Result 1 - 10 of total 97
Medical examiner (Philadelphia, Pa.)
2023 Volume 3, Issue 25, Page(s) 63–64
| Language | English |
|---|---|
| Publishing date | 2023-12-20 |
| Publishing country | United States |
| Document type | Journal Article |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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Therapeutic innovation & regulatory science
2021 Volume 55, Issue 5, Page(s) 989–1000
Abstract: Introduction: Quantitative patient-reported outcome (PRO) measures ideally are analyzed on their original scales and responder analyses are used to aid the interpretation of those primary analyses. As stated in the FDA PRO Guidance for Medical Product ... ...
| Abstract | Introduction: Quantitative patient-reported outcome (PRO) measures ideally are analyzed on their original scales and responder analyses are used to aid the interpretation of those primary analyses. As stated in the FDA PRO Guidance for Medical Product Development (2009), one way to lend meaning and interpretation to such a PRO measure is to dichotomize between values where within-patient changes are considered clinically important and those that are not. But even a PRO scale with a cutoff score that discriminates well between responder and non-responders is fraught with some misclassification. Methods: Using estimates of sensitivity and specificity on classification of responder status from a PRO instrument, formulas are provided to correct for such responder misclassification under the assumption of no treatment misclassification. Two case studies from sexual medicine illustrate the methodology. Results: Adjustment formulas on cell counts for responder misclassification are a direct extension of correction formulas for misclassification on disease from a two-way cross-classification table of disease (yes, no) and exposure (yes, no). Unadjusted and adjusted estimates of treatment effect are compared in terms of odds ratio, response ratio, and response difference. In the two case studies, there was considerable underestimation of treatment effect. Discussion and conclusions: The methodology can be applied to different therapeutic areas. Limitations of the methodology, such as when adjusted cell estimates become negative, are highlighted. The role of anchor-based methodology is discussed for obtaining estimates of sensitivity and specificity on responder classification. Correction for treatment effect bias from misclassification of responder status on PRO measures can lead to more trustworthy interpretation and effective decision-making. Clinicaltrials.gov: NCT00343200. |
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| MeSH term(s) | Bias ; Humans ; Odds Ratio ; Patient Reported Outcome Measures ; Sensitivity and Specificity |
| Language | English |
| Publishing date | 2021-05-27 |
| Publishing country | Switzerland |
| Document type | Journal Article |
| ZDB-ID | 2708397-4 |
| ISSN | 2168-4804 ; 2168-4790 |
| ISSN (online) | 2168-4804 |
| ISSN | 2168-4790 |
| DOI | 10.1007/s43441-021-00298-5 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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ACS pharmacology & translational science
2021 Volume 4, Issue 2, Page(s) 416–423
Abstract: Psychedelic and mindfulness interventions have been shown to improve mental ill-health and wellbeing, with a range of clinical processes and effects in common. However, each appear to contain specific challenges in the context of mental health treatment. ...
| Abstract | Psychedelic and mindfulness interventions have been shown to improve mental ill-health and wellbeing, with a range of clinical processes and effects in common. However, each appear to contain specific challenges in the context of mental health treatment. In this Perspective, we focus on a set of distinct affordances, "useful differences", within psychedelic and mindfulness interventions that might address common challenges within the other intervention. Accordingly, we propose a set of applied synergies, indicating specific ways in which these two promising interventions might be combined for greater benefit. Metaphorically, on the journey toward mental health and wellbeing, we propose that psychedelic treatments may serve the role of Compass (initiating, motivating, and steering the course of mindfulness practice), with mindfulness interventions serving the role of Vehicle (integrating, deepening, generalizing, and maintaining the novel perspectives and motivation instigated by psychedelic experience). We outline a set of testable hypotheses and future research associated with the synergistic action of psychedelic and mindfulness interventions toward improved clinical outcomes. |
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| Language | English |
| Publishing date | 2021-03-16 |
| Publishing country | United States |
| Document type | Journal Article ; Review |
| ISSN | 2575-9108 |
| ISSN (online) | 2575-9108 |
| DOI | 10.1021/acsptsci.1c00034 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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PloS one
2021 Volume 16, Issue 10, Page(s) e0258999
Abstract: Purpose: Medical students commonly experience elevated psychological stress and poor mental health. To improve psychological wellbeing, a 5-week mindfulness-based lifestyle course was delivered to a first-year undergraduate medical student cohort as ... ...
