Person-centred decision-making in mental health : a scoping review
- Hormazábal-Salgado, Raul, Whitehead, Dean, Osman, Abdi, Hills, Danny
- Authors: Hormazábal-Salgado, Raul , Whitehead, Dean , Osman, Abdi , Hills, Danny
- Date: 2024
- Type: Text , Journal article , Review
- Relation: Issues in Mental Health Nursing Vol. 45, no. 3 (2024), p. 294-310
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- Description: Person-centred decision-making approaches in mental health care are crucial to safeguard the autonomy of the person. The use of these approaches, however, has not been fully explored beyond the clinical and policy aspects of shared and supported decision-making. The main goal is to identify and collate studies that have made an essential contribution to the understanding of shared, supported, and other decision-making approaches related to adult mental health care, and how person-centred decision-making approaches could be applied in clinical practice. A scoping review of peer-reviewed primary research was undertaken. A preliminary search and a main search were undertaken. For the main search, eight databases were explored in two rounds, between October and November 2022, and in September 2023, limited to primary research in English, Spanish or Portuguese published from October 2012 to August 2023. From a total of 12,285 studies retrieved, 21 studies were included. These research articles, which had mixed quality ratings, focused on therapeutic relationships and communication in decision-making (30%), patients’ involvement in treatment decision-making (40%), and interventions for improving patients’ decision-making engagement (30%). While there is promising evidence for shared decision-making in mental health care, it is important that healthcare providers use their communicational skills to enhance the therapeutic relationship and engage patients in the process. More high-quality research on supported decision-making strategies and their implementation in mental health services is also required. © 2024 The Author(s). Published with license by Taylor & Francis Group, LLC.
- Authors: Hormazábal-Salgado, Raul , Whitehead, Dean , Osman, Abdi , Hills, Danny
- Date: 2024
- Type: Text , Journal article , Review
- Relation: Issues in Mental Health Nursing Vol. 45, no. 3 (2024), p. 294-310
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- Description: Person-centred decision-making approaches in mental health care are crucial to safeguard the autonomy of the person. The use of these approaches, however, has not been fully explored beyond the clinical and policy aspects of shared and supported decision-making. The main goal is to identify and collate studies that have made an essential contribution to the understanding of shared, supported, and other decision-making approaches related to adult mental health care, and how person-centred decision-making approaches could be applied in clinical practice. A scoping review of peer-reviewed primary research was undertaken. A preliminary search and a main search were undertaken. For the main search, eight databases were explored in two rounds, between October and November 2022, and in September 2023, limited to primary research in English, Spanish or Portuguese published from October 2012 to August 2023. From a total of 12,285 studies retrieved, 21 studies were included. These research articles, which had mixed quality ratings, focused on therapeutic relationships and communication in decision-making (30%), patients’ involvement in treatment decision-making (40%), and interventions for improving patients’ decision-making engagement (30%). While there is promising evidence for shared decision-making in mental health care, it is important that healthcare providers use their communicational skills to enhance the therapeutic relationship and engage patients in the process. More high-quality research on supported decision-making strategies and their implementation in mental health services is also required. © 2024 The Author(s). Published with license by Taylor & Francis Group, LLC.
Exploring hospital inpatients’ awareness of their falls risk : a qualitative exploratory study
- Dabkowski, Elissa, Cooper, Simon, Duncan, Jhodie, Missen, Karen
- Authors: Dabkowski, Elissa , Cooper, Simon , Duncan, Jhodie , Missen, Karen
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 20, no. 1 (2023), p.
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- Description: Patient falls in hospital may lead to physical, psychological, social and financial impacts. Understanding patients’ perceptions of their fall risk will help to direct fall prevention strategies and understand patient behaviours. The aim of this study was to explore the perceptions and experiences that influence a patient’s understanding of their fall risk in regional Australian hospitals. Semi-structured, individual interviews were conducted in wards across three Australian hospitals. Participants were aged 40 years and over, able to communicate in English and were mobile prior to hospital admission. Participants were excluded from the study if they returned a Standardised Mini-Mental State Examination (SMMSE) score of less than 18 when assessed by the researcher. A total of 18 participants with an average age of 69.8 years (SD ± 12.7, range 41 to 84 years) from three regional Victorian hospitals were interviewed for this study. Data were analysed using a reflexive thematic analysis identifying three major themes; (1) Environment (extrinsic) (2) Individual (intrinsic), and (3) Outcomes, as well as eight minor themes. Participants recognised the hazardous nature of a hospital and their personal responsibilities in staying safe. Falls education needs to be consistently delivered, with the focus on empowering the patient to help them adjust to changes in their clinical condition, whether temporary or permanent. © 2022 by the authors.
- Authors: Dabkowski, Elissa , Cooper, Simon , Duncan, Jhodie , Missen, Karen
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 20, no. 1 (2023), p.
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- Description: Patient falls in hospital may lead to physical, psychological, social and financial impacts. Understanding patients’ perceptions of their fall risk will help to direct fall prevention strategies and understand patient behaviours. The aim of this study was to explore the perceptions and experiences that influence a patient’s understanding of their fall risk in regional Australian hospitals. Semi-structured, individual interviews were conducted in wards across three Australian hospitals. Participants were aged 40 years and over, able to communicate in English and were mobile prior to hospital admission. Participants were excluded from the study if they returned a Standardised Mini-Mental State Examination (SMMSE) score of less than 18 when assessed by the researcher. A total of 18 participants with an average age of 69.8 years (SD ± 12.7, range 41 to 84 years) from three regional Victorian hospitals were interviewed for this study. Data were analysed using a reflexive thematic analysis identifying three major themes; (1) Environment (extrinsic) (2) Individual (intrinsic), and (3) Outcomes, as well as eight minor themes. Participants recognised the hazardous nature of a hospital and their personal responsibilities in staying safe. Falls education needs to be consistently delivered, with the focus on empowering the patient to help them adjust to changes in their clinical condition, whether temporary or permanent. © 2022 by the authors.
