49 research outputs found
The effects of supported employment interventions in populations of people with conditions other than severe mental health : a systematic review
To assess the effectiveness of supported employment interventions for improving competitive employment in populations of people with conditions other than only severe mental illness. Supported employment interventions have been extensively tested in severe mental illness populations. These approaches may be beneficial outside of these populations. We searched PubMed, Embase, CINAHL, PsycInfo, Web of Science, Scopus, JSTOR, PEDro, OTSeeker, and NIOSHTIC for trials including unemployed people with any condition and including severe mental illness if combined with other co-morbidities or other specific circumstances (e.g., homelessness). We excluded trials where inclusion was based on severe mental illness alone. Two reviewers independently assessed risk of bias (RoB v2.0) and four reviewers extracted data. We assessed rates of competitive employment as compared to traditional vocational rehabilitation or waiting list/services as usual. Ten randomised controlled trials (913 participants) were included. Supported employment was more effective than control interventions for improving competitive employment in seven trials: in people with affective disorders [risk ratio (RR) 10.61 (1.49, 75.38)]; mental disorders and justice involvement [RR 4.44 (1.36,14.46)]; veterans with posttraumatic stress disorder (PTSD) [RR 2.73 (1.64, 4.54)]; formerly incarcerated veterans [RR 2.17 (1.09, 4.33)]; people receiving methadone treatment [RR 11.5 (1.62, 81.8)]; veterans with spinal cord injury at 12 months [RR 2.46 (1.16, 5.22)] and at 24 months [RR 2.81 (1.98, 7.37)]; and young people not in employment, education, or training [RR 5.90 (1.91-18.19)]. Three trials did not show significant benefits from supported employment: populations of workers with musculoskeletal injuries [RR 1.38 (1.00, 1.89)]; substance abuse [RR 1.85 (0.65, 5.41)]; and formerly homeless people with mental illness [RR 1.55 (0.76, 3.15)]. Supported employment interventions may be beneficial to people from more diverse populations than those with severe mental illness alone. Defining competitive employment and increasing (and standardising) measurement of non-vocational outcomes may help to improve research in this area
Lecturers' use of Web 2.0 in the faculty of Information Science and communications at MZUZU University, Malawi
The study reported on in this article investigated the use of Web 2.0 technologies
by lecturers in the Faculty of Information Science and Communications at
Mzuzu University (MZUNI), Mzuzu, Malawi. By distributing a questionnaire to 19
lecturers, conducting follow-up interviews with seven lecturers and analysing the
curricula, the study showed that between 10 (58.8%) and 13 (76.5%) lecturers
use Wikipedia, YouTube, blogs, Google Apps and Twitter to accomplish various academic activities, such as handing out assignments to students; receiving
feedback from students; uploading lecture notes; searching for content; storing
lecture notes; and carrying out collaborative educational activities. The study
adopted the Decomposed Theory of Planned Behaviour (Taylor and Todd 1995)
and the theory's elements that strongly affected lecturers' use of the technologies
according to the results included attitude and perceived behaviour control. The
study also found that poor Internet access remains the key stumbling block
towards a successful adoption of Web 2.0 technologies by lecturers at MZUNI.
To this end, the study recommends that the newly established Department of
ICT Directorate with support from MZUNI management should install campuswide
Wi-Fi and improve Internet bandwidth so that lecturers' access to the
Internet is not limited to their offices but rather is available in the teaching rooms
across the campus.DHE
Impaired synaptic function is linked to cognition in Parkinson's disease
OBJECTIVE:
Cognitive impairment is frequent in Parkinson's disease, but the underlying mechanisms are insufficiently understood. Because cortical metabolism is reduced in Parkinson's disease and closely associated with cognitive impairment, and CSF amyloidâβ species are reduced and correlate with neuropsychological performance in Parkinson's disease, and amyloidâβ release to interstitial fluid may be related to synaptic activity; we hypothesize that synapse dysfunction links cortical hypometabolism, reduced CSF amyloidâβ, and presynaptic deposits of Îąâsynuclein. We expect a correlation between hypometabolism, CSF amyloidâβ, and the synapse relatedâmarkers CSF neurogranin and Îąâsynuclein.
METHODS:
Thirty patients with mildâtoâmoderate Parkinson's disease and 26 healthy controls underwent a clinical assessment, lumbar puncture, MRI, 18FâfludeoxyglucoseâPET, and a neuropsychological test battery (repeated for the patients after 2 years).
RESULTS:
All subjects had CSF amyloidâβ 1â42 within normal range. In Parkinson's disease, we found strong significant correlations between cortical glucose metabolism, CSF Aβ, Îąâsynuclein, and neurogranin. All PET CSF biomarkerâbased cortical clusters correlated strongly with cognitive parameters. CSF neurogranin levels were significantly lower in mildâtoâmoderate Parkinson's disease compared to controls, correlated with amyloidâβ and Îąâsynuclein, and with motor stage. There was little change in cognition after 2 years, but the cognitive tests that were significantly different, were also significantly associated with cortical metabolism. No such correlations were found in the control group.
