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PloS One 2022Emergency responders (ERs), often termed First Responders, such as police, fire and paramedic roles are exposed to occupational stressors including high workload, and...
Emergency responders (ERs), often termed First Responders, such as police, fire and paramedic roles are exposed to occupational stressors including high workload, and exposure to trauma from critical incidents, both of which can affect their mental health and wellbeing. Little is known about the impact of the ER occupation on the mental health and wellbeing of their families. The aim of the current study was to investigate what mental health and wellbeing outcomes and experiences have been researched internationally in ER families, and to examine the prevalence and associated risk and protective factors of these outcomes. We conducted a systematic review in accordance with an a priori PROSPERO approved protocol (PROSPERO 2019 CRD42019134974). Forty-three studies were identified for inclusion. The majority of studies used a quantitative, cross-sectional design and were conducted in the United States; just over half assessed police/law enforcement families. Themes of topics investigated included: 1) Spousal/partner mental health and wellbeing; 2) Couple relationships; 3) Child mental health and wellbeing; 4) Family support and coping strategies; and 5) Positive outcomes. The review identified limited evidence regarding the prevalence of mental health and wellbeing outcomes. Family experiences and risk factors described were ER work-stress spillover negatively impacting spousal/partner wellbeing, couple relationships, and domestic violence. Traumatic exposure risk factors included concerns family had for the safety of their ER partner, the negative impact of an ER partners' mental health problem on the couples' communication and on family mental health outcomes. Protective factors included social support; however, a lack of organisational support for families was reported in some studies. Study limitations and future research needs are discussed. Progressing this area of research is important to improve knowledge of baseline needs of ER families to be able to target interventions, improve public health, and support ER's operational effectiveness.
Topics: Child; Cross-Sectional Studies; Emergency Responders; Humans; Mental Health; Social Support; Spouses
PubMed: 35704626
DOI: 10.1371/journal.pone.0269659 -
Journal of Patient-reported Outcomes Jun 2022Life engagement in the context of mental health is a broad term that describes positive health aspects relating to cognition, vitality, motivation and reward, and the... (Review)
Review
BACKGROUND
Life engagement in the context of mental health is a broad term that describes positive health aspects relating to cognition, vitality, motivation and reward, and the ability to feel pleasure-concepts that are meaningful to patients. The aim of this systematic literature review was to identify validated patient-reported outcomes (PROs) that can assess any aspect of life engagement in adults, in the field of general mental health.
METHODS
This was a systematic literature review of articles in English from the MEDLINE database (date of search: September 9, 2020). The search strategy had three components: (1) terms to capture PROs; (2) terms to capture mental health; and (3) terms to capture aspects of life engagement. Articles were eligible if they included a PRO that: (1) is named; (2) can be used across mental health disorders; (3) is used to assess any aspect of life engagement; and (4) has undergone psychometric validation and/or qualitative content validation. A list of PROs was extracted.
RESULTS
A total of 1585 records were screened and 233 articles were eligible for inclusion. Within these 233 articles, 49 distinct PROs were identified, two of which specifically captured their authors' interpretation of life engagement: the Engaged Living Scale (ELS) and the Life Engagement Test (LET). However, while the ELS and LET covered motivation and reward, life fulfillment, and value-based living, neither scale captured the cognitive or vitality aspects of life engagement. The remaining identified PROs generally captured single aspects of life engagement, most commonly motivation/reward/energy-apathy, pleasure-anhedonia, and mental/psychological well-being.
CONCLUSION
Numerous PROs are available that may capture aspects of life engagement. However, a need remains for a new PRO that can be used in clinical trials to provide a more comprehensive description of the improvements in life engagement that patients with mental health disorders may experience with successful treatment.
PubMed: 35689159
DOI: 10.1186/s41687-022-00468-5 -
HSS Journal : the Musculoskeletal... May 2022Distal femoral varus osteotomy (DFVO) is an effective surgical intervention for the management of symptomatic valgus malalignment of the knee. Because it preserves the... (Review)
Review
Distal femoral varus osteotomy (DFVO) is an effective surgical intervention for the management of symptomatic valgus malalignment of the knee. Because it preserves the native knee joint and its ligamentous stability, DFVO is preferred to total knee arthroplasty (TKA) in the young, active population. We sought to assess return to work (RTW) and return to sport (RTS) rates following DFVO for valgus malalignment of the knee. For this systematic review, we searched EMBASE, MEDLINE, and Web of Science from inception through December 31, 2020. English language studies of all levels of evidence explicitly reporting on RTS and RTW rates following DFVO for valgus malalignment of the knee were eligible for inclusion. Seven studies and 127 patients were included in our analysis. Mean age was 32.4 ± 8.8 years with men comprising 46.7% ± 22.3% of study populations. The mean RTS rate was 87.2% ± 10.7%, with a return to preoperative activity levels rate of 65.4% ± 26.8%. The mean RTW rate was 81.8% ± 23.3%, with a return to preoperative activity levels of 72.8% ± 18.1%. The mean reoperation rate was 35.6% ± 18.8% within a mean follow-up period of 5.5 ± 1.9 years. This systematic review of low-level studies found DFVO to be a safe and effective procedure for the management of genu valgum in young, active populations, with most patients returning to sport and/or work, although not all at their preoperative activity levels. A paucity of data surrounds RTS and RTW rates following DFVO. Future studies should explicitly report both return to activity rates and whether patients returned to their preoperative activity levels.
