-
Scientific Reports Jun 2024The current study aimed to assess the impact of combined interventions including mindfulness and self-regulation on self-neglect and self-regulation among Iranian older... (Randomized Controlled Trial)
Randomized Controlled Trial
The current study aimed to assess the impact of combined interventions including mindfulness and self-regulation on self-neglect and self-regulation among Iranian older adults with type 2 diabetes. This was a three-arm cluster randomized controlled trial study conducted among 135 older diabetic patients in Shiraz, Iran. Three urban healthcare centers (clusters) were randomly assigned to three study groups. The intervention groups received either a Self-Regulation-based Intervention Program (SRIP) or a Combined Mindfulness and Self-Regulation Intervention Program (CMSRIP), while the control group received routine care and COVID-19 prevention training. These training programs, which consisted of text and video-based content, were conducted over 24 weeks using WhatsApp as a mobile-based communication platform. Outcomes were measured using the Elder Self-Neglect Scale and Short-Form Self-Regulation Questionnaire at baseline, week 4, and week 16 post-intervention, with data analysis conducted using SPSS software. The CMSRIP led to significantly greater improvement in the score of self-regulation (χ = 73.23, P-Value = < .001) and a reduction in the score of self-neglect (χ = 62.97, P-Value = < .001) at both 4 weeks and 16 weeks after education compared to SRIP. In the control group, there was also a slight improvement. Improvement of self-regulation and reduction of self-neglect in all three groups were less in week 16 than in week 4. Nevertheless, the changes in the intervention groups were significantly better than the control group. This study confirmed a combination of mindfulness-based intervention and self-regulation intervention can effectively improve self-neglect and self-regulation behavior in older patients with type 2 diabetes.Trial registration: This trial (ISRCTN77260130) was retrospectively registered on 28/09/2021.
Topics: Humans; Mindfulness; Aged; Male; Female; Self-Control; Diabetes Mellitus, Type 2; Iran; Middle Aged; COVID-19; Aged, 80 and over; Surveys and Questionnaires
PubMed: 38879620
DOI: 10.1038/s41598-024-64314-y -
Medicine Jun 2024Hypertension, a prevalent chronic condition characterized by elevated blood pressure, is a significant global health burden, contributing to approximately 7.5 million... (Review)
Review
Hypertension, a prevalent chronic condition characterized by elevated blood pressure, is a significant global health burden, contributing to approximately 7.5 million premature deaths annually. While existing literature predominantly focuses on conventional treatment modalities, this paper offers unique insights into dependable approaches to hypertension management. Drawing upon epidemiological data, it highlights the increasing prevalence of hypertension across diverse populations, emphasizing demographic disparities and regional variations. This article underscores the need for tailored interventions considering individual risk profiles and socioeconomic determinants. Beyond conventional lifestyle modifications and pharmacological therapies, it explores emerging trends such as mindfulness-based interventions and integrative medicine in hypertension management. Additionally, it discusses the role of digital health technologies and telemedicine in enhancing patient engagement and remote monitoring, optimizing treatment outcomes. Furthermore, the paper addresses the evolving landscape of personalized medicine and genomic advancements in predicting individual responses to antihypertensive therapies, advocating for precision medicine approaches. This paper advocates for a holistic and patient-centered approach to hypertension management by offering a comprehensive overview of established and emerging strategies. It underscores the importance of interdisciplinary collaboration, continuous education, and innovative research endeavors to address the multifaceted challenges posed by hypertension and improve global cardiovascular health outcomes.
Topics: Humans; Hypertension; Telemedicine; Antihypertensive Agents; Precision Medicine; Mindfulness; Integrative Medicine; Life Style
PubMed: 38875433
DOI: 10.1097/MD.0000000000038560 -
Science Advances Jun 2024The human ability to perceive vivid memories as if they "float" before our eyes, even in the absence of actual visual stimuli, captivates the imagination. To determine...
