bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economic evaluation of interventions for treatment-resistant depression: A systematic review
Authors: Hannah Laura A. , Walsh Cathy M. , Jopling Louise , Perez Jesus , Cardinal Rudolf N. , Cameron Rory A. 
Published: February 2023

BackgroundThe extraordinarily high prevalence of treatment-resistant depression (TRD), coupled with its high economic burden to both healthcare systems and society, underscore how critical it is that resources are managed optimally to address the significant challenge it presents.ObjectiveTo review the literature on economic evaluation in TRD systematically, with the aim of informing future studies by identifying key challenges specific to the area, and highlighting good practices.MethodsA systematic literature search across seven electronic databases was conducted to identify both within-trial and model-based economic evaluations in TRD. Quality of reporting and study design was assessed using the Consensus Health Economic Criteria (CHEC). A narrative synthesis was conducted.ResultsWe identified 31 evaluations, including 11 conducted alongside a clinical trial and 20 model-based evaluations. There was considerable heterogeneity in the definition of treatment-resistant depression, although with a trend for more recent studies to use a definition of inadequate response to two or more antidepressive treatments. A broad range of interventions were considered, including non-pharmacological neuromodulation, pharmacological, psychological, and service-level interventions. Study quality as assessed by CHEC was generally high. Frequently poorly reported items related to discussion of ethical and distributional issues, and model validation. Most evaluations considered comparable core clinical outcomes – encompassing remission, response, and relapse. There was good agreement on the definitions and thresholds for these outcomes, and a relatively small pool of outcome measures were used. Resource criteria used to inform the estimation of direct costs, were reasonably uniform. Predominantly, however, there was a high level of heterogeneity in terms of evaluation design and sophistication, quality of evidence used (particularly health state utility data), time horizon, population considered, and cost perspective.ConclusionEconomic evidence for interventions in TRD is underdeveloped, particularly so for service-level interventions. Where evidence does exist, it is hampered by inconsistency in study design, methodological quality, and availability of high quality long-term outcomes evidence. This review identifies a number of key considerations and challenges for the design of future economic evaluations. Recommendations for research and suggestions for good practice are made.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259848&amp;VersionID=1542096, identifier CRD42021259848.
Development, religious affiliation, and social context: Substance use disorders in Puerto Rican transitional age youth
Authors: Saunders David , Sussman Tamara , Corbeil Thomas , Canino Glorisa , Bird Hector , Alegria Margarita , Duarte Cristiane S. 
Published: February 2023

IntroductionTransitional age youth (i. e., ages 16–24; TAY) use higher levels of substances than any age group in the United States. Understanding what factors increase substance use during TAY could suggest novel targets for prevention/intervention. Studies suggest that religious affiliation is inversely associated with substance use disorders (SUDs). However, the association of religious affiliation and SUD, including the role of gender and social context, has not been studied in TAY of Puerto Rican ethnicity.MethodsUsing data from N = 2,004 TAY of Puerto Rican ethnicity across two social contexts—Puerto Rico (PR) and the South Bronx, NY (SBx)—we tested the association of religious identity (Catholic, Non-Catholic Christian, Other/Mixed, and no religious affiliation, or “None”), and four SUD outcomes (alcohol use disorder, tobacco use disorder, illicit SUD, and any SUD). Logistic regression models were used to examine the association between religious identity and SUDs, then we tested for interaction by social context and gender.ResultHalf the sample identified as female; 30, 44, and 25% were 15–20, 21–24, and 25–29 years of age, respectively; 28% of the sample received public assistance. There was a statistically significant difference between sites for public assistance (22 and 33% in SBx/PR, respectively; p &lt; 0.001); 29% of the sample endorsed None (38 and 21% in SBx/PR, respectively.) Compared to None, identifying as Catholic was associated with reduced risk of illicit SUD (OR = 0.51, p = 0.02), and identifying as Non-Catholic Christian with reduced risk for any SUD (OR = 0.68, p = 0.04). Additionally, in PR but not SBx, being Catholic or Non-Catholic Christian was protective for illicit SUD when compared to None (OR = 0.13 and 0.34, respectively). We found no evidence of an interaction between religious affiliation and gender.DiscussionThe percentage of PR TAY who endorse no affiliation is higher than the general PR population, reflective of increasing religious non-affiliation among TAY across cultures. Critically, TAY with no religious affiliation are twice as likely as Catholics to have illicit SUD, and 1.5 times as likely as Non-Catholic Christians to have any SUD. Endorsing no affiliation is more adverse for illicit SUD in PR than the SBx, underscoring the importance of social context.
Reward enhances resilience to chronic social defeat stress in mice: Neural ECs and mGluR5 mechanism via neuroprotection in VTA and DRN
Authors: Shi Peixia , Hu Linlin , Ren Hui , Dai Qin 
Published: February 2023

