scholarly journals Evaluation of Treatment Descriptions and Alignment With Clinical Guidance of Apps for Depression on App Stores: Systematic Search and Content Analysis

10.2196/14988 ◽  
2020 ◽  
Vol 4 (11) ◽  
pp. e14988 ◽  
Author(s):  
Dionne Bowie-DaBreo ◽  
Sandra I Sünram-Lea ◽  
Corina Sas ◽  
Heather Iles-Smith
Keyword(s):  
Content Analysis ◽  
Treatment Strategies ◽  
Treatment Fidelity ◽  
Evidence Base ◽  
Great Promise ◽  
Nice Guidelines ◽  
Safety Issues ◽  
Clinical Guidance ◽  
App Store ◽  
Treatment Of Depression

Background The use of apps for the treatment of depression shows great promise. However, there is uncertainty regarding the alignment of publicly available apps for depression with clinical guidance, their treatment fidelity and evidence base, and their overall safety. Objective Built on previous analyses and reviews, this study aims to explore the treatment and safety issues of publicly available apps for depression. Methods We conducted a content analysis of apps for depression in the 2 main UK app stores (Google Play and Apple App Store). App store listings were analyzed for intervention content, treatment fidelity, and fit with the National Institute for Health and Care Excellence (NICE) guidelines for the treatment of depression in adults. Results A total of 353 apps for depression were included in the review. App descriptions reported the use of 20 treatment approaches and 37 treatment strategies. Many apps used transdiagnostic (155/353, 43.9%) and multitheoretical interventions to treat multiple disorders including depression. Although many interventions appeared to be evidence-informed, there were issues with treatment fidelity, research evidence, and fit with clinical guidelines. None of the apps fully aligned with the NICE guidelines for depression. Conclusions App developers have adopted many evidence-informed treatments in their interventions; however, more work is needed to improve clinical validity, treatment fidelity, and the safety of apps. We urge developers to consult relevant guidelines and standards, and to engage in reflective questioning on treatment and safety to address these issues and to improve treatment content and intervention design.

scholarly journals Evaluation of Treatment Descriptions and Alignment With Clinical Guidance of Apps for Depression on App Stores: Systematic Search and Content Analysis (Preprint)

2019 ◽  
Author(s):  
Dionne Bowie-DaBreo ◽  
Sandra I Sünram-Lea ◽  
Corina Sas ◽  
Heather Iles-Smith
Keyword(s):  
Content Analysis ◽  
Treatment Strategies ◽  
Treatment Fidelity ◽  
Evidence Base ◽  
Great Promise ◽  
Nice Guidelines ◽  
Safety Issues ◽  
Clinical Guidance ◽  
App Store ◽  
Treatment Of Depression

BACKGROUND The use of apps for the treatment of depression shows great promise. However, there is uncertainty regarding the alignment of publicly available apps for depression with clinical guidance, their treatment fidelity and evidence base, and their overall safety. OBJECTIVE Built on previous analyses and reviews, this study aims to explore the treatment and safety issues of publicly available apps for depression. METHODS We conducted a content analysis of apps for depression in the 2 main UK app stores (Google Play and Apple App Store). App store listings were analyzed for intervention content, treatment fidelity, and fit with the National Institute for Health and Care Excellence (NICE) guidelines for the treatment of depression in adults. RESULTS A total of 353 apps for depression were included in the review. App descriptions reported the use of 20 treatment approaches and 37 treatment strategies. Many apps used transdiagnostic (155/353, 43.9%) and multitheoretical interventions to treat multiple disorders including depression. Although many interventions appeared to be evidence-informed, there were issues with treatment fidelity, research evidence, and fit with clinical guidelines. None of the apps fully aligned with the NICE guidelines for depression. CONCLUSIONS App developers have adopted many evidence-informed treatments in their interventions; however, more work is needed to improve clinical validity, treatment fidelity, and the safety of apps. We urge developers to consult relevant guidelines and standards, and to engage in reflective questioning on treatment and safety to address these issues and to improve treatment content and intervention design.

