Effects of mindfulness‐based interventions on neuropsychiatric symptoms and psychological well‐being on people with subjective cognitive decline and mild cognitive impairment: A meta‐analysis

Article

Lin, Rose Sin Yi, Su, Jing Jing, Abu-Odah, Hammoda and Bayuo, Jonathan. 2023. "Effects of mindfulness‐based interventions on neuropsychiatric symptoms and psychological well‐being on people with subjective cognitive decline and mild cognitive impairment: A meta‐analysis." International Journal of Geriatric Psychiatry. 38 (8). https://doi.org/10.1002/gps.5986
Article Title

Effects of mindfulness‐based interventions on neuropsychiatric symptoms and psychological well‐being on people with subjective cognitive decline and mild cognitive impairment: A meta‐analysis

ERA Journal ID13083
Article CategoryArticle
AuthorsLin, Rose Sin Yi, Su, Jing Jing, Abu-Odah, Hammoda and Bayuo, Jonathan
Journal TitleInternational Journal of Geriatric Psychiatry
Journal Citation38 (8)
Article Numbere5986
Number of Pages19
Year2023
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN0885-6230
1099-1166
Digital Object Identifier (DOI)https://doi.org/10.1002/gps.5986
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.1002/gps.5986
Abstract

Objectives
Neuropsychiatric symptoms (NPS) are highly prevalent in individuals with subjective cognitive decline (SCD) and mild cognitive impairment (MCI), and are strongly linked to accelerated cognitive decline and dementia onset. While mindfulness-based interventions have shown promise in improving psychological well-being in clinical and community settings, their efficacy for individuals in these pre-dementia stages remains unclear. This meta-analysis examined the effects of mindfulness-based interventions on NPS and psychological outcomes in these preclinical cohorts.

Methods
Eligible studies were retrieved from PubMed, EMBASE, JBI EPB, Web of Science, and Cochrane library. Two independent researchers conducted the literature search and data extraction. Cochrane Risk-of-Bias Assessment Tool was used to assess the methodological quality of included studies. Quality of evidence was evaluated using the GRADE approach. Intervention effects were estimated by Hedge's g and 95% confidence interval (CI).

Results
A total of 18 randomized controlled trials (including 974 participants from 21 studies) were included in the meta-analysis. The results demonstrated statistically significant immediate post-intervention effects of mindfulness-based interventions on anxiety (g = −0.30, 95% CI −0.49 to −0.11), stress (g = −0.58, 95% CI −0.91 to −0.24), and quality of life (g = 0.50, 95% CI 0.12–0.87). However, no significant effects were found for depression, apathy, mindfulness, and stress-related biomarkers. Follow-up data analysis also did not reveal significant effects for depression and anxiety.

Conclusions
The findings of this meta-analysis suggest that mindfulness-based interventions may improve anxiety, stress, and quality of life in individuals with SCD and MCI. However, more rigorous randomized controlled trials with larger sample sizes and evaluation using physiological parameters are needed to establish more definitive conclusions. Future interventions could consider incorporating cognitive training and health education to address the specific needs of the pre-dementia population.