The human ability to perceive vivid memories as if they "float" before our eyes, even in the absence of actual visual stimuli, captivates the imagination. To determine the neural substrates underlying visual memories, we investigated the neuronal representation of working memory content in the primary visual cortex of monkeys. Our study revealed that neurons exhibit unique responses to different memory contents, using firing patterns distinct from those observed during the perception of external visual stimuli. Moreover, this neuronal representation evolves with alterations in the recalled content and extends beyond the retinotopic areas typically reserved for processing external visual input. These discoveries shed light on the visual encoding of memories and indicate avenues for understanding the remarkable power of the mind's eye.
Topics: Animals; Neurons; Memory, Short-Term; Primary Visual Cortex; Visual Perception; Photic Stimulation; Macaca mulatta; Visual Cortex
PubMed: 38875332
DOI: 10.1126/sciadv.adk3953 -
PloS One 2024To assess the efficacy of acceptance and commitment therapy (ACT) for patients with chronic pain. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To assess the efficacy of acceptance and commitment therapy (ACT) for patients with chronic pain.
MATERIALS AND METHODS
The research conducted a systematic search of the Cochrane Library, Web of Science, PubMed, EMBASE, PsycINFO, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases following the PRISMA guidelines. The retrieval time limit was from the establishment of the database to October 2023. A meta-analysis was carried out for the randomized controlled trials (RCTs) that meet the inclusion and exclusion criteria by using RevMan 5.3.
RESULTS
Twenty-one RCTs were included. At post-treatment, a significant medium effect size (ES) was found in measuring pain interference, functional impairment, pain acceptance, psychological inflexibility, and depression; Pain intensity, anxiety, and quality of life (QOL) had a small ES. At three months post-treatment, a large ES was found in measuring functional impairment, and a medium ES was found in the other indicators.
CONCLUSION
The researchers provided evidence for the effectiveness of ACT as an intervention for patients with chronic pain, which can be applied by clinicians or nurses in practice. Future research should explore the applicability of ACT to different pain conditions and modalities.
IMPLICATIONS FOR NURSING
Post-treatment data highlight the efficacy of ACT in moderating pain-related outcomes. Clinical nurses are encouraged to incorporate ACT into routine patient education and interventions, including promoting pain acceptance, promoting mindfulness practices, and using cognitive stress reduction techniques. Standardized follow-up after an ACT intervention for patients with chronic pain is critical, including regular assessment, feedback, and realignment of treatment strategies. Overall, ACT became an important tool for nurses to improve the lives of patients with chronic pain.
Topics: Humans; Chronic Pain; Quality of Life; Acceptance and Commitment Therapy; Randomized Controlled Trials as Topic; Treatment Outcome; Anxiety
PubMed: 38875241
DOI: 10.1371/journal.pone.0301226 -
Journal of Clinical Tuberculosis and... Aug 2024The study focused on the association between knowledge, practice and attitude towards tuberculosis in the university population during the COVID-19 pandemic (Review)
Review
OBJECTIVE
The study focused on the association between knowledge, practice and attitude towards tuberculosis in the university population during the COVID-19 pandemic
METHODS
Used Jean Watson's theory of caring in mindfulness practice and surveyed 187 nursing surveyed 187 nursing interns from three universities. The instruments (knowledge, practice and attitude questionnaires) were validated and showed high reliability (Cronbach's α reliability Cronbach's α = 0.814).
RESULTS
A strong correlation was found between knowledge and practice of tuberculosis (r = 0.996, p < 0.05), indicating a significant association. However, the association between knowledge and attitude was weaker (r = 0.160, p < 0.05). The majority had knowledge (61.2 %), a neutral practice (52.2 %) and an acceptable attitude towards TB (85.4 %).
CONCLUSION
These findings suggest the need to strengthen anti-TB strategies, especially in times of pandemic. The inclusion of Watson's humanistic approach can improve the well-being of inmates and the care of patients.
PubMed: 38872870
DOI: 10.1016/j.jctube.2024.100452 -
Child Abuse & Neglect Jun 2024The internet has become a place of increased risk of abuse, including sexual abuse, for young people (YP). One potential risk factor to online abuse and exploitation is...