| Abstract | Purpose: Medical students commonly experience elevated psychological stress and poor mental health. To improve psychological wellbeing, a 5-week mindfulness-based lifestyle course was delivered to a first-year undergraduate medical student cohort as part of the core curriculum. This study investigated the effects of the program on mental health, perceived stress, study engagement, dispositional mindfulness, and whether any improvements were related to amount of formal and/or informal mindfulness practice. Methods: Participants were first year undergraduate medical students (N = 310, 60% female, M = 18.60 years) with N = 205 individuals completing pre and post course questionnaires in a 5-week mindfulness-based lifestyle intervention. At pre- and post-intervention, participants completed the Mental Health Continuum-Short Form, the Perceived Stress Scale, the Utrecht Work Engagement Scale for Students, the Freiburg Mindfulness Inventory, and the Mindfulness Adherence Questionnaire. Results: Mental health, perceived stress, study engagement, and mindfulness all improved from pre- to post-intervention (all p values < .001). Improvements on these outcome measures were inter-related such that PSS change scores were negatively correlated with all other change scores, FMI change scores were positively correlated with MHC-SF and UWES-S change scores, the latter of which was positively correlated with MHC-SF change scores (all p values < .01). Finally, observed improvements in all of these outcomes were positively related to informal practice quality while improved FMI scores were related to formal practice (all p values < .05). Conclusions: A 5-week mindfulness-based program correlates with improving psychological wellbeing and study engagement in medical students. These improvements particularly occur when students engage in informal mindfulness practice compared to formal practice. |
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| MeSH term(s) | Adolescent ; Female ; Humans ; Life Style ; Male ; Mental Health ; Mindfulness/methods ; Stress, Psychological/psychology ; Students, Medical/psychology ; Surveys and Questionnaires ; Young Adult |
| Language | English |
| Publishing date | 2021-10-21 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ISSN | 1932-6203 |
| ISSN (online) | 1932-6203 |
| DOI | 10.1371/journal.pone.0258999 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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2023
Abstract: Rationale: Research on psychedelics has recently shown promising results in the treatment of various psychiatric disorders, but relatively little remains known about the psychiatric risks associated with naturalistic use of psychedelics.: Objective: ... ...
| Abstract | Rationale: Research on psychedelics has recently shown promising results in the treatment of various psychiatric disorders, but relatively little remains known about the psychiatric risks associated with naturalistic use of psychedelics. Objective: The objective of the current study was to investigate associations between naturalistic psychedelic use and psychiatric risks. Methods: Using a sample representative of the US adult population with regard to sex, age, and ethnicity (N=2822), this study investigated associations between lifetime naturalistic psychedelic use, lifetime unusual visual experiences, and past 2-week psychotic symptoms. Results: Among respondents who reported lifetime psychedelic use (n=613), 1.3% reported having been told by a doctor or other medical professional that they had hallucinogen persisting perception disorder. In covariate-adjusted linear regression models, lifetime psychedelic use was associated with more unusual visual experiences at any point across the lifetime, but no association was observed between lifetime psychedelic use and past 2-week psychotic symptoms. There was an interaction between lifetime psychedelic use and family (but not personal) history of psychotic or bipolar disorders on past 2-week psychotic symptoms such that psychotic symptoms were highest among respondents who reported lifetime psychedelic use and a family history of psychotic or bipolar disorders and lowest among those who reported lifetime psychedelic use and no family history of psychotic or bipolar disorders. Conclusions: Although the results in this study should be interpreted with caution, the findings suggest that lifetime naturalistic use of psychedelics might be associated with more unusual visual experiences across the lifetime, as well as more psychotic symptoms in the past 2 weeks for individuals with a family history of psychotic or bipolar disorders and the reverse for those without such a family history. Future research should distinguish between different psychotic and bipolar disorders and should also utilize other research designs (e.g., longitudinal) and variables (e.g., polygenic risk scores) to better understand potential cause-and-effect relationships. |
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| Language | English |
| Publishing date | 2023-10-24 |
| Publishing country | Germany |
| Document type | Journal Article |
| ZDB-ID | 130601-7 |
| ISSN | 1432-2072 ; 0033-3158 |
| ISSN (online) | 1432-2072 |
| ISSN | 0033-3158 |
| DOI | 10.1007/s00213-023-06478-5 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
| Ui I Zs.240: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
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2023 , Page(s) 1–9
Abstract: Objectives: While mindfulness in the workplace has received substantial scientific attention in the past decades, it is not yet well-understood if, under what circumstances, and in what ways mindfulness training may be helpful for individuals working in ...