NICE Guidelines on Treatment of Depression in Childhood and Adolescence: Implications from a CBT Perspective

2006 ◽  
Vol 34 (2) ◽  
pp. 129-137 ◽  
Author(s):  
James Murray ◽  
Sam Cartwright-Hatton
Keyword(s):  
Young People ◽  
Clinical Excellence ◽  
Evidence Base ◽  
Childhood And Adolescence ◽  
Wait List ◽  
Limited Information ◽  
Nice Guidelines ◽  
Children And Young People ◽  
Psychological Therapies ◽  
Treatment Of Depression

The National Institute for Clinical Excellence recently published their guidelines on the treatment of depression in children and young people. This article critically reviews these guidelines in terms of their likely impact on BABCP members and the services in which they work. The evidence base that underpins the guideline is very sparse. There is particularly limited information on which to base guidance to therapists working with younger children. The use that has been made of this evidence is discussed, and some controversial interpretations are criticized. Implications for services and therapists are outlined. In particular, attention is drawn to the pressing need for very substantial additional training if the guidelines are to be implemented correctly. Some suggestions for deployment of staff with differing levels of knowledge and expertise in CBT are offered. Finally, challenges for the field as a whole are discussed. In particular, a great deal more research is needed into the effectiveness of psychological therapies versus wait list and versus each other and medications, and into the levels of training required to provide competent CBT to children and adolescents.

Electronic Communication, Telehealth, and Social Media

2018 ◽  
Author(s):  
Muniya S. Khanna ◽  
Tommy Chou
Keyword(s):  
Social Media ◽  
Rural Communities ◽  
Unmet Need ◽  
Mental Healthcare ◽  
Evidence Base ◽  
Intervention Delivery ◽  
Safety Issues ◽  
Video Teleconferencing ◽  
Empirically Supported ◽  
Traditional Service

Explosive growth of communication technologies and increased ubiquity of Internet access in both urban and rural communities and particularly in youth have occurred. Coupled with concerns regarding limitations to traditional service provision models, researchers and practitioners are looking to affordable, acceptable technologies to expand the reach of evidence-based care and reduce barriers to intervention and unmet need in areas with few providers. This chapter describes the present literature on use of video teleconferencing, web-based programs, social media, and smartphone apps to enhance mental health intervention delivery, psychiatric assessment, and training and supervision. The strengths of the various delivery methods are discussed for providing empirically supported mental healthcare, focusing on implications related to science and practice with children and families. Outlined also are current limitations, risks, and challenges to technology-mediated services, including the significant gaps in the evidence base underlying these technologies and the legal, ethical, and safety issues that remain.

scholarly journals The Jekyll and Hyde of Cellular Senescence in Cancer

Cells ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 208
Author(s):  
Dilara Demirci ◽  
Bengisu Dayanc ◽  
Fatma Aybuke Mazi ◽  
Serif Senturk
Keyword(s):  
Cancer Cell ◽  
Cellular Senescence ◽  
Expression Profiles ◽  
Treatment Strategies ◽  
Gene Expression Profiles ◽  
Therapy Resistance ◽  
Disease Recurrence ◽  
Adverse Outcomes ◽  
Cell Senescence ◽  
Great Promise

Cellular senescence is a state of stable cell cycle arrest that can be triggered in response to various insults and is characterized by distinct morphological hallmarks, gene expression profiles, and the senescence-associated secretory phenotype (SASP). Importantly, cellular senescence is a key component of normal physiology with tumor suppressive functions. In the last few decades, novel cancer treatment strategies exploiting pro-senescence therapies have attracted considerable interest. Recent insight, however, suggests that therapy-induced senescence (TIS) elicits cell-autonomous and non-cell-autonomous implications that potentially entail detrimental consequences, reflecting the Jekyll and Hyde nature of cancer cell senescence. In essence, the undesirable manifestations that generally culminate in inflammation, cancer stemness, senescence reversal, therapy resistance, and disease recurrence are dictated by the persistent accumulation of senescent cells and the SASP. Thus, mitigating these pro-tumorigenic effects by eliminating these cells or inhibiting their SASP production holds great promise for developing innovative therapeutic strategies. In this review, we describe the fundamental aspects and dynamics of cancer cell senescence and summarize the comprehensive research on the adverse outcomes of TIS. Furthermore, we underline the rationale and motivation of emerging senotherapeutic modalities surrounding the removal of senescent cells and the SASP to help maximize the overall efficacy of cancer therapies.