KeywordsMindfulness; meta‐analysis; mild cognitive impairment; neuropsychiatric symptoms; psychological well‐being; randomized controlled trials; subjective cognitive decline
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020420503. Community and primary care
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Byline AffiliationsUniversity of Rochester, United States
Hong Kong Polytechnic University, China
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Poku, Collins Atta, Bayuo, Jonathan, Mensah, Eva and Bam, Victoria. 2023. "Quality of work‐life and coping strategies of nurse educators and clinicians in COVID‐19: A cross‐sectional study." Nursing Open. 10 (7), pp. 4336-4345. https://doi.org/10.1002/nop2.1676
A meta‐ethnography of developing and living with post‐burn scars
Bayuo, Jonathan, Wong, Frances Kam Yue, Lin, Rose, Su, Jing Jing and Abu-Odah, Hammoda. 2023. "A meta‐ethnography of developing and living with post‐burn scars." Journal of Nursing Scholarship. 55 (1), pp. 319-328. https://doi.org/10.1111/jnu.12811
Transitional and aftercare needs of persons recovering from COVID‐19 using the Omaha system: A scoping review
Bayuo, Jonathan and Wong, Frances Kam Yuet. 2023. "Transitional and aftercare needs of persons recovering from COVID‐19 using the Omaha system: A scoping review." Journal of Clinical Nursing. 32 (19-20), pp. 6894-6916. https://doi.org/10.1111/jocn.16798
The extended case method in nursing research: Unpacking the 'what', 'why' and 'how'
Bayuo,Jonathan and Kuug, Anthony Kolsabilik. 2023. "The extended case method in nursing research: Unpacking the 'what', 'why' and 'how'." Journal of Advanced Nursing. 79 (11), pp. 4245-4254. https://doi.org/10.1111/jan.15843
Hospital Fire Outbreaks Before and During the COVID-19 Pandemic in Low- and Middle-Income Settings
Bayuo, Jonathan and Duodu, Precious Adade. 2023. "Hospital Fire Outbreaks Before and During the COVID-19 Pandemic in Low- and Middle-Income Settings." Journal of Patient Safety. 19 (4), pp. 223-228. https://doi.org/10.1097/PTS.0000000000001124
Global epidemiology of geriatric burns, capacities of care, and injury outcomes: Perspectives from the World Health Organization global burn registry
Bayuo, Jonathan, Agbeko, Anita Eseenam, Wong, Arkers Kwan Ching, Wong, Frances Kam Yuet, Baafi, Elisha Oduro, Baffour, Prince Kyei, Naw, Hser Eh and Agbenorku, Pius. 2023. "Global epidemiology of geriatric burns, capacities of care, and injury outcomes: Perspectives from the World Health Organization global burn registry." Burns. 49 (8), pp. 1796-1807. https://doi.org/10.1016/j.burns.2023.09.020
Technology: A metaparadigm concept of nursing
Bayuo, Jonathan, Abu-Odah, Hammoda, Su, Jing Jing and Aziato, Lydia. 2023. "Technology: A metaparadigm concept of nursing." Nursing Inquiry. 30 (4). https://doi.org/10.1111/nin.12592
Components, Models of Integration, and Outcomes Associated with Palliative/ end-of-Life Care Interventions in the Burn Unit: A Scoping Review
Bayuo, Jonathan, Abu-Odah, Hammoda and Koduah, Adwoa Owusuaa. 2023. "Components, Models of Integration, and Outcomes Associated with Palliative/ end-of-Life Care Interventions in the Burn Unit: A Scoping Review." Journal of Palliative Care. 38 (2), pp. 239-253. https://doi.org/10.1177/08258597221102735
A meta-synthesis of the transitioning experiences and career progression of migrant African nurses
Bayuo, Jonathan, Abboah‑Offei, Mary, Duodu, Precious Adade and Salifu, Yakubu. 2023. "A meta-synthesis of the transitioning experiences and career progression of migrant African nurses." BMC Nursing. 22 (1), pp. 1-20. https://doi.org/10.1186/s12912-023-01273-1
Effect of a Mobile Health Application With Nurse Support on Quality of Life Among Community-Dwelling Older Adults in Hong Kong: A Randomized Clinical Trial