- Brito, Sara, White, Jennifer, Hill, Bridget, Thomacos, Nikos
- Authors: Brito, Sara , White, Jennifer , Hill, Bridget , Thomacos, Nikos
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Hand Therapy Vol. 35, no. 2 (2022), p. 267-274
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- Description: •Given the long-term recovery following BPI, consideration should be given to relevance of slow stream rehab and interdisciplinary care.•Consider upskilling or an interdisciplinary care model to assist hand therapists and the provision of pain management and psychological support.•Increased dissemination of resources to support hand therapists working with individuals following BPI and enhanced communication opportunities to develop networks both nationally and internationally. Traumatic, brachial plexus injuries (BPI) result represent a significant cost to the individual and society. Recovery involves multiple surgeries, takes years, and often results in permanent physical dysfunction. While the last couple of decades have seen advancements in surgical management, the BPI rehabilitation literature has not kept pace with these developments. We aim to explore the experience of public and privately employed hand therapists’ in delivering effective long-term rehabilitation services to inviduals with BPI in Australia. An interpretative qualitative study. Two focus groups were conducted with Australian hand therapists’ (n = 10). Data were analyzed using an inductive thematic approach. Three key themes were generated from the data. The first theme ‘Falling through the gaps: overlooked components of therapy for BPI’ captures participants’ thoughts on postinjury health care and rehabilitation services. The second ‘Developing a therapeutic alliance: underpinned by time and trust’ relates to the relationship building challenges and opportunities following trauma that will withstand the long-term recovery of individuals following BPI. The last theme, ‘Factors required for professional development: knowledge and support,’ considers the variation seen with these clients in relation to therapy needs and outcomes. The findings of this study highlight the need to better equip hand therapists’ skills and knowledge in responding to pain and psychological management post BPI. Our results reinforce the benefit of interdisciplinary models of care in the management of individuals with BPI.
- Galbally, Megan, Watson, Stuart, Spigset, Olav, Lappas, Martha, Walker, Susan, Lewis, Andrew
- Authors: Galbally, Megan , Watson, Stuart , Spigset, Olav , Lappas, Martha , Walker, Susan , Lewis, Andrew
- Date: 2022
- Type: Text , Journal article
- Relation: Placenta Vol. 119, no. (2022), p. 44-51
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- Description: Placental dysfunction and inefficiency, is important in understanding fetal growth restriction and low birth weight. Two recent studies have examined the relationship between antidepressant use in pregnancy and placental weight ratios one found lower placental weight ratio associated with antidepressant use and the other found a higher ratio. This study examined 342 women recruited in early pregnancy, including 75 taking antidepressants, 29 with current depression and 238 controls. Antidepressant use was measured through self-report in early and late pregnancy, hospital records at delivery and drug concentrations in umbilical cord and maternal blood obtained at delivery. Maternal depression was measured using the Structured Clinical Interview for the DSM IV (SCID) at recruitment. Placentas were collected at delivery and weighed, and infant birth weight recorded. Placental efficiency was measured using standardised placental weight residuals and included as the outcome in general linear models (ANOVA/ANCOVA) to test hypotheses. While placental weight was higher for those on antidepressants compared to controls (z=.30 c.f. Z=-0.08, p=.012), there were no significant differences between the three groups after adjusting for maternal body mass index at recruitment. When comparing antidepressant groups separately there were small-to-moderate positive associations between (SSRI) concentrations and placental weight (rho's > 0.20, p's > 0.05), which did not reach significance. Antidepressant use in pregnancy was not associated with significant changes in placental efficiency after adjustment for confounding variables. Future research should expand on this to examine other aspects of placental function and include a wide range of potential confounding variables to draw clinically meaningful conclusions. •Birth weight to placental weight ratio is often used as a proxy for placental dysfunction.•Placental dysfunction may underlie the association between antenatal antidepressant use and low infant birth weight.•Two studies found the opposite relationship between antidepressants and placental weight but did not adjust for confounders.•We found placental weight, when adjusted for confounders, was not significantly different for those on antidepressants.
Portuguese version of the spiritual well-being questionnaire : validation study in people under assisted reproductive techniques
- Romeiro, Joana, Nogueira, Paulo, Fisher, John, Caldeira, Silvia
- Authors: Romeiro, Joana , Nogueira, Paulo , Fisher, John , Caldeira, Silvia
- Date: 2022
- Type: Text , Journal article
- Relation: Religions Vol. 13, no. 5 (2022), p.
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- Description: Attention has been given to the experience of individuals undergoing assisted reproductive techniques. However, only recent literature has focused on the spiritual journey triggered by such an event and highlighted the nurses and midwives’ roles in the assessment of the spiritual needs of those living with infertility. This study aimed to perform a psychometric test of the factor structure of the Portuguese version of the Spiritual Well-being Questionnaire in a sample of people undergoing assisted reproductive techniques. This descriptive cross-sectional study was conducted between September 2019 and June 2020 on a sample of 104 Portuguese adults attending fertility treatment. An online questionnaire was released on fertility-related websites. A confirmatory factor analysis was conducted on six hypothesized models of the instrument. The findings provided evidence of an adequate internal consistency of the instrument, and the validity and reliability of the oblique four-factor model was confirmed. Spiritual well-being had a significant association with the nature of infertility and a higher score was achieved by participants that perceived religion as very important. This study provides a validated tool for nurses and midwives to assess spiritual well-being and promote an integrated reproductive healthcare approach. Further longitudinal research with bigger samples would provide more evidence of the spiritual needs of people living with this condition. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Romeiro, Joana , Nogueira, Paulo , Fisher, John , Caldeira, Silvia
- Date: 2022
- Type: Text , Journal article
- Relation: Religions Vol. 13, no. 5 (2022), p.
