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Stress and Health : Journal of the... Jun 2024Increasing evidence points out that Executive Functions (i.e., EFs) may be core mechanisms for the generation of resilient responses to adversity. A systematic review... (Review)
Review
Increasing evidence points out that Executive Functions (i.e., EFs) may be core mechanisms for the generation of resilient responses to adversity. A systematic review testing the relations between either affective (hot) and/or non-affective (cold) EFs (i.e., inhibition, flexibility and working memory updating) and resilience was conducted. A total of 449 articles were initially identified. After two steps of title-and-abstract (k = 449), and full-text reading filtering (k = 67), 11 studies were reviewed. Three studies included cold measures of working memory and supported significant positive relations between higher working memory functioning and higher trait resilience levels. One study included cold measures of inhibition and another one both hot and cold measures, with only the first one supporting a positive relation between more efficient inhibition and higher trait resilience levels. Finally, 7 studies measured flexibility in its cold and/or hot dimensions and overall supported significant relations between higher flexibility and higher levels of trait, process and outcome resilience measures. These results support the role of EFs performance to promote different forms of resilience. This review allows to identify different issues that need to be addressed in future research and highlight the need to integrate the analysis of all hot and cold EFs components to understand their role in the generation of resilience.
PubMed: 38943558
DOI: 10.1002/smi.3439 -
European Journal of Psychotraumatology 2024Clonidine is a centrally acting anti-adrenergic agent that may have applications in post-traumatic stress disorder (PTSD), particularly for sleep. In this systematic... (Review)
Review
Clonidine is a centrally acting anti-adrenergic agent that may have applications in post-traumatic stress disorder (PTSD), particularly for sleep. In this systematic review, we aimed to summarize the effect of clonidine on sleep quality and duration, nightmares, and PTSD symptom severity in adults with PTSD. PubMed (Medline), Embase, PsycINFO, CINAHL, and clinicaltrials.gov were searched up to April 2023. Studies on clonidine use in adult PTSD patients reporting data on the effect on sleep, nightmares, and PTSD symptoms were included. A narrative summary and a meta-analysis of the study findings are presented. Ten reports, accounting for = 569 patients with PTSD (145 on clonidine and 436 controls), were included in the final selection. There were four case reports, four observational studies, one non-blind clinical trial, and one crossover randomized controlled trial (RCT). Median clonidine dose was 0.15 mg/day (range: 0.1-0.5 mg/day). Median follow-up time was 31 days (range: 3 days to 19 months). The quality of the evidence was rated from very low to low. There was marked between-study heterogeneity and low power in the individual studies, but many reported improved sleep quality, nightmare reduction, and improvement of PTSD symptoms for patients treated with clonidine. Meta-analysis was only possible for two studies reporting the effect of clonidine on nightmares, and showed no difference from the comparator (i.e. prazosin or terazosin) (odds ratio: 1.16; 95% confidence interval: 0.66 to 2.05), potentially pointing towards non-inferiority between these medications. Future research, such as well-powered RCTs, is needed to identify the efficacy in the lower dose range and the most suitable treatment group, and to obtain good evidence on the effects of clonidine in the treatment of sleep disorders related to PTSD.
Topics: Clonidine; Humans; Stress Disorders, Post-Traumatic; Dreams; Sleep Quality; Adrenergic alpha-2 Receptor Agonists
PubMed: 38941125
DOI: 10.1080/20008066.2024.2366049 -
Cancer Nursing Jun 2024Interventions to foster resilience may promote mental health recovery after exposure to stressors. However, comprehensive systematic syntheses of such evidence in family...
BACKGROUND
Interventions to foster resilience may promote mental health recovery after exposure to stressors. However, comprehensive systematic syntheses of such evidence in family members of pediatric cancer patients are lacking.
OBJECTIVE
To systematically review and meta-analyze the evidence for the effects of psychological interventions at fostering resilience in family members of pediatric cancer patients.
METHODS
PubMed, Cumulative Index to Nursing and Allied Health Literature, and 9 other databases were searched for articles published until March 2023. Empirical studies on psychological interventions to improve resilience in family members of pediatric cancer patients were included. Full-text and quality appraisals were performed independently by 2 reviewers. Pooled effect sizes were calculated using random-effects meta-analyses.
RESULTS
Seventeen studies were included, of which 10 were included in the meta-analyses. There was a positive effect of interventions on resilience at postintervention time points, but no effects on depressive symptoms, stress, or well-being. The improvement in resilience was sustained in the short term (≤3 months) and medium term (>3 to ≤6 months), with delayed effects on depressive symptoms and stress. In the 6 studies that reported moderate effect sizes, the interventions comprised problem-solving skills, cognitive strategies, promotion of personal strength, and social resources.
