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1.
Artigo em Inglês | MEDLINE | ID: mdl-34501545

RESUMO

The 2019 coronavirus disease (COVID-19) pandemic has globally caused widespread disruption, morbidity and mortality. The uptake of COVID-19 vaccination is critical for minimising further impacts of the pandemic. Health and aged care workers (HACWs) play a central role in public confidence in vaccines and are one of the priority groups for COVID-19 vaccination in Australia. Qualitative phone interviews with 19 HACWs aged 21-50 years old from New South Wales, Australia, were conducted, and the data were analysed thematically in order to understand the factors influencing HACWs' acceptance of COVID-19 vaccination. We found that HACWs reported a continuum of COVID-19 vaccination intentions with 12 enthusiastically accepting and 7 hesitant. Using the Behavioral and Social Drivers of COVID-19 Vaccination (BeSD) Framework, we found that participants' acceptance of vaccination was primarily driven by their perceptions of COVID-19 vaccination (such as safety, risk and benefits) and by the information sources, people and norms they trusted. Informed by study findings, we propose several communication strategies which may be helpful in addressing HACWs vaccination acceptance. We note however that as the pandemic continues, further studies with HACWs from diverse backgrounds are needed in order to provide accurate data on diverse motivational and practical drivers of evolving perceptions and attitudes towards vaccination.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , Idoso , Austrália , Amigos , Humanos , Pessoa de Meia-Idade , New South Wales , Percepção , SARS-CoV-2 , Vacinação , Adulto Jovem
2.
Proc Natl Acad Sci U S A ; 118(39)2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34518372

RESUMO

In order to navigate a complex web of relationships, an individual must learn and represent the connections between people in a social network. However, the sheer size and complexity of the social world makes it impossible to acquire firsthand knowledge of all relations within a network, suggesting that people must make inferences about unobserved relationships to fill in the gaps. Across three studies (n = 328), we show that people can encode information about social features (e.g., hobbies, clubs) and subsequently deploy this knowledge to infer the existence of unobserved friendships in the network. Using computational models, we test various feature-based mechanisms that could support such inferences. We find that people's ability to successfully generalize depends on two representational strategies: a simple but inflexible similarity heuristic that leverages homophily, and a complex but flexible cognitive map that encodes the statistical relationships between social features and friendships. Together, our studies reveal that people can build cognitive maps encoding arbitrary patterns of latent relations in many abstract feature spaces, allowing social networks to be represented in a flexible format. Moreover, these findings shed light on open questions across disciplines about how people learn and represent social networks and may have implications for generating more human-like link prediction in machine learning algorithms.


Assuntos
Cognição/fisiologia , Tomada de Decisões , Amigos/psicologia , Generalização Psicológica/fisiologia , Modelos Neurológicos , Comportamento Social , Rede Social , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
3.
Kennedy Inst Ethics J ; 31(3): 223-246, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34565743

RESUMO

This paper presents a challenge to the view that benign 'white lies' may be therapeutic in dementia care and preferable to more truthful alternatives. Drawing on Sissela Bok and Bernard Williams, the paper develops three key points: first, that another person's dementia is not a reason to suspend one's customary reluctance to deceive others; second, that the commonly drawn contrast between benign deceit and blunt disclosure is too simple to frame arguments for the acceptability of deceit in dementia care; and third, truthful regard-regard for a person living with dementia as one for whom truth matters, as it does for oneself-is a foundation for beneficent concern that is neither infantilizing nor condescending. The paper proposes that a morally significant human bond is established through regard for another person as one for whom truth matters, just as it does for oneself, irrespective of another's dementia, and that within dementia care, the commission of deceit should be seen as an unsettling exception to a general principle of truthfulness.


