Relaxation Techniques Research Articles

The Impact of Antidepressants on COVID-19 and Post-Acute COVID-19 Syndrome: A Scoping-Review Update

On May 20, 2024, this systematic scoping review in PUBMED identified 1016 articles related to AD and COVID-19, Long COVID and SARS-COV-2. These included 10 retrospective "large scale" studies (> 20000 chart reviews), 8 prospective clinical trials (plus 4 regarding Long COVID), 11 placebo-controlled randomized (RCT) (plus 2 regarding Long COVID) and 15 meta-analyses. COVID-19: Retrospective studies with cohorts taking AD primarily for psychiatric comorbidities or chronic pain conditions directly prior to SARS-COV-2 infection described that this substance class (most studied: Selective Serotonin Re-Uptake Inhibitors (SSRI) and Selective Serotonin Noradrenaline Re-Uptake Inhibitors (SSNRI)) were associated with (i) significantly fewer SARS-COV-2 infections and (ii) a milder course of COVID-19 ("COVID-19 protection"). Ten of the 11 RCTs found regarding COVID-19 tested fluvoxamine, as this old AD appeared suitable as a prophylactic agent against severe COVID-19, taking into account its in vitro potency against the progression of intracellular sepsis cascades. Therefore, most (12 out of 15) meta-analyses also referred to fluvoxamine. They found (iii) a significant (40-70% reduction) in mortality, intubation and hospitalization rates when fluvoxamine was used as an add-on to standard therapy for mild to moderate COVID-19. When this AD was used in the early stages of the disease, it was more successful than when it was given later in advanced, severe COVID-19 (e.g. severe pneumonia, final sepsis stages). A dose dependency was observed: 2x50 mg fluvoxamine over 15 days was less effective than 2x100 or even 3x100 mg with an adverse event profile still at the placebo level. Direct comparisons with drugs approved for COVID-19 do not yet exist. A first indirect meta-analytical comparison showed an advantage of paxlovid or molnupiravir versus fluvoxamine against the development of severe COVID-19: risk reduction of 95% (I2 = N/A, but only one study) or 78% (I2=0) versus 5+-5% (I2=48). However, an add-on of fluvoxamine was still significantly more efficacious than symptom-oriented standard therapy alone. Long COVID: A common Long COVID phenotype with dominant anxiety and depression symptoms, which responds to AD, relaxation therapy and/or psychotherapy, has now been identified. Casuistics report positive effects of AD on fatigue, cognitive and autonomic dysfunctions. A first large prospective open-label RCT has just shown significantly more favourable courses, less viral load and less pro-inflammatory cytokines in the treatment of mild to moderate COVID-19 with fluvoxamine versus standard treatment, also with regard to the subsequent development of neuropsychiatric and pulmonary Long COVID or fatigue. Overall, there is promising evidence of a preventive effect of AD (especially fluvoxamine) against progression to severe COVID-19 and against the development of Long COVID. It is likely, that the entire AD substance class could be effective here. This assumption is based on the results of retrospective large scale studies, but awaits verification by better controlled studies. The potential effectiveness/efficacy (currently low and moderate confidence of the evidence for the entire substance class and specifically fluvoxamine, respectively) of fluvoxamine as an add-on against COVID-19 and possibly also directly against Long COVID could stimulate similar projects in other infectious diseases that also have the potential to pose a lasting threat to the health of those affected. We consider the evidence to date to be sufficient to be able to emphasize a possible positive effect of these substances in the psychoeducation of patients with COVID-19 or Long COVID who are already receiving AD for other conditions - especially also against the symptoms associated with the viral disease or its consequences. In regions where neither vaccines nor antiviral agents currently approved for the prevention or treatment of COVID-19 are available, AD and in particular fluvoxamine would be a cost-effective alternative to protect against a severe course, even if this AD appears to have a smaller effect against COVID-19 than the currently approved antiviral agents, but with presumably better tolerability. A direct comparative clinical trial with approved antiviral agents is still pending and should be positive to further open the door for a guideline-based recommendation of fluvoxamine (or perhaps even AD) for COVID-19 or its aftermath.