IntroductionStress often leads to emotional disorders such as depression. The reward might render this effect through the enhancement of stress resilience. However, the effect of reward on stress resilience under different intensities of stress needs more evidence, and its potential neural mechanism has been poorly revealed. It has been reported that the endogenous cannabinoid system (ECs) and downstream metabolic glutamate receptor 5 (mGluR5) are closely related to stress and reward, which might be the potential cerebral mechanism between reward and stress resilience, but there is a lack of direct evidence. This study aims to observe the effect of reward on stress resilience under different intensities of stress and further explore potential cerebral mechanisms underlying this effect.MethodsUsing the chronic social defeat stress model, we applied reward (accompanied by a female mouse) under different intensities of stress in mice during the modeling process. The impact of reward on stress resilience and the potential cerebral mechanism were observed after modeling through behavioral tests and biomolecules.ResultsThe results showed that stronger stress led to higher degrees of depression-like behavior. Reward reduced depression-like behavior and enhanced stress resilience (all p-value &lt;0.05) (more social interaction in the social test, less immobility time in the forced swimming test, etc.), with a stronger effect under the large stress. Furthermore, the mRNA expression levels of CB1 and mGluR5, the protein expression level of mGluR5, and the expression level of 2-AG (2-arachidonoylglycerol) in both ventral tegmental area (VTA) and dorsal raphe nucleus (DRN) were significantly upregulated by reward after modeling (all p-value &lt;0.05). However, the protein expression of CB1 in VTA and DRN and the expression of AEA (anandamide) in VTA did not differ significantly between groups. Intraperitoneal injection of a CB1 agonist (URB-597) during social defeat stress significantly reduced depression-like behavior compared with a CB1 inhibitor (AM251) (all p-value &lt;0.05). Interestingly, in DRN, the expression of AEA in the stress group was lower than that of the control group, with or without reward (all p-value &lt;0.05).DiscussionThese findings demonstrate that combined social and sexual reward has a positive effect on stress resilience during chronic social defeat stress, potentially by influencing the ECs and mGluR5 in VTA and DRN.
Communicating diagnoses to individuals with a first episode psychosis: A qualitative study of individuals perspectives
Authors: Huurman Marina Elisabeth , Pijnenborg Gerdina Hendrika Maria , Sportel Bouwina Esther , van Rijsbergen Gerard David , Hasson-Ohayon Ilanit , Boonstra Nynke 
Published: February 2023

BackgroundReceiving the label of a psychotic disorder influences self-perception and may result in negative outcomes such as self-stigma and decreased self-esteem. The way the diagnosis is communicated to individuals may affect these outcomes.AimsThis study aims to explore the experiences and needs of individuals after a first episode of psychosis with regard to the way in which information about diagnosis, treatment options and prognosis is communicated with them.Design and methodsA descriptive interpretative phenomenological approach was used. Fifteen individuals who experienced a first episode of psychosis participated in individual semi-structured open-ended interviews on their experiences and needs regarding the process of providing information about diagnosis, treatment options and prognosis. Inductive thematic analysis was used to analyze the interviews.ResultsFour recurring themes where identified (1) timing (when); (2) content (what); and (3) the way information is provided (how). Individuals also reported that the provided information could elicit an emotional reaction, for which they would require specific attention, therefore the fourth theme is (4) reactions and feelings.ConclusionThis study provides new insights into the experiences and specific information needed by individuals with a first episode of psychosis. Results suggest that individuals have different needs regarding the type of (what), how and when to receive information about diagnosis and treatment options. This requires a tailor-made process of communicating diagnosis. A guideline on when, how and what to inform, as well as providing personalized written information regarding the diagnosis and treatment options, is recommended.
Prevalence of insomnia and its association with quality of life among Macau residents shortly after the summer 2022 COVID-19 outbreak: A network analysis perspective
Authors: Chen Pan , Zhang Ling , Sha Sha , Lam Mei Ieng , Lok Ka-In , Chow Ines Hang Iao , Si Tong Leong , Su Zhaohui , Cheung Teris , Feng Yuan , Jackson Todd , Xiang Yu-Tao 
Published: February 2023