Assuntos
Decepção , Demência , Relações Interpessoais , Obrigações Morais , Pessoalidade , Respeito , Revelação da Verdade/ética , Atitude , Beneficência , Cuidadores , Dissidências e Disputas , Emoções , Família , Amigos , Humanos , Princípios Morais , Apoio Social , Valor da Vida
5.
BMC Health Serv Res ; 21(1): 928, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34488732

RESUMO

BACKGROUND: Non-communicable diseases (NCDs) are projected to become the leading cause of disability and mortality in sub-Saharan Africa by 2030; a vast treatment gap exists. There is a dearth of knowledge on developing evidence-based interventions that address comorbid NCDs using a task-shifting approach. The Friendship Bench, a brief psychological intervention for common mental disorders delivered by trained community grandmothers, is a promising intervention for comorbid NCDs. Although task-shifting appears to be a rational approach, evidence suggests that it may bring about tension between existing professionals from whom tasks are shifted. A Theory of Change approach is an effective way of managing the unintended tension by bringing together different stakeholders involved to build consensus on how to task shift appropriately to the parties involved. We aimed to use a theory of change approach to formulating a road map on how to successfully integrate diabetes and hypertension care into the existing Friendship Bench in order to come up with an integrated care package for depression, hypertension and diabetes aimed at strengthening NCD care in primary health care systems in Zimbabwe. METHOD: A theory of change workshop with 18 stakeholders from diverse backgrounds was carried out in February 2020. Participants included grandmothers working on the Friendship Bench project (n = 4), policymakers from the ministry of health (n = 2), people with lived experience for the three NCDs (n = 4), health care workers (n = 2), and traditional healers (n = 2). Findings from earlier work (situational analysis, desk review, FGDs and clinic-based surveys) on the three NCDs were shared before starting the ToC. A facilitator with previous experience running ToCs led the workshop and facilitated the co-production of the ToC map. Through an iterative process, consensus between the 18 stakeholders was reached, and a causal pathway leading to developing a framework for an intervention was formulated. RESULTS: The ToC singled out the need to use expert clients (people with lived experience) to promote a patient-centred care approach that would leverage the existing Friendship Bench approach. In the face of COVID-19, the stakeholders further endorsed the use of existing digital platforms, notably WhatsApp, as an alternative way to reach out to clients and provide support. Leveraging existing community support groups as an entry point for people in need of NCD care was highlighted as a win-win by all stakeholders. A final framework for an NCD care package supported by Friendship Bench was presented to policymakers and accepted to be piloted in five geographical areas. CONCLUSIONS: The ToC can be used to build consensus on how best to use using an existing intervention for common mental disorders to integrate care for diabetes and hypertension. There is a need to evaluate this new intervention through an adequately powered study.


Assuntos
COVID-19 , Diabetes Mellitus , Hipertensão , Depressão , Diabetes Mellitus/terapia , Amigos , Humanos , Hipertensão/terapia , SARS-CoV-2 , Zimbábue/epidemiologia
6.
J Health Care Poor Underserved ; 32(3): 1604-1618, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34421051

RESUMO

PURPOSE: The Friendship Bench is a successful task-shifting intervention for addressing common mental disorders in Zimbabwe. The intervention takes a cognitive behavioural therapy and problem-solving approach provided by lay health workers (LHWs). The LHWs live in the same environment as their clients and are thus exposed to the same traumas and stressors as are their clients. Little is known about the long-term psychological effects on LHWs involved in this type of work. METHODS: A random sample of LHWs (n=182) was assessed using the Posttraumatic Stress Disorder Checklist (PCL-5) and the Shona Symptom Questionnaire (SSQ-14), both locally validated. RESULTS: The prevalence of PTSD and CMD was low among all surveyed LHWs. Eleven (6%) and 17 (11%) presented with probable PTSD and CMD, respectively. CONCLUSION: Despite living and working in the same settings as their clients, the Friendship Bench LHWs show good mental health outcomes.


Assuntos
Terapia Cognitivo-Comportamental , Transtornos Mentais , Transtornos de Estresse Pós-Traumáticos , Agentes Comunitários de Saúde , Amigos , Humanos , Transtornos Mentais/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Zimbábue/epidemiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-34360493

RESUMO

This study explored the internal and external factors affecting the first drinking experience during Korean adolescence. To achieve this, we collected 34 cases revealing specific drinking experiences during adolescence in Alcoholic Anonymous (A.A.), Korea. The collected data were analyzed using a qualitative case study method, and the analysis focused on the internal and external factors influencing drinking in adolescence. As per the results, internal factors that influenced drinking in adolescence were "curiosity" and "elevated mood and stress relief", and external factors were "family", "friends", "older friends at school", "neighbors", "Korean tradition of alcohol making", "workplaces that encourage alcohol consumption", and "a generous drinking culture." Based on these findings, we suggested several practical alternatives, such as a stringent alcohol punishment system, government-led campaigns to overcome the generous alcohol culture, monitoring the drinking status of working and intern youths, and using local crime prevention guards to curb youth drinking. In future research, it is necessary to quantitatively verify the results of this study to develop theories related to adolescent drinking behavior.


