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Trends in Psychiatry and Psychotherapy Jun 2022Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction, associated with the... (Review)
Review
INTRODUCTION
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction, associated with the presence of restricted and repetitive patterns of behavior, interests, or activities. Cannabis has been used to alleviate symptoms associated with ASD.
METHOD
We carried out a systematic review of studies that investigated the clinical effects of cannabis and cannabinoid use on ASD, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist). The search was carried out in four databases: MEDLINE/PubMed, Scientific Electronic Library Online (SciELO), Scopus, and Web of Science. No limits were established for language during the selection process. Nine studies were selected and analyzed.
RESULTS
Some studies showed that cannabis products reduced the number and/or intensity of different symptoms, including hyperactivity, attacks of self-mutilation and anger, sleep problems, anxiety, restlessness, psychomotor agitation, irritability, aggressiveness perseverance, and depression. Moreover, they found an improvement in cognition, sensory sensitivity, attention, social interaction, and language. The most common adverse effects were sleep disorders, restlessness, nervousness and change in appetite.
CONCLUSION
Cannabis and cannabinoids may have promising effects in the treatment of symptoms related to ASD, and can be used as a therapeutic alternative in the relief of those symptoms. However, randomized, blind, placebo-controlled clinical trials are necessary to clarify findings on the effects of cannabis and its cannabinoids in individuals with ASD.
SYSTEMATIC REVIEW REGISTRATION
International Prospective Register of Systematic Reviews (PROSPERO), code 164161.
Topics: Anxiety; Anxiety Disorders; Autism Spectrum Disorder; Cannabinoids; Cannabis; Humans; Psychomotor Agitation
PubMed: 34043900
DOI: 10.47626/2237-6089-2020-0149 -
Journal of Affective Disorders Oct 2023The affective, cognitive, and behavioral aspects of impulsivity involved in suicide-related outcomes can be investigated through the UPPS model, which conceptualizes... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The affective, cognitive, and behavioral aspects of impulsivity involved in suicide-related outcomes can be investigated through the UPPS model, which conceptualizes these facets in multidimensional terms related to negative and positive urgency, lack of premeditation and perseverance, and sensation seeking. This systematic review and meta-analysis provided a comprehensive understanding of the role of all facets of impulsivity in the development of suicidal ideation and behaviors.
METHODS
We conducted a systematic search on six databases (PsycINFO, PsycARTICLES, PubMed, MEDLINE, Scopus, and Web of Science) until May 5,2023. Overall, 49 studies met the criteria for systematic review, of which 37 were included in a meta-analysis of data from 17.898 individuals. Additional moderation analyses included age, gender, sample status, country of study conduct, assessment instruments, type of suicide-related outcome, study quality, and research design.
RESULTS
We found significant relationships between aspects of impulsivity and suicide-related outcomes. Specially, affective facets related to impulsivity showed a stronger association with suicidal ideations and attempts than cognitive and behavioral dimensions, recommending the main involvement of emotional aspects-positive and negative-in suicide-related dimensions.
LIMITATIONS
The limited number of studies may have negatively impacted the power of moderation analyses. In addition, for most dimensions of impulsivity, the limited number of longitudinal studies did not allow to test the moderating role of research design.
CONCLUSIONS
This study supports the role of impulsivity in suicidal ideation and behavior, identifying the affective component of impulsivity as the most involved, providing a significant contribution from a clinical and diagnostic point of view.
Topics: Humans; Suicide; Impulsive Behavior; Suicidal Ideation; Longitudinal Studies
PubMed: 37459976
DOI: 10.1016/j.jad.2023.07.086 -
Journal of Graduate Medical Education Dec 2016Rates of physician burnout have increased in recent years, and high burnout levels are reported by physicians in training. (Review)
Review
BACKGROUND
Rates of physician burnout have increased in recent years, and high burnout levels are reported by physicians in training.
OBJECTIVE
This review of the research on resident well-being seeks to identify factors associated with well-being, summarize well-being promotion interventions, and provide a framework for future research efforts.
METHODS
Keywords were used to search PubMed, PsycINFO, and MEDLINE. Studies included were conducted between 1989 and 2014. The search yielded 82 articles, 26 which met inclusion criteria, and were assessed using the Medical Education Research Study Quality Instrument.
