Effects of a veterinary functional music-based enrichment program on the psychophysiological responses of farm pigs.

Intensification of swine production can predispose pigs to chronic stress, with adverse effects on the neuroendocrine and immune systems that can lead to health problems, poor welfare, and reduced production performance. Consequently, there is an interest in developing tools to prevent or eliminate chronic stress. Music is widely used as a therapeutic strategy for stress management in humans and may have similar benefits in non-human animals. This study evaluated the effects of a music-based auditory enrichment program in pigs from a multidimensional perspective by assessing psychophysiological responses. Two experimental groups of 20 pigs each were selected for the study: one enriched, exposed to a program of functional veterinary music designed for pigs, and a control group without auditory stimulation. Qualitative behavior assessment (QBA) and skin lesions indicative of agonistic behavior were used to evaluate the psychological determinants underlying the observed behaviors. Physiological assessment included hemograms, with the determination of the neutrophil:lymphocyte ratio and daily measurements of cortisol and salivary alpha-amylase levels. The results demonstrated a positive effect of a music-based auditory program on psychophysiological responses. Therefore, this strategy developed for environmental enrichment may be beneficial in reducing stress and contributing to the welfare and health of pigs under production conditions.

Usefulness of mindfulness for the management of anxiety, stress, and quality of life in infertile women. A clinical exploratory study.

BACKGROUND: Infertility increases stress and affects life quality. Mindfulness reduces stress and improves life quality, but its role in infertility remains unclear. OBJECTIVE: To evaluate the effect of mindfulness on stress and quality of life of women with infertility. MATERIAL AND METHODS: An exploratory clinical study was conducted in women under infertility treatment, together with an 8-week mindfulness intervention (MND) or only infertility treatment (CTRL). Anxiety and quality of life were assessed at baseline and at the end of intervention with IDARE and FertiQoL questionnaires respectively, as well as salivary alpha-amylase and cortisol concentrations. Non-parametric statistics was used for analysis using an alpha value of 0.10. RESULTS: 14 MND and 15 CTRL completed follow-up. At baseline, CTRL patients exhibited better quality of life than MND; anxiety scores correlated negatively with quality of life. At the end of intervention, cortisol concentrations (p = 0.097), and the increments of amylase (p = 0.039), were higher in CTRL than in MND. Increases in quality of life were associated with basal anxiety score (p = 0.002), improvements in tolerability (p < 0.001), and mindfulness intervention (p = 0.014). CONCLUSION: Our results suggest that mindfulness reduces stress and improves quality of life in women under infertility treatment.

ANTECEDENTES: La infertilidad incrementa el estrés y afecta la calidad de vida. OBJETIVO: Evaluar el efecto de mindfulness (atención plena) sobre la ansiedad, estrés y calidad de vida de mujeres infértiles. MATERIAL Y MÉTODOS: Estudio exploratorio en pacientes tratadas por infertilidad más una intervención de ocho semanas con mindfulness (grupo MND) o solo tratamiento de la infertilidad (grupo de control). Al inicio y después de ocho semanas se evaluaron la ansiedad (Inventario de Ansiedad Rasgo-Estado), la calidad de vida (FertiQoL), y las concentraciones salivales de α-amilasa y cortisol. Se utilizó estadística no paramétrica, con α = 0.10. RESULTADOS: 14 mujeres del grupo MND y 15 del grupo de control completaron el seguimiento. Al inicio, las pacientes del grupo de control mostraron mejor calidad de vida; las puntuaciones de ansiedad correlacionaron negativamente con la calidad de vida. Al final, el incremento de cortisol (p = 0.097) y amilasa (p = 0.039) fueron mayores en el grupo de control. Los incrementos en la calidad de vida se asociaron a ansiedad basal (p = 0.002), incremento en la subescala tolerabilidad (p < 0.001) y mindfulness (p = 0.014). CONCLUSIÓN: Los resultados sugieren que mindfulness disminuye el estrés y mejora la calidad de vida de pacientes bajo tratamiento de la infertilidad.

Effects of circuit training and Yoga on biochemical and psychological responses to stress and cardiovascular markers: A randomized clinical trial with nursing and medical students in Southern Brazil.

A Randomized Controlled Trial involving 158 Brazilian medical and nursing students assessed one of three conditions over an 8-week period: 1) a circuit training protocol (CTG); 2) a yoga protocol (YG); or 3) no intervention (CG). The objective was to evaluate the effectiveness of circuit training and yoga protocols in reducing perceived mental stress and examining their effects on serum cortisol levels, as well as on traditional cardiovascular risk factors (CRFs), during an academic semester. Mental stress was measured using self-reported stress questionnaires. For the CTG, comparisons of pre- vs. post-intervention data indicated a reduction in self-reported stress levels on a Brazilian scale (p < 0.001) and an international scale (p < 0.05). Regarding CRFs, there was a reduction in waist circumference (WC) (p < 0.05), systolic blood pressure (SBP) (p < 0.05), and heart rate (HR) (p < 0.001). No changes were observed in diastolic blood pressure (DBP) (p = 0.211) and serum cortisol (SC) (p = 0.423). In the YG, pre- vs. post-intervention data indicated a reduction in self-reported stress levels on the ISSL (p < 0.001), in both resistance and exhaustion stress levels on the PSS scale (p < 0.001), and in SC levels (p < 0.001), WC (p < 0.05), and SBP (p < 0.05); however, HR and DBP did not change (p = 0.168 and p = 0.07, respectively) in this group. No changes were noted in any measures in the CG. The intervention protocols demonstrated that both CTG and YG can positively impact mental or biochemical stress responses, as well as CRFs.

