A systematic review of cognitive stimulation therapy for older adults with mild to moderate dementia: an occupational therapy perspective

In response to the need for effective non-pharmacological approaches for individuals with mild to moderate dementia, cognitive stimulation therapy (CST) interventions aim to optimize cognitive function. The present literature review explored the effectiveness of CST and the congruence of this approach with occupational therapy. Twenty-four databases and 13 "grey" sources were searched. Relevant papers were analysed using the McMaster Critical Literature Review Guidelines, the Modified Jadad Quality Scale and the Oxford Centre for Evidence-based Medicine Levels of Evidence Scale. To establish the congruence of CST with occupational therapy, themes were identified using the International Classification of Functioning and professional values outlined by the Canadian Association of Occupational Therapists. Twelve studies demonstrated a trend towards delayed cognitive decline following CST. This intervention strategy is congruent with occupational therapy values and may provide a useful structural framework to build rehabilitation programmes for this population. Psychometric properties of the McMaster Guidelines have not yet been established, and there is no standardized way to extract quantitative data from this measure. There is a need for further research exploring outcomes of CST interventions within the context of everyday function in individuals experiencing cognitive decline.     

Leisure-activity participation to prevent later-life cognitive decline: a systematic review

Objective: A systematic literature review was conducted to characterise the current state of knowledge concerning the definition, categorisation, and operationalisation of leisure activity in studies examining its possible role in preventing later-life cognitive decline. Following PRISMA guidelines for a systematic review, the study examined peer-reviewed empirical research publications focused on leisure activity, cognitive decline, and prevention. Methods: Searches in the PubMed/Medline reSEARCH, CINHAL, Ovid MEDLINE, Embase, Web of Science, PsychoINFO, ERIC Proquest, the Cochrane library, and PsycARTICLES databases for the years 2000 to 2011 identified 52 publications for inclusion. Results: The results are discussed and based on these findings are further interpreted using the Model of Human Occupation, which focuses on key factors identified in the review that are salient to associations between participation in leisure activities and prevention of dementia. Conclusions: While the findings support a growing consensus that participation in leisure activities might significantly contribute to prevention of dementia, it also identifies major hindrances to progress. Important limitations detected include a lack of theoretical underpinnings, and little consensus and standardisation in the measured key variables. The study reinforces the critical need to overcome these limitations to enable health care professionals (e.g. occupational therapists) to make evidence-based recommendations for increased participation in activities as a means of promoting health and preventing cognitive decline.     

Economic Evaluation of Cognitive Behavioral Therapy for Depression: A Systematic Review

ObjectivesThis study aimed to conduct a systematic review of cost-utility studies of internet-based and face-to-face cognitive behavioral therapy (CBT) for depression from childhood to adulthood and to examine their reporting and methodological quality.MethodsA structured search for cost-utility studies concerning CBT for depression was performed in 7 comprehensive databases from their inception to July 2020. Two reviewers independently screened the literature, abstracted data, and assessed quality using the Consolidated Health Economic Evaluation Reporting Standards and Quality of Health Economic Studies checklists. The primary outcome was the incremental cost-effectiveness ratio (ICER) across all studies. To make a relevant comparison of the ICERs across the identified studies, cost data were inflated to the year 2020 and converted into US dollars.ResultsThirty-eight studies were included in this review, of which 26 studies (68%) were deemed of high methodological quality and 12 studies (32%) of fair quality. Despite differences in study designs and settings, the conclusions of most included studies for adult depression were general agreement; they showed that face-to-face CBT monotherapy or combination therapy compared with antidepressants and usual care for adult depression were cost-effective from the societal, health system, or payer perspective (ICER ?$241 212.4/quality-adjusted life-year [QALY] to $33 032.47/QALY, time horizon 12-60 months). Internet-based CBT regardless of guided or unguided also has a significant cost-effectiveness advantage (ICER ?$37 717.52/QALY to $73 841.34/QALY, time horizon 3-36 months). In addition, CBT was cost-effective in preventing depression (ICER ?$23 932.07/QALY to $26 092.02/QALY, time horizon 9-60 months). Nevertheless, the evidence for the cost-effectiveness of CBT for children and adolescents was still ambiguous.ConclusionsFair or high-quality evidence showed that CBT monotherapy or combination therapy for adult depression was cost-effective; whether CBT-related therapy was cost-effective for children and adolescents depression remains inconclusive.     

A conceptual framework of functional capacity evaluation for occupational therapy in work rehabilitation

Functional capacity evaluation (FCE) is commonly used in work rehabilitation to assess the capacity of the injured worker for return to work. Occupational therapists are major providers of FCE, especially in Australia. Despite a history of involvement in the functional assessment of clients for work, occupational therapy has few theoretical models for work assessment in general, and for FCE in particular. This may account for some of the confusion that exists about the conceptual basis of FCE in occupational therapy practice. This paper presents a framework for FCE that parallels occupational therapy's occupational performance model and the World Health Organisation's International Classification of Functioning, Disability and Health. The framework is used to clarify some of the confusions that exist in FCE research and practice, particularly the issue of measuring a client's function versus impairment. A redefinition of FCE for occupational therapy practice in the work assessment continuum is presented that supports occupational therapy practice and research in the area.     