RESULTS
Articles measured resident well-being and associated factors, predictors, effects, barriers, as well as interventions to improve well-being. Factors identified in psychological well-being research-autonomy, building of competence, and strong social relatedness-are associated with resident well-being. Sleep and time away from work are associated with greater resident well-being. Perseverance is predictive of well-being, and greater well-being is associated with increased empathy. Interventions focused on health and coping skills appear to improve well-being, although the 3 studies that examined interventions were limited by small samples and single site administration.
CONCLUSIONS
An important step in evolving research in this area entails the development of a clear definition of resident well-being and a scale for measuring the construct. The majority (n = 17, 65%) of existing studies are cross-sectional analyses of factors associated with well-being. The literature summarized in this review suggests future research should focus on factors identified in cross-sectional studies, including sleep, coping mechanisms, resident autonomy, building competence, and enhanced social relatedness.
Topics: Burnout, Professional; Female; Humans; Internship and Residency; Job Satisfaction; Male; Physicians; Risk Factors; Young Adult
PubMed: 28018531
DOI: 10.4300/JGME-D-15-00764.1 -
Cureus Jul 2022The emergency treatment of atrial fibrillation (AF) involves utilizing two strategies. The first strategy normally involves permitting the atrial fibrillation to... (Review)
Review
An Integrative Comparative Study Between Digoxin and Amiodarone as an Emergency Treatment for Patients With Atrial Fibrillation With Evidence of Heart Failure: A Systematic Review and Meta-Analysis.
The emergency treatment of atrial fibrillation (AF) involves utilizing two strategies. The first strategy normally involves permitting the atrial fibrillation to persevere as the ventricular rate is controlled. The other method involves utilizing anti-arrhythmic drugs in cardioversion and attempting to maintain sinus rhythm. Different pharmacological treatments, including digoxin and amiodarone, have been used to manage AF. A literature review on amiodarone and digoxin in the treatment of AF among patients with heart failure (HF) has shown that both drugs have potential risks. Therefore, we are conducting this systematic review and meta-analysis to compare the effectiveness of amiodarone and digoxin in the treatment of AF among patients with evidence of HF. A literature search of relevant articles was conducted on six electronic databases (PubMed, Web of Science, Medline, ScienceDirect, Cochrane Library, and Google Scholar) from 2000 to 2022. The search yielded seven studies that had met the inclusion criteria. Our meta-analysis of four studies showed that there was no significant difference in the reduction of heart rate after treatment with either amiodarone or digoxin (mean difference (MD): -5.44; 95% confidence interval (CI): -9.53 to -1.34; I = 25%; p = 0.26). On the other hand, the statistical analysis showed that amiodarone had a better effect on the conversion to sinus rhythm than digoxin (63% versus 35%, respectively). Based on evidence from our meta-analysis, the clinical effect of amiodarone and digoxin in the emergency treatment of AF on heart rate control was unclear. However, amiodarone has a significant impact on the restoration of sinus rhythm compared with digoxin and can be considered the first-line drug regimen in conversion to sinus rhythm for AF patients with evidence of heart failure. However, the use of amiodarone and digoxin is complicated by adverse events and all-cause mortality.
PubMed: 35971374
DOI: 10.7759/cureus.26800 -
Medical Education Online Dec 2021Medical professionalism education intends to produce virtuous and humanistic healthcare professionals who demonstrate perseverance and professional integrity. However,...
BACKGROUND
Medical professionalism education intends to produce virtuous and humanistic healthcare professionals who demonstrate perseverance and professional integrity. However, today's medicine has embodied a mammoth transformation of medical practice towards sns and the digital realm. Such paradigm shift has challenged the medical professional's values, behaviors, and identities, and the distinct boundaries between personal and professional lives are blurred. This study aims to develop a framework for healthcare professionals coping with the challenges of medical professionalism in the digital realm.
METHODS
We followed a systematic approach for the development of a framework about e-professionalism. Qualitative data was collected from a systematic review and a delphi study, while quantitative data was collected by administering a validated questionnaire social networking sites for medical education (snsme). Subsequently, categorization of the selected data and identifying concepts, deconstruction and further categorizing concepts (philosophical triangulation), integration of concepts (theoretical triangulation), and synthesis and resynthesis of concepts were performed.