The Efficacy of Balance Training to Reduce Fall Risk in Older Adults

The study was carried out to find out the role of Occupational Therapy intervention in quality of life of women suffering from premenstrual syndrome among different age groups. Women with premenstrual syndrome in two age groups (18-30) years and (31-45) years were selected using systematic random sampling method. Both age groups were assessed for premenstrual syndrome using Premenstrual syndrome Questionnaire. Quality of life were assessed in two age groups (18-30) years and (31- 45) years using Short Form-36 (SF-36) health survey. To study the impact of OT intervention on quality of life (QOL) of both age groups with PMS, OT intervention Performa was explained to both age groups with practical implementation. As this study would be pre and post study design , so both age groups again will be assessed on PMS Questionnaire and Short Form-36 (SF-36) health survey after implementation of OT intervention for the fulfillment of all objectives. The data gathered from these assessment measures were then be subjected to statistical analysis to find whether there are differences in the quality of life of both age groups women suffering from Premenstrual syndrome after implementation of OT intervention. As Occupational Therapy intervention has shown significant results towards diminishing PMS symptoms of females in both groups. It was concluded that Occupational Therapy Intervention plays an important role in the improvement for the condition in PMS among females. Keywords: Pre-Menstrual Syndrome, Quality of life, Occupational Therapy, Relaxation Therapy, Females.

A study to assess the knowledge regarding Jacobson Progressive Muscle Relaxation Technique among undergraduate nursing students in a Sharda University, Greater Noida

A study to assess the knowledge regarding Jacobson Progressive Muscle Relaxation Technique among undergraduate nursing students in a Sharda University, Greater Noida

THE RELATIONSHIP OF MOTHER'S EDUCATION, JOB, AGE AND EDUCATION TO BABY MASSAGE

Baby massage is a relaxation technique performed on babies and toddlers that has many benefits. Infant massage is great to help increase the baby's immune system, help relaxation, make it easier to sleep and help control fussiness and breathing. This study was conducted with the aim of knowing the relationship between mother's education, occupation, age and knowledge of infant massage. This study used quantitative research methods with a cross sectional research design. The study population consisted of 85 mothers and babies aged 1-12 months. The sampling method used the overall sampling method. The variables studied were presented in the form of frequency distribution tables, and tested using variance analysis and multiplication using a questionnaire tool. This research was conducted by TPMB Ririn Sevda Korini, SKM, S.Keb Tanjung Agung in July 2023. Data analysis was performed using Chi-square, univariate and bivariate statistical tests. Based on the results of univariate analysis, 40 (47.1%) respondents were well informed, out of 85 respondents who practiced baby massage, 56 (65%) respondents were well informed, 50 (58.8%) respondents were working, 48 (56.5%) respondents were old, and 40 (47%) respondents were highly educated. The results of bivariate analysis showed that there was a relationship between cognition and infant massage (p-value 0.023), between maternal employment and infant massage (p-value 0.033), age of mother and child massaged (p-value 0.02)3, value (p 0.041). There is a relationship between mother's education and infant massage (p-value 0.007).

Asthma and allergic rhinitis connections with psychotherapy

There is a close relationship between emotional tensions and respiratory function, which makes it likely that many diseases of this apparatus have aetiology or are compromised by psychogenic factors, which occurs, for example, in allergic diseases such as rhinitis and asthma, as well as in certain inflammatory diseases. Asthma is diagnosed by the sensation of oppression in the chest, dyspnea that can evolve to cyanosis, discrepancy between the combined action of the diaphragm and the levator muscles of the ribs, which remove air through the narrowed bronchioles, and the weak exhalation force, which depends on the elasticity of the lungs, making breathing difficult and leading to emphysema during paroxysm. In the initial stages there may be simple cough; later, the expectoration of a thick, foamy phlegm begins. The temperature is normal and the pulse is tachycardic. Auscultation reveals crackling rales and wheezing. Asthmatics can improve with the various types of psychotherapy: supportive, cognitive behavioral techniques, counseling, relaxation techniques and mainly psychoanalytic therapy, either individual or in group. In conclusion, the treatment of asthma and allergic rhinitis, should be done by two specialists, the allergist and the psychotherapist.

