Holistic Treatment Research Articles

Explainable El Niño predictability from climate mode interactions.

The El Niño-Southern Oscillation(ENSO) provides most of the global seasonal climate forecast skill1-3, yet, quantifying the sources of skilful predictions is a long-standing challenge4-7. Different sources of predictability affect ENSO evolution, leading to distinct global effects. Artificial intelligence forecasts offer promising advancements but linking their skill to specific physical processes is not yet possible8-10, limiting our understanding of the dynamics underpinning the advancements. Here we show that an extended nonlinear rechargeoscillator (XRO) model shows skilful ENSO forecasts at lead times up to 16-18 months, better than global climate models and comparable to the most skilful artificial intelligence forecasts. The XRO parsimoniously incorporates the core ENSO dynamics and ENSO's seasonally modulated interactions with other modes of variability in the global oceans. The intrinsic enhancement of ENSO's long-range forecast skill is traceable to the initial conditions of other climate modes by means of their memory and interactions with ENSO and is quantifiable in terms of these modes' contributions to ENSO amplitude. Reforecasts using the XRO trained on climate model output show that reduced biases in both model ENSO dynamics and in climate mode interactions can lead to more skilful ENSO forecasts. The XRO framework's holistic treatment of ENSO's global multi-timescale interactions highlights promising targets for improving ENSO simulations and forecasts.

"I feel [so alone] nothing" - emotional vulnerability and detachment as transdiagnostic key characteristics of patients with chronic tinnitus: a schema mode model approach.

Gold-standard approaches for chronic tinnitus involve hearing amplification measures and psychological therapy, where applicable. Whilst schema therapy is accumulating evidence as a transdiagnostically useful treatment framework, its applicability for patients with chronic tinnitus has not yet been examined. The present study (a) explores latent dimensions of psychological distress in a sample of chronic tinnitus patients, and (b) examines whether the schema mode model might explain these dimensions - thus constituting a potentially helpful conceptualization and treatment framework. N = 696 patients with chronic tinnitus completed the Tinnitus Questionnaire, Tinnitus Handicap Inventory, Hospital Anxiety and Depression Scale, Perceived Stress Questionnaire and ICD-10 Symptom Rating. As criterion, patients further completed the Schema Mode Inventory (SMI-r) - which assesses psychological constructs linked to negative self-beliefs ("parent modes"), primary emotions resulting from unmet psychological needs ("child modes"), and secondary emotional or behavioral attempts to reinstate or maintain psychological equilibrium ("coping modes"). A varimax-rotated principal axis factor analysis grouped the primary item pool. Factor scale scores were then correlated with the SMI-r. A three-factor solution explained 37.4% of variance and represented 78% of the included items. Following item content examination, the factors represented (1) General emotional distress, (2) Tinnitus-attributed emotional distress, and (3) Socio-audiological impairment. Factors 1|2 correlated highly (r= 0.70), Factors 2|3 moderately (r = 0.62). Linked to the schema mode model, Factor 1 correlated highly with the "vulnerable child" (r = 0.78), and moderately with the "parent", "angry child", and "detached protector" modes (0.53 < r < 0.65). Factor 2 correlated moderately with the "vulnerable child" (r = 0.53). Factor 3 was largely uncorrelated with SMI-r scores - although a low correlation with the "detached protector" warrants further examination. "General" and "tinnitus-attributed" emotional distress correlate highly - warranting holistic (not symptom-specific) psychological case conceptualization and treatment planning. Viewed from a schema mode perspective, the "vulnerable child" explains substantial variance across both dimensions. Consequently, autobiographically anchored, unmet emotional needs and emotional detachment constitute key treatment targets. Social-audiological impairment should be multimodally conceptualised and treated with hearing aids and psychological support measures, as applicable.