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- Description: Attention has been given to the experience of individuals undergoing assisted reproductive techniques. However, only recent literature has focused on the spiritual journey triggered by such an event and highlighted the nurses and midwives’ roles in the assessment of the spiritual needs of those living with infertility. This study aimed to perform a psychometric test of the factor structure of the Portuguese version of the Spiritual Well-being Questionnaire in a sample of people undergoing assisted reproductive techniques. This descriptive cross-sectional study was conducted between September 2019 and June 2020 on a sample of 104 Portuguese adults attending fertility treatment. An online questionnaire was released on fertility-related websites. A confirmatory factor analysis was conducted on six hypothesized models of the instrument. The findings provided evidence of an adequate internal consistency of the instrument, and the validity and reliability of the oblique four-factor model was confirmed. Spiritual well-being had a significant association with the nature of infertility and a higher score was achieved by participants that perceived religion as very important. This study provides a validated tool for nurses and midwives to assess spiritual well-being and promote an integrated reproductive healthcare approach. Further longitudinal research with bigger samples would provide more evidence of the spiritual needs of people living with this condition. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Branson, Molly, March, Evita, Marrington, Jessica
- Authors: Branson, Molly , March, Evita , Marrington, Jessica
- Date: 2022
- Type: Text , Book chapter
- Relation: Social media and technology across the lifespan p. 27-42
- Full Text: false
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- Description: Experiencing antisocial online behaviour such as cyberbullying and internet trollingcyberbullying and internet trolling is associated with a range of negative psychological and physical outcomes. To understand why people are motivated to engage in antisocial online behaviour, researchers have explored a variety of individual differences including traitstraits, motivations, and cognitions. In the current study, we adopted developmental frameworks to explore antisocial use of social media across different age cohorts. Participants (N = 665, 51% female) with an average age of 28 years (SD = 8.86) completed an online questionnaire assessing antisocial use of social media. Adopting previous guidelines, participants were categorised as emerging adults (aged 18–25 years; 50%), adults (aged 26–44 years; 42%), and middle age (aged 45–59 years; 8%). A one-way ANOVA showed a statistically significant effect of age cohort on antisocial use; however, contrary to expectations, adults reported higher antisocial use of social media compared to emerging adults and middle-aged adults. There was no statistically significant difference between emerging adults and middle-aged adults. Results are discussed through the lens of Erikson’s psychosocial theoryErikson’s psychosocial model and Social Convoy ModelSocial Convoy Model and recommendations are provided to manage and prevent perpetration of antisocial online behaviour.
A survey of early-career researchers in Australia
- Christian, Katherine, Johnstone, Carolyn, Larkins, Jo-ann, Wright, Wendy, Doran, Michael
- Authors: Christian, Katherine , Johnstone, Carolyn , Larkins, Jo-ann , Wright, Wendy , Doran, Michael
- Date: 2021
- Type: Text , Journal article
- Relation: eLife Vol. 10, no. (2021), p. 1-19
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- Description: Early-career researchers (ECRs) make up a large portion of the academic workforce and their experiences often reflect the wider culture of the research system. Here we surveyed 658 ECRs working in Australia to better understand the needs and challenges faced by this community. Although most respondents indicated a ‘love of science’, many also expressed an intention to leave their research position. The responses highlight how job insecurity, workplace culture, mentorship and ‘questionable research practices’ are impacting the job satisfaction of ECRs and potentially compromising science in Australia. We also make recommendations for addressing some of these concerns. © Christian et al.
- Authors: Christian, Katherine , Johnstone, Carolyn , Larkins, Jo-ann , Wright, Wendy , Doran, Michael
- Date: 2021
- Type: Text , Journal article
- Relation: eLife Vol. 10, no. (2021), p. 1-19
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- Description: Early-career researchers (ECRs) make up a large portion of the academic workforce and their experiences often reflect the wider culture of the research system. Here we surveyed 658 ECRs working in Australia to better understand the needs and challenges faced by this community. Although most respondents indicated a ‘love of science’, many also expressed an intention to leave their research position. The responses highlight how job insecurity, workplace culture, mentorship and ‘questionable research practices’ are impacting the job satisfaction of ECRs and potentially compromising science in Australia. We also make recommendations for addressing some of these concerns. © Christian et al.
Match high-speed running distances are often suppressed after return from hamstring strain injury in professional footballers
- Whiteley, Rodney, Massey, Andrew, Gabbett, Tim, Blanch, Peter, Cameron, Matthew, Conlan, Greta, Ford, Matthew, Williams, Morgan
- Authors: Whiteley, Rodney , Massey, Andrew , Gabbett, Tim , Blanch, Peter , Cameron, Matthew , Conlan, Greta , Ford, Matthew , Williams, Morgan
- Date: 2021
- Type: Text , Journal article
- Relation: Sports Health Vol. 13, no. 3 (2021), p. 290-295
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- Description: Background: High-speed running is commonly implicated in the genesis of hamstring injury. The success of hamstring injury management is typically quantified by the duration of time loss or reinjury rate. These metrics do not consider any loss in performance after returning to play from hamstring injury. It is not known to what extent high-speed running is altered on return to play after such injury. Hypothesis: Match high-speed running distance will change after returning from hamstring injury. Study Design: Non-randomized cohort. Level of Evidence: Level 3. Methods: Match high-speed running distance in highest level professional football (soccer, Rugby League, Rugby Union, and Australian Rules) were examined for a minimum of 5 games prior and subsequent to hamstring strain injury for individual differences using a linear regression models approach. A total of 22 injuries in 15 players were available for analysis. Results: Preinjury cumulative high-speed running distances were strongly correlated for each individual (r2 = 0.92-1.0 P < 0.0001). Pre- and postinjury high-speed running data were available for a median of 15 matches (range, 6-15). Variance from the preinjury high-speed running distance was significantly less (P = 0.0005) than the post injury values suggesting a suppression of high-speed running distance after returning from injury. On return to play, 7 of the 15 players showed a sustained absolute reduction in preinjury high-speed running distance, 7 showed no change, and 1 player (only) showed an increase. Analysis of subsequent (second and third injury) return to play showed no differences to return from the index injury. Conclusion: Return to play was not associated with return to high-speed running performance for nearly half of the players examined, although the same number showed no difference. Persisting deficits in match high-speed running may exist for many players after hamstring strain injury. Clinical Relevance: Returning to play does not mean returning to (high-speed running) performance for nearly half of the high-level professional football players examined in this study. This suggests that successful return to play metrics should be expanded from simple time taken and recurrence to include performance.