Wong, Arkers Kwan Ching, Wong, Frances Kam Yuet, Chow, Karen Kit Sum, Wong, Siu Man, Bayuo, Jonathan and Ho, Annie Ka Ying. 2022. "Effect of a Mobile Health Application With Nurse Support on Quality of Life Among Community-Dwelling Older Adults in Hong Kong: A Randomized Clinical Trial." JAMA Network Open. 5 (11). https://doi.org/10.1001/jamanetworkopen.2022.41137
A randomized controlled trial of an mHealth application with nursing interaction to promote quality of life among community-dwelling older adults
Wong, Arkers Kwan Ching, Wong, Frances Kam Yuet, Bayuo, Jonathan, Chow, Karen Kit Sum, Wong, Siu Man and Lee, Athena Yin Lam. 2022. "A randomized controlled trial of an mHealth application with nursing interaction to promote quality of life among community-dwelling older adults." Frontiers in Psychiatry. 13. https://doi.org/10.3389/fpsyt.2022.978416
Investigating predictors of self‐care behavior among homebound older adults: The role of self‐efficacy, eHealth literacy, and perceived social support
Wong, Arkers Kwan Ching, Bayuo, Jonathan and Wong, Frances Kam Yuet. 2022. "Investigating predictors of self‐care behavior among homebound older adults: The role of self‐efficacy, eHealth literacy, and perceived social support." Journal of Nursing Scholarship. 54 (3), pp. 278-285. https://doi.org/10.1111/jnu.12730
Trends in antenatal care visits and associated factors in Ghana from 2006 to 2018
Duodu, Precious Adade, Bayuo, Jonathan, Mensah, Aboagye, Aduse-Poku, Livingstone, Arthur-Holmes, Francis, Dzomeku, Veronica Millicent, Dey, Nutifafa EugeneYaw, Agbadi, Pascal and Nutor, Jerry John. 2022. "Trends in antenatal care visits and associated factors in Ghana from 2006 to 2018." BMC Pregnancy and Childbirth. 22 (1). https://doi.org/10.1186/s12884-022-04404-9
Effects of a Nurse-Led Telehealth Self-care Promotion Program on the Quality of Life of Community-Dwelling Older Adults: Systematic Review and Meta-analysis
Wong, Arkers Kwan Ching, Bayuo,Jonathan, Wong, Frances Kam Yuet, Yuen, Wing Shan, Lee, Athena Yin Lam, Chang, Pui King and Lai, Jojo Tsz Chui. 2022. "Effects of a Nurse-Led Telehealth Self-care Promotion Program on the Quality of Life of Community-Dwelling Older Adults: Systematic Review and Meta-analysis." Journal of Medical Internet Research. 24 (3), pp. 124-140. https://doi.org/10.2196/31912
'Becoming and overcoming': A qualitative meta-synthesis of the experiences of men in nursing academia
Bayuo, Jonathan, Wong, Kwan Ching Arkers, Abu-Odah, Hammoda and Wong, Frances Kam Yuet. 2022. "'Becoming and overcoming': A qualitative meta-synthesis of the experiences of men in nursing academia." Journal of Professional Nursing. 43, pp. 83-106. https://doi.org/10.1016/j.profnurs.2022.07.022
Pattern and outcomes of medical malpractice cases in Ghana: a systematic content analysis
Bayuo, Jonathan and Koduah, Adwoa O.. 2022. "Pattern and outcomes of medical malpractice cases in Ghana: a systematic content analysis." Ghana Medical Journal. 56 (4), pp. 322-330. https://doi.org/10.4314/gmj.v56i4.11
Exploring the Background, Context, and Stressors of Caregiving to Elderly Burned Patients: A Qualitative Inquiry
Bayuo, Jonathan, Aniteye, Patience, Richter, Solina and Agbenorku, Pius. 2022. "Exploring the Background, Context, and Stressors of Caregiving to Elderly Burned Patients: A Qualitative Inquiry." Journal of Burn Care and Research. 43 (1), pp. 196-201. https://doi.org/10.1093/jbcr/irab077
"Resuscitate and Push": End-of-Life Care Experiences of Healthcare Staff in the Emergency Department – A Hermeneutic Phenomenological Study
Bayuo, Jonathan, Anag, Emmanuel Kwadwo, Agyei, Frank Bediako, Salifu, Yakubu, Baffour, Prince Kyei and Poku, Collins Atta. 2022. ""Resuscitate and Push": End-of-Life Care Experiences of Healthcare Staff in the Emergency Department – A Hermeneutic Phenomenological Study." Journal of Palliative Care. 37 (4), pp. 494-502. https://doi.org/10.1177/08258597211050740
Compassion Fatigue in the Burn Unit: A Review of Quantitative Evidence