| Abstract | Objectives: While mindfulness in the workplace has received substantial scientific attention in the past decades, it is not yet well-understood if, under what circumstances, and in what ways mindfulness training may be helpful for individuals working in political environments. The aim of this study was to explore the experience of mindfulness training among British politicians, as well as mindfulness facilitators who had taught mindfulness to politicians in the UK Parliament. Method: Between September and November 2021, semi-structured in-depth interviews were conducted with British politicians ( Results: Two main themes related to the experience of mindfulness training in politics were developed during the analytic process: (1) mindfulness approaches addressing particular challenges in political work, and (2) mindfulness sessions and group dynamics. Taken together, mindfulness training helped the politicians to better deal with the demands and stresses of political work, to reconnect with themselves and be more grounded, and - especially when taught in a group setting - to relate to other politicians and their viewpoints in a more humane and constructive way. Conclusions: The results suggest that mindfulness training can be beneficial at both the personal and professional level for individuals working in political contexts, which can provide a rationale for governments to introduce mindfulness-based programs to politicians. Supplementary information: The online version contains supplementary material available at 10.1007/s12671-023-02156-x. |
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| Language | English |
| Publishing date | 2023-05-29 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 2543424-X |
| ISSN | 1868-8535 ; 1868-8527 |
| ISSN (online) | 1868-8535 |
| ISSN | 1868-8527 |
| DOI | 10.1007/s12671-023-02156-x |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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Journal of affective disorders
2023 Volume 326, Page(s) 105–110
Abstract: Previous studies have investigated challenging, difficult, or distressing classic psychedelic experiences, but little is known about the prevalence and associations of such experiences. Using nationally representative data of the US adult population (N = ...
| Abstract | Previous studies have investigated challenging, difficult, or distressing classic psychedelic experiences, but little is known about the prevalence and associations of such experiences. Using nationally representative data of the US adult population (N = 2822), this study examined the prevalence and associations of challenging, difficult, or distressing experiences using classic psychedelics, in a subsample of respondents who reported lifetime classic psychedelic use (n = 613). Of the 613 respondents who reported lifetime classic psychedelic use, the majority of them (59.1 %) had never had a challenging, difficult, or distressing experience using a classic psychedelic, but 8.9 % of respondents reported functional impairment that lasted longer than one day as a result of such experiences. Notably, 2.6 % reported seeking medical, psychiatric, or psychological assistance in the days or weeks following their most challenging, difficult, or distressing classic psychedelic experience. In covariate-adjusted regression models, co-use of lithium, co-use of other mood stabilizers, and six set and setting variables (no preparation, disagreeable physical environment, negative mindset, no psychological support, dose was too large, major life event prior to experience) were associated with the degree of difficulty; and co-use of lithium, co-use of other mood stabilizers, and three set and setting variables (negative mindset, no psychological support, major life event prior to experience) were associated with overall risk of harm. In summary, this study provides insight into the prevalence and associations of challenging, difficult, or distressing classic psychedelic experiences. The findings broadly correspond with findings from previous studies and can inform harm reduction efforts and future experimental research designs. |
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| MeSH term(s) | Adult ; Humans ; Hallucinogens/adverse effects ; Lithium ; Prevalence ; Substance Withdrawal Syndrome/drug therapy ; Harm Reduction |
| Chemical Substances | Hallucinogens ; Lithium (9FN79X2M3F) |
| Language | English |
| Publishing date | 2023-01-30 |
| Publishing country | Netherlands |
| Document type | Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 135449-8 |
| ISSN | 1573-2517 ; 0165-0327 |
| ISSN (online) | 1573-2517 |
| ISSN | 0165-0327 |
| DOI | 10.1016/j.jad.2023.01.073 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
| Zs.A 1485: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
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2024 Volume 22, Issue 1, Page(s) 47
Abstract: Background: Patients recovering from SARS-CoV-2 infection and acute COVID-19 illness can experience a range of long-term post-acute effects. The potential clinical and economic burden of these outcomes in the USA is unclear. We evaluated diagnoses, ... ...
