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Chen Y, Lu J, Wang L, Gao X. Effective interventions for gaming disorder: A systematic review of randomized control trials. Front Psychiatry 2023; 14:1098922. [PMID: 36815197 PMCID: PMC9940764 DOI: 10.3389/fpsyt.2023.1098922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/16/2023] [Indexed: 02/08/2023] Open
Abstract
Objective To identify effective intervention methods for gaming disorder (GD) through a rigorous assessment of existing literature. Methods We conducted a search of six databases (PubMed, Embase, PsycINFO, CNKI, WanFang, and VIP) to identify randomized controlled trials (RCTs) that tested GD interventions, published from database inception to December 31, 2021. Standardized mean differences with 95% confidence intervals were calculated using a random effects model. Risk of bias was assessed with the Risk of Bias 2 (RoB 2) tool. Results Seven studies met the inclusion criteria. Five interventions were tested in these studies: group counseling, craving behavioral intervention (CBI), transcranial direct current stimulation (tDCS), the acceptance and cognitive restructuring intervention program (ACRIP), and short-term cognitive behavior therapy (CBT). Four of the five interventions (the tDCS was excluded) were found to have a significant effect on GD. The results of the quality assessment showed that the included studies had a medium to high risk in the randomization process and a medium to high risk of overall bias. Conclusion Rigorous screening identified that four interventions are effective for GD: group counseling, CBI, ACRIP, and short-term CBT. Additionally, a comprehensive review of the literature revealed that improvements could be made in the conceptualization of GD, experimental design, sample representativeness, and reporting quality. It is recommended that future studies have more rigorous research designs and be based on established standards to provide more credible evidence to inform the development of GD interventions.
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Affiliation(s)
- Yuzhou Chen
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Jiangmiao Lu
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Ling Wang
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Xuemei Gao
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
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Palma D, Mercuriali L, Figuerola J, Montalvo T, Bueno-Marí R, Millet JP, Simón P, Masdeu E, Rius C. Trends in the Epidemiology of Leishmaniasis in the City of Barcelona (1996-2019). Front Vet Sci 2021; 8:653999. [PMID: 33981743 PMCID: PMC8107217 DOI: 10.3389/fvets.2021.653999] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/29/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Leishmaniasis is a neglected zoonosis produced by 20 different flagellated parasites of the Leishmania genus, a protozoan transmitted to humans and other vertebrates by the bite of dipteran insects of the Phlebotominae subfamily. It is endemic in Mediterranean countries and the number of cases is expected to increase due to climate change and migration. Prioritizing public health interventions for prevention and control is essential. The objective was to characterize the epidemiology and temporal trends in the incidence of human leishmaniasis in the city of Barcelona, between the years 1996 and 2019. Methods: A population-based, analytical observational study among residents in the city of Barcelona was conducted of all the cases of leishmaniasis reported between 1996 and 2019 to the Public Health Agency. The epidemiological survey contains clinical, diagnostic, and epidemiological data, including contact with suspicious mammals or insects. Annual incidence-rates were calculated by sex, age, and country of origin. Chi-square tests were used to assess association between studied risk factors, periods of time and type of leishmaniasis. Results: During the study period a total of 177 cases of leishmaniasis were reported in Barcelona, being 74.6% (n = 132) of the total cases in Spanish born, although within the foreign-born population the incidence was higher. Median age was 34 years (IQR = 10-48) and 121 (66.8%) were male. The main type was cutaneous (46%) followed by visceral (35.1%). The cumulative incidence was 0.47 per 100,000 inhabitants, with the highest incidence found in 2017 (1.60 per 100,000 inhabitants). A higher incidence was observed in the 0-4-year-old group (1.73 per 100,000 inhabitants), but increased during the study period for all age groups. There was an increase of foreign origin cases, and a decrease in the number of cases associated to any immunosuppression. Conclusion: In Barcelona, leishmaniasis incidence continues to be higher in people under 5 years of age, and 25-64 years old males, but it has also increased in population from foreign country of birth. There is an increase of the cases since 2016, probably due to the changes in the notification system, increasing the diagnosis of cutaneous leishmaniasis. Improvements in the current surveillance system are needed. Notification of the disease, vector, and reservoir control activities are also essential for the control of the disease.