The psychosomatic impact of Yoga in medical education: a systematic review and meta-analysis.

Non-clinical approaches such as meditation, yoga, and mindfulness are popular traditional therapeutical interventions adopted by many educational institutions to improve the physical and mental well-being of learners. This study aimed to evaluate the effectiveness of yoga intervention in improving cardiopulmonary parameters such as blood pressure, heart rate, pulmonary function tests and psychosomatic symptoms such as depression, anxiety and stress in medical and dental students. Using the PRISMA protocol, a search from databases such as PubMed, Scopus, and Embase resulted in 304 relevant articles. After screening the title and abstracts, 47 papers were analyzed thoroughly and included in the qualitative analysis. 18 articles with homogenous statistical data on physiology and psychological parameters were included for meta-analysis. In comparison to the control group, the study showed a significant reduction of systolic blood pressure (SBP: 6.82 mmHg, z = -3.06, p = 0.002), diastolic blood pressure (DBP: 2.92 mmHg, z = -2.22, p = 0.03), and heart rate (HR: 2.55 beats/min, z = -2.77, p = 0.006). Additionally, data from 4 studies yielded a significant overall effect of a stress reduction of 0.77 on standardized assessments due to the yoga intervention (z = 5.29, p < 0.0001). Lastly, the results also showed a significant (z = -2.52, p = 0.01) reduction of 1.2 in standardized anxiety tests in intervention group compared to the control. The findings offer promising prospects for medical educators globally, encouraging them to consider reformation and policymaking in medical curricula to enhance academic success and improve the overall quality of life for medical students worldwide.

Mindfulness intervention effect on endometriosis-related pain dimensions and its mediator role on stress and vitality: a path analysis approach.

Endometriosis-related pain is supposedly mainly responsible for generating psychological stress and deteriorating the quality of life. However, the interaction between these factors has not been investigated, considering its multidimensional nature and through the path of effects of psychosocial approaches. The present study aims to investigate the effect of a brief mindfulness-based intervention (bMBI) on pain dimensions and its mediator role on psychological stress and QoL-Vitality improvement. A secondary analysis of a pilot randomized controlled trial using a series of parallel and serial mediators was carried out. The results showed that bMBI improves the sensory (B = -6.09 [-9.81, -2.52], ß = -0.42) and affective (B = -3.40 [-5.02, -1.80], ß = -0.47) pain. The bMBI effect on psychological stress reduction was mediated by these changes in sensory (B = -2.81 [-6.06, -0.41], ß = -0.21) and affective (B = -1.97 [-5.07, -0.17], ß = -0.15) pain. Serial sensory pain and psychological stress reduction (B = 2.27 [0.11, 5.81], ß = -0.09) mediated the bMBI effect on quality of life vitality. Meditation training promotes additional improvement in affective and sensory pain characteristics through which psychological stress is reduced. The sensory pain dimension must be positively impacted in combination with psychological stress for the bMBI improves women's vitality. Adding a psychosocial intervention like meditation training to the standard treatment plan may be required for some women to achieve the needed changes to restore well-being.

Eficacia y seguridad de la respiración consciente para el tratamiento de distintas condiciones clínicas / Efficacy and safety of mindful breathing for the treatment of different clinical conditions

NOMBRE DE LA TÉCNICA CON PRETENDIDA FINALIDAD SANITARIA: Respiración consciente. DEFINICIÓN DE LA TÉCNICA E INDICACIONES CLÍNICAS: La respiración consciente consiste en estar presente de forma plena en el momento en que se realiza la respiración y sentir los efectos de esta sobre el cuerpo. Esta práctica podría aliviar la sensación de angustia o estrés a la persona que la realiza, ya que disminuye el ritmo cardíaco y frecuencia respiratoria a nivel físico. Este informe ha investigado la utilidad de esta práctica en el estrés, la ansiedad y la depresión, así como en otras patologías como la disnea (dificultad respiratoria o falta de aire) y la hipertensión arterial, y en pacientes que están en cuidados paliativos. CALIDAD DE LA EVIDENCIA: Los estudios que evaluaron la respiración consciente no presentan una buena calidad, es decir, que pueden presentar errores en su planteamiento y, por tanto, sus resultados deben ser tomados con precaución. RESULTADOS CLAVE: La respiración consciente podría considerarse una práctica segura y no se espera que aparezcan efectos adversos. Los resultados de los estudios localizados apuntan que podría reducir el estrés, la ansiedad y la depresión. En el entorno paliativo podría mejorar la angustia/malestar y los niveles de depresión y ansiedad, aunque no se han encontrado beneficios sobre síntomas como el dolor, la falta de aliento y las náuseas en estos pacientes. En cuanto a su uso en otras patologías, la evidencia parece señalar que podría mejorar la disnea y la hipertensión arterial. Estos resultados deben ser interpretados con suma cautela, ya que baja calidad metodológica global de la evidencia científica identificada no garantiza que sean extrapolables a la práctica clínica. CONCLUSIÓN FINAL: No existe evidencia confiable que apoye la eficacia de la respiración consciente para el tratamiento de las condiciones clínicas evaluadas.