Bayuo, Jonathan and Agbenorku, Pius. 2022. "Compassion Fatigue in the Burn Unit: A Review of Quantitative Evidence." Journal of Burn Care and Research. 43 (4), pp. 957-964. https://doi.org/10.1093/jbcr/irab237
Palliative care interventions for adults in the emergency department: A review of components, delivery models, and outcomes
Bayuo, Jonathan, Agbeko, Anita Eseenam, Acheampong, Emmanuel, Abu-Odah, Hammoda and Davids, Jephtah. 2022. "Palliative care interventions for adults in the emergency department: A review of components, delivery models, and outcomes." Academic Emergency Medicine. 29 (11), pp. 1357-1378. https://doi.org/10.1111/acem.14508
Letter to the Editor on recommendations for burns care in mass casualty incidents: WHO emergency medical teams technical working group on burns (WHO TWGB) 2017–2020
Bayuo, Jonathan. 2022. "Letter to the Editor on recommendations for burns care in mass casualty incidents: WHO emergency medical teams technical working group on burns (WHO TWGB) 2017–2020 ." Burns. 48, pp. 731-732. https://doi.org/10.1016/j.burns.2021.11.026
An integrative review of the use of the concept of reassurance in clinical practice
Akyirem, Samuel, Salifu, Yakubu, Bayuo, Jonathan, Duodu, Precious Adade, Bossman, Irene Fosuhemaa and Abboah‑Offei, Mary. 2022. "An integrative review of the use of the concept of reassurance in clinical practice." Nursing Open. 9 (3), pp. 1515-1535. https://doi.org/10.1002/nop2.1102
Identifying barriers and facilitators of translating research evidence into clinical practice: A systematic review of reviews
Abu-Odah, Hammoda, Said, Nizar B., Nair, Satish Chandrasekha, Allsop, Matthew J., Currow, David C., Salah, Motasem Said, Hamad, Bassam Abu, Elessi, Khamis, Alkhatib, Ali, ElMokhallalati, Y., Bayuo, Yousuf and AlKhaldi, Mohammed. 2022. "Identifying barriers and facilitators of translating research evidence into clinical practice: A systematic review of reviews." Health and Social Care in the Community. 30 (6), pp. e3265-e3276. https://doi.org/10.1111/hsc.13898
Corrigendum to "A rapid review of the use of face mask in preventing the spread of COVID-19" [International Journal of Nursing Studies Advances 3 (2021) 100013
Abboah‑Offei, Mary, Salifu, Yakubu, Adewale, Bisi, Bayuo, Jonathan, Ofosu-Poku, Rasheed and Opare-Lokko, Edwina Beryl Addo. 2022. "Corrigendum to "A rapid review of the use of face mask in preventing the spread of COVID-19" [International Journal of Nursing Studies Advances 3 (2021) 100013." International Journal of Nursing Studies Advances. 4 (1). https://doi.org/10.1016/j.ijnsa.2022.100093
Effects of a nurse-led transitional burns rehabilitation programme (4Cs-TBuRP) for adult burn survivors: protocol for a randomised controlled trial
Bayuo, Jonathan, Wong, Frances Kam Yuet and Chung, Loretta Yuet Foon. 2021. "Effects of a nurse-led transitional burns rehabilitation programme (4Cs-TBuRP) for adult burn survivors: protocol for a randomised controlled trial." Trials. 22 (1). https://doi.org/10.1186/s13063-021-05679-7
Intervention Content and Outcomes of Postdischarge Rehabilitation Programs for Adults Surviving Major Burns: A Systematic Scoping Review
Bayuo, Jonathan and Wong, Frances Kam Yuet. 2021. "Intervention Content and Outcomes of Postdischarge Rehabilitation Programs for Adults Surviving Major Burns: A Systematic Scoping Review." Journal of Burn Care and Research. 42 (4), pp. 651-710. https://doi.org/10.1093/jbcr/iraa110
Issues and concerns of family members of burn patients: A scoping review
Bayuo, Jonathan and Wong, Frances Kam Yuet. 2021. "Issues and concerns of family members of burn patients: A scoping review." Burns. 47 (3), pp. 503-524. https://doi.org/10.1016/j.burns.2020.04.023
“Hanging in a balance”: A qualitative study exploring clinicians’ experiences of providing care at the end of life in the burn unit
