scholarly journals IS MINDFULNESS-BASED STRESS REDUCTION EFFECTIVE IN REDUCING STRESS DURING COVID-19 PANDEMIC AND INCREASING LEVEL OF SATISFACTION AMONG HEALTH CARE PROFESSIONALS? A META-ANALYSIS OF RCTs

2020 ◽  
Vol 7 (9) ◽  
pp. 948-953
Author(s):  
Rasha Adel Moussa ◽  
◽  
Fawziya Saleh Alhor ◽  
Ben Min-Woo illigens ◽  
◽  
...  

Introduction: During Covid-19 pandemics, healthcare workers are on the front lines putting themselves and their families at risk this could result in mental health problems .stress is a major obstacle for health care personnel that makes them less satisfied, less capable of making the best choices and could have difficulties when confronted with their patients which affects patient's care. Mindfulness – Based stress reduction (MBSR) is a program aimed to improve awareness of one’s mental processes, become flexible and act with the principal of compassion. (2). Many researches proposed MBSR for helping practitioners of becoming less vulnerable to stressors. However, results were inconclusive. Objective: To evaluate the effectiveness of MBSR intervention in stress reduction and enhancing level of satisfaction among health care professionals. Method and design: Meta-analysis of Randomized Controlled Trials (RCTs). Data Source: Medline, Psych info, PubMed, Web science and Cochrane Library Database from 2009 till 2019 for related RCTs. Selection Criteria: Published RCTs Comparing Mindfulness- Based Stress Reduction with other modalities for stress reduction and improving level of satisfaction among health care workers and stressed personnel were eligible for inclusion. Data Collection and analysis: Data entered organized in Microsoft excel 2010 then exported to comprehensive meta-analysis software version 3. Pooled: for analysis of multiple studies, and found adjusted accumulative outcome Z score method: to test difference in mean. Test for heterogeneity: Cochran’s Q test and I2. Results: In the ALL 6 included studies, 2896 subjects. There is significant improvement in perceived stress score significantly more among intervention (MBSR) group with pooled significant difference (Mean change-3.47 & SE 1.01, Z score 8.11) with no significant heterogeneity among studies. There is significant job satisfaction improvement in MBSR group significantly more than other group with pooled significant difference (mean change 5.18, SE 1.23, Z score 13.2) with no significant heterogeneity. Conclusion: these finding support that MBSR program is effective in reducing stress and increases job satisfaction among health care professionals. KEYWORDS: Mindfulness, Health workers, Stress, COVID-19 Pandemic, Systematic review, RCTs.

2021 ◽  
Author(s):  
Lunbo Zhang ◽  
Ming Yan ◽  
Kaito Takashima ◽  
Wenru Guo ◽  
Yuki Yamada

BACKGROUND The COVID-19 pandemic has been declared a public health emergency of international concern; this has caused excessive anxiety among health care workers. In addition, publication bias and low-quality publications have become widespread, which can result in the dissemination of unreliable findings.  OBJECTIVE This paper presents the protocol for a meta-analysis with the following two aims: (1) to examine the prevalence of anxiety among health care workers and determine whether it has increased due to the COVID-19 pandemic, and (2) to investigate whether there has been an increase in publication bias.  METHODS All related studies that were published/released from 2015 to 2020 will be searched in electronic databases (Web of Science, PubMed, PsyArXiv, and medRxiv). The risk of bias in individual studies will be assessed using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist. The heterogeneity of the studies will be assessed using the I2 statistic. The effect size (prevalence rates of anxiety) and a 95% CI for each paper will also be calculated. We will use a moderator analysis to test for the effect of COVID-19 on health care workers’ anxiety levels and detect publication bias in COVID-19 studies. We will also assess publication bias using the funnel plot and Egger regression. In case of publication bias, if studies have no homogeneity, the trim-and-fill procedure will be applied to adjust for missing studies. RESULTS The pooled meta-analysis prevalence was 35.3% (95% CI: 32.2%−38.4%). The moderator analysis revealed no significant difference between articles related to COVID-19 and those unrelated to COVID-19 (p = 0.831). Moreover, no significant difference was found between articles related to COVID-19 and preprints (p = 0.981). Significant heterogeneity was found in each subgroup. Egger’s tests revealed publication bias in articles related to COVID-19 and preprints (p < 0.001).  CONCLUSIONS Our study found no significant differences in the effect sizes (prevalence of anxiety) between studies related and those unrelated to COVID-19. Concluding whether the anxiety state of health care workers is altered by the COVID-19 pandemic currently is difficult. However, we have strong evidence that their anxiety levels are always high, although this could also be a false positive caused by a large publication bias. Moreover, without comparing the results with those of non-healthcare workers, we cannot be sure that their anxiety is particularly high. The present study highlights the need to generalize valid and reliable measurements to more accurately examine health care workers’ anxiety in the future. Furthermore, we found a large publication bias in studies; however, the quality of the studies is relatively stable and reliable. INTERNATIONAL REGISTERED REPORT RR2-10.2196/24136