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Affiliation(s)
- David Palma
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain.,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | | | - Jordi Figuerola
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain.,Estación Biológica de Doñana (EBD-CSIC), Sevilla, Spain
| | - Tomás Montalvo
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain.,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | - Rubén Bueno-Marí
- Department of Research and Development (R&D), Laboratorios Lokímica, Valencia, Spain.,Parasitology Area, Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Valencia, Spain
| | - Joan-Pau Millet
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain.,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | - Pere Simón
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Eva Masdeu
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Cristina Rius
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain.,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
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Horrillo L, Castro A, Matía B, Molina L, García-Martínez J, Jaqueti J, García-Arata I, Carrillo E, Moreno J, Ruiz-Giardin JM, San Martín J. Clinical aspects of visceral leishmaniasis caused by L. infantum in adults. Ten years of experience of the largest outbreak in Europe: what have we learned? Parasit Vectors 2019; 12:359. [PMID: 31340851 PMCID: PMC6657057 DOI: 10.1186/s13071-019-3628-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/19/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An outbreak of leishmaniasis caused by Leishmania infantum was declared in the southwest of the Madrid region (Spain) in June 2009. This provided a unique opportunity to compare the management of visceral leishmaniasis (VL) in immunocompetent adults (IC-VL), patients with HIV (HIV-VL) and patients receiving immunosuppressants (IS-VL). METHODS A cohort of adults with VL, all admitted to the Hospital Universitario de Fuenlabrada between June 2009 and June 2018, were monitored in this observational study, recording their personal, epidemiological, analytical, diagnostic, treatment and outcome variables. RESULTS The study population was made up of 111 patients with VL (10% HIV-VL, 14% IS-VL, 76% IC-VL). Seventy-one percent of the patients were male; the mean age was 45 years (55 years for the IS-VL patients, P = 0.017). Fifty-four percent of the IC-VL patients were of sub-Saharan origin (P = 0.001). Fever was experienced by 98% of the IC-VL patients vs 73% of the LV-HIV patients (P = 0.003). Plasma ferritin was > 1000 ng/ml in 77% of the IC-VL patients vs 17% of the LV-HIV patients (P = 0.007). Forty-two percent of patients fulfilled the criteria for haemophagocytic lymphohistiocytosis. RDT (rK39-ICT) serological analysis returned sensitivity and specificity values of 45% and 99%, respectively, and ELISA/iIFAT returned 96% and 89%, respectively, with no differences in this respect between patient groups. Fourteen (13.0%) patients with VL experienced treatment failure, eight of whom were in the IC-VL group. Treatment with < 21 mg/kg (total) liposomal amphotericin B (LAB) was associated with treatment failure in the IC-VL patients [P = 0.002 (OR: 14.7; 95% CI: 2.6-83.3)]. CONCLUSIONS IS-VL was more common than HIV-VL; the lack of experience in dealing with IS-VL is a challenge that needs to be met. The clinical features of the patients in all groups were similar, although the HIV-VL patients experienced less fever and had lower plasma ferritin concentrations. RDT (rK39-ICT) analysis returned a good specificity value but a much poorer sensitivity value than reported in other scenarios. The patients with HIV-VL, IS-VL and IC-VL returned similar serological results. Current guidelines for treatment seem appropriate, but the doses of LAB required to treat patients with HIV-VL and IS-VL are poorly defined.
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Affiliation(s)
- Luis Horrillo
- Área de Infecciosas, Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Camino del Molino 2, 28942, Fuenlabrada, Madrid, Spain.,Universidad Rey Juan Carlos, Avda. Atenas s/n, 28922, Alcorcón, Madrid, Spain
| | - Alicia Castro
- Área de Infecciosas, Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Camino del Molino 2, 28942, Fuenlabrada, Madrid, Spain
| | - Belén Matía
- Área de Infecciosas, Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Camino del Molino 2, 28942, Fuenlabrada, Madrid, Spain
| | - Laura Molina
- Área de Microbiología, Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, Camino del Molino 2, 28942, Fuenlabrada, Madrid, Spain
| | - Jesús García-Martínez
- Área de Microbiología, Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, Camino del Molino 2, 28942, Fuenlabrada, Madrid, Spain
| | - Jerónimo Jaqueti
- Área de Microbiología, Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, Camino del Molino 2, 28942, Fuenlabrada, Madrid, Spain
| | - Isabel García-Arata
- Área de Microbiología, Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, Camino del Molino 2, 28942, Fuenlabrada, Madrid, Spain
| | - Eugenia Carrillo
- Centro Nacional de Microbiología, WHO Collaborating Centre for Leishmaniasis, Majadahonda, Madrid, Spain
| | - Javier Moreno
- Centro Nacional de Microbiología, WHO Collaborating Centre for Leishmaniasis, Majadahonda, Madrid, Spain
| | - José Manuel Ruiz-Giardin
- Área de Infecciosas, Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Camino del Molino 2, 28942, Fuenlabrada, Madrid, Spain
| | - Juan San Martín
- Área de Infecciosas, Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Camino del Molino 2, 28942, Fuenlabrada, Madrid, Spain.
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