- Authors: Whiteley, Rodney , Massey, Andrew , Gabbett, Tim , Blanch, Peter , Cameron, Matthew , Conlan, Greta , Ford, Matthew , Williams, Morgan
- Date: 2021
- Type: Text , Journal article
- Relation: Sports Health Vol. 13, no. 3 (2021), p. 290-295
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- Description: Background: High-speed running is commonly implicated in the genesis of hamstring injury. The success of hamstring injury management is typically quantified by the duration of time loss or reinjury rate. These metrics do not consider any loss in performance after returning to play from hamstring injury. It is not known to what extent high-speed running is altered on return to play after such injury. Hypothesis: Match high-speed running distance will change after returning from hamstring injury. Study Design: Non-randomized cohort. Level of Evidence: Level 3. Methods: Match high-speed running distance in highest level professional football (soccer, Rugby League, Rugby Union, and Australian Rules) were examined for a minimum of 5 games prior and subsequent to hamstring strain injury for individual differences using a linear regression models approach. A total of 22 injuries in 15 players were available for analysis. Results: Preinjury cumulative high-speed running distances were strongly correlated for each individual (r2 = 0.92-1.0 P < 0.0001). Pre- and postinjury high-speed running data were available for a median of 15 matches (range, 6-15). Variance from the preinjury high-speed running distance was significantly less (P = 0.0005) than the post injury values suggesting a suppression of high-speed running distance after returning from injury. On return to play, 7 of the 15 players showed a sustained absolute reduction in preinjury high-speed running distance, 7 showed no change, and 1 player (only) showed an increase. Analysis of subsequent (second and third injury) return to play showed no differences to return from the index injury. Conclusion: Return to play was not associated with return to high-speed running performance for nearly half of the players examined, although the same number showed no difference. Persisting deficits in match high-speed running may exist for many players after hamstring strain injury. Clinical Relevance: Returning to play does not mean returning to (high-speed running) performance for nearly half of the high-level professional football players examined in this study. This suggests that successful return to play metrics should be expanded from simple time taken and recurrence to include performance.
- Kerbage, Samira, Garvey, Loretta, Lambert, Gavin, Willetts, Georgina
- Authors: Kerbage, Samira , Garvey, Loretta , Lambert, Gavin , Willetts, Georgina
- Date: 2021
- Type: Text , Journal article , Review
- Relation: International Journal of Nursing Studies Vol. 122, no. (2021), p.
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- Description: Background: Pain is frequently encountered in the intensive care setting. Given the impact of pain assessment on patient outcomes and length of hospital stay, studies have been conducted to validate tools, establish guidelines and cast light on practices relating to pain assessment. Objective: To examine the extent, range and nature of the evidence around pain assessment practices in adult patients who cannot self-report pain in the intensive care setting and summarise the findings from a heterogenous body of evidence to aid in the planning and the conduct of future research and management of patient care. The specific patient cohort studied was the sedated/ ventilated patient within the intensive care setting. Design: A scoping review protocol utilised the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping review checklist (PRISMA-ScR). Methods: The review comprised of five phases: identifying the research question, identifying relevant studies, study selection, charting the data and collating, summarizing, and reporting the results. Databases were systematically searched from January to April 2020. Databases included were Scopus, Web of Science, Medline via Ovid, CINAHL COMPLETE via EBSCO host, Health Source and PUBMED. Limits were applied on dates (2000 to current), language (English), subject (human) and age (adult). Key words used were “pain”, “assessment”, “measurement”, “tools”, “instruments”, “practices”, “sedated”, “ventilated”, “adult”. A hand search technique was used to search citations within articles. Database alerts were set to apprise the availability of research articles pertaining to pain assessment practices in the intensive care setting. Results: The review uncovered literature categorised under five general themes: behaviour pain assessment tools, pain assessment guidelines, position statements and quality improvement projects, enablers and barriers to pain assessment, and evidence appertaining to actual practices. Behaviour pain assessment tools are the benchmark for pain assessment of sedated and ventilated patients. The reliability and validity of physiologic parameters to assess pain is yet to be determined. Issues of compliance with pain assessment guidelines and tools exist and impact on practices. In some countries like Australia, there is a dearth of information regarding the prevalence and characteristics of patients receiving analgesia, type of analgesia used, pain assessment practices and the process of recording pain management. In general, pain assessment varies across different intensive care settings and lacks consistency. Conclusion: Research on pain assessment practices requires further investigation to explore the causative mechanisms that contribute to poor compliance with established pain management guidelines. The protocol of this review was registered with Open Science Framework (https://osf.io/25a6) Tweetable abstract: Pain assessment in intensive care settings lacks consistency. New information is needed to understand the causative mechanisms underpinning poor compliance with guidelines. © 2021
- Galbally, Megan, Watson, Stuart, Keelan, Jeffrey, Spigset, Olav, Lewis, Andrew
- Authors: Galbally, Megan , Watson, Stuart , Keelan, Jeffrey , Spigset, Olav , Lewis, Andrew
- Date: 2021
- Type: Text , Journal article
- Relation: Progress in Neuro-Psychopharmacology and Biological Psychiatry Vol. 109, no. (2021), p. 110218-110218
