Identifying evidence of effectiveness in the co-creation of research: a systematic review and meta-analysis of the international healthcare literature.

BACKGROUND: To investigate and address the evidence gap on the effectiveness of co-creation/production in international health research. METHODS: An initial systematic search of previous reviews published by 22 July 2017 in Medline, Embase, PsycINFO, Scopus and Web of Science. We extracted reported aims, elements and outcomes of co-creation/production from 50 reviews; however, reviews rarely tested effectiveness against intended outcomes. We therefore checked the reference lists in 13 included systematic reviews that cited quantitative studies involving the public/patients in the design and/or implementation of research projects to conduct meta-analyses on their effectiveness using standardized mean difference (SMD). RESULTS: Twenty-six primary studies were included, showing moderate positive effects for community functions (SMD = 0.56, 95%CI = 0.29-0.84, n = 11) and small positive effects for physical health (SMD = 0.25, 95%CI = 0.07-0.42, n = 9), health-promoting behaviour (SMD = 0.14, 95%CI = 0.03-0.26, n = 11), self-efficacy (SMD = 0.34, 95%CI = 0.01-0.67, n = 3) and health service access/receipt (SMD = 0.36, 95%CI = 0.21-0.52, n = 12). Non-academic stakeholders that co-created more than one research stage showed significantly favourable mental health outcomes. However, co-creation was rarely extended to later stages (evaluation/dissemination), with few studies specifically with ethnic minority groups. CONCLUSIONS: The co-creation of research may improve several health-related outcomes and public health more broadly, but research is lacking on its longer term effects.

Religiosity and the psychological outcomes of trauma: A systematic review of quantitative studies.

OBJECTIVE: This is a broad review examining the relationships between religiosity and the psychological outcomes of trauma. Previous studies showed that some constructs of religiosity are associated with lower severity of symptoms of mental disorders, whereas others, for instance, negative religious coping, predict deteriorated mental health. METHOD: A systematic review of peer-reviewed quantitative studies was conducted to examine the patterns of relationships between religiosity and psychological outcomes of trauma, potential causal relationships, and specific effect of religiosity on the outcomes on trauma. RESULTS: A total of 79 quantitative studies were included. The majority focused on military trauma or various types of traumatic exposure in the general population. Most of the studies employed a cross-sectional design. CONCLUSIONS: The associations between religiosity and psychological outcomes of trauma depend on the concept of religion used in a study, type of trauma. There is not enough evidence to support the causal effect of religiosity.

Religiosity and the concept of god moderate the relationship between the type of trauma, posttraumatic cognitions, and mental health.

The aim of the study was to examine the role of religiosity as a moderator in the relationships between trauma, posttraumatic cognitions, and mental health. A one-dimensional measure of religiosity and a multidimensional "concept of god" measure were used; sexual and nonsexual traumatic events were assessed and posttraumatic cognitions related to either sexual or nonsexual trauma were taken into account. A total of 337 females from Poland participated in the cross-sectional study. It was predicted that the relationships between sexual trauma and mental health would be stronger in religious individuals - this hypothesis was supported in the case of negative mental health (PTSD, z = -1.88, p = .003). No significant effects were found for nonsexual trauma; overall, highly religious individuals who had recently experienced trauma showed higher levels of satisfaction with life than nonreligious participants. As for the posttraumatic cognitions, one-dimensional religiosity was not a significant factor, but the self-blame cognitions and the concept of severe god were positively linked. In the case of sexual trauma, this effect was significant among nonreligious individuals. Moreover, the relationship between self-blame and PTSD was stronger in individuals who had the severe god concept. The current study was conducted in a religious society, where the majority of the population is raised as Roman Catholics. It has been demonstrated that religiosity is an important factor in the processing of trauma. This does not apply to religious individuals only: the concept of god was also a significant factor in nonreligious women.

Cumulative trauma, gender discrimination and mental health in women: mediating role of self-esteem.

