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Translational Psychiatry Jun 2020The mechanisms by which childhood maltreatment increases anxiety is unclear, but a propensity for increased defensive behavior in rodent models of early life stress... (Meta-Analysis)
Meta-Analysis
The mechanisms by which childhood maltreatment increases anxiety is unclear, but a propensity for increased defensive behavior in rodent models of early life stress (ELS) suggests that work in rodents may clarify important mechanistic details about this association. A key challenge in studying the effects of ELS on defensive behavior in rodents is the plethora of inconsistent results. This is particularly prominent with the maternal separation (MS) literature, one of the most commonly used ELS models in rodents. To address this issue we conducted a systematic review and meta-analysis, examining the effects of MS on exploratory-defensive behavior in mice and rats using the open field test (OFT) and the elevated plus maze (EPM). This search yielded a total of 49 studies, 24 assessing the effect of MS on behavior in the EPM, 11 tested behavior in the OFT, and 14 studies provided data on both tasks. MS was associated with increased defensive behavior in rats (EPM: Hedge's g = -0.48, p = 0.02; OFT: Hedge's g = -0.33, p = 0.05), effect sizes that are consistent with the anxiogenic effect of early adversity reported in humans. In contrast, MS did not alter exploratory behavior in mice (EPM: Hedge's g = -0.04, p = 0.75; OFT: Hedge's g = -0.03, p = 0.8). There was a considerable amount of heterogeneity between studies likely related to the lack of standardization of the MS protocol. Together, these findings suggest important differences in the ability of MS to alter circuits that regulate defensive behaviors in mice and rats.
Topics: Animals; Anxiety; Anxiety Disorders; Behavior, Animal; Exploratory Behavior; Maternal Deprivation; Mice; Rats; Rodentia
PubMed: 32483128
DOI: 10.1038/s41398-020-0856-0 -
Reproductive Health Sep 2017Risky sexual practice is a major public health problem in Ethiopia. There are various studies on the prevalence and determinants of risky sexual practice in different... (Review)
Review
BACKGROUND
Risky sexual practice is a major public health problem in Ethiopia. There are various studies on the prevalence and determinants of risky sexual practice in different regions of the country but there is no study which shows the national estimate of risky sexual practices in Ethiopia. Therefore, this review was conducted to estimate the national pooled prevalence of risky sexual practice and its risk factors in Ethiopia.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed to review published and unpublished studies in Ethiopia. The databases used were; PubMed, Google Scholar, CINAHL and African Journals Online. Search terms were; risky sexual behavior, risky sexual practice, unprotected sex, multiple sexual partner, early sexual initiation, and/or Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal. The meta-analysis was conducted using Review Manager software. Descriptive information of studies was presented in narrative form and quantitative results were presented in forest plots. The Cochran Q test and I test statistics were used to test heterogeneity across studies. The pooled estimate prevalence and the odd ratios with 95% confidence intervals were computed by a random effect model.
RESULTS
A total of 31 studies with 43,695 participants were included in the meta-analysis. The pooled prevalence of risky sexual practice was 42.80% (95% CI: 35.64%, 49.96%). Being male (OR: 1.69; 95% CI: 1.21, 2.37), substance use (OR: 3.42; 95% CI: 1.41, 8.31), peer pressure (OR: 3.41; 95% CI: 1.69, 6.87) and watching pornography (OR: 3.6; 95% CI: 2.21, 5.86) were factors associated with an increase in risky sexual practices.
CONCLUSIONS
The prevalence of risky sexual practices is high in Ethiopia. Being male, substance use, peer pressure and viewing pornographic materials were found to be associated with risky sexual practices. Therefore, life skills training is recommended to reduce peer pressure among individuals. Interventions should be designed to reduce substance use and viewing pornography.
Topics: Adult; Ethiopia; Female; Health Risk Behaviors; Humans; Male; Peer Influence; Sexual Behavior; Substance-Related Disorders; Unsafe Sex
PubMed: 28877736
DOI: 10.1186/s12978-017-0376-4 -
European Neuropsychopharmacology : the... Jul 2023The endocannabinoid system is a promising candidate for anxiolytic therapy, but translation to the clinic has been lagging. We meta-analyzed the evidence for... (Meta-Analysis)
Meta-Analysis Review
The endocannabinoid system is a promising candidate for anxiolytic therapy, but translation to the clinic has been lagging. We meta-analyzed the evidence for anxiety-reduction by compounds that facilitate endocannabinoid signaling in humans and animals. To identify areas of specific potential, effects of moderators were assessed. Literature was searched in Pubmed and Embase up to May 2021. A placebo/vehicle-control group was required and in human studies, randomization. We excluded studies that co-administered other substances. Risk of bias was assessed with SYRCLE's RoB tool and Cochrane RoB 2.0. We conducted three-level random effects meta-analyses and explored sources of heterogeneity using Bayesian regularized meta-regression (BRMA). The systematic review yielded 134 studies. We analyzed 120 studies (114 animal, 6 human) that investigated cannabidiol (CBD, 61), URB597 (39), PF-3845 (6) and AM404 (14). Pooled effects on conditioned and unconditioned anxiety in animals (with the exception of URB597 on unconditioned anxiety) and on experimentally induced anxiety in humans favored the investigational drugs over placebo/vehicle. Publication year was negatively associated with effects of CBD on unconditioned anxiety. Compared to approach avoidance tests, tests of repetitive-compulsive behavior were associated with larger effects of CBD and URB597, and the social interaction test with smaller effects of URB597. Larger effects of CBD on unconditioned anxiety were observed when anxiety pre-existed. Studies reported few side effects at therapeutic doses. The evidence quality was low with indications of publication bias. More clinical trials are needed to translate the overall positive results to clinical applications.
