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BMC Endocrine Disorders Sep 2023The effect of stress on Graves' disease (GD) is controversial. Our purpose was to quantify the impacts of stress on patients with Graves' disease. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The effect of stress on Graves' disease (GD) is controversial. Our purpose was to quantify the impacts of stress on patients with Graves' disease.
METHODS
Systematic searches of PubMed, MEDLINE, Embase, Web of Science, Scopus, Cochrane Library and PsycInfo were conducted from inception to 1 January 2023. Studies comparing the incidence of stressful life events (SLEs) that occurred before diagnosis and during drug therapy in cases diagnosed with GD and controls were included in the final analysis.
RESULTS
Nine case-control studies and four cohort studies enrolling 2892 participants (1685 [58%] patients) were included. Meta-analysis revealed a high and significant effect-size index in a random effect model (d = 1.81, P = 0.01), indicating that stress is an important factor in the onset of GD. The relationship between SLEs and GD was stronger in studies with higher proportions of female patients (β = 0.22, P < 0.01) and weaker in studies with older patients with GD (β =-0.62, P < 0.01). However, stress did not significantly affect the outcome of antithyroid drug therapy for GD (d = 0.32, P = 0.09).
CONCLUSIONS
The results of this meta-analysis suggest that stress is one of the environmental triggers for the onset of GD. Therefore, we recommend stress management assistance for individuals genetically susceptible to GD, especially for young females.
Topics: Humans; Female; Graves Disease; Antithyroid Agents; Case-Control Studies; Genetic Predisposition to Disease
PubMed: 37700292
DOI: 10.1186/s12902-023-01450-y -
Arab Journal of Urology Mar 2019: To identify various predisposing factors, the clinical presentation, and the management of vaginal mesh-related complications, with special emphasis on mesh exposure... (Review)
Review
: To identify various predisposing factors, the clinical presentation, and the management of vaginal mesh-related complications, with special emphasis on mesh exposure and the indications for and results of vaginal mesh removal. : A systematic literature review was performed using a search strategy based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria. PubMed was queried for studies regarding aetiology, risk factors, and management of vaginal mesh exposure from 1 January 2008 to June 2018. Full-text articles were obtained for eligible abstracts. Relevant articles were included, and the cited references were used to identify relevant articles not previously included. : A total of 102 abstracts were identified from the PubMed search criteria. An additional 45 studies were identified based on review of the cited references. After applying eligibility criteria and excluding impertinent articles, 58 studies were included in the final analysis. : Numerous studies have found at least some degree of symptomatic improvement regardless of the amount of mesh removed. Focal areas of exposure or pain can be successfully managed with partial mesh removal with low rates of complications. With partial mesh removal, many patients will ultimately require subsequent mesh removal procedures. For this reason, complete mesh excision is an alternative for patients with diffuse vaginal pain, large mesh exposure, and extrusion of mesh into adjacent viscera. However, when considering complete mesh removal, it is important to counsel patients regarding possible complications of removal and the increased risk of recurrent stress urinary incontinence and pelvic organ prolapse postoperatively. : MUS: midurethral sling; OR: odds ratio; POP: pelvic organ prolapse; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-analyses; SUI: stress urinary incontinence; TOT: transobturator; TVT: tension-free vaginal tape.
PubMed: 31258942
DOI: 10.1080/2090598X.2019.1589787 -
Health Psychology : Official Journal of... Sep 2021Stress management interventions (SMIs) targeting psychological stress and other psychosocial factors associated with heart failure (HF) morbidity and mortality are... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Stress management interventions (SMIs) targeting psychological stress and other psychosocial factors associated with heart failure (HF) morbidity and mortality are increasingly recommended for adults with HF. SMI content and delivery varies widely and meta-analyses are needed to synthesize current findings to identify gaps in the literature. The purpose of this meta-analysis is to examine the efficacy of SMIs for improving anxiety, depressive symptoms, exercise capacity, and disease-specific quality of life in adults with HF.
METHOD
Comprehensive searches of 10 electronic bibliographic databases identified peer-reviewed, published, randomized controlled trials (RCTs) of SMIs for adults with HF.
RESULTS
Twenty-three RCTs were included (N = 2,294; Mage = 63.09 ± 7.27 years; 40% women, 56% White). Pooled effects indicated greater improvements in anxiety (d+ = .49, 95% confidence interval [CI] = [.09-.89], k = 10), depressive symptoms (d+ = .39, 95% CI [.03, .75], k = 13), disease-specific quality of life (d+ = .82, 95% CI [.40, 1.24], k = 16), and exercise capacity (d+ = .57, 95% CI [.20, .95], k = 14) among SMI recipients relative to controls at the first postintervention assessment. The benefits were not maintained at follow-up. Participant characteristics (e.g., proportion women, HF severity), but not intervention type, moderated the findings.
