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Medicina (Kaunas, Lithuania) Apr 2024: There has been an increasing interest in the use of non-pharmacological approaches for the multidimensional treatment of chronic pain. The aim of this systematic... (Review)
Review
: There has been an increasing interest in the use of non-pharmacological approaches for the multidimensional treatment of chronic pain. The aim of this systematic review was to assess the effectiveness of mindfulness-based therapies and Guided Imagery (GI) interventions in managing chronic non-cancer pain and related outcomes. : Searching three electronic databases (Web of Science, PubMed, and Scopus) and following the PRISMA guidelines, a systematic review was performed on Randomized Controlled Trials (RCTs) and pilot RCTs investigating mindfulness or GI interventions in adult patients with chronic non-cancer pain. The Cochrane Risk of Bias Tool was utilized to assess the quality of the evidence, with outcomes encompassing pain intensity, opioid consumption, and non-sensorial dimensions of pain. : Twenty-six trials met the inclusion criteria, with most of them exhibiting a moderate to high risk of bias. A wide diversity of chronic pain types were under analysis. Amongst the mindfulness interventions, and besides the classical programs, Mindfulness-Oriented Recovery Enhancement (MORE) emerges as an approach that improves interoception. Six trials demonstrated that mindfulness techniques resulted in a significant reduction in pain intensity, and three trials also reported significant outcomes with GI. Evidence supports a significant improvement in non-sensory dimensions of pain in ten trials using mindfulness and in two trials involving GI. Significant effects on opioid consumption were reported in four mindfulness-based trials, whereas one study involving GI found a small effect with that variable. : This study supports the evidence of benefits of both mindfulness techniques and GI interventions in the management of chronic non-cancer pain. Regarding the various mindfulness interventions, a specific emphasis on the positive results of MORE should be highlighted. Future studies should focus on specific pain types, explore different durations of the mindfulness and GI interventions, and evaluate emotion-related outcomes.
Topics: Humans; Mindfulness; Chronic Pain; Imagery, Psychotherapy; Pain Management
PubMed: 38792869
DOI: 10.3390/medicina60050686 -
Trauma, Violence & Abuse Oct 2023Firefighters are repeatedly exposed to work-related potential traumatic events and have an increased risk of developing post-traumatic stress disorder (PTSD). However,... (Review)
Review
Firefighters are repeatedly exposed to work-related potential traumatic events and have an increased risk of developing post-traumatic stress disorder (PTSD). However, the mechanisms implicated in this relationship are not clear. The aim of this study was to analyse the risk and protective factors related to the development of PTSD in firefighters. According to PRISMA, a systematic review of scientific literature was conducted in Web of Science, PsycINFO, Scopus, PubMed and the Cochrane Central Register of Controlled Trials. Quality in Prognosis Studies (QUIPS) was used as the methodological quality indicator of the selected articles (PROSPERO reference CRD42020213009). Prognostic studies involving active firefighters with presence of post-traumatic symptomatology, presenting original findings, and written in Spanish or English were included. A total of 1768 potentially eligible articles were identified. According to the inclusion criteria, 87 articles were selected to evaluate the full text. Finally, 19 articles were included, comprising 12,298 active firefighters. There is high heterogeneity in the variables evaluated in the different studies. Taking the data for which this review has found more evidence (moderate support), operational stress, job duration, burnout, expressive suppression and rumination could be risk factors of PTSD, and belongingness and dispositional mindfulness could be protective factors. Other variables with weak support (e.g. resilience) were analysed. This review analyses the available literature, highlighting its scarcity for future research on the subject. Due to repeated trauma exposure, it is important to continue investigations and bear these variables in mind for the prevention of PTSD in firefighters.
Topics: Humans; Stress Disorders, Post-Traumatic; Firefighters; Resilience, Psychological; Stress, Psychological
PubMed: 35521996
DOI: 10.1177/15248380221082944 -
The American Journal of Hospice &... Jun 2024Palliative care is a medical and humanitarian approach that improves the quality of life of patients, and their families, who are facing problems associated with chronic...
INTRODUCTION
Palliative care is a medical and humanitarian approach that improves the quality of life of patients, and their families, who are facing problems associated with chronic and life-threatening illnesses. Few studies have evaluated the effectiveness of mindfulness-based interventions for terminally ill or incurable patients. The aim of this study was to systematically review the literature on the effect of mindfulness-based interventions on symptom control and quality of life in patients in palliative care.
METHODS
PubMed, Web of Science and Cochrane databases were searched for articles, published between January 2017 and December 2022, in English, including randomized controlled and clinical trials. : terminally ill or incurable patients. : any mindfulness-based intervention. : any. : symptom control and quality of life. The risk of bias was analysed through Cochrane's ROB-2 tool.
