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PloS One 2023Given the predominance of the theory of planned behaviour (TPB) to represent the psychological determinants underlying people's charitable decisions, the present study... (Meta-Analysis)
Meta-Analysis
Given the predominance of the theory of planned behaviour (TPB) to represent the psychological determinants underlying people's charitable decisions, the present study synthesised the model's key relationships, using meta-analysis, and tested the predictive utility of the model for charitable giving encompassing donations of blood, organs, time, and money. Given its relevance to altruistic decisions, the impact of moral norm was assessed also. A systematic literature review identified 117 samples (from 104 studies) examining donation intentions and/or prospective behaviour using TPB measures. The sample-weighted average effects for all associations were moderate-to-strong with perceived behavioural control (PBC) most strongly associated with intention (r+ = 0.562), followed by moral norm (r+ = 0.537), attitude (r+ = 0.507), and subjective norm (r+ = 0.472). Intention (r+ = 0.424) showed stronger associations with prospective behaviour than PBC (r+ = 0.301). The standard TPB predictors explained 44% of variance in intention (52% including moral norm). Intention and PBC explained 19% of variance in behaviour. A number of TPB associations showed differences when analysed for moderator variables such as length of follow-up for prospective behaviour and type of target behaviour. Stronger associations were found for the (subjective and moral) norm-intention associations among some of the different types of giving behaviours, especially for donating organs and time. Overall, the large proportion of variance explained by the TPB predictors especially for intention highlights those cognitions associated with people's plans to give, informative for charities reliant on people's propensity to give.
Topics: Humans; Prospective Studies; Theory of Planned Behavior; Attitude; Intention; Morals; Psychological Theory; Surveys and Questionnaires
PubMed: 37205662
DOI: 10.1371/journal.pone.0286053 -
Journal of Neuromuscular Diseases 2023Muscular dystrophies (MDs) are characterized by chronic muscle wasting but also poorly understood metabolic co-morbidities. We have recently shown that Duchenne MD (DMD)... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Muscular dystrophies (MDs) are characterized by chronic muscle wasting but also poorly understood metabolic co-morbidities. We have recently shown that Duchenne MD (DMD) patients, dogs and asymptomatic carriers are affected by a new form of dyslipidemia that may exacerbate muscle damage.
OBJECTIVE
We aimed to perform a systematic review and meta-analysis for evidence that other types of MDs are associated with dyslipidemia compared to healthy controls.
METHODS
Search was conducted using MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials for reports that compare plasma/serum lipids from MD patients and controls, and meta-analysis of cross-sectional studies quantifying total cholesterol, high-density lipoprotein, low density lipoprotein and triglycerides was performed.
RESULTS
Out of 749 studies, 17 met our inclusion criteria for meta-analysis. 14 of the 17 studies (82%) included investigated myotonic dystrophy (DM); other studies were on pseudohypertrophic MD (PMD) or DMD. As a whole, MD individuals had significantly higher levels of circulating total cholesterol (Hedges' g with 95% confidence interval [CI], 0.80 [0.03 - 1.56]; p = 0.04) and triglycerides (Hedges' g with 95% confidence interval [CI], 2.28[0.63 - 3.92]; p = 0.01) compared to controls. Meta-regression analysis showed the percentage of male gender was significantly associated with the difference in total cholesterol (beta = 0.05; 95% CI, - 0.02 to 0.11; p = 0.043) and high-density lipoprotein (beta = - 9.38; 95% CI, - 16.26 to - 2.50; p = 0.028).
CONCLUSIONS
MD is associated with significantly higher circulating levels of total cholesterol and triglycerides. However, caution on the interpretation of these findings is warranted and future longitudinal research is required to better understand this relationship.
Topics: Male; Cholesterol; Cross-Sectional Studies; Dyslipidemias; Lipoproteins, HDL; Muscular Dystrophies; Triglycerides; Female; Humans
PubMed: 37182897
DOI: 10.3233/JND-230064 -
The Lancet. Healthy Longevity Jun 2023Physical exercise is effective at attenuating ageing-related physical decline in general, but evidence of its benefits for older adults in residential care, who often... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Physical exercise is effective at attenuating ageing-related physical decline in general, but evidence of its benefits for older adults in residential care, who often have functional dependency, multimorbidity, and polypharmacy, is inconclusive. We aimed to establish the effects of exercise interventions on the physical function of this population.