PubMed: 35645636
DOI: 10.1177/15563316211051295 -
Contraception Aug 2022Systematically review the existing evidence about couples-based interventions and postpartum contraceptive uptake and generate recommendations for future research. (Review)
Review
OBJECTIVE
Systematically review the existing evidence about couples-based interventions and postpartum contraceptive uptake and generate recommendations for future research.
DATA SOURCES
PubMed, Web of Science, PsycINFO, Embase, and CINAHL through June 7, 2021.
STUDY SELECTION AND DATA EXTRACTION
Studies with a couples-based intervention assessing postpartum contraceptive uptake. Two independent reviewers screened studies, extracted data, and assessed risk of bias with RoB-2 (Cochrane Risk of Bias 2) for randomized and ROBINS-I (Risk of Bias in Non-Randomized Studies - Interventions) for observational studies. Data were synthesized in tables, figures, and a narrative review.
RESULTS
A total of 925 papers were identified, 66 underwent full text review, and 17 articles, which included 18 studies - 16 randomized, 2 observational - were included. The lack of intervention and outcome homogeneity precluded meta-analysis and isolating the effect of partner involvement. Four studies were partner-required, where partner involvement was a required component of the intervention, and 14 were partner-optional. Unadjusted risk differences ranged from 0.01 to 0.51 in favor of couples-based interventions increasing postpartum contraceptive uptake versus standard of care. Bias assessment of the 16 randomized studies classified 8, 3, and 5 studies as at a high, some concern, and low risk of bias. Common sources of bias included intervention non-adherence and missing outcome data. One observational study was at a high and the other at a low risk of bias.
CONCLUSIONS
Future studies that assess couples-based interventions must clearly define and measure how partners are involved in the intervention and assess how intervention adherence impacts postpartum contraceptive uptake.
Topics: Contraceptive Agents; Contraceptive Devices; Female; Humans; Observational Studies as Topic; Postpartum Period; Text Messaging
PubMed: 35577147
DOI: 10.1016/j.contraception.2022.05.001 -
The Annals of Otology, Rhinology, and... Apr 2023This review provides a summary of the current understanding of the health and well-being of the head and neck cancer (HNC) caregiver. Our goal is to understand the... (Review)
Review
OBJECTIVE
This review provides a summary of the current understanding of the health and well-being of the head and neck cancer (HNC) caregiver. Our goal is to understand the healthcare needs required by the caregivers of our oncologic patients, which may ultimately influence quality of care and support that cancer patients require during treatment and recovery.
METHODS
Independent database searches were conducted to identify articles describing HNC caregiver health and healthcare utilization. Search terms included key synonyms for head and neck cancer, caregiver, psychological stress, anxiety, depression, mental health service, and delivery of healthcare in the title/abstract.
RESULTS
After following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocol, a total of 21 studies were included. Among the 21 studies in the review, a total of 1745 caregivers were included. The average age was 57 years, the majority were female (58%-100%), and spouses/partners of the patients (77%). The literature demonstrates significant anxiety, depression, post-traumatic stress disorder (PTSD), and physical health decline in addition to multifaceted unmet physical and mental health needs among HNC caregivers.
CONCLUSION
There is no standard for examining HNC caregiver healthcare needs, while there is evidence of increased healthcare utilization. The literature is limited regarding medical burdens faced by caregivers. Future research is needed to assess the physical health and comorbidities of HNC caregivers and their engagement with the healthcare system to guide further implementation of support models to address the needs of this population.
Topics: Humans; Male; Female; Middle Aged; Caregivers; Head and Neck Neoplasms; Stress, Psychological; Anxiety; Health Services Needs and Demand
PubMed: 35549916
DOI: 10.1177/00034894221088180 -
Frontiers in Psychology 2022Informal caregivers (ICGs) provide care to their family or friends in case of an illness, disability, or frailty. The caregiving situation of informal caregivers may...
