Evidence Base For Efficacy Research Articles

Probiotics and Prebiotics Intervention in Respiratory and Digestive Infections Linked to Covid-19.

Probiotics and prebiotics have been suggested as natural agents against viral infections and dysbiosis and may encourage clinical applications. This review aims to analyze the main and recent advances related to viral infections such as Covid-19 and its gastrointestinal complications, antiviral immunity generated and possible preventive role that probiotics and/or prebiotics can play in controlling and promoting antiviral immunity. The literature search was performed through a critical analysis of relevant publications reported in PubMed and Scopus databases on clinical trials and assays conducted in vitro on colon cells and in vivo on mice. Some studies using probiotics and prebiotics for the prevention of viral infection in different age groups are discussed. Covid-19 patients have been shown to suffer from gastrointestinal complications in addition to respiratory symptoms due to interactions between the respiratory system and the gastrointestinal tract infected with SARS-CoV-2. Unfortunately, therapies used to prevent (or treat) symptoms of Covid-19 have proven to be of limited effectiveness. In addition, the lack of access to coronavirus vaccines around the world and vaccine hesitancy continue to hamper control of Covid-19. It is therefore crucial to find alternative methods that can prevent disease symptoms. Evidence-based efficacy of certain probiotics (Lactobacillus and Bifidobacterium) that may be useful in viral infections was shown with immunomodulatory properties (pro-inflammatory mediators reduction), promoting antiviral immunity (antibodies production, virus titers) and controlling inflammation (anti-inflammatory effect), as well as viral clearance and antimicrobial potential against opportunistic bacteria (anti-dysbiosis effect). But, available data about clinical application of probiotics in Covid-19 context remain limited and relevant scientific investigation is still in its early stages. Also, evidence for prebiotics potential in this field is limited, since the exact mechanism involved in systemic immune modulation by these compounds is till now unknown. Thus, further research is necessary to explore in the viral infection context the mechanism by which gut and lung interact in the presence of probiotics and prebiotics through more animal and clinical experiments.

Multiple mechanisms enable broad-spectrum activity of the Pelargonium sidoides root extract EPs 7630 against acute respiratory tract infections.

There is clinical evidence showing that the Pelargonium sidoides root extract EPs 7630 is a safe and effective treatment for a range of acute infectious respiratory illnesses. Moreover, EPs 7630 has been shown to reduce the use of antibiotics, which is important in the context of rising antibiotic resistance levels. A wide range of mechanisms appears to contribute to the beneficial effects of EPs 7630, e.g. antibacterial, antiviral, immunomodulatory, and epithelial barrier effects. This broad spectrum of pharmacological activities seems to enable the clinical activity of EPs 7630 against multiple respiratory infections. In particular, the combination of antiviral and immunomodulatory effects may enable EPs 7630 to tackle acute viral respiratory infections both in early stages of the disease process, which are driven by virus replication, as well as in later stages, which are caused by an overshooting immune response. Hence, EPs 7630 is a prime example of a plant extract with evidence-based clinical efficacy, including a solid understanding of the underlying mechanisms of action. The example of EPs 7630 demonstrates that plant extracts have a potential role as evidence-based clinical treatments and that they deserve pre-clinical and clinical testing and investigation in the same way as any other drug class.

Unpacking Technical Assistance (TA) Strategies Within a State-Level Prevention Support System: A Mixed-Method Study in Determining Types and Amount of TA.

The research-practice gap between evidence-based intervention efficacy and its uptake in real-world contexts remains a central challenge for prevention and implementation science. Providing technical assistance (TA) is considered a crucial support mechanism that can help narrow the gap. However, empirical measurement of TA strategies and their variation is often lacking. The current study unpacks the black box of TA, highlighting different TA strategies, amounts, and their relation to intervention characteristics. First, we qualitatively categorized interactions between TA providers and implementers. Second, we explored how characteristics of implementing organizations and the intervention related to variations in the amount of TA delivered. Using data spanning six years, we analyzed over 10,000 encounters between TA providers and implementers. Content analysis yielded four distinct strategies: Consultation (27.2%), Coordination Logistics (24.5%), Monitoring (16.5%), and Resource Delivery (28.2%). Organizations with prior experience required less monitoring and resource delivery. Additionally, characteristics of the intervention were significantly associated with the amount of consultation, monitoring, coordination logistics, and resource delivery provided. The specific features of the intervention showed significant variation in their relation to TA strategies. These findings provide initial insights into the implications of intervention characteristics in determining how much of which TA strategies are needed to support implementations in real-world settings.