RESULTS
Eight studies were included involving 609 patients and 75 dyads patients-spousal caregivers. The overall risk of bias was low to moderate. Mindfulness-based interventions are helpful in managing suffering, anxiety and depressive symptoms, fatigue, insomnia, drowsiness, appetite, and spiritual well-being.
CONCLUSION
Mindfulness-based interventions control several symptoms and improve spiritual quality of life in patients in palliative care. Additionally, their informal caregivers also benefit from these interventions. Future trials are crucial to investigate other effects of mindfulness-based interventions, and their long-term benefits, in patients in palliative care.
Topics: Humans; Palliative Care; Quality of Life; Mindfulness; Anxiety; Anxiety Disorders
PubMed: 37468131
DOI: 10.1177/10499091231190879 -
International Journal of Yoga 2023Stress is an enormous concern in our culture because it is the root cause of many health issues. Yoga asanas and mindfulness-based practices are becoming increasingly... (Review)
Review
Stress is an enormous concern in our culture because it is the root cause of many health issues. Yoga asanas and mindfulness-based practices are becoming increasingly popular for stress management; nevertheless, the biological effect of these practices on stress reactivity is still a research domain. The purpose of this review is to emphasize various biosignals that reflect stress reduction through various yoga-based practices. A comprehensive synthesis of numerous prior investigations in the existing literature was conducted. These investigations undertook a thorough examination of numerous biosignals. Various features are extracted from these signals, which are further explored to reflect the effectiveness of yoga practice in stress reduction. The multifaceted character of stress and the extensive research undertaken in this field indicate that the proposed approach would rely on multiple modalities. The notable growth of the body of literature pertaining to prospective yoga processes is deserving of attention; nonetheless, there exists a scarcity of research undertaken on these mechanisms. Hence, it is recommended that future studies adopt more stringent yoga methods and ensure the incorporation of suitable participant cohorts.
PubMed: 38463652
DOI: 10.4103/ijoy.ijoy_218_23 -
Journal of Clinical Medicine Aug 2023The present systematic review aimed to investigate the accuracy of zygomatic implant (ZI) placement using dynamic computer-aided surgery (d-CAIS), static computer-aided... (Review)
Review
PURPOSE
The present systematic review aimed to investigate the accuracy of zygomatic implant (ZI) placement using dynamic computer-aided surgery (d-CAIS), static computer-aided surgery (s-CAIS), and a free-hand approach in patients with severe atrophic edentulous maxilla and/or deficient maxilla.
METHODS
Electronic and manual literature searches until May 2023 were performed in the PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases. Clinical trials and cadaver studies were selected. The primary outcome was planned/placed deviation. Secondary outcomes were to evaluate the survival of ZI and surgical complications. Random-effects meta-analyses were conducted and meta-regression was utilized to compare fiducial registration amounts for d-CAIS and the different designs of s-CAIS.
RESULTS
A total of 14 studies with 511 ZIs were included (Nobel Biocare: 274, Southern Implant: 42, SIN Implant: 16, non-mentioned: 179). The pooled mean ZI deviations from the d-CAIS group were 1.81 mm (95% CI: 1.34-2.29) at the entry point and 2.95 mm (95% CI: 1.66-4.24) at the apex point, and angular deviations were 3.49 degrees (95% CI: 2.04-4.93). The pooled mean ZI deviations from the s-CAIS group were 1.19 mm (95% CI: 0.83-1.54) at the entry point and 1.80 mm (95% CI: 1.10-2.50) at the apex point, and angular deviations were 2.15 degrees (95% CI: 1.43-2.88). The pooled mean ZI deviations from the free-hand group were 2.04 mm (95% CI: 1.69-2.39) at the entry point and 3.23 mm (95% CI: 2.34-4.12) at the apex point, and angular deviations were 4.92 degrees (95% CI: 3.86-5.98). There was strong evidence of differences in the average entry, apex, and angular deviation between the navigation, surgical guide, and free-hand groups ( < 0.01). A significant inverse correlation was observed between the number of fiducial screws and the planned/placed deviation regarding entry, apex, and angular measurements.
CONCLUSION
Using d-CAIS and modified s-CAIS for ZI surgery has shown clinically acceptable outcomes regarding average entry, apex, and angular deviations. The maximal deviation values were predominantly observed in the conventional s-CAIS. Surgeons should be mindful of potential deviations and complications regardless of the decision making in different guide approaches.
