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To systematically review the literature with the primary aim of identifying behavioural interventions to improve vitamin D stores in children from at-risk ethnic groups.
Review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PROSPERO registration number: CRD42017080932. Health Behaviour Model and Behaviour Change Wheel framework constructs used to underpin evaluation of interventions. Methodological quality evaluated using Cochrane Risk of Bias, Cochrane ROBINS-I and NHLBI tools.
Databases Cochrane Library, MEDLINE, EMBASE, CINAHL with secondary search of Google Scholar. No country limits set. Papers between January 1990 and February 2018, published in English included. Anticipating study heterogeneity, outcome measures not pre-specified and identified from individual full papers. Updated literature search November 2020.
Patient or population including pregnant women, newborns and children aged under 18 years, from Asian or African ethnic groups.
Of 10 690 articles screened, 298 underwent full-text review, with 24 ultimately included for data extraction. All identified studies conducted a vitamin D pharmacological supplementation intervention, with two also incorporating a behavioural intervention strategy. No study explicitly defined a primary aim of evaluating a behavioural intervention, undertaken to study its effect on vitamin D supplement uptake.
There is a need to address the paucity of data in ethnic at-risk children on how behavioural interventions ideally developed and co-produced with the community under study, affect and help improve vitamin D uptake, within the antenatal and pregnancy phase as well as during childhood.
The conventional wisdom that human growth is optimal when adequate amounts of all nutrients, minimal infection, and adequate psychosocial stimulation are available is too simplistic. The extensive interacting networks of material, biological, social, and ideological variables that comprise human life give rise to a hugely complicated matrix of factors that shape human phenotypes. There is no single optimal pattern of growth. There are ranges of possibilities with a multitude of local optima within the developmental matrix. The importance of social-economic-political-emotional (SEPE) factors is discussed in relation to new hypotheses of community effects and strategic growth adjustments on human development.
A student’s hope – their ability to both envision paths to desirable future goals and believe that they will get there – is a powerful force within the school context. In this chapter, I discuss the relevance and utility of hope within the school setting for school psychologists. The chapter begins with an overview of hope theory, including how it is typically measured and its documented relationships with the achievement, academic engagement, mental health, and socioemotional functioning of students. Next, I discuss several ways school psychologists can promote hope schoolwide through various school policies and actions. Lastly, I go over several research-based hope interventions that can be employed in small groups as well as several informal hope-based interventions that can be utilized by school personnel more broadly. There are many ways that hope can be useful to school psychologists. This chapter provides a starter hope toolkit for how it can be leveraged.
Asthma is increasing in prevalence in school-aged children. Causes for it include psychological triggers such as anxiety, stress, and depression. Interventions that are derived from education and psychology appear promising for symptom reduction. These treatments include written emotional expression, relaxation and guided imagery, gratitude exercises, mindfulness, and yoga, amongst others. This chapter reviews the myriad causes and treatments for childhood asthma.
In this chapter, we provide an overview of the theoretical basis of, barriers to, and interventions aimed at improving belonging in schools. Our discussion focuses on interpersonal relations and individual perceptions as fundamental to the sense of belonging. We review research on belonging as a fundamental human motive as well as newer work exploring variability in the experience of belonging. We also address barriers to belonging, illustrating the relational role of peers and teachers. We conclude by highlighting three interventions shown to foster belonging in an educational context, focusing on challenging psychological perceptions of threat (Walton & Cohen, 2011), changing the climate (Walton et al., 2015), and promoting cross-group friendships (Page-Gould, Mendoza-Denton, & Tropp, 2008). Throughout the chapter, we highlight the importance of the roles of the institution, community, and individuals involved.
Parental autonomy and relatedness support are crucial aspects of parental involvement and address core psychological needs. Although parental autonomy support has been incorporated into successful prevention programs, broader preventive possibilities will be examined. Six parental autonomy support intervention studies have been conducted with mostly middle to high socioeconomic status (SES) students in the United States, Canada, and Italy, yielding positive effects on intrinsic motivation, emotions toward learning, engagement, altruism, and mental health. Although cross-sectional and longitudinal studies have indicated that parental autonomy support promotes positive outcomes among students across all SES levels and in diverse countries, it is time to assess whether parental autonomy support interventions are equally or more effective for youth of low-SES backgrounds, diverse ethnicities, and diverse nationalities. The specific components of parental autonomy support will be discussed, as well as the potential to integrate autonomy supportive parenting with other valuable aspects of parent involvement.