Topics: Animals; Humans; Anti-Anxiety Agents; Endocannabinoids; Bayes Theorem; Anxiety; Cannabidiol
PubMed: 37094409
DOI: 10.1016/j.euroneuro.2023.04.001 -
PLoS Neglected Tropical Diseases Dec 2014Access to "safe" water and "adequate" sanitation are emphasized as important measures for schistosomiasis control. Indeed, the schistosomes' lifecycles suggest that... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Access to "safe" water and "adequate" sanitation are emphasized as important measures for schistosomiasis control. Indeed, the schistosomes' lifecycles suggest that their transmission may be reduced through safe water and adequate sanitation. However, the evidence has not previously been compiled in a systematic review.
METHODOLOGY
We carried out a systematic review and meta-analysis of studies reporting schistosome infection rates in people who do or do not have access to safe water and adequate sanitation. PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to 31 December 2013, without restrictions on year of publication or language. Studies' titles and abstracts were screened by two independent assessors. Papers deemed of interest were read in full and appropriate studies included in the meta-analysis. Publication bias was assessed through the visual inspection of funnel plots and through Egger's test. Heterogeneity of datasets within the meta-analysis was quantified using Higgins' I2.
PRINCIPAL FINDINGS
Safe water supplies were associated with significantly lower odds of schistosomiasis (odds ratio (OR) = 0.53, 95% confidence interval (CI): 0.47-0.61). Adequate sanitation was associated with lower odds of Schistosoma mansoni, (OR = 0.59, 95% CI: 0.47-0.73) and Schistosoma haematobium (OR = 0.69, 95% CI: 0.57-0.84). Included studies were mainly cross-sectional and quality was largely poor.
CONCLUSIONS/SIGNIFICANCE
Our systematic review and meta-analysis suggests that increasing access to safe water and adequate sanitation are important measures to reduce the odds of schistosome infection. However, most of the studies were observational and quality was poor. Hence, there is a pressing need for adequately powered cluster randomized trials comparing schistosome infection risk with access to safe water and adequate sanitation, more studies which rigorously define water and sanitation, and new research on the relationships between water, sanitation, hygiene, human behavior, and schistosome transmission.
Topics: Cross-Sectional Studies; Humans; Sanitation; Schistosomiasis; Water Quality; Water Supply
PubMed: 25474705
DOI: 10.1371/journal.pntd.0003296 -
Frontiers in Endocrinology 2021Sleep duration is thought to play a key role in the development of metabolic syndrome. However, the results have been inconsistent. (Meta-Analysis)
Meta-Analysis
PURPOSE
Sleep duration is thought to play a key role in the development of metabolic syndrome. However, the results have been inconsistent.
METHODS
We conducted a systematic review and meta-analysis of cohort studies and searched publications in PubMed, Embase, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov. The summary relative risks (RRs) were estimated using a random model. The sensitivity analysis was performed by sequentially excluding each study to test the robustness of the pooled estimates.
FINDING
We included 13 studies involving 300,202 patients in which short sleep and long sleep significantly increased the risk of metabolic syndrome 15% (RR = 1.15, 95%CI = 1.09-1.22, p < 0.001) and 19% (RR = 1.19, 95%CI = 1.05-1.35, p < 0.001). Moreover, the relationship between sleep duration and metabolic syndrome risk presented a U-shaped curve. Short and long sleep increased the risk of obesity by 14% (RR = 1.14, 95%CI = 1.07-1.22, p<0.001) and 15% (RR = 1.15, 95%CI = 1.00-1.30, p = 0.04), and high blood pressure 16% (RR = 1.16, 95%CI = 1.02-1.31, p = 0.03) and 13% (RR = 1.13, 95%CI = 1.04-1.24, p = 0.01), respectively. Short sleep can potentially increase the risk of high blood sugar by 12% (RR = 1.12, 95%CI = 1.00-1.15, P = 0.05).
