Effects of Hormonal Replacement Therapy and Mindfulness-Based Stress Reduction on Climacteric Symptoms Following Risk-Reducing Salpingo-Oophorectomy

This article belongs to the Special Issue Mental Health Promotion and Illness Prevention in Vulnerable Populations—2nd Edition.Supplementary Materials The following supporting information can be downloaded at https://www.mdpi.com/article/10.3390/healthcare12161612/s1: Supplementary Table S1: Fit indices of multi-group analysis models examining the differences in the effects of mindfulness-based stress reduction (MBSR) and hormone replacement therapy (HRT) among women with RRSO, File S2: Possible mechanism of menopausal symptom flaring following HRT treatment in RRSO patients with BRCA1 mutation and a history of cancer.Funding: This work was supported by FCT—Fundação para a Ciência e a Tecnologia, I.P. (UIDB/05704/2020 and UIDP/05704/2020) and by the Scientific Employment Stimulus—Institutional Call [https://doi.org/10.54499/CEECINST/00051/2018/CP1566/CT0012, accessed on 30 July 2024].Breast Cancer Associated Susceptibility Proteins Type 1/2 (BRCA1/2) promote cellular functioning by modulating NRF2-mediated antioxidant signaling. Redox failure in women with BRCA1/2 insufficiency increases the risk for breast/ovarian/uterine cancers. Risk-reducing salpingo-oophorectomy (RRSO) is a prophylactic surgery of the reproductive organs, which is frequently conducted by the age of 40 to lower the occurrence of cancer in women with BRCA1/2 mutations. However, abrupt estrogen decline following RRSO causes ovarian failure, which implicates various cellular physiological processes, resulting in the increased release of free radicals and subsequent severe onset of menopausal symptoms. Comfort measures (e.g., hormonal replacement therapy (HRT) and mindfulness-based stress reduction (MBSR)) may improve chronological menopause-related quality of life, but their specific effects are not clear in women with gene mutations. Aiming to fill the gap, this study used path analysis to examine the effects of HRT and MBSR on menopausal symptoms among RRSO patients (N = 199, mean age = 50.5 ± 6.7 years). HRT directly alleviated the levels of urogenital symptoms (β = −0.195, p = 0.005), which mediated its indirect significant effects on the somatic–vegetative and psychological symptoms of menopause (β = −0.046, −0.067; both p values = 0.004, respectively), especially in BRCA2 carriers and in women who were currently physically active, premenopausal at the time of RRSO, had a high BMI, and had no history of breast cancer. It increased the severity of urogenital symptoms in women with a history of cancer. MBSR, on the other hand, was associated with indirect increases in the intensity of the somatic–vegetative and psychological symptoms of menopause (β = 0.108, 0.029; p = 0.003, 0.033, respectively). It exerted positive direct effects on different menopausal symptoms in multigroup analysis. The results suggest that young women undergoing recent RRSO may benefit from HRT at an individual level, while their need for extensive measures to optimize their psychological wellbeing is ongoing. The adverse effects of MBSR, which are captured in the present study, imply that MBSR may interfere with redox sensitivity associated with estradiol fluctuations in BRCA1/2 carriers. Investigations are needed to test this hypothesis and elaborate on the underlying mechanisms in these women.info:eu-repo/semantics/publishedVersio

Nitty-gritties of customer experience in metaverse retailing

Metaverse has revolutionized the retail landscape and related customer experience. Yet, research in this area remains limited. This study unveils metaverse retailing aspects and their impact on customer experience by linking extracted twenty latent topics grouped under four themes, namely, immersive technology adoption, controlled interaction, agency interface integration, and novel metaverse environment with the Uses and Gratification Theory 2.0 (UGT 2.0) elements - modality, agency, interactivity, and navigability. The paper discusses metaverse retailing and customer experience research that can advance consumer research and help companies identify metaverse retailing customer experience improvement areas. The paper concludes with possible directions that can be undertaken in future research related to the four themes identified in the context of customer experience in metaverse retailing. The authors also propose three probable future research models that are well grounded in theory and arise from our analysis of work undertaken in the area of customer experience in metaverse retailing