Evaluation of the impact of a 20-week exercise referral scheme on Mauritian adults diagnosed with non-communicable diseases

AbstractThe escalating prevalence of non-communicable diseases (NCD) presents a concern in Mauritius. These diseases, caused by many factors, reflect the social, economic and environmental conditions within which people live and work. Type 2 diabetes mellitus, hypertension and obesity are the most prevalent among Mauritian adults. Within the framework of a comprehensive systems approach aiming at addressing the social determinants of health, there is a need for customised strategies for both management and prevention of non-communicable diseases. One such example is exercise referral. Exercise referral schemes (ERS) represent an emerging tool for helping people become more physically active and healthier. Evidence of their effectiveness is equivocal and lacks contextual insight into their value in a Mauritian context. Hence, this study serves to bridge this gap. We report the outcomes of a 20-week ERS. Two hundred sixty consenting adults recruited from Area Health Centres (AHC) and Mediclinic’s around Mauritius were assigned to one of two groups: intervention group (ERS + guidance and support by exercise referral consultant) or control group (exercise ‘advice’ from a general practitioner). Body mass index (BMI), grip strength, waist circumference, fasting blood sugar (FBS), HbA1c, lipid profile and blood pressure were measured at week 0, 10 and 20. This quasi-experimental longitudinal study successfully demonstrated improvements in parameters associated with risk factors for coronary heart disease, particularly among women in the intervention group. Significant reductions in weight, waist circumference, FBS and BMI at week 10 and 20 were noted. A less pronounced decline in parameters was observed in men, except for waist circumference, which reached near significance (p = 0.076). Using female participants as a primary focal point, this study supports the notion of exercise referral as part of a holistic treatment plan to control NCDs. We advocate future ERS initiatives prioritise a patient-centred comprehensive approach in design and implementation to ensure successful outcomes.

The Nursing Role in the Management of Medication Overuse Headache: Realities and Prospects.

This review aims to analyze the current literature to identify articles related to the role of nurses and, in general, the nursing management of patients suffering from medication overuse headache (MOH), a globally spread disease. We specifically argue for non-pharmacological approaches to pain management, such as multidisciplinary team approaches, holistic treatment, cognitive behavioral therapy and exercise. For this review, we investigated international scientific databases, including PubMed, CINAHL, Scopus and Embase, in the period between 2000 and 2024. We observed a wealth of scientific articles related to MOH, but a poverty of articles relating to the nursing management of headache. The research included the presence of academic-level training for nurses, whereas there are few institutions that train competent professionals in both pharmacological and non-pharmacological management of MOH patients. Nursing assessment and assistance strategies are indicated to plan tailored treatment paths related to the specific needs of these patients.

Chinese expert consensus on minimal residual disease detection in multiple myeloma based on bone marrow samples (2024)

Multiple myeloma (MM) is the second most common hematologic malignant tumor. Standard holistic treatment model and new drug-based regimens have greatly improved the survival of patients with MM; however, minimal residual disease (MRD) causes relapse in most patients. Therefore, combining MRD testing on the basis of traditional serological efficacy evaluation is necessary to achieve a more accurate assessment of the patient's disease status. At present, next-generation flow cytometry (NGF) and next-generation sequencing (NGS) are the mainstream technologies for detecting MRD based on bone marrow samples. To standardize and normalize MRD detection, the expert group discussed and formulated Chinese expert consensus on the application of NGF and NGS technology for bone marrow MRD detection in patients with MM.

Status and influencing factors of frailty in hospitalized patients with chronic heart failure: A cross-sectional study.