Assuntos
Comportamento do Adolescente , Consumo de Álcool por Menores , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Amigos , Humanos , República da Coreia
8.
Artigo em Inglês | MEDLINE | ID: mdl-34360527

RESUMO

This is an English translation with some expansion of the article originally published in Japanese as a university bulletin in 2009. Previous research has found both differences and similarities between ijime in Japan and bullying in England. Bullying is often by pupils in different classes or higher year groups whom the victim does not know very well; ijime is often by victims' classmates whom the victim knows very well. However, it has not been shown whether these differences are found for all types of bullying, or how they relate to friendships generally and the impact of differing school systems. We aimed to see whether previously found differences between ijime and bullying could be replicated, and, if so, whether they held for six different types of victimization, and whether friendship characteristics were consistent with explaining why they occur. To investigate the role of friendships and their location, 1036 Japanese and 931 English secondary school pupils participated in a comparative study of perceptions of bullying and ijime. The previous differences were confirmed and found to hold irrespective of type of bullying. Japanese pupils mainly formed friendships on a class basis, English pupils on a broader basis including pupils in different years. In school, English pupils spent much time in the playground with their friends and saw this as a likely venue for bullying, whereas Japanese pupils spent more time in the classroom and saw this as a likely venue for ijime. The difference in friendship formation, together with differences in the organization of class-based teaching in the two countries, are hypothesized to play a significant role in explaining some differences between bullying and ijime.


Assuntos
Bullying , Vítimas de Crime , Criança , Inglaterra , Amigos , Humanos , Japão , Grupo Associado , Percepção , Instituições Acadêmicas
9.
Chem Senses ; 462021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34351415

RESUMO

Olfactory impairment is one of the more unique symptoms of COVID-19 infection and has therefore enjoyed increased public attention in recent months. Olfactory impairment has various implications and consequences ranging from difficulty detecting dangerous pathogens to hindering social functioning and social behaviors. We provide an overview of how olfactory impairment can impact 3 types of close social relationships: family relationships, friendships, and romantic relationships. Evidence is divided into several categories representing potential mechanisms by which olfactory impairment can impact close social relationships: bonding disruptions, decreased social support, missed group-eating experiences, hygiene concerns, and altered sexual behaviors. We conclude with a discussion of emerging future research questions.


Assuntos
COVID-19/psicologia , Transtornos do Olfato/psicologia , SARS-CoV-2/metabolismo , Relações Familiares/psicologia , Feminino , Amigos/psicologia , Humanos , Relações Interpessoais , Solidão , Masculino , Comportamento Sexual/psicologia , Comportamento Social , Estresse Psicológico/psicologia
10.
Laryngorhinootologie ; 100(9): 684, 2021 09.
Artigo em Alemão | MEDLINE | ID: mdl-34461637

Assuntos
Amigos , Humanos
11.
Am J Speech Lang Pathol ; 30(5): 2228-2240, 2021 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-34310195

