Mindfulness- and Acceptance-Based Interventions for Stroke Survivors: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 003435522110432
Author(s):  
Areum Han

Objective: Mindfulness- and acceptance-based intervention (MABI) is an emerging evidenced-based practice, but no systematic review incorporating meta-analyses for MABIs in stroke survivors has been conducted. The objective of this systematic review was to measure the effectiveness of MABIs on outcomes in people with stroke. Method: Three electronic databases, including PubMed, CINAHL, and PsycINFO, were searched to identify relevant studies published in peer-reviewed journals. The methodological quality of the included studies was assessed. Data were extracted and combined in a meta-analysis with a random-effect model to compute the size of the intervention effect. Results: A total of 11 studies met the eligibility criteria. Meta-analyses found a small-to-moderate effect of MABIs on depressive symptoms (standardized mean difference [SMD] = 0.39, 95% confidence interval [CI] = [0.12, 0.66]) and a large effect on mental fatigue (SMD = 1.22, 95% CI = [0.57, 1.87]). No statistically significant effect of MABIs on anxiety, quality of life, and mindfulness was found, but there was a trend in favor of MABIs overall. Conclusions: This meta-analysis found positive effects of MABIs on depressive symptoms and mental fatigue in stroke survivors, but future high-quality studies are needed to guarantee treatment effects of MABIs on varied outcomes in stroke survivors.

2021 ◽  
pp. 1-14
Author(s):  
Nathalia Garrido-Torres ◽  
Idalino Rocha-Gonzalez ◽  
Luis Alameda ◽  
Aurora Rodriguez-Gangoso ◽  
Ana Vilches ◽  
...  

Abstract Background It is unclear what the prevalence of metabolic syndrome (MetS) in drug-naïve first-episode of psychosis (FEP) is, as previous meta-analyses were conducted in minimally exposed or drug-naïve FEP patients with psychotic disorder at any stage of the disease; thus, a meta-analysis examining MetS in naïve FEP compared with the general population is needed. Methods Studies on individuals with FEP defined as drug-naïve (0 days exposure to antipsychotics) were included to conduct a systematic review. A meta-analysis of proportions for the prevalence of MetS in antipsychotic-naïve patients was performed. Prevalence estimates and 95% CI were calculated using a random-effect model. Subgroup analyses and meta-regressions to identify sources and the amount of heterogeneity were also conducted. Results The search yielded 4143 articles. After the removal of duplicates, 2473 abstracts and titles were screened. At the full-text stage, 112 were screened, 18 articles were included in a systematic review and 13 articles in the main statistical analysis. The prevalence of MetS in naïve (0 days) FEP is 13.2% (95% CI 8.7–19.0). Ethnicity accounted for 3% of the heterogeneity between studies, and diagnostic criteria used for MetS accounted for 7%. When compared with controls matched by sex and age, the odds ratio is 2.52 (95% CI 1.29–5.07; p = 0.007). Conclusions Our findings of increased rates of MetS in naïve FEP patients suggest that we are underestimating cardiovascular risk in this population, especially in those of non-Caucasian origin. Our findings support that altered metabolic parameters in FEPs are not exclusively due to antipsychotic treatments.


2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii131-ii131
Author(s):  
Nima Hamidi ◽  
Elie Massaad ◽  
Jacalynn Goetz ◽  
Alireza Mansouri

Abstract INTRODUCTION Vestibular schwannomas (VS) are benign neoplasms that present as cystic or solid variants. Cystic VS are associated with fast and unpredictable growth patterns, and their adherence to nearby structures can lead to poor surgical outcomes. While radiosurgery (RS) has gained popularity for VS, the heterogeneity of literature necessitates a systematic review. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), PubMed, EMBASE, Web of Science, and Cochrane were searched for observational studies reporting cystic and solid VS radiosurgical outcomes. Pooled estimates were calculated using random-effect models with generic inverse variance to compare tumor control rates between cystic and solid VS. Quality assessment was done using the Newcastle Ottawa Criteria (NOS). RESULTS The search yielded 2,989 studies from which 680 were selected for full-text screening and 6 were included in this review and meta-analysis. The quality of studies ranged between good (3 studies, NOS 7/9), fair (2 studies, NOS 6/9), and poor (1 study, NOS 4/9). The patient pool included 1,070 solid and 347 cystic VS, all treated by gamma knife RS. No difference in tumor control was observed (RR: 1.02, 95%CI 0.91-1.16, p=0.7). 3 studies reported post-RS complications. Haseguawa reported hydrocephalus in 7 of 74 cystic cases. Ryu reported 1 case of hydrocephalus and 1 case of trigeminal pain in their 14 cystic cases. Shirato reported 5 transient trigeminal Neuralgia, 1 transient vertigo and 1 shunt operation in their 20 cystic cases. CONCLUSION Evidence presented in this meta-analysis supports the safety and efficacy of radiosurgery in treating cystic VS.