To investigate the frailty status of inpatients with chronic heart failure (CHF) and analyse its influencing factors, so as to provide evidence for the early identification of high-risk groups and frailty management. Early identification of frailty can guide the development and implementation of holistic and individualized treatment plans. However, at present, the frailty of patients with CHF has not attracted enough attention. A cross-sectional study. From June 2022 to June 2023, a convenience sample of 256 participants were recruited at a hospital in China. Multivariate logistic regression analysis was used to explore the influencing factors of frailty in patients with CHF, and an ROC curve was drawn to determine the cut-off values for each influencing factor. STROBE checklist guides the reporting of the manuscript. A total of 270 questionnaires were sent out during the survey, and 256 valid questionnaires were ultimately recovered, resulting in an effective recovery rate of 94.8%. The incidence of frailty in hospitalized patients with CHF was 68.75%. Multivariable logistic regression analysis showed that age, self-care ability, nutritional risk, Kinesiophobia and NT-proBNP were risk factors for frailty, while albumin and LVEF were protective factors. Multidimensional frailty was prevalent in hospitalized patients with CHF. Medical staff should take measures as early as possible from the aspects of exercise, nutrition, psychology and disease to delay the occurrence and development of frailty and reduce the occurrence of clinical adverse events caused by frailty. This study emphasizes the importance of the early identification of multidimensional frailty and measures can be taken to delay the occurrence and development of frailty through exercise, nutrition, psychology and disease treatment. Patients contributed through sharing their information required for the case report form and filling out questionnaires.

Sustainable supply chains – Designing a requisite holistic model

AbstractOur study explored the relationships between supply chain (SC) members and their local and global stakeholders in achieving sustainability goals based on requisite holistic analysis and system dynamics modeling, which goes beyond the previous attempts to improve SC sustainability. In this research, we first developed a model that addresses the basic holistic treatment of SC sustainability; in a second model of sustainable SC (SSC), we then considered requisite holistic interactions among its stakeholders. We used the theory‐based viable system model to diagnose the proposed holistic model of SSC. The results show that especially the low‐tier SC members require supporting frameworks to develop and maintain the capacity for sustainable interactions with nature and society. These supportive frameworks should be provided by the regulatory bodies, society, and nature representatives to surpass the limited SC profit‐oriented incentives and structures. The implications of the proposed models are aimed at developing supportive SC sustainable policies and improving the capacities of SC members to coexist with local social and natural environments. Regulators, society, and the natural environment representatives can apply the proposed models to establish new policies for sustainable interactions between SC members and other societal stakeholders.

Nabilone as Part of the Holistic Treatment in Early Onset Alzheimer's Dementia: A Case Study

Nabilone as Part of the Holistic Treatment in Early Onset Alzheimer's Dementia: A Case Study

Environmental factors and fibromyalgia syndrome: a narrative review.

This in-depth review of fibromyalgia (FM), which is a complex condition characterised by chronic pain, fatigue, sleep disturbances, and a spectrum of diagnostically and therapeutically challenging symptoms, underlines the need for a comprehensive and integrated approach that also takes into account the psychological factors affecting patient responses. We focus on the substantial impact that environmental factors (climatic variations, air pollution, electromagnetic field exposure, physical and emotional traumas, dietary patterns, and infections) have on the manifestation and intensity of symptoms, and advocate personalised, holistic treatment of patients' psychological and environmental sensitivities by suggesting the benefits of tailored dietary and stress management. We also call for further research into the complex interplay of environmental, biological and psychological factors influencing FM in order to develop more effective individualised treatments that are capable of enhancing patient care and outcomes.

POSSIBILITIES OF ART THERAPY IN WORKING WITH A CHILD WITH ATTENTION DEFICIT AND HYPERACTIVITY DISORDER

Art therapy offers promising avenues for therapeutic intervention in children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). This paper explores the potentials and benefits of utilizing art therapy techniques as part of a holistic treatment approach for children with ADHD. Through a review of existing literature and case studies, the effectiveness of art therapyin improving attention span, emotional regulation, and social skills is examined. Practical considerations for implementing art therapy in clinical and educational settings are discussed, including the role of the therapist, suitable techniques, and potential challenges. The paper concludes with recommendations for future research directions and underscores the importance of integrating art therapy into multidisciplinary ADHD treatment plans.