METHODS
For this systematic review and network meta-analysis, we searched PubMed, Web of Science, Cochrane Library, Rehabilitation & Sports Medicine Source, and SPORTDiscus to identify randomised controlled trials assessing the effects of exercise interventions (vs usual care) on physical function (ie, functional independence, physical performance, and other related measures, such as muscle strength, balance, or flexibility) in adults aged 60 years or older living in residential care. Relevant studies published in English or Spanish up to Jan 12, 2023, were included in the systematic review. The quality of studies was assessed using the Tool for the Assessment of Study Quality and Reporting in Exercise (TESTEX) score. A network meta-analysis was performed for physical function-related outcomes reported in at least ten studies, with subanalyses for specific intervention (ie, exercise type, training volume, and study duration) and participant (eg, having cognitive impairment or dementia, pre-frail or frail status, and being functionally dependent) characteristics. The study protocol was registered on PROSPERO (CRD42021247809).
FINDINGS
147 studies (11 609 participants, with mean ages ranging from 67 years [SD 9] to 92 years [2]) were included in the systematic review, and were rated as having overall good quality (median TESTEX score 9 [range 3-14]). In the meta-analysis (including 105 studies, n=7759 participants), exercise interventions were associated with significantly improved overall physical function, with a standardised mean difference [SMD] of 0·13 (95% credible interval [CrI] 0·04-0·21), which was confirmed in all analysed subpopulations. The strongest association was observed with 110-225 min per week of exercise, and the greatest improvements were observed with 170 min per week (SMD 0·36 [95% CrI 0·20-0·52]). No significant differences were found between exercise types. Subanalyses showed significant improvements for almost all analysed physical function-related outcomes (Barthel index, five-times sit-to-stand test, 30-s sit-to-stand test, knee extension, hand grip strength, bicep curl strength, Short Physical Performance Battery, 6-min walking test, walking speed, Berg balance scale, and sit-and-reach test). Large heterogeneity was found between and within studies in terms of population and intervention characteristics.
INTERPRETATION
Exercise interventions are associated with improved physical function in older adults in residential care, and should, therefore, be routinely promoted in long-term care facilities.
FUNDING
None.
TRANSLATION
For the Spanish translation of the abstract see Supplementary Materials section.
Topics: Aged; Humans; Exercise; Exercise Therapy; Hand Strength; Muscle Strength; Network Meta-Analysis; Randomized Controlled Trials as Topic; Aged, 80 and over
PubMed: 37182530
DOI: 10.1016/S2666-7568(23)00057-0 -
World Journal of Pediatrics : WJP Aug 2023Advances in cancer treatments, particularly the development of radiation therapy, have led to improvements in survival outcomes in children with brain tumors. However,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Advances in cancer treatments, particularly the development of radiation therapy, have led to improvements in survival outcomes in children with brain tumors. However, radiation therapy is associated with significant long-term neurocognitive morbidity. The present systematic review and meta-analysis aimed to compare the neurocognitive outcomes of children and adolescents with brain tumors treated with photon radiation (XRT) or proton therapy (PBRT).
METHODS
A systematic search was conducted (PubMed, Embase, Cochrane, and Web of Science from inception until 02/01/2022) for studies comparing the neurocognitive outcomes of children and adolescents with brain tumors treated with XRT vs. PBRT. The pooled mean differences (expressed as Z scores) were calculated using a random effects method for those endpoints analyzed by a minimum of three studies.
RESULTS
Totally 10 studies (n = 630 patients, average age range: 1-20 years) met the inclusion criteria. Patients who had received PBRT achieved significantly higher scores (difference in Z scores ranging from 0.29-0.75, all P < 0.05 and significant in sensitivity analyses) after treatment than those who had received XRT for most analyzed neurocognitive outcomes (i.e., intelligence quotient, verbal comprehension and perceptual reasoning indices, visual motor integration, and verbal memory). No robust significant differences (P > 0.05 in main analyses or sensitivity analyses) were found for nonverbal memory, verbal working memory and working memory index, processing speed index, or focused attention.
CONCLUSIONS
Pediatric brain tumor patients who receive PBRT achieve significantly higher scores on most neurocognitive outcomes than those who receive XRT. Larger studies with long-term follow-ups are needed to confirm these results.
Topics: Child; Adolescent; Humans; Infant; Child, Preschool; Young Adult; Adult; Protons; Brain Neoplasms; Proton Therapy
PubMed: 37154861
DOI: 10.1007/s12519-023-00726-6 -
Frontiers in Psychology 2023The impact of social movements (SMs) and collective behavior (CB) supports the relevance of approaching this phenomenon from social psychology. Several systematic... (Review)
Review
BACKGROUND
The impact of social movements (SMs) and collective behavior (CB) supports the relevance of approaching this phenomenon from social psychology. Several systematic reviews (10) and meta-analyses (6) have been carried out in the 21st century, but there is a lack of integration.
AIM
This study seeks to review the patterns of CB and corroborate the psychosocial factors that explain participation in CB and SMs, as well as the long-term psychological effects of participating in them.