Bayuo, Jonathan, Bristowe, Katherine, Harding, Richard, Agbeko, Anita Eseenam, Wong, Frances Kam Yuet, Agyei, Frank Bediako, Allotey, Gabriel, Baffour, Prince Kyei, Agbenorku, Pius, Hoyte-Williams, Paa Ekow and Agambire, Ramatu. 2021. "“Hanging in a balance”: A qualitative study exploring clinicians’ experiences of providing care at the end of life in the burn unit." Palliative Medicine. 35 (2), pp. 417-425. https://doi.org/10.1177/0269216320972289
"Managing uncertainty": Experiences of family members of burn patients from injury occurrence to the end-of-life period
Bayuo, Jonathan, Bristowe, Katherine, Harding, Richard, Agbeko, Anita Eseenam, Baffour, Prince Kyei, Agyei, Frank Bediako, Wong, Frances Kam Yuet, Allotey, Gabriel, Agbenorku, Pius and Hoyte-Williams, Paa Ekow. 2021. ""Managing uncertainty": Experiences of family members of burn patients from injury occurrence to the end-of-life period." Burns. 47 (7), pp. 1647-1655. https://doi.org/10.1016/j.burns.2021.02.009
"Surviving to thriving": a meta-ethnography of the experiences of healthcare staff caring for persons with COVID-19
Agyei, Frank Bediako, Bayuo, Jonathan, Baffour, Prince Kyei and Laari, Cletus. 2021. ""Surviving to thriving": a meta-ethnography of the experiences of healthcare staff caring for persons with COVID-19 ." BMC Health Services Research. 21 (1). https://doi.org/10.1186/s12913-021-07112-w
A rapid review of the use of face mask in preventing the spread of COVID-19
Abboah‑Offei, Mary, Salifu, Yakubu, Adewale, Bisi, Bayuo, Jonathan, Ofosu-Poku, Rasheed and Opare-Lokko, Edwina Beryl Addo. 2021. "A rapid review of the use of face mask in preventing the spread of COVID-19." International Journal of Nursing Studies Advances. 3 (1). https://doi.org/10.1016/j.ijnsa.2020.100013
"On the Recovery Journey:" An Integrative Review of the Needs of Burn Patients From Immediate Pre‐Discharge to Post‐Discharge Period Using the Omaha System
Bayuo, Jonathan, Wong, Frances Kam Yuet and Agyei, Frank Bediako. 2020. ""On the Recovery Journey:" An Integrative Review of the Needs of Burn Patients From Immediate Pre‐Discharge to Post‐Discharge Period Using the Omaha System." Journal of Nursing Scholarship. 52 (4), pp. 360-368. https://doi.org/10.1111/jnu.12563
The role of palliative care in burns: A scoping review
Bayuo, Jonathan, Bristowe, Katherine, Harding, Richard, Agyei, Frank Bediako, Agbeko, Anita Eseenam, Agbenorku, Pius, Baffour, Prince Kyei, Allotey, Gabriel and Hoyte-Williams, Paa Ekow. 2020. "The role of palliative care in burns: A scoping review." Journal of Pain and Symptom Management. 59 (5), pp. 1089-1108. https://doi.org/10.1016/j.jpainsymman.2019.11.006
Seeking healthcare at their 'right' time; the iterative decision process for women with breast cancer
Agbeko, Anita Eseenam, Arthur, Joshua, Bayuo, Jonathan, Kaburi, Basil Benduri and Kyei, Ishmael. 2020. "Seeking healthcare at their 'right' time; the iterative decision process for women with breast cancer." BMC Cancer. 20 (1). https://doi.org/10.1186/s12885-020-07520-x
Developing support strategies for burn care nurses through an understanding of their experiences: A meta‐ethnographic study
Bayuo, Jonathan, Agyei, Frank Agyei, Allotey, Gabriel and Baffour, Prince Kyei. 2019. "Developing support strategies for burn care nurses through an understanding of their experiences: A meta‐ethnographic study." International Journal of Nursing Practice. 25 (2). https://doi.org/10.1111/ijn.12685
Epidemiology and outcome of suspected inhalational burn injury in a Ghanaian tertiary hospital
Agbenorku, Pius, Agbenorku, Manolo, Bayuo, Jonathan and Asare, Nana Yaa Odamea. 2019. "Epidemiology and outcome of suspected inhalational burn injury in a Ghanaian tertiary hospital." Burns Open. 3 (2), pp. 45-50. https://doi.org/10.1016/j.burnso.2019.02.001
Burns in the middle belt of Ghana: A systematic review
Bayuo, Jonathan, Agyei, Frank Bediako and Baffour, Prince Kyei. 2018. "Burns in the middle belt of Ghana: A systematic review." Burns Open. 2 (2), pp. 85-89. https://doi.org/10.1016/j.burnso.2018.02.001
