Attitudes of mothers and health care providers towards behavioural interventions promoting breastfeeding uptake: A systematic review of qualitative and mixed-method studies

PURPOSE: Recommendations for exclusive breastfeeding are not often adhered to despite the robust evidence of its benefits. This systematic review aims to collate evidence on the attitudes mothers and health care providers have towards breastfeeding interventions to understand what aspects best contribute to acceptability and feasibility. METHODS: This review further investigates the value of identifiable behaviour change techniques (BCTs) to uncover which components of an intervention are perceived to be most useful and acceptable. The main biomedical databases were searched, and 17 (n = 17) studies met the inclusion criteria. RESULTS: A total of nine BCTs were identified within the interventions. The thematic analysis produced four main domains: usefulness, accessibility, value and sustainability. Women discussed the importance of the support they received in these interventions and demonstrated a positive view towards three BCTs: 'social support (unspecified)', 'instruction on how to perform behaviour' and 'demonstration of behaviour'. Additionally, women highlighted the benefit of personal, non-clinical and flexible emotional and practical support from peers, lactation consultants and support groups. Health care providers echoed these opinions and specifically highlighted the usefulness of interventions that allowed for continuity of care and more personal breastfeeding support. CONCLUSIONS: These findings suggest that ongoing practical as well as emotional support is crucial for standard in-hospital support to succeed at increasing breastfeeding rates. Future research would need to better understand the nuances of the interventions among women and providers to enhance their implementation

Risk prediction models for melanoma: a systematic review.

Melanoma incidence is increasing rapidly worldwide among white-skinned populations. Earlier diagnosis is the principal factor that can improve prognosis. Defining high-risk populations using risk prediction models may help targeted screening and early detection approaches. In this systematic review, we searched Medline, EMBASE, and the Cochrane Library for primary research studies reporting or validating models to predict risk of developing cutaneous melanoma. A total of 4,141 articles were identified from the literature search and six through citation searching. Twenty-five risk models were included. Between them, the models considered 144 possible risk factors, including 18 measures of number of nevi and 26 of sun/UV exposure. Those most frequently included in final risk models were number of nevi, presence of freckles, history of sunburn, hair color, and skin color. Despite the different factors included and different cutoff values for sensitivity and specificity, almost all models yielded sensitivities and specificities that fit along a summary ROC with area under the ROC (AUROC) of 0.755, suggesting that most models had similar discrimination. Only two models have been validated in separate populations and both also showed good discrimination with AUROC values of 0.79 (0.70-0.86) and 0.70 (0.64-0.77). Further research should focus on validating existing models rather than developing new ones.This report is independent research arising from a Clinician Scientist award supported by the National Institute for Health Research (RG 68235) and J Usher-Smith is funded by a National Institute for Health Research Clinical LectureshipThis is the author accepted manuscript. The advanced access published version can be found on the publisher's website at: http://cebp.aacrjournals.org/content/early/2014/06/03/1055-9965.EPI-14-0295.abstrac

Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis

Background This systematic review examined the evidence on effectiveness and acceptability of cognitive behavioral therapy (CBT) interventions in improving quality of life (QoL) and psychological well-being of unaccompanied minors (UM). Methods PubMed, Scopus, Embase, ProQuest, PsycInfo, PsycArticles, and Open Dissertations databases were used to identify quantitative and qualitative studies. The Effective Public Health Practice Project (EPHPP) and Critical Appraisal Skills Programme (CASP) tools were used for quality assessment. Narrative synthesis and qualitative research synthesis were carried out to collate the findings. Results 18 studies were included. Two studies examined QoL, and five studies examined acceptability of interventions. Most quantitative studies (n = 10) were appraised as methodologically weak. Trauma-Focused CBT appears to have the most evidence demonstrating effectiveness in ameliorating symptoms of post-traumatic stress disorder, depression, and anxiety. Promising findings (i.e., increased mindfulness and psychological flexibility) were observed for third wave interventions but further replication is required. Conclusions The literature is tainted by under-powered studies, lacking blinding, and follow-up assessments. Female UM remain largely underrepresented. This review calls for a drastic augmentation of high quality quantitative and qualitative research focusing on augmenting QoL and examining acceptability rather than merely aiming for psychological symptom reduction in UM to enhance overall well-being and functionality. The research protocol was registered in PROSPERO (registration number: CRD42021293881)

Working as a Healthcare Professional and Wellbeing During the COVID-19 Pandemic: Work Recovery Experiences and Need for Recovery as Mediators