Evidence-based efficacy, safety and technical features of performing percutaneous nephrolithotomy (systematic review of meta-analyses)

To date, the literature presents a wide data regarding the effectiveness, safety, and technical features of percutaneous nephrolithotomy. A significant proportion of studies are presented in the format of systematic literature reviews and meta-analyses. This article presents an analysis of the accumulated data was carried out in the form of a systematic review of meta-analyses.

A review on the pharmacology of cariprazine and its role in the treatment of negative symptoms of schizophrenia.

Management of negative symptoms is one of the most challenging and important unmet needs of schizophrenia treatment. Negative symptoms together with positive symptoms result in significant psychosocial impairment and poor quality of life. Existing studies on atypical antipsychotics reported limited treatment adherence due to higher prevalence of treatment-emergent adverse events, such as diabetes, weight gain, hyperlipidemia, hyperprolactinemia and hypertension. A compound with greater affinity for dopamine D2/D3 receptors may improve negative symptoms, mood, and cognitive impairment associated with schizophrenia. In 2015, the US FDA has approved cariprazine, a partial D2/D3 agonist for treatment of schizophrenia, mania or mixed episodes. Midlands and Lancashire Commissioning Support Unit, UK (2019) has particularly suggested cariprazine for the treatment of predominant negative symptoms of schizophrenia. India's Central Drugs Standard Control Organization (CDSCO) has approved cariprazine in 2021 for the treatment of schizophrenia, manic or mixed episodes associated with bipolar I disorder. A ten-fold greater affinity for D3 receptors and partial agonism to serotonin receptors, along with longer half-life make cariprazine distinct when compared with other atypical antipsychotics. Cariprazine is also reported to have fewer incidents of metabolic and hormonal adverse events, and has been shown to provide better relapse prevention. Recent evidence indicates promising effect of cariprazine in ameliorating negative symptoms as well as psychotic symptoms in patients with schizophrenia. In addition, improved adherence to treatment (adjunctive/monotherapy) with cariprazine in patients having inadequate response to an ongoing antipsychotic treatment has also been clinically established. This review presents the evidence-based safety and efficacy of cariprazine for treatment of predominant negative symptoms of schizophrenia.

Pharmacogenomic overlap between antidepressant treatment response in major depression & antidepressant associated treatment emergent mania in bipolar disorder

There is increasing interest in individualizing treatment selection for more than 25 regulatory approved treatments for major depressive disorder (MDD). Despite an inconclusive efficacy evidence base, antidepressants (ADs) are prescribed for the depressive phase of bipolar disorder (BD) with oftentimes, an inadequate treatment response and or clinical concern for mood destabilization. This study explored the relationship between antidepressant response in MDD and antidepressant-associated treatment emergent mania (TEM) in BD. We conducted a genome-wide association study (GWAS) and polygenic score analysis of TEM and tested its association in a subset of BD-type I patients treated with SSRIs or SNRIs. Our results did not identify any genome-wide significant variants although, we found that a higher polygenic score (PGS) for antidepressant response in MDD was associated with higher odds of TEM in BD. Future studies with larger transdiagnostic depressed cohorts treated with antidepressants are encouraged to identify a neurobiological mechanism associated with a spectrum of depression improvement from response to emergent mania.

