scholarly journals Psycho-oncology: a coming of age

1999 ◽  
Vol 23 (7) ◽  
pp. 431-435 ◽  
Author(s):  
Charles Montgomery
Keyword(s):  
World Wide ◽  
Coming Of Age ◽  
Psychiatric Morbidity ◽  
Survival Rates ◽  
Psychosocial Interventions ◽  
Conclusive Evidence ◽  
Controlled Trials ◽  
High Quality ◽  
Positive Effects ◽  
Research Findings

Every once in a while there is a mini renaissance in an area of medicine. The flowering of research that has taken place world-wide in the field of psycho-oncology in the last decade is one such example. This deepening interest in all the different psychological aspects of cancer, with the prevention of psychiatric morbidity and the development of a healthy adaptation being the main outcome aims, has led to hundreds of publications in recent years, along with the launching of two high-quality journals, the Journal of Psychosocial Oncology and the Journal of Psycho-Oncology. There have been numerous robust research findings proving the efficacy of psychosocial interventions in cancer patients on a range of outcome measures (Stein et al, 1993; Fawzy et al, 1995). The search for conclusive evidence of the positive effects of psychological therapy on disease progression and hence survival rates has also developed, becoming a holy grail for researchers in mind/body medicine, and has been brought tantalisingly within reach by a number of well-controlled trials (Spiegel et al, 1989; Richardson et al, 1990; Fawzy et al, 1993; Ratcliffe et al, 1995).

A systematic review of exercise and psychosocial rehabilitation interventions to improve health-related outcomes in patients with bladder cancer undergoing radical cystectomy

2017 ◽  
Vol 32 (5) ◽  
pp. 594-606 ◽  
Author(s):  
Elke Rammant ◽  
Karel Decaestecker ◽  
Renée Bultijnck ◽  
Nora Sundahl ◽  
Piet Ost ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Physical Fitness ◽  
Cancer Patients ◽  
Radical Cystectomy ◽  
Web Of Science ◽  
Psychosocial Rehabilitation ◽  
Psychosocial Interventions ◽  
Controlled Trials ◽  
Positive Effects ◽  
Health Related

Objective: Summarizing the evidence on the effects of pre- and postoperative exercise and psychosocial rehabilitation interventions on patient-reported outcomes (PROs) and physical fitness in bladder cancer patients undergoing radical cystectomy. Data sources: The Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Web of Science and the Physiotherapy Evidence Database were searched independently by two authors from inception until 10 November 2017. Cited references of the studies and citing references retrieved via Web of Science were also checked. Review methods: Randomized controlled trials (RCTs) and non-randomized studies assessing effects of exercise and psychosocial interventions in bladder cancer patients undergoing radical cystectomy were eligible. Primary outcome measures were PROs and physical fitness. Risk of bias was assessed using the Cochrane Collaboration tool and the Newcastle–Ottawa Scale. Results: Five RCTs (three exercise and two psychosocial studies) and one non-randomized psychosocial study comprising 317 bladder cancer patients were included. Timing of the intervention was preoperative ( n = 2), postoperative ( n = 2) or both pre- and postoperative ( n = 2). Positive effects of exercise were found for physical fitness ( n = 3), some health-related quality-of-life (HRQoL) domains ( n = 2), personal activities in daily living ( n = 1) and muscle strength ( n = 1). Psychosocial interventions showed positive effects on anxiety ( n = 1), fatigue ( n = 1), depression ( n = 1), HRQoL ( n = 1) and posttraumatic growth ( n = 1). Quality assessment showed most shortcomings with sample sizes and strong heterogeneity was observed between studies. Conclusion: The evidence relating to the effects of exercise in bladder cancer is very limited and is even less for psychosocial interventions.

The new generation of psychosocial interventions for dementia care

2012 ◽  
Vol 201 (5) ◽  
pp. 342-343 ◽  
Author(s):  
Martin Orrell
Keyword(s):  
Cost Effectiveness ◽  
Randomised Controlled Trials ◽  
Psychosocial Interventions ◽  
Dementia Care ◽  
Controlled Trials ◽  
High Quality ◽  
Randomised Controlled ◽  
New Generation

SummaryThe new generation of psychosocial interventions for dementia has been characterised by great improvements in methodology and high-quality randomised controlled trials, including cost-effectiveness analyses. There are a growing number of interventions with established effectiveness but despite this there can be difficulties with implementation in practice.