Patients' Experiences During the Long Journey Before Initiating Migraine Prevention with a Calcitonin Gene-Related Peptide (CGRP) Monoclonal Antibody (mAb).

Migraine is under-diagnosed and under-treated. Many people with migraine do not seek medical care, and those who do may initially receive a different diagnosis and/or be dissatisfied with provided care on their journey before treatment with a CGRP-mAb (calcitonin-gene-related-peptide monoclonal antibody). This is a cross-sectional, self-reported, online survey of subjects in Lilly's Emgality® Patient Support Program in 2022. Questionnaires collected insights into subjects' prior experiences with migraine and interactions with healthcare professionals before receiving CGRP-mAbs. Of the 250 participants with episodic and 250 with chronic migraine, 90% were female and white with a mean age of 26.2years (±11.9) at diagnosis and 40.6 (±12.0) years at survey enrollment. Many participants (71%) suspected they had migraine before diagnosis, with 31% reluctant to seek help. Of these, approximately one-third were unaware of treatment, did not think that a physician could do anything more for migraine, would not take them seriously, or were reluctant due to a previous unhelpful experience. Participants mainly received information from friends/family (47%) or the internet (28%). Participants initially sought treatment due to an increase in migraine frequency (77%), attacks interfering with work or school (75%), or increased pain intensity (74%). Subjects saw a mean of 4.1 (±4.3) healthcare providers before migraine diagnosis, and 20% of participants previously received a different diagnosis. Participants reported migraine causes included stress/anxiety/depression (42%), hormonal changes (30%), nutrition (20%), and weather (16%). Acute treatment of migraine included prescription (82%) and over-the-counter (50%) medications, changes in nutrition (62%), adjusting fluid intake (56%), and relaxation techniques (55%). Preventive medications included anticonvulsants (61%), antidepressants (44%), blood pressure-lowering medications (43%), and botulinum toxin A injections (17%). Most discontinuations were due to lack of efficacy or side effects. People with migraine describe reluctance in seeking health care, and misunderstandings seem common especially in the beginning of their migraine journey. Graphical abstract available for this article.

Impacts of Small SBA-15 Mesopores on Translation and Rotational Diffusion of Benzyl Alcohol.

Small SBA-15 pores can enhance the catalytic activity of gold catalysts in the selective oxidation of benzyl alcohol reaction. The goal of this work is to probe the impact of SBA-15 pores on the translational and rotational diffusion of the reactive species (e.g., benzyl alcohol). Herein, we demonstrate the use of nuclear magnetic resonance-based diffusion-ordered spectroscopy (DOSY) and T1 relaxation techniques to measure the translational and rotational diffusion coefficients of liquid benzyl alcohol molecules in three distinct environments: bulk, pore, and near-surface. The DOSY and T1 relaxation techniques render the routine diffusion measurements for liquid molecules confined in small pores possible. Furthermore, we measure the translational and rotational diffusion coefficients of benzyl alcohol molecules in the bulk, pore, and near-surface environments at varying temperatures. These measurements are then correlated via the Arrhenius equation to determine the activation energy associated with their translational (Et) and rotational (Er) diffusion. A higher activation energy suggests a more difficult diffusion process, while a lower activation energy implies a facile diffusion process. Our findings demonstrate that the ranking of Et follows the order of bulk (difficult) > near-surface > pore (easy), whereas the ranking of Er follows the order of pore (difficult) > bulk > near-surface (easy). This result suggests that the small SBA-15 pores can facilitate the translational diffusion but hinder the rotational diffusion of benzyl alcohol molecules.

