scholarly journals Effects of public green space on acute psychophysiological stress response: a systematic review and meta-analysis of the experimental and quasi-experimental evidence

2019 ◽  
Author(s):  
Lærke Mygind ◽  
Eva Kjeldsted ◽  
Rikke Hartmeyer ◽  
Erik Mygind ◽  
Matt P. Stevenson ◽  
...  

Contact with nature is widely considered to ameliorate psychological stress, but the empirical support for a causal link is limited. We conducted a systematic review to synthesize and critically assess the evidence. Six electronic databases were searched. Twenty-six studies evaluated the difference between the effect of natural environments and that of a suitable control on the acute psychophysiological stress response. Eighteen studies were rated as being of moderate quality, 4 low quality, and 4 high quality. Meta-analyses indicated that seated relaxation (g = .5, p =.06) and walking (g = .3, p =.02) in natural environments enhanced heart rate variability more than the same activities in control conditions. Cortisol concentration measures were inconsistent. While intuitively and theoretically sound, the empirical support for acute stress-reducing effects of immersion in natural environments is tentative due to small sample sizes and methodological weaknesses in the studies. We provide guidelines for future research.

2019 ◽  
pp. 001391651987337 ◽  
Author(s):  
Lærke Mygind ◽  
Eva Kjeldsted ◽  
Rikke Hartmeyer ◽  
Erik Mygind ◽  
Matt P. Stevenson ◽  
...  

Contact with nature is widely considered to ameliorate psychological stress, but the empirical support for a causal link is limited. We conducted a systematic review to synthesize and critically assess the evidence. Six electronic databases were searched. Twenty-six studies evaluated the difference between the effect of natural environments and that of a suitable control on the acute psychophysiological stress response. Eighteen studies were rated as being of moderate quality, four studies of low quality, and four studies of high quality. Meta-analyses indicated that seated relaxation ( g = .5, p = .06) and walking ( g = .3, p = .02) in natural environments enhanced heart rate variability more than the same activities in control conditions. Cortisol concentration measures were inconsistent. While intuitively and theoretically sound, the empirical support for acute stress-reducing effects of immersion in natural environments is tentative due to small sample sizes and methodological weaknesses in the studies. We provide guidelines for future research.


Author(s):  
Peter Cox ◽  
Sonal Gupta ◽  
Sizheng Steven Zhao ◽  
David M. Hughes

AbstractThe aims of this systematic review and meta-analysis were to describe prevalence of cardiovascular disease in gout, compare these results with non-gout controls and consider whether there were differences according to geography. PubMed, Scopus and Web of Science were systematically searched for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded, as were reviews, editorials and comments. Where possible meta-analysis was performed using random-effect models. Twenty-six studies comprising 949,773 gout patients were included in the review. Pooled prevalence estimates were calculated for five cardiovascular diseases: myocardial infarction (2.8%; 95% confidence interval (CI)s 1.6, 5.0), heart failure (8.7%; 95% CI 2.9, 23.8), venous thromboembolism (2.1%; 95% CI 1.2, 3.4), cerebrovascular accident (4.3%; 95% CI 1.8, 9.7) and hypertension (63.9%; 95% CI 24.5, 90.6). Sixteen studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases. There were no identifiable reliable patterns when analysing the results by country. Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. Future research is needed to investigate the link between gout, hyperuricaemia and increased cardiovascular risk and also to establish a more thorough picture of prevalence for less common cardiovascular diseases.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249753
Author(s):  
John L. Ferrand ◽  
Aaron J. Blashill ◽  
Heather L. Corliss ◽  
Eric R. Walsh-Buhi