The integration of big data analytics in examining the effects of mental illness screening on mortality and burden of illness among patients with cancer.

e23083 Background: Cancer patients receiving cancer care in US hospitals undergo notable psychological suffering, characterized by manifestations of multiple psychiatric disorders and a further doubling of healthcare spending each year. The psychological burden of illness (BOI) frequently accompanies the physical obstacles of the disease, hence increasing the intricacy of cancer care. Analysis was conducted on cancer patients admitted to hospitals in the US in 2017 for the treatment of prostate (PC), cancers of the lip, oral cavity, and pharynx (CLOP), lung (LC), and leukemia. The aim was to understand better and compare the differences in mental illness screening (MIS) and its impact on these patients. Methods: We employed generalized linear models to examine the association between MIS and outcomes––BOI, such as cost, total charge, length of stay (LOS), and in-hospital mortality after controlling for clinical and patient variables. Results: Among 224,540 LC, 178,470 patients underwent MIS. This was 151,285 vs. 58,125 among PC; among CLOP, 35,770 vs. 18,495; for leukemia, this was 53,019 vs.18,759. In the adjusted analysis, MIS among the LC cohort was associated with lower length of stay—(coefficient, 0.96, 95% CI, 0.92-0.98), lower total charges, (0.94, 0.92-0.96), and lower mortality (aOR, 0.77, 95% CI, 0.73-0.82). In the LC cohort, when compared to Whites, Blacks (1.11, 1.05-1.17) and Others (Native Americans, Asians, and Others (1.1, 1.02-1.20) had longer LOS. Compared to high-income neighborhoods, low-income neighborhoods showed higher LOS (1.09, 1.03-1.153), and compared to "Central" counties of metro areas of ≥ 1 million population, Not metropolitan or micropolitan counties had a lower LOS (0.86, 0.80-0.92). Private insurance holders had lower total charges than Medicare beneficiaries (0.84, 0.81-0.88). Females, when compared to males, had a lower total charge (0.96, 0.94-0.98), and when compared to Whites, Hispanics (1.35, 1.25-1.45), and Others (1.28, 1.19-1.37) had a higher total-charges. And compared to Whites, Others had a higher in-hospital mortality (aOR, 1.16, 95% CI, 1.03-1.31). Further, the analysis was stratified into surgical and non-surgical cohorts in the LC cohort. Compared to LC, none of the other solid or liquid cancer cohorts, MIS showed no beneficial association with BOI or mortality. Conclusions: The LC cohort showed a positive association between MIS and BOI and in-hospital mortality. To provide holistic treatment for all cancer patients, including MIS as a standard practice is advantageous. This study can offer helpful information for future research on the impacts and implementation of routine mental illness screening among patients with cancer.

Multifactorial Nature of Fatigue in North Indian Rheumatoid Arthritis Patients.

Fatigue is a common, disabling, and poorly understood aspect of Rheumatoid arthritis (RA) treatment. Better understanding of fatigue is required for holistic treatment of RA. The present study was conducted to evaluate factors (disease activity, pain, sleep quality, and vitamin D) contributing to fatigue in RA. A cross-sectional study was conducted on 204 patients of RA. Fatigue was measured using CFQ-11 scale, pain and sleep impairment were assessed on visual analogue scale, disease activity by DAS 28 ESR, and vitamin D levels by enzyme chemiluminescence immunoassay. Univariate and multivariate binary logistic regression analyses were done to study association. Mean age of study subjects was 51±11.63 years with majority (89.7%) being females and mean duration of RA was 8.54 years. Prevalence of fatigue was 66.2% (CFQ-11 score >4/11). Deficiency of vitamin D was found in 12.3% subjects. Mean sleep impairment and pain score on VAS were 32.60±21.53 and 26.37±21.65 respectively. Univariate analysis revealed that CFQ-11 fatigue score was independently associated with disease activity, pain, sleep, and vitamin D deficiency. Further Multivariate binary logistic regression analysis showed strongest association of vitamin D deficiency with fatigue (OR of 6.38 with 95% confidence interval of 1.58, 25.71). Disease activity (OR - 1.714, 95% CI- 1.14, 2.55) and sleep impairment (OR - 1.038, 95% CI- 1.005, 1.071) have also been found to be significantly associated with fatigue. Fatigue in RA is multifactorial, and it is mediated by disease-related factors (disease activity, sleep impairment) and non-disease-related factors (vitamin D deficiency).