METHOD
A systematic search was carried out in the databases Web of Science, Scopus, ProQuest, ScienceDirect, Willey Online Library, EBSCO, and JSTOR for articles dated between 1969 and 2022. We searched for meta-analyses and systematic reviews that empirically evaluated social movements and collective behavior. Of the 494 initial records, after scanning and eligibility phases, 16 meta-analyses and systematic reviews were analyzed in the present work.
RESULTS
The evidence reviewed shows that participation in collective gatherings and CB are common. A cross-cultural survey suggests that collective gatherings are mostly of a leisure type, to a lesser extent religious and sporting, and to an even lesser extent, demonstrations and large religious rites. World Value surveys found that one to three persons out of 10 participate in protests or CB related to SMs and four out of 10 movements achieved some kind of success. Studies challenged that CBs were characterized by unanimity of beliefs, identification and behavior, generalized excitement, as well as mass panic and riot after catastrophes. Only two out of 10 CB are violent. Meta-analysis and systematic reviews confirm that participation in CB and SMs was associated with (a) intergroup conflict and realistic threat ( = 0.30); (b) positive attitudes, expectations, or agreement with goals or collective motive ( = 0.44); (c) cognitive fraternal relative deprivation ( = 0.25); (d) collective efficacy ( = 0.36); (e) collective identity ( = 0.34); (f) emotions and affective relative deprivation ( = 0.35); (g) moral conviction and threat to moral ( = 0.29); and (h) disagreement with system justification belief ( = -0.26). Participation in successful CB and SMs provokes positive changes in emotions, social identity and social relationships, values and beliefs, and empowerment, as well as negative effects such as depression, stress, burnout, and disempowerment related to the failures of SMs.
CONCLUSION
Studies confirm the importance of explanatory factors for SMs, with data from various cultural regions. There is a lack of systematic studies of CB as well as meta-analyses and more culturally diverse studies of the effects of participation in them.
PubMed: 37151317
DOI: 10.3389/fpsyg.2023.1096877 -
Trauma, Violence & Abuse Apr 2024The current research examines potentially morally injurious events (PMIEs) faced by healthcare professionals working in forensic and psychiatric environments. A... (Review)
Review
The current research examines potentially morally injurious events (PMIEs) faced by healthcare professionals working in forensic and psychiatric environments. A systematic literature review was conducted to identify peer-reviewed articles reporting on sources of moral injury or similar concepts (e.g., moral distress) for healthcare workers in such settings. Thirty articles were included and analyzed using a meta-ethnographic approach. Synthesis yielded three third-order factors, each reflecting a moral dichotomy: (a) "between profession and system," (b) "between relations with patients and relations with others," and (c) "between principles and practices." Findings illustrated the hierarchical relationships between dichotomies, with discordance between values of the healthcare profession and features of the healthcare system providing the conditions for PMIEs to occur. The review advances conceptual understandings of PMIEs in forensic and psychiatric settings, illustrating the multilayered dimensions within which morally injurious events are experienced. Theoretical and practical implications are offered that may support the early detection and prevention of moral injury in healthcare professionals.
Topics: Humans; Stress Disorders, Post-Traumatic; Health Personnel
PubMed: 37083056
DOI: 10.1177/15248380231167390 -
The British Journal of Surgery Jun 2023Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the...
BACKGROUND
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
METHODS
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low-middle-income countries.
RESULTS
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of 'single-use' consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low-middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
CONCLUSION
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high- and low-middle-income countries.
Topics: Humans; Developing Countries; Delivery of Health Care; Health Personnel; Environment
PubMed: 37079880
DOI: 10.1093/bjs/znad092 -
Frontiers in Medicine 2023COVID-19 has endangered healthcare systems at multiple levels worldwide. Published data suggests that moral dilemmas faced during these unprecedented times have placed...
BACKGROUND
COVID-19 has endangered healthcare systems at multiple levels worldwide. Published data suggests that moral dilemmas faced during these unprecedented times have placed physicians at the intersections of ethical and unethical considerations. This phenomenon has questioned the physicians' morality and how that has affected their conduct. The purpose of our review is to tap into the spectrum of the transforming optics of patient care during the pandemic and its impact on psychological wellbeing of physicians.
METHODS
We adopted the Arksey and O'Malley's framework, defining research questions, identifying relevant studies, selecting the studies using agreed inclusion and exclusion criteria, charting the data, and summarizing and reporting results. Databases of PubMed/Medline, Web of Science, Scopus, Science Direct, CINAHL, and PsycInfo were searched using a predefined search string. The retrieved titles and abstracts were reviewed. Later, a detailed full-text analysis of the studies which matched our inclusion criteria was performed.