Informal caregivers (ICGs) provide care to their family or friends in case of an illness, disability, or frailty. The caregiving situation of informal caregivers may vary based on the relationship they have with the care recipient (CR), e.g., being a spouse or being an adult child. It might be that these different ICGs also have different needs. This study aims to explore and compare the needs of different groups of ICGs based on the relationship they have with their CR. We conducted a systematic review, performing a search in the databases PubMed, CINAHL, and PsycINFO. We included studies with qualitative, quantitative, or mixed-method study designs. We analyzed the data using the thematic analysis method. We included 22 articles (18 qualitative; 4 quantitative). The included articles reported the needs of ICGs taking care of a spouse (spousal ICGs), parent (adult child ICG), or sibling aged 18 years or above (adult sibling ICGs). We did not include other relationships due to the limited number of articles on these relationships. The most prominent needs reported by the spousal, adult child, and adult sibling ICGs were the need for information and need for support. The three groups differed in their needs as well. Adult child and adult sibling ICGs indicated a need to be acknowledged by the people around them for their role of carer, while they also needed to be seen as an individual having their own personal needs. Moreover, spousal ICGs indicated a unique need of redefining their role and relationship with their CR. Overall, the findings indicate that along with experiencing common needs, the investigated groups have unique needs as well. Knowing the needs of different groups of ICGs can help develop tailored solutions to improve the quality of life of the ICGs and their CR. [www.crd.york.ac.uk/prospero/], identifier [CRD42020188560].
PubMed: 35401295
DOI: 10.3389/fpsyg.2022.832974 -
Archives of Physical Medicine and... Nov 2022The latest literature review on partner relationships after traumatic brain injury (TBI), conducted a decade ago, discussed solely quantitative work and noted... (Review)
Review
OBJECTIVE
The latest literature review on partner relationships after traumatic brain injury (TBI), conducted a decade ago, discussed solely quantitative work and noted significant knowledge gaps. The current review updates and expands on this work by providing an overview of the current state of knowledge on factors related to relationship quality and stability after TBI.
DATA SOURCES
Cumulative Index to Nursing and Allied Health, Embase, MEDLINE, Psychology and Behavioral Sciences Collection, APA PsycINFO, and PubMed were searched on April 23, 2020, for literature on factors associated with (1) relationship quality; and (2) relationship stability after TBI.
STUDY SELECTION
English quantitative and qualitative studies investigating factors associated with relationship quality and/or stability after TBI were included. Two reviewers independently assessed eligibility. If consensus was not reached, a third reviewer's conclusion was decisive. Forty-three studies were included.
DATA EXTRACTION
Information regarding study objectives and characteristics, participant demographics, independent and dependent variables, and main findings was extracted. Study quality was rated using the JBI Checklist for Analytical Cross-Sectional Studies and/or the CASP Checklist for Qualitative Research. Both were performed by the lead reviewer and checked by the second reviewer.
DATA SYNTHESIS
Thirty-eight factors related to relationship quality and/or stability were identified, covering injury characteristics (eg, severity), body functions (eg, personality changes), activities (eg, communication), participation (eg, social dependence), environment (eg, children), and personal factors (eg, coping strategies).
CONCLUSIONS
Relationship quality and stability after TBI are related to a multitude of factors, including newly identified factors such as personality changes and dependence. Future research may wish to quantitatively investigate factors thus far only identified in qualitative research, explore possible positive effects of TBI on relationships, study the experiences of same-sex couples, and include the perspectives of both partners with and without the injury.
Topics: Child; Humans; Cross-Sectional Studies; Adaptation, Psychological; Qualitative Research; Communication; Brain Injuries, Traumatic
PubMed: 35395254
DOI: 10.1016/j.apmr.2022.02.021 -
Frontiers in Psychology 2022Research on the impact of cancer on close relationships brings up conflicting results. This systematic review collects empirical evidence on the research questions...
INTRODUCTION
Research on the impact of cancer on close relationships brings up conflicting results. This systematic review collects empirical evidence on the research questions whether a cancer diagnosis in general or the type of cancer affects the divorce rate.
MATERIALS AND METHODS
This systematic review was conducted according to the guidelines of the Cochrane Collaboration and the PRISMA statement. The following electronic databases were searched: Web of Science, Ovid SP MEDLINE, PsycINFO, PsyINDEX, CINAHL, ERIC. Risk of bias assessment was performed with the preliminary risk of bias for exposures tool template (ROBINS-E tool). The grading of methodological quality was assessed with the Newcastle-Ottawa Scale.