BackgroundThe latest wave of the coronavirus disease 2019 (COVID-19) pandemic in Macau began on 18 June 2022 and was more serious than previous waves. Ensuing disruption from the wave is likely to have had a variety of negative mental health consequences for Macau residents including increased risk for insomnia. This study investigated the prevalence and correlates of insomnia among Macau residents during this wave as well as its association with quality of life (QoL) from a network analysis perspective.MethodsA cross-sectional study was conducted between 26 July and 9 September 2022. Univariate and multivariate analyses explored correlates of insomnia. Analysis of covariance (ANCOVA) examined the relationship between insomnia and QoL. Network analysis assessed the structure of insomnia including “Expected influence” to identify central symptoms in the network, and the flow function to identify specific symptoms that were directly associated with QoL. Network stability was examined using a case-dropping bootstrap procedure.ResultsA total of 1,008 Macau residents were included in this study. The overall prevalence of insomnia was 49.0% (n = 494; 95% CI = 45.9–52.1%). A binary logistic regression analysis indicated people with insomnia were more likely to report depression (OR = 1.237; P &lt; 0.001) and anxiety symptoms (OR = 1.119; P &lt; 0.001), as well as being quarantined during the COVID-19 pandemic (OR = 1.172; P = 0.034). An ANCOVA found people with insomnia had lower QoL (F(1,1,008) = 17.45, P &lt; 0.001). “Sleep maintenance” (ISI2), “Distress caused by the sleep difficulties” (ISI7) and “Interference with daytime functioning” (ISI5) were the most central symptoms in the insomnia network model, while “Sleep dissatisfaction” (ISI4), “Interference with daytime functioning” (ISI5), and “Distress caused by the sleep difficulties” (ISI7) had the strongest negative associations with QoL.ConclusionThe high prevalence of insomnia among Macau residents during the COVID-19 pandemic warrants attention. Being quarantined during the pandemic and having psychiatric problems were correlates of insomnia. Future research should target central symptoms and symptoms linked to QoL observed in our network models to improve insomnia and QoL.
Informal caregivers in Germany – who are they and which risks and resources do they have?
Authors: Fuchs Judith , Gaertner Beate , Rommel Alexander , Starker Anne 
Published: February 2023

BackgroundThe aim of this study is to describe the social characteristics, the health and living situation and the prevalence of behavioral risk factors of adult informal caregivers compared to non-caregivers in Germany.MethodsWe used data from the German Health Update (GEDA 2019/2020-EHIS survey) which is a cross-sectional population-based health interview survey conducted between 04/2019 and 09/2020. The sample comprised 22,646 adults living in private households. Three mutually exclusive groups of providing informal care or assistance were differentiated: intense caregivers (informal care ≥10 h/week), less-intense caregivers (informal care&lt;10 h/week) and non-caregivers. For the three groups weighted prevalences of social characteristics, health status (self-perceived health, health-related activity limitations, chronic diseases, low back disorder or other chronic back defect, depressive symptoms), behavioral risk factors (at-risk drinking, current smoking, insufficient physical activity, non-daily fruit and vegetable consumption, obesity) and social risk factors (single household, low social support) were calculated and stratified by gender. Separate regression analyses adjusted for age-group were conducted to identify significant differences between intense and less-intense caregivers vs. non-caregivers, respectively.ResultsOverall, 6.5% were intense caregivers, 15.2% less-intense caregivers and 78.3% non-caregivers. Women provided care more often (23.9%) than men (19.3%). Informal care was most frequently provided in the age group of 45 to 64 years. Intense caregivers reported worse health status, were more often current smokers, physical inactive, obese and lived less often alone than non-caregivers. However, in age-group adjusted regression analyses only few significant differences were seen: Female and male intense caregivers had more often a low back disorder and lived less often alone compared to non-caregivers. In addition, male intense care-givers reported more often worse self-perceived health, health-related activity limitation, and the presence of chronic diseases. In contrast, less-intense caregivers and non-caregivers differed in favor of the less-intense caregivers.DiscussionA substantial proportion of the adult German population provides informal care regularly, especially women. Intense caregivers are a vulnerable group for negative health outcomes, especially men. In particular measures to prevent low back disorder should be provided. As the necessity of providing informal care will probably increase in the future, this will be important for the society and public health.
Applying the theory of planned behavior to investigate type 2 diabetes patients' intention to receive injection therapy
Authors: Hsu Su-Han , Tang Kung-Pei , Lin Chia-Hui , Chen Pei-Chun , Wang Li-Hsuan 
Published: February 2023