INTERPRETATION:
CSF Aβ, Îąâsynuclein, and neurogranin concentrations are related to cortical metabolism and cognitive decline. Synaptic dysfunction due to Aβ and Îąâsynuclein dysmetabolism may be central in the evolution of cognitive impairment in Parkinson's disease
Global and regional estimates for COPD prevalence: Systematic review and meta-analysis
Background The burden of chronic obstructive pulmonary disease
(COPD) across many world regions is high. We aim to estimate COPD
prevalence and number of disease cases for the years 1990 and 2010
across world regions based on the best available evidence in publicly
accessible scientific databases.
Methods We conducted a systematic search of Medline, EMBASE and
Global Health for original, populationâbased studies providing spirometryâ
based prevalence rates of COPD across the world from January
1990 to December 2014. Random effects metaâanalysis was conducted
on extracted crude prevalence rates of COPD, with overall summaries
of the metaâestimates (and confidence intervals) reported separately for
World Health Organization (WHO) regions, the World Bank's income
categories and settings (urban and rural). We developed a metaâregression
epidemiological model that we used to estimate the prevalence of
COPD in people aged 30 years or more.
Findings Our search returned 37 472 publications. A total of 123 studies
based on a spirometryâdefined prevalence were retained for the review.
From the metaâregression epidemiological model, we estimated
about 227.3 million COPD cases in the year 1990 among people aged
30 years or more, corresponding to a global prevalence of 10.7% (95%
confidence interval (CI) 7.3%â14.0%) in this age group. The number
of COPD cases increased to 384 million in 2010, with a global prevalence
of 11.7% (8.4%â15.0%). This increase of 68.9% was mainly driven
by global demographic changes. Across WHO regions, the highest
prevalence was estimated in the Americas (13.3% in 1990 and 15.2%
in 2010), and the lowest in South East Asia (7.9% in 1990 and 9.7% in
2010). The percentage increase in COPD cases between 1990 and 2010
was the highest in the Eastern Mediterranean region (118.7%), followed
by the African region (102.1%), while the European region recorded the
lowest increase (22.5%). In 1990, we estimated about 120.9 million
COPD cases among urban dwellers (prevalence of 13.2%) and 106.3
million cases among rural dwellers (prevalence of 8.8%). In 2010, there
were more than 230 million COPD cases among urban dwellers (prevalence
of 13.6%) and 153.7 million among rural dwellers (prevalence
of 9.7%). The overall prevalence in men aged 30 years or more was
14.3% (95% CI 13.3%â15.3%) compared to 7.6% (95% CI 7.0%â
8.2%) in women.
Conclusions Our findings suggest a high and growing prevalence of
COPD, both globally and regionally. There is a paucity of studies in Africa,
South East Asia and the Eastern Mediterranean region. There is a
need for governments, policy makers and international organizations to
consider strengthening collaborations to address COPD globall
Alpha-synuclein measured in cerebrospinal fluid from patients with Alzheimerâs disease, mild cognitive impairment, or healthy controls: a two year follow-up study
Safety and Efficacy of Acceptance and Commitment Therapy (ACT) in Schizophrenia Spectrum and Other Psychotic Disorders: Protocol for a Systematic Review and Meta-Analysis
Acceptance and commitment therapy (ACT) has been reported to be effective in the treatment of some psychiatric disorders. It remains uncertain, however, whether ACT is safe and effective in treating schizophrenia spectrum and other psychotic disorders (e.g., psychosis). This protocol describes the methodology for a systematic review and meta-analysis of the safety and efficacy of ACT in the treatment of psychosis. The review will be guided by the standards set by the Cochrane Collaboration. We will search the Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medica database (EMBASE), EMCARE, Education Resources Information Center (ERIC), MEDLINE, and PsycINFO databases for randomized controlled trials, whose arms are ACT and any comparator, as well as ClinicalTrials.gov, Australian New Zealand Clinical Trials Registry (ANZCTR), and Current Controlled Trials (ISRCTN), for unpublished and ongoing trials. The primary outcome will be any standard (or surrogate) measure of psychotic pathology. The meta-analysis will summarize short-term and long-term effects and different control conditions with or without treatment as usual or comparative to other interventions. In cases where heterogeneity is detected (via χ2 and I2), we will adopt the random effects model for computation
Accuracy of PCA3 Measurement in Predicting Short-Term Biopsy Progression in an Active Surveillance Program
Ureterorenoscopy with stenting and its effect on male sexual function: A controlled randomised prospective study
Seventy-two male patients, who were included in this study, underwent ureteroscopic stone surgery (study group). Forty-two healthy males were enrolled as control group. Changes in sexual function were evaluated using International Index of Erectile Function questionnaire in pre-operative, first and third postoperative terms. Overall satisfaction in relation to the age, operation time, presence of stents, body mass index, educational status, previous operations, International Index of Erectile Function score, International Prostate Symptom Score, Quality of Life, income status, Male Sexual Health Questionnaire, stone-free rates and Beck's depression scale were evaluated. Erectile and ejaculatory functions, quality of life and lower urinary tract symptoms were negatively affected due to ureteroscopic stone surgery, while educational status, psychogenic aspect and income status remained stable. In conclusion, ureteroscopic stone surgery with JJ catheterisation seems to have a progressively decreasing negative effect on male sexual function and whenever possible, stenting should be avoided. If JJ stenting is necessary, patients should be informed that they may experience sexual dysfunction at least for 3 months and if stenting proves necessary the indwelling should be kept as short as possible