Acceptability of mindfulness-based interventions for substance use disorder: A systematic review

Backgroundand Purpose: Mindfulness-based interventions (MBI) for substance use disorders (SUD) have shown promising results. However, acceptability of MBIs in the context of SUD treatment has yet to be systematically assessed across published studies. Our aims were to (a) review the literature for assessments of acceptability; (b) summarize how, when, and for whom acceptability is being measured; and (c) create suggestions for best practices in measuring acceptability of MBIs for SUD.MethodsFive databases were searched with key terms related to mindfulness, relapse prevention, and SUD.ResultsResults highlight that studies of MBIs for SUD treatment lack acceptability assessment, a consistent definition of acceptability, and standardized measurements of acceptability. Conclusion: The lack of measurement and conceptual consistency make it difficult to conclude acceptability of MBIs for SUD treatment. It is imperative that more efforts be directed toward measurement of intervention acceptability to assess whether such interventions could be taken to scale.     

Effect of mindfulness-based cognitive infertility stress therapy on psychological well-being of women with infertility

Objective

Infertility is a critical major life problem that has deleterious effects on the psychological well-being of infertile women. Infertile women experience greater stress in their life compared to fertile women and have a lower quality of life. The present study aimed to evaluate the effectiveness of mindfulness-based cognitive infertility stress therapy (MBCIST) for the promotion of the psychological well-being of women with infertility.

The effectiveness of mindfulness-based stress reduction intervention on physical function in individuals with chronic low back pain: Systematic review and meta-analysis of randomized controlled trials

BackgroundMindfulness-based stress reduction (MBSR) is often used as a complementary treatment for chronic low back pain (CLBP), but its effects on the physical function component of the outcome are not addressed. This systematic review aims to examine the effectiveness of MBSR on outcomes of physical functions in CLBP individuals.MethodsDatabases searched included PubMed/MEDLINE, PEDro, The Cochrane Database of Systematic Reviews, Web of Science, Scopus, CINAHL, Embase, and other sources (Google Scholar, ProQuest, Research Gate) from inception to January 2022. Randomized controlled trials (RCTs) comparing MBSR with additional interventions that evaluated physical function among CLBP individuals were included. Two independent reviewers performed data extraction. The risk of bias was assessed using the Cochrane risk-of-bias tool.ResultsSix RCTs involving CLBP individuals were eligible for review. The between-group differences in RMDQ for the MBSR therapies against comparator therapies were significant at eight weeks follow-up (3 RCTs; MD, −1.28 [CI, −2.04 to −0.53]) and six months follow-up (2 RCTs; MD, −0.16 [CI, −1.01 to 0.69]).ConclusionMBSR therapy improves physical function at 8 weeks and 6 months follow-up in CLBP individuals. Further high-quality RCTs are warranted for the long-term effect of MBSR therapy on physical function outcomes.     

Salutogenically focused outcomes in systematic reviews of intrapartum interventions: A systematic review of systematic reviews

Introduction

research on intrapartum interventions in maternity care has focused traditionally on the identification of risk factors' and on the reduction of adverse outcomes with less attention given to the measurement of factors that contribute to well-being and positive health outcomes. We conducted a systematic review of reviews to determine the type and number of salutogenically-focused reported outcomes in current maternity care intrapartum intervention-based research. For the conduct of this review, we interpreted salutogenic outcomes as those relating to optimum and/or positive maternal and neonatal health and well-being.

Objectives

to identify salutogenically-focused outcomes reported in systematic reviews of randomised trials of intrapartum interventions.

Review methods

we searched Issue 9 (September) 2011 of the Cochrane Database of Systematic Reviews for all reviews of intrapartum interventions published by the Cochrane Pregnancy and Childbirth Group using the group filter “hm-preg”. Systematic reviews of randomised trials of intrapartum interventions were eligible for inclusion. We excluded protocols for systematic reviews and systematic reviews that had been withdrawn. Outcome data were extracted independently from each included review by at least two review authors. Unique lists of salutogenically and non-salutogenically focused outcomes were established.