Considering the high impact strain that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has put on medical personnel worldwide, identifying means to alleviate stress on healthcare professionals and to boost their subjective and psychological wellbeing is more relevant than ever. This study investigates the extent to which the relationships between the status of working in healthcare and the subjective and psychological wellbeing are serially mediated by work recovery experiences and the need for recovery. Data were collected from 217 Romanian employees (44 health professionals and 173 employees from other domains) using a cross-sectional design with self-report instruments, during the first stage of the nationwide lockdown. The results of the serial mediation analyses revealed that working in the medical field is indirectly related to subjective and psychological wellbeing through the following: (i) mastery experiences and (ii) mastery experiences as an antecedent of the need for recovery. As such, our findings indicate that (i) working in the medical field is, in fact, linked to healthcare professionals' subjective and psychological wellbeing, and they provide some input on (ii) how recovery experiences and the need for recovery intervene in these relationships. Based on these findings, theoretical, methodological, and practical implications were suggested, and future research directions were proposed to maximize healthcare professionals' wellbeing

Psychological impact of covid-19: moderated-mediation effect of social support and of psychologiccal flexibility

Com o aparecimento da COVID-19 as pessoas tiveram que lidar e se adaptar à nova realidade tal como aos seus impactos a nível psicológico, em particular o stress. O suporte social percebido e a flexibilidade psicológica são componentes que podem influenciar positivamente o stress provocado pelo contexto da pandemia. Esta investigação foi realizada com uma subamostra portuguesa do estudo COVID-IMPACT (Gloster et al., 2020). Recorreu-se a um Questionário sociodemográfico, e às medidas Inventário Breve de Saúde Mental, Escala de Stress Percebido, Escala de Suporte Social de Oslo e Medida de Flexibilidade Psicológica (Psyflex). Os resultados indicam que o stress percebido se relaciona com a saúde mental, e o suporte social percebido e a flexibilidade psicológica apresentam uma boa capacidade preditiva sobre o mesmo. O suporte social percebido modera a relação entre stress percebido e saúde mental, e a flexibilidade psicológica medeia a relação entre stress percebido e saúde mental. A realização deste estudo permitiu aprofundar o conhecimento do contexto pandémico, assim como a relação existente entre as variáveis saúde mental, stress percebido, suporte social percebido e flexibilidade psicológica, e do efeito moderador do suporte social percebido e mediador da flexibilidade psicológica, na relação entre o stress percebido e a saúde mental. Estes resultados podem ser úteis para o aumento e enriquecimento da literatura da temática COVID-19, da associação das variáveis em estudo e do conhecimento científico.With the appearance of COVID-19 people had to deal with and adapt to the new reality as well as its psychological impacts, in particular stress. Perceived social support and psychological flexibility are components that can positively influence the stress caused by the context of the pandemic. This investigation was carried out with a portuguese sub-sample of the Impact of COVID19 study (Gloster et al., 2020).A sociodemographic questionnaire was used, and the measures Mental Health Continuum-Short Form, Perceived Stress Scale, Oslo Social Support Scale and Measure of Psychological Flexibility (Psyflex). The results indicate that perceived stress is related to mental health, and perceived social support and psychological flexibility have a good predictive capacity for it. Perceived social support moderates the relationship between perceived stress and mental health, With the appearance of COVID-19 people had to deal with and adapt to the new reality as well as its psychological impacts, in particular stress. Perceived social support and psychological flexibility are components that can positively influence the stress caused by the context of the pandemic. This investigation was carried out with a portuguese sub-sample of the Impact of COVID19 study (Gloster et al., 2020).A sociodemographic questionnaire was used, and the measures Mental Health Continuum-Short Form, Perceived Stress Scale, Oslo Social Support Scale and Measure of Psychological Flexibility (Psyflex). The results indicate that perceived stress is related to mental health, and perceived social support and psychological flexibility have a good predictive capacity for it. Perceived social support moderates the relationship between perceived stress and mental health, With the appearance of COVID-19 people had to deal with and adapt to the new reality as well as its psychological impacts, in particular stress. Perceived social support and psychological flexibility are components that can positively influence the stress caused by the context of the pandemic. This investigation was carried out with a portuguese sub-sample of the Impact of COVID19 study (Gloster et al., 2020).A sociodemographic questionnaire was used, and the measures Mental Health Continuum-Short Form, Perceived Stress Scale, Oslo Social Support Scale and Measure of Psychological Flexibility (Psyflex). The results indicate that perceived stress is related to mental health, and perceived social support and psychological flexibility have a good predictive capacity for it. Perceived social support moderates the relationship between perceived stress and mental health, and psychological flexibility mediates the relationship between perceived stress and mental health. The realization of this study allowed to deepen our knowledge of the pandemic context, as well as the relationship between the variable mental health, perceived stress, perceived social support and psychological flexibility, and the moderating effect of perceived social support and mediator of psychological flexibility, in the relationship between perceived stress and mental health. These results may be useful for increasing and enriching the literature on the COVID-19 theme, the association of variables under study and scientific knowledge.info:eu-repo/semantics/publishedVersio