IMPLICATIONS
Based on our findings, sleep is a behavior that can be changed and is economical. Clinically doctors and health professionals should be encouraged to increase their efforts to promote healthy sleep for all people.
Topics: Humans; Hypertension; Metabolic Syndrome; Sleep; Sleep Quality
PubMed: 34867820
DOI: 10.3389/fendo.2021.773646 -
Borderline Personality Disorder and... Dec 2021The gap between treatment need and treatment availability is particularly wide for individuals seeking Dialectical Behavior Therapy (DBT), and mobile apps based on DBT...
BACKGROUND
The gap between treatment need and treatment availability is particularly wide for individuals seeking Dialectical Behavior Therapy (DBT), and mobile apps based on DBT may be useful in increasing access to care and augmenting in-person DBT. This review examines DBT based apps, with a specific focus on content quality and usability.
METHODS
All apps referring to DBT were identified in Google Play and iOS app stores and were systematically reviewed for app content and quality. The Mobile App Rating Scale (MARS) was used to evaluate app usability and engagement.
RESULTS
A total of 21 free to download apps were identified. The majority of apps (71%) included a component of skills training, five apps included a diary card feature. Most (76.19%) apps were designed to function without help from a therapist. The average user "star" rating was 4.39 out of 5. The mean overall MARS score was 3.41, with a range of 2.15 to 4.59, and 71.43% were considered minimally 'acceptable,' as defined by a score of 3 or higher. The average star rating was correlated with the total MARS score (r = .51, p = .02). Estimates of app usage differed substantially between popular and unpopular apps, with the three most popular apps accounting for 89.3% of monthly active users.
CONCLUSIONS
While the present study identified many usable and engaging apps in app stores designed based on DBT, there are limited apps for clinicians. DBT based mobile apps should be carefully developed and clinically evaluated.
PubMed: 34857035
DOI: 10.1186/s40479-021-00167-5 -
Journal of the American Academy of... Jun 2021To conduct a systematic review of the measures designed to assess sluggish cognitive tempo (SCT) since the first SCT scale using careful test-construction procedures was... (Review)
Review
OBJECTIVE
To conduct a systematic review of the measures designed to assess sluggish cognitive tempo (SCT) since the first SCT scale using careful test-construction procedures was published in 2009.
METHOD
MEDLINE (PubMed), Embase, PsychINFO, and Web of Science databases were searched from September 2009 through December 2019. Articles reporting on reliability (internal consistency, test-retest, and interrater reliability), structural validity (an aspect of construct validity focused on items' convergent and discriminant validity), concurrent and longitudinal external validity, invariance, or intervention/experimental findings were included.
RESULTS
Full criteria for data extraction and inclusion were met by 76 studies. Nine measures for assessing SCT were identified (7 assessing parent report, teacher report, and/or self-report in children and 2 assessing self-report and/or collateral informant report in adults). Each measure demonstrated acceptable to excellent reliability. All or at least the majority of SCT items on each measure also had structural validity (high loadings on an SCT factor and low loadings on an attention-deficit/hyperactivity disorder [ADHD] inattention factor). Studies have supported the invariance of SCT across sex and time, and there is initial evidence of invariance across informants, youths with ADHD and youths without ADHD, and ADHD presentations. The Child and Adolescent Behavior Inventory (CABI), Child Concentration Inventory, Second Edition (CCI-2), and Barkley Adult ADHD Rating Scale-IV (BAARS-IV) have particularly strong support for assessing parent/teacher-reported, youth self-reported, and adult self-reported SCT, respectively.
CONCLUSION
The SCT measures included in this review share numerous positive properties, have promising psychometric support, and have proven useful for examining the external correlates of SCT across the life span. Although substantial progress has been made over the last decade, work remains to be done to further improve the assessment of SCT and key directions for future research are provided.
Topics: Adolescent; Adult; Attention Deficit Disorder with Hyperactivity; Child; Cognition; Cognition Disorders; Humans; Reproducibility of Results; Self Report
PubMed: 33166623
DOI: 10.1016/j.jaac.2020.10.016 -
Health Literacy Research and Practice Feb 2020Health literacy is a significant determinant of health behaviors, but the pathways through which health literacy influences health behaviors are not completely clear nor...
BACKGROUND
Health literacy is a significant determinant of health behaviors, but the pathways through which health literacy influences health behaviors are not completely clear nor consistent. The purpose of this systematic review is to critically appraise studies that have empirically tested the potential pathways linking health literacy to health behavior.
METHODS
We performed searches of the electronic databases PubMed, Embase, and CINAHL to identify studies that proposed a conceptual framework and empirically tested the proposed mechanism through which health literacy influences certain health behaviors. Twenty eligible studies were included for analysis.