2020 ◽  
Author(s):  
Yuan Lu ◽  
Chaojie Liu ◽  
Dehua Yu ◽  
Sally Fawkes ◽  
Jia Ma ◽  
...  

Abstract Background: Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia, with amnesic MCI (aMCI) being the dominant subtype. This study aims to synthesise the prevalence results of MCI and aMCI in community-dwelling populations in China through a meta-analysis and systematic review.Methods: The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol. English and Chinese studies published before 1 March 2020 were searched from ten electronic bibliographic databases. Two reviewers screened for relevance of the studies against the pre-defined inclusion and exclusion criteria and assessed the quality of the included studies using the Risk of Bias Tool independently. A random-effect model was adopted to estimate the prevalence of MCI and aMCI, followed by subgroup analyses and meta-regression. Sensitivity and publication bias tests were performed to verify the robustness of the meta-analyses.Results: A total of 41 studies with 112,632 participants were included in the meta-analyses. The Chinese community-dwelling populations over 55 years old had a pooled prevalence of 12.2% [95% confidence interval (CI): 10.6%, 14.2%] for MCI and 10.9% [95% CI: 7.7%, 15.4%] for aMCI, respectively. The prevalence of MCI increased with age. The American Psychiatric Association’s Diagnostic tool (DSM-IV) generated the highest MCI prevalence (13.5%), followed by the Petersen criteria (12.9%), and the National Institute on Aging Alzheimer’s Association (NIA-AA) criteria (10.3%). Women, rural residents, and those who lived alone and had low levels of education had higher MCI prevalence than others. ​Conclusion:Higher MCI prevalence was identified in community-dwelling populations in China compared with some other countries, possibly due to more relaxed criteria being adopted for confirming the diagnosis. The study shows that aMCI accounts for 66.5% of MCI, which is consistent with findings of studies undertaken elsewhere.Systematic review registration number: PROSPERO CRD42019134686


2020 ◽  
Author(s):  
Yuan Lu ◽  
Chaojie Liu ◽  
Dehua Yu ◽  
Sally Fawkes ◽  
Jia Ma ◽  
...  

Abstract Background: Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia, with amnesic MCI (aMCI) being the dominant subtype. This study aims to synthesise the prevalence results of MCI and aMCI in community-dwelling populations in China through a meta-analysis and systematic review.Methods: The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol. English and Chinese studies published before 1 March 2020 were searched from ten electronic bibliographic databases. Two reviewers screened for relevance of the studies against the pre-defined inclusion and exclusion criteria and assessed the quality of the included studies using the Risk of Bias Tool independently. A random-effect model was adopted to estimate the prevalence of MCI and aMCI, followed by sub-group analyses and meta-regression. Sensitivity and publication bias tests were performed to verify the robustness of the meta-analyses.Results: A total of 41 studies with 112,632 participants were included in the meta-analyses. The Chinese community-dwelling populations over 55 years old had a pooled prevalence of 12.2% [95% confidence interval (CI): 10.6%, 14.2%] for MCI and 10.9% [95% CI: 7.7%, 15.4%] for aMCI, respectively. The prevalence of MCI increased with age. The American Psychiatric Association’s Diagnostic tool (DSM-IV) generated the highest MCI prevalence (13.5%), followed by the Petersen criteria (12.9%), and the National Institute on Aging Alzheimer’s Association (NIA-AA) criteria (10.3%). Women, rural residents, and those who lived alone and had low levels of education had higher MCI prevalence than others. ​Conclusion:Higher MCI prevalence was identified in community-dwelling populations in China compared with some other countries, possibly due to more relaxed criteria being adopted for confirming the diagnosis. The study shows that aMCI accounts for 66.5% of MCI, which is consistent with findings of studies undertaken elsewhere.Systematic review registration number:PROSPERO CRD42019134686