NAME OF THE TECHNIQUE WITH HEALTH PURPOSES: Mindful breathing or mindful breath awareness. DEFINITION OF THE TECHNIQUE AND CLINICAL INDICATIONS: Mindful breathing or mindful breath awareness, consists of being fully present in the moment of breathing and feeling the effects of the breath on the body. This practice may reduce feelings of distress or stress for people who practice it, causing decreases in heart rate and respiratory rate at a physical level. This report has investigated the usefulness of this practice on stress, anxiety and depression, as well as in other pathologies such as dyspnea (shortness of breath), arterial hypertension, and palliative care patients. QUALITY OF THE EVIDENCE: The studies that have evaluated mindful breathing are generally of low quality, including failures in their approach, and therefore their results should be taken with cautio. KEY RESULTS: Mindful breathing could be considered as a safe practice and no adverse effects are expected. Results from studies suggest that mindful breathing may reduce stress, anxiety, and depression. In the palliative setting it may reduce distress, discomfort, depression, and anxiety levels, although no benefits have been found on symptoms such as pain, shortness of breath and nausea in these patients. In respect of its use in other conditions, the evidence seems to indicate that it could improve dyspnoea and arterial hypertension. These results should be interpreted with extreme caution, as the overall low methodological quality of the scientific evidence identified does not guarantee that they can be extrapolated to clinical practice. FINAL CONCLUSION: There is currently no reliable evidence to support the efficacy of mindful breathing for the treatment of the clinical conditions evaluated.

Effect of cardiovascular biofeedback on nursing staff stress: a randomized controlled clinical trial.

OBJECTIVE: to assess the effect of cardiovascular biofeedback on nursing staff stress when compared to an activity without self-monitoring. METHOD: a randomized controlled clinical trial, carried out with nursing professionals from a university hospital. The intervention group (n=58) performed cardiovascular biofeedback, and the control (n=57) performed an online puzzle without self-monitoring, totaling nine meetings over three weeks. The outcome was assessed using the Stress Symptoms and Work-Related Stress scales, and the biological marker heart rate variability. The generalized estimating equations method was used. RESULTS: the intervention had no effect on self-reported instruments (p>0.050). However, there was an effect of time (p<0.050) on all heart rate variability indicators, demonstrating changes over the sessions. CONCLUSION: cardiovascular biofeedback showed promising results in the biological marker, suggesting that it can be used in nursing staff as a complementary therapy by promoting better autonomic nervous system regulation.

Impact of a Stress Reduction, Meditation, and Mindfulness Program in Patients with Chronic Heart Failure: A Randomized Controlled Trial. / Impacto de um Programa de Redução do Estresse, Meditação e Mindfulness em Pacientes com Insuficiência Cardíaca Crônica: Um Ensaio Clínico Randomizado.

Heart Failure is a significant public health problem leading to a high burden of physical and psychological symptoms despite optimized therapy. To evaluate primarily the impact of a Stress Reduction, Meditation, and Mindfulness Program on stress reduction of patients with Heart Failure. A randomized and controlled clinical trial assessed the effect of a stress reduction program compared to conventional multidisciplinary care in two specialized centers in Brazil. The data collection period took place between April and October 2019. Thirty-eight patients were included and allocated to the intervention or control groups. The intervention took place over 8 weeks. The protocol assessed the scales of perceived stress, depression, quality of life, anxiety, mindfulness, quality of sleep, a 6-minute walk test, and biomarkers analyzed by a blinded team, considering a p-value <0.05 statistically significant. The intervention resulted in a significant reduction in perceived stress from 22.8 ± 4.3 to 14.3 ± 3.8 points in the perceived stress scale-14 items in the intervention group vs. 23.9 ± 4.3 to 25.8 ± 5.4 in the control group (p-value<0.001). A significant improvement in quality of life (p-value=0.013), mindfulness (p-value=0.041), quality of sleep (p-value<0.001), and the 6-minute walk test (p-value=0.004) was also observed in the group under intervention in comparison with the control. The Stress Reduction, Meditation, and Mindfulness Program effectively reduced perceived stress and improved clinical outcomes in patients with chronic Heart Failure.