A relaxation‐based Voronoi diagram approach for equitable resource distribution

AbstractThis paper introduces a methodology designed to reduce cost, improve demand coverage, and ensure equitable vaccine distribution during the initial stages of the vaccination campaign when demand significantly exceeds supply. We formulate an enhanced maximum covering problem as a mixed integer linear program, aiming to minimize the total vaccine distribution cost while maximizing the allocation of vaccines to population blocks under equity constraints. Block‐level census data are employed to define demand locations, identifying gender, age, and racial groups within each block using population data. A Lagrangian relaxation technique integrated with a modified Voronoi diagram is proposed to solve the location–allocation problem efficiently. Empirical case studies in Pennsylvania, using real‐world data from the Centers for Disease Control and Prevention and health department websites, were conducted for the first 4 months of the COVID‐19 vaccination campaign. Preliminary results show that the proposed solution algorithm effectively solves the problem, achieving a 5.92% reduction in total transportation cost and a 28.15% increase in demand coverage. Moreover, our model can reduce the deviation from equity to 0.07 (∼50% improvement).

Trigger Point Therapy Techniques as an Effective Unconventional Method of Treating Tension Headaches: A Systematic Review.

Background/Objectives The main aim of the literature review was to determine whether different trigger point therapy techniques are effective in decreasing the intensity, frequency, and duration of tension-type headaches. An additional aim was to assess the impact of trigger point therapy on other physical and psychological variables in tension-type headaches. Methods This literature review was conducted in accordance with PRISMA guidelines, and the inclusion and exclusion criteria were developed using the PICO(s) strategy. Searches were carried out in four databases: PubMed, Science Direct, Cochrane Library, and PEDro. Results Of the 9 included studies with 370 participants, 6 studies were randomised controlled trials, 2 were pilot studies, and 1 was a case report. Conclusions Trigger point therapy has reduced the duration, intensity, and frequency of headaches. Dry needling, ischaemic compression, Positional Relaxation Techniques, and massage protocols focused on deactivating trigger points are effective methods of unconventional treatment of tension-type headaches.

The effect of arm muscle discrete relaxation training and fine-coordination training on proprioceptive control

Proprioception makes an important contribution to the regulation of speed, strength and spatial parameters of movements, determining the level of proficiency in motor skills. However, the effectiveness of various training approaches in relation to voluntary proprioceptive control of target muscles has not been sufficiently studied. In this paper, we investigated the effectiveness of three types of manipulative training: 1) fine coordination, 2) discrete muscle relaxation and 3) their combinations in relation to the accuracy of reproducing:а) the angular deviation of the joystick from the vertical and b) static muscle efforts during the pronation and supination of the joystick. The study involved 40 young (18-35 years old), physically active volunteers who randomly made up 4 groups of 10 people: “Control” (lack of training), “Coordination” (training of passing an analog of a slit maze with a thin probe), “Discrete relaxation” (training of discrete muscle relaxation of pronators and supinators of the forearm), “Combined” (combined training of maze passing and discrete relaxation). Before and after training (n = 10) we evaluated: 1) the accuracy of reproduction of the deviation of the wrist joystick from the vertical by 20, 50, 80 degrees and 2) the accuracy of reproduction of isometric contraction (0, 20, 50 and 80% of the maximum effort) in the descending, ascending directions as well as discrete achievement of any effort level by pronation /supination of the wrist joystick. It was found that coordination training increased the length of the traversed path in 3 minutes with a reduced number of errors, and increased the proprioceptive accuracy of reproducing the angle of deviation of the joystick by 20 degrees also. In the “Discrete Relaxation” group the average modulus of errors in reproducing descending, ascending and discrete forces during supination, as well as the average modulus of errors in reproducing descending, ascending and discrete forces during forearm pronation decreased after course training. At the same time, no changes in the accuracy of reproducing the angular positions of the joystick were found in this group. In the “Combined” group, training led to an increase in the accuracy of reproducing ascending and descending efforts during pronation, as well as the accuracy of descending efforts during supination of the forearm. In addition, in this group, a decrease in the error modulus during reproducing the tilt of the joystick by 50 degrees by supination was revealed. Correlation analysis did not reveal positive links between training changes in proprioceptive control of different modality. Thus, the training effects used on the target muscles of the forearm have a specific effect on the proprioceptive control of muscle effort and spatial position in the hand joints. The high efficiency of discrete relaxation training regarding the accuracy of voluntary efforts allows us to recommend its use in order to increase the level of mastery of the motor skills of the hand.