CONCLUSION
The findings indicated that psychological interventions targeting resilience have the potential to positively affect the resilience and mental health outcomes of family members, particularly parents.
IMPLICATIONS FOR PRACTICE
Psychological interventions targeting resilience hold promise in improving the mental health of family members. Future interventions should clearly specify the characteristics of the intervention, such as mode of delivery, format, and duration.
PubMed: 38941110
DOI: 10.1097/NCC.0000000000001368 -
Environmental Science and Pollution... Jun 2024The proliferation of water hyacinths (Eichhornia crassipes), recognized as one of the most invasive aquatic plants worldwide, presents profound ecological and... (Review)
Review
The proliferation of water hyacinths (Eichhornia crassipes), recognized as one of the most invasive aquatic plants worldwide, presents profound ecological and socioeconomic challenges across diverse ecosystems, particularly in rural communities. This systematic review examines the extensive global impacts and explores various mitigation strategies to manage and utilize this pervasive species. Ecologically, water hyacinth disrupts aquatic ecosystems by depleting oxygen levels, obstructing sunlight, and displacing native species, which in turn compromises water quality and biodiversity. Economically, its rapid spread affects agriculture, fishing, and navigation, imposing significant costs on local economies and livelihoods. In response, this review assesses integrated management approaches combining mechanical, chemical, and biological controls that have been implemented to curb its growth. Moreover, innovative strategies that repurpose the biomass for bioenergy, handicrafts, and bio-remediation are discussed, highlighting their potential to transform an ecological menace into an economic resource. These strategies not only mitigate the plant's negative impacts but also contribute to sustainable development by providing economic opportunities and enhancing ecosystem services. This review stresses the necessity for a holistic approach to water hyacinth management that is adaptive, sustainable, and beneficial to affected communities.
PubMed: 38937356
DOI: 10.1007/s11356-024-33905-7 -
PloS One 2024At some point in their career, many healthcare workers will experience psychological distress associated with being unable to take morally or ethically correct action,...
OBJECTIVE
At some point in their career, many healthcare workers will experience psychological distress associated with being unable to take morally or ethically correct action, as it aligns with their own values; a phenomenon known as moral distress. Similarly, there are increasing reports of healthcare workers experiencing long-term mental and psychological pain, alongside internal dissonance, known as moral injury. This review examined the triggers and factors associated with moral distress and injury in Health and Social Care Workers (HSCW) employed across a range of clinical settings with the aim of understanding how to mitigate the effects of moral distress and identify potential preventative interventions.
METHODS
A systematic review was conducted and reported according to recommendations from Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were conducted and updated regularly until January 2024 on 2 main databases (CENTRAL, PubMed) and three specialist databases (Scopus, CINAHL, PsycArticles), alongside hand searches of study registration databases and other systematic reviews reference lists. Eligible studies included a HSCW sample, explored moral distress/injury as a main aim, and were written in English or Italian. Verbatim quotes were extracted, and article quality was assessed via the CASP toolkit. Thematic analysis was conducted to identify patterns and arrange codes into themes. Specific factors like culture and diversity were explored, and the effects of exceptional circumstances like the pandemic.
RESULTS
Fifty-one reports of 49 studies were included in the review. Causes and triggers were categorised under three domains: individual, social, and organisational. At the individual level, patients' care options, professionals' beliefs, locus of control, task planning, and the ability to make decisions based on experience, were indicated as elements that can cause or trigger moral distress. In addition, and relevant to the CoVID-19 pandemic, was use/access to personal protection resources. The social or relational factors were linked to the responsibility for advocating for and communication with patients and families, and professionals own support network. At organisational levels, hierarchy, regulations, support, workload, culture, and resources (staff and equipment) were identified as elements that can affect professionals' moral comfort. Patients' care, morals/beliefs/standards, advocacy role and culture of context were the most referenced elements. Data on cultural differences and diversity were not sufficient to make assumptions. Lack of resources and rapid policy changes have emerged as key triggers related to the pandemic. This suggests that those responsible for policy decisions should be mindful of the potential impact on staff of sudden and top-down change.
CONCLUSION
This review indicates that causes and triggers of moral injury are multifactorial and largely influenced by the context and constraints within which professionals work. Moral distress is linked to the duty and responsibility of care, and professionals' disposition to prioritise the wellbeing of patients. If the organisational values and regulations are in contrast with individuals' beliefs, repercussions on professionals' wellbeing and retention are to be expected. Organisational strategies to mitigate against moral distress, or the longer-term sequalae of moral injury, should address the individual, social, and organisational elements identified in this review.