Results

16 salutogenically-focused outcome categories were identified in 102 included reviews. Maternal satisfaction and breast feeding were reported most frequently. 49 non-salutogenically-focused outcome categories were identified in the 102 included reviews. Measures of neonatal morbidity were reported most frequently.

Conclusion

there is an absence of salutogenically-focused outcomes reported in intrapartum intervention-based research. We recommend the development of a core outcome data set of salutogenically-focused outcomes for intrapartum research.     

The effectiveness of Mindfulness-Based Cognitive Therapy on the illness perception and Psychological Symptoms in patients with Rheumatoid Arthritis

This study was conducted to evaluate the Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) on the Illness Perception (IP) and Psychological Symptoms (PS) for Patients in primary care with an active symptom of Rheumatoid Arthritis (RA). The present design is a clinical trial that uses the pre-test and post-test design with a control group. MBCT as an evidence-based psychotherapeutic intervention and Mindfulness-Based Intervention (MBI), is an 8-week course developed for patients with relapsing depression that integrates mindfulness meditation practices and cognitive therapy. This semi-experimental study was conducted using a pretest-posttest and control group. Diagnostic criteria for the diagnosis of patients with RA were all patients with RA who visited the clinic of Jam Rheumatology Centers and met other inclusion criteria in Mashhad in the spring of 2018. Therefore, 28 patients were randomly selected from the diagnostic group. They were randomly assigned to an experimental group and a control group (14 individuals in each group) and then were post-tested after two months. The data were collected using the revised Illness Perception Questionnaire (IPQ-R) and Depression Anxiety Stress Scales (DASS-21 scores) which were completed by the participants. The data were analyzed using repeated measures MANOVA. The results showed that there was a significant difference between the mean scores of pre-test (before MBI) and post-test (after MBI) in the experimental group compared to the control group, and MBCT had a significant effect on the perception of the disease and the psychological syndrome in the experimental group compared to the control group. Therefore, it can be concluded that MBCT is effective on IP and psychological syndrome and can be used as an MBI method to reduce the illness perceptions in people with RA. The future researches with longer pursuing period's efficacy continuation are suggested.     

Recovery of ovarian activity in women with functional hypothalamic amenorrhea who were treated with cognitive behavior therapy

OBJECTIVE: To determine whether cognitive behavior therapy (CBT) targeted to problematic attitudes common among women with functional hypothalamic amenorrhea would restore ovarian function. DESIGN: Randomized, prospective, controlled intervention. SETTING: Clinical research center in an academic medical institution. PATIENT(S): Sixteen women participated who had functional hypothalamic amenorrhea; were of normal body weight; and did not report psychiatric conditions, eating disorders, or excessive exercise. INTERVENTION(S): Subjects were randomized to CBT or observation for 20 weeks. MAIN OUTCOME MEASURE(S): Serum levels of E(2) and P and vaginal bleeding were monitored. RESULT(S): Of eight women treated with CBT, six resumed ovulating, one had partial recovery of ovarian function without evidence of ovulation, and one did not display return of ovarian function. Of those randomized to observation, one resumed ovulating, one had partial return of ovarian function, and six did not recover. Thus, CBT resulted in a higher rate of ovarian activity (87.5%) than did observation (25.0%), chi(2) = 7.14. CONCLUSION(S): A cognitive behavioral intervention designed to minimize problematic attitudes linked to hypothalamic allostasis was more likely to result in resumption of ovarian activity than observation. The prompt ovarian response to CBT suggests that a tailored behavioral intervention offers an efficacious treatment option that also avoids the pitfalls of pharmacological modalities.     

A systematic review of systematic reviews of interventions to improve maternal mental health and well-being

Objective

to identify non-invasive interventions in the perinatal period that could enable midwives to offer effective support to women within the area of maternal mental health and well-being.