2021 ◽  
Author(s):  
TG Savian ◽  
J Oling ◽  
FZM Soares ◽  
RO Rocha

Clinical Relevance Vital bleaching impairs the bonding of adhesive systems to enamel and dentin. Thus, restoration placement should be delayed for at least two weeks after completion of bleaching procedures. SUMMARY Objective: This systematic review evaluates the influence of vital bleaching on the bond strength of adhesive systems to enamel and dentin. Methods: This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). In vitro studies comparing the bond strength of bleached and unbleached enamel and dentin were searched at the electronic databases—PubMed/MEDLINE, Scopus, and Web of Science—with no limit on year or language. The studies were screened and had data extracted by two reviewers independently. Bond strength data were meta-analyzed using the inverse variance method and the random effect model (p≤0.05). Results: The electronic search provided 4941 eligible studies, and 52 were included in the systematic review and the meta-analysis. The global meta-analysis showed that bleaching impairs the bond strength of adhesive systems to enamel and dentin (p<0.001; mean difference [MD]: –0.96; confidence interval [CI]: −1.18 to −0.73), regardless of the bleaching agent (p<0.001; MD: −9.98; CI: −1.37 to −0.58) or substrate (p<0.001; MD: −0.89; CI: −1.12 to −0.66). The detrimental effect of bleaching on bond strength was not observed after two and three weeks after bleaching (p=0.1; MD: −0.39; CI: −0.84 to 0.65; and p=0.18; MD: −0.99; CI: −2.45 to 0.47, respectively). Conclusion: This systematic review and meta-analysis demonstrated that vital bleaching impairs the bonding of adhesive systems to enamel and dentin, and this adverse effect persists for two weeks.


BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021157 ◽  
Author(s):  
Wondale Getinet Alemu ◽  
Tadele Amare Zeleke ◽  
Wubet Worku Takele

IntroductionThese days, in Ethiopia, khat chewing is one of the widely spreading public health problems affecting the most productive segment of the population. The health implications of khat chewing among students are strongly linked with poor mental, physical and social performances. However, the national magnitude of khat chewing and the associated factors among Ethiopian students are unknown. Therefore, this systematic review and meta-analysis will answer the national prevalence of khat chewing and the associated factors among students in Ethiopia.MethodsPublished primary relevant articles will be accessed using various databases, such as Medline, PubMed, EMBASE and Scopus. Other electronic search engines, for instance, Google Scholar and Google, will be used. Furthermore, additional studies will be collected by communicating with the author(s) and following the references of relevant articles. To select eligible studies, the Joanna Briggs Institute quality appraisal checklist will be used. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be followed to keep the scientific rigour of the study. Heterogeneity between studies will be examined through forest plot and I2heterogeneity tests. To identify influential studies, sensitivity analysis will be done. For substantial heterogeneity (I2>50%), the DerSimonian and Laird random-effects model will be employed. Subgroup analyses will be conducted using the random-effect model. Moreover, small studies’ publication bias will be checked by funnel plots and objectively by Egger’s regression test. If in case Egger’s test was found to be statistically significant (p<0.05), trim and fill (Duval and Tweedie) analysis will be performed. The presence of association will be declared using p≤0.05 and OR with corresponding 95% CI.Ethics and disseminationSince the intention of the study is to describe earlier primary studies qualitatively and pool the results of those articles, ethical clearance will not be a concern. The results of the study will be published in a reputable peer-reviewed journal and presented at different scientific research conferences. It will also be disseminated to academic as well as other concerned institutions.PROSPERO registration numberCRD-42,017,081,886.


2020 ◽  
pp. 152483802093386
Author(s):  
Esperanza Debby Ng ◽  
Joelle Yan Xin Chua ◽  
Shefaly Shorey

In consideration of the adverse societal, physical, and psychological impacts of bullying on a child’s development and future, many studies have developed anti-bullying programs and educational interventions to curb bullying occurrences. Therefore, this systematic review aimed to examine the effectiveness of such educational interventions at reducing the frequencies of traditional bullying or cyberbullying and cybervictimization among adolescents. A comprehensive search was conducted using PubMed, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Google Scholar, and ProQuest Dissertations and Theses. Only quantitative studies that reported the effects of educational interventions on reducing the frequencies of traditional bullying or cyberbullying victimization and perpetration were included. Seventeen studies ( N total = 35,694 adolescents, Rangechild age = 10–18 years) were finalized, and meta-analyses were conducted using a random effect model. Overall, the existing educational interventions had very small to small effect sizes on traditional bullying and cyberbullying perpetration (traditional: standardized mean differences [SMD] = −.30 and cyber: SMD = −.16) and victimization (traditional: SMD = −18 and cyber: SMD = −.13) among adolescents. Type of intervention (i.e., whole school–based or classroom-based), program duration, and presence of parental involvement did not moderate program effectiveness, but cyberbullying programs were more effective when delivered by technology-savvy content experts compared to teachers. Since existing educational interventions were marginally effective in reducing bullying frequencies, further research is needed to identify key moderators that enhance educational programs or develop alternative forms of anti-bullying interventions.


