Western Medical Acupuncture Perception and Use for Pain Management Among Athletes: A Systematic Review.

Purpose: This systematic review aims to assess the use and perception of "Western" medical acupuncture-based on conventional biomedical mechanisms and evidence-based medicine for diagnosis and needle placement-for pain management among athletes and their healthcare providers. Methods: A systematic review is reported based on the PRISMA guidelines. PubMed, Web of Science, SPORTDiscus, Allied and Complementary Medicine databases, and Google Scholar were searched (search: from database inception to July 2023). Two authors independently conducted multi-stage screening, data extraction, and quality assessment. The outcomes of interest were prevalence of acupuncture prescriptions by healthcare professionals, prevalence of acupuncture use by athletes, and perceptions related to acupuncture effectiveness among healthcare professionals and athletes. Only studies wherein "Western" medical acupuncture was used for pain management were included. Results: Our review included 11 observational studies and clinical trials. The prevalence of "Western" medical acupuncture prescription varied from 15.4% (UK) to 58.4% (US) among sports medicine healthcare professionals. Prevalence of acupuncture use among athletes ranged from 2.2% among college athletes in Palestine to 61% among professional football players in the Netherlands. Acupuncture was used for managing delayed-onset of soreness and pain due to various types of musculoskeletal injuries. Both athletes and their healthcare providers reported positive perceptions of acupuncture. Conclusion: Our systematic review identifies a notable research gap in evaluating the practice and perception of "Western" medical acupuncture among healthcare professionals and athletes. Our findings suggest that "Western" medical acupuncture is not only prescribed by sport medicine professionals and used by athletes for diverse musculoskeletal pains but is also generally perceived positively for its effectiveness. Given the positive clinical experience of health professionals, athletes' favorable perception, and acupuncture's well-established safety profile, acupuncture should be given serious consideration-as a complementary approach-in the overall management of pain. Registration: Open Science Framework (https://osf.io/qb9gc).

Burnout increased among university students during the COVID-19 pandemic: a systematic review and meta-analysis.

Generally, university students are at risk of burnout. This likely was exacerbated during the COVID-19 pandemic. We aimed to investigate burnout prevalence among university students during the COVID-19 pandemic and examine its distribution across countries, sexes, fields of study, and time-period. PubMed, EMBASE, PsycINFO, World Health Organization's Global COVID-19 database, Scopus, Epistemonikos, ERIC and Google Scholar were searched (protocol: https://doi.org/10.17605/OSF.IO/BYRXW ). Studies were independently screened and extracted. Random-effects meta-analysis was performed. Study quality was appraised, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. We identified 44 primary studies comprising 26,500 students. Global prevalence rates were 56.3% for high emotional exhaustion (EE), 55.3% for high cynicism (CY) and 41.8% for low personal accomplishment (PA). Prevalence of EE, CY, and PA domains varied significantly across fields of study, countries and WHO and World Bank regions, but not sex. All studies demonstrated good internal validity, although substantial heterogeneity existed between studies. The certainty of evidence was rated as moderate. Considering its potentially severe consequences, burnout is a significant public health concern. The development and implementation of evidence-based localized interventions at organizational and individual levels are necessary to mitigate burnout.

Sleep disorders and associated factors among medical students in the Middle East and North Africa: a systematic review and meta-analysis.

Sleep disturbances like poor and insufficient sleep are common among medical students in the Middle East and North Africa (MENA) countries; however, the extent of medically defined sleep disorders (SDs) remains unclear. This meta-analysis determines SD prevalence and identifies associated factors among medical students in the MENA. PubMed, Web of Science, Google Scholar, and reference lists of included studies were searched (latest search: June 2022). Meta-analyses included 22 studies and were performed using random-effect models. Included studies used self-reported screening tools for assessing SDs and then estimated the proportion of participants at high risk of developing a SD. Central disorders of hypersomnolence were the most prevalent SD [prevalencepooled range: 30.9% (Jordan) to 62.5% (Saudi Arabia)], followed by insomnia disorders [prevalencepooled range: 30.4% (Jordan) to 59.1% (Morocco)], circadian rhythm sleep-wake disorders [prevalencepooled range: 13.5% (Jordan) to 22.4% (Saudi Arabia)], sleep-related breathing disorders [prevalencepooled range: 12.2% (Jordan) to 22.5% (Pakistan)], sleep-related movement disorders [prevalencepooled range: 5.9% (Egypt) to 30.6% (Saudi Arabia)], and parasomnias [prevalencepooled range: 5.6% (Jordan) to 17.4% (Saudi Arabia)]. Female sex, studying in the latter academic years, having anxiety, excessive internet use, and poor academic performance were significantly associated with SDs. SDs are prevalent among MENA medical students. Implementing student-centered interventions targeting high risk groups in medical schools should be considered to improve students' health and wellbeing.