Methods

a total of 9 databases were searched: MEDLINE, PubMed, EBSCO (CINAHL/British Nursing Index), MIDIRS Online Database, Web of Science, The Cochrane library, CRD (NHS EED/DARE/HTA), Joanne Briggs Institute and EconLit. A systematic search strategy was formulated using key MeSH terms and related text words for midwifery, study aim, study design and mental health. Inclusion criteria were articles published from 1999 onwards, English language publications and articles originating from economically developed countries, indicated by membership of the Organisation for Economic Co-operation and Development (OECD). Data were independently extracted using a data collection form, which recorded data on the number of papers reviewed, time frame of the review, objectives, key findings and recommendations. Summary data tables were set up outlining key data for each study and findings were organised into related groups. The methodological quality of the reviews was assessed based on predefined quality assessment criteria for reviews.

Findings

32 reviews were identified as examining interventions that could be used or co-ordinated by midwives in relation to some aspect of maternal mental health and well-being from the antenatal to the postnatal period and met the inclusion criteria. The review highlighted that based on current systematic review evidence it would be premature to consider introducing any of the identified interventions into midwifery training or practice. However there were a number of examples of possible interventions worthy of further research including midwifery led models of care in the prevention of postpartum depression, psychological and psychosocial interventions for treating postpartum depression and facilitation/co-ordination of parent-training programmes. No reviews were identified that supported a specific midwifery role in maternal mental health and well-being in pregnancy, and yet, this is the point of most intensive contact.

Key conclusions and implications for practice

This systematic review of systematic reviews provides a valuable overview of the current strengths and gaps in relation to maternal mental health interventions in the perinatal period. While there was little evidence identified to inform the current role of midwives in maternal mental health, the review provides the opportunity to reflect on what is achievable by midwives now and in the future and the need for high quality randomised controlled trials to inform a strategic approach to promoting maternal mental health in midwifery.     

Challenges in the peer review of systematic reviews and meta-analyses

Abstract

Objective: To assess the role of the referees in assisting the peer review process of systematic reviews and meta-analyses.

Methods: A one-page questionnaire was mailed to 1391 referees of two journals, the American Journal of Obstetrics and Gynecology and Obstetrics and Gynecology. The referees were asked how often they verified by their own independent analysis 11 key items related to the methodology and statistical analysis of systematic reviews and meta-analyses. Response categories included “always”, “frequently” (>50% of the time), “infrequently” (≤50% of the time) and “never”. A second and a third mailing was sent to the non-respondents.

Results: 42 mailings were returned because of change of address. Of the remaining 1349 referees, 272 responded (response rate 20%). Of the 272 respondents, 159 (58%) had previously reviewed articles dealing with systematic reviews or meta-analyses. The responses varied according to the key items in the questions but the referees used their own independent analyses “always” in only 2%–17% of the time. The rates of “infrequently” or “never” responses combined together ranged from 51% to 86% for the various key items.

Conclusion: The overwhelming majority of the referees do not verify, by their own independent analysis, key items related to methodology and statistical analysis of submitted systematic reviews and meta-analyses.     

Evolution of homeopathy: A scientometric analysis of global homeopathy literature between 1975 and 2017