Self-regulated learning (SRL) involves a system of cyclically related, goal-directed skills and processes that students can use to overcome academic challenges and to optimize their success in school. Although there are many complex models of SRL, the purpose of this chapter is to distill key themes among prominent SRL theories and to provide practical guidelines for incorporating SRL principles into classroom instruction or direct service activities with students. In this chapter, we describe how students can be taught to engage in a cyclical process of SRL involving the use of metacognitive skills (i.e., setting goals, planning, and evaluating), strategic thinking and action, and adaptive motivational beliefs. The authors also illustrate how educators can support SRL skills by fostering a supportive learning environment encompassing five key principles (e.g., helping students set clear and relevant goals, talking in the language of strategies) and/or by implementing established school-based SRL intervention programs. The characteristics of a SRL intervention program, called the Self-Regulation Empowerment Program (SREP), concrete SRL case scenarios, and supplemental resources are also emphasized.
Mental health difficulties and mental disorders are common in adolescents living with HIV or who are affected by HIV because of living in HIV-affected households in low- and middle-income (LMICs) countries, but little is known about the interventions that target these individuals and whether they are effective.
This systematic review aims to address these gaps by examining what has worked and what has not worked to support the mental health of adolescents living with HIV or affected by HIV in low- and middle-income contexts (PROSPERO Number: CRD42018103269).
A systematic literature review of online databases from the year 2000 to 2018, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, included English-language publications of quantitative evaluations of psychosocial interventions aiming to improve mental health among adolescents living with HIV and adolescents from HIV-affected households (aged 10–24 years) in LMICs.
Out of 2956 articles, 16 studies from 8 LMICs met the inclusion criteria. Thirteen studies focused on adolescents affected by HIV and only three studies on adolescents living with HIV. Only five studies included were from Sub-Saharan Africa. Interventions most often used a family-strengthening approach strengthening caregiver–adolescent relationships and communication and some problem-solving in groups or individually. Five studies reported statistically significant changes in adolescent and caregiver mental health or mental well-being, five among adolescents only and two among caregivers only.
Research on what works to improve mental health in adolescents living with HIV in LMIC is in its nascent stages. Family-based interventions and economic strengthening show promise.
Intimate Partner violence (IPV) is a global major public health problem, exposing women and children to adverse health outcomes. Refugee families are particularly at risk for IPV, a consequence of previous exposure to organized violence as well as migration stress and lack of societal protection. Refugee families from societies with traditional and patriarchal values resettling in secular societies cherishing gender equality and children’s rights face a challenge when women and children adjust to new ideals more rapidly than the men do. It is important to address that migration stress may cause or increase conflicts in the family and learn to handle conflicts in close relationships without violence. Health care procedures developed to recognize women exposed to IPV in general, such as screening for IPV in maternal care and child health care, need to be available for immigrants and refugee women. In the chapter, a case vignette illustrates how clinicians can work to unveil domestic violence and wartime trauma in refugee families and find ways to support a child exposed to both through collaboration with the parents.
Systematic reviews and meta-analyses suggest that behaviour change interventions have modest effect sizes, struggle to demonstrate effect in the long term and that there is high heterogeneity between studies. Such interventions take huge effort to design and run for relatively small returns in terms of changes to behaviour.
So why do behaviour change interventions not work and how can we make them more effective? This article offers some ideas about what may underpin the failure of behaviour change interventions. We propose three main reasons that may explain why our current methods of conducting behaviour change interventions struggle to achieve the changes we expect: 1) our current model for testing the efficacy or effectiveness of interventions tends to a mean effect size. This ignores individual differences in response to interventions; 2) our interventions tend to assume that everyone values health in the way we do as health professionals; and 3) the great majority of our interventions focus on addressing cognitions as mechanisms of change. We appeal to people’s logic and rationality rather than recognising that much of what we do and how we behave, including our health behaviours, is governed as much by how we feel and how engaged we are emotionally as it is with what we plan and intend to do.