TCVM Treatment of the Subfertile Mare

The treatment of reproductive disorders and the promotion of fertility represent cornerstones of the equine and bovine industries. Along with conventional medical treatments, the use of Traditional Chinese Medicine (TCM), which has been used to treat reproductive problems for thousands of years in humans, is showing increasing potential through evidence-based studies to treat infertility in animals. In this article, a traditional Chinese veterinary medicine (TCVM) approach to treatment of infertility in the mare will be presented. Discussion of common TCVM infertility patterns in the sub-fertile mare such as Kidney Qi and Blood Deficiency and Kidney Yin Deficiency will be explored. Review of research studies substantiating evidence-based efficacy of TCVM techniques along with practical tips for acupuncture and herbal medicine treatment for infertility will also be presented.

Community pharmacists' knowledge, attitudes, and practices regarding counselling on vitamins and dietary supplements in Malaysia: A study on complementary medicines

BackgroundThe utilization of vitamins and dietary supplements (DSs) among consumers in Malaysia has seen a notable increase. However, there is limited research available on how pharmacists in Eastern countries manage the provision of these products. ObjectiveThis study aims to assess the knowledge, attitudes, and practices of community pharmacists in Malaysia regarding the provision of counselling services on vitamins and DSs. The findings will inform education strategies in this area. MethodsA cross-sectional quantitative study was conducted from February to April 2022 using a validated online-based questionnaire. The survey was distributed to community pharmacists across Malaysia through social media channels. t-test and ANOVA test were used for data analysis. ResultsAmong the 260 participants, 73.5% were categorized as having average product knowledge. Key concerns included a lack of knowledge about the indications of new products and when to discontinue their use. Regarding dosing in specific patient groups, 33.5% of pharmacists only occasionally consulted references and primarily relied on product labels. Furthermore, 29% of pharmacists believed it was unnecessary to refer patients to doctors when they experienced ongoing symptoms while taking vitamins or DSs. Interestingly, 44.6% of pharmacists believed there was a correlation between the efficacy of vitamins and their price, often recommending more expensive brands despite similar content. ConclusionThere is an opportunity to enhance the knowledge of pharmacists in Malaysia regarding vitamins and DSs. Education interventions should focus on areas such as dosing for specific patient groups, when to discontinue products, understanding new products, evidence-based efficacy of products for specific conditions, and providing a framework for appropriate referral to support pharmacists in their practice.

Parenteral nutrition overview: the role of the nurse and equipment

Parenteral nutrition is the intravenous provision of nutrition, made up of a mixture of components. It is for patients where conditions, such as intestinal failure, short bowel syndrome or bowel obstruction, are present and necessiate additional nutrition to meet patients’ needs and avoid malnutrition. Parenteral nutrition can be life-preserving for patients. There are four main types of central intravenous catheters that deliver these nutrients: an implantable port device, a tunnelled central venous catheter, a non-tunnelled central venous catheter and a peripherally-inserted central catheter. The three main bag types that contain of bags that contain these nutrients: pre-made, multi-chamber and bespoke. This article outlines the importance and involvement of nurses in the parenteral nutrition process, including the selection and administration of parenteral equipment, as well as presenting a summary of parenteral catheters and bags, their safety and evidence-based efficacy.

Evidence-based Clinical Efficacy of Certain Indigenous Traditional Siddha Formulations in Combating Anemia: A Global Health Burden – A Systematic Review and Meta-analysis

ABSTRACT Background: Anemia is a widespread issue impacting the well-being of millions and their quality of life. It also hinders the growth and learning of children, which can detrimentally affect a nation’s progress. In Siddha System of medicine, various pharmaceutical formulations are available for anemia treatment. However, there is a lack of evidence-based clinical trial data supporting these traditional Siddha claims. Aim and Objective: This study aimed to conduct an extensive meta-analysis to assess the therapeutic effectiveness of Siddha formulations in anemia management and also to evaluate the clinical evidence’s validity. Materials and Methods: The study gathered data from various sources, showcasing the use of different Siddha preparations in clinical studies for anemia treatment. Rev-Man 5.2 software was used for meta-analysis. The study revealed a significant improvement in both adults and paediatric groups after treatment with various Siddha formulations. Results: The meta-analysis showed a standardized mean difference (SMD) of 1.92 for haemoglobin level before and after treatment over an average period of 44 ± 20 days (P≤0.0001). Conclusion: This analysis demonstrates that Siddha formulations have substantial evidence-based therapeutic efficacy in treating anemia. These Siddha formulations hold promise for inclusion in public health programs and policies aimed at combating anemia in the population. However, conducting more randomized control trials (RCTs) in anemia treatment is essential to establish robust scientific evidence which potentially leads to global acceptance of these Siddha formulations.

