE
To explore the intervention effect of mindfulness training on athletes' performance using meta-analysis method.
METHODS
A total of 11 articles and 23 effect sizes were included through retrieval of Chinese and English databases, with a total sample size of 582.
RESULT
Mindfulness training improves the level of mindfulness [SMD =1.08, 95%CI (0.30, 1.86), < 0.01], fluency (The optimal competitive psychological state of the athlete, the athlete's attention is all focused on the task, and other things no longer attract their attention) [SMD =1.47, 95%CI (0.87, 2.08), < 0.001] and performance [SMD =0.92, 95% CI (0.40, 1.43), < 0.01], reduced psychological anxiety [SMD = -0.87, 95% CI (-1.54, -0.20), < 0.05], and all reached the level of large effect size.
CONCLUSION
The effect of mindfulness training on athletes' sports performance is effective, and it can be used as an effective psychological skill intervention method to improve athletes' sports performance. In the future, we should further expand the sample size, strengthen the comparative study of different sports and intervention modes, and pay attention to the difference between the time effect and trait mindfulness level in fluency state.
PubMed: 38939219
DOI: 10.3389/fpsyg.2024.1375608 -
Journal of Child & Adolescent Trauma Jun 2024Youth living in poverty are more likely to experience cumulative stressors including multiple adverse childhood events. Further, the Covid-19 pandemic has...
Youth living in poverty are more likely to experience cumulative stressors including multiple adverse childhood events. Further, the Covid-19 pandemic has disproportionality affected Hispanic youth and communities, leading to unprecedented levels of trauma. This research responded to a need for a youth resiliency-building program in an urban and impoverished area with a majority Hispanic population. We conducted a formative evaluation of a youth intervention entitled , which aims to help youth overcome adversity and to build resilience via psychoeducation and skill development. Just prior to the pandemic in the United States (August-December, 2019), youth (=12) participated in as part of an after-school program. Immediately following, we utilized focus groups to solicit youth's perspectives on the acceptability of the program, what they had learned, content areas they liked best, and their recommendations for program improvement. Follow-up phone interviews were also conducted three months later (March 2020) while youth were at home as a result of the pandemic. Youth enjoyed the program and were able to apply skills learned to cope with stress in their daily lives and across ecological contexts. Findings point to the program as particularly well-suited to older adolescents. During the pandemic, most youth continued to utilize self-soothing and mindfulness skills to emotionally self-regulate while facing challenges related to home schooling. Findings highlight the importance of trauma-resiliency programming for youth and offer recommendations to practitioners utilizing the program.
PubMed: 38938959
DOI: 10.1007/s40653-023-00585-3 -
Frontiers in Psychiatry 2024Internet Gaming Disorder (IGD) is an emerging public health concern; effective treatments are still under development. This mini-review focuses on summarizing the main... (Review)
Review
Internet Gaming Disorder (IGD) is an emerging public health concern; effective treatments are still under development. This mini-review focuses on summarizing the main scientific evidence from psychological, pharmacological, brain imaging, and emerging treatment approaches for IGD. We searched PubMed and Scopus databases using keywords related to IGD and treatment. Cognitive behavioral therapy (CBT) is the most extensively researched psychological treatment for IGD, supported by several randomized controlled trials (RCTs). Other promising approaches include mindfulness, relapse prevention, abstinence protocols, and family therapy. Pharmacological treatments like bupropion and escitalopram have shown benefits, especially when IGD is comorbid with conditions like major depressive disorder. However, the quality of evidence is moderate for psychological interventions but low to moderate for pharmacological approaches. Emerging treatments such as transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and electro-acupuncture have demonstrated efficacy in reducing IGD symptoms and modulating brain activity. Brain imaging techniques like functional magnetic resonance imaging (fMRI) have provided insights into the neural mechanisms underlying IGD and treatment effects, although these studies lack randomized controlled designs. While multimodal approaches show promise, larger, well-designed RCTs are needed to establish effective IGD treatments.
PubMed: 38938461
DOI: 10.3389/fpsyt.2024.1408560 -
MicroPublication Biology 2024A Continuous Performance Task is an example of a mental stressor which requires vigilance, attention, and effort. We hypothesized that a sympathetic nervous system...
A Continuous Performance Task is an example of a mental stressor which requires vigilance, attention, and effort. We hypothesized that a sympathetic nervous system response would be evident from a resting baseline period to this attention test, and explored if physiological measures were correlated to state and trait anxiety, perceived stress, mindfulness, and performance on the task. In 20 undergraduates, blood pressure and skin conductance increased due to the attention test but heart rate variability did not change. The physiological variables did not correlate to psychological variables; there was a trend of higher perceived stress correlating to lower foil accuracy rate ( = 0.09). ClinicalTrials.gov ID: NCT06098352.
PubMed: 38938412
DOI: 10.17912/micropub.biology.001059 -
BMC Medicine Jun 2024Non-pharmacological interventions have a myriad of available intervention options and contain multiple components. Whether specific components of non-pharmacological... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Non-pharmacological interventions have a myriad of available intervention options and contain multiple components. Whether specific components of non-pharmacological interventions or combinations are superior to others remains unclear. The main aim of this study is to compare the effects of different combinations of non-pharmacological interventions and their specific components on health-related outcomes in adults with subjective cognitive decline.
METHODS
PubMed, Embase, Cochrane, CINAHL, PsycINFO, CENTRAL, Web of Science, and China's two largest databases, CNKI and Wanfang, were searched from inception to 22nd, January 2023. Randomized controlled trials using non-pharmacological interventions and reporting health outcomes in adults with subjective cognitive decline were included. Two independent reviewers screened studies, extracted data, and assessed risk of bias. Component network meta-analysis was conducted employing an additive component model for network meta-analysis. This study followed the PRISMA reporting guideline and the PRISMA checklist is presented in Additional file 2.
RESULTS
A total of 39 trials with 2959 patients were included (range of mean ages, 58.79-77.41 years). Resistance exercise might be the optimal intervention for reducing memory complaints in adults with subjective cognitive decline; the surface under the cumulative ranking p score was 0.888, followed by balance exercise (p = 0.859), aerobic exercise (p = 0.832), and cognitive interventions (p = 0.618). Music therapy, cognitive training, transcranial direct current stimulation, mindfulness therapy, and balance exercises might be the most effective intervention components for improving global cognitive function (iSMD, 0.83; 95% CI, 0.36 to 1.29), language (iSMD, 0.31; 95% CI, 0.24 to 0.38), ability to perform activities of daily living (iSMD, 0.55; 95% CI, 0.21 to 0.89), physical health (iSMD, 3.29; 95% CI, 2.57 to 4.00), and anxiety relief (iSMD, 0.71; 95% CI, 0.26 to 1.16), respectively.
CONCLUSIONS
The form of physical activity performed appears to be more beneficial than cognitive interventions in reducing subjective memory complaints for adults with subjective cognitive decline, and this difference was reflected in resistance, aerobic, and balance exercises. Randomized clinical trials with high-quality and large-scale are warranted to validate the findings.
TRIAL REGISTRATION
PROSPERO registry number. CRD42022355363.
Topics: Humans; Cognitive Dysfunction; Network Meta-Analysis; Middle Aged; Aged; Randomized Controlled Trials as Topic; Exercise Therapy
PubMed: 38937777
DOI: 10.1186/s12916-024-03491-z