BACKGROUND: Evidence suggests that women show symptoms of trauma-related symptoms more often than men. Gender discrimination is also associated with the severity of symptoms in women. AIMS: This study explored the relations among cumulative trauma, gender discrimination and mental health in women with a mediating role of self-esteem and emotion regulation. Two types of gender discrimination were taken into account: discrimination by parents and in the social context. Cumulative trauma over the lifetime was assessed, as well as three types of symptoms: internalising, externalising, psychoticism. METHODS: A total of 277 females from Poland participated in the study. It was hypothesised that gender discrimination and cumulative trauma would be positively related to symptoms and that lowered self-esteem mediates these relations. RESULTS: Hypotheses received partial confirmation, as both gender discrimination and cumulative trauma have been shown to be related to three types of symptoms. Self-esteem was a partial mediator between gender discrimination in the social context and symptoms. It was also demonstrated that emotion suppression is a partial mediator between cumulative trauma and symptoms. CONCLUSIONS: It has been demonstrated that socio-cultural factors, such as gender discrimination, play an important role in psychiatric symptoms development.

Sexual and Non-Sexual Trauma, Depression and Self-Esteem in a Sample of Polish Women. A Cross-Sectional Study.

The purpose of this research was to explore the issue of the psychological aftermaths of traumatic events in women. According to the existing body of evidence, women suffer more often than men from mental health problems as a result of a traumatic event-one of the explanations for this is that women experience sexual trauma more frequently and this type of trauma causes more severe negative consequences. Therefore, the main aim of this research was to compare the aftermaths of sexual and non-sexual traumatic events in women. Only traumatic events in adulthood were taken into consideration and were divided into two categories: recent events (previous two years) and those of an earlier occurrence. Depression and low level of self-esteem were included in the research model as possible consequences of traumatic events. A total of 273 women from Poland took part in a questionnaire survey. As hypothesized, in the case of recent events, participants who experienced a sexual trauma showed a higher level of depression and lower level of self-esteem compared with those subjects, who experienced a non-sexual trauma or did not experience a traumatic event at all. However, this effect was not observed in the case of events of earlier occurrence. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Relations between traumatic experiences and the level of depression and self-esteem in women were demonstrated. Women who experienced sexual trauma showed higher levels of depression and lower levels of self-esteem than women who experienced other types of trauma. Time of the occurrence of the traumatic events matters: the relations between traumatic events, depression and self-esteem were demonstrated in the case of the events that occurred within the last two years.

May Patients with Recurrent Venous Disease Benefit from Sequential Treatment More than Those without Previous Intervention? A Single-Center Retrospective Study on the Safety and Efficacy of Abdominal and Pelvic Veins Embolization in Sequential Approach.

Background/Objective: The endovenous embolization of insufficient abdominal/pelvic veins is the preferred method of treatment. Also, it seems to be crucial in the treatment of lower limb vein insufficiency, particularly in recurrent disease. This study aimed to evaluate of pelvic vein embolization safety and its impact on the short-term outcome in the sequential treatment of venous disease. Methods: A retrospective analysis involved data from 506 female patients with venous disease involving abdominal and pelvic veins. All records were extracted from the medical database and included patient history, imaging reports as well as pre- and post-operative surveys. Results: Among the patients analyzed, 37.2% underwent some venous intervention in the past, with significant differences in symptom severity between groups. The embolization procedure revealed a high safety profile, with no serious complications. Pain during and after the procedure was generally low, with significantly lower pain scores in patients with recurrence. In patients who required left renal vein venoplasty a 1.7-fold increased risk of lumbar pain after embolization and venoplasty procedure was observed. Overall, 66.6% of patients reported improvement in pelvic symptoms and 72.1% experienced improvement in leg symptoms. The full sequential treatment protocol (abdominal, pelvic, and leg compartment) demonstrated superior outcomes in leg symptom improvement compared to embolization alone. Conclusions: Pelvic vein embolization is a safe and effective method of treatment, significantly improving both pelvic and leg symptoms, particularly in patients with a history of previous interventions in lower limb veins. Further studies are warranted to validate our findings and further refine treatment protocols.

[Mental health problems in ethnic minority groups]. / Problemy psychiczne w grupach mniejszosci etnicznych i narodowych.