Intersecting Realities: Body Dysmorphic Disorder and Substance Abuse in Women – A Holistic Treatment Approach

The intersection of Body Dysmorphic Disorder (BDD) and substance abuse in women presents a clinical tableau rich with complexity and challenges. This review explores the intricate relationship between BDD—a disorder characterized by an obsessive preoccupation with perceived physical flaws—and substance abuse, where women may turn to drugs or alcohol as a maladaptive coping mechanism to alleviate the distress associated with BDD. A literature-focused methodology was employed in the study. In this context, databases such as PubMed, DergiPark, WoS, and ScienceDirect were utilized to explore the relevant literature. The analysis delves into the unique manifestation of BDD in women, influenced by societal, cultural, and psychological factors that often impose stringent beauty standards and exacerbate body image concerns. Patterns of substance abuse among women are discussed, highlighting the rapid progression from usage to dependency, known as telescoping, and the impact of societal stigma that compounds the struggles of women with addiction. Risk factors for both conditions are examined, with a focus on shared contributors such as trauma, mental health comorbidities, and societal pressures. Current treatment approaches are reviewed, advocating for an integrated model that combines psychotherapy, pharmacotherapy, and holistic or alternative interventions. The review emphasizes the importance of Cognitive Behavioral Therapy for BDD and Medication-Assisted Treatment for substance abuse, as well as the inclusion of mindfulness, meditation, and gender- The conclusion reinforces the imperative of a cohesive treatment strategy, underscoring the need for gender-specific, trauma-informed care that understands and addresses the complex interplay between BDD and substance abuse in women. This comprehensive approach promises more effective support and a hopeful pathway to recovery for women entangled in the web of these co-occurring disorders.

The impact of psychological factors on in vitro fertilization (IVF) outcomes: a comprehensive review

This comprehensive review explores the significant impact of psychological factors on the outcomes of In Vitro Fertilization (IVF) treatments. Despite the advancements in medical technology enhancing the physical success rates of IVF procedures, the psychological well-being of individuals undergoing these treatments plays a crucial role in their overall effectiveness. This paper delves into the various psychological stressors faced by couples, including anxiety, depression, and stress, and their direct correlation with IVF treatment outcomes. By examining a wide range of studies, this review highlights the importance of psychological interventions and support systems in improving the success rates of IVF treatments. Furthermore, it discusses the current gaps in the literature and suggests directions for future research. The findings of this review underscore the necessity of integrating psychological care into fertility treatments to address the mental health needs of individuals undergoing IVF, thereby enhancing their quality of life and increasing the likelihood of successful outcomes. Through a detailed analysis of existing research and methodologies, this paper aims to contribute to the understanding of the psychosocial aspects of IVF and encourage the development of more holistic treatment approaches.

#2579 Chronic pain in chronic kidney disease: differences between stages and replacement therapies