RESUMO

Purpose Speech-language pathologists (SLPs) who work with people with aphasia focus on assessment and intervention to support improved communication outcomes for their clients. Friendship, a key component of quality of life, often depends on communicative interaction, and many people with aphasia report having reduced social circles. The purpose of this study was to explore the perceptions of SLPs working with clients with aphasia on their role in supporting friendship development and maintenance. Method An online survey composed of questions addressing SLP perspectives and goal setting, assessment, and treatment practices related to aphasia and friendship was distributed to SLPs across the United States. Survey data were analyzed using both quantitative and qualitative methods. Results Forty-seven SLPs completed the survey. While many SLPs reported that the friendships of their clients with aphasia were impacted by aphasia and that it was within their scope of practice to support friendship development and maintenance, many did not specifically assess or target friendship and friendship outcomes in the treatment plan. SLPs identified barriers and facilitators to focusing on friendship within the context of speech and language therapy. Conclusions Findings suggest the majority of participating SLPs were interested in addressing friendship with clients with aphasia; however, they experienced barriers in practice. Further examination of SLP perspectives and clinical practice regarding friendship and aphasia is warranted. Additionally, research investigating effective assessment and therapeutic methods that target friendship in aphasia is needed to support clinical practice and the well-being of clients with aphasia. Supplemental Material https://doi.org/10.23641/asha.15032217.


Assuntos
Afasia , Patologia da Fala e Linguagem , Afasia/diagnóstico , Afasia/terapia , Amigos , Humanos , Patologistas , Qualidade de Vida , Fala , Estados Unidos
12.
J Youth Adolesc ; 50(10): 1939-1951, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34245427

RESUMO

Adolescents use some types of homophobic language (e.g., "that's so gay") as a form of banter, while other types are directly targeted as an intentional insult (e.g., calling someone a "fag, dyke, homo"). Little research has investigated adolescents' use and judgments about these types of homophobic language and whether judgments differ if they are used among friends or directed toward non-friend peers. This study investigated how relationship context and victim's (N = 477, Mage = 14.7, SD = 1.63) emotional responses related to judgments about anti-gay banter and homophobic name-calling. Adolescents evaluated homophobic name-calling as more wrong than anti-gay banter. While adolescents' evaluations of homophobic name-calling did not differ based on relationship context, adolescents did differentiate between anti-gay banter perpetrated by a friend vs. a peer. Further, emotional responses mediated these relationships in the anti-gay banter situation. These results suggest that adolescents' judgments about homophobic language are related to the relationship context and the type of homophobic language used.


Assuntos
Bullying , Amigos , Adolescente , Emoções , Humanos , Julgamento , Grupo Associado
13.
14.
J Adolesc Health ; 69(1S): S23-S30, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34217455

RESUMO

PURPOSE: This study aimed to describe the changes in adolescents' perceptions of a sexual double standard (SDS) over time and to examine the developmental and social factors associated with these changing perceptions. METHODS: The sample includes 2,163 10- to 14-year-old adolescents from Kinshasa, interviewed at two time points (T0 and T1), 1 year apart. We examined associations between SDS and pubertal onset, family interactions, peer interactions, and media exposure. We conducted sex-stratified generalized estimation equation models to test associations between changes in SDS and sociodevelopmental factors at T0 as well as with changes in sociodevelopmental factors between T0 and T1. RESULTS: At T0, the SDS score was 4.15/5 among boys and 4.43/5 among girls, signaling highly gender unequal perceptions. SDS scores increased over time, shifting toward greater inequality. Adolescents who were prepubertal at T0 experienced greater increases in SDS scores than those who were pubertal at T0. The greatest increase in SDS scores was observed among girls who transitioned through puberty between T0 and T1. High parental monitoring of boys mitigated the increase in SDS as did boys' increased exposure to social media between T0 and T1. Girls who had mixed-sex friendships also experienced less change in SDS perceptions compared with those who socialized in same-sex groups. CONCLUSIONS: Puberty was associated with changes in SDS perceptions for all adolescents, whereas family interactions and media exposure affected changes in SDS perceptions for boys and peer interactions affected changes in SDS perceptions for girls.


Assuntos
Amigos , Comportamento Sexual , Adolescente , Criança , República Democrática do Congo , Feminino , Identidade de Gênero , Humanos , Masculino , Fatores Sexuais
15.
Math Biosci Eng ; 18(4): 4264-4292, 2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-34198436

RESUMO

The typical aim of user matching is to detect the same individuals cross different social networks. The existing efforts in this field usually focus on the users' attributes and network embedding, but these methods often ignore the closeness between the users and their friends. To this end, we present a friend closeness based user matching algorithm (FCUM). It is a semi-supervised and end-to-end cross networks user matching algorithm. Attention mechanism is used to quantify the closeness between users and their friends. We considers both individual similarity and their close friends similarity by jointly optimize them in a single objective function. Quantification of close friends improves the generalization ability of the FCUM. Due to the expensive costs of labeling new match users for training FCUM, we also design a bi-directional matching strategy. Experiments on real datasets illustrate that FCUM outperforms other state-of-the-art methods that only consider the individual similarity.