The aim of this paper is to provide an insight into the specificity of mental health issues as experienced by ethnic minority groups' representatives. A substantial body of evidence clearly indicates the differences in incidence of psychosis, affective disorders and suicidal tendencies in members of minority groups compared to the rest of the population. Relevant statistical data will be presented and examined from both a biological and socio-cultural point of view. Hoffman's Social Deafferentation Hypothesis will be introduced as a possible explanation of high incidence of psychotic disorders in immigrants. Subsequently, socio-cultural factors will receive attention. Acculturation and identity issues will be taken into account with regards to the data suggesting that these are second generation immigrants that suffer from mental health disorders most. The fact of being discriminated against and being exposed to negative social messages regarding one's group of reference will also be taken into consideration. Moreover, ethnic minorities will be compared on this dimension with other groups discriminated against, such as women and sexual minorities.

Trauma proliferation and stress generation (TPSG) dynamics and their implications for clinical science.

The current research and clinical focus on single traumas fails to assess numerous important trauma dynamics including trauma proliferation. In this study, 2 trauma proliferation pathways were identified that utilize a developmentally based trauma framework (DBTF). Data previously collected from 6 different cultural groups (N = 2279; 2 mental health clinics in Egypt and the United States, Native Americans, Palestinian adults in Gaza, and college students in Poland and Egypt) were reanalyzed. The 6 studies utilized DBTF-based measures of cumulative trauma and trauma types. Path analysis was used to test the trauma proliferation model and PROCESS software was used to identify mediators and their effect sizes. Results of the analyses indicated that attachment trauma and collective identity trauma independently predicted (directly and through mediators) personal identity trauma, role identity trauma, secondary trauma, and survival trauma. The pattern of proliferation was configurally invariant across the 6 groups and strictly invariant across genders. Implications for the consideration of trauma global dynamics, such as trauma proliferation, are discussed. (PsycINFO Database Record

Sex differences in the appraisal of traumatic events and psychopathology.

OBJECTIVE: The current study is an investigation of the relationship between the appraisal of traumatic events and mental disorder symptoms: internalizing symptoms and externalizing/substance-abuse symptoms. Cumulative trauma over the lifetime was taken into account. Also, specific effects related to traumatic events of various types (i.e., betrayal trauma, accident involving a family member, physical violence, and natural disaster) were assessed. Participants, 190 young men and 277 young women, were asked to evaluate the strength with which the traumatic event impacted their lives. METHOD: It was hypothesized that the relationship between traumatic experiences and mental disorder symptoms would be stronger in women than in men, and also that cognitive appraisal, in interaction with gender, would be related to the severity of the symptoms. RESULTS: Women showed higher levels of internalizing symptoms, but lower levels of externalizing/substance-abuse symptoms than men. Still, the correlation between cumulative trauma and both types of symptoms was stronger in women. For all types of trauma, women reported a stronger negative appraisal of the event than men. Interaction of sex and cognitive appraisal was demonstrated to be related to the severity of internalizing disorders. CONCLUSION: In the present study, women, as compared with men, evaluated traumatic events more negatively (for all types of trauma) and the relationship between trauma and mental disorder symptoms was also stronger in women. These results show the importance of the appraisal of trauma in the development of psychiatric symptoms in women and men following trauma. (PsycINFO Database Record

Feminist Identity Styles, Sexual and Non-Sexual Traumatic Events, and Psychological Well-Being in a Sample of Polish Women.

The aim of the study was to investigate the relations between the development of a feminist identity and effects of traumatic stress in a sample of Polish women. The distinction between non-sexual and sexual traumatic events was made. It was hypothesized that individuals scoring high on the Synthesis and Active Commitment scales of the Feminist Identity Development Model would present a higher self-esteem and lower level of depression as compared with individuals having low scores on those scales and high scores on the Passive Acceptance scale. It was also assumed that the relation between the feminist identity styles and self-esteem and depression would be stronger in women who had experienced sexual traumatic events as compared with those who had experienced other kinds of trauma. A total of 273 women participated in the questionnaire research. Regression analyses were performed to test the interaction model, and the obtained results support all of the hypotheses.