scholarly journals Adjunctive cytoprotective therapies in acute ischemic stroke: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
I. A. Mulder ◽  
E. T. van Bavel ◽  
H. E. de Vries ◽  
J. M. Coutinho
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Nitrosative Stress ◽  
Vasogenic Edema ◽  
Treatment Strategies ◽  
Oxidative And Nitrosative Stress ◽  
Main Trial ◽  
Safety Issues ◽  
Favourable Safety Profile ◽  
Neuro Inflammation

AbstractWith the introduction of endovascular thrombectomy (EVT), a new era for treatment of acute ischemic stroke (AIS) has arrived. However, despite the much larger recanalization rate as compared to thrombolysis alone, final outcome remains far from ideal. This raises the question if some of the previously tested neuroprotective drugs warrant re-evaluation, since these compounds were all tested in studies where large-vessel recanalization was rarely achieved in the acute phase. This review provides an overview of compounds tested in clinical AIS trials and gives insight into which of these drugs warrant a re-evaluation as an add-on therapy for AIS in the era of EVT. A literature search was performed using the search terms “ischemic stroke brain” in title/abstract, and additional filters. After exclusion of papers using pre-defined selection criteria, a total of 89 trials were eligible for review which reported on 56 unique compounds. Trial compounds were divided into 6 categories based on their perceived mode of action: systemic haemodynamics, excitotoxicity, neuro-inflammation, blood–brain barrier and vasogenic edema, oxidative and nitrosative stress, neurogenesis/-regeneration and -recovery. Main trial outcomes and safety issues are summarized and promising compounds for re-evaluation are highlighted. Looking at group effect, drugs intervening with oxidative and nitrosative stress and neurogenesis/-regeneration and -recovery appear to have a favourable safety profile and show the most promising results regarding efficacy. Finally, possible theories behind individual and group effects are discussed and recommendation for promising treatment strategies are described.

scholarly journals Preoperative Fasting Practices Across Three Anesthesia Societies: Survey of Practitioners

10.2196/15905 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e15905 ◽  
Author(s):  
Richard Neville Merchant ◽  
Navraj Chima ◽  
Olle Ljungqvist ◽  
Juliana Nai Jia Kok
Keyword(s):  
Fluid Intake ◽  
Evidence Base ◽  
Pulmonary Aspiration ◽  
Internet Survey ◽  
Preoperative Fasting ◽  
Clear Fluid ◽  
Safety Issues ◽  
Solid Foods ◽  
Gastric Contents ◽  
Operating Room Schedule

Background Pulmonary aspiration of gastric contents is recognized as a complication of anesthesia. To minimize that risk, anesthesiologists advised fasting for solid foods and liquids for an often prolonged period of time. However, 30 years ago, evidence was promulgated that fasting for clear liquids was unnecessary to ensure an empty stomach. Despite a strong evidence base and the knowledge that fasting may be physiologically harmful and unpleasant for patients, the adoption of society guidelines recommending short fasting periods for clear fluids into clinical practice is uncertain. Objective This study aimed to determine the current practices of anesthetists with respect to fasting guidelines. Methods An electronic internet survey was distributed to anesthetists in Canada (CAN), Australia and New Zealand (ANZ), and Europe (EUR) during April 2014 to February 2015. The anesthetists were asked about fasting guidelines, their recommendations to patients for the consumption of clear fluids and solid foods, and the reasons and consequences if these guidelines were not followed. Results A total of 971 anesthetists completed the survey (CAN, n=679; ANZ, n=185; and EUR, n=107). Although 85.0% (818/962) of these participants claimed that their advice to patients followed current society guidelines, approximately 50.4% (476/945) enforced strict fasting and did not allow clear fluids after midnight. The primary reasons given were with regard to problems with a variable operating room schedule (255/476, 53.6%) and safety issues surrounding the implementation of clear fluid drinking guidelines (182/476, 38.2%). Conclusions Many anesthetists continue to follow outdated practices. The current interest in further liberalizing preoperative fluid intake will require more change in anesthesia culture.