Epidemiology and outcomes of burn injury among older adults in a Ghanaian tertiary hospital
Bayuo, Jonathan, Agbenorku, Pius, Amankwa, Richcane and Agbenorku, Manolo. 2018. "Epidemiology and outcomes of burn injury among older adults in a Ghanaian tertiary hospital." Burns Open. 2 (2), pp. 98-103. https://doi.org/10.1016/j.burnso.2017.12.003
Coping strategies among nurses in the Burn Intensive Care Unit: A qualitative study
Bayuo, Jonathan and Agbenorku, Pius. 2018. "Coping strategies among nurses in the Burn Intensive Care Unit: A qualitative study." Burns Open. 2 (1), pp. 47-52. https://doi.org/10.1016/j.burnso.2017.10.004
"The Last Bath": A Reflexive Ethnography of Caring for a Prisoner-Patient
Bayuo, Jonathan. 2018. ""The Last Bath": A Reflexive Ethnography of Caring for a Prisoner-Patient." International Journal for Human Caring. 22 (1), pp. 56-61. https://doi.org/10.20467/1091-5710.22.1.pg21
Burn injury in epileptics: The trend and risk factors in the middle belt of Ghana
Agbenorku, Pius, Adamu Bukari, Abdul-Rahman, Effah, Angelina Tima, Agbenorku, Manolo, Asare, Nana Yaa Odamea and Bayuo, Jonathan. 2018. "Burn injury in epileptics: The trend and risk factors in the middle belt of Ghana." Burns Open. 2 (3), pp. 122-125. https://doi.org/10.1016/j.burnso.2018.05.001
A Reflection on the Theoretical Basis of the "A-Pie" Model of Clinical Education
Bayuo, Jonathan and Amoah, Edward Obeng. 2017. "A Reflection on the Theoretical Basis of the "A-Pie" Model of Clinical Education." International Journal for Human Caring. 21 (3), pp. 134-136. https://doi.org/10.20467/1091-5710.21.3.134
Assessment and management of burn pain at the Komfo Anokye Teaching Hospital: a best practice implementation project
Bayuo, Jonathan, Munn, Zachary and Campbell, Jared. 2017. "Assessment and management of burn pain at the Komfo Anokye Teaching Hospital: a best practice implementation project." The JBI Database of Systematic Reviews and Implementation Reports. 15 (9), pp. 2398-2418. https://doi.org/10.11124/JBISRIR-2016-003272
Burns among older persons: A narrative review
Bayuo, Jonathan and Botchway, Anita Esi. 2017. "Burns among older persons: A narrative review." Burns Open. 1 (1), pp. 2-8. https://doi.org/10.1016/j.burnso.2017.05.006
Experiences with out-patient hospital service utilisation among older persons in the Asante Akyem North District- Ghana
Bayuo, Jonathan. 2017. "Experiences with out-patient hospital service utilisation among older persons in the Asante Akyem North District- Ghana." BMC Health Services Research. 17. https://doi.org/10.1186/s12913-017-2604-6
"Worlds apart": the case of evidence utilization in Ghanaian health facilities
Bayuo, Jonathan. 2017. ""Worlds apart": the case of evidence utilization in Ghanaian health facilities." The JBI Database of Systematic Reviews and Implementation Reports. 15 (9), pp. 2225-2226. https://doi.org/10.11124/JBISRIR-2017-003554
Management strategies of burns associated hyperthermia: A case report
Bayuo, Jonathan. 2017. "Management strategies of burns associated hyperthermia: A case report." Burns Open. 1 (1), pp. 45-47. https://doi.org/10.1016/j.burnso.2017.05.011
Case Study in Caring Application of Watson’s Theory of Human Caring to End of Life Care in the Burns Intensive Care Unit: A Case Report
Bayuo, Jonathan. 2017. "Case Study in Caring Application of Watson’s Theory of Human Caring to End of Life Care in the Burns Intensive Care Unit: A Case Report." International Journal for Human Caring. 21 (3), pp. 142-144. https://doi.org/10.20467/1091-5710.21.3.142
Study on acute burn injury survivors and the associated issues
Bayuo, Jonathan, Agbenorku, Pius and Amankwa, Richcane. 2016. "Study on acute burn injury survivors and the associated issues." Journal of Acute Disease. 5 (3), pp. 206-209. https://doi.org/10.1016/j.joad.2016.03.006