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- Description: Antidepressant treatment of perinatal depression is increasingly common and accepted in clinical guidelines. It has been suggested that serotonergic antidepressants may effect changes in the oxytocinergic system, including oxytocin levels, and that this may be one of the beneficial mechanisms of action for these drugs. Furthermore, oxytocin has been associated with the quality of the parent-child relationship, which may be important in treatment of perinatal depression. This study will explore if there is a relationship between antidepressant use over the perinatal period and oxytocin levels. Data from a pregnancy cohort study are used from 279 women across three groups: women taking antidepressants in pregnancy (n = 48), women with untreated depression (n = 31) and healthy control women (n = 200). Data included antidepressant use, maternal depression and oxytocin plasma concentrations in pregnancy and up to 12 months postpartum. We found that concurrent oxytocin blood concentrations were not associated with perinatal antidepressant use. However, oxytocin blood concentrations increased more steeply in those on antidepressants across the perinatal period compared to control women. A steeper increase for Selective Serotonergic Reuptake Inhibitors was observed, however, this effect was on the boarder of statistical significance. In conclusion, although antidepressant use and oxytocin was not associated at any time point, women taking antidepressants during pregnancy had larger increases in oxytocin over the perinatal period. Future research could examine specific agents and class of antidepressant and the relationship to parenting. •Animal studies have suggested that SSRI antidepressants may be associated with increased oxytocin levels•Oxytocin levels increased for women from early pregnancy to 12 months postpartum•Differences in cross-sectional perinatal oxytocin blood concentrations were not associated with antidepressant use•Antidepressant blood concentrations and oxytocin blood concentrations were not associated•Antidepressants across pregnancy and the postpartum were assocaited with a steeper increase in levels of oxytocin
- Mortezanejad, Marzieh, Ehsani, Fatemeh, Masoudian, Nooshin, Zoghi, Maryam, Jaberzadeh, Shapour
- Authors: Mortezanejad, Marzieh , Ehsani, Fatemeh , Masoudian, Nooshin , Zoghi, Maryam , Jaberzadeh, Shapour
- Date: 2020
- Type: Text , Journal article
- Relation: Clin Rehabilitation Vol. 34, no. 8 (2020), p. 1103-1111
- Full Text: false
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- Description: Objective: To compare the effects of anodal trans-cranial direct current stimulation (a-tDCS) over primary motor and dorsolateral prefrontal cortices on Fatigue Severity Scale and its lasting effect on fatigue reduction and improvement in quality of life in patients with multiple sclerosis. Design: A randomized, double-blinded, sham-controlled parallel clinical trial study. Setting: Neurological physiotherapy clinics. Subjects: Thirty-nine participants were randomly assigned to three groups: dorsolateral prefrontal cortex a-tDCS, primary motor a-tDCS (experimental groups) and sham a-tDCS. Finally, 36 participants completed the whole study (n = 12 in each group). Interventions: Participants in the experimental groups received six-session a-tDCS (1.5 mA, 20 minutes) during two weeks (three sessions per week). The sham group received six sessions of 20-minute sham stimulation. Main measures: The Fatigue Severity Scale and quality of life were assessed before, immediately and four weeks after the intervention. Results: Findings indicated a significant reduction in the Fatigue Severity Scale and a significant increase in the quality of life in both experimental groups, immediately after the intervention (P < 0.001), while Fatigue Severity Scale and quality of life changes were not significant in the sham a-tDCS group (P > 0.05). In addition, improvement of the variables remained four weeks after the intervention in dorsolateral prefrontal cortex a-tDCS (mean differences (95% confidence interval): 0.03 (−0.63 to 0.68) as compared to primary motor (−0.62 (−0.11 to −1.14) and sham a-tDCS groups (−0.47 (−1.37 to 0.43)). Conclusion: Both primary motor and dorsolateral prefrontal cortex a-tDCS as compared to sham intervention can immediately improve fatigue and quality of life. However, the effects last up to four weeks only by the dorsolateral prefrontal cortex a-tDCS.
Determination of anodal tDCS intensity threshold for reversal of corticospinal excitability: an investigation for induction of counter-regulatory mechanisms
- Hassanzahraee, Maryam, Nitsche, Michael, Zoghi, Maryam, Jaberzadeh, Shapour
- Authors: Hassanzahraee, Maryam , Nitsche, Michael , Zoghi, Maryam , Jaberzadeh, Shapour
- Date: 2020
- Type: Text , Journal article
- Relation: Scientific Reports Vol. 10, no. 1 (2020), p. 16108-16108
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- Description: Transcranial direct current stimulation is applied to modulate activity, and excitability of the brain. Basically, LTP-like plasticity is induced when anodal tDCS (a-tDCS) is applied over the primary motor cortex. However, it has been shown that specific parameters of a-tDCS can induce a plasticity reversal. We aimed to systematically assess the intensity threshold for reversal of the direction of plasticity induced by a-tDCS, monitored by corticospinal excitability (CSE), and explored mechanisms regulating this reversal. Fifteen healthy participants received a-tDCS in pseudo-random order for 26 min with four intensities of 0.3, 0.7, 1, and 1.5 mA. To measure CSE changes, single-pulse TMS was applied over the left M1, and motor evoked potentials of a contralateral hand muscle were recorded prior to a-tDCS, immediately and 30-min post-intervention. Paired-pulse TMS was used to evaluate intracortical excitation and inhibition. CSE increased significantly following a-tDCS with an intensity of 0.7 mA however, the expected effect decreased and even reversed at intensities of 1 and 1.5 mA. ICF was significantly increased while SICI and LICI decreased at 0.7 mA. On the other hand, a significant decrease of ICF, but SICI and LICI enhancement was observed at intensities of 1, and 1.5 mA. The present findings show an intensity threshold of ≥ 1 mA for 26 min a-tDCS to reverse LTP- into LTD-like plasticity. It is suggested that increasing stimulation intensity, with constant stimulation duration, activates counter-regulatory mechanisms to prevent excessive brain excitation. Therefore, stimulation intensity and plasticity induced by a-tDCS might non-linearly correlate in scenarios with prolonged stimulation duration.
