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Item Paced Respiration for Vasomotor and Other Menopausal Symptoms: A Randomized, Controlled Trial(Office of the Vice Chancellor for Research, 2013-04-05) Carpenter, Janet S.; Burns, Debra S.; Wu, Jingwei; Otte, Julie L.; Yu, MenggangBackground: Paced respiration has been internationally recommended for vasomotor symptoms (e.g., hot flashes, night sweats) despite limited empirical evidence. Objective: To evaluate efficacy of a paced respiration intervention against breathing control and usual care control for vasomotor and other menopausal symptoms. Design: A 16-week, 3-group, partially blinded, controlled trial with 2:2:1 randomization and stratification by group (breast cancer, no cancer) was conducted in a Midwestern city and surrounding area. Participants: 218 randomized women (96 breast cancer survivors, 122 menopausal women without cancer) were recruited through community mailings and registries (29% minority). Interventions: Training, home practice support, and instructions to use the breathing at the time of each hot flash were delivered via compact disc with printed booklet (paced respiration intervention) or digital videodisc with printed booklet (fast shallow breathing control). Usual care control received a letter regarding group assignment. Main Measures: Outcomes included hot flash frequency, severity, and bother (primary), hot flash interference in daily life, perceived control over hot flashes, and mood and sleep disturbances (secondary). Intervention performance, adherence, and adverse events were assessed. Key Results: There were no significant group differences for primary outcomes at 8- or 16-weeks post-randomization. Most intervention participants did not achieve 50% reduction in vasomotor symptoms despite demonstrated ability to correctly do paced respiration and daily practice. Statistically significant differences in secondary outcomes at 8- and 16-weeks were small, not likely to be clinically relevant, and as likely to favor intervention as breathing control. Conclusions: Paced respiration is unlikely to provide clinical benefit for vasomotor or other menopausal symptoms in breast cancer survivors or menopausal women without cancer.Item A Systematic Review of Palpitations Prevalence by Menopausal Status(Springer, 2021-03) Carpenter, Janet S.; Sheng, Ying; Elomba, Charles D.; Alwine, Jennifer S.; Yue, Min; Pike, Caitlin A.; Chen, Chen X.; Tisdale, James E.; School of NursingPurpose of the Review The purpose was to systematically review evidence on the prevalence of palpitations by menopausal stage. Palpitations are a feeling of missed, irregular, or exaggerated heart beats. Recent Findings Carefully delineated search, screening, and data extraction strategies resulted in five articles for review. Articles offered cross-sectional findings from menopausal symptom surveys from five countries between 1974 and 2011 with clinic- and community-based samples of premenopausal, perimenopausal, and postmenopausal women. Reported studies were good (n = 2) to fair (n = 3) quality with low (n = 2) to moderate (n = 3) bias. Menopausal palpitations were not the focus of any study but were assessed as a single item of heart racing, pounding, or discomfort over the past 2 weeks, month, or year. Palpitations prevalence rates by menopausal stage were 3.7 to 40.2% premenopausal, 20.1 to 40.2% perimenopausal, and 15.7 to 54.1% postmenopausal. Three of five articles showed that compared with premenopausal and postmenopausal women, palpitation prevalence was significantly higher among perimenopausal and surgically postmenopausal women. Summary Good-quality evidence on palpitation prevalence by menopausal stage is limited but suggests that physiological changes of menopause may play a role in this symptom. Measurement varied, suggesting a need to standardize the assessment of menopausal palpitations. The review findings suggest a strong need for clinicians and researchers to collaborate to standardize documentation of menopausal palpitations across the menopause transition.