KEY RESULTS
The 20 studies addressed various health behaviors: chronic disease self-management (n = 8), medication adherence (n = 2), overall health status (n = 4), oral care (n = 1), cancer screening (n = 1), shared decision-making (n = 1), health information sharing (n = 1), physical activity and eating behaviors (n = 1), and emergency department visits (n = 1). Most studies were conducted in the United States (n = 13) and used a cross-sectional design (n = 15). The Short Test of Functional Health Literacy in Adults was commonly used to assess health literacy levels. Selection of variables and their operationalization were informed by a theoretical model in 12 studies. Age, gender, race/ethnicity, and insurance status were reported antecedents to health literacy. The most commonly tested mediators were self-efficacy (n = 8) and disease knowledge (n = 4). Fit indices reported in the studies ranged from acceptable to excellent.
DISCUSSION
Current evidence supports self-efficacy as a mediator between health literacy and health behavior. Further research is needed to identify how health literacy interplays with known psychosocial factors to inform people's use of preventive care services. Future studies should include more disadvantaged populations such as immigrants with high disease burden and those with low health literacy. Theory-based, empirically tested health literacy models can serve as the conceptual basis for developing effective health interventions to improve health behaviors and ultimately decrease the burden of disease in such vulnerable populations. [HLRP: Health Literacy Research and Practice. 2020;4(1):e21-e44.] PLAIN LANGUAGE SUMMARY: This review systemically compiles, and critically appraises 20 existing studies that test conceptual frameworks that propose potential pathways through which health literacy affects health behaviors. The findings from this review can help inform the development of health literacy-focused interventions to improve the health behaviors of populations with disease burdens.
Topics: Health Behavior; Health Literacy; Humans; Self Efficacy
PubMed: 32053206
DOI: 10.3928/24748307-20191025-01 -
SAGE Open Medicine 2022This review is aimed to estimate the pooled prevalence of mothers' health care-seeking behavior and associated factors in Ethiopia. (Review)
Review
OBJECTIVE
This review is aimed to estimate the pooled prevalence of mothers' health care-seeking behavior and associated factors in Ethiopia.
METHODS
International databases were systematically searched for studies that were published between 2008 and 2019. Data were extracted in Microsoft Excel 2019 and then exported to STATA version 14 for further analysis. Publication bias was determined by funnel plot, Begg's test, and Egger's test. Heterogeneity between the studies was checked by I statistic. The pooled proportion was estimated using random-effects meta-analysis model.
RESULTS
This review and meta-analysis included 14 studies from a total of 581 papers that were screened. The pooled proportion of mothers' health care-seeking behavior in Ethiopia was 50.24% (95% CI: 37.13%, 63.35%). Health facility distance (OR = 2.07), awareness about common childhood illnesses (OR = 2.06), educational levels (OR = 1.82), and income (OR = 2.07) were significantly associated variables.
CONCLUSION
The overall health care-seeking behavior of mothers for common childhood illnesses in Ethiopia is low. Accordingly, educating mothers/caregivers about the importance of health care-seeking behavior and increasing the proximity of health facilities were recommended to improve health care-seeking behavior.
PubMed: 35615524
DOI: 10.1177/20503121221099019 -
Iranian Journal of Public Health Sep 2023We aimed to review the effectiveness of health promotion interventions in the use of helmet and to identify the types of effective health promotion strategies among the... (Review)
Review
BACKGROUND
We aimed to review the effectiveness of health promotion interventions in the use of helmet and to identify the types of effective health promotion strategies among the examined studies.
METHODS
A systematic search was performed on the PubMed, Scopus, Cochrane, and Embase databases up to 1 Aug 2022 to find the studies evaluated the effectiveness of health promotion interventions for helmet use among target population. In this systematic review and meta-analysis, interventions with pre- post-test design were included. The dependent variable of the study is the percentage of participants who responded positively toward helmet use in the baseline and after the interventions. Random-effects models were used to pool study results.
RESULTS
Overall, 1,675 articles were found in the initial search and entered into the Endnote software. Of these, 917 duplicate articles were removed, leaving 758 articles were screened based on title and abstract. Finally, 12 eligible articles were included in the review and five with pre and post-test design were included in the meta-analysis. The overall random-effects pooled estimation of persons wearing helmets before and after interventions was 70% (95%CI 21 -119; <0.001), without a heterogeneity (I =0%; =0.94), which means that the average percentage of changing to helmet use is 70%. Community-based education program was the most commonly applied for interventional studies. The next most commonly used approaches were campaign designing.
CONCLUSION
Wearing helmet approximately increased 70% among participant. Health promotion strategies may target helmet-wearing behavior to reduce head injuries in motorcyclist road traffic accidents.
PubMed: 38033843
DOI: 10.18502/ijph.v52i9.13569