1,881 research outputs found
Emotional Eating, Nutritional Knowledge, and Socioeconomic Status as Predictors of Body Mass Index
Obesity is an ill-health condition that can lead to other ill-health conditions such as cardiovascular disease, high blood pressure, asthma, type 2 diabetes, and some types of cancer. Obesity is also a condition that does not discriminate regarding age, gender, or race/ethnicity. In light of obesity’s status as a global epidemic, efforts for prevention and intervention treatments are needed to improve individuals’ health and quality of life. The purpose of this quantitative study was to examine emotional eating, nutritional knowledge, and socioeconomic status, as predictors of body mass index (BMI). These factors were examined through the lens of general strain theory. A survey design was used to collect data from 76 participants. Emotional eating scores were obtained from the Emotional Appetite Questionnaire, and nutritional knowledge scores were obtained from the General Nutrition Knowledge Questionnaire-Revised. Simple regression and multiple regression analyses showed no significant relationship between predictor variables and BMI. The positive social change implications of the study results will be clearer with further research examining these variables in greater detail. As each variable may impact differently upon different demographics of the population, more detailed research would help better identify the best ways to address these variables whether independently or collectively
Schizophrenia – time to commit to policy change
Schizophrenia is recognised as one of the most complex and profound mental health conditions, steeped in both myth and reality. Efforts needs to be multifaceted, including policy development, treatment guidance and scientific innovation, with all stakeholders working together to ensure meaningful progress. This report delves into the unique needs of people with schizophrenia, exploring supportive measures for their well-being, practical and attainable recommendations for change. The message to all nations, policy makers, payers and healthcare professionals is clear: strive for excellence, but most importantly – start somewhere
Sociodemographic and clinical predictors of adherence to antidepressants in depressive disorders: a systematic review with a meta-analysis
Introduction: Current evidence reveals concerning rates of non-adherence to antidepressant treatment, possibly influenced by various relevant determinants such as sociodemographic factors or those related to the health system and their professionals. The aim of this paper is to review the scientific evidence on sociodemographic and clinical predictors of adherence to pharmacological treatment in patients diagnosed with a depressive disorder.Methods: a systematic review (SR) was conducted. The search for a previous SR was updated and de novo searches were performed in Medline, EMBASE, Web of Science (WoS) and PsycInfo (last 10 years). The risk of bias was assessed using the Cochrane tool for non-randomized studies—of Exposure (ROBINS-E). Meta-analyses were conducted.Results: Thirty-nine studies (n = 2,778,313) were included, 24 of them in the meta-analyses. In the initiation phase, no association of adherence was found with any of the predictors studied. In the implementation and discontinuation phases, middle-aged and older patients had better adherence rates and lower discontinuation rates than younger ones. White patients adhered to treatment better than African-American patients.Discussion: Age and ethnicity are presented as the predictive factors of pharmacological adherence. However, more research is needed in this field to obtain more conclusive results on other possible factors.Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023414059], identifier [CRD42023414059
Determinants of embryonic and foetal growth
The main aims of this thesis were:1. To investigate whether there are associations between determinants related to the living environment (in particular neighbourhood deprivation and air pollution) and embryonic growth, foetal growth and pregnancy outcomes;2. To assess the associations between maternal cardiometabolic determinants in pregnancy (lipid status and the presence of hypertensive disorders of pregnancy)and embryonic growth, foetal growth and childhood outcomes;3. To investigate the impact of neighbourhood deprivation on the effectiveness ofthe mHealth “Smarter Pregnancy” program, aimed at improving nutrition and lifestyle behaviours;<br/
A systematic review of gerontechnologies to support aging in place among community-dwelling older adults and their family caregivers
ObjectivePaucity of information concerning the efficacy of gerontechnologies to support aging in place among community-dwelling older adults prevents potential users, healthcare professionals, and policymakers from making informed decisions on their use. The goal of this study was to identify gerontechnologies tested for home support in dyads of community-dwelling older adults with unimpaired cognition and their family caregivers, including their benefits and challenges. We also provide the level of evidence of the studies and recommendations to address the specific challenges preventing their use, dissemination, and implementation.MethodsWe conducted a systematic review of the literature published between 2016 and 2021 on gerontechnologies tested for home support in dyads. Two independent reviewers screened the abstracts according to the inclusion/exclusion criteria. A third reviewer resolved eligibility discrepancies. Data extraction was conducted by two independent reviewers.ResultsOf 1,441 articles screened, only 13 studies met the inclusion criteria with studies of moderate quality. Mostly, these gerontechnologies were used to monitor the older adult or the environment, to increase communication with family caregivers, to assist in daily living activities, and to provide health information. Benefits included facilitating communication, increasing safety, and reducing stress. Common challenges included difficulties using the technologies, technical problems, privacy issues, increased stress and dissatisfaction, and a mismatch between values and needs.ConclusionOnly a few gerontechnologies have proven efficacy in supporting community-dwelling older adults and their family caregivers. The inclusion of values and preferences, co-creation with end users, designing easy-to-use technologies, and assuring training are strongly recommended to increase acceptability and dissemination.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=310803, identifier CRD42022310803