Assuntos
Amigos , Rede Social , Algoritmos , Humanos
16.
Artigo em Inglês | MEDLINE | ID: mdl-34209078

RESUMO

The purpose of this study was to explore individual, interpersonal, and organizational factors that may influence the physical activity of adolescents (ages 10-14) in Pakistani schools. A set of questionnaires that included individual, interpersonal, and organizational factors and PA behavior was completed by the 618 students selected from Pakistani schools. Stepwise forward regression model was applied to check the possible effects of multilevel variables on physical activity and to extract the stronger predictors. The results showed that physical activity was significantly predicted by individual level factors such as self-efficacy, motivation, and attitude. Among the demographic correlates, gender, age, and BMI did not affect physical activity, while socioeconomic status and geographic characteristics had a meaningful association with PA. At the interpersonal level, adolescents' perception of family support had a potential influence on physical activity, while there was no impact of friends/peers and teachers support on adolescents' PA. A school environmental characteristic, such as PA facility, was positively related to PA; however, the impact of PA equipment, safety, and policy and PA culture were statistically non-significant. The findings suggest that public health intervention strategies aimed at promoting PA in adolescents should recognize multiple levels of influences that may either enhance or impede the likelihood of PA among adolescents.


Assuntos
Exercício Físico , Instituições Acadêmicas , Adolescente , Criança , Amigos , Promoção da Saúde , Humanos , Paquistão , Inquéritos e Questionários
17.
Lancet Psychiatry ; 8(8): 696-707, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34246324

RESUMO

BACKGROUND: There is a large clinical need for improved treatments for patients with persecutory delusions. We aimed to test whether a new theoretically driven cognitive therapy (the Feeling Safe Programme) would lead to large reductions in persecutory delusions, above non-specific effects of therapy. We also aimed to test treatment effect mechanisms. METHODS: We did a parallel, single-blind, randomised controlled trial to test the Feeling Safe Programme against befriending with the same therapists for patients with persistent persecutory delusions in the context of non-affective psychosis diagnoses. Usual care continued throughout the duration of the trial. The trial took place in community mental health services in three UK National Health Service trusts. Participants were included if they were 16 years or older, had persecutory delusions (as defined by Freeman and Garety) for at least 3 months and held with at least 60% conviction, and had a primary diagnosis of non-affective psychosis from the referring clinical team. Patients were randomly assigned to either the Feeling Safe Programme or the befriending programme, using a permuted blocks algorithm with randomly varying block size, stratified by therapist. Trial assessors were masked to group allocation. If an allocation was unmasked then the unmasked assessor was replaced with a new masked assessor. Outcomes were assessed at 0 months, 6 months (primary endpoint), and 12 months. The primary outcome was persecutory delusion conviction, assessed within the Psychotic Symptoms Rating Scale (PSYRATS; rated 0-100%). Outcome analyses were done in the intention-to-treat population. Each intervention was provided individually over 6 months. This trial is registered with the ISRCTN registry, ISRCTN18705064. FINDINGS: From Feb 8, 2016, to July 26, 2019, 130 patients with persecutory delusions (78 [60%] men; 52 [40%] women, mean age 42 years [SD 12·1, range 17-71]; 86% White, 9% Black, 2% Indian; 2·3% Pakistani; 2% other) were recruited. 64 patients were randomly allocated to the Feeling Safe Programme and 66 patients to befriending. Compared with befriending, the Feeling Safe Programme led to significant end of treatment reductions in delusional conviction (-10·69 [95% CI -19·75 to -1·63], p=0·021, Cohen's d=-0·86) and delusion severity (PSYRATS, -2·94 [-4·58 to -1·31], p<0·0001, Cohen's d=-1·20). More adverse events occurred in the befriending group (68 unrelated adverse events reported in 20 [30%] participants) compared with the Feeling Safe group (53 unrelated adverse events reported in 16 [25%] participants). INTERPRETATION: The Feeling Safe Programme led to a significant reduction in persistent persecutory delusions compared with befriending. To our knowledge, these are the largest treatment effects seen for patients with persistent delusions. The principal limitation of our trial was the relatively small sample size when comparing two active treatments, meaning less precision in effect size estimates and lower power to detect moderate treatment differences in secondary outcomes. Further research could be done to determine whether greater effects could be possible by reducing the hypothesised delusion maintenance mechanisms further. The Feeling Safe Programme could become the recommended psychological treatment in clinical services for persecutory delusions. FUNDING: NIHR Research Professorship and NIHR Oxford Health Biomedical Research Centre.