CONCLUSIONS
SMIs for adults with HF demonstrated short-term improvements in anxiety, depressive symptoms, quality of life, and exercise capacity. Future research sampling patients who are psychologically distressed with more thorough assessment of stress and longer follow-ups can elucidate the benefits of SMIs among adults with HF. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Adult; Anxiety; Anxiety Disorders; Female; Heart Failure; Humans; Male; Psychotherapy; Quality of Life
PubMed: 34843321
DOI: 10.1037/hea0001084 -
International Journal of Clinical... Oct 2023Burnout is an occupational phenomenon caused by ineffectively managed work-related stress. Burnout is common among healthcare professionals and has the capacity to... (Review)
Review
BACKGROUND
Burnout is an occupational phenomenon caused by ineffectively managed work-related stress. Burnout is common among healthcare professionals and has the capacity to compromise patient care, but is not well characterised in pharmacists.
AIM
This systematic review aimed to establish the prevalence of burnout among pharmacists, and its associated risk factors.
METHOD
A systematic search of Embase, PubMed, CINAHL and PsychInfo was carried out. Studies were included using the following eligibility criteria; original research investigating burnout prevalence in pharmacists in patient-facing roles in any jurisdiction, using any validated burnout measurement instrument. No language or date barriers were set. Data were extracted by the first author and accuracy checked by co-authors. A pooled prevalence was estimated, and narrative synthesis provided.
RESULTS
Burnout prevalence data were extracted from 19 articles involving 11,306 pharmacist participants across eight countries. More than half (51%) of pharmacists were experiencing burnout. Associated risk factors included longer working hours, less professional experience, high patient and prescription volumes, excessive workload and poor work/life balance. The COVID-19 pandemic has negatively impacted pharmacist burnout and resilience. Involvement in education and training and access to burnout management resources were associated with lower rates of burnout, but burnout intervention effectiveness is unknown.
CONCLUSION
Burnout remains high among pharmacists and may negatively affect the quality of patient care. There is significant heterogeneity pertaining to the definition and assessment of burnout and there remains a need to identify and evaluate effective individual and organisational burnout interventions.
Topics: Humans; Pharmacists; Pandemics; Prevalence; Burnout, Professional; Health Personnel
PubMed: 36446993
DOI: 10.1007/s11096-022-01520-6 -
Biomedicine & Pharmacotherapy =... Sep 2023Neurodegenerative diseases (NDDs) encompass a range of conditions that involve progressive deterioration and dysfunction of the nervous system. Some of the common NDDs... (Review)
Review
Neurodegenerative diseases (NDDs) encompass a range of conditions that involve progressive deterioration and dysfunction of the nervous system. Some of the common NDDs include Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS). Although significant progress has been made in understanding the pathological mechanisms of NDDs in recent years, the development of targeted and effective drugs for their treatment remains challenging. Kaempferol is a flavonoid whose derivatives include kaempferol-O-rhamnoside, 3-O-β-rutinoside/6-hydroxykaempferol 3,6-di-O-β-d-glucoside, and kaempferide. Emerging studies have suggested that kaempferol and its derivatives possess neuroprotective properties and may have potential therapeutic benefits in NDDs. Here, we aimed to provide a theoretical basis for the use of kaempferol and its derivatives in the clinical treatment of NDDs. We systematically reviewed the literature in the PubMed, Web of Science, and Science Direct databases until June 2022 using the search terms "kaempferol," "kaempferol derivatives," "NDDs," "pharmacokinetics," and "biosynthesis" according to the reporting items for systematic review (PRISMA) standard. Based on combined results of in vivo and in vitro studies, we summarize the basic mechanisms and targets of kaempferol and its derivatives in the management of AD, PD, HD, and ALS. Kaempferol and its derivatives exert a neuroprotective role mainly by preventing the deposition of amyloid fibrils (such as Aβ, tau, and α-synuclein), inhibiting microglia activation, reducing the release of inflammatory factors, restoring the mitochondrial membrane to prevent oxidative stress, protecting the blood-brain barrier, and inhibiting specific enzyme activities (such as cholinesterase). Kaempferol and its derivatives are promising natural neuroprotective agents. By determining their pharmacological mechanism, kaempferol and its derivatives may be new candidate drugs for the treatment of NDDs.