A Insuficiência Cardíaca é um importante problema de saúde pública, que leva à alta carga de sintomas físicos e psicológicos, apesar da terapia otimizada. Avaliar primariamente o impacto de um Programa de Redução de Estresse, Meditação e Atenção plena na redução do estresse de pacientes com Insuficiência Cardíaca. Ensaio clínico randomizado e controlado que avaliou o impacto de um programa de redução de estresse comparado ao atendimento multidisciplinar convencional, em dois centros especializados no Brasil. O período de coleta de dados ocorreu entre abril e outubro de 2019. Um total de 38 pacientes foram alocados nos grupos de intervenção ou controle. A intervenção aconteceu ao longo de 8 semanas. O protocolo consistiu na avaliação das escalas de estresse percebido, depressão, qualidade de vida, ansiedade, atenção plena, qualidade do sono, teste de 6 minutos de caminhada e biomarcadores por um grupo cego, considerando um p-valor <0,05 como estatisticamente significativo. A intervenção resultou em redução significativa no estresse percebido de 22,8 ± 4,3 para 14,3 ± 3,8 pontos na escala de estresse percebido no grupo de intervenção vs. 23,9 ± 4,3 para 25,8 ± 5,4 no grupo controle (p-valor<0,001). Foi observada melhora significativa na qualidade de vida (p-valor=0,013), atenção plena (p-valor=0,041), qualidade do sono (p-valor<0,001) e no teste de 6 minutos de caminhada (p-valor=0,004) no grupo sob intervenção comparado com o controle. O Programa de Redução de Estresse, Meditação e Atenção plena reduziu efetivamente o estresse percebido e melhorou desfechos clínicos em pacientes com Insuficiência Cardíaca.

Eficácia de uma intervenção online para prevenção da ansiedade: um ensaio clínico / Efectividad de una intervención online para prevención de ansiedad: un ensayo clínico / Efficacy of an online intervention for anxiety prevention: a clinical trial

The purpose of this study was to test the effectiveness, and the sustained effect (follow-up) of a fourweek mindfulness intervention in reducing anxiety and stress in a group of Brazilian university students, the intervention was adapted to be made available through the application Neurosaúde, created as part of this work to serve as a platform for intervention. The research as a whole took place in a virtual environment, with forty-eight participants recruited who were randomly allocated to the intervention group or to the waiting list control. Measures were used to access the levels of mindfulness, anxiety and stress before, after the intervention and at the 4-week follow-up. Applying the intention-to-treat analysis, we found significant differences between the groups for the measurement of anxiety in the follow-up with a large feat size (F (2.92) = 10.275, p = 0.000, η2 = 0.183). Our results suggest that the 4-week mindfulness intervention through a mobile application was able to act as a protective factor against the anxiety developed by university students during the occurrence of the pandemic caused by Covid-19, whereas while the treatment group maintained levels reduced anxiety the control group demonstrated a continuous increase in anxiety in the post-test and follow-up that coincided with the first wave of Covid-19 in the region where the participants lived.

El propósito de este estudio fue probar la eficacia y el efecto sostenido (seguimiento) de una intervención de atención plena de cuatro semanas para reducir la ansiedad y el estrés en un grupo de estudiantes universitarios brasileños, la intervención se adaptó para estar disponible a través del app. Neurosaúde, creada como parte de este trabajo para servir como plataforma de intervención. La investigación en su conjunto se llevó a cabo en un entorno virtual, siendo reclutados cuarenta y ocho participantes que fueron asignados aleatoriamente al grupo de intervención o al control en lista de espera. Se utilizaron medidas para evaluar los niveles de atención plena, ansiedad y estrés antes, después de la intervención y en el seguimiento a las 4 semanas. Al aplicar el análisis por intención de tratar, encontramos diferencias significativas entre los grupos para la medida de ansiedad en el seguimiento con un tamaño de efecto grande (F (2.92) = 10.275, p = 0.000, η2 = 0.183). Nuestros resultados sugieren que la intervención de mindfulness de 4 semanas a través de una aplicación móvil fue capaz de actuar como factor protector contra la ansiedad desarrollada por estudiantes universitarios durante la ocurrencia de la pandemia de Covid-19, ya que mientras el grupo de tratamiento mantuvo niveles, el grupo control demostró un aumento continuo de la ansiedad en el postest y seguimiento que coincidió con la primera ola de Covid-19 en la región donde residían los participantes.

O propósito deste estudo foi testar a eficácia e o efeito sustentado (follow-up) de uma intervenção de mindfulness de quatro semanas na redução da ansiedade e estresse em um grupo de estudantes universitários brasileiros. A intervenção foi adaptada para ser disponibilizada pelo aplicativo Neurosaúde, criado como parte deste trabalho para servir de plataforma para a intervenção. A pesquisa como um todo ocorreu em ambiente virtual, sendo recrutados 48 participantes que foram alocados randomicamente para o grupo intervenção ou para o controle de lista de espera. Medidas foram utilizadas para acessar os níveis de mindfulness, ansiedade e estresse antes, após a intervenção e no follow-up de quatro semanas. Aplicando a análise por intenção de tratar, encontramos diferenças significativas entre os grupos para a medida de ansiedade no follow-up com um tamanho de efeito grande (F (2.92) = 10.275, p = 0.000, η2 = 0.183). Nossos resultados sugerem que a intervenção de mindfulness de quatro semanas por meio de um aplicativo móvel foi capaz de agir como um fator protetor contra a ansiedade desenvolvida pelos estudantes universitários durante a ocorrência da pandemia causada pelo Covid-19, visto que, enquanto o grupo tratamento manteve níveis reduzidos de ansiedade, o grupo controle demonstrou um contínuo aumento de ansiedade no pós-teste e follow-up que coincidiu com a primeira onda de Covid-19 na região onde os participantes residiam.