Drawing on our team’s experience of developing multiple interventions to promote and support health behaviour change with a variety of populations in different global contexts, this article explores strategies with potential to address these issues.
Psychosocial interventions in families of children with cancer are considered an effective way of empowering family members to tackle the complex hurdles they face. The ability of parents to develop adaptive coping strategies during the child's treatment is not only important to their own mental and physical health, but also to their child's well-being and long-term adjustment with the disease.
The aim of this review was to evaluate the existing literature for the period from 2009 to 2017 on psychosocial interventions targeting families of children with cancer. We searched the PubMed database using the following combination of keywords: “cancer AND children AND (intervention OR training) AND (mothers OR primary caregivers OR parents OR fathers OR siblings).”
After careful evaluation of 995 papers, 17 full-text papers were found to match our criteria (12 randomized controlled trials and 5 quasi-experimental studies). The quality of the studies was assessed using the Delphi score questionnaire, and the score of the reviewed studies ranged from 3 to 5. The findings suggest that most interventions reduced distress and improved coping strategies among participants. Interventions, mainly cognitive behavioral therapy and problem-solving skills training targeting maternal distress, were associated with improved adjustment outcomes in mothers of children with cancer.
Significance of results
Psychosocial interventions are helpful, and efforts should be made to promote them in a larger scale. Protocols should be implemented to ensure that all parents benefit. Computer-assisted methods may provide additional benefit by improving cancer-related knowledge and cancer-related communication.
Children and adolescents display different symptoms of post-traumatic stress disorder (PTSD) than adults. Whilst evidence for the effectiveness of psychological interventions has been synthesised for adults, this is not directly applicable to younger people. Therefore, this systematic review and meta-analysis synthesised studies investigating the effectiveness of psychological interventions for PTSD in children, adolescents and young adults. It provides an update to previous reviews investigating interventions in children and adolescents, whilst investigating young adults for the first time.
We searched published and grey literature to obtain randomised control trials assessing psychological interventions for PTSD in young people published between 2011 and 2019. Quality of studies was assessed using the Cochrane Risk of Bias tool. Data were analysed using univariate random-effects meta-analysis.
From 15 373 records, 27 met criteria for inclusion, and 16 were eligible for meta-analysis. There was a medium pooled effect size for all psychological interventions (d = −0.44, 95% CI −0.68 to −0.20), as well as for Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and Eye Movement Desensitisation and Reprocessing (EMDR) (d = −0.30, 95% CI −0.58 to −0.02); d = −0.46, 95% CI −0.81 to −0.12).
Some, but not all, psychological interventions commonly used to treat PTSD in adults were effective in children, adolescents and young adults. Interventions specifically adapted for younger people were also effective. Our results support the National Institute for Health and Care Excellence guidelines which suggest children and adolescents be offered TF-CBT as a first-line treatment because of a larger evidence base, despite EMDR being more effective.
Cognition changes with age, and the amount and trajectory of change varies across individuals and functions. In this review, we argue that three general principles characterize adult life-span changes in brain and cognition. (1) Dimensionality: Many features of brain and cognition in aging and neurodegenerative disease represent quantitative differences along a continuum and are not unique to pathology. (2) Early influences – developmental origins of health and disease: Genetic dispositions and early environmental factors, likely even from fetal life, can have lasting impact on the brain and cognition. (3) Influences from a multitude of environmental factors: Current brain state and cognitive function will be determined by a combination of early factors and later environmental influences, often in interaction. These principles entail a model of age-associated cognitive decline and dementia based on dimensions rather than categories, life span rather than aging, and multidimensional systems-vulnerability rather than one major “biomarker.”
Aging is marked by cognitive decline, which in the case of Alzheimer’s disease is associated with tremendous global economic burden. Identifying modifiable risk factors for cognitive decline is therefore of paramount importance. In this chapter, we describe how aging compromises sleep quality and sleep architecture at a rate that parallels normal age-related cognitive decline. We argue that understanding the neurocognitive functions of sleep – frontal lobe restoration, memory consolidation, and metabolite clearance – and how such functions change in later life will be key to informing why some older individuals maintain healthy cognitive functioning and other older individuals do not. Critically, by investigating how sleep, cognition, and aging interact, researchers and clinicians can develop sleep-related treatments that target preventing, or at least ameliorating, pathologies such as Alzheimer’s disease.