2021 ◽  
Author(s):  
lunbo zhang ◽  
YAN MING ◽  
Kaito Takashima ◽  
GUO WENRU ◽  
Yuki Yamada

Background. The COVID-19 pandemic has been declared a public health emergency of international concern; this has caused excessive anxiety among health care workers. In addition, publication bias and low-quality publications have become widespread, which can result in the dissemination of unreliable findings.This paper performed a meta-analysis with the following two aims: (1) to examine the prevalence of anxiety among health care workers and determine whether it has increased due to the COVID-19 pandemic, and (2) to investigate whether there has been an increase in publication bias.Methods. All related studies published/released from 2015 to 2020 were searched in electronic databases (Web of Science, PubMed, PsyArXiv, and medRxiv). The heterogeneity of the studies was assessed using the I2 statistic. The effect size (prevalence rates of anxiety) and a 95% CI for each paper were also calculated. We used a moderator analysis to test for the effect of COVID-19 on health care workers’ anxiety levels and detect publication bias in COVID-19 studies. We also assessed publication bias using the funnel plot and Egger regression.Results.The pooled meta-analysis prevalence was 35.3% (95% CI: 32.2%−38.4%). The moderator analysis revealed no significant difference between articles related to COVID-19 and those unrelated to COVID-19 (p = 0.831). Moreover, no significant difference was found between articles related to COVID-19 and preprints (p = 0.981). Significant heterogeneity was found in each subgroup. Egger’s tests revealed publication bias in articles related to COVID-19 and preprints (p &lt; 0.001).Conclusions. Concluding whether the anxiety state of health care workers is altered by the COVID-19 pandemic currently is difficult. However, we have strong evidence that their anxiety levels are always high, although this could also be a false positive caused by a large publication bias. Moreover, without comparing the results with those of non-health care workers, we cannot be sure that their anxiety is particularly high. Furthermore, we found a large publication bias in studies; however, the quality of the studies is relatively stable and reliable.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Aongart Mahittikorn ◽  
Frederick Ramirez Masangkay ◽  
Kwuntida Uthaisar Kotepui ◽  
Giovanni De Jesus Milanez ◽  
Manas Kotepui

