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Asian Journal of Psychiatry May 2023Depression is an independent risk factor for coronary artery disease (CAD). Both illnesses contribute significantly to the global burden of disease. This systematic... (Review)
Review
Depression is an independent risk factor for coronary artery disease (CAD). Both illnesses contribute significantly to the global burden of disease. This systematic literature review examines treatment interventions for CAD patients with comorbid depression. We systematically reviewed The Cochrane Library, MEDLINE, EMBASE, PsycINFO, PUBMED, CINAHL and the ISRCTN Registry for English language randomised control trials investigating treatment interventions for depression in adults with CAD and comorbid depression. Data extracted included author name(s), year published, number of participants, enrolment criteria, depression definition/measures (standardised interviews, rating scales), description of control arms and interventions (psychotherapy and/or medications), randomisation, blinding, follow-up duration, follow-up loss, depression scores and medical outcome. The database search revealed 4464 articles. The review yielded 19 trials. Antidepressant and/or psychotherapy did not significantly influence CAD outcomes in the overall population. There was no difference between antidepressant use and aerobic exercises. Psychological interventions and pharmacological interventions provide small effect on depression outcomes in CAD patients. Patient autonomy in choice of treatment is associated with greater depression treatment satisfaction, but the majority of studies are underpowered. More research is required to explore the role of neurostimulation treatment, complementary and alternative treatments.
Topics: Adult; Humans; Coronary Artery Disease; Depression; Psychotherapy; Antidepressive Agents; Psychosocial Intervention
PubMed: 36871435
DOI: 10.1016/j.ajp.2023.103534 -
BMC Primary Care Feb 2023Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement...
BACKGROUND
Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth.
METHODS
Fifteen databases and 12 websites were searched in December 2017 and again in October 2021. Pre-defined search terms pertained to Indigenous children and youth, CANZUS country names, and wellbeing or mental health measures. PRISMA guidelines were followed, with eligibility criteria guiding screening of titles and abstracts, and selected full-text papers. Results are presented based on the characteristics of documented measurement instruments assessed according to five desirability criteria: development for Indigenous youth populations, adherence to relational strength-based constructs, administration by child and or youth self-report, reliability and validity, and usefulness for identifying wellbeing or risk levels.
RESULTS
Twenty-one publications were found that described the development and or use by primary healthcare services of 14 measurement instruments, employed across 30 applications. Four of the 14 measurement instruments were developed specifically for Indigenous youth populations, four focused solely on strength-based wellbeing concepts but none included all Indigenous wellbeing domains.
CONCLUSION
There is a diversity of measurement instruments available, but few fit our desirability criteria. Although it is possible that we missed relevant papers and reports, this review clearly supports the need for further research to develop, refine or adapt instruments cross-culturally to measure the wellbeing of Indigenous children and youth.