- Authors: Hassanzahraee, Maryam , Nitsche, Michael , Zoghi, Maryam , Jaberzadeh, Shapour
- Date: 2020
- Type: Text , Journal article
- Relation: Scientific Reports Vol. 10, no. 1 (2020), p. 16108-16108
- Full Text:
- Reviewed:
- Description: Transcranial direct current stimulation is applied to modulate activity, and excitability of the brain. Basically, LTP-like plasticity is induced when anodal tDCS (a-tDCS) is applied over the primary motor cortex. However, it has been shown that specific parameters of a-tDCS can induce a plasticity reversal. We aimed to systematically assess the intensity threshold for reversal of the direction of plasticity induced by a-tDCS, monitored by corticospinal excitability (CSE), and explored mechanisms regulating this reversal. Fifteen healthy participants received a-tDCS in pseudo-random order for 26 min with four intensities of 0.3, 0.7, 1, and 1.5 mA. To measure CSE changes, single-pulse TMS was applied over the left M1, and motor evoked potentials of a contralateral hand muscle were recorded prior to a-tDCS, immediately and 30-min post-intervention. Paired-pulse TMS was used to evaluate intracortical excitation and inhibition. CSE increased significantly following a-tDCS with an intensity of 0.7 mA however, the expected effect decreased and even reversed at intensities of 1 and 1.5 mA. ICF was significantly increased while SICI and LICI decreased at 0.7 mA. On the other hand, a significant decrease of ICF, but SICI and LICI enhancement was observed at intensities of 1, and 1.5 mA. The present findings show an intensity threshold of ≥ 1 mA for 26 min a-tDCS to reverse LTP- into LTD-like plasticity. It is suggested that increasing stimulation intensity, with constant stimulation duration, activates counter-regulatory mechanisms to prevent excessive brain excitation. Therefore, stimulation intensity and plasticity induced by a-tDCS might non-linearly correlate in scenarios with prolonged stimulation duration.
Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019
- Abd-Allah, Foad, Adebayo, Oladimeji, Agrawal, Anurag, Alam, Tahiya, Rahman, Muhammad Aziz
- Authors: Abd-Allah, Foad , Adebayo, Oladimeji , Agrawal, Anurag , Alam, Tahiya , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: Lancet Vol. 396, no. 10258 (2020), p. 1160-1203
- Full Text:
- Reviewed:
- Description: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Bill & Melinda Gates Foundation. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
- Authors: Abd-Allah, Foad , Adebayo, Oladimeji , Agrawal, Anurag , Alam, Tahiya , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: Lancet Vol. 396, no. 10258 (2020), p. 1160-1203
- Full Text:
- Reviewed:
- Description: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Bill & Melinda Gates Foundation. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
- Galbally, Megan, Watson, Stuart, van Ijzendoorn, Marinus, Saffery, Richard, Ryan, Joanne, de Kloet, Edo Ronald, Oberlander, Tim, Lappas, Martha, Lewis, Andrew
- Authors: Galbally, Megan , Watson, Stuart , van Ijzendoorn, Marinus , Saffery, Richard , Ryan, Joanne , de Kloet, Edo Ronald , Oberlander, Tim , Lappas, Martha , Lewis, Andrew
- Date: 2020
- Type: Text , Journal article
- Relation: Psychoneuroendocrinology Vol. 115, no. (2020), p. 104611
- Full Text: false
- Reviewed:
- Description: •Maternal depression is associated with lower infant cortisol reactivity.•Early pregnancy depression is associated with reduced placental NR3C2 DNA methylation.•No association of maternal depression and cortisol with placental or infant buccal NR3C1 DNA methylation.•No association of antidepressant use with cortisol and placental or infant buccal NR3C1 and NR3C2 DNA methylation.•Association between infant cortisol reactivity and maternal depression was suppressed by placental NR3C2 DNA methylation. Understanding fetal programming pathways that underpin the relationship between maternal and offspring mental health necessitates an exploration of potential role of epigenetic variation in early development. Two genes involved in stress response regulation, the glucocorticoid and mineralocorticoid receptors (NR3C1 and NR3C2) have been a focus in understanding stressful exposures and mental health outcomes. Data were obtained from 236 pregnant women from the Mercy Pregnancy Emotional Wellbeing Study (MPEWS), a selected pregnancy cohort, recruited in early pregnancy. Depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV) and repeated measures of the Edinburgh Postnatal Depression Scale (EPDS). Antidepressant use, stressful events and anxiety symptoms were measured. NR3C1 and NR3C2 DNA methylation was measured in placental and infant buccal samples. Infant cortisol was measured in repeat saliva samples across a task. This study found maternal early pregnancy depressive disorder and symptoms were associated with lower DNA methylation at NR3C2 CpG_24 in placental tissue. There were no significant differences for depression or antidepressant use for DNA methylation of NR3C1. Antenatal depression was associated with lower infant cortisol reactivity at 12 months. DNA methylation in CpG_24 site in NR3C2 in placental samples suppressed the relationship between early maternal depressive symptoms and infant cortisol reactivity. These findings show a relationship between antenatal depression, NR3C2 DNA methylation and infant cortisol response providing support for a specific fetal programming pathway. Further research is required to examine the stability of this epigenetic mark across childhood and long-term mental health outcomes.
A feature agnostic approach for glaucoma detection in OCT volumes
- Maetschke, Stefan, Antony, Bhavna, Ishikawa, Hiroshi, Wollstein, Gadi, Schuman, Joel, Garnavi, Rahil
- Authors: Maetschke, Stefan , Antony, Bhavna , Ishikawa, Hiroshi , Wollstein, Gadi , Schuman, Joel , Garnavi, Rahil
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS One Vol. 14, no. 7 (2019), p. e0219126
- Full Text:
- Reviewed:
- Description: Optical coherence tomography (OCT) based measurements of retinal layer thickness, such as the retinal nerve fibre layer (RNFL) and the ganglion cell with inner plexiform layer (GCIPL) are commonly employed for the diagnosis and monitoring of glaucoma. Previously, machine learning techniques have relied on segmentation-based imaging features such as the peripapillary RNFL thickness and the cup-to-disc ratio. Here, we propose a deep learning technique that classifies eyes as healthy or glaucomatous directly from raw, unsegmented OCT volumes of the optic nerve head (ONH) using a 3D Convolutional Neural Network (CNN). We compared the accuracy of this technique with various feature-based machine learning algorithms and demonstrated the superiority of the proposed deep learning based method. Logistic regression was found to be the best performing classical machine learning technique with an AUC of 0.89. In direct comparison, the deep learning approach achieved a substantially higher AUC of 0.94 with the additional advantage of providing insight into which regions of an OCT volume are important for glaucoma detection. Computing Class Activation Maps (CAM), we found that the CNN identified neuroretinal rim and optic disc cupping as well as the lamina cribrosa (LC) and its surrounding areas as the regions significantly associated with the glaucoma classification. These regions anatomically correspond to the well established and commonly used clinical markers for glaucoma diagnosis such as increased cup volume, cup diameter, and neuroretinal rim thinning at the superior and inferior segments.