Second Language Writing Anxiety of Thai EFL Undergraduate Students: Dominant Causes, Levels and Coping Strategies

Using a mixed-methods research design, this study explored the dominant causes, levels, and coping strategies of second language writing anxiety among 55 second-year Thai EFL undergraduate students majoring in English for International Communication. Data were collected from the Causes of Writing Anxiety Inventory (CWAI) questionnaire developed by Rezaei and Jafari (2014), the Second Language Writing Anxiety Inventory (SLWAI) developed by Cheng (2004), and a stimulated recall interview. Descriptive statistics were applied to analyze the data obtained from CWAI and SLWAI, while thematic analysis was used to identify themes from the stimulated recall interview. The results revealed that the predominant cause of writing anxiety was writing assignments, affecting 77.09% of students, followed by linguistic difficulties and fear of writing tests, each affecting 70.09%. Additionally, the study found that the level of writing anxiety among these students was high according to the writing anxiety questionnaire. Furthermore, during the stimulated recall interview, participants revealed five strategies typically used to manage their writing anxiety, namely positive self-talk, starting with a plan, relaxation techniques, goal setting, and seeking social support.

The Effect of Working Posture on Musculoskeletal Disorders Complaints Moderated By Smoking Copra Workers in Tanjung Balai, Asahan Regency

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Musculoskeletal complaints refer to discomfort or pain in the musculoskeletal system, ranging from mild to severe. One type of job that is particularly prone to musculoskeletal disorders is copra work, primarily due to poor working posture. This study aims to analyze the effect of working posture on musculoskeletal disorder complaints among copra workers in Tanjung Balai, Asahan Regency. The study is an analytical survey with a cross-sectional design, conducted in Bandar Jawa Village, Tanjung Balai Subdistrict, Asahan Regency, from December 2023 to February 2024. The study population consisted of all 139 copra workers in Bandar Jawa Village, and a sample of 104 workers was selected using the Slovin formula. The sampling technique employed was simple random sampling. Data were collected through surveys and questionnaires administered to respondents. The research instruments used were the Nordic Body Map and the Rapid Entire Body Assessment (REBA) evaluation sheet. Data analysis was performed using SPSS version 24, with three stages: univariate analysis using frequency, bivariate analysis using simple linear regression, and multivariate analysis using Moderated Regression Analysis (MRA) with a significance level of 95% (α=0.05). The results showed that working posture significantly affected musculoskeletal disorder complaints, moderated by smoking habits, with a p-value of 0.001. It can be concluded that smoking exacerbates the negative effects of poor working posture on musculoskeletal health, increasing the risk of injury and slowing recovery. It is recommended that copra workers take preventive measures against musculoskeletal disorder complaints by improving their work environment, paying attention to rest periods, engaging in light relaxation exercises, and that employers provide education on worker safety and health to copra workers.</em></p><p><em> </em></p></td></tr></tbody></table></div><p><strong><em>Keywords: </em></strong> <strong><em>Musculoskeletal disorders, Smoking, Work posture</em></strong></p>

