Neurofeedback for attention-deficit/hyperactivity disorder: meta-Analysis of clinical and neuropsychological outcomes from randomized controlled trials

Objective:We performed meta-analyses of randomized controlled trials to examine the effects of neurofeedback on attention-deficit/hyperactivity disorder (ADHD) symptoms and neuropsychological deficits in children and adolescents with ADHD.Method:We searched PubMed, Ovid, Web of Science, ERIC, and CINAHAL through August 30, 2015. Random-effects models were employed. Studies were evaluated with the Cochrane Risk of Bias tool.Results:We included 13 trials (520 participants with ADHD). Significant effects were found on ADHD symptoms rated by assessors most proximal to the treatment setting, that is, the least blinded outcome measure (standardized mean difference [SMD]: ADHD total symptoms = 0.35, 95% CI = 0.11?0.59; inattention = 0.36, 95% CI = 0.09?0.63; hyperactivity/impulsivity = 0.26, 95% CI = 0.08?0.43). Effects were not significant when probably blinded ratings were the outcome or in trials with active/sham controls. Results were similar when only frequency band training trials, the most common neurofeedback approach, were analyzed separately. Effects on laboratory measures of inhibition (SMD = 0.30, 95% CI = ?0.10 to 0.70) and attention (SMD = 0.13, 95% CI = ?0.09 to 0.36) were not significant. Only 4 studies directly assessed whether learning occurred after neurofeedback training. The risk of bias was unclear for many Cochrane Risk of Bias domains in most studies.Conclusion:Evidence from well-controlled trials with probably blinded outcomes currently fails to support neurofeedback as an effective treatment for ADHD. Future efforts should focus on implementing standard neurofeedback protocols, ensuring learning, and optimizing clinically relevant transfer

Use of SMS texts for facilitating access to online alcohol interventions: a feasibility study

A41 Use of SMS texts for facilitating access to online alcohol interventions: a feasibility study In: Addiction Science & Clinical Practice 2017, 12(Suppl 1): A4

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The political economy of state-level adoption of natural resource damage programs

Political economy, Natural resource damage, State policy, K32, Q28, Q58,

Reconstructing Reefs: Qualitative Methods and the Environmental History of the Great Barrier Reef, Australia

Given recent concerns about the degradation of coral reef\ud ecosystems world-wide, we investigated the environmental history of the Great Barrier Reef of Australia using qualitative methods. In particular,we used archival and oral history sources to reconstruct changes in coral reefs, islands and marine wildlife species for the period 1860–1970 and we evaluated the potential of qualitative methods to inform marine environmental research. Here, we argue that qualitative research offers a valuable means of reconstructing environmental changes, their drivers and their historical contexts. However, we found that qualitative methods also had important limitations. Hence we identify strategies for addressing those challenges and we suggest criteria for ensuring the accuracy and rigor of qualitative sources in marine environmental research. Overall, we argue that qualitative methods offer distinctive\ud insights into the environmental history of the Great Barrier Reef, and that qualitative reconstructions can act as important triggers for conservation of marine ecosystems