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Aging & Mental Health 2015Services provided to older people should be developed based on active ageing policies. Nutrition is one aspect of active ageing, but little is known about how food... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Services provided to older people should be developed based on active ageing policies. Nutrition is one aspect of active ageing, but little is known about how food activities contribute to psychological well-being in later life. This is a systematic review of qualitative and quantitative research that answers the question 'What is known about the relationship between food activities and the maintenance of identities in old age?'.
METHODS
We followed the preferred reporting items for systematic reviews and meta-analyses guidelines and used quality assessment parameters to complete a systematic review and narrative synthesis. Academic Search Premier, MEDLINE, CINAHL Plus, and PsycINFO databases were searched.
RESULTS
We initially identified 8016 articles, of which 167 full-text articles were screened for inclusion. Twenty-two articles were included in the review. There was moderate evidence from nine qualitative and two quantitative studies, of variable quality, that food activities contribute to the maintenance of women's gendered identities, the ethnic identities of men and women, and community identities. There was moderate evidence from 10 qualitative studies, of variable quality, that a change in food choice and deteriorating health changed food activity participation. These changes threatened identities. Most studies included both younger adults and older adults.
CONCLUSION
In later life, there are many life experiences leading to change. Further research is needed to develop understanding of how identity and mental well-being are maintained, despite changes in everyday activities like cooking and eating. This may enable health care professionals to meet psychological needs alongside biological needs during nutritional interventions.
Topics: Aged; Aging; Feeding Behavior; Female; Food; Gender Identity; Humans; Male; Social Identification
PubMed: 25373998
DOI: 10.1080/13607863.2014.971707 -
Journal of the Academy of Nutrition and... Jul 2014In light of the obesity epidemic, there is growing interest in the use of financial incentives for dietary behavior change. Previous reviews of the literature have... (Review)
Review
In light of the obesity epidemic, there is growing interest in the use of financial incentives for dietary behavior change. Previous reviews of the literature have focused on randomized controlled trials and found mixed results. The purpose of this systematic review is to update and expand on previous reviews by considering a broader range of study designs, including randomized controlled trials, quasi-experimental, observational, and simulation studies testing the use of financial incentives to change dietary behavior and to inform both dietetic practice and research. The review was guided by theoretical consideration of the type of incentive used based on the principles of operant conditioning. There was further examination of whether studies were carried out with an institutional focus. Studies published between 2006 and 2012 were selected for review, and data were extracted regarding study population, intervention design, outcome measures, study duration and follow-up, and key findings. Twelve studies meeting selection criteria were reviewed, with 11 finding a positive association between incentives and dietary behavior change in the short term. All studies pointed to more specific information on the type, timing, and magnitude of incentives needed to motivate individuals to change behavior, the types of incentives and disincentives most likely to affect the behavior of various socioeconomic groups, and promising approaches for potential policy and practice innovations. Limitations of the studies are noted, including the lack of theoretical guidance in the selection of incentive structures and the absence of basic experimental data. Future research should consider these factors, even as policy makers and practitioners continue to experiment with this potentially useful approach to addressing obesity.
Topics: Administrative Personnel; Diet; Feeding Behavior; Health Behavior; Humans; Motivation; Observational Studies as Topic; Randomized Controlled Trials as Topic; Reward; Weight Loss
PubMed: 24836967
DOI: 10.1016/j.jand.2014.03.011 -
International Journal of Environmental... Dec 2022Planetary and human health depend on Westerners' ability to reduce meat consumption. Meat production degrades the environment while excessive meat intake is associated... (Review)
Review
Planetary and human health depend on Westerners' ability to reduce meat consumption. Meat production degrades the environment while excessive meat intake is associated with cancer and cardiovascular disease, among others. Effective reasons and motivations are needed for consumers to change their diet. The fact that modern animal agriculture inflicts a great deal of pain on animals from their birth to their slaughter, animal welfare/suffering may drive consumers to curtail their meat consumption. This systematic review examined a total of 90 papers to ascertain consumers' awareness of the pain animals experience in animal agriculture, as well as consumer attitudes towards meat reduction due to animal welfare. Results show that consumers have low awareness of animal agriculture. Awareness of animal agricultural practices and animal sentience is associated with increased negative attitudes towards animal suffering. Animal suffering due to farming practices, transportation, slaughter, and animal sentience are factors that may encourage a reduction in meat consumption, and even dietary change in the short term. There is also evidence that animal suffering may be a more compelling motivation for consumers' willingness to change their diet than for health or environmental reasons. Therefore, increasing consumers' awareness of animal suffering in meat production is paramount to contributing to reduced pressure on the environment and improved human health.