Can general exercise training and pelvic floor muscle training be used as an empowering tool among women with endometriosis? Experiences among women with endometriosis participating in the intervention group of a randomized controlled trial

BackgroundThe potential benefit of exercise in alleviating symptoms of endometriosis is unclear. Still, exercise may be used to empower women and manage disease symptoms. The purpose of this study was to explore how regular supervised group- and individual exercise training, including pelvic floor muscle training (PFMT), is experienced among women with endometriosis after participating in a randomized controlled trial (RCT).MethodsAmong 41 women randomized to exercise training for four months, ten women were interviewed about their experiences with exercise training after participation in the trial. The weekly group training was led by women’s health physiotherapists and included individualized and progressive muscular strength training of large muscle groups and the pelvic floor muscles, in addition to endurance-, flexibility, and relaxation training. An individual training program followed the same principles as the group training and was to be performed 3–5 times per week, depending on the level of intensity. PFMT was recommended daily. The women also received a group pain management course emphasizing exercise training as self-management. Using inductive reflexive thematic analysis, responses to the question “Did participation in the study change your view of exercise as part of the treatment for endometriosis?“ were analyzed.ResultsThe women brought forward the importance of knowledge about the benefits of exercise to make informed decisions in disease management. Further, the women described how exercise training was perceived as less frightening and manageable when exposed to various intensities, dosages, and types of exercises in a safe and supportive environment. PFMT was especially brought forward as something new and appreciated, and for some of the women, to be performed on days when their bodies could not handle the general exercise training. They also expressed that the supervised exercise brought an extra dimension of belonging through group participation.ConclusionsIndividualization and regular supervision seem important to empower women with knowledge about exercise training as self-management and to experience exercise training as safe and non-threatening. Further, creating a sense of belonging through group training may improve social support and build active coping strategies that are essential for disease management of endometriosis.Trial registrationNCT05091268 (registered 23.09.2021).

A - 34 CBT Improves Cognitive Functioning in ADHD, Mixed Type

Abstract Objective To further expand on previous smaller study (with 25 participants) that found that children with ADHD, Mixed Type, improved their cognitive functioning after 12 weeks of CBT. Method In the current study 68 children (20 girls) diagnosed with ADHD, mixed type, between the ages of 9 and 12 (M = 10.25, SD = 1.88) were assessed with the WISC-V, CBCL, TEA-Ch2, and CPT-2, clinical interview with parents and teachers before the beginning of CBT. The same assessment was repeated 14 weeks later, following 12, weeks of individualized CBT. CBT included thought restructuring, impulse control exercises, relaxation techniques, and mindfulness exercises. Results Average Based Change (ABC) was employed and significant improvements, with large Cohen’s d (>. 80) effect size, were detected for Working Memory, Hyperactivity, Externalizing Behavior, Impulsivity, Selective, Sustained, and Everyday Attention. Ratings, during interviews, by teachers, psychologists, and parents agreed also that there was a significant clinical improvement. Conclusion In agreement with the first study, and other literature, CBT seems to be an important tool in helping significantly children with ADHD, Mixed Type, improve in behavior and cognitive functioning. More studies with younger and older children are needed to cement the utility of CBT with children and teens.

Patients’ and health professionals’ research priorities for chronic pain associated with inflammatory bowel disease: a co-produced sequential mixed methods Delphi consensus study

ObjectiveChronic pain in inflammatory bowel disease (IBD) is common and detrimental to quality of life. Recent Cochrane reviews identified a multitude of randomised controlled trial interventions, but the certainty of...