Effects of Occupational Therapy Program Based on Active Meditation on Hair Cortisol Levels in Undergraduate Healthcare Students.

Methods: Undergraduate students from the University of Chile's health careers were divided at random into control (n = 7) and treated groups (n = 15). The treated group participated in an active meditation program once a week for three months. This treatment included different techniques such as Chakra Sounds, Nataraj, Mandala, Kundalini, Devavani, Gourishankar, and Nadabrahma. Hair samples were taken before and after the treatment period to measure cortisol. Results: The control group increased cortisol level 168.9 ± 76.8 pg/mg compared with initial levels. The treated group shows a decrease of initial cortisol values in 28.5 ± 12.8 pg/mg after meditation protocol application. Conclusions: Blending active meditation in students' daily routine through occupational therapy intervention might prevent undergraduate students' stress in healthcare careers.

Acupuncture for perceived stress in pregnant women: an intervention study.

OBJECTIVE: To analyze the effects of acupuncture in the treatment of perceived stress in pregnant women. METHOD: A before-after intervention study, carried out in a primary health unit in Fortaleza-Ceará, with 56 pregnant women. The pregnant women underwent six acupuncture sessions, with two 30-minute sessions per week. Before the first session, an instrument to collect sociodemographic, clinical, and obstetric data was applied. The Global Perceived Stress Scale (PSS10) was applied weekly to monitor the progression of stress during treatment. RESULTS: After the intervention, there was a significant decrease in the scores of the following scale items: being upset, inability to control, nervousness, tiredness, anger, and inability to overcome stress. (p < 0.05). There was a significant increase in the score of the item control of situations (p = 0.003). There was a significant difference in the mean perceived stress of the initial session compared to the 1st, 2nd and 3rd week sessions (p < 0.001). CONCLUSION: The use of acupuncture to treat stress during pregnancy reduced the stress perceived by pregnant women.

Dignity therapy in Mexican lung cancer patients with emotional distress: Impact on psychological symptoms and quality of life.

Lung cancer (LC) is the most frequent and deadly neoplasm in the world, and patients have shown a tendency to have more emotional distress than other cancer populations. Dignity Therapy (DT) is a brief intervention aimed to improve emotional well-being in patients facing life-threatening illness. OBJECTIVE: To analyze the effect of DT on anxiety, depression, hopelessness, emotional distress, dignity-related distress, and quality of life (QoL) in a group of Mexican patients with stage IV LC undergoing active medical treatment with baseline emotional distress. METHOD: In this preliminary pretest-posttest study, patients received three sessions of DT and were evaluated with the HADS, Distress Thermometer, Patient Dignity Inventory, single-item questions, and QLQ-30. RESULTS: In total, 24 out of 29 patients completed the intervention. Statistically significant improvements were found in anxiety, depression, emotional distress, hopelessness, and dignity-related distress with large effect sizes. Patients reported that DT helped them, increased their meaning and purpose in life, their sense of dignity, and their will to live, while it decreased their suffering. No changes were found in QoL. SIGNIFICANCE OF RESULTS: DT was well accepted and effective in improving the emotional symptoms of LC patients with distress that were undergoing medical treatment. Although more research is warranted to confirm these results, this suggests that DT can be used in the context of Latin-American patients.

Lower Maternal Chronic Physiological Stress and Better Child Behavior at 18 Months: Follow-Up of a Cluster Randomized Trial of Neonatal Intensive Care Unit Family Integrated Care.

OBJECTIVE: To assess whether Family Integrated Care (FICare) in the neonatal intensive care unit improves maternal chronic physiological stress and child behavior at 18 months of corrected age for infants born preterm. STUDY DESIGN: Follow-up of a multicenter, prospective cluster-randomized controlled trial comparing FICare and standard care of children born at <33 weeks of gestation and parents, stratified by tertiary neonatal intensive care units, across Canada. Primary outcomes at 18 months of corrected age were maternal stress hormones (cortisol, ie, hair cumulative cortisol [HCC], dehydroepiandrosterone [DHEA]) assayed from hair samples. Secondary outcomes included maternal reports of parenting stress, child behaviors (Internalizing, Externalizing, Dysregulation), and observer-rated caregiving behaviors. Outcomes were analyzed using multilevel modeling. RESULTS: We included 126 mother-child dyads from 12 sites (6 FICare sites, n = 83; 6 standard care sites, n = 43). FICare intervention significantly lowered maternal physiological stress as indicated by HCC (B = -0.22 [-0.41, -0.04]) and cortisol/DHEA ratio (B = -0.25 [-0.48, -0.02]), but not DHEA (B = 0.01 [-0.11, 0.14]). Enrollment in FICare led to lower child Internalizing (B = -0.93 [-2.33, 0.02]) and Externalizing behavior T scores (B = -0.91 [-2.25, -0.01]) via improvements to maternal HCC (mediation). FICare buffered the negative effects of high maternal HCC on child Dysregulation T scores (B = -11.40 [-23.01, 0.21]; moderation). For mothers reporting high parenting stress at 18 months, FICare was related to lower Dysregulation T scores via maternal HCC; moderated mediation = -0.17 (-0.41, -0.01). CONCLUSIONS: FICare has long-term beneficial effects for mother and child, attenuating maternal chronic physiological stress, and improving child behavior in toddlerhood. CLINICAL TRIAL REGISTRATION: NCT01852695.

