Alternative Interventions Research Articles

Sensory Appeal and Anxiety Reduction: A Study on Ashwagandha, Sweet Basil, and Cinnamon Tea Blends

Background: Anxiety disorders are prevalent among young adults, especially women of childbearing age, necessitating the exploration of alternative therapeutic interventions. The present study investigates a specialized tea blend combining Ashwagandha, Sweet Basil, and cinnamon for potential anxiety alleviation in this demographic. Objective: The primary objectives encompassed (1) formulating a tea blend combining Ashwagandha and Sweet Basil with cinnamon, (2) evaluating its nutritional and sensory attributes, and (3) assessing its potential to reduce anxiety using the Beck Anxiety Inventory (BAI). Methods: Ingredients were procured from Faisalabad's native market and crushed to formulate two tea variants. The study was conducted over 21 days with 30 participants, divided into three groups: G0 (Control), G1 (Ashwagandha and Cinnamon), and G2 (Sweet Basil and Cinnamon). Anxiety levels were assessed using BAI at the start and end of the intervention. Results: Nutritional analysis indicated variations in moisture, ash, crude fat, crude protein, and NFE content among formulations. Sensory evaluations pointed to G1 having superior aroma, texture, flavor, and overall acceptability, while G2 excelled in appearance. BAI assessments, though indicative of potential anxiety-reducing effects, were not conclusively significant due to sample size constraints. Conclusion: The tea formulations exhibited promising relationships between sensory appeal, nutritional value, and potential anxiety-reducing effects. However, further studies with larger sample sizes and longer intervention periods are warranted for more definitive insights. The study contributes to the exploration of natural interventions for anxiety management, emphasizing the nexus between sensory experiences, nutrition, and emotional well-being.

Neurobiomechanical mechanism of Tai Chi to improve upper limb coordination function in post-stroke patients: a study protocol for a randomized controlled trial

BackgroundUpper limb dysfunction seriously affects the ability of stroke patients to perform activities of daily living. As a popular exercise therapy, Tai Chi may become an alternative intervention. However, the neurophysiological mechanism by which Tai Chi improves upper limb dysfunction in stroke patients is still unclear, which limits its further promotion and application. Therefore, conducting a strict randomized clinical trial is necessary to observe how Tai Chi affects upper limb dysfunction in stroke patients and to explore its neurophysiological mechanism.Methods/designThis report describes a randomized, parallel-controlled trial with distributive concealment and evaluator blinding. A total of 84 eligible participants will be randomly assigned to the Tai Chi group or the control group in a 1:1 ratio. The participants in the Tai Chi group will receive 4 weeks of Tai Chi training: five 60-min sessions a week for a total of 20 sessions. The participants in the control group will not receive Tai Chi training. Both groups will receive medical treatment and routine rehabilitation training. The primary outcome measure is the mean change in the Fugl-Meyer Assessment Upper Extremity (FMA-UE) scale score between baseline and 4 weeks; the secondary outcomes are the mean changes in kinematic characteristics and the Wolf Motor Function Test (WMFT) and Stroke Impact Scale (SIS) scores. In addition, the corticomuscular coupling level and near-infrared brain functional imaging will be monitored to explore the mechanism by which Tai Chi improves upper limb function of stroke patients.DiscussionThis randomized controlled trial will examine the effectiveness of Tai Chi in stroke patients with upper limb dysfunction and explore the neurophysiological mechanism. Positive results will verify that Tai Chi can improve upper limb function of stroke patients.Trial registrationChinese Clinical Trial Registration Center, ChiCTR2200061376 (retrospectively registered). Registered June 22, 2022. http://www.chictr.org.cn/listbycreater.aspx. Manuscript Version: 3.0 Manuscript Date: October 10, 2023.

Navigating the streets


 The Indian government’s approach to dog population management for the last two decades – the animal birth control (ABC) program – has yielded poor results. Aside from its implementation failures, the ABC is scientifically unsuited to the scale and severity of the harms posed by free-ranging dogs. It is based on a deficient understanding of both animal behaviour and animal welfare. The Indian Supreme Court, which is hearing multiple petitions relating to the danger to human life and safety posed by India’s burgeoning population of free-ranging dogs, has issued interim orders that restrict alternative interventions such as long-term sheltering and euthanasia. While the legal dispute has meandered through the judicial system for more than a decade, the harms caused by free-ranging dogs continue unabated. Recent legislative changes, which encourage the maintenance of dogs on streets, have pushed government policy in a seemingly regressive pathway. This paper presents a critical discussion of the legal and policy position, and suggests integrated and contextual approaches for viable dog population management. 