Young Adult Cancer Patients (AYA): Preferences for Outpatient Psychosocial Care and Gender-Specific Differences - Results from the AYA-LE study

To investigate the importance of individual topics in outpatient care services and the preferences for their design from the perspective of young adults with cancer (AYA="adolescents and young adults") in Germany. A total of 514 AYAs aged 18-39 years were surveyed twice over a 12-month period (t1=immediately after acute treatment, t2=12 months post-treatment) regarding the importance and satisfaction with topics such as anxiety, the impact of the illness on partnerships/family and social environment, future perspectives, personal coping strategies, sexuality, and desire for children/fertility, as well as the types of care services. The subjective importance and satisfaction with the care topics and services were analyzed using variance and moderator analyses. The most important topics for care services were future career prospects (M=3.22, SD=1.56), social impact (M=3.19, SD=1.54), and personal coping strategies (M=3.52, SD=1.46). The greatest dissatisfaction was noted in the areas of sexuality (M=2.01, SD=1.59) and desire for children/fertility (M=2.08, SD=1.72). At time t2, relaxation techniques (M=3.46, SD=1.36) and psychological counseling (M=3.43, SD=1.46) were the most desired care services. Female AYAs rated psychological counseling (F[1.199)=9.21, p=0.003), social counseling (F[1.221]=6.60, p=0.011), creative therapy options (F[1.219]=21.74, p<0.001), support groups (F[1.215]=4.29, p=0.040), patient education (F[1.210]=6.96, p=0.009), and relaxation techniques (F[1.194]=23.68, p<0.001) significantly more important than male AYAs. The study highlighted several areas of dissatisfaction with the current outpatient care services for AYAs. The results demonstrate the need to incorporate cross-sex and gender-specific care preferences of AYAs to improve outpatient psychosocial care. A specific set of AYA-care services should be designed and implemented to address the aforementioned psychosocial topics, which include sexuality and the desire for children/fertility. It is also crucial for outpatient practice to raise awareness among the involved professional groups. Further research is required to gain a deeper understanding of sex differences.

Coevolutionary multitasking for constrained multiobjective optimization

Addressing the challenges of constrained multiobjective optimization problems (CMOPs) with evolutionary algorithms requires balancing constraint satisfaction and optimization objectives. Coevolutionary multitasking (CEMT) offers a promising strategy by leveraging synergies from distinct, complementary tasks. The primary challenge in CEMT frameworks is constructing suitable auxiliary tasks that effectively complement the main CMOP task. In this paper, we propose an adaptive CEMT framework (ACEMT), which customizes two adaptive auxiliary tasks to enhance CMOP-solving efficiency. The first auxiliary task dynamically narrows constraint boundaries, facilitating exploration in regions with smaller feasible spaces. The second task focuses specifically on individual constraints, continuously adapting to expedite convergence and uncover optimal regions. In solving the main CMOP task, this dual-auxiliary-task strategy not only improves search thoroughness but also clarifies the balance between constraints and objectives. Concretely, ACEMT incorporates an adaptive constraint relaxation technique for the first auxiliary task and a specialized constraint selection strategy for the second. These innovations foster effective knowledge transfer and task synergy, addressing the key challenge of auxiliary task construction in CEMT frameworks. Extensive experiments on three benchmark suites and real-world applications demonstrate ACEMT’s superior performance compared to state-of-the-art constrained evolutionary algorithms. ACEMT sets a new standard in CMOP-solving by strategically constructing and adapting auxiliary tasks, representing a significant advancement in this research direction.

A Quasi Experimental Study to Assess the Effectiveness of Jacobson’s Progressive Muscle Relaxation Therapy on Anxiety and Quality of Sleep Among Covid-19 Patients at Selected Covid Care Centre, Coimbatore