RESULTS
Of 13,929 identified records, 15 were included in the qualitative synthesis. In 263,616 cancer patients and 3.4 million healthy individuals, we found that cancer is associated with a slightly decreased divorce rate, except for cervical cancer, which seems to be associated with an increased divorce rate.
DISCUSSION
According to this systematic review, cancer is associated with a tendency to a slightly decreased divorce rate. However, most of the included studies have methodologic weaknesses and an increased risk of bias. Further studies are needed.
PubMed: 35356338
DOI: 10.3389/fpsyg.2022.828656 -
JAMA Network Open Mar 2022There are concerns that low- and no-calorie sweetened beverages (LNCSBs) do not have established benefits, with major dietary guidelines recommending the use of water... (Meta-Analysis)
Meta-Analysis
Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk: A Systematic Review and Meta-analysis.
IMPORTANCE
There are concerns that low- and no-calorie sweetened beverages (LNCSBs) do not have established benefits, with major dietary guidelines recommending the use of water and not LNCSBs to replace sugar-sweetened beverages (SSBs). Whether LNCSB as a substitute can yield similar improvements in cardiometabolic risk factors vs water in their intended substitution for SSBs is unclear.
OBJECTIVE
To assess the association of LNCSBs (using 3 prespecified substitutions of LNCSBs for SSBs, water for SSBs, and LNCSBs for water) with body weight and cardiometabolic risk factors in adults with and without diabetes.
DATA SOURCES
Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception through December 26, 2021.
STUDY SELECTION
Randomized clinical trials (RCTs) with at least 2 weeks of interventions comparing LNCSBs, SSBs, and/or water were included.
DATA EXTRACTION AND SYNTHESIS
Data were extracted and risk of bias was assessed by 2 independent reviewers. A network meta-analysis was performed with data expressed as mean difference (MD) or standardized mean difference (SMD) with 95% CIs. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to assess the certainty of the evidence.
MAIN OUTCOMES AND MEASURES
The primary outcome was body weight. Secondary outcomes were other measures of adiposity, glycemic control, blood lipids, blood pressure, measures of nonalcoholic fatty liver disease, and uric acid.
RESULTS
A total of 17 RCTs with 24 trial comparisons were included, involving 1733 adults (mean [SD] age, 33.1 [6.6] years; 1341 women [77.4%]) with overweight or obesity who were at risk for or had diabetes. Overall, LNCSBs were a substitute for SSBs in 12 RCTs (n = 601 participants), water was a substitute for SSBs in 3 RCTs (n = 429), and LNCSBs were a substitute for water in 9 RCTs (n = 974). Substitution of LNCSBs for SSBs was associated with reduced body weight (MD, -1.06 kg; 95% CI, -1.71 to -0.41 kg), body mass index (MD, -0.32; 95% CI, -0.58 to -0.07), percentage of body fat (MD, -0.60%; 95% CI, -1.03% to -0.18%), and intrahepatocellular lipid (SMD, -0.42; 95% CI, -0.70 to -0.14). Substituting water for SSBs was not associated with any outcome. There was also no association found between substituting LNCSBs for water with any outcome except glycated hemoglobin A1c (MD, 0.21%; 95% CI, 0.02% to 0.40%) and systolic blood pressure (MD, -2.63 mm Hg; 95% CI, -4.71 to -0.55 mm Hg). The certainty of the evidence was moderate (substitution of LNCSBs for SSBs) and low (substitutions of water for SSBs and LNCSBs for water) for body weight and was generally moderate for all other outcomes across all substitutions.
CONCLUSIONS AND RELEVANCE
This systematic review and meta-analysis found that using LNCSBs as an intended substitute for SSBs was associated with small improvements in body weight and cardiometabolic risk factors without evidence of harm and had a similar direction of benefit as water substitution. The evidence supports the use of LNCSBs as an alternative replacement strategy for SSBs over the moderate term in adults with overweight or obesity who are at risk for or have diabetes.
Topics: Adult; Body Weight; Cardiovascular Diseases; Diabetes Mellitus; Female; Humans; Male; Obesity; Overweight; Sugar-Sweetened Beverages; Water
PubMed: 35285920
DOI: 10.1001/jamanetworkopen.2022.2092 -
Journal of Clinical Medicine Jan 2022I read the above-mentioned work with great interest, and I would like to thank the authors for considering two papers from our working group [...].
I read the above-mentioned work with great interest, and I would like to thank the authors for considering two papers from our working group [...].
PubMed: 35160205
DOI: 10.3390/jcm11030752