Topics: Humans; Health Personnel; Morals; Social Workers; Qualitative Research; COVID-19; Psychological Distress; Stress, Psychological
PubMed: 38935754
DOI: 10.1371/journal.pone.0303013 -
European Child & Adolescent Psychiatry Jun 2024This systematic review examined the evidence on effectiveness and acceptability of cognitive behavioral therapy (CBT) interventions in improving quality of life (QoL)... (Review)
Review
BACKGROUND
This systematic review examined the evidence on effectiveness and acceptability of cognitive behavioral therapy (CBT) interventions in improving quality of life (QoL) and psychological well-being of unaccompanied minors (UM).
METHODS
PubMed, Scopus, Embase, ProQuest, PsycInfo, PsycArticles, and Open Dissertations databases were used to identify quantitative and qualitative studies. The Effective Public Health Practice Project (EPHPP) and Critical Appraisal Skills Programme (CASP) tools were used for quality assessment. Narrative synthesis and qualitative research synthesis were carried out to collate the findings.
RESULTS
18 studies were included. Two studies examined QoL, and five studies examined acceptability of interventions. Most quantitative studies (n = 10) were appraised as methodologically weak. Trauma-Focused CBT appears to have the most evidence demonstrating effectiveness in ameliorating symptoms of post-traumatic stress disorder, depression, and anxiety. Promising findings (i.e., increased mindfulness and psychological flexibility) were observed for third wave interventions but further replication is required.
CONCLUSIONS
The literature is tainted by under-powered studies, lacking blinding, and follow-up assessments. Female UM remain largely underrepresented. This review calls for a drastic augmentation of high quality quantitative and qualitative research focusing on augmenting QoL and examining acceptability rather than merely aiming for psychological symptom reduction in UM to enhance overall well-being and functionality. The research protocol was registered in PROSPERO (registration number: CRD42021293881).
PubMed: 38935131
DOI: 10.1007/s00787-024-02500-z -
Psychological Trauma : Theory,... Jun 2024Several primary studies examined the effectiveness of various psychotherapies in treating earthquake-related posttraumatic stress disorder (PTSD). Variations in methods,...
Systematic review of psychotherapies and meta-analysis of cognitive behavior therapy and narrative exposure therapy for treating earthquake-related posttraumatic stress disorder.
OBJECTIVE
Several primary studies examined the effectiveness of various psychotherapies in treating earthquake-related posttraumatic stress disorder (PTSD). Variations in methods, employed psychotherapy approaches, and differences across studies warrant a systematic review and meta-analysis.
METHOD
In this study, first, a systematic review of experimental studies aiming to reduce the symptoms of PTSD in the aftermath of an earthquake was carried out. Second, a meta-analysis of cognitive behavior therapy (CBT) and narrative exposure therapy (NET) was conducted.
RESULTS
Several psychological treatments were used for treating earthquake-related PTSD. However, only CBT and NET were tested in multiple studies. Meta-analysis results suggested that CBT and NET significantly reduce earthquake-related PTSD symptoms compared to control groups.
CONCLUSIONS
Results suggest that CBT and NET are promising psychological treatment options. Further research on NET and other major PTSD interventions (e.g., prolonged exposure, eye movement desensitization and reprocessing, cognitive processing therapy) is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
PubMed: 38934933
DOI: 10.1037/tra0001743 -
American Journal of Health-system... Jun 2024In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been...
DISCLAIMER
In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
PURPOSE
Integration of pharmacists into the perioperative practice has the potential to improve patients' clinical outcomes. The aim of this systematic review is to systematically investigate the evidence on the roles of pharmacists in perioperative settings and the effects of pharmacist interventions on clinical outcomes and therapy optimization.
METHODS
A protocol-led (CRD42023460812) systematic review was conducted using search of PubMed, Embase, CINAHL and Google Scholar databases. Studies that investigated the roles and impact of pharmacist-led interventions in the perioperative settings on clinical outcomes were included. Data were extracted and quality assessed independently by two reviewers using the DEPICT-2 (Descriptive Elements of Pharmacist Intervention Characterization Tool) and the Crowe Critical Appraisal Tool (CCAT), respectively. Studies were grouped according to the clinical area into 5 sections: (1) pain control and opioid consumption; (2) venous thromboembolism (VTE); (3) surgery-related gastrointestinal complications; (4) postoperative medication management; and (5) total parenteral nutritional.