RESULTS
Our first search identified 875 titles and abstracts. After excluding duplicates, irrelevant, and incomplete titles, we selected 28 studies for further analysis. The sample size in 28 studies was 15,509 with an average size of 637 per study. Both quantitative and qualitative approaches were used, with cross-sectional surveys being utilized in all 16 quantitative studies. Using the data from semi-structured interviews, several discrete codes were generated, which led to the identification of five main themes; mental health, individual challenges, decision-making, change in patient care, and support services.
CONCLUSION
This scoping review reports an alarming rise in psychological distress, moral injury, cynicism, uncertainty, burnout, and grief among physicians during the pandemic. Decision-making and patient care were mostly regulated by rationing, triaging, age, gender, and life expectancy. Poor professional controls and institutional services potentially led to physicians' crumbling wellbeing. This research calls for the remediation of the deteriorating mental health and a restoration of medical profession's advocacy and equity.
PubMed: 37056734
DOI: 10.3389/fmed.2023.1071537 -
Journal of Medical Internet Research Apr 2023Retaining participants in clinical trials is an established challenge. Currently, the industry is moving to a technology-mediated, decentralized model for running... (Review)
Review
BACKGROUND
Retaining participants in clinical trials is an established challenge. Currently, the industry is moving to a technology-mediated, decentralized model for running trials. The shift presents an opportunity for technology design to aid the participant experience and promote retention; however, there are many open questions regarding how this can be best supported. We advocate the adoption of a stronger theoretical position to improve the quality of design decisions for clinical trial technology to promote participant engagement.
OBJECTIVE
This study aimed to identify and analyze the types of retention strategies used in published clinical trials that successfully retain participants.
METHODS
A systematic scoping review was carried out on 6 electronic databases for articles published from 1990 to September 2020, namely CINAHL, The Cochrane Library, EBSCO, Embase, PsycINFO, and PubMed, using the concepts "retention," "strategy," "clinal trial," and "clinical research." This was followed by an analysis of the included articles through the lens of self-determination theory, an evidence-based theory of human motivation.
RESULTS
A total of 26 articles were included in this review. The motivational strategies identified in the clinical trials in our sample were categorized into 8 themes: autonomy; competence; relatedness; controlled motivation; branding, communication material, and marketing literature; contact, tracking, and scheduling methods and data collection; convenience to contribute to data collection; and organizational competence. The trials used a wide range of motivational strategies. Notably, the trials often relied on controlled motivation interventions and underused strategies to support intrinsic motivation. Moreover, traditional clinical trials relied heavily on human interaction and "relatedness" to support motivation and retention, which may cause problems in the move to technology-led decentralized trials. We found inconsistency in the data-reporting methods and that motivational theory-based approaches were not evident in strategy design.
CONCLUSIONS
This study offers direction and a framework to guide digital technology design decisions for future decentralized clinical trials to enhance participant retention during clinical trials. This research defines previous clinical trial retention strategies in terms of participant motivation, identifies motivational strategies, and offers a rationale for selecting strategies that will improve retention. It emphasizes the benefits of using theoretical frameworks to analyze strategic approaches and aid decision-making to improve the quality of technology design decisions.
Topics: Humans; Motivation; Communication; Data Collection; Personal Autonomy; Technology
PubMed: 37052985
DOI: 10.2196/38159 -
The Gerontologist Apr 2024Self-perception of aging is an important psychosocial factor that can influence quality of life in older age. This review aimed to synthesize findings on the association...
BACKGROUND AND OBJECTIVES
Self-perception of aging is an important psychosocial factor that can influence quality of life in older age. This review aimed to synthesize findings on the association between self-perception of aging and quality of life among older adults aged 60 and above.
RESEARCH DESIGN AND METHODS
A systematic search was conducted in 4 electronic databases (Ovid Medline, PsycInfo, CINAHL, and Web of Science). Studies conducted in English and including measures on the perception of aging and quality of life were included in this review. A total of 32 observational studies (21 cross-sectional, 8 longitudinal, 2 mixed-method, and 1 qualitative) met the inclusion criteria. Outcomes reported in the included studies were quality of life, physical health and functioning, psychological health, mental health, and general well-being.
RESULTS
Overall, 20 quantitative studies indicated a strong association between positive perception of aging and increased quality of life. Similarly, 9 quantitative studies demonstrated that negative perception of aging is associated with lower quality of life. Results of the mixed-method and qualitative studies indicated that older adults with higher morale and good physical capability had more positive perceptions of health.
DISCUSSION AND IMPLICATIONS
These results suggest that promoting a positive perception of aging and a self-care attitude would help to enhance older adults' quality of life and should be incorporated into future health promotions and interventions.
Topics: Humans; Aged; Quality of Life; Cross-Sectional Studies; Aging; Self Concept; Databases, Factual
PubMed: 37029753
DOI: 10.1093/geront/gnad041