Because of age-related cognitive declines, people sometimes expect older adults to be incompetent, senile, or extremely forgetful. Research on stereotype threat suggests that these negative expectations can interfere with older adults’ performance on cognitive tests and can cause them to underperform compared to their potential. However, research also shows that not all cognitive domains, and not all older adults, are equally affected by stereotype threat. Stereotype threat effects seem to occur most reliably on cognitive tasks where there are larger deficit expectations and for people who have concerns or negative expectations about aging and cognition. In addition to outlining these task and individual differences, in this chapter we also review potential mechanisms underlying these effects and discuss the applied implications of stereotype threat for how older adults’ memory is assessed in clinical and eyewitness settings.
My journey in the field of stress and coping began in the mid 1980s when I was researching the rather new field of childhood depression. It was a relatively under-explored field, and as a clinical and educational psychologist it was becoming increasingly apparent that there were concerns of young people, with some of these reflected in their experiences of sadness and despair. However, as I researched and measured the depression construct, I became aware of despair as a growing phenomenon, with an increased focus and emphasis on stress, anxiety and depression. In time, the statistics would bear out the concerns, as one in four young people have identified as being or are likely to be depressed in their lifetime in some Western communities like Australia, the United States and the United Kingdom (WHO, 2018). Given the growing ‘ill health’ of our Western communities, something had to change. In the 1980s, young people were concerned about their future with the fear of nuclear war. As I was writing this invited retrospective in late 2019, there were widespread concerns about global warming, and in the first half of 2020 concerns arising from the pandemic of COVID-19 are dominating. Coping theory research and practice can make a significant contribution to how we cope with our world in general and the specifics of our lives in particular. This article reports a body of work in the field of coping to illustrate the value of the core constructs and their applications in diverse settings providing opportunities for helpful adaptation and development in the face of whatever circumstances arise.
Children in armed conflict are frequently deprived of basic needs, psychologically supportive environments, educational and vocational opportunities, and other resources that promote positive psychosocial development and mental health. This article describes the mental health challenges faced by conflict-affected children and youth, the interventions designed to prevent or ameliorate the psychosocial impact of conflict-related experiences, and a case example of the challenges and opportunities related to addressing the mental health needs of Rohingya children and youth.
Introduction: Administrative data can aid in study and intervention design, incorporating hard-to-reach individuals who may otherwise be poorly represented. We aim to use administrative health data to examine emergency department visits by people experiencing homelessness and explore the application of this data for planning interventions. Methods: We conducted a serial cross-sectional study examining emergency department use by people experiencing homelessness and non-homeless individuals in the Niagara region of Ontario, Canada. The study period included administrative health data from April 1st, 2010 to March 31st, 2018. Outcomes included number of visits, number of unique patients; group proportions of Canadian Triage and Acuity Scale (CTAS) scores; time spent in emergency; and time to see an MD. Descriptive statistics were generated, and t-tests were performed for point estimates and a Mann-Whitney U test for distributional measures. Results: Our data included 1,486,699 emergency department visits. The number of unique people experiencing homelessness ranged from 91 in 2010 to 344 in 2017, trending higher over the study period compared to non-homeless patients. The rate of visits increased from 1.7 to 2.8 per person. People experiencing homelessness tend to present later in the day and with higher overall acuity as compared to the general population. Time in emergency department and time to see an MD were greater among people experiencing homelessness. Conclusion: Administrative health data allows researchers to enhance interventions and models of care to improve services for vulnerable populations. Given the challenging fiscal realities of research, our study provides insights to more effectively target interventions for vulnerable populations.