Globally, and in the United States (U.S.) specifically, rates of reported sexually transmitted infections (STIs) have been steadily increasing and are especially high among youth aged 13–25 years. Using condoms correctly and consistently is an effective STI prevention measure for sexually active youth, yet public health endeavors tend to focus only on condom use consistency. Directly measuring condom application is challenging and expensive. Alternative tools evaluate this behaviour, but little evidence exists on the appropriateness of these instruments in measuring application skills. This systematic review and meta-analysis examined the association between condom application skills and self-efficacy. We conducted a search of several databases as well as unpublished works. Studies were included if they were in English, examined youth aged 13–25 years, and were available between 1992 and 2019. The authors screened 630 titles and abstracts for initial inclusion criteria. A full-text review of 30 studies was conducted. The authors included 19 studies in the systematic review and 5 studies were included in the meta-analysis. Both a fixed- and random-effects model (Q = .2321, I2 = 0%) yielded a medium-sized statistically non-significant association (r = 0.217) between skills and self-efficacy. Despite the small sample size, findings suggest that skills and self-efficacy may not be as interchangeable as previously assumed when assessing condom application. Implications for future research are discussed.


2020 ◽  
Author(s):  
Kurt D Shulver ◽  
Nicholas A Badcock

We report the results of a systematic review and meta-analysis investigating the relationship between perceptual anchoring and dyslexia. Our goal was to assess the direction and degree of effect between perceptual anchoring and reading ability in typical and atypical (dyslexic) readers. We performed a literature search of experiments explicitly assessing perceptual anchoring and reading ability using PsycInfo (Ovid, 1860 to 2020), MEDLINE (Ovid, 1860 to 2019), EMBASE (Ovid, 1883 to 2019), and PubMed for all available years up to June (2020). Our eligibility criteria consisted of English-language articles and, at minimum, one experimental group identified as dyslexic - either by reading assessment at the time, or by previous diagnosis. We assessed for risk of bias using an adapted version of the Newcastle-Ottawa scale. Six studies were included in this review, but only five (n = 280 participants) were included in the meta-analysis (we were unable to access the necessary data for one study).The overall effect was negative, large and statistically significant; g = -0.87, 95% CI [-1.47, 0.27]: a negative effect size indicating less perceptual anchoring in dyslexic versus non-dyslexic groups. Visual assessment of funnel plot and Egger’s test suggest minimal bias but with significant heterogeneity; Q (4) = 9.70, PI (prediction interval) [-2.32, -0.58]. The primary limitation of the current review is the small number of included studies. We discuss methodological limitations, such as limited power, and how future research may redress these concerns. The variability of effect sizes appears consistent with the inherent variability within subtypes of dyslexia. This level of dispersion seems indicative of the how we define cut-off thresholds between typical reading and dyslexia populations, but also the methodological tools we use to investigate individual performance.


2020 ◽  
Vol 133 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Anthony T. Lee ◽  
John F. Burke ◽  
Pranathi Chunduru ◽  
Annette M. Molinaro ◽  
Robert Knowlton ◽  
...  

OBJECTIVERecent trials for temporal lobe epilepsy (TLE) highlight the challenges of investigating surgical outcomes using randomized controlled trials (RCTs). Although several reviews have examined seizure-freedom outcomes from existing data, there is a need for an overall seizure-freedom rate estimated from level I data as investigators consider other methods besides RCTs to study outcomes related to new surgical interventions.METHODSThe authors performed a systematic review and meta-analysis of the 3 RCTs of TLE in adults and report an overall surgical seizure-freedom rate (Engel class I) composed of level I data. An overall seizure-freedom rate was also collected from level II data (prospective cohort studies) for validation. Eligible studies were identified by filtering a published Cochrane meta-analysis of epilepsy surgery for RCTs and prospective studies, and supplemented by searching indexed terms in MEDLINE (January 1, 2012–April 1, 2018). Retrospective studies were excluded to minimize heterogeneity in patient selection and reporting bias. Data extraction was independently reverified and pooled using a fixed-effects model. The primary outcome was overall seizure freedom following surgery. The historical benchmark was applied in a noninferiority study design to compare its power to a single-study cohort.RESULTSThe overall rate of seizure freedom from level I data was 72.4% (55/76 patients, 3 RCTs), which was nearly identical to the overall seizure-freedom rate of 71.7% (1325/1849 patients, 18 studies) from prospective cohorts (z = 0.134, p = 0.89; z-test). Seizure-freedom rates from level I and II studies were consistent over the years of publication (R2< 0.01, p = 0.73). Surgery resulted in markedly improved seizure-free outcomes compared to medical management (RR 10.82, 95% CI 3.93–29.84, p < 0.01; 2 RCTs). Noninferiority study designs in which the historical benchmark was used had significantly higher power at all difference margins compared to using a single cohort alone (p < 0.001, Bonferroni’s multiple comparison test).CONCLUSIONSThe overall rate of seizure freedom for temporal lobe surgery is approximately 70% for medically refractory epilepsy. The small sample size of the RCT cohort underscores the need to move beyond standard RCTs for epilepsy surgery. This historical seizure-freedom rate may serve as a useful benchmark to guide future study designs for new surgical treatments for refractory TLE.