Does the advertisement in Swiss pharmacy windows rest on evidence-based medicine? An observational study

ObjectivesThe aim of the study was to analyse the proportion of evidence-based medication displayed in pharmacies and compare it between the different linguistic regions of the country, at different times...

Metformin use among obese patients with prediabetes in Qassim, Saudi Arabia: An observational study

Background and aimsThe high prevalence of prediabetes and diabetes mellitus and its secondary complications in Saudi Arabia is a major healthcare concern. Evidence suggests that despite evidence-based efficacy and safety, metformin is underutilized in prediabetic obese patients. Thus, the aim of this study was to investigate the use of metformin in prediabetic obese patients in the Qassim region of Saudi Arabia. MethodsPrediabetic patients' electronic health records were accessed and screened from 2017 to 2021. The inclusion criteria were patients with obesity (BMI ≥ 35) diagnosed with prediabetes, and who received metformin. Patients with chronic kidney disease and those using metformin for other diseases were excluded. The first major endpoint of this study was the rate of metformin use among obese, prediabetic individuals. The second major endpoint was the factors associated with metformin prescribing in our cohort. Descriptive statistics were used to report the primary and secondary outcomes. Data are presented as percentages, means, standard deviations (SDs), medians, and interquartile ranges, as appropriate. All analyses were conducted using Stata version 16.1. ResultsA total of 304 prediabetic patients were included in this study after screening the records of 1,789 patients. The average age was found to be 40, and the majority were female (72%). The average BMI was found to be 39.4 kg/m2, while the average HbA1c was 5.8%. In the entire sample, only 25 (8.22%) obese patients received metformin for diabetes prevention. Among obese patients with a BMI ≥ 30, 19 patients (8.7%) received metformin. Metformin users had higher odds of being on statins (OR 2.72, 95% CI 1.01 to 7.36; p = 0.049). ConclusionAccording to the study, metformin is not frequently prescribed to prediabetic obese individuals in the Qassim region of Saudi Arabia. This prevention strategy is a missed opportunity in the management of prediabetes in high-risk patients. Future studies are needed to investigate the root causes of the underuse of metformin and potential interventions to promote evidence-based practice in Saudi Arabia.

Hierarchy of pathogenetic mechanisms of chronic cerebrovascular insufficiency and therapeutic strategies for neuroprotection

Chronic cerebrovascular insufficiency (CCI) is an independent disease with complex etiopathogenetic mechanisms and a polymorphic clinical picture. The complex hierarchy of pathogenetic mechanisms and clinical manifestations forces the doctor to choose a strategy for drug therapy, taking into account the multifunctional effect on all pathogenetic mechanisms. With regard to chronic cerebrovascular insufficiency, there are still no unambiguous standards, mainly the use of preventive strategies (antihypertensive drugs, antiplatelet agents, anticoagulants, statins) is recommended. At the same time, a combination of pathological factors leads to a violation of the integrity of the homeostasis system and mitochondrial and endothelial dysfunction, atrophy of the cerebral cortex, neurodegeneration, and proliferation of glial cells. Violations of metabolic, protein-synthetic processes in the vascular wall and neurons underlie subsequent morphological damage, which is the foundation for the development or manifestation of a particular symptom. Therefore, only preventive or symptomatic therapy separately from each other is unlikely to have the expected effect. Due to the fact that there are no unified diagnostic criteria, a unified pathogenetic paradigm, there are no standards in the treatment of CNMC, neuropeptides have been actively studied in recent years. They are capable of selective binding to endogenous proteins and can form structural conformations in response to various stimuli in the biological environment, which allows for various therapeutic applications of peptide assemblies. The drugs have pronounced neurotrophic, mediator, effector and anti-inflammatory properties, are highly effective, can be used in small doses, and have no side reactions. A promising drug in this group is a polypeptide from the brain of porcine embryos6 which has a good evidence base for efficacy and safety in patients with cerebrovascular diseases. . To increase the effectiveness of therapy, it is advisable to combine neurope-tides with antioxidants and antihypoxants, choline precursor drugs.