Current trends in psychotherapies and psychosocial interventions for people with dementia: a scoping review of randomized controlled trials
An outcome of dementia is a progressive decline in cognitive function. Implementing psychotherapies and psychosocial interventions is crucial for bolstering cognitive abilities, promoting independence, and elevating the quality of life for individuals with dementia. This review aims to identify current trends in psychotherapies and psychosocial interventions for people with dementia. A Scoping review was developed based on the framework proposed by Arksey and O’Malley. The literature search was conducted on electronic databases, including Scopus, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, Nursing & Allied Health Collection, and MedicLatina. Executed in June 2023, the search focused on articles published in English, Portuguese, and Spanish between 2013 and 2023. Through this search, 1409 articles were initially identified. After selecting and analyzing the reports, sixteen trials were included in this review. Eight distinct categories were identified, covering different strategies. These categories run from computerized game-based cognitive training and reminiscence therapy to compensatory and restorative strategies, memory and attention training, calculation training, dual-task training, counseling, and personalized goal attainment. The findings of this scoping review highlight the diverse landscape of psychotherapies and psychosocial interventions for people with dementia
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Mobilizing pilot-based evidence for the spread and sustainability of innovations in healthcare: The role of innovation intermediaries
An endemic challenge facing healthcare systems around the world is how to spread innovation more widely and sustainably. A common response to this challenge involves conducting pilot implementation studies to generate evidence of the innovation's benefits. However, despite the key role that such studies play in the local adoption of innovation, their contribution to the wider spread and sustainability of innovation is relatively under-researched and under-theorized. In this paper we examine this contribution through an empirical examination of the experiences of an innovation intermediary organization in the English NHS (National Health Service). We find that their work in mobilizing pilot-based evidence involves three main strands; configuring to context; transitioning evidence; and managing the transition. Through this analysis we contribute to theory by showing how the agency afforded by intermediary roles can support the effective transitioning of pilot-based evidence across different phases in the innovation journey, and across different occupational groups, and can thus help to create a positive feedback loop from localized early implementers of an innovation to later more widespread adoption and sustainability. Based on these findings, we develop insights on the reasons for the unnecessary repetition of pilots – so-called ‘pilotitis’- and offer policy recommendations on how to enhance the role of pilots in the wider spread and sustainability of innovation
Digital psychosocial interventions for individuals with spinal cord injury: a scoping review
ObjectiveTo provide an overview of the digital mental health care landscape for individuals with spinal cord injury (SCI).MethodsPubMed, PsycInfo, and PSYNDEX were searched for articles meeting the following criteria: (1) article written in English or German; (2) digital psychosocial intervention; (3) SCI only; (4) treatment of individuals with SCI and not their relatives or caregivers. Records were screened by title and abstract and records meeting the inclusion criteria were obtained for full text screening. The references of identified articles were screened to find further relevant articles. The literature search was updated before submission. Risk of Bias was assessed by using the Cochrane risk-of-bias tool for randomized trials (RoB 2) and a narrative synthesis was conducted.ResultsTen randomized-controlled trials (RCT) and ten non-randomized-controlled trials were identified and compared in this review, evaluating twelve internet- and mobile-based interventions, five smartphone apps, and three virtual reality applications. The interventions were primarily used as stand-alone aftercare programs. While some were not based on any theory, cognitive behavioral therapy mostly served as the theoretical basis for the online interventions. The extent of human support also varied greatly between the studies. The number of intervention modules ranged between 2 and 72. There were also major differences in outcome variables and effects. A meta-analytical evaluation of the data was not conducted due to heterogeneity of studies.ConclusionDigital applications to promote the psychosocial health of individuals with SCI are an emerging field of research with many treatment approaches still to come. First high quality RCT studies report promising results. Unfortunately, not all studies are of high quality or the interventions have been insufficiently adapted to the needs of people with SCI. Therefore, more research is needed to further develop applications, and to generalize and test the effects found in the long term
Strategies to prevent Type 2 Diabetes in the postnatal period, in women with history of Gestational Diabetes Exploring different research methodologies based on dietary and pharmacological interventions