Assuntos
Terapia Cognitivo-Comportamental , Delusões/terapia , Amigos , Transtornos Psicóticos/terapia , Adulto , Escalas de Graduação Psiquiátrica Breve , Feminino , Amigos/psicologia , Humanos , Masculino , Medicina Estatal , Reino Unido
18.
Aging Clin Exp Res ; 33(9): 2623-2631, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34247344

RESUMO

BACKGROUND: Studies on age differences in emotional states during the COVID-19 pandemic showed that older adults experienced greater emotional wellbeing compared to younger adults. We hypothesized these age differences to be related to the perception of closeness to family/friends or the engagement in daily activities during the pandemic. AIM: To investigate age differences in positive and negative emotional experiences and whether the perception of closeness to family/friends and the engagement in daily activities during pandemic explained such age-related differences. METHODS: Through a cross-sectional study, 1,457 adults aged 18-87 years old completed an online survey assessing positive and negative emotional experiences, the perception of more closeness to family/friends, and daily activities that participants started/re-started during the pandemic. RESULTS: Increasing age was associated with more positive and less negative emotional experiences. Age differences in positive emotional experience were explained by the perception of more closeness to friends and not by the engagement in daily activities. For negative emotional experience age, differences remained significant even after accounting for the perception of closeness to family/friends and engagements in daily activities. DISCUSSION: Older adults' greater overall level of positive emotional experience was explained by their greater perception of more closeness to friends. We speculate that social closeness provides a coping mechanism to increase emotional wellbeing employed especially in older adults. CONCLUSION: Our findings reinforce the link between perceived social closeness and emotional wellbeing especially in older adults. To cope with stressful situation, it is important to encourage older adults to increase the closeness to their social network.


Assuntos
COVID-19 , Pandemias , Idoso , Idoso de 80 Anos ou mais , Controle de Doenças Transmissíveis , Estudos Transversais , Amigos , Humanos , SARS-CoV-2
19.
Cochrane Database Syst Rev ; 7: CD010771, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34278564