The use of antidementia therapy in non-dementia cognitive disorders associated with COVID-19

IntroductionThe new coronavirus infection causes severe damage to the human body. One of the most serious complication is cognitive impairment.According to a meta-analysis by Maxime Taquet et al. (2021), which assessed neurological and psychiatric outcomes among 236,379 patients diagnosed with COVID-19, 1.7% of participants over 65 years of age were diagnosed with dementia.In a US online survey of 1,500 people (Sarah Ballou et al., 2020), about half reported difficulty concentrating on any task after experiencing COVID-19.It was also found that there is a decrease in the speed of reactions and problem-solving (Jeffrey D. Pyne et al., 2021).There are a number of studies that present the evidence-based efficacy of acetylcholinesterase (AChE) inhibitors in dementia prevention.However, in accordance with clinical guidelines for cognitive disorders in the elderly, anti-dementia drugs are not used at the stage of mild to moderate cognitive impairment (Ministry of Health of the Russian Federation, 2020).ObjectivesThe use of AChE inhibitors in cognitive impairments that do not reach the degree of dementia.MethodsResearch data from open sources.ResultsThe development of early cholinergic deficiency correlates with the development of cognitive impairment, while acetylcholine has a pronounced neuroplastic effect and increases the number of neurons (Gabriela Dumitrita Stanciu et al., 2019).In a double-blind, placebo-controlled study, a positive effect of rivastigmine was found in patients with mild to moderate cognitive impairment. The study’s results show that rivastigmine treatment (3, 6, 9 mg/day) for six months increases brain activity of the hippocampus in the control group by 32,5%. Rivastigmine prevented the clinical progression of symptoms of cognitive impairment and caused activation of some parts of the cerebral cortex (Nagaendran Kandiah et al., 2017).In a study by Wolfson C. et al. (2002), it was found that rivastigmine can slow down the development of cognitive impairment for at least six months in patients with mild to moderate massive cognitive dysfunction. Subjects treated with 1 to 21 mg per day for 7 to 12 weeks got more favorable ADAS-cog scores for the six months after treatment. While those who took the drug in doses of 6 to 12 mg showed a more pronounced positive effect compared to the placebo group.The Luca Rozzini in 2006 conducted a study based on 59 subjects with mild cognitive impairment. 15 subjects received both neuropsychological examination and acetylcholinesterase inhibitors. As a result, the remaining subjects were behind in terms of abstract thinking and behavioral symptoms, in comparison with a combined treatment group.ConclusionsIt is advisable to conduct further studies on the effectiveness of AChE inhibitors to prevent the progression of mild to moderate cognitive impairment and their transition to dementia.Disclosure of InterestNone Declared

Depression in Major Neurodegenerative Diseases and Strokes: A Critical Review of Similarities and Differences among Neurological Disorders.

Depression and anxiety are highly prevalent in most neurological disorders and can have a major impact on the patient's disability and quality of life. However, mostly due to the heterogeneity of symptoms and the complexity of the underlying comorbidities, depression can be difficult to diagnose, resulting in limited recognition and in undertreatment. The early detection and treatment of depression simultaneously with the neurological disorder is key to avoiding deterioration and further disability. Although the neurologist should be able to identify and treat depression initially, a neuropsychiatry team should be available for severe cases and those who are unresponsive to treatment. Neurologists should be also aware that in neurodegenerative diseases, such as Alzheimer's or Parkinson's, different depression symptoms could develop at different stages of the disease. The treatment options for depression in neurological diseases include drugs, cognitive-behavioral therapy, and somatic interventions, among others, but often, the evidence-based efficacy is limited and the results are highly variable. Here, we review recent research on the diagnosis and treatment of depression in the context of Alzheimer's disease, Parkinson's disease, and strokes, with the aim of identifying common approaches and solutions for its initial management by the neurologist.