| Abstract | Background: Patients recovering from SARS-CoV-2 infection and acute COVID-19 illness can experience a range of long-term post-acute effects. The potential clinical and economic burden of these outcomes in the USA is unclear. We evaluated diagnoses, medications, healthcare utilization, and medical costs before and after acute COVID-19 illness in US patients who were not at high risk of severe COVID-19. Methods: This study included eligible adults who were diagnosed with COVID-19 from April 1 to May 31, 2020, who were 18 - 64 years of age, and enrolled within Optum's de-identified Clinformatics® Data Mart Database for 12 months before and 13 months after COVID-19 diagnosis. Patients with any condition or risk factor placing them at high risk of progression to severe COVID-19 were excluded. Percentages of diagnoses, medications, healthcare utilization, and costs were calculated during baseline (12 months preceding diagnosis) and the post-acute phase (12 months after the 30-day acute phase of COVID-19). Data were stratified into 3 cohorts according to disposition during acute COVID-19 illness (i.e., not hospitalized, hospitalized without intensive care unit [ICU] admission, or admitted to the ICU). Results: The study included 3792 patients; 56.5% of patients were men, 44% were White, and 94% did not require hospitalization. Compared with baseline, patients during the post-acute phase had percentage increases in the diagnosis of the following disorders: blood (166%), endocrine and metabolic (123%), nervous system (115%), digestive system (76%), and mental and behavioral (75%), along with increases in related prescriptions. Substantial increases in all measures of healthcare utilization were observed among all 3 cohorts. Total medical costs increased by 178% during the post-acute phase. Those who were hospitalized with or without ICU admission during the acute phase had the greatest increases in comorbidities and healthcare resource utilization. However, the burden was apparent across all cohorts. Conclusions: As evidenced by resource use in the post-acute phase, COVID-19 places a significant long-term clinical and economic burden among US individuals, even among patients whose acute infection did not merit hospitalization. |
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| MeSH term(s) | Adult ; Male ; Humans ; Female ; COVID-19/epidemiology ; SARS-CoV-2 ; Financial Stress ; Acute Disease ; COVID-19 Testing |
| Language | English |
| Publishing date | 2024-02-02 |
| Publishing country | England |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 2131669-7 |
| ISSN | 1741-7015 ; 1741-7015 |
| ISSN (online) | 1741-7015 |
| ISSN | 1741-7015 |
| DOI | 10.1186/s12916-023-03235-5 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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2022 Volume 10, Page(s) 947898
Abstract: Introduction: Mindfulness-based interventions are associated with improved health and wellbeing. Online mindfulness interventions offer potential scalability and cost advantages over face-to-face interventions. However, little is known about the ... ...