RESULTS
The initial process yielded six overlapping concepts from personal, professional, character (implicit) and characteristic (explicit) domains: environment, behavior, competence, virtues, identity, and mission. Further integration of data was done for the development of the medical education e-professionalism (meep) framework with a central concept of a commitment to mission. The mission showed deep connections with values (conformity, beneficence, universalism, and integrity), behaviours (communication, self-awareness, tolerance, power), and identity (reflection, conscientiousness, self-directed, self-actualization). The data demonstrated that all medical professionals require updated expertise in sns participation.
CONCLUSION
The meep framework recognises a mission-based social contract by the medical community. This mission is largely driven by professional values, behaviors and identity. Adherence to digital standards, accountability, empathy, sensitivity, and commitment to society are essential elements of the meep framework.
Topics: Communication; Education, Medical; Health Personnel; Humans; Professionalism; Social Networking
PubMed: 34775927
DOI: 10.1080/10872981.2021.1983926 -
Health Psychology Open 2017Information and compassion assist families of potential organ donors to make informed decisions. However, psychological implications of the in-hospital process are not... (Review)
Review
Information and compassion assist families of potential organ donors to make informed decisions. However, psychological implications of the in-hospital process are not well described with past research focusing on decision-making. To enhance understanding and improve service delivery, a systematic review was conducted. Inductive analysis and synthesis utilised Grounded Theory Methodology within a systems theory framework and contributed to a model proposing that family and staff form a System of Systems with shared responsibility for process outcomes. This model can guide evaluation and improvement of care and will be tested by means of a longitudinal study of family experiences.
PubMed: 28680696
DOI: 10.1177/2055102917709375 -
Frontiers in Psychology 2023Recent years have witnessed increasing attention to personality strength (grit) due to its merit in goal-seeking language learning processes. Two facets of grit, namely... (Review)
Review
Recent years have witnessed increasing attention to personality strength (grit) due to its merit in goal-seeking language learning processes. Two facets of grit, namely perseverance of effort (PE) and consistency of interest (CI), play a critical role in overcoming learning difficulties and strengthening willpower to pursue learning goals. The current review seeks to explore various issues related to grit, including its factor structure, the relationship between grit and frequently associated factors, as well as the utility of PE and CI in facilitating language learning. This exploration is based on the findings of 32 empirical articles published between 2017 and 2022 from three databases. The results indicate that although research which examines the role of grit has entered a fast growth phase since 2020, there is still a need for expansion and diversification in scopes, participants, research methods, and language contexts. Moreover, previous studies have not adequately addressed the critical issue of grit's conceptualization and factor structure. Finally, this study suggests that future researchers should impartially assess the factor structure and nature of PE and CI, to provide more robust evidence to clarify the relationship between grit and diverse emotions and positive institutions, in order to advance understanding of grit in second language learning.
PubMed: 37727745
DOI: 10.3389/fpsyg.2023.1238788 -
Nature Human Behaviour Nov 2018Success in school and the labour market relies on more than high intelligence. Associations between "non-cognitive" skills in childhood, such as attention,...
Success in school and the labour market relies on more than high intelligence. Associations between "non-cognitive" skills in childhood, such as attention, self-regulation, and perseverance, and later outcomes have been widely investigated. In a systematic review of this literature, we screened 9553 publications, reviewed 554 eligible publications, and interpreted results from 222 better quality publications. Better quality publications comprised randomised experimental and quasi-experimental studies (EQIs), and observational studies that made reasonable attempts to control confounding. For academic achievement outcomes there were 26 EQI publications but only 14 were available for meta-analysis with effects ranging from 0.16 to 0.37SD. However, within sub-domains effects were heterogeneous. The 95% prediction interval for literacy was consistent with negative, null and positive effects (-0.13 to 0.79). Similarly heterogeneous findings were observed for psychosocial, cognitive and language, and health outcomes. Funnel plots of EQIs and observational studies showed asymmetric distributions and potential for small study bias. There is some evidence that non-cognitive skills associate with improved outcomes. However, there is potential for small study and publication bias that may over-estimate true effects, and heterogeneity of effect estimates spanned negative, null and positive effects. The quality of evidence from EQIs under-pinning this field is lower than optimal and more than a third of observational studies made little or no attempt to control confounding. Interventions designed to develop children's non-cognitive skills could potentially improve outcomes. The inter-disciplinary researchers interested in these skills should take a more strategic and rigorous approach to determine which interventions are most effective.