Eficacia y seguridad de la aromaterapia / Efficacy and safety of aromatherapy

DEFINICIÓN DE LA TÉCNICA E INDICACIONES CLÍNICAS: La aromaterapia es una rama de la fitoterapia que utiliza aceites esenciales (extraídos de plantas) con el objetivo de mejorar el bienestar, reducir la ansiedad, el estrés y otros síntomas clínicos tanto emocionales como físicos. CALIDAD DE LA EVIDENCIA: En general, la calidad de la evidencia según las revisiones sistemáticas incluidas en este informe se ha considerado baja o muy baja. Muchos de los resultados son inconsistentes, imprecisos y se basan en estudios con riesgo de sesgo alto o incierto. Solo para las enfermedades cardiovasculares y la dismenorrea la evidencia se ha considerado moderada o alta. RESULTADOS CLAVES: Se incluyeron 74 revisiones sistemáticas, en una amplia variedad de enfermedades y condiciones de salud. El aceite esencial más evaluado fue la lavanda y las variables de resultado más estudiadas la ansiedad y el dolor. Los resultados de los estudios incluidos sugieren que la aromaterapia mejora el ritmo cardíaco en personas con hipertensión, enfermedad coronaria, síndrome coronario agudo o fallo cardíaco (calidad de la evidencia alta). También parece reducir la ansiedad y la frecuencia respiratoria en enfermedades cardiovasculares y mejorar el dolor en dismenorrea (calidad de la evidencia moderada). La aromaterapia podría mejorar la presión arterial sistólica en personas con enfermedades cardiovasculares, reducir la necesidad de antieméticos tras procedimientos quirúrgicos, mejorar el dolor agudo y reducir e estrés subjetivo (calidad de la evidencia baja). La evidencia es incierta sobre el efecto de la aromaterapia en la mejora de la ansiedad, el dolor o la calidad de vida en personas con cáncer, la ansiedad y el dolor tras cesárea o la ansiedad ante procedimientos dentales (calidad de la evidencia muy baja). CONCLUSIÓN FINAL: Las conclusiones no pueden ser definitivas debido a la baja calidad metodológica de muchos de los estudios incluidos en las revisiones sistemáticas identificadas. La aromaterapia puede ser un recurso complementario de algún valor para el tratamiento de síntomas físicos y psicológicos en enfermedades cardiovasculares y dismenorrea. Los aceites esenciales son naturales, pero no inocuos, y se han identificado una serie de eventos adversos leves asociados a su uso.

DEFINITION OF THE TECHNIQUE AND CLINICAL INDICATIONS: Aromatherapy is a field of phytotherapy that utilizes essential oils (extracted from plants) with the aim of improving well-being and reducing anxiety, stress and other emotional and physical symptoms. QUALITY OF THE EVIDENCE: In general, the quality of the evidence, based on the systematic reviews included in this report, has been rated as low or very low. Some results are inconsistent, imprecise and based on studies with high or unclear risk of bias. The evidence has been only considered moderate or high for cardiovascular diseases and dysmenorrhea. KEY RESULTS: 74 systematic reviews were included, covering a wide variety of diseases and health conditions. The most evaluated essential oil was lavender, and the most studied outcomes were anxiety and pain. The results of the included studies show that aromatherapy improves heart rate in people with hypertension, coronary heart disease, acute coronary syndrome or heart failure (high quality of evidence). It also probably reduces anxiety and breathing rate in cardiovascular disease and improves pain in dysmenorrhea (moderate quality of evidence). Aromatherapy may improve systolic blood pressure in people with cardiovascular disease, reduce the need for anti-emetics after surgical procedures, improve acute pain and reduce subjective stress (low quality of evidence). The evidence is uncertain about the effect of aromatherapy in improving anxiety, pain or quality of life in people with cancer, anxiety and pain after caesarean section or anxiety before dental procedures (very low quality of evidence). FINAL CONCLUSION: No definitive conclusion could be reached due to the low methodological quality of many of the studies included in the identified systematic reviews. Aromatherapy can be a valuable complementary resource for managing physical and psychological symptoms in cardiovascular diseases and dysmenorrhea. Essential oils are natural, but not necessarily harmless, and some mild adverse events associated with its use have been identified.