BACKGROUND
The internet has become a place of increased risk of abuse, including sexual abuse, for young people (YP). One potential risk factor to online abuse and exploitation is the ability to mentalise. We developed the i-Minds app, a mentalisation-based digital health intervention (DHI) for YP who have experienced technology assisted sexual abuse (TASA), which we tested in a clinical feasibility trial. Nested within the trial was a qualitative implementation study with clinicians who referred to the trial.
OBJECTIVE
To explore the barriers and enablers to the future integration of i-Minds into clinical practice.
PARTICIPANTS AND SETTING
Twelve HCPs were recruited from across two trial recruitment sites (Manchester and Edinburgh).
METHODS
Semi-structured interviews were informed by Normalisation Process Theory (NPT). Framework analysis was used; transcripts were coded deductively to NPT constructs.
RESULTS
Practitioners were positive about the need for, and added value of, the i-Minds app over existing interventions, including other DHIs. While they felt confident with the app, concerns remained around the safety of using the app without practitioner support. i-Minds promoted changes in practitioners' work and impacted online behaviour of YP. There was an identified need for further training and organisational support.
CONCLUSIONS
Practitioners are aware of TASA but have limited knowledge, skills and tools to work with TASA in clinical practice with YP. There is a need for awareness raising and education about TASA and DHI. i-Minds offers a theory-informed DHI for working with YP exposed to TASA that is acceptable to practitioners and YP.
PubMed: 38870708
DOI: 10.1016/j.chiabu.2024.106883 -
Clinical and Applied... 2024Aspirin is a widely used antiplatelet medication to prevent blood clots, reducing the risk of cardiovascular event. Healthcare providers need to be mindful of the risk...
BACKGROUND
Aspirin is a widely used antiplatelet medication to prevent blood clots, reducing the risk of cardiovascular event. Healthcare providers need to be mindful of the risk of aspirin-induced bleeding and carefully balancing its benefits against potential risks. The objective of this study was to create a practical nomogram for predicting bleeding risk in patients with a history of myocardial infarction treating with aspirin.
METHODS
A total of 2099 myocardial infarction patients with aspirin were enrolled. The patients were randomly divided into two groups, with a 7:3 ratio, for model development and internal validation. Boruta analysis was utilized to identify clinically significant features associated with bleeding. Logistic regression model based on independent bleeding risk factors was constructed and presented as a nomogram. Model performance was assessed from three aspects: identification, calibration, and clinical utility.
RESULTS
Boruta analysis identified eight clinical features from 25, and further multivariate logistic regression analysis selected four independent risk factors: hemoglobin, platelet count, previous bleeding, and sex. A visual nomogram was created based on these variables. The model achieved an area under the curve of 0.888 (95% CI: 0.845-0.931) in the training dataset and 0.888 (95% CI: 0.808-0.968) in the test dataset. Calibration curve analysis showed close approximation to the ideal curve. Decision curve analysis demonstrated favorable clinical net benefit for the model.
CONCLUSIONS
Our study focused on creating and validating a model to evaluate bleeding risk in patients with a history of myocardial infarction treated with aspirin, which demonstrated outstanding performance in discrimination, calibration, and net clinical benefit.
Topics: Humans; Nomograms; Myocardial Infarction; Aspirin; Hemorrhage; Female; Male; Middle Aged; Aged; Risk Factors; Platelet Aggregation Inhibitors; Risk Assessment
PubMed: 38870349
DOI: 10.1177/10760296241262789 -
Cell Reports Jun 2024Beliefs-attitudes toward some state of the environment-guide action selection and should be robust to variability but sensitive to meaningful change. Beliefs about...