Topics: Humans; Child; Adolescent; United States; Reproducibility of Results; Population Groups; Mental Health Services; Mental Health; Primary Health Care
PubMed: 36803458
DOI: 10.1186/s12875-023-02001-z -
American Journal of Public Health Mar 2023Schools are sites of dating and relationship violence (DRV) and of gender-based violence (GBV) victimization and perpetration. School-based interventions can reach a... (Meta-Analysis)
Meta-Analysis
Schools are sites of dating and relationship violence (DRV) and of gender-based violence (GBV) victimization and perpetration. School-based interventions can reach a broad range of students, targeting both individual and group processes that may underpin DRV and GBV. Considering DRV and GBV jointly is important because of their shared etiologies. Comparing the effectiveness of interventions using network meta-analysis (NMA) can support decision-making on optimal resource use. To evaluate the comparative effectiveness of school-based interventions for children aged 5 to 18 years on DRV and GBV victimization, perpetration, and related mediators. We searched 21 databases in July 2020 and June 2021, alongside extensive supplementary search methods, including gray literature searches, forward and backward citation chasing, and searches on first and last author names. We included randomized-controlled trials of interventions for children of compulsory school age implemented within the school setting, and either partially or wholly aimed at changing DRV or GBV outcomes. Pairwise meta-analyses using random-effects robust variance estimation considered intervention effectiveness on DRV and GBV victimization and perpetration using odds ratios, and on mediators (e.g., knowledge and attitudes) using standardized mean differences. Effects were divided into short-term (< 12 months postbaseline) and long-term (≥ 12 months postbaseline). NMAs on victimization and perpetration outcomes compared interventions categorized by breadth of mechanism and complexity of delivery and implementation. Meta-regression tested sensitivity to percentage of girls in the trial sample and country context. Our analysis included 68 trials. Evidence was stronger overall for effects on DRV than for GBV, with significant long-term impacts on DRV victimization (odds ratio [OR] = 0.82; 95% confidence interval [CI] = 0.68, 0.99) and DRV perpetration (OR = 0.78; 95% CI = 0.64, 0.94). Knowledge and attitudinal effects were predominantly short-term (e.g., for DRV-related violence acceptance, = 0.16; 95% CI = 0.08, 0.24). NMAs did not suggest the superiority of any intervention type; however, most analyses for GBV outcomes were inconsistent. A higher proportion of girls in the sample was associated with increased effectiveness on long-term victimization outcomes. Evidence is stronger for DRV than for GBV, despite considerable heterogeneity. Certainty of findings was low or very low overall. Violence reductions may require more than 1 school year to become apparent. More extensive interventions may not be more effective. A possible reason for stronger effectiveness for DRV is that whereas GBV is ingrained in school cultures and practices, DRV is potentially more open to change via addressing individual knowledge and attitudes. (. 2023;113(3):320-330. https://doi.org/10.2105/10.2105/AJPH.2022.307153).
Topics: Child; Female; Humans; Gender-Based Violence; Network Meta-Analysis; Violence; Crime Victims; Attitude
PubMed: 36791352
DOI: 10.2105/AJPH.2022.307153 -
Frontiers in Public Health 2022Payments to physicians by the pharmaceutical industry are common, but recent evidence shows that these payments influence physician prescribing behavior in the form of...
BACKGROUND
Payments to physicians by the pharmaceutical industry are common, but recent evidence shows that these payments influence physician prescribing behavior in the form of increased prescription of brand-name drugs, expensive and low-cost drugs, increased prescription of payer company drugs, etc. Considering that these payments increase drug costs for patients and health systems, there is a public interest in controlling them. Therefore, this study aimed to identify and propose policy options for managing physician-pharmaceutical industry interactions in the context of Iran's health system.
METHODS
In the first phase, a systematic search was conducted to identify relevant policies and interventions in Web of Science, PubMed, and ProQuest databases from 2000 to 2022. Then, the opinions of the research team and an expert group (physicians, health policy and transparency experts, and industry representatives) were used to categorize the interventions and propose policy options along with their advantages, disadvantages, and implementation considerations.
RESULTS
In the search, 579 articles were retrieved, and 44 articles were found suitable for the final analysis. Twenty-nine interventions and strategies were identified, and based on these; Five policy options were identified: prohibition, restriction, physician self-regulation, voluntary industry disclosure, and mandatory industry disclosure.
CONCLUSION
The proposed policies in our study include advantages, challenges, and implementation considerations based on up-to-date evidence that can help policymakers use them to manage COI in physician-pharmaceutical industry interactions in Iran's health system. A combination of measures seems to help manage COI: firstly, using self-regulating physicians and industry to institutionalize transparency, and in the next step, implementing mandatory industry disclosure policies and establishing restrictions on some financial interactions.
Topics: Humans; Physicians; Drug Industry; Gift Giving; Disclosure; Health Policy
PubMed: 36711334
DOI: 10.3389/fpubh.2022.1072708 -
Medical Science Monitor : International... Dec 2022BACKGROUND This systematic review aimed to identify and evaluate publications using the Dundee Ready Educational Environment Measure (DREEM) and its domains, genders,...