ObjectiveScientometrics is the evaluation of scientific literature in a certain field. Although popularity and use of homeopathy have increased in the recent years, scientific literature lacks a bibliometric or scientometric evaluation of homeopathy literature.MethodsWe collected all data of this study from four databases provided by Web of Science. All documents published between 1975 and 2017 were included. The keywords we searched for in detail were “homeopathy”, “homeopathic”, “homoeopathy” and “homoeopathic”. We used Spearman's correlation test to investigate a possible correlation between publication numbers or the productivity and features of the countries. We created infographics and infomaps by using GunnMap and VOSviewer sources. Gross domestic product (GDP) ranking data of countries was procured from The World Data Bank.ResultsOur search retrieved a total of 4183 articles. The great majority of documents were original articles (n = 3043, 72.75%). The UK dominated homeopathy literature with 950 articles followed by the USA, Germany, India and Brazil (n = 636, 590, 277 and 246 items, respectively). Switzerland was found to be most productive country (20.41) followed by the UK, Norway and Israel (14.35, 11.31 and 8.41, respectively). University of Exeter (UK) was the leading institutions with 204 items (4.88%). Most productive journal was Homeopathy dominating and covering 24% of all literature. We detected very high correlation between publication number and citation number by year (r = 0.95, p < 0.001). A high correlation was measured between gross domestic product (GDP) per capita and productivity of the countries. A moderate correlation was measured between GDP and publication number of the countries (r = 0.66 and p < 0.001). In scientometric network analysis, the USA, the UK and Germany were noted to be three major association centers.ConclusionsWe detected that developed countries dominated homeopathy literature and we suggest that physicians from least-developed and developing countries should be funded and encouraged to carry out homeopathy studies.     

Clinical effectiveness and safety of acupotomy: An overview of systematic reviews

Background and PurposeAcupotomy is a modern type of acupuncture that uses a blade-needle combined with a flat surgical scalpel at its tip. This study was conducted to summarize and critically evaluate the current evidence on acupotomy.Materials and methodsAll relevant studies up to February 19, 2019, were included, through comprehensive searches in 11 electronic databases without language restrictions.ResultsEleven systematic reviews (SRs) comprising of 69 randomized controlled trials were included, and the methodological quality was medium-to-high in AMSTAR. All the included studies reviewed musculoskeletal disorders and reported a significantly higher total effective and cure rates in the acupotomy group for frozen shoulder, cervical spondylosis, third lumbar vertebrae transverse process syndrome, trigger finger, knee osteoarthritis, and lumbar spinal stenosis, compared to the other active control groups.ConclusionAcupotomy showed promising results for some musculoskeletal disorders; however, additional high-quality evidence is required to make clinical recommendations regarding this procedure.     

Effects of nonpharmacological interventions on depressive symptoms and depression among nursing students: A systematic review and meta-analysis

ObjectivesWe aim to examine whether nonpharmacological interventions could effectively improve depressive symptoms and depression to provide more treatment options for nursing students.MethodsPubMed, the Cochrane Library, EMBase, Web of Science, PsycINFO, and three Chinese electronic databases were comprehensively searched for papers that were published from January 1990 through March 2018. Quality assessment, sensitivity analysis and heterogeneity were performed.ResultsIn our review, 13 controlled trials met the inclusion criteria. The meta-analysis indicated that the depressive symptoms and depression of nursing students in the intervention groups showed significantly moderate improvements compared with the control groups. Three subgroup analyses showed that mindfulness interventions and stress management programs were common and effective, short-term interventions were beneficial to depression, nonpharmacological interventions had great improvements for Asian nursing students and more rigorous researches on methodological quality are recommended.ConclusionNonpharmacological interventions can serve as promising complementary and alternative approaches in reducing the depressive symptoms and depression of nursing students.     

Gynaecologists blaze the trail in primary studies and systematic reviews of diagnostic test accuracy

As the Cochrane Collaboration is poised to begin publishing systematic reviews of diagnostic test accuracy studies in addition to its traditional systematic reviews of treatment effectiveness, we are likely to see a major expansion in the number of primary studies and systematic reviews of diagnostic test accuracy in the medical literature. Obstetricians and gynaecologists have played an important role in initiating this newer area of research. However, the methodology for such studies is challenging and the published literature is riddled with pitfalls. This editorial seeks to simplify the concepts involved in diagnostic test accuracy studies and systematic reviews, to reflect on the early development of this research in our specialty and to envision the future pathway for screening and diagnostic research.     

Recurrence patterns and prognosis of endometrial stromal sarcoma and the potential of tyrosine kinase-inhibiting therapy

Objective

Endometrial stromal sarcoma (ESS) is a rare uterine malignancy. The current treatment approaches yield unsatisfactory results, and potential therapeutic targets need exploration.