2020 ◽  
Vol 1;24 (1;1) ◽  
pp. 61-72

BACKGROUND: Psychological comorbidities in chronic pain (CP) are common and contribute to adverse health outcomes and poor quality of life. Evidence-based guidance for the management of depressive symptoms in CP is limited, particularly for mind-body interventions. OBJECTIVES: To investigate the effectiveness of mind-body interventions for the management of depressive symptoms in people with CP. STUDY DESIGN: Systematic review (SR) of SRs. SETTING: SRs with meta-analyses of clinical interventions for the management of depressive symptoms in people with CP. METHODS: This SR was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic searches were performed for MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, the Cochrane Database of Systematic Reviews, and the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports from inception to March 14, 2019. Reference lists and overviews were also hand-searched. SRs of mind-body interventions for CP were included if they conducted a meta-analysis of depression outcomes in people with any CP type not including headache. Two independent reviewers screened, extracted, and evaluated the quality of articles found. Quality was assessed using the AMSTAR 2 criteria and data were summarized narratively with standardized mean differences and 95% confidence intervals of the depression outcome. RESULTS: Eleven SRs with 20 distinct meta-analyses demonstrated a small to moderate beneficial effect for mind-body interventions (effect sizes: -0.05 to -0.63). LIMITATIONS: Depressive symptomatology was a subordinate concern compared with other outcomes. The primary literature base was reasonably broad with 33 primary studies, but small when compared with the number of meta-analyses. CONCLUSIONS: Mind-body interventions show consistent small to moderate effects in reducing depressive symptoms in CP. The literature in this area demonstrates understudy and oversynthesis. There is a need for more clinical trials focusing on people with axial pain, people with comorbid major depressive disorder, and with depression as the primary outcome of interest. Full SR registered on PROSPERO: CRD42019131871. KEY WORDS: Mind-body, meditation, yoga, depression, chronic pain, umbrella review


2021 ◽  
Vol 9 (1) ◽  
pp. 17-17
Author(s):  
Masood Shirmohammadi ◽  
Mohammad Hossein Somi ◽  
Morteza Ghojazadeh ◽  
Hossein Hosseinfard ◽  
Fatemeh Tahmasebi ◽  
...  

Background: Pancreatitis is considered as the most prevalent serious disorders of endoscopic retrograde cholangiopancreatography (ERCP). Different approaches have been suggested to prevent or reduce this complication. Therefore we aim to investigate them in the current study. This systematic review was performed in 2019 using Pubmed, Embase, google scholar and Cochrane library. Two reviewers selected eligible studies and outcomes of interest were extracted. Meta-analysis was done by using the random or fixed-effect models. I-square statistic test was used for heterogeneity analysis. Material and Methods: Totally, 2758 articles were searched. Thereafter duplicated and irrelevant articles were excluded, and six articles were entered to the present study. Six RCTs were considered eligible with a total participants of 1685. Results: The relative risk of PEP was not significantly different in NSAID and hydration groups (Pooled RR=1.19, 95%CI: 0.40 to 3.50, P-value=0.74). The random effect model indicated no significant differences between NSAID and NSAID+hydration groups regarding the incidence of PEP (Pooled RR=2.19, 95%CI: 0.70 to 6.88, P-value=0.17). Conclusion: Additionally, the results of one study showed that rectal indomethacin alone appeared to be more effective for preventing PEP than no prophylaxis, PSP alone, and the combination of indomethacin and PSP. Using NSAIDs alone or the combination of NSAIDs and hydration can reduce the risk of post-ERCP pancreatitis. Lack of studies comparing different approaches of prophylaxis in post-ERCP patient or the reporting of different parameters among the existing studies seriously limited the possibility and quality of meta-analysis. Further well-designed studies with accurate reporting of data is necessary to provide more reliable conclusion.


2018 ◽  
Vol 5 (7) ◽  
pp. 2493-2503 ◽  
Author(s):  
Hamid Salehiniya ◽  
Soheil Hassanipour ◽  
Fariborz Mansour-Ghanaei ◽  
Shokrollah Mohseni ◽  
Farahnaz Joukar ◽  
...  

Background: Esophageal Cancer (EC) is the eighth most common cancer in terms of incidence. Despite various studies, there is no general estimate of EC incidence in Iran. Therefore, the present study is conducted to evaluate the incidence rates of EC in Iran. Method: A systematic search was conducted on all published studies of EC incidence using Medline/PubMed, Scopus, Web of sciences, Google scholar, and four Iranian databases (Scientific Information Database, MagIran, IranMedex, and IranDoc) until November 2017. This systematic review was done according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Result: The database, grey literature searches, and hand searching yielded 346 potentially relevant studies. A total of 22 studies were included. The results of the random effect model were demonstrated the age-standardized rate (ASR) of EC was 25.05, 95% CI (20.84 to 29.26) among males and 22.93 95 % CI (18.97-26.88) among females. Conclusion: In comparison to other geographical locations, the incidence of EC is higher in Iran. However, organized system for collecting data of cancer is required to specify the incidence and trend of EC in Iran.


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