Topics: Animals; Humans; Consumer Behavior; Meat; Animal Welfare; Motivation; Pain
PubMed: 36498444
DOI: 10.3390/ijerph192316372 -
Nutrients Aug 2023The aim of this systematic review and meta-analysis was to examine the prevalence of feeding and eating disorder (FED) symptoms or dysfunctional eating behaviours (DEB)... (Meta-Analysis)
Meta-Analysis Review
The Impact of the First and Second Wave of the COVID-19 Pandemic on Eating Symptoms and Dysfunctional Eating Behaviours in the General Population: A Systematic Review and Meta-Analysis.
BACKGROUND
The aim of this systematic review and meta-analysis was to examine the prevalence of feeding and eating disorder (FED) symptoms or dysfunctional eating behaviours (DEB) in the general population during the COVID-19 outbreak.
METHOD
We searched eligible articles in biomedical databases from 1 January 2020 to 31 March 2022. Prevalence rates of FED or DEB changes between pre-pandemic and pandemic time and correlation with psychological distress were pooled with a meta-analysis using a random-effects model. Heterogeneity was tested using I-squared () statistics. A total of 186 studies with 406,076 participants met the inclusion criteria.
RESULTS
The more prevalent FED or DEB during the COVID-19 outbreak were: body image concerns (52%, 95% CI 0.38, 0.66), binge eating (40%, 95% CI 0.25, 0.55), and overeating (40%, 95% CI = 0.32-0.48). Pooled data of longitudinal studies (k = 8) only showed a significant difference in the prevalence of weight gain from pre-pandemic to the pandemic time. Finally, increased levels of psychological distress (k = 35) positively correlated with some ED symptoms.
CONCLUSION
This meta-analysis evidenced a negative impact of the pandemic on eating symptoms and DEB in the general population.
Topics: Humans; COVID-19; Pandemics; Binge-Eating Disorder; Body Image; Feeding Behavior
PubMed: 37630798
DOI: 10.3390/nu15163607 -
Seizure Feb 2021We aimed to conduct a systematic review to evaluate the personality changes in adult patients with drug-resistant epilepsy following surgical treatment. (Review)
Review
PURPOSE
We aimed to conduct a systematic review to evaluate the personality changes in adult patients with drug-resistant epilepsy following surgical treatment.
METHODS
A systematic review was conducted using the Preferred Reporting Items of Systematic Reviews and MetaAnalyses (PRISMA) statement. We searched PubMed, Medline databases, and the Cochrane Controlled Trials Register, with search terms 'personality', 'epilepsy', and 'surgery'.
RESULTS
Eleven studies were selected. In 7 out of 11 studies, personality changes were more adaptive, with patients experiencing decreased neuroticism, impulsivity, hypochondriasis, psychasthenia. One study showed increased emotional lability. The remainder of the studies showed no changes in personality dimensions. Changes in personality differed according to the localization of the epileptogenic area, depended on seizure status after treatment and duration of follow-up. Seizure freedom as an outcome of surgical treatment influenced the existence of personality changes, and their severity. Adaptive personality changes could be seen from early follow-up assessments even in patients who were not seizure-free, though further follow-ups showed that improvements after 1-2 years were specific to seizure-free patients.
LIMITATIONS
The main limitation of our research is the heterogeneity of approaches used to evaluate personality in the included studies. Furthermore, the included studies also had different sample sizes and comparison groups, different designs, and different follow-up durations. We only included studies that were written in English.
CONCLUSIONS
The majority of studies reported changes in personality dimensions in patients suffering from refractory epilepsy.
Topics: Anticonvulsants; Drug Resistant Epilepsy; Humans; Personality; Seizures
PubMed: 33453594
DOI: 10.1016/j.seizure.2020.12.026 -
The Cochrane Database of Systematic... May 2014Horticultural therapy is defined as the process of utilising fruits, vegetables, flowers and plants facilitated by a trained therapist or healthcare provider, to achieve... (Review)
Review
BACKGROUND
Horticultural therapy is defined as the process of utilising fruits, vegetables, flowers and plants facilitated by a trained therapist or healthcare provider, to achieve specific treatment goals or to simply improve a person's well-being. It can be used for therapy or rehabilitation programs for cognitive, physical, social, emotional, and recreational benefits, thus improving the person's body, mind and spirit. Between 5% to 15% of people with schizophrenia continue to experience symptoms in spite of medication, and may also develop undesirable adverse effects, horticultural therapy may be of value for these people.
