518 research outputs found
Effectiveness of Physical Activity in Primary Prevention of Anxiety: Systematic Review and Meta-Analysis of Randomized Controlled Trials
This study is supported by the Spanish Ministry of Health, Carlos III Institute of Health, and the European Regional Development Fund > (grant FIS references: PI15/00401; PI15/01021; PI15/01035) and the Andalusian Council of Health (grant reference: AP-00952016); as well as by the Prevention and Health Promotion Research Network `redIAPP' (RD12/0005 and RD16/0007).The aim of this study was to evaluate the effectiveness of physical activity in the primary prevention of anxiety. A systematic review of randomized controlled trials (RCTs) was performed. RCTs were searched in seven electronic databases. We included RCTs that assessed either the incidence of anxiety or the reduction of anxiety symptoms which excluded participants with baseline anxiety. Measurements were required to have been made using validated instruments. Objective or subjective (with validated questionnaires) verification of the performance of physical activity was required. Three reviewers carried out the search, selection, data extraction, and risk assessment of Cochrane Collaboration's tool simultaneously and independently, reaching an agreement in their discrepancies by consensus. In addition, a meta-analysis of fixed-effects model was carried out. Three RCTs met inclusion criteria, comprising 350 patients from 3 different countries. A meta-analysis was performed using five comparisons extracted from the selected studies, and the pooled standardized mean difference (SMD) was -0.18 (95% CI: -0.44; 0.07), p = 0.158. The heterogeneity was irrelevant, I-2 = 17.7% (p = 0.30). There is no evidence that anxiety can be prevented through physical activity, although the quality of evidence was very low.Instituto de Salud Carlos III
Spanish Government
Instituto de Salud Carlos IIIEuropean Regional Development Fund "Una manera de hacer Europa" PI15/00401
PI15/01021
PI15/01035Andalusian Council of Health AP-00952016Prevention and Health Promotion Research Network 'redIAPP' RD12/0005
RD16/000
Patients’ opinions about knowing their risk for depression and what to do about it: The PredictD-Qualitative study
Background: The predictD study developed and validated a risk algorithm for predicting the onset of major depression in
primary care. We aimed to explore the opinion of patients about knowing their risk for depression and the values and
criteria upon which these opinions are based.
Methods: A maximum variation sample of patients was taken, stratified by city, age, gender, immigrant status, socioeconomic status and lifetime depression. The study participants were 52 patients belonging to 13 urban health centres in
seven different cities around Spain. Seven Focus Groups (FGs) were given held with primary care patients, one for each of
the seven participating cities.
Results: The results showed that patients generally welcomed knowing their risk for depression. Furthermore, in light of
available evidence several patients proposed potential changes in their lifestyles to prevent depression. Patients generally
preferred to ask their General Practitioners (GPs) for advice, though mental health specialists were also mentioned. They
suggested that GPs undertake interventions tailored to each patient, from a ‘‘patient-centred’’ approach, with certain
communication skills, and giving advice to help patients cope with the knowledge that they are at risk of becoming
depressed.
Conclusions: Patients are pleased to be informed about their risk for depression. We detected certain beliefs, attitudes,
values, expectations and behaviour among the patients that were potentially useful for future primary prevention
programmes on depression.Junta de Andalucía 2008/0195Gobierno Vasco 2008/111021Spanish Network of Primary Care Research (redIAPP) RD06/0018Salud Mental, Servicios y Atención Primaria (SAMSERAP
Complex multiple risk intervention topromote healthy behaviours in peoplebetween 45 to 75 years attended inprimary health care (EIRA study): study protocol for a hybrid trial
Background:Health promotion is a key process of current health systems. Primary Health Care (PHC) is the idealsetting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority ofthe adult population engages two or more risk behaviours, that is why a multiple intervention might be moreeffective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness andan implementation strategy of a complex multiple risk intervention to promote healthy behaviours in peoplebetween 45 to 75 years attended in PHC.Methods:This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing acomplex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. Thestudy focuses on people between 45 and 75 years who carry out two or more of the following unhealthybehaviours: tobacco use, low adherence to the Mediterranean dietary pattern or insufficient physical activity level.The intervention is based on the Transtheoretical Model and it will be made by physicians and nurses in theroutine care of PHC practices according to the conceptual framework of the“5A’s”. It will have a maximum durationof 12 months and it will be carried out to three different levels (individual, group and community). Incremental costper quality-adjusted life year gained measured by the tariffs of the EuroQol-5D questionnaire will be estimated. Theimplementation strategy is based on the“Consolidated Framework for Implementation Research”, a set of discreteimplementation strategies and an evaluation framework.