2021 ◽  
Author(s):  
Polona Caserman ◽  
Augusto Garcia-Agundez ◽  
Alvar Gámez Zerban ◽  
Stefan Göbel

AbstractCybersickness (CS) is a term used to refer to symptoms, such as nausea, headache, and dizziness that users experience during or after virtual reality immersion. Initially discovered in flight simulators, commercial virtual reality (VR) head-mounted displays (HMD) of the current generation also seem to cause CS, albeit in a different manner and severity. The goal of this work is to summarize recent literature on CS with modern HMDs, to determine the specificities and profile of immersive VR-caused CS, and to provide an outlook for future research areas. A systematic review was performed on the databases IEEE Xplore, PubMed, ACM, and Scopus from 2013 to 2019 and 49 publications were selected. A summarized text states how different VR HMDs impact CS, how the nature of movement in VR HMDs contributes to CS, and how we can use biosensors to detect CS. The results of the meta-analysis show that although current-generation VR HMDs cause significantly less CS ($$p<0.001$$ p < 0.001 ), some symptoms remain as intense. Further results show that the nature of movement and, in particular, sensory mismatch as well as perceived motion have been the leading cause of CS. We suggest an outlook on future research, including the use of galvanic skin response to evaluate CS in combination with the golden standard (Simulator Sickness Questionnaire, SSQ) as well as an update on the subjective evaluation scores of the SSQ.


Energies ◽  
2021 ◽  
Vol 14 (12) ◽  
pp. 3530
Author(s):  
Fukang Ma ◽  
Shuanlu Zhang ◽  
Zhenfeng Zhao ◽  
Yifang Wang

The hydraulic free-piston engine (HFPE) is a kind of hybrid-powered machine which combines the reciprocating piston-type internal combustion engine and the plunger pump as a whole. In recent years, the HFPE has been investigated by a number of research groups worldwide due to its potential advantages of high efficiency, energy savings, reduced emissions and multi-fuel operation. Therefore, our study aimed to assess the operating characteristics, core questions and research progress of HFPEs via a systematic review and meta-analysis. We included operational control, starting characteristics, misfire characteristics, in-cylinder working processes and operating stability. We conducted the literature search using electronic databases. The research on HFPEs has mainly concentrated on four kinds of free-piston engine, according to piston arrangement form: single piston, dual pistons, opposed pistons and four-cylinder complex configuration. HFPE research in China is mainly conducted in Zhejiang University, Tianjin University, Jilin University and the Beijing Institute of Technology. In addition, in China, research has mainly focused on the in-cylinder combustion process while a piston is free by considering in-cylinder combustion machinery and piston dynamics. Regarding future research, it is very important that we solve the instabilities brought about by chance fluctuations in the combustion process, which will involve the hydraulic system’s efficiency, the cyclical variation, the method of predicting instability and the recovery after instability.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e043722
Author(s):  
Naomi Priest ◽  
Kate Doery ◽  
Mandy Truong ◽  
Shuaijun Guo ◽  
Ryan Perry ◽  
...  