A Protocol of a Pilot Experimental Study Using Social Network Interventions to Examine the Social Contagion of Attitudes Towards Childhood Vaccination in Parental Social Networks

Increasing vaccination hesitancy that burdens global health and safety can be attributed to multiple reasons. Individuals’ social environment seems to be the catalyst for vaccination hesitancy perpetuation, thus it is important to examine the influence of different social network mechanisms in vaccination attitudes’ contagion. The proposed pilot experiment will examine the social contagion of childhood vaccination attitudes within a parental community using social network interventions. By identifying centrally-located people or groups of like-minded individuals from a parents’ community, we will examine whether the position of a person within a social group can have a greater impact in spreading positive vaccination messages to other community members. Parents will be recruited from social media and will be randomly assigned into three groups. Firstly, each group will participate in an online game to map their social networks and identify members with certain network position, who will then receive a short training about valid vaccination information provisions. All groups’ members will participate in daily vaccination discussion groups for one week, where the selected members will spread positive vaccination attitudes to others. We hypothesize that centrally located individuals and like-minded group of people will more likely cause a change on the childhood-vaccination attitudes and will sustain a long-term change at 3 months follow-up, compared to randomly located people

Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution

Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors. Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors. Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context. Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution

Delphi survey on the most promising areas and methods to improve systematic reviews' production and updating

Background: Systematic reviews (SRs) are invaluable evidence syntheses, widely used in biomedicine and other scientific areas. Tremendous resources are being spent on the production and updating of SRs. There is a continuous need to automatize the process and use the workforce and resources to make it faster and more efficient.Methods: Information gathered by previous EVBRES research was used to construct a questionnaire for round 1 which was partly quantitative, partly qualitative. Fifty five experienced SR authors were invited to participate in a Del‑ phi study (DS) designed to identify the most promising areas and methods to improve the efficient production and updating of SRs. Topic questions focused on which areas of SRs are most time/effort/resource intensive and should be prioritized in further research. Data were analysed using NVivo 12 plus, Microsoft Excel 2013 and SPSS. Thematic analysis findings were used on the topics on which agreement was not reached in round 1 in order to prepare the questionnaire for round 2.Results: Sixty percent (33/55) of the invited participants completed round 1; 44% (24/55) completed round 2. Participants reported average of 13.3 years of experience in conducting SRs (SD 6.8). More than two thirds of the respondents agreed/strongly agreed the following topics should be prioritized: extracting data, literature searching, screen‑ ing abstracts, obtaining and screening full texts, updating SRs, finding previous SRs, translating non-English studies, synthesizing data, project management, writing the protocol, constructing the search strategy and critically appraising. Participants have not considered following areas as priority: snowballing, GRADE-ing, writing SR, deduplication, formulating SR question, performing meta-analysis.Conclusions: Data extraction was prioritized by the majority of participants as an area that needs more research/ methods development. Quality of available language translating tools has dramatically increased over the years (Google translate, DeepL). The promising new tool for snowballing emerged (Citation Chaser). Automation cannot substitute human judgement where complex decisions are needed (GRADE-ing). Trial registration Study protocol was registered at https://osf.io/bp2hu/peer-reviewe

Behavioral, cognitive and emotional determinants of getting vaccinated for COVID-19 and the mediating role of institutional trust among young adults in Cyprus

Background: Vaccination uptake is a complex behavior, influenced by numerous factors. Behavioral science theories are commonly used to explain the psychosocial determinants of an individual’s health behavior. This study examined the behavioural, cognitive, and emotional determinants of COVID-19 vaccination intention based on well-established theoretical models: Acceptance and Commitment Therapy (ACT), Capability, Opportunity, Motivation, and Behaviour (COM-B) and the Health Belief Model (HBM). Additionally, it examined the mediating role of institutional trust in the relationship between determinants of these models and vaccination intentions. Methods: A cross-sectional study was conducted from January to May 2022, where university students in Cyprus completed an online survey. Results: A total of 484 university students completed the online survey, with 23.8% reporting being vaccinated with fewer than three vaccination doses and/or no intention to vaccinate further. Hierarchical logistic regression analysis showed that higher scores in institutional trust, perceived severity, motivation, physical and psychological capability were significantly associated with higher odds of intending to vaccinate. Higher psychological flexibility and not being infected with COVID-19 were also associated with higher odds of vaccination intention, but not in the final model when all determinants were included. Additionally, significant indirect effects of psychological and physical capability, motivation and perceived severity on vaccination intention were found to be mediated by institutional trust. Conclusions: When tackling COVID-19 vaccination hesitancy, behavioural, cognitive, and emotional aspects should be considered. Stakeholders and policymakers are advised to implement targeted vaccination programs in young people while at the same time building trust and improving their capabilities and motivation towards getting vaccinated