Complementary and Alternative Therapy for Picky Eater: Systematic Review

The picky eater problem is one of the beginnings of toddler stunting. This problem needs to be solved with scientifically proven interven- tions. This systematic review is focused on looking at complementary and alternative interventions that are scientifically proven to be ef- fective in treating picky eaters. This study aims to identify, evaluate, and summarize the findings of all relevant literature on complemen- tary & alternative therapies for picky eaters in children (1-6 years). Search for articles on PubMed, ProQUestProQuest, Google Scholar, and Crossref search engines related to literature from 2012-2022. Inclusion criteria were original research articles that examined an intervention on picky eating in children with complementary & alter- native therapeutic approaches. Quantitative, experimental research published in English and Indonesian with child participants with picky eater problems. The data were studied and analyzed with qualitative and narrative methods. There are a few articles (10 items) that re- view the effectiveness of an intervention to treat nutritional problems and the symptoms of picky eaters. Interventions with complementary approaches and alternative therapies were found to be very few. Most of them are in the form of conventional interventions such as health education, oral supplementation, counselling, and interventions with similar approaches. Several interventions are given in combination. There is an intervention for handling picky eaters given to respon- dents who have nutritional problems accompanied by other diseases. There is an insufficient number of scientific articles found related to interventions for picky eaters with complementary approaches and alternative therapies, therefore scientific evidence with research and publications is still a big opportunity and is very much needed in the future.

ANALYSIS OF INSTITUTIONAL ENGINEERING IN ONE OF THE WET CLIMATE DRY LAND AGROECOSYSTEM VEGETABLE PLANTING

This study is the first to apply a relationship approach between farmer groups and other supporting institutions to develop a farming system and rice crop institutions in a region. The study aims to solve the problems faced by rice farmers in Rawa Medang village, West Tanjung Jabung Regency, by facilitating the adoption of sustainable rice farming system technology through institutional cooperation. The methodology used in this study applies the Participatory Research Appraisal (PRA) method, to explore the problems faced by rice farmers. Alternative interventions include the formation of several farmer groups or Gapoktan, named Joint Enterprises, a short discussion about the rice farming system, looking at the urgent needs of farmer groups, and connecting them with supporting institutions. Based on the PRA results, the problems prioritized are (1) Rice stem disease by Blas, (2) The presence of snail pests, (3) Seedlings, (4) Capital, (5) Subsidized fertilizer, (6) Meetings between groups, and (7) Technical guidance for rice plants. The novelty of this study is that it introduces a new framework of institutional engineering analysis supporting rice farming technology, based on the FSA (Farming System Analysis) concept. The study also provides empirical evidence of the effectiveness of the relationship approach in improving the productivity and profitability of rice farming in the region. The study contributes to the literature on agricultural development and innovation by highlighting the role of institutional cooperation in enhancing the adoption of sustainable rice farming system technology.

The effects of dance movement therapy for children with Autism spectrum disorder

ABSTRACT Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition characterized by social/communication challenges and restrictive or repetitive behaviours. While motor challenges are not considered core diagnostic criteria, they are common among children with ASD. Additional evidence suggests motor and social/communication skills are coupled at a young age and are predictively associated with one another. Dance Movement Therapy (DMT) is a non-conventional psychotherapeutic intervention using dance and movement as a process to enhance physical and psychological conditions. The purpose of this study was to examine the effects of DMT for children with ASD through the perspective of the therapist. Fifteen therapists completed a questionnaire containing a collection of questions concerning basic demographic information and general outcomes following therapy. Four participants further engaged in one-on-one semi-structured interviews to elaborate on their perceived outcomes. The results of this study show DMT has the potential to ameliorate physical, social, and emotional domains among children with ASD. More specifically, mood management, overall wellbeing, socialization and communication were recognized as the most improved outcomes following therapy. Although not the main objective of practice, motor challenges were also seen to improve with DMT participation. This study highlights the benefits of DMT for children with ASD and can assist in providing diagnosed individuals with an alternative intervention approach.

