The safety and effectiveness of mind body interventions for women with pregnancy induced hypertension and or preeclampsia: A systematic review and meta-analysis.

OBJECTIVES: To undertake a systematic review of the safety and effectiveness of mind body approaches for women with hypertensive disorders in pregnancy (HDP). DESIGN: A search was undertaken of databases from inception to 2019 for randomised and quasi randomised controlled trials. MAIN OUTCOME MEASURES: The primary outcome was a reduction in systolic and / or diastolic blood pressure for women with hypertension and or preeclampsia in pregnancy. RESULTS: 121 studies were identified and eight studies were included in this review. These included mind body interventions examining yoga, guided imagery, relaxation, music, and acupuncture for HDP. Two studies of relaxation found a reduction in systolic (MD -11.3, 95%CI -13.23 to -9.39) and diastolic blood pressure (MD -6.59, 95%CI -9.43 to -3.75) and reduced stress (MD -11.4, 95%CI -16.5 to -6.3). In one study of yoga, the risk of developing HDP was reduced (RR 0.28, 95% CI 0.09 to 0.91, 59 women) and a second study found a reduction in stress at the end of the intervention of yoga. One trial of guided imagery found a reduction in mean arterial blood pressure compared to the control (4.35, 95% -8.04 to -0.66, p=0.02). Overall there was no effect on the development of preeclampsia, use of anti-hypertensive medication and any neonatal outcomes from the interventions evaluated. Few trials reported on safety outcomes, one trial of acupuncture reported one case of placental abruption and three cases of acupuncture related side effects. CONCLUSION: Few high quality trials have examined the effectiveness and safety of mind body interventions to manage HDP. Relaxation, yoga, guided imagery and music may have some potential benefit. Safety issues are completely unclear and thus the risk-benefit ratio of all interventions could not be determined. Further research is recommended.

Adapting operator settings in genetic algorithms.

In the majority of genetic algorithm implementations, the operator settings are fixed throughout a given run. However, it has been argued that these settings should vary over the course of a genetic algorithm run--so as to account for changes in the ability of the operators to produce children of increased fitness. This paper describes an investigation into this question. The effect upon genetic algorithm performance of two adaptation methods upon both well-studied theoretical problems and a hard problem from operations research, the flowshop sequencing problem, are therefore examined. The results obtained indicate that the applicability of operator adaptation is dependent upon three basic assumptions being satisfied by the problem being tackled.