Abstract Background Malaria mixed infections are often unrecognized by microscopists in the hospitals, and a delay or failure to treat Plasmodium-mixed infection may lead to aggravated morbidity and increased mortality. The present study aimed to quantify the pooled proportion and risk of malarial recurrences after the treatment of Plasmodium-mixed infection. The results of the study may provide benefits in the management of Plasmodium-mixed infection in co-endemic regions. Methods This systematic review and meta-analysis searched the international Prospective Register of Systematic Reviews (PROSPERO; ID = CRD42020199709), MEDLINE, Web of Science, and Scopus for potentially relevant studies in any language published between January 1, 1936, and July 20, 2020, assessing drug efficacy in patients with Plasmodium-mixed infection. The primary outcome was the pooled prevalence of Plasmodium parasitemia after initiating antimalarial treatment for Plasmodium-mixed infection. The secondary outcome was the pooled risk ratio (RR) of malarial recurrence in Plasmodium-mixed infection compared with those in Plasmodium falciparum and Plasmodium vivax mono-infection. The pooled analyses were calculated by random-effects meta-analysis. After the initial treatment in different days of recurrences (≤ 28 days or > 28 days), the risk of Plasmodium parasitemia was compared in subgroup analysis. Results Out of 5217 screened studies, 11 were included in the meta-analysis, including 4390 patients from six countries. The pooled prevalence of all recurrences of Plasmodium-mixed parasitemia was 30% (95% confidence interval (CI) 16–43; I2: 99.2%; 11 studies). The RR of malarial recurrence within 28 days after the initial treatment (clinical treatment failure) of Plasmodium-mixed parasitemia compared with the treatment of P. falciparum was 1.22 (p: 0.029; 95% CI 1.02–1.47; Cochran Q: 0.93; I2: 0%; six studies), while there was no significant difference in the risk of recurrence 28 days after initial treatment compared with the treatment of P. falciparum (p: 0.696, RR: 1.14; 95% CI 0.59–2.18; Cochran Q < 0.05; I2: 98.2%; four studies). The subgroup analysis of antimalarial drugs showed that significant malarial recurrence within 28 days was observed in patients treated with artemisinin-based combination therapies (ACTs) with no significant heterogeneity (p: 0.028, RR: 1.31; 95% CI 1.03–1.66; Cochran Q: 0.834; I2: 0%). Conclusions The present findings showed a high prevalence of malarial recurrence after the initial treatment of Plasmodium-mixed infection. Moreover, significant malaria recurrence of mixed infection occurred within 28 days after treatment with ACTs. Graphic Abstract


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sadayuki Kawai ◽  
Nozomi Takeshima ◽  
Yu Hayasaka ◽  
Akifumi Notsu ◽  
Mutsumi Yamazaki ◽  
...  

Abstract Background Irinotecan (IRI) and oxaliplatin (Ox) are standard therapeutic agents of the first-line treatments for metastatic colorectal cancer (mCRC). Previous meta-analyses of randomized controlled trials (RCTs) showed that treatment with Ox-based compared with IRI-based regimens was associated with better overall survival (OS). However, these reports did not include trials of molecular targeting agents and did not take methods for the administration of concomitant drugs, such as bolus or continuous infusion of 5-fluorouracil, into account. A systematic literature review was performed to compare the efficacy and toxicity profiles between IRI- and Ox-based regimens as the first-line treatments for mCRC. Methods This meta-analysis used data from the Cochrane Central Register of Controlled Trials, PubMed, and SCOPUS. The primary endpoint was OS, and the secondary endpoints were progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs). Results Nineteen trials involving 4571 patients were included in the analysis. No statistically significant difference was observed between the two groups in terms of OS, PFS, and ORR. There was no significant heterogeneity. Regarding ≥ grade 3 AEs, IRI-based regimens were associated with a high incidence of leukopenia, febrile neutropenia, and diarrhea. Moreover, there was a high incidence of thrombocytopenia and peripheral sensory neuropathy in patients who received Ox-based regimens. In a subgroup analysis, IRI combined with bevacizumab was correlated with a better PFS (HR = 0.90, 95% CI = 0.82–0.98, P = 0.02), but not with OS (pooled HR = 0.91, 95% CI = 0.80–1.03, P = 0.15). Conclusion Although the safety profiles of IRI- and Ox-based regimens varied, their efficacy did not significantly differ. The combination of anti-VEGF antibody and IRI was associated with better PFS compared with anti-VEGF antibody and Ox. Both regimens could be used as the first-line treatments for mCRC with consideration of the patients’ condition or toxicity profiles.