OBJECTIVES
To evaluate the effects of horticultural therapy for people with schizophrenia or schizophrenia-like illnesses compared with standard care or other additional psychosocial interventions.
SEARCH METHODS
We searched the Cochrane Schizophrenia Group Trials Register (Janurary 2013) and supplemented this by contacting relevant study authors, and manually searching reference lists.
SELECTION CRITERIA
We included one randomised controlled trial (RCT) comparing horticultural therapy plus standard care with standard care alone for people with schizophrenia.
DATA COLLECTION AND ANALYSIS
We reliably selected, quality assessed and extracted data. For continuous outcomes, we calculated a mean difference (MD) and for binary outcomes we calculated risk ratio (RR), both with 95% confidence intervals (CI). We assessed risk of bias and created a 'Summary of findings' table using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach.
MAIN RESULTS
We included one single blind study (total n = 24). The overall risk of bias in the study was considered to be unclear although the randomisation was adequate. It compared a package of horticultural therapy which consisted of one hour per day of horticultural activity plus standard care with standard care alone over two weeks (10 consecutive days) with no long-term follow-up. Only two people were lost to follow-up in the study, both in the horticultural therapy group (1 RCT n = 24,RR 5.00 95% CI 0.27 to 94.34, very low quality evidence). There was no clear evidence of a difference in Personal Wellbeing Index (PWI-C) change scores between groups, however confidence intervals were wide (1 RCT n = 22, MD -0.90 95% CI -10.35 to 8.55, very low quality evidence). At the end of treatment, the Depression Anxiety Stress Scale (DASS21) change scores in horticultural therapy group were greater than that in the control group (1 RCT n = 22, MD -23.70 CI -35.37 to - 12.03, very low quality evidence). The only included study did not report on adverse effects of interventions.
AUTHORS' CONCLUSIONS
Based on the current very low quality data, there is insufficient evidence to draw any conclusions on benefits or harms of horticultural therapy for people with schizophrenia. This therapy remains unproven and more and larger randomised trials are needed to increase high quality evidence in this area.
Topics: Horticultural Therapy; Humans; Randomized Controlled Trials as Topic; Schizophrenia
PubMed: 24842458
DOI: 10.1002/14651858.CD009413.pub2 -
The International Journal of Behavioral... Feb 2017Changing diet and physical activity behaviour is one of the cornerstones of type 2 diabetes treatment, but changing behaviour is challenging. The objective of this study... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Changing diet and physical activity behaviour is one of the cornerstones of type 2 diabetes treatment, but changing behaviour is challenging. The objective of this study was to identify behaviour change techniques (BCTs) and intervention features of dietary and physical activity interventions for patients with type 2 diabetes that are associated with changes in HbA and body weight.
METHODS
We performed a systematic review of papers published between 1975-2015 describing randomised controlled trials (RCTs) that focused exclusively on both diet and physical activity. The constituent BCTs, intervention features and methodological rigour of these interventions were evaluated. Changes in HbA and body weight were meta-analysed and examined in relation to use of BCTs.
RESULTS
Thirteen RCTs were identified. Meta-analyses revealed reductions in HbA at 3, 6, 12 and 24 months of -1.11 % (12 mmol/mol), -0.67 % (7 mmol/mol), -0.28 % (3 mmol/mol) and -0.26 % (2 mmol/mol) with an overall reduction of -0.53 % (6 mmol/mol [95 % CI -0.74 to -0.32, P < 0.00001]) in intervention groups compared to control groups. Meta-analyses also showed a reduction in body weight of -2.7 kg, -3.64 kg, -3.77 kg and -3.18 kg at 3, 6, 12 and 24 months, overall reduction was -3.73 kg (95 % CI -6.09 to -1.37 kg, P = 0.002). Four of 46 BCTs identified were associated with >0.3 % reduction in HbA: 'instruction on how to perform a behaviour', 'behavioural practice/rehearsal', 'demonstration of the behaviour' and 'action planning', as were intervention features 'supervised physical activity', 'group sessions', 'contact with an exercise physiologist', 'contact with an exercise physiologist and a dietitian', 'baseline HbA >8 %' and interventions of greater frequency and intensity.