Methods

We reviewed the electronic medical records of 74 patients with low-grade ESS who had been evaluated at the University of Texas MD Anderson Cancer Center between 1995 and 2006. Using immunohistochemistry, we tested the expression of targets in paraffin-embedded tissue samples taken from 13 of the patients.

Results

Forty-seven patients (64%) had a recurrence, and 16 (22%) had died of their disease at last follow-up. The 10-year progression-free survival (PFS) rate was 43% (median PFS duration, 108 months), and the overall survival (OS) rate was 85% (median OS, 288 months). Patients who received hormonal therapy had an overall response rate of 27%; another 53% had stable disease, with a median time to progression of 24 months. No complete response or partial response was observed among patients who received radiotherapy or chemotherapy. In the paraffin-embedded specimens we tested, c-abl was expressed universally. Expression of PDGF-α, PDGF-β, VEGF, and c-Kit was detected in 33%, 36%, 54%, and 8%, of specimens, respectively. EGFR and HER-2 were not detectable in any specimens.

Conclusions

Our study suggests that ESS is a hormone-dependent malignancy, with hormonal therapy having activity in recurrent disease. Targeted therapy, specifically targeting c-abl may be a potential treatment for this disease.     

Effects of mindfulness on maternal stress,depressive symptoms and awareness of present moment experience: A pilot randomised trial

ObjectiveTo determine the feasibility and acceptability and measure the effects of a mindfulness intervention compared to a pregnancy support program on stress, depressive symptoms and awareness of present moment experience.DesignA pilot randomised trial using mixed methods.Participants and SettingForty‐eight women attending a maternity service were randomly allocated to a mindfulness-based or pregnancy support program.MeasuresPerceived Stress Scale, Edinburgh Postnatal Depression Scale, Mindfulness Attention Awareness Scale, and Birth Outcomes. Women's perceptions of the impact of the programs were examined via summative evaluation, interviews, diaries and facilitator field notes.FindingsNine women in the mindfulness program and 11 in the pregnancy support program completed post-program measures. There were no statistically significant differences between groups. Of practical significance, was an improvement in measures for both groups with a greater improvement in awareness of present moment experience for the intervention group. The intervention group reported learning how to manage stressors, fear, anxiety, and to regulate their attention to be more present. The control group reported learning how to calm down when stressed which increased their confidence. Intervention group themes were: releasing stress, becoming aware, accepting, having options and choices, connecting and being compassionate. Control group themes were:managing stress, increasing confidence, connecting, focussing, being accepted, preparing.Key conclusionThe feasibility and acceptability of the intervention was confirmed. Programs decreased women's self-reported stress in different ways. Women in the mindfulness program accepted themselves and their experiences as they arose and passed in the present moment, while those in the control group gained acceptance primarily from external sources such as peers.Implications for practiceMindfulness programs can foster an internalised locus of self-acceptance which may result in woman becoming less dependent on others for their wellbeing. Adequately powered RCTs, with an active control, long-term follow up and economic evaluation are recommended.     

Complementary and alternative medicine for natural and treatment-induced vasomotor symptoms: An overview of systematic reviews and meta-analyses

Background and purposeVasomotor symptoms (VMS) are very common in menopausal populations and cancer patients and can cause physical and mental discomfort. We aim to summarize the findings of systematic reviews and meta-analyses (SRs/MAs) that assessed the effectiveness of complementary and alternative medicines(CAMs)on VMS to provide solid evidence for future practice.MethodsPubMed, Embase, the Cochrane Library, and Web of Science were searched from inception to May 2019 to identify relevant SRs/MAs. The methodological quality of SRs/MAs and evidence levels of the outcomes were assessed.ResultsA total of 29 SRs/MAs were reviewed. Evidence has shown that acupuncture, hypnosis, paced respiration, cognitive behavioural therapy, genistein, soy isoflavones, S-equol, combined preparations of black cohosh, and omega-3 supplements could significantly reduce VMS. The methodological quality of the SRs/MAs was moderate or high.ConclusionCAMs might be beneficial for reducing VMS, but the evidence levels were not high. Several priorities for future practice were identified.     