- Authors: Maetschke, Stefan , Antony, Bhavna , Ishikawa, Hiroshi , Wollstein, Gadi , Schuman, Joel , Garnavi, Rahil
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS One Vol. 14, no. 7 (2019), p. e0219126
- Full Text:
- Reviewed:
- Description: Optical coherence tomography (OCT) based measurements of retinal layer thickness, such as the retinal nerve fibre layer (RNFL) and the ganglion cell with inner plexiform layer (GCIPL) are commonly employed for the diagnosis and monitoring of glaucoma. Previously, machine learning techniques have relied on segmentation-based imaging features such as the peripapillary RNFL thickness and the cup-to-disc ratio. Here, we propose a deep learning technique that classifies eyes as healthy or glaucomatous directly from raw, unsegmented OCT volumes of the optic nerve head (ONH) using a 3D Convolutional Neural Network (CNN). We compared the accuracy of this technique with various feature-based machine learning algorithms and demonstrated the superiority of the proposed deep learning based method. Logistic regression was found to be the best performing classical machine learning technique with an AUC of 0.89. In direct comparison, the deep learning approach achieved a substantially higher AUC of 0.94 with the additional advantage of providing insight into which regions of an OCT volume are important for glaucoma detection. Computing Class Activation Maps (CAM), we found that the CNN identified neuroretinal rim and optic disc cupping as well as the lamina cribrosa (LC) and its surrounding areas as the regions significantly associated with the glaucoma classification. These regions anatomically correspond to the well established and commonly used clinical markers for glaucoma diagnosis such as increased cup volume, cup diameter, and neuroretinal rim thinning at the superior and inferior segments.
Belief in conspiracy theories : the predictive role of schizotypy, machiavellianism, and primary psychopathy
- Authors: March, Evita , Springer
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 14, no. 12 (2019), p.
- Full Text:
- Reviewed:
- Description: A conspiracy theory refers to an alternative explanation of an event involving a conspirator plot organised by powerful people or organisations. Belief in conspiracy theories is related to negative societal outcomes such as poor medical decisions and a decrease in prosocial behaviour. Given these negative outcomes, researchers have explored predictors of belief in conspiracy theories in an attempt to understand and possibly manage these beliefs. In the current study, we explored the utility of personality in predicting belief in conspiracy theories. The aim of the current study was to explore the utility of the odd beliefs/magical thinking subtype of schizotypy, Machiavellianism, grandiose narcissism, vulnerable narcissism, primary psychopathy, and secondary psychopathy in predicting belief in conspiracy theories. Participants (N = 230; 44.7% male, 55.3% female) completed an anonymous, confidential online questionnaire which comprised demographics and measures of personality traits and belief in conspiracy theories. The total regression model indicated odd beliefs/magical thinking, trait Machiavellianism, and primary psychopathy were significant, positive predictors of belief in conspiracy theories. No other predictors reached significance. Results of the current study highlight individuals who might be more susceptible to believing conspiracy theories. Specifically, these results indicate that the individual more likely to believe in conspiracy theories may have unusual patterns of thinking and cognitions, be strategic and manipulative, and display interpersonal and affective deficits. © 2019 March, Springer. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- Authors: March, Evita , Springer
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 14, no. 12 (2019), p.
- Full Text:
- Reviewed:
- Description: A conspiracy theory refers to an alternative explanation of an event involving a conspirator plot organised by powerful people or organisations. Belief in conspiracy theories is related to negative societal outcomes such as poor medical decisions and a decrease in prosocial behaviour. Given these negative outcomes, researchers have explored predictors of belief in conspiracy theories in an attempt to understand and possibly manage these beliefs. In the current study, we explored the utility of personality in predicting belief in conspiracy theories. The aim of the current study was to explore the utility of the odd beliefs/magical thinking subtype of schizotypy, Machiavellianism, grandiose narcissism, vulnerable narcissism, primary psychopathy, and secondary psychopathy in predicting belief in conspiracy theories. Participants (N = 230; 44.7% male, 55.3% female) completed an anonymous, confidential online questionnaire which comprised demographics and measures of personality traits and belief in conspiracy theories. The total regression model indicated odd beliefs/magical thinking, trait Machiavellianism, and primary psychopathy were significant, positive predictors of belief in conspiracy theories. No other predictors reached significance. Results of the current study highlight individuals who might be more susceptible to believing conspiracy theories. Specifically, these results indicate that the individual more likely to believe in conspiracy theories may have unusual patterns of thinking and cognitions, be strategic and manipulative, and display interpersonal and affective deficits. © 2019 March, Springer. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- Galbally, Megan, Watson, Stuart, Permezel, Michael, Lewis, Andrew
- Authors: Galbally, Megan , Watson, Stuart , Permezel, Michael , Lewis, Andrew
- Date: 2019
- Type: Text , Journal article
- Relation: Psychological Medcine Vol. 49, no. 9 (2019), p. 1490-1499
- Full Text: false
- Reviewed:
- Description: There is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning. This study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy and followed to 12 months postpartum. Women were assessed for depression using the Structured Clinical Interview for the DSM-IV, repeated measurement of depressive symptoms using the Edinburgh Postnatal Depression Scale and sexual functioning using the Female Sexual Functioning Inventory. Data were also collected on antidepressant use, mode of delivery, history of childhood trauma, breastfeeding and partner support. Women showed a decline in sexual functioning over pregnancy and the first 6 months postpartum, which recovered by 12 months. For women with depression, sexual functioning was lower throughout pregnancy and continued to be lower at 6 months postpartum than those without depression. Ongoing depressive symptoms at 12 months were also associated with lower sexual functioning. Sexual functioning was not predicted by mode of delivery, antidepressant use or childhood trauma. Breastfeeding predicted lower sexual functioning only at 6 months. Higher partner support predicted higher female sexual functioning. Pregnancy and the postpartum are a time of reduced sexual functioning for women however, women with depression are more likely to have lower levels of sexual functioning and this was not predicted by antidepressant use. In women with perinatal depression, consideration of the impact on sexual functioning should be an integral part of care.