Clinical Chronicle: The Use of Ventriculo-Atrial Shunt in Tuberculous Hydrocephalus Treatment

Tuberculous meningitis (TBM) is the predominant bacterial meningitis form in children under 13, with an incidence of 8.6 per 100,000 before age 15. Tuberculous Hydrocephalus (TH), often presenting with hydrocephalus, poses a significant challenge in Indonesia for both children and adults. The commonly used Ventriculo-peritoneal (VP)-shunt procedure for TH, though prevalent, is associated with multiple complications. As an alternative, the Ventriculo-atrial (VA)-shunt procedure has been explored, but reports on its use in TH in Indonesia are lacking. This case report details a 1-year-old girl with TH who initially underwent a VP-shunt procedure, which proved unsuccessful. Subsequently, the VA-shunt procedure was employed, leading to a complete recovery. Our findings contribute valuable insights into the potential effectiveness of the VA-shunt as an alternative intervention for TH, especially in the Indonesian medical landscape.

Recommendation of a customized diet focusing on blood group: An alternative intervention

Recommendation of a customized diet focusing on blood group: An alternative intervention

Anopheles larval habitats seasonality and environmental factors affecting larval abundance and distribution in Arjo-Didessa sugar cane plantation, Ethiopia

BackgroundWater resource development projects are essential for increasing agricultural productivity and ensuring food security. However, these activities require the modification of pre-existing environmental settings, which may alter mosquito larval habitat availability and seasonality. The intensive utilization of current adult vector control tools results in insecticide resistance among the main vectors. When coupled with behavioural resistances, a shift in malaria vector feeding and resting behaviours could compromise the effectiveness of the current adult vector control strategies. Thus, it is important to look for new or alternative vector control interventions for immatures to complement adult control by focusing on different larval habitats and their seasonal availability. Thus, this study investigated larval habitat seasonality and seasonal larval abundance and distribution in irrigated sugar cane plantation settings in Ethiopia.MethodsAnopheles mosquito larval habitats were surveyed and visited twice a month for a period of 14 months. Anopheline larvae and pupae were collected, reared, and fed finely ground fish food. Adults were provided with sucrose solution and kept under standard conditions. Female Anopheles mosquitoes were identified morphologically and using a species-specific PCR assay. Environmental parameters, which include habitats’ physico-chemical characteristics, were assessed. Larval habitat diversity and larval abundance and distribution were determined across different seasons.ResultsThe study revealed that Anopheles gambiae sensu lato (s.l.) was the most predominant 4197(57%) vector species, followed by Anopheles coustani complex 2388 (32.8%). Molecular analysis of sub-samples of An. gambiae s.l. resulted in Anopheles arabiensis (77.9%) and Anopheles amharicus (21.5%), and the remaining 1.1% (n = 7) sub-samples were not amplified. Physico-chemical parameters such as temperature (t = 2.22, p = 0.028), conductivity (t = 3.21, p = 0.002), dissolved oxygen (t = 7.96, p = 0.001), nitrate ion (t = 2.51, p = 0.013), and ammonium ion (t = 2.26, p = 0.025) showed a significant and direct association with mosquito larval abundance. Furthermore, mosquito larval abundance was correlated with distance to the nearest houses (r = − 0.42, p = 0.001), exposure to sunlight (r = 0.34, p = 0.001), during long and short rainy season animal hoof prints, truck tires/road puddles and rain pools were negatively correlated (r = − 0.22, p = 0.01) and types of habitat (r = − 0.20, p = 0.01). Significant habitat type productivity were observed in man-made pools (t = 3.881, P = 0.01163), rain pools, animal hoof prints, (t = − 4.332, P = 0.00749 in both short and long rainy season, whereas, during dry seasons habitat type productivity almost similar and have no significance difference.ConclusionThe study found that different larval habitats had variable productivity in different seasons, and that physical and physicochemical features like ammonium and nitrate, as well as the distance between larval habitats and households, are related to larval production. As a result, vector control should take into account the seasonality of Anopheles larval habitat as well as the impact of pesticide application on larval source management.