Eficacia y seguridad de la musicoterapia empleada para reducir la ansiedad, estrés y depresión / Efficacy and safety of Music Therapy to reduce anxiety, stress and depression

NOMBRE DE LA TÉCNICA CON PRETENDIDA FINALIDAD SANITARIA Musicoterapia (MT) DEFINICIÓN DE LA TÉCNICA E INDICACIONES CLÍNICAS La Asociación Americana de Musicoterapia (AMTA) define la musicoterapia como el "uso clínico y basado en la evidencia de intervenciones musicales para lograr objetivos individualizados dentro de una relación terapéutica por parte de un profesional acreditado que ha completado un programa de musicoterapia aprobado". CALIDAD DE LA EVIDENCIA Las revisiones analizadas carecen de elementos metodológicos esenciales. Los ensayos en los que se basan estas revisiones presentan numerosas limitaciones, por ejemplo, incluyen a un número reducido de participantes, los diseños muestran debilida des a la hora de aleatorizar a los pacientes y ocultar la asignación de intervención y control a los/as analistas de resultados. Resultados claves De las 10 revisiones incluidas, únicamente tres sugieren que la musicoterapia podría tener beneficios relevantes en el control de la ansiedad o la depresión. Dos de ellas son revisiones centradas en poblaciones concretas y los resultados positivos se obtienen en condiciones de aplicación muy determinadas. No se han encontrado resultados que puedan asociar el uso de la MT con mayor o menor número de efectos adversos La confianza en estos resultados es baja. CONCLUSIÓN FINAL La confianza en las revisiones y sus estudios incluidos es de un nivel bajo. La evidencia en la que se sustentan los resultados positivos obtenidos varía entre estudios y está sujeta a limitaciones. Existe variabilidad en la forma de administración, pautas y el enfoque de la intervención (duración, rol de los/as participantes, tiempo hasta resultados, etc.). No es posible asociar la MT con mayor o menor número de efectos adversos. Esto plantea difi cultades a la hora de evaluar esta práctica, no siendo posible establecer unas condiciones de aplicación sólidas, sistemáticas y consistentes. En definitiva, las carencias metodológicas de los estudios origin les y la falta de elementos clave en las RRSS hacen que no sea posible formular recomendaciones a favor del empleo de la MT para el tratamiento de la ansiedad, estrés y depresión.

NAME OF THE TECHNIQUE WITH HEALTH PURPOSES Music Therapy (MT) DEFINITION OF THE TECHNIQUE AND CLINICAL INDICATIONS The American Music Therapy Association (AMTA) defines Music therapy as "the clinical and evidence-based use of music inter ventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program". Quality of the evidence Systematic reviews analysed lack essential methodological elements. Clinical trials on which these reviews are based have numerous limitations, for example, they include a small number of participants, there are weaknesses in their designs related to random sequence generation, the allocation concealment of intervention and analysts blinding. KEY RESULTS Only three reviews suggest that MT could have relevant benefits for relieving anxiety, depression or stress. Only for specific populations and/or certain application conditions. Confidence in these results is considered low. FINAL CONCLUSION Confidence in reviews analysed and their included studies is low. The evidence supporting the positive results obtained varies between studies and may be biased. There is variability in the administration, guidelines and focus of the intervention (duration, role of the participants, time until results, etc.). Music therapy was not associated with more or fewer adverse events. This raises uncertainty when considering MT as a systematic and consistent therapeutic alternative.

[Community Therapy and psychic distress in the family system: an approach based on the new paradigm of science]. / Terapia Comunitária e sofrimento psíquico no sistema familiar: um enfoque baseado no novo paradigma da ciência.

The scope of this study was to analyze the behavior patterns adopted by family members dealing with individuals in psychological distress within the scope of the relationships established in the family system, after participating in Community Therapy sessions. It was based on research with a qualitative approach using the research-action-intervention method. The intervention used centered around twelve Community Therapy sessions. Ten family members of people in psychological distress monitored by a Psychosocial Care Center took part in the study. Field notebook records, videos obtained with the tapes of the Community Therapy sessions, the interview material and Community Therapy itself were used as the empirical material production technique. The study revealed that the family members' understanding of psychological distress could be transformed as they attributed new meanings and performed fundamental actions to balanced living in the family. Community Therapy was seen as a practice that facilitated changes in the lives of its participants, as it contributed to generate social and individual interactions that stimulated family members to rethink concepts and to create spaces of coexistence and human and respectful care that permeated the family unit.

O presente estudo buscou analisar os comportamentos adotados por familiares que lidam com entes em sofrimento psíquico, no âmbito das relações estabelecidas no sistema familiar, depois de participarem de rodas de Terapia Comunitária. Pesquisa de abordagem qualitativa que utilizou o método da pesquisa-ação-intervenção. A intervenção utilizada foram doze rodas de Terapia Comunitária. Fizeram parte do estudo dez familiares de pessoas em sofrimento psíquico acompanhadas em um Centro de Atenção Psicossocial. Como técnicas de produção do material empírico foram utilizados os registros do caderno de campo, os vídeos obtidos com a gravação das rodas de Terapia Comunitária, o material das entrevistas e a própria Terapia Comunitária. O estudo revelou que a compreensão dos familiares acerca do sofrimento psíquico pôde ser transformada na medida que atribuíam novos significados e realizavam ações fundamentais ao convívio equilibrado na família. A Terapia Comunitária pôde ser elucidada como uma prática que facilitou mudanças na vida de seus participantes, pois contribuiu para gerar interações sociais e individuais que estimularam os familiares a repensarem conceitos e a criarem espaços de convivência e cuidado humanos e respeitosos que se difundiram para o sistema familiar.

