tion or observes another person performing an action. 4 Alternatively, visual input of what appears to be movement of the amputated limb might reduce the activity of systems that perceive protopathic pain. 5 Although the underlying mechanism accounting for the success of this therapy remains to be elucidated, these results suggest that mirror therapy may be helpful in alleviating phantom pain in an amputated lower limb.
Background To date, research on mental health in HIV-affected children (children who have an HIV-positive caregiver or live with the virus themselves) has focused on risk factors associated with the disease. However, simultaneous identification of factors that contribute to resilience in the face of risks is also needed. A greater understanding of modifiable protective processes that contribute to resilience in the mental health of children affected by HIV can inform the design of interventions that bolster naturally-occurring supports and contribute to early prevention or better management of risks. Methods We reviewed the recent literature on mental health and resilience in children and adolescents affected by HIV/AIDS. Literature searches of PsycInfo and PubMed were conducted during July-December 2011 consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Qualitative and quantitative studies were included for review if primary research questions pertained to mental health and coping or protective processes in children and families affected by HIV/AIDS. All studies subject to full review were evaluated for quality using a modified Systematic Assessment of Quality in Observational Research (SAQOR) rating system. Results 171 unique studies were returned from online searches of the literature and bibliography mining. Of these, 29 were evaluated as pertaining directly to mental health and resilience in families and children living with HIV/AIDS. Eight studies presented qualitative analyses. Ten quantitative studies examined individual resources contributing to child resilience and four quantitative studies looked at family-level resources. Ten studies also investigated community-level interactions. Four presented findings from resilience-focused interventions. Conclusions There is a clear need for rigorous research on mental health and resilience in HIV-affected children and adolescents. The evidence base would greatly benefit from more standardized and robust approaches to thinking about resilience from an ecological perspective inclusive of resources at multiple levels and their interactions.
he growth of the minority population in the United States is outpacing the growth of the non-Hispanic white population. Current projections estimate that the United States will achieve "majority-minority" status in which minority populations total over 50% of the overall population by 2044. 1 This demographic shift has not been reflected in medical research. African Americans, Hispanic individuals, and women are underrepresented in clinical 2 and randomized controlled trials generally, 3 as well as within specific subspecialties including cancer clinical trials, 4 pulmonary research, 5 vascular surgery trials, 6 and orthopedic research. 7 General reporting of the racial and ethnic demographics of study cohorts is uncommon as well, with less than one-third of papers published in high-impact journals across all fields reporting racial or ethnic demographics. 8 Federal efforts have targeted inclusion of clinical trial and research subjects at levels proportionate with those in the US population. 9 The US Food and Drug Administration (FDA) currently requires that all investigational new drug and new drug applications studies include demographic information prior to approval. 10 Additionally, National Institutes of Health (NIH)funded clinical research studies must include women and minorities. 11 Despite a call to action to achieve diversity in research, that we know of there has been no systematic evaluation of clinical and research diversity among dermatology research subjects to date. Hirano et al 12 examined racial representation in atopic dermatitis research, demonstrating that only 60% of clinical trials of eczema and/or atopic dermatitis reported race.This systematic review of the dermatology literature analyzed the degree of racial, ethnic, and sex representation in recent randomized clinical trials (RCTs) for acne, psoriasis, atopic dermatitis and eczema, vitiligo, alopecia areata, seborrheic dermatitis, and lichen planus (LP). These conditions were selected because they are: IMPORTANCE Though there have been significant shifts in US demographic data over the past 50 years, research cohorts lack full racial and ethnic representation. There is little data available regarding the diversity of dermatology research cohorts with respect to sex, race, and ethnicity.OBJECTIVE To characterize and assess the representation of racial and ethnic minorities and women in randomized controlled trials across a range of dermatologic conditions.EVIDENCE REVIEW All randomized clinical trials (RCTs) were identified between July 2010 and July 2015 within the PubMed database using the following keywords: "psoriasis," "atopic dermatitis," "acne," "vitiligo," "seborrheic dermatitis," "alopecia areata," and "lichen planus." Diverse study populations were defined as including a greater than 20% racial or ethnic minority participants based on US census data. The distributions of sex and race groups in studies were compared by journal type, disease type, and funding source.FINDINGS Of the 626 articles reporting RCTs included in this ...
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