Pengaruh Metode SPEOS (Stimulasi Pijat Endorphin, Oksitosin, dan Sugestif) dan Murottal Al-Qur’an terhadap Produksi Asi Ibu Post Sectio Caesarea

ASI is an important food that babies need especially during the first 6 months of life. The success of exclusive breastfeeding is determined from the beginning of breastfeeding. There are many factors that hinder the production of breast milk, one of which is that mothers with casarean delivery are at 3 times greater risk of hampering the breastfeeding process. Apart from medicines, mothers also experience discomfort due to pain which makes the mother helpless and worries about her ang her baby’s helath. This is what will hinder the formation and excretion of breast milk. SPEOS method is a methods for breastfeeding and Murottal Al-Qur'an is a method to reduce anxiety and pain. This intervention not only looks at the mother physicallu but also psychologically. The purpose of this study was to determine the effect of SPEOS method and Murottal Al-Qur'an on Breast Milk Production of Post Sectio Caesarean mothers. This study was a quasy experiment with pretest-posttest control group design. Respondents were post sectio caesarean mothers who met the inclusion criteria. The number of respondents was 58 who were taken by consecutive sampling technique, and were divided into the intervention group and control group. The intervention was given at 24 hours after surgery for 2 days within 27 minutes, SPEOS method for 15 minutes and Murottal Al-Qur’an for 12 minutes. The intervention was carried out 2 times a day. The data were collected through the breast milk production assessment using observation sheet and analyzed using the Wilcoxon and the Mann-Whitney test. The results showed an increase in breast milk production after the intervention (p = 0.000 <0.05). SPEOS and Murottal AL-Qur'an methods indicated significant effect on breast milk production in post-sectio caesarean mothers p = 0.000 <0.05. Based on the results of the study, it is suggested that SPEOS method and Murottal Al-Qur'an could be used as alternative intervention to overcome the problem of milk production in post sectio caesarean mothers

Transcatheter aortic valve implantation versus surgical aortic valve replacement in severe aortic stenosis patients at low surgical mortality risk: a cost-effectiveness analysis in Belgium

Background Transcatheter aortic valve implantation (TAVI) with the SAPIEN 3 device has recently shown significant clinical benefits, compared to surgical aortic valve replacement (SAVR), in patients at low risk for surgical mortality (PARTNER 3 trial, NCT02675114). Currently in Belgium, TAVI use is restricted to high-risk or inoperable patients with severe symptomatic aortic stenosis (sSAS). This cost-utility analysis aimed to assess whether TAVI with SAPIEN 3 could lead to potential cost-savings compared with SAVR, in the low-risk sSAS population in Belgium. Methods A previously published, two-stage, Markov-based cost-utility model was used. Clinical outcomes were captured using data from PARTNER 3 and the model was adapted for the Belgian context using cost data from the perspective of the Belgian National Healthcare System, indexed to 2022. A lifetime horizon was chosen. The model outputs included changes in direct healthcare costs, survival and health-related quality of life using TAVI versus SAVR. Results TAVI with SAPIEN 3 provides meaningful clinical and cost benefits over SAVR, in terms of an increase in quality-adjusted life years (QALYs) of 0.94 and cost-saving of €3 013 per patient. While initial procedure costs were higher for TAVI compared with SAVR, costs related to rehabilitation, disabling stroke, treated atrial fibrillation, and rehospitalization were lower. The cost-effectiveness of TAVI over SAVR remained robust in sensitivity analyses. Conclusion TAVI with SAPIEN 3 may offer a meaningful alternative intervention to SAVR in Belgian low-risk patients with sSAS, showing both clinical benefits and cost savings associated with post-procedure patient management.

Handgrip echocardiography predicts clinical outcomes in patients with ischemic mitral regurgitation