IntroductionRacism is a critical determinant of health and health inequities for children and youth. This protocol aims to update the first systematic review conducted by Priest et al (2013), including a meta-analysis of findings. Based on previous empirical data, it is anticipated that child and youth health will be negatively impacted by racism. Findings from this review will provide updated evidence of effect sizes across outcomes and identify moderators and mediators of relationships between racism and health.Methods and analysisThis systematic review and meta-analysis will include studies that examine associations between experiences of racism and racial discrimination with health outcomes of children and youth aged 0–24 years. Exposure measures include self-reported or proxy reported systemic, interpersonal and intrapersonal racism. Outcome measures include general health and well-being, physical health, mental health, biological markers, healthcare utilisation and health behaviours. A comprehensive search of studies from the earliest time available to October 2020 will be conducted. A random effects meta-analysis will examine the average effect of racism on a range of health outcomes. Study-level moderation will test the difference in effect sizes with regard to various sample and exposure characteristics. This review has been registered with the International Prospective Register of Systematic Reviews.Ethics and disseminationThis review will provide evidence for future research within the field and help to support policy and practice development. Results will be widely disseminated to both academic and non-academic audiences through peer-review publications, community summaries and presentations to research, policy, practice and community audiences.PROSPERO registration numberCRD42020184055.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shelly Soffer ◽  
Eyal Klang ◽  
Orit Shimon ◽  
Yiftach Barash ◽  
Noa Cahan ◽  
...  

AbstractComputed tomographic pulmonary angiography (CTPA) is the gold standard for pulmonary embolism (PE) diagnosis. However, this diagnosis is susceptible to misdiagnosis. In this study, we aimed to perform a systematic review of current literature applying deep learning for the diagnosis of PE on CTPA. MEDLINE/PUBMED were searched for studies that reported on the accuracy of deep learning algorithms for PE on CTPA. The risk of bias was evaluated using the QUADAS-2 tool. Pooled sensitivity and specificity were calculated. Summary receiver operating characteristic curves were plotted. Seven studies met our inclusion criteria. A total of 36,847 CTPA studies were analyzed. All studies were retrospective. Five studies provided enough data to calculate summary estimates. The pooled sensitivity and specificity for PE detection were 0.88 (95% CI 0.803–0.927) and 0.86 (95% CI 0.756–0.924), respectively. Most studies had a high risk of bias. Our study suggests that deep learning models can detect PE on CTPA with satisfactory sensitivity and an acceptable number of false positive cases. Yet, these are only preliminary retrospective works, indicating the need for future research to determine the clinical impact of automated PE detection on patient care. Deep learning models are gradually being implemented in hospital systems, and it is important to understand the strengths and limitations of these algorithms.


2017 ◽  
Vol 158 (2) ◽  
pp. 249-256 ◽  
Author(s):  
Daniel C. Sukato ◽  
Jason M. Abramowitz ◽  
Marina Boruk ◽  
Nira A. Goldstein ◽  
Richard M. Rosenfeld

Objective Up to 75% of patients with chronic rhinosinusitis (CRS) suffer with poor sleep quality and reduced quality of life. Endoscopic sinus surgery has demonstrated encouraging results in improving sleep function. The aim of this systematic review is to assess the change in sleep quality after surgery for CRS. Data Sources PubMed, Web of Science, EMBASE. Review Methods An electronic search was conducted with the keywords “sinusitis” or “rhinosinusitis” and “sleep.” Studies were included only when adults underwent endoscopic sinus surgery and were evaluated pre- and postoperatively by the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Apnea-Hypopnea Index (AHI), the sleep domain of Sino-Nasal Outcome Test–22, or the sleep domain of Rhinosinusitis Disability Index. Results The database search yielded 1939 studies, of which 7 remained after dual-investigator screening. The standardized mean differences (95% CI) for the ESS, PSQI, and AHI were −0.94 (−1.63 to −0.26), −0.80 (−1.46 to −0.14), and −0.20 (−0.32 to −0.07), indicating large, moderate to large, and small improvements, respectively. All analyses displayed high heterogeneity ( I2 = 95%-99%). Conclusion Sleep quality, as measured by the ESS and PSQI surveys, shows substantial improvement after surgery for CRS, with smaller improvement seen for AHI. Generalizability of our results is limited by high heterogeneity among studies and by broad confidence intervals that cannot exclude small to trivial changes. The findings of this meta-analysis provide insight into the effect of CRS-related endoscopic sinus surgery on sleep quality, which should guide future research direction and counseling of patients in the clinical setting.


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