Introduction: Acute pain is frequent among patients visiting the emergency department (ED). In addition to the acute discomfort, pain has been linked to adverse events and poorest outcomes in older adults. However, pain is frequently overlooked by emergency clinicians, particularly in older adults. Advanced age has been linked to poor recognition and under treatment of pain. The contribution of ED investigations and procedures to the patient's pain is unknown. This study aims to determine the intensity of the pain induced by the investigations and procedures commonly performed in the ED. Methods: In two EDs, a convenience sample of older adults (≥ 65 years old) with at least two investigations or procedures performed during their ED visit were eligible. Patients were excluded if they were hemodynamically unstable, in palliative care or not oriented in time and space. The pain intensity was assessed at bedside by a research assistant for the following investigations or procedures: blood sampling, intravenous catheter, electrocardiogram, X-rays, computed tomography, beside ultrasound, urinary catheter, cervical collar and prehospital immobilization mattress. The predetermined sample size was 50 pain assessment per investigation or procedure. The pain intensity was assessed using a numerous rating scale (NRS) ranging from 0 (no pain) to 10 (most severe pain), for each investigation or procedure received. NRS results are presented using median (med) and interquartile range (IQR) and classified as followed: no pain (0), mild pain (1-3), moderate pain (4-6) and severe pain (7-10). Results: Between June 2018 and December 2019, 494 patients were screened of which 318 were finally included (exclusion: not oriented (n = 113), refusal (n = 27), palliative care (n = 34), other reasons (n = 12)). The mean age of included patients was 77.8 years old (standard deviation = 8.0), 54.4% were female and 78.6% were living in the community. Only 15 patients (4.7%) were known to have cognitive impairment or dementia and 23 patients (7.2%) were on regular or PRN opioid medication at home. The expected sample size of at least 50 pain score assessment per investigation or procedure was obtained for all interventions with the exception of urinary catheter (n = 23) and immobilization mattress (n = 35). For the other investigations or procedures, the number of pain assessment ranged between 51 (cervical collar) and 231 (blood sampling). All investigations and procedures were associated with a median pain score of 0 with the exception of blood sampling (n = 231, med NRS 1 (IQR 0;3)), intravenous catheter (n = 241, med NRS 1 (IQR 0;4)), urinary catheter (n = 23, med NRS 4 (IQR 1;6)), cervical collar (n = 51, med NRS 5 (IQR 0;8)) immobilisation mattress (n = 35, med NRS 3 (IQR 0;8)). Moderate or severe pain (NRS 4-10) was infrequently reported following most investigations or procedures with the exception of urinary catheter (60.8%), cervical collar (54.9%) and immobilization mattress (48.5%). Cervical collar induced severe pain in 41.8% of the patients. Conclusion: Most investigations and procedures commonly administered in the ED to older adults are associated with no pain or low intensity of pain. Severe pain is also infrequently induced by these interventions for most older adults. However, urinary catheter, cervical collar and immobilization mattress are associated with a higher intensity of pain and more than 40% of patients suffering from severe pain following the application of cervical collar. Considering the potential adverse effects of pain and the lack of evidence-based data to support the use of some interventions such as the cervical collar, the decision to use these interventions should be carefully weighted and could include a shared-decision making process. The generalizability of those findings to older adults with cognitive impairment is unknown. Future studies should focus on circumstances in which these procedures are beneficial to the patient to limit the unnecessary pain associated with their use.
L’efficacité des interventions destinées aux proches des individus vivant une psychose a été soulignée par de nombreuses études dont des méta analyses [5,6] et elles sont recommandées dans les Guides de meilleures pratiques en raison de leurs effets reconnus, soit la diminution des rechutes des personnes souffrant de psychose et une augmentation de leur soutien social [1,3,4].
Cette étude a évalué les retombées d’une nouvelle intervention (AVEC) élaborée par l’auteur et son associée, conçue selon les principes de la thérapie cognitive comportementale pour la psychose, manualisée et administrée par des infirmières spécialisées en santé mentale à des groupes de proches.
les proches (n = 40) furent évalués avant et après l’intervention et des tests T pairés furent effectués.
78,6 % présentent des améliorations significatives de leur soutien social (The Multidimensional Scale of Perceived Social Support, ) et une diminution significative de leur détresse (Brief Symptom Inventory, ). Ils témoignent aussi de leur satisfaction à l’égard de l’intervention de groupe. Des résultats qualitatifs de même que le contenu du manuel d’intervention seront présentés et les implications cliniques discutées.