Abstract Background Mitral regurgitation (MR) is frequent in patients with ischemic heart disease and carries a dismal prognosis. Previous studies already demonstrated the prognostic benefit of bicycle exercise testing in patients with ischemic MR. Thus, current guidelines emphasize the role of exercise testing in patients with valvular heart disease. Isometric handgrip exercise resembles an alternative exercise intervention, that can also be performed in frail, comorbid patients. Until now, there are no data on the prognostic impact of handgrip echocardiography in heart failure patients with ischemic MR. Purpose To assess the prognostic benefit of isometric handgrip testing in heart failure patients with ischemic MR. Methods We prospectively enrolled patients with ischemic cardiomyopathy (left ventricular ejection fraction <50%) and at least mild MR that underwent echocardiography at rest and during handgrip exercise between January 2019 and September 2021. Patients were followed-up for one year to assess clinical outcomes. The combined endpoint included all-cause mortality, heart failure hospitalisation, ventricular assist device implantation (VAD), heart transplantation and mitral valve (MV) surgery/intervention. Results We included 133 patients (mean age was 75±10 years, 21% were female). Seventy patients (53%) presented with mild MR, while 54 patients had moderate MR (41%), and 9 patients (7%) showed severe MR at rest. Twenty-five patients (20%) with non-severe MR at rest, developed severe MR during handgrip exercise. One-year follow-up (median 321 (162-427) days) was complete in 128 patients (96%). Seventy-one patients (56%) experienced an adverse event: 13 patients (10%) died, 33 patients (26%) were re-admitted to hospital due to heart failure symptoms, 30 patients (24%) underwent MV transcatheter edge-to-edge repair, six patients (5%) received MV surgery, one patient (1%) underwent VAD implantation, and another three patients (4%) underwent heart transplantation. According to MR severity at rest, there was no difference in outcomes in patients with mild, moderate and severe MR (p=0.189). As expected, patients with severe MR at rest more often tended to undergo mitral valve surgery/interventions compared to the other groups (p=0.064). However, patients with non-severe MR at rest and exercise-induced severe MR presented with adverse outcomes similar to patients with severe MR at rest (p=0.005). Furthermore, patients with severe MR at rest and patients with dynamic severe MR underwent mitral valve surgery/interventions more frequently than patients with non-severe MR (p<0.001). Conclusion(s) In heart failure patients with ischemic MR, isometric handgrip testing unmasks severe MR in approximately every fifth patient with non-severe MR at rest. These patients showed similar clinical outcomes as compared to patients with severe MR already at rest. Thus, handgrip exercise testing might be a useful tool to guide further therapeutic decision making.

Inflammation and Mental Health Disorders: Immunomodulation as a Potential Therapy for Psychiatric Conditions.

Mood disorders are the leading cause of disability worldwide and their incidence has significantly increased after the COVID-19 pandemic. Despite the continuous surge in the number of people diagnosed with psychiatric disorders, the treatment methods for these conditions remain limited. A significant number of people either do not respond to therapy or discontinue the drugs due to their severe side effects. Therefore, alternative therapeutic interventions are needed. Previous studies have shown a correlation between immunological alterations and the occurrence of mental health disorders, yet immunomodulatory therapies have been barely investigated for combating psychiatric conditions. In this article, we have reviewed the immunological alterations that occur during the onset of mental health disorders, including microglial activation, an increased number of circulating innate immune cells, reduced activity of natural killer cells, altered T cell morphology and functionality, and an increased secretion of pro-inflammatory cytokines. This article also examines key studies that demonstrate the therapeutic efficacy of anti-inflammatory medications in mental health disorders. These studies suggest that immunomodulation can potentially be used as a complementary therapy for controlling psychiatric conditions after careful screening of candidate drugs and consideration of their efficacy and side effects in clinical trials.

The Effect of Alarm Use on the Awareness of Taking Iron Supplements (Haemoglobin Levels) as a Prevention of Haemorrhagic Postpartum

Anemia is one of the indirect causes of Postpartum Hemorrhage (HPP) during childbirth. The development of iron supplement alarm reminders can be used as an alternative intervention to increase awareness and consumption of iron supplements as a preventive measure against HPP. This study aims to analyze the Effect of Alarm Usage on Awareness in Consuming Iron Supplements (Hemoglobin Levels) as a Prevention of HPP in the Working Area of the Tempurejo Community Health Center, Jember Regency. The research employs a one-group pre-post-test design (pre-experiment) with a cross-sectional approach involving 30 respondents through Accidental Sampling. Data collection includes coding, editing, tabulation, and subsequent manual and computer-based analysis using Paired T-Test. Among the 30 respondents, the awareness of taking iron supplements before using the alarm showed non-compliance in 22 respondents (73.3%) and compliance in only 8 respondents (26.7%), with all 30 (100%) pregnant women experiencing anemia, either moderate (73.3%) or mild (26.7%). After the alarm was used, the number of respondents aware and compliant in taking iron supplements increased to 27 respondents (90%), with only 3 respondents (10%) remaining non-compliant. This was also indicated by an increase in normal Hb levels in 18 respondents (60%). The P-value was 0.000 and a = 0.05, meaning r < a, indicating the influence of alarm usage on awareness in consuming iron supplements (hemoglobin levels) as a preventive measure against HPP. This is crucial for pregnant women to regularly consume iron supplements for safe and healthy childbirth. Midwives should consistently remind pregnant women to consume a minimum of 90 supplements during pregnancy and adapt to technological advancements by using gadgets familiar to the community

Is Research on Augmentative and Alternative Communication Intervention With Children With Autism Spectrum Disorder Reflected in the Clinical Practice of Speech-Language Pathologists?