BACKGROUND This systematic review aimed to identify and evaluate publications using the Dundee Ready Educational Environment Measure (DREEM) and its domains, genders, and educational level (EL) to monitor the education environment in medical colleges (MCs), applied medical science colleges (AMSCs), and dental colleges (DCs) in Saudi Arabia (SA). MATERIAL AND METHODS A literature search was performed using PubMed, ScienceDirect, Scopus, Wiley Library, and Web of Science database keywords and medical, applied medical science, dental colleges headings, followed by a summary and analysis of results. We included all related studies that used DREEM as a tool and were published up to 2022. The following information was extracted from the included studies: researcher's name(s), publication year, overall DREEM, domain, gender, and educational levels. RESULTS Among the 40 studies included in this review, 25 papers were conducted in medical colleges, 5 in applied medical science, and 10 in dental colleges. Overall, DREEM scores among all involved colleges were "more positive than negative," with scores between 101 and 150. In relation to the 5 domains of DREEM, the percentages of medical colleges ranged from 75% to 88% for all domains, whereas it was higher in dental (80% to 90%) in most domains, but considerably lower for applied medical science (50% to 75%). Females had higher DREEM values in dental than medical and applied medical science colleges, whereas educational levels were higher in applied medical science colleges. CONCLUSIONS Overall, DREEM scores were more positive than negative and moved in the correct direction among all involved colleges, with varying degrees of significance between genders and educational levels.
Topics: Humans; Male; Female; Saudi Arabia; Perception; Surveys and Questionnaires; Educational Status; Educational Measurement; Students, Medical
PubMed: 36578190
DOI: 10.12659/MSM.938987 -
Heliyon Dec 2022The advancement of information and communication technologies has led to an increasing use of conversational chatbots in the learning and teaching sector, especially for...
The advancement of information and communication technologies has led to an increasing use of conversational chatbots in the learning and teaching sector, especially for the second language (L2) acquisition. In the field of second language acquisition, the use of AI chatbots has been explored, mainly studying pedagogical approaches. However, there is a limited study in the development of empathetic strategies for dealing with learners' emotional discomfort, the impact of humor and the consideration of learners' cultural backgrounds. Thus, this study reviews the existing studies on AI second language (L2) chatbots to investigate the development of empathetic strategies for enhancing learners' learning outcomes. To achieve the aim of this study, prior studies from 2012 and 2022 of several popular databases, including Web of Science, ProQuest, IEEE and ScienceDirect are collected and analyzed. This study found that three dimensions such as cultural, empathetic and humorous dimensions have a positive influence on the application of AI L2 chatbots for enhancing learners' learning outcomes. This study also found that the development of an AI chatbot in L2 education has plenty of room for improvement. Several recommendations are made for enhancing the use of AI L2 chatbots which include integrating cross-cultural empathetic responses in conversational L2 chatbots, identifying how learners perceive and react to the learning content, and investigating the effects of cross-culture humor on learners' language proficiency.
PubMed: 36531630
DOI: 10.1016/j.heliyon.2022.e12056 -
Environmental Pollution (Barking, Essex... Dec 2022Per-and polyfluoroalkyl substances (PFAS) is a collective name for approximately 4700 synthetic chemicals ubiquitous in the aquatic environment worldwide. They are used... (Meta-Analysis)
Meta-Analysis Review
Per-and polyfluoroalkyl substances (PFAS) is a collective name for approximately 4700 synthetic chemicals ubiquitous in the aquatic environment worldwide. They are used in a wide array of products and are found in living organisms around the world. Some PFAS have been associated with cancer, developmental toxicity, endocrine disruption, and other health effects. Only a fraction of PFAS are currently monitored and regulated and the presence and effects on aquatic organisms of many PFAS are largely unknown. The aim of this study is to investigate the health effects of environmentally relevant concentrations of PFAS on aquatic organisms at different consumer trophic levels through a systematic review and meta-analysis. The main result shows that PFAS in concentrations up to 13.5 μg/L have adverse effects on body size variables for secondary consumers. However, no significant effects on liver or gonad somatic indices and neither on fecundity were found. In addition, the results show that there are large research gaps for PFAS effects on different organisms in aquatic environments at environmentally relevant concentrations. Most studies have been performed on secondary consumers and there is a substantial lack of studies on other consumers in aquatic ecosystems.