PubMed: 37629460
DOI: 10.3390/jcm12165418 -
Advances in Health Sciences Education :... Mar 2024The number of studies on the effects of mindfulness on healthcare professionals is increasing. The main aim of this study was to collate the quantitative results of... (Meta-Analysis)
Meta-Analysis Review
The number of studies on the effects of mindfulness on healthcare professionals is increasing. The main aim of this study was to collate the quantitative results of original studies analyzing the effects of mindfulness-based interventions on a variety of outcomes in medical students. We also analyzed how the study design and characteristics of the intervention affect the results, and identified qualitative effects of mindfulness interventions. A literature search was performed in different databases in June 2020. Original articles meeting the following criteria were included: (1) at least 50% of the participants were medical students, (2) included a mindfulness intervention, (3) analyzed any outcome relating to mindfulness intervention, (4) peer-reviewed (5) written in English. Eventually, 31 articles including 24 different samples were included. Over half of the studies were RCTs. In over half of the studies, the intervention was 4- to 10-week original Mindfulness-Based Stress Reduction or Mindfulness-Based Cognitive Therapy or a modification of these. In general, satisfaction with the interventions was good. Based on a meta-analysis, after the intervention, the intervention group had statistically significantly fewer symptoms of stress and distress and had higher mindfulness than the controls. The beneficial effects persisted in follow-ups over months or years. Both long and shorter courses and courses with and without face-to-face sessions were effective. Both controlled and uncontrolled studies had statistically significant results. Qualitative results revealed potential factors behind the quantitative effects. The number of studies on mindfulness interventions in medical students has increased drastically. Mindfulness-based interventions seem to offer a good possibility to enhance medical students' well-being.
Topics: Humans; Students, Medical; Mindfulness; Cognitive Behavioral Therapy
PubMed: 37227541
DOI: 10.1007/s10459-023-10231-0 -
Npj Mental Health Research Mar 2024Mindfulness-based interventions (MBIs) have demonstrated therapeutic efficacy for various psychological conditions, and smartphone apps that facilitate mindfulness... (Review)
Review
Mindfulness-based interventions (MBIs) have demonstrated therapeutic efficacy for various psychological conditions, and smartphone apps that facilitate mindfulness practice can enhance the reach and impact of MBIs. The goal of this review was to summarize the published evidence on the impact of mindfulness apps on the psychological processes known to mediate transdiagnostic symptom reduction after mindfulness practice. A literature search from January 1, 1993, to August 7, 2023 was conducted on three databases, and 28 randomized controlled trials involving 5963 adults were included. Across these 28 studies, 67 outcome comparisons were made between a mindfulness app group and a control group. Between-group effects tended to favor the mindfulness app group over the control group in three psychological process domains: repetitive negative thinking, attention regulation, and decentering/defusion. Findings were mixed in other domains (i.e., awareness, nonreactivity, non-judgment, positive affect, and acceptance). The range of populations examined, methodological concerns across studies, and problems with sustained app engagement likely contributed to mixed findings. However, effect sizes tended to be moderate to large when effects were found, and gains tended to persist at follow-up assessments two to six months later. More research is needed to better understand the impact of these apps on psychological processes of change. Clinicians interested in integrating apps into care should consider app-related factors beyond evidence of a clinical foundation and use app databases to identify suitable apps for their patients, as highlighted at the end of this review.
PubMed: 38609511
DOI: 10.1038/s44184-023-00048-5 -
Heliyon Aug 2023This article aims to provide the experiences of mindfulness treatments from the perspectives of patients with a history of substance abuse.
OBJECTIVE
This article aims to provide the experiences of mindfulness treatments from the perspectives of patients with a history of substance abuse.
DATA SOURCE
Peer-reviewed articles on 5 databases, namely, PubMed, PsychINFO, Medline, CINAHL and the Cochrane Library, between the year of 2000 and 2023.
STUDY INCLUSION AND EXCLUSION CRITERIA
Studies were included if they were published in the English language and reported on qualitative studies that directly engaged patients with experiences of substance abuse and mindfulness treatments.
DATA EXTRACTION
After our initial search, 5355 studies were reviewed by title and abstract, consequently, 10 studies were included.
DATA SYNTHESIS
Meta-ethnography were used in this study. Data were obtained from the quotations from participants and text under the heading "results" or "findings" from the included 10 studies.
RESULTS
Effective mindfulness-based interventions (MBI) influence recovery from substance abuse. Four themes were identified as factors influencing the MBI treatment effect. They were (1) engaging in mindfulness: entry and retention, (2) perceived benefits of MBIs, (3) implementation of treatment group and (4) maintenance of treatment effect.