Global prevalence of anxiety and depression increased to 25% during the first year of pandemic. Pandemic is not just a medical phenomenon; it affected individuals, society and caused emotional disruptions, anxiety, stress, stigma and sleep problems. Aim: The present study was undertaken with the aim to assess the effectiveness of Jacobson’s Progressive Muscle Relaxation Therapy on anxiety and quality of sleep among COVID-19 patients. Methodology: A quantitative approach with Quasi-Experimental, one group pretest-posttest design was adopted. A purposive sampling technique was used to recruit the study participants, and the sample size was 60. Pretest level of anxiety and quality of sleep were assessed using Hamilton Anxiety Rating Scale and Modified Pittsburgh Sleep Quality Index. Jacobson’s progressive muscle relaxation therapy (JPMR) was administered in individual session for 20 minutes, one session per day for 6 consecutive days. Posttest was conducted by using same questionnaires on the 7th day, after the intervention. Results: ‘z’ test was used to compare the level of anxiety before and after the intervention, the calculated value z=4.85 was greater than the tabulated value 3.29 at 0.001 level of significance. With regard to the quality of sleep before and after intervention, the calculated value z=5.87 was greater than the tabulated value 3.29 at 0.001 level of significance. Conclusion: The study concluded that Jacobson's Progressive Muscle Relaxation Therapy was effective in reducing the anxiety and improving the sleep quality among COVID-19 patients.

Sleep quality in middle-aged and elderly hemodialysis patients: Impact of a structured nursing intervention program.

Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being. This study aimed to evaluate the effectiveness of a structured nursing intervention program in improving sleep quality in middle-aged and elderly hemodialysis patients. To evaluate the impact of nursing intervention on sleep quality in hemodialysis patients. This cross-sectional study was conducted in a tertiary hospital, the First Affiliated Hospital of Nanchang University, in 2023. This study included 105 middle-aged and elderly hemodialysis patients aged ≥ 45 years who underwent maintenance hemodialysis for at least 3 mo, utilizing the Pittsburgh Sleep Quality Index (PSQI) to identify poor sleepers. Those identified underwent a 12-wk nursing intervention program focusing on education, relaxation techniques, and counseling. Post-intervention, sleep quality was reassessed using the PSQI. The study found that 68.6% of hemodialysis patients were poor sleepers. Following the 12-wk nursing intervention program, there was a significant decrease in the mean global PSQI score from 8.9 ± 3.2 to 5.1 ± 2.7 (P < 0.001), indicating improved sleep quality. This demonstrated the effectiveness of the structured nursing intervention in enhancing sleep quality for middle-aged and elderly hemodialysis patients. The structured nursing intervention program focusing on sleep hygiene education, relaxation techniques, and counseling effectively improved sleep quality among middle-aged and elderly hemodialysis patients. The significant decrease in the mean global PSQI score post-intervention indicates the positive impact of tailored nursing interventions in addressing poor sleep quality in this patient population. These findings emphasize the importance of implementing targeted nursing interventions to enhance the quality of life for hemodialysis patients by addressing the prevalent issue of poor sleep quality.

Hypnosis support in anaesthesia is rarely used in German anaesthesia departments - a nationwide survey among leading physicians of anaesthesia departments

BackgroundThe aim of this study was to investigate whether and to what extent perioperative hypnosis and relaxation techniques are used in German anaesthesia departments, what they are, where any difficulties in their application lie and how great the interest in this type of therapy is. Another research question was to find out whether there are specialist areas in which these methods are used more frequently than in other specialist areas.MethodsA descriptive survey was conducted by means of a questionnaire in all hospitals with anaesthesia departments in Germany. 1124 questionnaires were sent out by post. The survey period was five months from 27/02/2023 to 31/07/2023. The clinic directors of all anaesthesiology departments in German hospitals were surveyed.Results476 departments (42%) responded by pre-paid envelope. Of these, only 39 (8%) use hypnosis and relaxation techniques perioperatively. These are mostly progressive muscle relaxation, hypnotic trance according to Erickson, calming words and suggestions or the use of virtual reality (e.g. using VR-glasses).ConclusionsHypnosis techniques have been shown in many studies to be effective in increasing patient comfort (less anxiety and stress) and reducing both the need for medication and perioperative pain. The therapy is rarely used in Germany, although once established it can be easily integrated into perioperative procedures. Many departments have shown great interest in the topic. In the interests of patients, a structural change should be considered to promote the use of hypnotic procedures.