Topics: Fluorocarbons; Aquatic Organisms; Ecosystem
PubMed: 36244496
DOI: 10.1016/j.envpol.2022.120422 -
JAMA Oncology Oct 2022The phosphoinositide 3-kinase (PI3K) pathway is among the most frequently activated pathways in human cancers. As the use of PI3K inhibitors for cancer treatment grows,...
IMPORTANCE
The phosphoinositide 3-kinase (PI3K) pathway is among the most frequently activated pathways in human cancers. As the use of PI3K inhibitors for cancer treatment grows, there is increasing need for understanding the cutaneous effects associated with these therapies.
OBJECTIVE
To systematically review the published literature reporting incidence of cutaneous adverse events with PI3K inhibitors and to provide pooled incidence estimates using meta-analysis.
DATA SOURCES
This systematic review and meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. The literature search concerned entries through September 2021 in the following sources: PubMed, Cochrane registry, ClinicalTrials.gov, and evidence from the NHS UK and Trip medical database. To analyze PI3K inhibitors' cutaneous adverse events incidence, only randomized clinical trials (RCTs) were considered. The search strategy used the following keywords: (prevalence OR incidence OR epidemiology) and (phosphoinositide 3 kinase inhibitors OR PI3K inhibitors). No language restriction was applied. Analysis was conducted on July 1, 2022.
STUDY SELECTION
Studies included phase 2 and phase 3 RCTs that reported incidence of cutaneous adverse events associated with use of PI3K inhibitors.
DATA EXTRACTION AND MEASURES
Data extracted included sex, medication name and class, sample size, rash incidence, and grade. The bias risk was assessed by the Cochrane tool for risk of bias assessment in RCTs.
MAIN OUTCOMES AND MEASURES
The primary outcome was incidence of PI3K inhibitor cutaneous adverse events (with 95% CIs) among the overall population and among subgroups. Between-study heterogeneity was assessed using the I2 statistic.
RESULTS
The analysis found the incidence of PI3K inhibitor cutaneous events of any grade to be 29.30% in the intervention group, translating to a pooled odds ratio (OR) for incidence of cutaneous adverse events of any grades of 2.55 (95% CI, 1.74-3.75). Incidence of severe grade (grade ≥3) of rash in the intervention group was estimated to be 6.95%, yielding a pooled Peto OR of 4.64 (95% CI, 2.70-7.97). Subgroup analyses revealed that the incidence of severe cutaneous adverse events (grade ≥3) was higher with the use of Pan-class-1 PI3K inhibitors (OR, 6.67; 95% CI, 4.28-10.38) than isoform-selective PI3K inhibitors (OR, 6.37; 95% CI, 3.25-12.48).
CONCLUSIONS AND RELEVANCE
This systematic review and meta-analysis identified an overall incidence of PI3K inhibitor cutaneous adverse events of any grade to be 29.30% with a pooled OR of 2.55; (95% CI, 1.74-3.75). These findings clarify the risk of cutaneous adverse events associated with this important class of anticancer therapies.
PubMed: 36227613
DOI: 10.1001/jamaoncol.2022.4327 -
Revista Brasileira de Ginecologia E... Oct 2022To explore the main sexuality complaints of gynecologic cancer survivors after treatment and to identify the care strategies provided.
OBJECTIVE
To explore the main sexuality complaints of gynecologic cancer survivors after treatment and to identify the care strategies provided.