Topics: Humans; Neurodegenerative Diseases; Neuroprotective Agents; Amyotrophic Lateral Sclerosis; Kaempferols; Alzheimer Disease; Parkinson Disease; Huntington Disease
PubMed: 37494786
DOI: 10.1016/j.biopha.2023.115215 -
Complementary Therapies in Medicine Sep 2022Lavender is considered as one of the medicinal plants to manage stress. Although many preliminary studies evaluated the effect of lavender on individuals' stress level,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Lavender is considered as one of the medicinal plants to manage stress. Although many preliminary studies evaluated the effect of lavender on individuals' stress level, to the best of our knowledge, we did not find a study that summarizes the results. Therefore, the present study aimed to estimate the Pooled effect of lavender on the stress level of individuals using systematic review and meta-analysis.
METHOD
A systematic literature review based on PRISMA 2020 was performed on the SID, MagIran, Embase, PubMed, Scopus, Web of Science (WoS) databases, and Google Scholar motor engine using related MeSH/Emtree and Free Text words, including "Lavender*", "Lavandula*", "Stress*", "Stress Disorders, Traumatic", and "Stress, Psychological" with no time limitation until August 2021: We also searched two Iranain free local resourses including MagIran https://www.magiran.com and Scientific Information Database (SID) https://www.sid.ir. The quality assessment of studies was performed using JBI checklist. Heterogeneity among studies was quantified using I index and Random Effects model was used to combine the data and perform the meta-analysis.
RESULTS
In the initial search, 1520 articles were found. After excluding the irrelevant studies, finally, 21 articles with a sample size of 791 in the intervention group and 804 in the control group were included in the meta-analysis. As a result of combining the studies, stress score after using lavender in the intervention group showed a significant decrease of 0.63 ± 0.13 (95% CI) more than that in the control group (P < 0.001). The results of subgroup analysis demonstrated that the highest standardized mean difference (SMD) before and after the intervention in the intervention group compared to the control group was related to L. angustifolia species with 0.73 ± 0.22, student groups with 2.27 ± 1.34, and diagnostic tool of Perceived Stress Scale (PSS) with 0.82 ± 0.42, indicating that the difference between the groups was statistically significant (P < 0.001).
CONCLUSION
The pooled estimation of this systematic reiew and meta-analysis revealed that lavender significantly reduces individuals' stress. Therefore, it seems that the use of lavender can be considered as a part of a stress management programs, especially in student groups.
Topics: Humans; Lavandula; Plants, Medicinal; Psychotherapy
PubMed: 35429599
DOI: 10.1016/j.ctim.2022.102832 -
Resuscitation Nov 2019During resuscitation decisions are made frequently and based on limited information in a stressful environment.
BACKGROUND
During resuscitation decisions are made frequently and based on limited information in a stressful environment.
AIM
This systematic review aimed to identify human factors affecting decision-making in challenging or stressful situations in resuscitation. The secondary aim was to identify methods of improving decision-making performance under stress.
METHODS
The databases PubMed, EMBASE and The Cochrane Library were searched from their commencement to the 13th of April 2019. MeSH terms and key words were combined (Stress* OR "human factor") AND Decision. Articles were included if they involved decision makers in medicine where decisions were made under challenging circumstances, with a comparator group and an outcome measure relating to change in decision-making performance.
RESULTS
22,368 records in total were initially identified, from which 82 full text studies were reviewed and 16 finally included. The included studies ranged from 1995 to 2018 and included a total of 570 participants. The studies were conducted in several different countries and settings, with participants of varying experience and backgrounds. Of the 16 studies, 5 were randomised controlled trials, 3 of which were deemed to have a high risk of bias. The stressors identified were (i) illness severity (ii) socio-evaluative, (iii) noise, (iv) fatigue. The mitigators identified were (i) cognitive aids including checklists, (ii) stress management training and (iii) meditation.
CONCLUSIONS
Human factors contributing to decision-making during resuscitation are identified and can be mitigated by tailored stress training and cognitive aids. Understanding these factors may have implications for clinician education and the development of decision-support tools.
Topics: Cardiopulmonary Resuscitation; Decision Making; Decision Support Techniques; Humans; Injury Severity Score; Severity of Illness Index; Stress, Psychological
PubMed: 31562904
DOI: 10.1016/j.resuscitation.2019.09.023 -
Internet Interventions Apr 2022College students face several sources of stress. Self-guided stress management interventions offer an excellent opportunity for scaling up evidence-based interventions... (Review)
Review
BACKGROUND
College students face several sources of stress. Self-guided stress management interventions offer an excellent opportunity for scaling up evidence-based interventions for self-management of these stresses. However, little is known about the overall effects of these interventions. Increasing this understanding is essential because self-guided stress management interventions might be a cost-effective and acceptable way of providing help to this important segment of the population during a critical life course stage.
METHODS
We carried out a systematic literature search of bibliographical databases (PubMed, PsycINFO, Embase, and Cochrane Library) for randomized controlled trials (RCTs) of self-guided stress management interventions published up through April 2020. We conducted two separate meta-analyses for perceived stress, depression, and anxiety. The first included interventions for general college student samples. The second included studies for students with high levels of perceived stress.