CONCLUSION
This article examines the scientific literature to date and presents the evidence on the factors that influentially impact the effect of MBIs in patients with substance abuse. The findings of this study should be helpful in guiding clinical practice, policy, and future research focused on the treatment effect of MBIs for person with substance use.
PubMed: 37649842
DOI: 10.1016/j.heliyon.2023.e18911 -
World Neurosurgery Jun 2024Despite centuries of joint investigation of philosophy and neurological interventions, a founding account for the philosophy of neurosurgery has yet to be rigorously...
INTRODUCTION
Despite centuries of joint investigation of philosophy and neurological interventions, a founding account for the philosophy of neurosurgery has yet to be rigorously constructed or defended. This paper reviews recent work on the philosophy of neurosurgery, spanning metaphysics, epistemology, and value theory, to establish a framework and clinical relevance for study in the philosophy of neurosurgery.
METHODS
A systematic review of an online database was conducted using the broad search terms, "Philosophy AND (Neurosurgery OR Neurological Surgery)." Records were included if they demonstrated relevance to the philosophy of neurosurgery and analytical rigor, but were excluded if solely legal, clinical, or ethical principles were considered without substantive discussion of underlying ethical frameworks and philosophical principles.
RESULTS
Of 8025 candidates from online and print records, 16 records (14 from online sources and 2 from an edited volume) met inclusion criteria for the systematic review. Three dealt with metaphysics, 3 dealt with epistemology, 4 dealt with value theory, 5 dealt with metaphysics/epistemology, and 1 dealt with value theory/metaphysics. Questions of free will, consciousness, personal identity, neurosurgical knowledge, ascription of other minds, deontology, and minimalism, among others, were considered.
DISCUSSION
Based on identified studies, the philosophy of neurosurgery is defined as the discipline of rigorously and methodically addressing metaphysical, epistemological, and value-theoretic questions arising from physically intervening in the nervous system. We discuss future directions for questions within the philosophy of neurosurgery and consider their relevance for patient care and the practice of neurosurgery.
Topics: Humans; Knowledge; Metaphysics; Neurosurgery; Philosophy, Medical
PubMed: 38493892
DOI: 10.1016/j.wneu.2024.03.036 -
JNCI Cancer Spectrum Apr 2024Considering the persistent nature and higher prevalence of insomnia in cancer patients and survivors compared with the general population, there is a need for effective... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Considering the persistent nature and higher prevalence of insomnia in cancer patients and survivors compared with the general population, there is a need for effective management strategies. This systematic review and meta-analysis aimed to comprehensively evaluate the available evidence for the efficacy of pharmacological and nonpharmacological interventions for insomnia in adult cancer patients and survivors.
METHODS
Following the PRISMA guidelines, we analyzed data from 61 randomized controlled trials involving 6528 participants. Interventions included pharmacological, physical, and psychological treatments, with a focus on insomnia severity and secondary sleep and non-sleep outcomes. Frequentist and Bayesian analytical strategies were employed for data synthesis and interpretation.
RESULTS
Cognitive-Behavioral Therapy for Insomnia (CBT-I) emerged as the most efficacious intervention for reducing insomnia severity in cancer survivors and further demonstrated significant improvements in fatigue, depressive symptoms, and anxiety. CBT-I showed a large postintervention effect (g = 0.86; 95% confidence interval [CI] = 0.57 to 1.15) and a medium effect at follow-up (g = 0.55; 95% CI = 0.18 to 0.92). Other interventions such as bright white light therapy, sleep medication, melatonin, exercise, mind-body therapies, and mindfulness-based therapies showed benefits, but the evidence for their efficacy was less convincing compared with CBT-I. Brief Behavioral Therapy for Insomnia showed promise as a less burdensome alternative for patients in active cancer treatment.
CONCLUSIONS
CBT-I is supported as a first-line treatment for insomnia in cancer survivors, with significant benefits observed across sleep and non-sleep outcomes. The findings also highlight the potential of less intensive alternatives. The research contributes valuable insights for clinical practice and underscores the need for further exploration into the complexities of sleep disturbances in cancer patients and survivors.
Topics: Adult; Humans; Anxiety; Cancer Survivors; Cognitive Behavioral Therapy; Depression; Exercise Therapy; Fatigue; Hypnotics and Sedatives; Melatonin; Mind-Body Therapies; Mindfulness; Neoplasms; Phototherapy; Sleep Aids, Pharmaceutical; Sleep Initiation and Maintenance Disorders
PubMed: 38781520
DOI: 10.1093/jncics/pkae041