| Abstract | Introduction: Mindfulness-based interventions are associated with improved health and wellbeing. Online mindfulness interventions offer potential scalability and cost advantages over face-to-face interventions. However, little is known about the experiences of learners, what they identify as being helpful to developing a practice of mindfulness and what outcomes they experience from undertaking an online mindfulness program. Methods: The Mindfulness for Wellbeing and Peak Performance Massive Open Online Course is a 4-week mindfulness program which includes psychoeducation, mindfulness meditation, applications and moderated discussion forums. Of the 3,335 participants who completed the March 2020 course, 527 (16%) responded to the final forum which invited participants to describe the highlights of the course. In order to enhance understanding of participant experiences and perceived outcomes of undertaking the course, a qualitative analysis of these free text comments was conducted using reflexive thematic analysis. Results: Two overarching themes were identified: (1) internal mechanisms of developing mindfulness (subthemes: paying attention to the present moment, learning to let go and find acceptance, cultivating an attitude of gentleness, and learning through a sense of belonging) and (2) the translation of mindfulness into daily living (subthemes: mindfulness being a support to mental wellbeing, learning to deal with uncertainty and adversity, living a more conscious life, a greater connection with self and others and channeling attention into productivity). Discussion: The themes and subthemes provided insights into the mechanisms learners used to develop mindfulness and how they translated mindfulness into their lives in a variety of beneficial ways. This understanding of learners' experiences could inform delivery of future online mindfulness interventions. |
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| MeSH term(s) | Humans ; Learning ; Mindfulness |
| Language | English |
| Publishing date | 2022-08-12 |
| Publishing country | Switzerland |
| Document type | Journal Article |
| ZDB-ID | 2711781-9 |
| ISSN | 2296-2565 ; 2296-2565 |
| ISSN (online) | 2296-2565 |
| ISSN | 2296-2565 |
| DOI | 10.3389/fpubh.2022.947898 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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JAMA network open
2022 Volume 5, Issue 10, Page(s) e2235089
Abstract: Importance: A new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code (U09.9 Post COVID-19 condition, unspecified) was introduced by the Centers for Disease Control and Prevention on October 1, 2021. ...
| Abstract | Importance: A new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code (U09.9 Post COVID-19 condition, unspecified) was introduced by the Centers for Disease Control and Prevention on October 1, 2021. Objective: To examine the use of the U09.9 code and describe concurrently diagnosed conditions to understand physician use of this code in clinical practice. Design, setting, and participants: This cohort study of US patients with an ICD-10-CM code for post-COVID-19 condition used deidentified patient-level claims data aggregated by HealthVerity. Children and adolescents (aged 0-17 years) and adults (aged 18-64 and ≥65 years) with a post-COVID-19 condition code were identified between October 1, 2021, and January 31, 2022. To identify a prior COVID-19 diagnosis, 3 months of continuous enrollment (CE) before the post-COVID-19 diagnosis date was required. Main outcomes and measures: Presence of the ICD-10-CM U09.9 code. Results: There were 56 143 patients (7723 female patients [61.2%]; mean [SD] age, 47.6 [19.2] years) with a post-COVID-19 diagnosis code, with cases increasing in mid-December 2021 following the trajectory of the Omicron case wave by 3 to 4 weeks. The analysis cohort included 12 622 patients after the 3-month preindex CE criteria was applied. Among this cohort, the median (IQR) age was 49 (35-61) years; however, 1080 (8.6%) were pediatric patients. The U09.9 code was used most often in the outpatient setting, although 305 older adults (14.0%) were inpatients. Only 698 patients (5.5%) had at least 1 of the 5 codes listed as possible concurrent conditions in the coding guidance. Only 8879 patients (70.4%) had a documented acute COVID-19 diagnosis code (569 [52.7%] among children), and the median (IQR) time between acute COVID-19 and post-COVID-19 diagnosis codes was 56 (21-200) days. The most common concurrently coded conditions varied by age; children experienced COVID-19-like symptoms (eg, 207 [19.2%] had cough and 115 [10.6%] had breathing abnormalities), while 459 older adults aged 65 years or older (21.1%) experienced respiratory failure and 189 (8.7%) experienced viral pneumonia. Conclusions and relevance: This retrospective cohort study found patients with a post-COVID-19 ICD-10-CM diagnosis code following the acute phase of COVID-19 disease among patients of all ages in clinical practice in the US. The use of the U09.9 code encompassed a wide range of conditions. It will be important to monitor how the use of this code changes as the pandemic continues to evolve. |
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| MeSH term(s) | Adolescent ; Aged ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19 Testing ; Child ; Cohort Studies ; Female ; Humans ; Middle Aged ; Pandemics ; Retrospective Studies |
| Language | English |
| Publishing date | 2022-10-03 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ISSN | 2574-3805 |
| ISSN (online) | 2574-3805 |
| DOI | 10.1001/jamanetworkopen.2022.35089 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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