CONCLUSIONS
Diet and physical activity interventions achieved clinically significant reductions in HbA at three and six months, but not at 12 and 24 months. Specific BCTs and intervention features identified may inform more effective structured lifestyle intervention treatment strategies for type 2 diabetes.
Topics: Adult; Behavior Therapy; Diabetes Mellitus, Type 2; Diet; Exercise; Feeding Behavior; Female; Glycated Hemoglobin; Humans; Life Style; Male
PubMed: 28178985
DOI: 10.1186/s12966-016-0436-0 -
Journal of Medical Internet Research Mar 2023Borderline personality disorder (BPD) is characterized by frequent and intense moment-to-moment changes in affect, behavior, identity, and interpersonal relationships,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Borderline personality disorder (BPD) is characterized by frequent and intense moment-to-moment changes in affect, behavior, identity, and interpersonal relationships, which typically result in significant and negative deterioration of the person's overall functioning and well-being. Measuring and characterizing the rapidly changing patterns of instability in BPD dysfunction as they occur in a person's daily life can be challenging. Ecological momentary assessment (EMA) is a method that can capture highly dynamic processes in psychopathology research and, thus, is well suited to study intense variability patterns across areas of dysfunction in BPD. EMA studies are characterized by frequent repeated assessments that are delivered to participants in real-life, real-time settings using handheld devices capable of registering responses to short self-report questions in daily life. Compliance in EMA research is defined as the proportion of prompts answered by the participant, considering all planned prompts sent. Low compliance with prompt schedules can compromise the relative advantages of using this method. Despite the growing EMA literature on BPD in recent years, findings regarding study design features that affect compliance with EMA protocols have not been compiled, aggregated, and estimated.
OBJECTIVE
This systematic meta-analytic review aimed to investigate the relationship between study design features and participant compliance in EMA research of BPD.
METHODS
A systematic review was conducted on November 12, 2021, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analyses of Observational Studies in Epidemiology) guidelines to search for articles featuring EMA studies of BPD that reported compliance rates and included sufficient data to extract relevant design features. For studies with complete data, random-effect models were used to estimate the overall compliance rate and explore its association with design features.
RESULTS
In total, 28 peer-reviewed EMA studies comprising 2052 participants were included in the study. Design features (sampling strategy, average prompting frequency, number of items, response window, sampling device, financial incentive, and dropout rate) showed a large variability across studies, and many studies did not report design features. The meta-analytic synthesis was restricted to 64% (18/28) of articles and revealed a pooled compliance rate of 79% across studies. We did not find any significant relationship between design features and compliance rates.
CONCLUSIONS
Our results show wide variability in the design and reporting of EMA studies assessing BPD. Compliance rates appear to be stable across varying setups, and it is likely that standard design features are not directly responsible for improving or diminishing compliance. We discuss possible nonspecific factors of study design that may have an impact on compliance. Given the promise of EMA research in BPD, we also discuss the importance of unifying standards for EMA reporting so that data stemming from this rich literature can be aggregated and interpreted jointly.
Topics: Humans; Surveys and Questionnaires; Ecological Momentary Assessment; Borderline Personality Disorder; Self Report; Research Design
PubMed: 36920466
DOI: 10.2196/44853 -
The International Journal of Behavioral... Mar 2022Globally, significant efforts have focused on increasing physical activity and reducing sedentary behaviour in youth and adults across a range of settings (e.g.,... (Review)
Review
BACKGROUND
Globally, significant efforts have focused on increasing physical activity and reducing sedentary behaviour in youth and adults across a range of settings (e.g., schools, workplaces, community, and home). Despite this, interventions have had varied efficacy and typically have failed to sustain changes in behaviours over time. One explanation that has been put forth to explain the mixed success of interventions is activity compensation. However, little is known about activity compensation, including whether compensation occurs, and perceptions and potential mechanisms of activity compensation. Understanding activity compensation would assist in tailoring and targeting of potential intervention strategies. The primary aim of this review was to synthesise research that has investigated activity compensation in youth and adults. The secondary aim was to identify potential reasons for and/or awareness of compensatory changes that may have occurred.