RESULTS
Nineteen studies involving a total of 7,168 patients were included; most studies were conducted in gastrointestinal (n = 7) and orthopedics (n = 6) surgical units. Most included studies (n = 14) employed a multicomponent intervention including pharmaceutical care, education, guideline development, drug information services, and recommendations formulation. The processes of developing the implemented interventions and their structures were seldom reported. Positive impacts of pharmacist intervention on clinical outcomes included significant improvement in pain control and reductions in the incidence of VTE, surgery-related stress ulcer, nausea, and vomiting. There is inconsistency in the findings related to medication management (ie, achieving desired therapeutic ranges) and management of chronic conditions (hypertension and type 2 diabetes).
CONCLUSION
Whilst there is some evidence of positive impacts of pharmacist intervention on clinical outcomes and optimizing drug therapy, this evidence is generally of low quality and insufficient volume. While this review suggests that pharmacists have essential roles in improving the care of patients undergoing surgery, more research with rigorous designs is required.
PubMed: 38934846
DOI: 10.1093/ajhp/zxae177 -
Neurobiology of Stress Jul 2024Many everyday decisions, including those concerning our health, finances and the environment, involve choosing between a smaller but imminent reward (e.g., €20 now)... (Review)
Review
Many everyday decisions, including those concerning our health, finances and the environment, involve choosing between a smaller but imminent reward (e.g., €20 now) and a later but larger reward (e.g., €40 in a month). The extent to which an individual prefers smaller imminent rewards over larger delayed rewards can be measured using delay discounting tasks. Acute stress induces a cascade of biological and psychological responses with potential consequences for how individuals think about the future, process rewards, and make decisions, all of which can impact delay discounting. Several studies have shown that individuals focus more on imminent rewards under stress. These findings have been used to explain why individuals make detrimental choices under acute stress. Yet, the evidence linking acute stress to delay discounting is equivocal. To address this uncertainty, we conducted a meta-analysis of 11 studies (14 effects) to systematically quantify the effects of acute stress on monetary delay discounting. Overall, we find no effect of acute stress on delay discounting, compared to control conditions (SMD = -0.18, 95% CI [-0.57, 0.20], p = 0.32). We also find that neither the gender/sex of the participants, the type of stressor (e.g., physical vs. psychosocial) nor whether monetary decisions were hypothetical or incentivized (i.e. monetary decisions were actually paid out) moderated the impact of acute stress on monetary delay discounting. We argue that establishing the effects of acute stress on the separate processes involved in delay discounting, such as reward valuation and prospection, will help to resolve the inconsistencies in the field.
PubMed: 38933285
DOI: 10.1016/j.ynstr.2024.100653 -
Journal of Diabetes and Metabolic... Jun 2024Frailty is a multifaceted geriatric syndrome characterized by an increased vulnerability to stressful events. metabolomics studies are valuable tool for better... (Review)
Review
BACKGROUND
Frailty is a multifaceted geriatric syndrome characterized by an increased vulnerability to stressful events. metabolomics studies are valuable tool for better understanding the underlying mechanisms of pathologic conditions. This review aimed to elucidate the metabolomics profile of frailty.
METHOD
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 statement. A comprehensive search was conducted across multiple databases. Initially, 5027 results were retrieved, and after removing duplicates, 1838 unique studies were subjected to screening. Subsequently, 248 studies underwent full-text screening, with 21 studies ultimately included in the analysis. Data extraction was performed meticulously by two authors, and the quality of the selected studies was assessed using the Critical Appraisal Skills Program (CASP) checklist.
RESULTS
The findings revealed that certain Branched-chain amino acids (BCAAs) levels were lower in frail subjects compared to robust subjects, while levels of glutamate and glutamine were higher in frail individuals. Moreover, sphingomyelins and phosphatidylcholines (PC) displayed a decreasing trend as frailty advanced. Additionally, other metabolic derivatives, such as carnitine, exhibited significant associations with frailty. These metabolites were primarily interconnected through biochemical pathways related to the tricarboxylic acid and urea cycles. Notably, frailty was associated with a decrease in metabolic derivatives, including carnitine.
CONCLUSION
This study underscores the intricate relationship between essential metabolites, including amino acids and lipids, and their varying levels in frail individuals compared to their robust counterparts. It provides a comprehensive panel of metabolites, shedding light on their potential associations with frailty and expanding our understanding of this complex syndrome.
PubMed: 38932837
DOI: 10.1007/s40200-023-01379-y