Functional outcome measures for distal radius fractures: A systematic review

Objective: This systematic review aimed to identify and describe the utility of functional outcome measures reported in intervention trials between 2010 and 2020, and to map these measures to the International Classification of Functioning, Disability and Health (ICF) model.Method: The search was carried out on MEDLINE, CINAHL and Cochrane Register of Clinical Trials. Peer-reviewed intervention studies detailing the functional outcome measures used for any treatment for distal radius fracture were selected. Participant characteristics, outcome measures reported and the trends in their use over time and geographical locations were extracted.Results: This review analysed 119 studies. Thirty-one functional outcome measures were used across 36 countries. Ninety-two percent of studies measured both the Body Function/Structure and Activity/Participation domains of the ICF. The most frequently used measures were the Disabilities of the Arm, Shoulder and Hand Questionnaire, Range of Motion and Grip Strength. There is a lack of measures on successful return to meaningful occupation.Conclusion: The outcome measures identified were equally spread across the ICF domains. There is a growing importance of Patient-Reported Outcome Measures to supplement performance-based measures, but a lack of measure on successful return to meaningful occupation.     

A systematic review of evaluations of prison‐based alcohol and other drug use behavioural treatment for men

Objective : A history of alcohol and other drug (AoD) use is common among men entering prison and often linked to the crime for which they are imprisoned. This is the first systematic review of prison‐based, behavioural AoD treatment programs for more than a decade and the first that reviews the methodological quality of evaluations. This review aims to create an understanding of the quality of research in this field and identify the most effective AoD use treatment for men in prison. Methods : A PRISMA‐compliant systematic review of international, peer‐reviewed research published between January 1995 and December 2015. The Dictionary for Effective Public Health Practice Project was used to assess the methodological quality of papers. Results : A total of 25 relevant papers were identified, of which 12 were rated as methodologically sound. Four of these measured post‐release AoD use and three reported statistically significant reductions in AoD use. Conclusions : Although there is relatively little methodologically strong evidence of the impact of prison‐based AoD treatment, and no Australian papers studies, current best‐evidence practice is Cognitive behavioural therapy delivered in Therapeutic Community (TC) settings. Implications for public health : Prison‐based TC treatment should be available to people in prison who have a history of AoD use.     

中国1996—2014年肺癌经济负担研究系统评价

目的 探讨中国1996-2014年肺癌经济负担研究状况,为肺癌防控措施相关评价及卫生决策提供参考依据。方法 以癌症、经济负担、费用等为检索词,检索中国知网、万方和PubMed数据库1996年1月1日-2014年12月31日发表的关于中国肺癌经济负担的文献,再按非肺癌相关文献等标准进行排除,对最终纳入的32篇文献进行摘录,所有费用数据均按照2013年我国医疗保健消费价格指数行贴现处理,且以均值表示,同时计算年均增长率。结果 最终纳入的32篇文献中,基于住院患者和人群的研究分别有30和2篇;经济负担类型方面,关注直接经济负担、间接经济负担、直接和间接经济负担的文献分别有26、1和5篇;本研究分析结果显示,中国1996-2011年肺癌例均直接医疗费用为10 415~27 595元,年均增长率为2.2%（其中检查费、药品费和化验费用年均增长率分别为3.5%、-3.2%和2.2%）;1997-2010年肺癌次均直接医疗费用为9 463~38 209元,年均增长率为-1.7%（其中检查费、药品费和化验费年均增长率分别为16.9%、-2.2%和17.3%）;1996-2009年肺癌直接医疗日均费用为426~1 036元,年均增长率为6.3%;直接非医疗费用和间接费用因涵盖项目及方法差异,无法得出趋势数据。结论 中国肺癌经济负担研究数据的收集及分析方法不一,例均和次均费用整体趋势不明显,但细化项目多呈增长趋势且幅度不同。     

阿立哌唑联合氯氮平结合音乐疗法对精神分裂症患者的疗效及对患者甲状腺激素水平的影响

目的研究系统式集体音乐治疗(systematic group music therapy,SGMT)模式对社区精神分裂症患者的社会、生活功能及生存质量的影响。方法按系统抽样的方法抽取160名患者,按1 : 1配对,80例为干预组,另80例为对照组。对干预组实施系统式集体音乐治疗(SGMT)干预,对照组接受常规社区精神病康复管理。使用日常生活能力量表(ADL)、社会功能缺陷筛选量表(SDSS)、社会适应不良量表(SOC)分别对两组患者干预前与干预第18个月时的社会、生活功能进行比较;采用WHO生存质量简明量表(WHOQOL-BREF)对两组患者干预前后生存质量得分进行比较。结果在实施干预后的第18个月,与对照组比较,干预组的社会、生活功能得分降低明显(均P < 0.05);生存质量评价中,干预组生理健康、心理健康和社会关系维度得分均高于对照组患者?两组差异有统计学意义(P < 0.05),周围环境维度两组差异不明显(P>0.05)。结论实施SGMT干预,能有效地改善社区分裂症患者社会、生活功能,提高其生存质量。