RESULTS
The first meta-analysis included 26 studies with 29 intervention-control comparisons based on a total of 4468 students. The pooled effect size was small but statistically significant ( = 0.19; 95% CI [0.10, 0.29]; < 0.001). Results showed moderate heterogeneity across studies [ = 48%; 95% CI (19, 66%)]. The second meta-analysis, included four studies based on a total of 491 students with high levels of stress. The pooled effect size was small but statistically significant ( = 0.34; 95% CI [0.16, 0.52]; < 0.001). Results showed no heterogeneity across studies ( = 0%; 95% CI [0, 79%]), but risk of bias was substantial.
DISCUSSION
Our results suggest that self-guided stress management programs may be effective when compared to control conditions, but with small average effects. These programs might be a useful element of a multi-component intervention system. Given the psychological barriers to treatment that exist among many college students, self-help interventions might be a good first step in facilitating subsequent help-seeking among students reluctant to engage in other types of treatment. More studies should be conducted to investigate these interventions, sample specifications, mediating effects, and individual-level heterogeneity of effects.
PubMed: 35242591
DOI: 10.1016/j.invent.2022.100503 -
Brazilian Journal of Medical and... Jul 2017The aim of the present study was to systematically review the recent literature about pain and distress outcomes in children and critically analyze the methodological... (Review)
Review
The aim of the present study was to systematically review the recent literature about pain and distress outcomes in children and critically analyze the methodological quality of the reports. The systematic review was based on the PRISMA statement and performed by selecting articles that are indexed in scientific databases. The methodological quality of reports was examined using STROBE statement, for observational studies, and CONSORT statement, for randomized controlled trials. The PedIMMPACT consensus was used to evaluate the psychometric quality of pain instruments. We analyzed 23 empirical studies, including 14 randomized controlled trials, seven cross-sectional studies, and two studies with cohort designs. Fourteen studies included preschool- and schoolchildren, and nine studies included infants. Regarding studies with infants, pain responses were evaluated by heart rate, crying and behavioral observation scales, and distress was evaluated only by salivary cortisol. Four-handed care and sensorial saturation interventions were used to evaluate efficacy to reduce pain and distress responses. Concerning studies with children, both pain and distress responses were evaluated by self- and hetero-reports, behavioral observation and/or physiological measures. Distraction was effective for reducing pain and distress during burn dressing changes and needle procedures, and healing touch intervention reduced distress and pain in chronic patients. All of the studies scored at least 60% in the methodological quality assessment. The pain outcomes included measures of validity that were classified as well-established by the PedIMMPACT. This systematic review gathers scientific evidence of distress-associated pain in children. Pain and distress were measured as distinct constructs, and their associations were poorly analyzed.
Topics: Child; Humans; Infant; Pain Management; Pain Measurement; Randomized Controlled Trials as Topic; Stress, Psychological
PubMed: 28678920
DOI: 10.1590/1414-431X20175984 -
BMC Medical Education Nov 2022The effects of stress on surgical residents and how stress management training can prepare residents to effectively manage stressful situations is a relevant topic. This...
BACKGROUND
The effects of stress on surgical residents and how stress management training can prepare residents to effectively manage stressful situations is a relevant topic. This systematic review aimed to analyze the literature regarding (1) the current stress monitoring tools and their use in surgical environments, (2) the current methods in surgical stress management training, and (3) how stress affects surgical performance.
METHODS
A search strategy was implemented to retrieve relevant articles from Web of Science, Scopus, and PubMed. The 787 initially retrieved articles were reviewed for further evaluation according to the inclusion/exclusion criteria (Prospero registration number CRD42021252682).
RESULTS
Sixty-one articles were included in the review. The stress monitoring methods found in the articles showed heart rate analysis as the most used monitoring tool for physiological parameters while the STAI-6 scale was preferred for psychological parameters. The stress management methods found in the articles were mental-, simulation- and feedback-based training, with the mental-based training showing clear positive effects on participants. The studies analyzing the effects of stress on surgical performance showed both negative and positive effects on technical and non-technical performance.
CONCLUSIONS
The impact of stress responses presents an important factor in surgical environments, affecting residents' training and performance. This study identified the main methods used for monitoring stress parameters in surgical educational environments. The applied surgical stress management training methods were diverse and demonstrated positive effects on surgeons' stress levels and performance. There were negative and positive effects of stress on surgical performance, although a collective pattern on their effects was not clear.
Topics: Humans; Clinical Competence; Surgeons
PubMed: 36380334
DOI: 10.1186/s12909-022-03841-6