2016 ◽  
Vol 46 (4) ◽  
pp. 292-300 ◽  
Author(s):  
Lauren Hirsch ◽  
Nathalie Jette ◽  
Alexandra Frolkis ◽  
Thomas Steeves ◽  
Tamara Pringsheim

Background: Parkinson's disease (PD) is a common neurodegenerative disorder. Epidemiological studies on the incidence of PD are important to better understand the risk factors for PD and determine the condition's natural history. Objective: This systematic review and meta-analysis examine the incidence of PD and its variation by age and gender. Methods: We searched MEDLINE and EMBASE for epidemiologic studies of PD from 2001 to 2014, as a previously published systematic review included studies published until 2001. Data were analyzed separately for age group and gender, and meta-regression was used to determine whether a significant difference was present between groups. Results: Twenty-seven studies were included in the analysis. Meta-analysis of international studies showed rising incidence with age in both men and women. Significant heterogeneity was observed in the 80+ group, which may be explained by methodological differences between studies. While males had a higher incidence of PD in all age groups, this difference was only statistically significant for those in the age range 60-69 and 70-79 (p < 0.05). Conclusion: PD incidence generally increases with age, although it may stabilize in those who are 80+.


Author(s):  
Olaide Oluwole-Sangoseni ◽  
Michelle Jenkins-Unterberg

Background: Attempts to address health and health care disparities in the United States have led to a renewed focus on the training of healthcare professionals including physical therapists. Current health care policies emphasize culturally competent care as a means of promoting equity in care delivery by health care professionals. Experts agree that cultural insensitivity has a negative association with health professionals’ ability to provide quality care. Objective: To evaluate the cultural awareness and sensitivity of physical therapy (PT) students in a didactic curriculum aimed to increase cultural awareness. Methods: Using the Multicultural Sensitivity Scale (MSS), a cross-sectional survey was conducted to assess cultural sensitivity among three groups of students, (N = 139) from a doctor of physical therapy (DPT) program at a liberal arts university in Saint Louis, MO. Results: Response rate was 76.3%. Participants (n=100) were students in first (DPT1, n=36), third (DPT3, n=36), and sixth (DPT6, n=28) year of the program. Mean ranked MSS score was DPT1 = 45.53, DPT3 = 46.60 DPT6 = 61.91. Kruskal-Wallis analysis of the mean ranked scores showed a significant difference among three groups, H = 6.05 (2, N=100), p ≤ .05. Discussion: Students who have completed the cultural awareness curriculum, and undergone clinical experiences rated themselves higher on the cultural sensitivity/awareness. Results provide initial evidence that experiential learning opportunities may help PT students to more effectively integrate knowledge from classroom activities designed to facilitate cultural competence.


2021 ◽  
Author(s):  
Natasha Marcella Vaselli ◽  
Daniel Hungerford ◽  
Ben Shenton ◽  
Arwa Khashkhusha ◽  
Nigel A. Cunliffe ◽  
...  

AbstractBackgroundA year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection.ObjectivesThis systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity.MethodsWe searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019 - 30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country.Results109 studies were included spanning 17 European countries, that estimated the seroprevalence of SAR-CoV2 from samples obtained between November 2019 – August 2020. A total of 53/109 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence among different age groups and the majority of studies reported there was no significant difference by gender.ConclusionThis review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.


Author(s):  
Salmeen D. Babelgaith ◽  
Mansour Almetwazi ◽  
Syed Wajid ◽  
Saeed Alfadly ◽  
Ahmed M Shaman ◽  
...  

Background: This study aimed to evaluate the Impact of diabetes continuing education on knowledge and practice of diabetes care among health care professionals in Yemen. Methods: A quasi-experimental study was carried out among health care professionals. The original questionnaire consisted of 22 multiple choice questions. A total of 73 HCPs received continuing education (CE) intervention.  Knowledge attitude and practice (KAP) was assessed using a validated questionnaire.  Results: The result showed that majority of the HCPs has a good general knowledge on diabetes and its managements prior to the CE program. Evaluation of the general knowledge score of the HCPs found some improvement in the knowledge score, however the improvement was not significant (p=0.31). The result of this study found that HCPs has good knowledge on monitoring the sign, symptoms and laboratory parameters. Conclusion: Evaluation of the knowledge score on Goal of Diabetes Management of HCPs found significant (p=0.024) improvement in the knowledge score. The results indicated that the lab values were rated as the most important in the goal for the treatment of diabetes patients.  The study also found no significant difference in practice score after CE program among HCPs.


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