Diagnostics and modern treatment of migraine: what can a general practitioner do?

2021 ◽  
pp. 13-18
Author(s):  
V. V. Osipova
Keyword(s):  
Migraine Attack ◽  
Behavioral Therapy ◽  
Treatment Strategies ◽  
Diagnostic Errors ◽  
Evidence Base ◽  
Preventive Therapy ◽  
Basic Principles ◽  
High Effect ◽  
Primary Health ◽  
Modern Treatment

The article focuses on the basic principles of diagnosis and treatment of migraine at the stage of primary health care. The diagnostic criteria of migraine, common diagnostic errors and alarming symptoms that are indications for instrumental investigations are given. The main treatment strategies of migraine are described: behavioral therapy, attack relief, and preventive therapy. Special attention is being paid to the treatment of a migraine attack, depending on its severity, including the features of the use of simple analgesics and triptans – specific drugs that have a pathogenetic antimigrenous effect. The principles of the use of tryptans that provide a high effect of relieving a migraine attack are being listed. The advantages of eletriptan as a last‑generation triptan, which is highly effective in relieving migraine attacks and is safer than other drugs in this class, are highlighted. Among the modern classes of drugs that have an evidence base in migraine prevention, those that can be successfully used by general practitioners are indicated.

Interpersonal psychotherapy

2020 ◽  
pp. 261-264
Author(s):  
Philip Wilkinson ◽  
Ken Laidlaw
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Older People ◽  
Psychological Treatment ◽  
Interpersonal Psychotherapy ◽  
Evidence Base ◽  
Theory And Practice ◽  
Role Transitions ◽  
Treatment Of Depression

This chapter on interpersonal psychotherapy (IPT) describes the theory and practice of this structured psychological treatment. It discusses the implementation of IPT with older people. Next it reviews the applications of IPT with a main focus on the treatment of depression in older adults and distinguishes between the treatment of depression with and without cognitive impairment. It summarizes the structure of IPT and the use of specific techniques, and it then addresses the main therapeutic foci encountered in treatment (grief, interpersonal role disputes, role transitions, and interpersonal deficits). Finally, it briefly reviews the evidence base for IPT with older people.

Optimal medical therapy in percutaneous coronary intervention patients: statins and ACE inhibitors as disease-modifying agents

2010 ◽  
pp. 456-475
Author(s):  
Simon J. Corbett ◽  
Kim F. Fox
Keyword(s):  
Research Effort ◽  
Treatment Strategies ◽  
Coronary Intervention ◽  
Evidence Base ◽  
Pathological Process ◽  
Atherosclerotic Burden ◽  
Coronary Stenoses ◽  
Coronary Syndromes ◽  
Artery Disease ◽  
Disease Modifying Agents

The majority of this textbook is concerned with the indications for, and applications of, the numerous techniques that interventional cardiologists have at their disposal to assess and treat significant coronary stenoses. However, it is well recognized that atherosclerosis is far from being a discrete pathological process, such that by the time a person presents with clinically apparent coronary artery disease (CAD), they will often have widespread atheroma throughout their coronary tree. Combined with the reproducible observation that the majority of acute coronary syndromes arise from lesions that were not previously flow-limiting, much research effort has been directed at identifying treatment strategies that will favourably modify all of the patient’s atherosclerotic burden, not just that which can be targeted by percutaneous or surgical revascularization. In this chapter, we focus on the rationale and evidence base supporting the use of statins and renin–angiotensin–aldosterone system (RAAS) inhibition in patients with CAD.

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