"I Could Have Stood a Little More Education Rather than Just: 'Hey, you're Diabetic Man, Make the Best out of It'": Revisioning Diabetes Self-Management Education for Older Adults.

Objectives: Providing diabetes self-management education (DSME) in an evidence-based format that is accessible and tailored to the population needs is crucial for individuals living with diabetes mellitus. Our qualitative study explores the experiences of older adults living with diabetes while residing in a rural setting. Methods: Adults aged 65 or older and residing in a rural area of Ontario completed a photovoice activity and semi-structured interviews to illustrate their experience of living with diabetes and accessing DSME. Results: Fourteen participants (11 males; mean age = 74 years) completed the photovoice activity and interview. Four main themes were identified pertaining to learning about diabetes education, the depth and breadth of learning, applying knowledge to daily life, and engaging older adults in DSME. Discussion: Diabetes self-management education should account for older adults' preferences in learning about diabetes and self-management to promote access to evidence-based information, bolster knowledge and self-management efficacy, and improve disease control.

Preparations for enteral nutrition: an overview

Enteral nutrition is the delivery of specially formulated nutrients, called enteral preparations, either orally or via tubes to meet patients' nutritional needs and avoid malnutrition. These feeds can be life-changing or lifesaving for patients. There are three broad enteral feed types: polymeric; pre-digested and disease-specific; and immune-enhancing. This article outlines the importance and involvement of nurses in the enteral feed process, including the selection and administration of enteral feeds, as well as presenting a summary of enteral preparations, their safety and evidence-based efficacy. Nurses should work within a well-coordinated multidisciplinary team, use existing knowledge and resources and refer to national guidelines, as well as practising in line with their professional roles and responsibilities to select and administer enteral preparations and continually monitor patients receiving enteral nutrition. Research has identified that enteral nutrition intolerance is an issue, particularly among critically ill patients. However, polymeric formula has been found to improve daily energy intake and tolerance and it is more cost-effective compared with semi-elemental formula in brain-injured critically ill patients. Immune-enhancing enteral nutrition could improve the immune function in patients with severe neurological diseases. While these findings are promising and can support enteral nutrition, there is a need for more research into the efficacy of specific formulas for certain conditions and for continuing to address enteral nutrition intolerance.

Evaluation of herbal ingredients used in an ethno-polyherbal formulation for treating menorrhagia and dysmenorrhea in Bangladesh

BackgroundGlobally, gynecological complications such as menorrhagia and dysmenorrhea lack attention. A female folk medicine practitioner (FMP) residing in the Thakurgaon district of Bangladesh, uses a phytomedicine that has explicitly been prescribed for many years to treat abnormal uterine bleeding accompanying severe lower abdominal pain. ObjectiveWe aim to corroborate original ethno-phytomedicine data that was prescribed for menorrhagia and dysmenorrhea treatment, by studying the evidence-based therapeutic efficacy of medicinal plants and the potential role of gut microbiota in relevant phytopharmacology. MethodsFirst, we documented the process of the phytomedicine preparation by visiting the folk practitioner with her Prior Informed Consent and completed the plant's taxonomic identification from Bangladesh National Herbarium. This was followed by the study of relevant literature available on PubMed and Google Scholar databases to elucidate the scientific efficacy of the herbal ingredients used in the phytomedicine preparation. ResultsThe plant species Phyllanthus reticulatus, Piper nigrum, and Acacia catechu was used as ingredients in the phytomedicine preparation, which has been corroborated by phytochemical and pharmacological data, as well as previous ethnopharmacological uses. The accumulated information aids to hypothesize that a phytochemical, catechin in Acacia catechu and Piper nigrum might act as β-glucuronidase and aromatase inhibitor to balance estrogen levels of patients with menorrhagia and dysmenorrhea. ConclusionAs traditional phytomedicines are suffering from a lack of standardization parameters compared to modern synthetic drugs, the implementation of advanced technologies and emerging scientific strategies can significantly impact the scientific validity, quality, and standardization of traditional herbal medicines. The present study suggests further biological research towards a more updated standardized phytomedicine formulation that can effectively treat menorrhagia and dysmenorrhea.