PubMed: 30525112
DOI: 10.1038/s41562-018-0461-x -
Diagnostics (Basel, Switzerland) Jan 2023Neurogenic lower urinary tract dysfunction requires lifelong surveillance and management for the perseveration of patients' quality of life and the prevention of... (Review)
Review
BACKGROUND
Neurogenic lower urinary tract dysfunction requires lifelong surveillance and management for the perseveration of patients' quality of life and the prevention of significant morbidity and mortality. Urine biomarkers are an attractive noninvasive method of surveillance for these patients. The aim of this systematic review is to search for and critically appraise studies that investigate the clinical usefulness of urine biomarkers in the management of neurogenic lower urinary tract dysfunction (NLUTD) in adults.
METHODS
This review was conducted according to PRISMA and MOOSE guidelines. Search strategy included PubMed, CENTRAL, and Scopus (until October 2022). Studies investigating potential urine biomarkers for the management of adults with NLUTD were included.
RESULTS
Fifteen studies fulfilled the criteria. To date, a variety of different urine molecules have been investigated for the diagnosis and management of neurogenic overactive bladder and detrusor overactivity (nerve growth factor, brain-derived neurotrophic factor, prostaglandin E2, prostaglandin F2α, transformation growth factor β-1, tissue inhibitor metalloproteinase-2, matrix metalloproteinase-2, substance P, microRNA), diagnosis of vesicoureteral reflux (exosomal vitronectin), urinary tract infection (neutrophil gelatinase-associated lipocalin, interleukin 6) and bladder cancer screening (cytology, BTA stat, survivin) in neurological patients.
CONCLUSION
Further studies are needed to specify the utility of each molecule in the management algorithm of adult NLUTD.
PubMed: 36766573
DOI: 10.3390/diagnostics13030468 -
BMC Geriatrics Mar 2019As older patients' health care needs become more complex, they often experience challenges with managing medications across transitions of care. Families play a major...
BACKGROUND
As older patients' health care needs become more complex, they often experience challenges with managing medications across transitions of care. Families play a major role in older patients' lives. To date, there has been no review of the role of families in older people's medication management at transitions of care. This systematic review aimed to examine family involvement in managing older patients' medications across transitions of care.
METHODS
Five databases were searched for quantitative, qualitative and mixed methods empirical studies involving families of patients aged 65 years and older: Cumulative Index to Nursing and Allied Health Literature Complete, Medline, the Cochrane Central Register of Controlled Trials, PsycINFO, and EMBASE. All authors participated independently in conducting data selection, extraction and quality assessment using the Mixed Methods Appraisal Tool. A descriptive synthesis and thematic analysis were undertaken of included papers.
RESULTS
Twenty-three papers were included, comprising 17 qualitative studies, 5 quantitative studies and one mixed methods study. Families participated in information giving and receiving, decision making, managing medication complexity, and supportive interventions in regard to managing medications for older patients across transitions of care. However, health professionals tended not to acknowledge the medication activities performed by families. While families actively engaged with older patients in strategies to ensure safe medication management, communication about medication plans of care across transitions tended to be haphazard and disorganised, and there was a lack of shared decision making between families and health professionals. In managing medication complexity across transitions of care, family members perceived a lack of tailoring of medication plans for patients' needs, and believed they had to display perseverance to have their views heard by health professionals.
CONCLUSIONS
Greater efforts are needed by health professionals in strengthening involvement of families in medication management at transitions of care, through designated family meetings, clinical bedside handovers, ward rounds, and admission and discharge consultations. Future work is needed on evaluating targeted strategies relating to family members' contribution to managing medications at transitions of care, with outcomes directed on family understanding of medication changes and their input in preventing and identifying medication-related problems.
Topics: Aged; Aged, 80 and over; Decision Making; Family; Health Personnel; Hospitalization; Humans; Medication Reconciliation; Patient Discharge; Patient Transfer; Professional-Family Relations; Qualitative Research
PubMed: 30925899
DOI: 10.1186/s12877-019-1102-6