Beliefs-attitudes toward some state of the environment-guide action selection and should be robust to variability but sensitive to meaningful change. Beliefs about volatility (expectation of change) are associated with paranoia in humans, but the brain regions responsible for volatility beliefs remain unknown. The orbitofrontal cortex (OFC) is central to adaptive behavior, whereas the magnocellular mediodorsal thalamus (MDmc) is essential for arbitrating between perceptions and action policies. We assessed belief updating in a three-choice probabilistic reversal learning task following excitotoxic lesions of the MDmc (n = 3) or OFC (n = 3) and compared performance with that of unoperated monkeys (n = 14). Computational analyses indicated a double dissociation: MDmc, but not OFC, lesions were associated with erratic switching behavior and heightened volatility belief (as in paranoia in humans), whereas OFC, but not MDmc, lesions were associated with increased lose-stay behavior and reward learning rates. Given the consilience across species and models, these results have implications for understanding paranoia.
PubMed: 38870010
DOI: 10.1016/j.celrep.2024.114355 -
PCN Reports : Psychiatry and Clinical... Mar 2024Olfactory reference disorder (ORD) is a mental illness in which individuals overestimate their sense of smell and worry about the negative impact of odors. Little is...
BACKGROUND
Olfactory reference disorder (ORD) is a mental illness in which individuals overestimate their sense of smell and worry about the negative impact of odors. Little is known about its successful treatment. A new cognitive behavioral model was developed based on cognitive behavioral therapy (CBT) for obsessive-compulsive disorder. Using this model, this study reports a successful treatment process of a 53-year-old female with ORD.
CASE PRESENTATION
The patient's initial diagnosis was schizophrenia, and improvements were observed, such as the disappearance of persecutory delusions, through medication therapy. During this treatment process, it became clear that the patient's preoccupation with her own offensive body odor was not a hallucination or delusion caused by schizophrenia but rather a symptom of ORD. Within a limited 4-week hospitalization period, high-intensity CBT was provided by a clinical psychologist and a psychiatrist. Multiple CBT techniques were employed, including case formulation to identify her beliefs, reviewing safety-seeking behaviors, attention shift training, behavioral experiments, public opinion polls, mindfulness meditation, and exposure and response prevention.
CONCLUSION
Following a seven-sessions intensive intervention over 3 weeks, her symptoms of ORD, anxiety, and depression reduced. High-frequency CBT practices could be beneficial in treatment of patients with severe ORD, addressing severe ORD cases, facilitating rapid improvement in both ORD symptoms and functioning.
PubMed: 38868464
DOI: 10.1002/pcn5.179 -
PCN Reports : Psychiatry and Clinical... Sep 2023The coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented stress. Mindfulness-based interventions (MBIs) are known to be effective in reducing stress....
AIM
The coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented stress. Mindfulness-based interventions (MBIs) are known to be effective in reducing stress. However, it is unclear how long-term outcomes differ between those who continue mindfulness practice after MBIs and those who do not. In this study, we hypothesized that those who continued mindfulness practice would have higher stress tolerance, and we examined this hypothesis through a survey of MBI graduates. In this study, we examined the association between the continuation of mindfulness practice among MBI completers and individual stress during the COVID-19 epidemic.
METHODS
A cross-sectional survey of MBI graduates was conducted. The physical and mental health states were compared between those who established a habit of mindfulness practice (practice group) and those who did not (no practice group).
RESULTS
The data were collected from 95 participants (response rate: 53.7%). Of the total respondents, 66 (69.5%) practiced mindfulness. Although the degree of perceived stress due to the COVID-19 pandemic was not statistically different between the practice and no practice groups, the practice group showed significantly lower levels of depression ( = 0.007), higher levels of resilience ( = 0.006), higher levels of overall health ( = 0.006), and higher levels of mental health ( = 0.039). The effect of mindfulness practice on reducing depression was fully mediated by resilience.
CONCLUSION
Among MBI graduates, those who regularly practiced mindfulness had lower levels of depression and higher levels of physical and mental health. Thus, the continuation of mindfulness practice increases resilience, buffers against new stressors such as the COVID-19 pandemic, and has the potential to prevent depression.
PubMed: 38867829
DOI: 10.1002/pcn5.132