METHODS
An electronic search of the EBSCOhost (via Academic Search Complete, CINAHL Complete, Education Source, Health Source: Nursing/Academic Edition, PsycINFO, SPORTdiscus with Full Text), MEDLINE Complete, Global Health, EMBASE, Scopus and Web of Science databases up to May 2021 was conducted. Quality assessment of included quantitative studies used a modified compensation-specific McMaster Quality Assessment Tool.
RESULTS
A total of 44 studies met the inclusion criteria (22 = adult populations; 22 = youth populations) and were classified as (1) quantitative (n = 31); (2) combination of quantitative and behavioural (n = 11); (3) behavioural only (n = 1); and (4) qualitative (n = 1). Of the 42 studies that included a quantitative component, 11 (26%) reported compensation occurred. Within the 13 studies examining specific behaviours, 35 behaviours were assessed, and evidence of compensation was inconsistent. Compensation mechanisms included fatigue, time constraints, lack of motivation, drive to be inactive, fear of overexertion, and autonomous motivation.
CONCLUSION
Little evidence of compensation was reported in the included quantitative studies; however, inconsistencies between studies makes comparisons difficult. There was considerable variability in the types of behaviours assessed in quantitative studies, and few studies examined potential compensatory mechanisms. Future research, using compensation specific study designs, methods, and analytic techniques, within different population sub-groups, should address these evidence gaps.
Topics: Adolescent; Adult; Fatigue; Humans; Motivation; Schools; Sedentary Behavior; Workplace
PubMed: 35279187
DOI: 10.1186/s12966-022-01264-6 -
Journal of Medical Internet Research Dec 2023Embodied conversational agents (ECAs) are advanced human-like interfaces that engage users in natural face-to-face conversations and interactions. These traits position... (Review)
Review
BACKGROUND
Embodied conversational agents (ECAs) are advanced human-like interfaces that engage users in natural face-to-face conversations and interactions. These traits position ECAs as innovative tools for delivering interventions for promoting health-related behavior adoption. This includes motivational interviewing (MI), a therapeutic approach that combines brief interventions with motivational techniques to encourage the adoption of healthier behaviors.
OBJECTIVE
This study aims to identify the health issues addressed by ECAs delivering MI interventions, explore the key characteristics of these ECAs (eg, appearance, dialogue mechanism, emotional model), analyze the implementation of MI principles and techniques within ECAs, and examine the evaluation methods and primary outcomes of studies that use ECAs providing MI interventions.
METHODS
We conducted a scoping review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) methodology. Our systematic search covered the PubMed, Scopus, IEEE Xplore, ACM Digital, and PsycINFO databases for papers published between January 2008 and December 2022. We included papers describing ECAs developed for delivering MI interventions targeting health-related behaviors and excluded articles that did not describe ECAs with human appearances and without the necessary evaluation or MI explanation. In a multistage process, 3 independent reviewers performed screening and data extraction, and the collected data were synthesized using a narrative approach.
RESULTS
The initial search identified 404 articles, of which 3.5% (n=14) were included in the review. ECAs primarily focused on reducing alcohol use (n=5, 36%), took on female representations (n=9, 64%), and gave limited consideration to user ethnicity (n=9, 64%). Most of them used rules-driven dialogue mechanisms (n=13, 93%), include emotional behavior to convey empathy (n=8, 57%) but without an automatic recognition of user emotions (n=12, 86%). Regarding MI implementation, of 14 studies, 3 (21%) covered all MI principles, 4 (29%) included all processes, and none covered all techniques. Most studies (8/14, 57%) conducted acceptability, usability, and user experience assessments, whereas a smaller proportion (4/14, 29%) used randomized controlled trials to evaluate behavior changes. Overall, the studies reported positive results regarding acceptability, usability, and user experience and showed promising outcomes in changes in attitudes, beliefs, motivation, and behavior.
CONCLUSIONS
This study revealed significant advancements in the use of ECAs for delivering MI interventions aimed at promoting healthier behaviors over the past 15 years. However, this review emphasizes the need for a more in-depth exploration of ECA characteristics. In addition, there is a need for the enhanced integration of MI principles, processes, and techniques into ECAs. Although acceptability and usability have received considerable attention, there is a compelling argument for placing a stronger emphasis on assessing changes in attitudes, beliefs, motivation, and behavior. Consequently, inclusion of more randomized controlled trials is essential for comprehensive intervention evaluations.
Topics: Humans; Female; Motivational Interviewing; Health Behavior; Communication; Motivation; Emotions
PubMed: 38064707
DOI: 10.2196/52097