Discussion:EIRA study will determine the effectiveness and cost-effectiveness of a complex multiple riskintervention and will provide a better understanding of implementation processes of health promotioninterventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriersthat affect implementation of these interventions and to quantify the contextual factors that moderate theeffectiveness of implementation
Effectiveness of online interventions in preventing depression: a protocol for systematic review and meta-analysis of randomised controlled trials
IntroductionAlthough evidence exists for the efficacy of psychosocial interventions in preventing depression, little is known about its prevention through online interventions. The objective of this study is to conduct a systematic review and meta-analysis of randomised controlled trials assessing the effectiveness of online interventions in preventing depression in heterogeneous populations.Methods and analysisWe will conduct a systematic review and meta-analysis of randomised controlled trials that will be identified through searches of PubMed, PsycINFO, WOS, Scopus, OpenGrey, Cochrane Central Register of Controlled Trials, ClinicalTrials. gov and Australia New Zealand Clinical Trials Register . We will also search the reference lists provided in relevant studies and reviews. Experts in the field will be contacted to obtain more references. Two independent reviewers will assess the eligibility criteria of all articles, extract data and determine their risk of bias (Cochrane Collaboration Tool). Baseline depression will be required to have been discarded through standardised interviews or validated self-reports with standard cut-off points. The outcomes will be the incidence of new cases of depression and/or the reduction of depressive symptoms as measured by validated instruments. Pooled standardised mean differences will be calculated using random-effect models. Heterogeneity and publication bias will be estimated. Predefined sensitivity and subgroup analyses will be performed. If heterogeneity is relevant, random-effect meta-regression will be performed
Use of a personalised depression intervention in primary care to prevent anxiety: a secondary study of a cluster randomised trial
Background
In the predictD-intervention, GPs used a
personalised biopsychosocial programme to
prevent depression. This reduced the incidence of
major depression by 21.0%, although the results
were not statistically significant.
Aim
To determine whether the predictD-intervention
is effective at preventing anxiety in primary care
patients without depression or anxiety.
Design and setting
Secondary study of a cluster randomised trial
with practices randomly assigned to either the
predictD-intervention or usual care. This study
was conducted in seven Spanish cities from
October 2010 to July 2012.
Method
In each city, 10 practices and two GPs per
practice, as well as four to six patients every
recruiting day, were randomly selected until there
were 26–27 eligible patients for each GP. The
endpoint was cumulative incidence of anxiety as
measured by the PRIME-MD screening tool over
18 months.
Results
A total of 3326 patients without depression and
140 GPs from 70 practices consented and were
eligible to participate; 328 of these patients were
removed because they had an anxiety syndrome
at baseline. Of the 2998 valid patients, 2597
(86.6%) were evaluated at the end of the study.
At 18 months, 10.4% (95% CI = 8.7% to 12.1%) of
the patients in the predictD-intervention group
developed anxiety compared with 13.1% (95%
CI = 11.4% to 14.8%) in the usual-care group
(absolute difference = –2.7% [95% CI = –5.1% to
–0.3%]; P = 0.029).
Conclusion
A personalised intervention delivered by GPs for
the prevention of depression provided a modest
but statistically significant reduction in the
incidence of anxiety
Reliability of a 13000-SHS photovoltaic rural electrification programme
In this paper, a reliability analysis of a photovoltaic rural electrification (PVRE) programme is proposed considering the failures in the 13 000 installed Solar Home System (SHS) devices occurring over a long operating period of 5 years. A previous arrangement of the database and a brief explanation of the reliability concepts will serve to introduce the failure distribution of every component, from which the SHS lifetime operating features will be described. An application example will show the usefulness of the obtained results in the forecasting of spare parts during the maintenance period. The conclusions of this study may be useful in the scientific design of PVRE programme maintenance structures, with the goal of shedding some light on the technical management mechanisms in decentralised rural electrification
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