A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain

BackgroundAn increasing number of people suffer from chronic neck pain due to increased telecommuting. Manual therapy is considered a safe and less painful method and has been increasingly used to alleviate chronic neck pain. However, there is controversy about the effectiveness of manipulation therapy on chronic neck pain. Therefore, this systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to determine the effectiveness of manipulative therapy for chronic neck pain.MethodsA search of the literature was conducted on seven databases (PubMed, Cochrane Center Register of Controlled Trials, Embase, Medline, CNKI, WanFang, and SinoMed) from the establishment of the databases to May 2022. This study included RCTs on chronic neck pain managed with manipulative therapy compared with sham, exercise, and other physical therapies. The retrieved records were independently reviewed by two researchers. Further, the methodological quality was evaluated using the PEDro scale. All statistical analyses were performed using RevMan V.5.3 software. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment was used to evaluate the quality of the study results.ResultsSeventeen RCTs, including 1190 participants, were included in this meta-analysis. Manipulative therapy showed better results regarding pain intensity and neck disability than the control group. Manipulative therapy was shown to relieve pain intensity (SMD = −0.83; 95% confidence interval [CI] = [-1.04 to −0.62]; p < 0.0001) and neck disability (MD = −3.65; 95% CI = [-5.67 to - 1.62]; p = 0.004). However, the studies had high heterogeneity, which could be explained by the type and control interventions. In addition, there were no significant differences in adverse events between the intervention and the control groups.ConclusionsManipulative therapy reduces the degree of chronic neck pain and neck disabilities.     

Outcomes and patterns of relapse after definitive radiation therapy for oligometastatic cervical cancer

Purpose

Survival rates for women with metastatic cervical cancer are low, with limited management options. Definitive radiation therapy (RT) for oligometastatic disease has led to prolonged survival in other malignancies, but this approach has yet to be systematically studied for cervical cancer.

Effectiveness of cognitive-behavioral therapy (CBT) in improving the quality of life and psychological fatigue in women with polycystic ovarian syndrome: a randomized controlled clinical trial

Introduction: Given the increasing prevalence of complications caused by the polycystic ovarian syndrome (PCOS) such as medical and psychological problems and also the chronicity of this disease, patients with the PCOS tend to experience lower quality of life and greater psychological fatigue similar to other patients with chronic diseases. This study was conducted to determine the effects of cognitive-behavioral therapy (CBT) on the quality of life and psychological fatigue in women with the PCOS.

Methods: This randomized controlled clinical trial study, conducted from 2016 to 2017, enrolled 74 women aged between 18 and 35?years from the Iranian city of Saqqez. The participants were assigned to a CBT group and a control group via block randomization. The intervention group received 8 weekly CBT sessions between 45 and 60?minutes each. The Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ) and the Fatigue Impact Scale (FIS) were completed by the patients before and after the intervention.

Results: No significant differences were observed between the two groups before the intervention in terms of sociodemographic characteristics and the mean scores of quality of life and psychological fatigue. After the intervention, the mean (standard deviation [SD]) of the quality of life score was 60.2 (13.3) in the intervention group and 24.4 (15) in the control group, with the mean score of quality of life being significantly higher in the intervention group than in the control group (adjusted mean difference?=?33.1). The mean (SD) score of psychological fatigue was 28.2 (13.9) in the intervention group and 78.2 (37.1) in the control group, with the mean score of psychological fatigue being significantly lower in the intervention group than in the control group (?54.8).

Conclusions: The results showed that CBT was able to reduce fatigue and improve quality of life in our sample of women with the PCOS and ultimately boost their health.