RESUMO

BACKGROUND: The IQCODE (Informant Questionnaire for Cognitive Decline in the Elderly) is a commonly used questionnaire based tool that uses collateral information to assess for cognitive decline and dementia. Brief tools that can be used for dementia "screening" or "triage" may have particular utility in primary care / general practice healthcare settings but only if they have suitable test accuracy. A synthesis of the available data regarding IQCODE accuracy in a primary care setting should help inform cognitive assessment strategies for clinical practice; research and policy. OBJECTIVES: To determine the accuracy of the informant-based questionnaire IQCODE, for detection of dementia in a primary care setting. SEARCH METHODS: A search was performed in the following sources on the 28th of January 2013: ALOIS (Cochrane Dementia and Cognitive Improvement Group), MEDLINE (Ovid SP), EMBASE (Ovid SP), PsycINFO (Ovid SP), BIOSIS (Ovid SP), ISI Web of Science and Conference Proceedings (ISI Web of Knowledge), CINHAL (EBSCOhost) and LILACs (BIREME). We also searched sources specific to diagnostic test accuracy: MEDION (Universities of Maastricht and Leuven); DARE (York University); HTA Database (Health Technology Assessments Database via The Cochrane Library) and ARIF (Birmingham University). We developed a sensitive search strategy; search terms were designed to cover key concepts using several different approaches run in parallel and included terms relating to cognitive tests, cognitive screening and dementia. We used standardized database subject headings such as MeSH terms (in MEDLINE) and other standardized headings (controlled vocabulary) in other databases, as appropriate. SELECTION CRITERIA: We selected those studies performed in primary care settings, which included (not necessarily exclusively) IQCODE to assess for the presence of dementia and where dementia diagnosis was confirmed with clinical assessment. For the "primary care" setting, we included those healthcare settings where unselected patients, present for initial, non-specialist assessment of memory or non-memory related symptoms; often with a view to onward referral for more definitive assessment. DATA COLLECTION AND ANALYSIS: We screened all titles generated by electronic database searches and abstracts of all potentially relevant studies were reviewed. Full papers were assessed for eligibility and data extracted by two independent assessors. Quality assessment (risk of bias and applicability) was determined using the QUADAS-2 tool. Reporting quality was determined using the STARDdem extension to the STARD tool. MAIN RESULTS: From 71 papers describing IQCODE test accuracy, we included 1 paper, representing data from 230 individuals (n=16 [7%] with dementia). The paper described those patients consulting a primary care service who self-identified as Japanese-American. Dementia diagnosis was made using Benson & Cummings criteria and the IQCODE was recorded as part of a longer interview with the informant. IQCODE accuracy was assessed at various test thresholds, with a "trade-off" between sensitivity and specificity across these cutpoints. At an IQCODE threshold of 3.2 sensitivity: 100%, specificity: 76%; for IQCODE 3.7 sensitivity: 75%, specificity: 98%. Applying the QUADAS-2 assessments, the study was at high risk of bias in all categories. In particular degree of blinding was unclear and not all participants were included in the final analysis. AUTHORS' CONCLUSIONS: It is not possible to give definitive guidance on the test accuracy of IQCODE for the diagnosis of dementia in a primary care setting based on the single study identified. We are surprised by the lack of research using the IQCODE in primary care as this is, arguably, the most appropriate setting for targeted case finding of those with undiagnosed dementia in order to maximise opportunities to intervene and provide support for the individual and their carers.


Assuntos
Disfunção Cognitiva/diagnóstico , Demência/diagnóstico , Família , Amigos , Medicina Geral , Inquéritos Epidemiológicos/normas , Americanos Asiáticos , Humanos , Japão/etnologia , Atenção Primária à Saúde , Sensibilidade e Especificidade , Estados Unidos
20.
Addict Behav ; 122: 107042, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34303119

RESUMO

OBJECTIVE: Limited research has examined how alcohol use and related consequences affect drinking-related cognitions, which is important as these cognitions may contribute to future drinking. The current study examines daily associations between alcohol use and alcohol-related negative consequences with next-day Prototype Willingness Model (PWM) social reaction pathway cognitions. METHOD: Participants ages 15-25 years (N = 124, Mean age 18.7, SD = 2.87) completed daily surveys for up to three weeks (i.e., up to 11 surveys/week) using an ecological momentary assessment design. Linear mixed models and Poisson generalized mixed models were conducted to examine whether number of alcoholic drinks or number of negative alcohol-related consequences were associated with next-day PWM social reaction cognitions, including perceived vulnerability, descriptive normative perceptions of number of drinks consumed and the percentage of friends who drink, prototype favorability, prototype similarity, and willingness (i.e., openness) to drink. RESULTS: Within-person results indicated more alcohol use on a given day was associated with lower next-day normative perceptions of the percentage of friends who drink on that day of the week and higher prototype similarity. Furthermore, within-person results indicated that experiencing more negative alcohol-related consequences on a given day was associated with higher perceived vulnerability and lower willingness to drink the next day. CONCLUSIONS: Findings showed that next-day social reaction PWM cognitions were associated with prior day alcohol use and negative alcohol-related consequences, suggesting that an intervention might be timed to target drinking cognitions the morning following a drinking event, particularly after experiencing negative alcohol-related consequences.


Assuntos
Consumo de Bebidas Alcoólicas , Cognição , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Avaliação Momentânea Ecológica , Etanol , Amigos , Humanos , Adulto Jovem
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