- Yosephi, Mohaddeseh, Ehsani, Fatemeh, Daghiani, Maryam, Zoghi, Maryam, Jaberzadeh, Shapour
- Authors: Yosephi, Mohaddeseh , Ehsani, Fatemeh , Daghiani, Maryam , Zoghi, Maryam , Jaberzadeh, Shapour
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Clinical Neuroscience Vol. 62, no. (2019), p. 7-13
- Full Text: false
- Reviewed:
- Description: •Cathodal tDCS may reduce fear and disrupt the fear memory more than anodal tDCS.•Phase of fear memory is important factor in determining polarity of tDCS electrodes.•The brain region is important factor in determining polarity of tDCS electrodes.•The assessed fear parameters are important to show the effect of the tDCS intervention. Intensifying fear and fear of pain may lead to some diseases such as panic disorder, phobias, post-traumatic stress disorder (PTSD), anxiety disorders, depression, etc. A number of studies indicated positive effect of transcranial direct current stimulation (tDCS) on controlling fear and some studies did not observe any effect or even negative effect on decreasing fear. Due to lack of consensus in the findings of research, we aimed to systematically review studies, which investigated the effect of tDCS on fear. A literature search was conducted using the databases of PubMed, Science Direct, OVID, CINAHL, PEDro, Cochrane, Scopus and MEDLINE. Fear, fear memory, fear of pain, anxiety, post-traumatic stress disorder, electrical brain stimulation were applied as keywords. The valid assessment scale was used to evaluate the methodological quality of the included studies. The results of this systematic review revealed that the cathodal tDCS (c-tDCS) on the left dorsolateral prefrontal cortex (DLPFC) as compared to anodal tDCS (a-tDCS) could significantly reduce fear and modulate the fear memory. In addition, the findings of this study showed that the c-tDCS has positive effect on behavioural parameters of fear, while it cannot change biochemical parameters of fear during limited sessions of intervention. Application of c-tDCS on the left DLPFC could significantly reduce fear and modulate the fear memory.
- Sansonetti, Danielle, Nicks, Rebecca, Unsworth, Carolyn
- Authors: Sansonetti, Danielle , Nicks, Rebecca , Unsworth, Carolyn
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Occupational Therapy Journal Vol. 65, no. 6 (2018), p. 512-522
- Full Text: false
- Reviewed:
- Description: Background/aim: Life roles are integral to occupational therapy practice. Goal setting is a method of establishing priorities to measure outcomes. While acquired brain injury can impact a person's ability to fulfil meaningful life roles, the alignment of goals set in rehabilitation to life roles, is unclear. This study aimed to (i) explore the alignment of goals with life roles for people with an acquired brain injury participating in inpatient rehabilitation; and (ii) identify barriers and enablers to life role discussions within a patient-directed goal setting framework. Method: A mixed-methods study was conducted on an inpatient rehabilitation unit in Victoria, Australia. Quantitative data were obtained from a retrospective file audit of randomly selected medical records. Qualitative data were collected through: a) interviews with patients and their families; and b) A focus group with occupational therapists. Thematic analysis of both audit data and narrative data was undertaken. Results: Thirty files were examined and demonstrated 33% alignment between goals and life roles. Four interviews were completed with patients, with a family member participating in two of these. Themes identified were: readiness, role concept, recovery concept and goal review. Five therapists attended the focus group. Themes identified were: Patient factors, goal review, expectations, role change and environment. Interview and focus group data identified that barriers to life role discussions included: lack of patient and family readiness, patients’ difficulty understanding role concept, focus on impairments and lack of family/ significant others support. Enablers included: having early conversations involving family, regular goal review and use of standardised tools. Conclusion: Goal setting in alignment with life roles is important in acquired brain injury rehabilitation, but may be limited. This process can be enhanced by including patients and their significant others in early goal setting conversations, along with regular goal review across the rehabilitation process. © 2018 Occupational Therapy Australia
- Lane, Haylee, Sturgess, Tamica, Philip, Kathleen, Markham, Donna, Martin, Jennifer
- Authors: Lane, Haylee , Sturgess, Tamica , Philip, Kathleen , Markham, Donna , Martin, Jennifer
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Health Services Vol. 48, no. 2 (2018), p. 349-364
- Full Text: false
- Reviewed:
- Description: An ethnographic study was conducted in 2 stages to understand how allied health professionals define and apply equity when making resource allocation decisions. Participants were allied health managers and clinicians from Victoria, Australia. Stage 1 included 4 semi-structured forums that incorporated real-life case studies, group discussions, and hypothetical scenarios. The project’s steering committee began a thematic analysis during post-forum discussions. Stage 2 included a key stakeholder working party that further discussed the concept of equity. The forum recordings were transcribed verbatim, and a detailed thematic analysis ensured the initial thematic analysis was complete. Several domains of equity were discussed. Participants would readily identify that equity was a consideration when making resource decisions but were generally silent for a prolonged period when prompted to identify what they meant when using this term. The findings indicate that asking allied health professionals to directly state how they define and apply equity to their decision-making could be too difficult a task, as this did not elicit rich and meaningful discussions. Future research should examine individual domains of equity when applied to resource allocation decisions. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Jennifer Martin” is provided in this record**