Aim and objectives The aim of this thesis is to investigate methods to prevent the progression to type 2 diabetes in the immediate postnatal period, in women diagnosed with gestational diabetes mellitus (GDM). The objectives of this thesis are to explore the views of pregnant women diagnosed with gestational diabetes and healthcare professionals, with regards to the use of an app in the postnatal period which will provide information about diet for type 2 diabetes prevention. The development of a protocol for a single-arm feasibility study on a Mediterranean-style diet for the prevention of type 2 diabetes in the postnatal period. To pilot the trial design and study processes and assess the feasibility of a large-scale trial on the effectiveness of a Mediterranean-style diet in postnatal period for type 2 diabetes prevention. To examine the acceptability of a Mediterranean-style diet for type 2 diabetes prevention in women taking part in a feasibility study and explore the opinions of women and healthcare professionals on trial processes. To develop a protocol for a pilot trial on metformin for the prevention of type 2 diabetes in the postnatal period. Pilot the trial design and study processes and assess the feasibility of a large-scale trial on the effectiveness of metformin in postnatal period for type 2 diabetes prevention. Methods The methods employed in this thesis include a cross-sectional survey, a single arm mixed method feasibility study with qualitative evaluation (which included the use of an app) and a mixed method randomised controlled double blind feasibility study with the use of metformin or placebo. Results Survey The survey demonstrated that app usage is part of everyday life, with 84% (85/101) of pregnant GDM women and 82% (71/87) of healthcare professionals using apps daily. All pregnant women who participated in this survey had a device by which they could access apps (100%, 101/101) and 95% (179/188) of the participants had a smartphone. The participants agreed that an app which provides dietary information in the postnatal period for diabetes prevention would be welcomed by postnatal women with GDM history. Single arm feasibility study on a Mediterranean-style diet for the prevention of T2D in the postnatal period (MERIT) A total of 69% (83/121) of eligible multi-ethnic women agreed to participate and 67% (56/83) of those initially recruited commenced the intervention. The last visit (12 months postnatally) was completed by 73.2% (41/56) of participants. A higher number of participants completed visit 2 (which is at 6 months postnatally) 80.4% (45/56), but this visit was completed remotely due to COVID-19 pandemic lockdown restrictions, whereas visit 3 was completed face-to-face. Participants had high engagement with the coach, both face-to-face and via phone-calls or text messages. Adherence based on the ESTEEM diet questionnaire was high at the end of the study. There was a trend of reduction of total dysglycaemia, and the participants weight was also reduced by 1.3kg, from visit 1 (6 to 13 weeks) to visit 3 (12 months postnatally). Clinical effectiveness discussion is exploratory due to the small sample size. The intervention and trial processes were acceptable to women and healthcare professionals, adherence was high when women had a supportive environment, provided by their family and the health coach. The group chat function was not successful in this study. Randomised double-blind placebo-controlled pilot trial on metformin for the prevention of T2D in the postnatal period (OMAhA) A total of 57.9% (175/302) of eligible multi-ethnic women agreed to take part in the study, out of those 82.3% (144/175) were randomised to receive metformin or placebo. The attendance rates for visits 2 (6 months) and 3 (12 months) were similar, with 54.6% (71/130) and 55.7 (64/115) attending each visit respectively. Due to the COVID-19 pandemic visit 3 was completed over the phone for 21.7% (39/115) of the participants which led to limited blood samples collection. Total dysglycaemia reduction was evident in the metformin group (18.3%) compared to the placebo group (24.7%) but this discussion is exploratory, and the study is not powered to measure effectiveness. The metformin group maintained their weight throughout the study, whereas the placebo group gained 400g. Adherence was 54.1% (participants who took at least 75% of the recommended dosage). The study was acceptable to both women and healthcare professionals, but the element of peer-support should be included in future studies. Conclusion It is feasible and acceptable to recruit women in the postnatal period in studies that are focused on diabetes prevention and introduce dietary or pharmacological interventions. The MERIT protocol will have to be revised to address how follow-up rates can be improved. The OMAhA protocol will also be revised to target improvement in adherence and follow-up rates. The COVID-19 pandemic lockdown restrictions and staffing issues have impacted data collection of both studies. More research is needed in this population with larger sample sizes to be able to prove efficacy. The strongest motivator that affects adherence and retention is the woman’s perception of her own risk of developing diabetes. Future studies should include the element of peer support and an education session about the risk of Type 2 Diabetes in postnatal period
Determinants of embryonic and foetal growth
The main aims of this thesis were:1. To investigate whether there are associations between determinants related to the living environment (in particular neighbourhood deprivation and air pollution) and embryonic growth, foetal growth and pregnancy outcomes;2. To assess the associations between maternal cardiometabolic determinants in pregnancy (lipid status and the presence of hypertensive disorders of pregnancy)and embryonic growth, foetal growth and childhood outcomes;3. To investigate the impact of neighbourhood deprivation on the effectiveness ofthe mHealth “Smarter Pregnancy” program, aimed at improving nutrition and lifestyle behaviours;<br/
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