Abstract Background and Aims Pain is one of the most common symptoms among patients with End-Stage Renal Disease (ESRD), often going unrecognized or inadequately managed in people undertaking hemodialysis. Over 50% of people on hemodialysis experience pain, with 75% of them being ineffectively treated due to healthcare professionals' lack of awareness of this symptom. Managing pain in this population is a complex and challenging task for healthcare professionals. Variables related to chronic pain can influence the patient's response to pain. There is a gap in the literature on this topic, as it has not been studied whether patients with ESRD undergoing hemodialysis exhibit characteristics of chronic pain that may be influencing their pain response. The objective of this study is to evaluate the presence and characteristics of variables related to chronic pain in hemodialysis patients with ESRD to assess whether including the management of chronic pain is relevant in the holistic treatment of these patients. Method This is a cross-sectional observational study that is currently ongoing. Participants included subjects that were willing to participate, with chronic kidney disease (CKD) stages 3 and 4, CKD stage 5 in hemodialysis and transplanted patients. Several questionnaires were recorded to report different aspects related to chronic pain. The Kruskal-Wallis test was used to assess differences between groups. Results Preliminary results on 26 subjects are shown in Table 1. No significant differences were found between groups. Transplanted and hemodialysis patients (in the hospital) experience more sleep disturbances and more pain catastrophizing. Transplanted and hemodialysis patients (in the hospital) present higher belief in their abilities to handle stressful situations in daily life, but they also suffer more headaches. Hemodialysis patients (hospital and home) present higher levels of anxiety and depression. Hemodialysis patients (at home) and transplanted patients exhibit higher levels of stress conditions. Finally, patients undergoing hemodialysis (in the hospital) and CKD stages 3 and 4 present higher levels of chronic pain. Conclusion A bigger sample is needed. However, based on the data, it seems that patients with CKD exhibit characteristics of chronic pain that should be addressed by healthcare professionals.

Human Resource Management in the Healthcare Industry: An Analysis of the Connection Between Patient Care and Buddhist Practice

Since its inception, Buddhism and medicine have been closely associated, with each having a unique focus on reducing and averting human suffering. Despite the well-established connection between Buddhism and healthcare, there is still a dearth of Buddhist literature that can help healthcare professionals in both their personal and professional lives. Examples of the Buddha as a doctor, the Dharma as a treatment, and laypeople in general as patients can all be found in the sutras. Illness is strongly correlated with an individual's social, cultural, environmental, mental, and physical well-being. It is insufficient to approach medicine by focusing only on symptom elimination; It is crucial to address the psychosocial components of sickness as well as its psychological causes and treatments. All three components must be in harmony for holistic treatment to be provided, and Buddhist philosophy offers medical professionals insight. The medical ethical values of non-malice, compassion, justice, and autonomy are inevitably followed by health care practitioners who get ethical guidance from Buddhist medicine.

A Clinical Focus on Shared Decision Making in Clinical Practice When Providing Dysarthria and Dysphagia Services to Individuals With Amyotrophic Lateral Sclerosis

Purpose: Traditional health care decision-making models center on clinicians making decisions for patients/caregivers based on the best available research evidence. However, this diminishes patient/caregiver involvement in their care and hinders the ability to align care plans with patient values and preferences. Shared decision making is a potentially beneficial process to implement with individuals with amyotrophic lateral sclerosis (ALS) to provide more holistic, patient-centered dysarthria and dysphagia treatment. Shared decision making promotes active involvement by patients/caregivers by informing them of potential treatment options, understanding their values and preferences, and aligning their desires with treatment options to determine the most optimal individualized care plan. Conclusions: The benefits and barriers to incorporating shared decision making within ALS multidisciplinary clinics are discussed in this clinical focus article. Furthermore, a fictional case study example of how to apply shared decision making to dysarthria and dysphagia management of individuals with ALS is provided.

Knowledge and attitudes of oral health care workers on HIV-associated oral lesions: A study at PHC facilities in Gauteng