Purpose: Individuals with autism spectrum disorder (ASD) who have little to no functional speech require augmentative and alternative communication (AAC). Research on AAC intervention with individuals with ASD consistently indicates that teaching requesting skills has been the primary focus, with limited guidance on teaching social communication skills, despite the critical impact of these skills on language development. Furthermore, receptive language is typically not considered when measuring responsiveness to intervention. Thus, it is unclear how individuals with severely affected receptive language respond to current intervention techniques and whether these techniques support generalization of skills. The purpose of this qualitative study was to determine if clinical practice follows the patterns observed in the research literature and to learn more about how intervention techniques are impacting individuals in this population. Method: Thirteen practicing speech-language pathologists (SLPs) were interviewed to describe AAC intervention with this population. An interpretive phenomenological approach was used to analyze qualitative data and identify unique themes. Results: Seven primary themes emerged related to intervention targets, requesting, social communication, motivation, receptive language, perceived efficacy and challenges, and communication partners. Subthemes for each primary theme are described. Conclusions: Clinical practice resembles the research literature, as SLPs emphasize requesting and report the use of evidence-based strategies. However, SLPs reported a lack of guidance for teaching social communication, limited generalization of skills, and lack of AAC uptake by communication partners. Finally, SLPs may not consider individual receptive language abilities when making clinical decisions related to AAC. This article indicates a robust need to identify more effective AAC intervention methods that promote social communication, meet the needs of children with severely affected receptive language, and include families to improve outcomes.

Slow Deep Breathing Intervention to Reduce Pain Intensity in Mild Head Injury Patients

Background: One of the most common factors that cause head injuries is traffic accidents. Minor head injury is a nervous system disorder caused by a violent blow or jolt to the head or body. As a result of this accident an individual can lose consciousness which is characterized by headaches and pain. Pain is a physiological problem. Interventions that can be used in overcoming pain are by providing slow deep breathing non pharmacological therapy.
 Purpose: This study was to obtain an overview of slow deep breathing therapy in patients with mild head injuries and reduce pain intensity.
 Methods: The writing used is descriptive method in the form of case studies through the nursing process approach which includes assessment, nursing diagnoses, planning, implementation and evaluation. The study was conducted at the BLUD RSU Banjar City on 27-31 May 2022. The participants in this study were the patient Mrs. S is 36 years old. Complains of pain in the back of the head. The process of assessing and establishing a diagnosis is focused on the main problem. Subjective and objective data become a reference for evaluation of nursing implementation on a regular basis.
 Result: Based on the assessment of the pain scale, it was found that the original scale decreased from 4 (1-10) to 1 (1-10). Using the Numeric Rating Scale (NRS) measurning instrument.
 Conclusion: The author found the effect after giving slow deep breathing intervention on reducing pain intensity in patients with mild head injury and getting effective results, as evidenced by a decrease in the intensity of the pain scale. From the case study, slow deep breathing intervention can be an alternative intervention for mild head injury patients so that complications from the disease do not occur.

The Effect of Benson's Relaxation on Pain in Patients Post Open Reduction Internal Fixation (orif) Extremity Fractures

The most common complaint felt by patients due to fractures and the main complaint of patients after surgery is pain. Pain that is felt continuously can result in clinical and psychological changes. Benson's relaxation can be an alternative intervention in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures to reduce pain by stimulating the pituitary gland to release endorphins and inhibit pain impulses from the cerebral cortex and thalamus. Benson Relaxation is safe and easy to do, has no risk of injury/side effects. The purpose of this study was to determine the effect of Benson relaxation on pain in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures in the Dahlia Room at Mardi Waluyo General Hospital, Blitar. The research design uses a quasi-experimental pre-post test design. The population was all post ORIF patients with extremity fractures in the Dahlia (surgical) room at Mardi Waluyo Blitar Hospital with a total of 35 patients. The sample was post ORIF extremity fracture patients in the Dahlia Room of Mardi Waluyo General Hospital Blitar with a total sample of 13 respondents in each group using the Consecutive Sampling technique. Pain measurement data uses a Numerical Rating Scale. Statistical test using independent t-test. The results showed that the mean decrease in pain score in the Benson relaxation intervention group was 1.10, while the mean decrease in pain score in the control group was 0.44 with a pvalue of 0.00 <��� 0.05. It was concluded that there was an effect of Benson relaxation on pain in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures. Benson relaxation is effective in reducing pain in patients with post open reduction internal fixation (ORIF) limb fractures. There needs to be a standard operating procedure regarding Benson's relaxation, so that later it can be implemented by all nurses.Keywords: Benson Relaxation, Pain, Fracture, Post ORIF