scholarly journals Psychosocial interventions to support the mental health of informal caregivers of persons living with dementia – a systematic literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Henrik Wiegelmann ◽  
Sarah Speller ◽  
Lisa-Marie Verhaert ◽  
Liane Schirra-Weirich ◽  
Karin Wolf-Ostermann
Keyword(s):  
Mental Health ◽  
Informal Caregivers ◽  
Psychosocial Interventions ◽  
Health Interventions ◽  
Subjective Burden ◽  
Dementia Caregivers ◽  
Targeted Interventions ◽  
Positive Effects ◽  
Increased Risk ◽  
Mental Health Interventions

Abstract Background Informal caregivers of persons living with dementia have an increased risk of adverse mental health effects. It is therefore important to systematically summarize published literature in order to find out which mental health interventions generate effective support for informal caregivers of persons living with dementia. The objective of this study is to conduct a systematic review of intervention content, effectiveness and subgroup differentiation of mental health interventions for informal caregivers of persons with dementia living at home. Method We searched four electronic databases (PubMed, PsychINFO, Scopus and CINAHL) and included only methodically high-quality randomized controlled trials (RCTs), published in English or German language between 2009 and 2018. The intervention programmes focused on mental health of family caregivers. A narrative synthesis of the included studies is given. Results Forty-eight publications relating to 46 intervention programmes met the inclusion criteria. Burden, depression and quality of life (QoL) are the predominant parameters that were investigated. Twenty-five of forty-six interventions (54.3%) show positive effects on at least one of the outcomes examined. Most often, positive effects are reported for the outcome subjective burden (46.2%). Only six studies explicitly target on a certain subgroup of informal dementia caregivers (13%), whereas all other interventions (87%) target the group as a whole without differentiation. Conclusion The most beneficial results were found for cognitive behavioural approaches, especially concerning the reduction of depressive symptoms. Besides this, leisure and physical activity interventions show some good results in reducing subjective caregiver burden. In order to improve effectiveness, research and practice may focus on developing more targeted interventions for special dementia informal caregiver subgroups.

scholarly journals Effects of Vitamin A Supplementation on Immune Responses and Correlation with Clinical Outcomes

2005 ◽  
Vol 18 (3) ◽  
pp. 446-464 ◽  
Author(s):  
Eduardo Villamor ◽  
Wafaie W. Fawzi
Keyword(s):  
Vitamin A ◽  
Clinical Outcomes ◽  
Age Groups ◽  
Lymphocyte Activation ◽  
The Elderly ◽  
Conclusive Evidence ◽  
Vitamin A Supplementation ◽  
Mortality And Morbidity ◽  
Severe Diarrhea ◽  
Positive Effects

SUMMARY Vitamin A supplementation to preschool children is known to decrease the risks of mortality and morbidity from some forms of diarrhea, measles, human immunodeficiency virus (HIV) infection, and malaria. These effects are likely to be the result of the actions of vitamin A on immunity. Some of the immunomodulatory mechanisms of vitamin A have been described in clinical trials and can be correlated with clinical outcomes of supplementation. The effects on morbidity from measles are related to enhanced antibody production and lymphocyte proliferation. Benefits for severe diarrhea could be attributable to the functions of vitamin A in sustaining the integrity of mucosal epithelia in the gut, whereas positive effects among HIV-infected children could also be related to increased T-cell lymphopoiesis. There is no conclusive evidence for a direct effect of vitamin A supplementation on cytokine production or lymphocyte activation. Under certain circumstances, vitamin A supplementation to infants has the potential to improve the antibody response to some vaccines, including tetanus and diphtheria toxoids and measles. There is limited research on the effects of vitamin A supplementation to adults and the elderly on their immune function; currently available data provide no consistent evidence for beneficial effects. Additional studies with these age groups are needed.

Effectiveness of Multimodal Training on Functional Capacity in Frail Older People: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 26 (3) ◽  
pp. 407-418 ◽  
Author(s):  
Pedro Lopez ◽  
Mikel Izquierdo ◽  
Regis Radaelli ◽  
Graciele Sbruzzi ◽  
Rafael Grazioli ◽  
...  
Keyword(s):  
Older People ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Maximum Strength ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Frail Older People ◽  
Timed Up And Go ◽  
Positive Effects ◽  
Multimodal Training

In this meta-analysis, we investigated the effect of resistance training (RT) alone or included in a multimodal training on physical frailty outcomes, and whether different variables of RT prescription affect these outcomes. We identified 15 relevant studies searching through MEDLINE, Cochrane Central Register of Controlled Trials, SPORTDiscus, and PEDro database. Postintervention standardized mean difference scores were computed and combined using fixed effects meta-analysis. Analyses have shown positive effects of interventions on maximum strength, gait speed, and Timed Up and Go test. Further analyses have shown significant greater effect of shorter periods on maximum strength. Regarding RT prescription, percentage of one-repetition maximum showed significant effect on physical variables, whereas RT based on rate of perceived effort presented lower effect in the Timed Up and Go test. Although multimodal training is an effective intervention to increase physical capacity, caution should be taken regarding the period and the method to control RT intensity to optimize enhancements in frail older people.