DATA SOURCE
Searches were conducted in six electronic databases: Scopus, Web of Science, LILACS, MEDLINE, PsychINFO, and EMBASE.
STUDY SELECTION
Articles published between 2010 and 2020 were selected and the following descriptors were used in the English language: and . The methodological quality of the studies used the Mixed Methods Appraisal Tool (MMAT).
DATA COLLECTION
The primary data extracted were: names of the authors, year of publication, country of origin, objective and type of study, data collection instrument, sample size and age range, types of cancer, and symptoms affected with the strategies adopted.
DATA SUMMARY
A total of 34 out of 2,536 screened articles were included. The main strategies found for patient care were patient-clinician communication, practices for sexuality care, individualized care plan, multiprofessional team support, and development of rehabilitation programs. For sexuality care, the most common practices are pelvic physiotherapy sessions and the use of vaginal gels and moisturizers.
CONCLUSION
The main complaints identified in the scientific literature were low libido and lack of interest in sexual activity, vaginal dryness, pain during sexual intercourse, and stenosis. Different care strategies may be adopted, such as follow-up with a multidisciplinary health team and sexual health rehabilitation programs, which could minimize these symptoms and ensure the quality of life of patients.
Topics: Female; Humans; Quality of Life; Sexuality; Sexual Behavior; Genital Neoplasms, Female; Survivors
PubMed: 36174653
DOI: 10.1055/s-0042-1756312 -
Sports Health May 2023Patellar tendinopathy (PT), or jumper's knee, is a chronic painful overuse patellar tendon injury. For PT, prevention is more important than treatment. However, there is... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Patellar tendinopathy (PT), or jumper's knee, is a chronic painful overuse patellar tendon injury. For PT, prevention is more important than treatment. However, there is still a lack of strong evidence to confirm the effectiveness of prevention.
OBJECTIVE
This study will analyze by meta-analysis the effect of a prophylactic program on high PT risk people (but without PT) in reducing PT occurrence.
DATA SOURCES
PubMed, Embase, the Cochrane Library, Scopus, and Ebscohost, from inception to January 11, 2022.
STUDY SELECTION
A study comparing the effects of prophylactic programs and controls on the risk of PT was included in the analysis. After a database search with search terms ((patellar tendinopathy) OR (jumper's knee) OR (patellar tendinitis) OR (patellar tendinosis) OR (patellar tendonitis)) AND ((Prevent*) OR (prophyla*)), a total of 1444 items were obtained. Of these, 11 studies with 6091 participants were eligible for inclusion in this meta-analysis.
STUDY DESIGN
Systematic review and meta-analysis.
LEVEL OF EVIDENCE
Level 2.
DATA EXTRACTION
The first author's name, publication year, study design, country, population, mean age, sex, prophylactic program, control, study duration, and the frequency or incidence of PT in each group were extracted.
RESULTS
A total of 11 articles were included in the analysis. Overall, no significant difference was considered in the risk of PT between the prophylactic program and control groups based on the random-effect model (odds ratio [OR], 0.85; 95% CI, 0.67, 1.08; = 0.18). In the recruit subgroup, there was even a tendency to elevate the risk of PT occurrence after prophylaxis was executed (OR, 1.89; 95% CI, 0.68, 5.28; = 0.22). In athletes, the prophylactic program tended to decrease the risk of PT compared with the control (OR, 0.81; 95% CI, 0.63, 1.04; = 0.10); however, the difference was not statistically significant. Trial sequential analysis results suggested that prophylaxis may still be effective for athletes, but this needs to be confirmed with a larger sample size.
CONCLUSION
The risk of PT cannot be reduced with the current prophylactic program. However, for athletes, the negative results may be due to insufficient sample size.
Topics: Humans; Patellar Ligament; Tendinopathy; Cumulative Trauma Disorders; Athletes; Patella
PubMed: 36146934
DOI: 10.1177/19417381221121808