Terapia Comunitária e sofrimento psíquico no sistema familiar: um enfoque baseado no novo paradigma da ciência / Community Therapy and psychic distress in the family system: an approach based on the new paradigm of science

Resumo O presente estudo buscou analisar os comportamentos adotados por familiares que lidam com entes em sofrimento psíquico, no âmbito das relações estabelecidas no sistema familiar, depois de participarem de rodas de Terapia Comunitária. Pesquisa de abordagem qualitativa que utilizou o método da pesquisa-ação-intervenção. A intervenção utilizada foram doze rodas de Terapia Comunitária. Fizeram parte do estudo dez familiares de pessoas em sofrimento psíquico acompanhadas em um Centro de Atenção Psicossocial. Como técnicas de produção do material empírico foram utilizados os registros do caderno de campo, os vídeos obtidos com a gravação das rodas de Terapia Comunitária, o material das entrevistas e a própria Terapia Comunitária. O estudo revelou que a compreensão dos familiares acerca do sofrimento psíquico pôde ser transformada na medida que atribuíam novos significados e realizavam ações fundamentais ao convívio equilibrado na família. A Terapia Comunitária pôde ser elucidada como uma prática que facilitou mudanças na vida de seus participantes, pois contribuiu para gerar interações sociais e individuais que estimularam os familiares a repensarem conceitos e a criarem espaços de convivência e cuidado humanos e respeitosos que se difundiram para o sistema familiar.

Abstract The scope of this study was to analyze the behavior patterns adopted by family members dealing with individuals in psychological distress within the scope of the relationships established in the family system, after participating in Community Therapy sessions. It was based on research with a qualitative approach using the research-action-intervention method. The intervention used centered around twelve Community Therapy sessions. Ten family members of people in psychological distress monitored by a Psychosocial Care Center took part in the study. Field notebook records, videos obtained with the tapes of the Community Therapy sessions, the interview material and Community Therapy itself were used as the empirical material production technique. The study revealed that the family members' understanding of psychological distress could be transformed as they attributed new meanings and performed fundamental actions to balanced living in the family. Community Therapy was seen as a practice that facilitated changes in the lives of its participants, as it contributed to generate social and individual interactions that stimulated family members to rethink concepts and to create spaces of coexistence and human and respectful care that permeated the family unit.

Effect of extremely low frequency magnetic fields on oxidative balance in rat brains subjected to an experimental model of chronic unpredictable mild stress.

BACKGROUND: There has been an increasing interest in researching on the effects of extremely low-frequency magnetic fields on living systems. The mechanism of action of extremely low-frequency magnetic fields on organisms has not been established. One of the hypotheses is related to induce changes in oxidative balance. In this study, we measured the effects of chronic unpredictable mild stress induced-oxidative balance of rat's brain exposed to extremely low-frequency magnetic fields. METHODS: A first experiment was conducted to find out if 14 days of chronic unpredictable mild stress caused oxidative unbalance in male Wistar rat's brain. Catalase activity, reduced glutathione concentration, and lipoperoxidation were measured in cerebrum and cerebellum. In the second experiment, we investigate the effects of 7 days extremely low-frequency magnetic fields exposure on animals stressed and unstressed. RESULTS: The main results obtained were a significant increase in the catalase activity and reduced glutathione concentration on the cerebrum of animals where the chronic unpredictable mild stress were suspended at day 14 and then exposed 7 days to extremely low-frequency magnetic fields. Interestingly, the same treatment decreases the lipoperoxidation in the cerebrum. The stressed animals that received concomitant extremely low frequency magnetic fields exposure showed an oxidative status like stressed animals by 21 days. Thus, no changes were observed on the chronic unpredictable mild stress induced-oxidative damage in the rat's cerebrum by the extremely low-frequency magnetic field exposure together with chronic unpredictable mild stress. CONCLUSIONS: The extremely low-frequency electromagnetic field exposure can partially restore the cerebrum antioxidant system of previously stressed animals.

Komagataella pastoris KM71H modulates neuroimmune and oxidative stress parameters in animal models of depression: A proposal for a new probiotic with antidepressant-like effect.

Many studies have suggested that imbalance of the gut microbial composition leads to an increase in pro-inflammatory cytokines and promotes oxidative stress, and this are directly associated with neuropsychiatric disorders, including major depressive disorder (MDD). Clinical data indicated that the probiotics have positive impacts on the central nervous system and thus may have a key role to treatment of MDD. This study examined the benefits of administration of Komagataella pastoris KM71H (8 log UFC·g-1/animal, intragastric route) in attenuating behavioral, neurochemical, and neuroendocrine changes in animal models of depressive-like behavior induced by repeated restraint stress and lipopolysaccharide (0.83 mg/kg). We demonstrated that pretreatment of mice with this yeast prevented depression-like behavior induced by stress and an inflammatory challenge in mice. We believe that this effect is due to modulation of the permeability of the blood-brain barrier, restoration in the mRNA levels of the Nuclear factor kappa B, Interleukin 1ß, Interferon γ, and Indoleamine 2 3-dioxygenase, and prevention of oxidative stress in the prefrontal cortices, hippocampi, and intestine of mice and of the decrease the plasma corticosterone levels. Thus, we conclude that K. pastoris KM71H has properties for a new proposal of probiotic with antidepressant-like effect, arising as a promising therapeutic strategy for MDD.