A systematic review of randomised controlled trials of psychosocial interventions for acute mental health inpatients

2021 ◽  
Vol 10 (3) ◽  
pp. 1-17
Author(s):  
Laura D Wainwright ◽  
Gillian Haddock ◽  
Charlotte Dunster-Page ◽  
Katherine Berry
Keyword(s):  
Quality Of Life ◽  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Social Care ◽  
Psychosocial Interventions ◽  
Controlled Trials ◽  
Patient Functioning ◽  
Electronic Search ◽  
Randomised Controlled

Background/Aims Inpatient wards provide an opportunity to intervene with medical, psychological and social care to contain distress and prevent future relapse. However, they have been criticised for an over-reliance on medication and risk management with limited psychosocial interventions. The aim of this study was to investigate clinical trials of psychosocial interventions for inpatients to identify interventions that are effective at improving quality of life, symptoms or patient functioning. Methods An electronic search of six databases was conducted for papers published from 1806 up until February 2017. A total of 18 randomised controlled trials was identified in which outcomes for symptoms, quality of life or functioning were reported. Results Overall, 15 trials showed a statistically significant result for at least one outcome. Seven categories were identified from the 18 studies, at least one in each category was found to be effective for symptoms, quality of life or functioning. The majority were effective (15 out of 18). Conclusions Given that the methodological quality was generally low and number of randomised controlled trials were small, it is difficult to draw definitive conclusions. Recommendations include more and repeated trials using rigorous methods of testing and reporting.

scholarly journals Neuroprognostication of Cardiac Arrest Patients: Outcomes of Importance

2017 ◽  
Vol 38 (06) ◽  
pp. 775-784
Author(s):  
Tobias Cronberg
Keyword(s):  
Cardiac Arrest ◽  
Vegetative State ◽  
Survival Rates ◽  
High Quality ◽  
Cognitive Difficulties ◽  
Cardiac Arrest Survivor ◽  
Chain Of Survival ◽  
Quality Decision ◽  
Improved Methods

AbstractDuring the last two decades, survival rates after cardiac arrest have increased while the fraction of patients surviving with a severe neurological disability or vegetative state has decreased in many countries. While improved survival is due to improvements in the whole “chain of survival,” improved methods for prognostication of neurological outcome may be of major importance for the lower disability rates. Patients who are resuscitated and treated in intensive care will die mainly from the withdrawal of life-sustaining (WLST) therapy due to presumed poor chances of meaningful neurological recovery. To ensure high-quality decision-making and to reduce the risk of premature withdrawal of care, implementation of local protocols is crucial and should be guided by international recommendations. Despite rigorous neurological prognostication, cognitive impairment and related psychological distress and reduced participation in society will still be relevant concerns for cardiac arrest survivors. The commonly used outcome measures are not designed to provide information on these domains. Follow-up of the cardiac arrest survivor needs to consider the cardiovascular burden as an important factor to prevent cognitive difficulties and future decline.

scholarly journals TRADE-OFFS BETWEEN EPISTEMIC AND MORAL VALUES IN EVIDENCE-BASED POLICY

2018 ◽  
Vol 35 (1) ◽  
pp. 49-78 ◽  
Author(s):  
Donal Khosrowi
Keyword(s):  
Controlled Trials ◽  
Evidence Based ◽  
Epistemic Values ◽  
High Quality ◽  
Political Values ◽  
Randomized Controlled ◽  
High Quality Evidence ◽  
Evidence Based Policy ◽  
Trade Offs ◽  
Quality Evidence

Abstract:Proponents of evidence-based policy (EBP) call for public policy to be informed by high-quality evidence from randomized controlled trials. This methodological preference aims to promote several epistemic values, e.g. rigour, unbiasedness, precision, and the ability to obtain causal conclusions. I argue that there is a trade-off between these epistemic values and several non-epistemic, moral and political values. This is because the evidence afforded by standard EBP methods is differentially useful for pursuing different moral and political values. I expand on how this challenges ideals of value-freedom and -neutrality in EBP, and offer suggestions for how EBP methodology might be revised.

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