ObjectivesThis study applied the theory of planned behavior (TPB) in shared decision making (SDM) to understand behavioral intention in patients with type 2 diabetes with regard to injection therapy for blood sugar control.MethodsA cross sectional study was conducted. Two hundred and fifty-four patients with type 2 diabetes participated this study and were interviewed by pharmacists in different clinics. A patient decision aid (PDA) entitled “Should I receive injection therapy regarding my type 2 diabetes condition?” was developed for this study and served as interview agenda which comprised 18 items to inquire their willingness to use injection therapy and related considerations during the SDM process.ResultsThe questionnaires were revised using item analysis, exploratory factor analysis, and a criteria of Cronbach's α &gt; 0.7. This resulted in three constructs for all questionnaires that fit the TPB model. Attitude (β = 0.432;P&lt; 0.001) and PBC (β = 0.258;P&lt; 0.001) were directly correlated with intention. TPB explained 35.2% of the variance in intention toward the use of injection therapy.ConclusionsAttitude and PBC toward injection therapy positively and significantly influence the patients' intention to use injection therapy.Practical implicationsThese findings identify a key association for understanding behavioral intention in patients with type 2 diabetes with regard to blood sugar control during SDM.
Structural racism theory, measurement, and methods: A scoping review
Authors: Wien Simone , Miller Andres L. , Kramer Michael R. 
Published: February 2023

IntroductionEpidemiologic and public health interest in structural racism has grown dramatically, producing both increasingly sophisticated questions, methods, and findings, coupled with concerns of atheoretical and ahistorical approaches that often leave the actual production of health or disease ambiguous. This trajectory raises concerns as investigators adopt the term “structural racism” without engaging with theories and scholars with a long history in this area. This scoping review aims to build upon recent work by identifying current themes about the incorporation of structural racism into (social) epidemiologic research and practice with respect to theory, measurement, and practices and methods for trainees and public health researchers who are not already deeply grounded in this work.MethodsThis review uses methodological framework and includes peer-review articles written in English published between January 2000–August 2022.ResultsA search of Google Scholar, manual collection, and referenced lists identified a total of 235 articles; 138 met the inclusion criteria after duplicates were removed. Results were extracted by, and organized into, three broad sections: theory, construct measurement, and study practice and methods, with several themes summarized in each section.DiscussionThis review concludes with a summary of recommendations derived from our scoping review and a call to action echoing previous literature to resist an uncritical and superficial adoption of “structural racism” without attention to already existing scholarship and recommendations put forth by experts in the field.
Implementation and evaluation of a model-based risk management process and service enhancement for home-based community care services amidst COVID-19 pandemic in Hong Kong: A mixed-method approach
Authors: Yang Caroline W. L. , Wan Alice N. T. , Kwok Mable C. W. , Lam Tai-Hing , Lai Agnes Y. K. 
Published: February 2023

BackgroundThe COVID-19 pandemic has greatly challenged all public social services, particularly home-based community care services (HBCCS). Aberdeen Kai-fong Association (AKA) is a non-government organization (NGO) in Hong Kong that systematically manages the challenges to HBCCS. This paper presents a practical example of the implementation and evaluation of the risk management process for HBCCS.MethodsMixed-method design was used to evaluate the implementation of the risk management process in encountering the challenges from existing and potential problems to maintain and enhance HBCCS in four major areas amidst the pandemic. A cross-sectional questionnaire survey and three qualitative focus group interviews were conducted by AKA from 30 December 2021 to 12 March 2022 to collect staff feedback on the institutional risk management process in four areas.Results109 HBCCS staff members (69% aged 40 years or above; 80% female) completed the questionnaire survey. For resource arrangement and staff training, over 90% of the participants agreed (including strongly agreed) that they had sufficient and reliable personal protective equipment and clear infection control guideline and effective training. Over 80% agreed they had safe working space and effective manpower allocation. However, only 75% agreed they had received emotional support from the organization. Over 90% agreed that the basic services were maintained for service continuation and enhancement, the service users and their families trusted the organization, and the provided services were adjusted according to users' needs. 88% agreed that the organization had obtained support from the neighborhood. For communication among stakeholders, over 80% agreed they had open discussions with the senior management team, and the senior management team was willing to listen. Twenty-six staff members joined the three focus group interviews. The qualitative findings corroborated the quantitative results. Staff appreciated the organisation's work to enhance staff safety and continue advancing services during this difficult period. Regular in-service training, updated information and guidelines to staff, and proactive phone calls to service users, especially the elderly, were suggested to enhance the quality of services.ConclusionsThe paper could help NGOs and others encountering management challenges in community social services in diverse settings amidst the pandemic and beyond.