Oral health care workers (OHCWs) are critical in providing holistic treatment and preventing the spread of HIV disease. They are uniquely placed to identify, diagnose, manage and treat HIV-related oral lesions.Aim To determine oral health clinicians’ knowledge and attitudes towards HIV-associated oral lesions. Methodology A descriptive cross-sectional survey was conducted at Gauteng’s primary health care (PHC) facilities. Data collection targeted the three categories of OHCWs – dentists, dental therapists and oral hygienists. ResultsThe response rate was 67.5% (n=110), majority of the participants, 76.4% (n=84), were female. Nearly all participants, 91.8% (n=100), agreed that oral lesions are common in people living with HIV and AIDS (PLWHA) and that early diagnosis of HIV/treatment increases PLHIV’s life expectancy. More than three-quarters (80%) reported that they had no problem treating patients diagnosed with HIV. Almost a third, 36.4% (n=40), listed necrotising periodontal conditions and oral candidiasis 34.5% (n=38) as the most common oral manifestations. Most respondents correctly identified oral candidiasis (92.7%), Kaposi sarcoma (84.5%) and necrotising ulcerative periodontal conditions (80.9%).ConclusionAlthough OHCWs had sound knowledge of oral manifestations of HIV, training programmes must be prioritised for knowledge transfer. Dental facilities can be used as a health-promoting platform and a viable location for provider-initiated testing and counselling (PICT) and client-initiated counselling and testing (CICT), also known as voluntary counselling and testing (VCT). The use of HIV rapid testing kits is an option to be explored in the dental facility by OHCWs.

An osteopathic orientation to interprofessional education.

The osteopathic tenets may serve as a useful guideline for an interprofessional program. There is an alignment between the osteopathic tenets and the concept of interprofessional education (IPE). IPE occurs when students from two or more professions work with each other to collaborate or improve healthcare outcomes. Holistic treatment is fundamental in both instances, and the interrelatedness of structure and function requires acknowledgment of all healthcare professionals' roles in treating a patient. IPE allows students to gain a better understanding of their own professional roles and the roles of their fellow healthcare providers in treating patients more effectively. The objectives of this analysis are to evaluate the ability of an interprofessional summer workshop/lecture utilizing an osteopathic focus to educate students from different healthcare colleges about the interconnectedness of the systems of the human body and how working with a team-based approach will ultimately benefit their collective patients. A secondary objective was to determine the students' perceptions before and after the lecture/workshop to see if there were any perceived differences among students in different healthcare professions at either time. This was a retrospective data analysis conducted on pretest/posttest surveys completed by 73 incoming students from six different healthcare colleges participating in the Summer Preparedness and Readiness Course (SPaRC), held annually at Western University of Health Sciences (WUHS) in Pomona, California. Analysis was conducted on responses collected during the SPaRC programs of 2013, 2016, and 2019. Participants were given surveys containing five questions scored on a five-point Likert scale. The surveys were given before and after an integrated lecture/hands-on workshop presented at SPaRC that reviewed multiple studies showing the utility of connecting the healthcare professions to best treat a patient. A total of 73 students responded to both the prelecture and postlecture surveys. When the number of positive scores were totaled from students from all colleges, there was an increase in positive responses from 190 (52.2 %) in prelecture surveys when compared to 336 (92.3 %) in postlecture surveys. A Wilcoxon signed-rank test suggested that the lecture workshop elicited a significant improvement in scores from prelecture to postlecture for all students (Z=-6.976, p=0.000). Median scores improved from 3.60 at baseline to 4.40 after the lecture/workshop. Secondary analysis conducted utilizing Kruskal-Wallis H to examine the differences between the responses of the different colleges prelecture and postlecture showed no significant differences prelecture (H [6]=7.58, p=0.271) and a significant difference between postlecture answers (H [6]=14.04, p=0.029). A series of post hoc independent Kruskal-Wallis H analyses was conducted to identify where differences were, and the only identifiable difference after Bonferroni corrections was between students from the Doctor of Osteopathic Medicine college and the Physician Assistant's college after the lecture/survey (p=0.041). An interprofessional program with the osteopathic principles of focusing on body unity and relatedness of structure and function may serve as a helpful tool for uniting healthcare professionals in their ultimate goal of better serving their patients.

ECAP-controlled closed-loop versus open-loop SCS for the treatment of chronic pain: 36-month results of the EVOKE blinded randomized clinical trial

IntroductionThe evidence for spinal cord stimulation (SCS) has been criticized for the absence of blinded, parallel randomized controlled trials (RCTs) and limited evaluations of the long-term effects of SCS in...