Effects of Reminiscence Therapy on Cognition, Depression and Quality of Life in Elderly People with Alzheimer's Disease: A Systematic Review of Randomized Controlled Trials.

Background: Patients with Alzheimer’s disease (AD) present with cognitive function deterioration, neuropsychiatric symptoms (NPS)—especially depression—and low quality of life (QoL). Management of AD remains difficult, especially in the elderly. Reminiscence therapy (RT) is a well-known cognitive rehabilitation intervention that can be adopted in nursing and residential care homes to restore autobiographical memory, ameliorate NPS, and improve the QoL of people with dementia. However, the evidence-based efficacy of RT for elderly patients with AD remains to be determined. Methods: Here, we synthesized findings of randomized controlled trials (RCTs) exploring the effects of RT on cognition, depression, and QoL in elderly people with AD, according to the most recent PRISMA statement. We searched for RCTs in PubMed, Web of Science, and Cochrane Central Register of Controlled Trials, and in trial registries (i.e., clinicaltrials.gov and International Clinical Trials Registry Platform of the World Health Organization). Two review authors extracted data of interest, with cognition, depression, and QoL measures as outcomes. Results: A total of five articles were included in the final analysis. Findings globally showed that RT, both administered in individual or group sessions at least once a week for 30–35 min over a period of 12 weeks, is effective in supporting global cognition, ameliorating depression, and improving specific aspects of the QoL in elderly people with AD. Conclusions: RT has the potential to be a routine non-pharmacological therapy for elderly people with AD, thanks to its wider effects on the individual in terms of cognitive vitality and emotional status promotion, with positive implications for patient’s daily life. Despite such evidences, caution should be used in findings’ generalizability in relation to the paucity of existing RCTs with long-term follow-up.

Explaining adults’ mental health help-seeking through the lens of the theory of planned behavior: a scoping review

BackgroundDespite evidence-based efficacy, mental health services are underutilized due to low rates of help-seeking, leaving unmet mental health needs a global concern. The Theory of Planned Behavior (TPB) has been applied to understand the help-seeking process and in the development of behavior change interventions. The aim of this scoping review was to map the literature on the TPB as applied to mental health help-seeking in adults aged >18 years.MethodsThis scoping review was conducted based on the methodology presented by Arksey and O’Malley (2005). Six databases (CINAHL, PsycINFO, MEDLINE, ProQuest Health and Medicine, ProQuest Dissertations and Theses, Web of Science) and two grey literature sources (OpenGrey, Google Scholar) were systematically searched in February 2018 and updated in March 2020. Studies that explicitly discussed the TPB in the context of mental health help-seeking were initially selected; only studies that explored formal help-seeking for mental health problems and were published in English were retained. Data were extracted using Microsoft Excel.ResultsInitially, 8898 records were identified. Of these, 49 met the selection criteria and were included: 32 were journal articles and 17 were theses. Forty-three papers reported on non-intervention studies and seven articles reported on TPB-based interventions. Most studies (n = 39) identified predictors of help-seeking intentions. Attitudes and perceived behavioral control were significant predictors of intentions in 35 and 34 studies, respectively. Subjective norms were a significant predictor of intentions in 23 studies. Few studies aimed to predict help-seeking behavior (n = 8). Intentions and perceived behavioral control were significant predictors of behavior in seven and six studies, respectively. Only six TPB-based interventions were identified, all used digital technology to influence help-seeking, with mixed results.ConclusionsThe present scoping review identified a considerable evidence base on the TPB for predicting mental health help-seeking intentions. Attitudes and perceived behavioral control were frequently found to be significant predictors of help-seeking intentions. Knowledge on the TPB for predicting mental health help-seeking behavior, and on TPB-based interventions, is limited. Thus, the role of the TPB in developing help-seeking interventions remains unclear. Recommendations are presented to address such research gaps and inform policy and practice.