The Effect of Benson's Relaxation on Pain in Patients Post Open Reduction Internal Fixation (orif) Extremity Fractures

The most common complaint felt by patients due to fractures and the main complaint of patients after surgery is pain. Pain that is felt continuously can result in clinical and psychological changes. Benson's relaxation can be an alternative intervention in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures to reduce pain by stimulating the pituitary gland to release endorphins and inhibit pain impulses from the cerebral cortex and thalamus. Benson Relaxation is safe and easy to do, has no risk of injury/side effects. The purpose of this study was to determine the effect of Benson relaxation on pain in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures in the Dahlia Room at Mardi Waluyo General Hospital, Blitar. The research design uses a quasi-experimental pre-post test design. The population was all post ORIF patients with extremity fractures in the Dahlia (surgical) room at Mardi Waluyo Blitar Hospital with a total of 35 patients. The sample was post ORIF extremity fracture patients in the Dahlia Room of Mardi Waluyo General Hospital Blitar with a total sample of 13 respondents in each group using the Consecutive Sampling technique. Pain measurement data uses a Numerical Rating Scale. Statistical test using independent t-test. The results showed that the mean decrease in pain score in the Benson relaxation intervention group was 1.10, while the mean decrease in pain score in the control group was 0.44 with a pvalue of 0.00 <��� 0.05. It was concluded that there was an effect of Benson relaxation on pain in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures. Benson relaxation is effective in reducing pain in patients with post open reduction internal fixation (ORIF) limb fractures. There needs to be a standard operating procedure regarding Benson's relaxation, so that later it can be implemented by all nurses.Keywords: Benson Relaxation, Pain, Fracture, Post ORIF

Macrophage polarization in osteoarthritis progression: a promising therapeutic target

Osteoarthritis (OA) is one of the leading causes of pain and disability in the elderly. Synovitis, cartilage destruction and osteophyte formation histologically manifest OA. Unfortunately, there is currently no effective therapy to delay its progression and the underlying mechanisms of OA require further exploration. Macrophage is a main cellular component of joint synovium. It is highly plastic and can be stimulated to polarize to different phenotypes, namely, the pro-inflammatory phenotype (M1) and the anti-inflammatory/tissue-repairing phenotype (M2). Ample evidence has demonstrated the vital roles of macrophages in the progression of OA. Imbalanced M1/M2 ratio is significantly related to OA severity indicating macrophage polarization might be a promising therapeutic target for OA. In this review, we summarized the involvements of polarized macrophages in synovitis, cartilage degradation, osteophyte formation and OA-related chronic pain. Promising therapies targeting macrophage polarization including the intra-articular cell/derivates-based therapy and the alternative non-invasive intervention such as photobiomodulation therapy were reviewed as well.

Exploring the heterogeneity of obesity: A Public Health Perspective

Abstract Body Mass Index (BMI) has been traditionally used in the biomedical field as the main anthropometric measure to classify individuals in relation to their body weight status. High BMI levels are usually associated with an increased risk of adverse health outcomes. However, measures of obesity, including body mass index (BMI) and waist circumference (WC), do not fully capture the complexity of obesity-related health risks. In fact, obesity is a very complex condition with wide heterogeneity across individuals. The belief that weight loss is the best recommendation for all people with high BMI as the only path to health should be revisited. In fact, weight loss in some subjects does not necessarily translate in health improvements. Novel evidence support alternative approaches to weight loss in the promotion of health for high BMI individuals. This presentation will provide an overview of the complexity and heterogeneity of obesity, with a critical discussion about the current approaches used to define weight status as well as on alternative interventions to improve health independent of body weight loss.