Non-pharmacological Interventions Research Articles

Mental Health Issues Among Adolescents: Challenges and Management

Abstract: Adolescence is an important stage of life between childhood and adulthood. The shift in lifestyle, physical inactivity, high expectations of family/friends/teachers, and continuous exposure to social media and the internet have created physical, social, emotional, and mental imbalances in adolescents. The individuals of this age group are vulnerable and exposed to these stressful factors, leading to psychological complications. Most psychological problems diagnosed in the later stages of life begin in adolescence. The purpose of this mini-review was to identify mental health problems and available non-pharmacological interventions to manage the overall well-being of adolescents. A literature search was conducted to identify relevant studies, including research, review, and other articles/data available on PubMed, Google Scholar, ScienceDirect, WHO, GHDx, and AACAP. Search keys included essential keywords like adolescence, yoga, mental health, anxiety, depression, and a combination of these words. The literature search identified several mental disorders like emotional, behavioral, identity, psychosis, dietary, and other risky behaviors. Most of these non-pharmacological interventions adopted focused on improving the mental and physical well-being in school and community settings. Among all the interventions, we found yoga to be the most popular and widely accepted effective tool that reduces anxiety, depression, and psychological problems. Yoga also improved resilience, attention, and other well-being parameters. Yoga helps manage physical and mental health in adolescence.

COMPREHENSIVE MIDWIFERY CARE FOR A PRIMIGRAVIDA WITH BACK PAIN

During the third trimester of pregnancy, a woman will usually experience changes that will cause a lot of discomfort, one of which is back pain. This complaint can be overcome with non-pharmacological treatment, one of which is endorphin massage. Based on data at PMB "N" in 2023, out of 82 third trimester pregnant women, 73.58% experienced back pain discomfort. This study aims to determine midwifery care to reduce the intensity of back pain in third trimester pregnant women. Data collection methods with interviews, observations, and documentation studies. The subject of this midwifery care is Mrs. "A" G1P0A0 37 weeks gestation with complaints of back pain discomfort. The results showed that the comprehensive midwifery care carried out took place normally without any complication. During pregnancy, Mrs. "A" experienced back pain discomfort in the third trimester and was given endorphin massage care to relieve back pain. After the intervention was carried out 5 times, namely with the frequency of endorphin massage starting on the first day of the visit to the PMB and carried out again on day 3, day 5, day 6 and day 7 after the visit to the PMB, the back pain in Mrs. "A" decreased and she said she felt comfortable and more relaxed. It can be concluded comprehensive midwifery care in Mrs. "A" runs normally and effectively to overcome the discomfort experienced. This comprehensive midwifery care is expected to be applied to minimize complications that may occur during pregnancy, childbirth, newborn, postpartum to contraceptive services. Keywords: Back Pain, Endorphin Massage, Use of Video

The Effect of Haptonomy on Fear of Childbirth and Maternal-fetal Attachment: A Systematic Review and Meta-analysis

Background: Haptonomy is considered one of the non-pharmacological interventions in reducing Fear of Childbirth (FOC) and increasing Maternal Fetal Attachment (MFA). No review study has been conducted for an evidence-based conclusion in this regard. Objective: This study aimed to evaluate the pooled effect of haptonomy on FOC and MFA. Methods: A systematic literature search was conducted in an electronic database (Scopus, Cochrane Library, Clinical Trials.gov, Embase, ProQuest, PubMed, Google Scholar, Web of Science, SID, and Magiran) until January 30th, 2023, to find all interventional studies that reported the effect of haptonomy on FOC and MFA. Results: A total of 26 relevant articles were retrieved in the search, of which 4 articles were included in the systematic review. Meta-analysis was conducted for three research studies with the outcome of FOC and three studies with the outcome of MFA. The metaanalysis of three research conducted on 239 participants indicated the positive effect of hatonomy intervention on reducing FOC (MD: -22.91; 95% CI: -28.21 to -17.61; p < .001 ), and owing to the moderate heterogeneity, the random effect model was used (I2 = 41.38%). The results of the meta-analysis of three research with 286 participants indicated the ineffectiveness of haptonomy intervention on the MFA (MD: 4.35; 95% CI: - 2.72 to 11.42; p = .23) (I2 = 59.95%). Conclusion: Haptonomy intervention during pregnancy reduces FOC without playing any role in increasing MFA. However, conducting the clinical trials with a larger sample size by means of standard tools is recommended due to the limited number of haptonomy interventions on MFA and the moderate heterogeneity of reviewed studies.

Effect of Animal-Assisted Activities on Symptoms and Emotions of Children with Neoplastic Disease: A Systematic Review with Meta-Analysis

BACKGROUND: Animal-assisted activities (AAAs) have long been present in pediatric oncology as a nonpharmacological intervention aimed at helping children cope with symptoms and negative emotions during hospitalization and antineoplastic treatment. Among the systematic reviews in the literature, there is a lack of one with meta-analysis that includes only RCTs centered on the effect of the intervention on symptoms and emotions in children with neoplastic disease. OBJECTIVE: To synthesize the effect of AAAs on symptoms and emotions of children with neoplastic disease. METHODS: Studies were searched from biomedical databases Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, Scopus, AMED, sciELO, LILACS, CNKI, J-GLOBAL, J-STAGE, main trial registries and major sources of grey literature. Searching for useful documents took place from the inception of each resource until April 18, 2024. The risk of bias of included studies was assessed with RoB 2, and the overall effect size of the intervention was calculated by creating random-effects meta-analyses graphically represented by forest plots. The summary of findings was illustrated with a table in accordance with the GRADE method. RESULTS: Three parallel-group randomized controlled trials with low risk of bias were included (N = 151, mean age: 8.5-11.2 years). AAAs are promising for anxiety reduction (N = 134; SMD = -0.07 [95% CI: -0.40, 0.27], p > 0.05) and quality of life improvement (N = 84; SMD = -0.11 [95% CI: -0.53, 0.31], p > 0.05) in children and for anxiety reduction (N = 154; SMD = -0.50 [95% CI: -1.52, 0.52], p > 0.05) in parents/caregivers. The certainty/quality of evidence is low to very low. CONCLUSIONS: The effect of animal-assisted activities to reduce anxiety and improve the quality of life of children with neoplastic disease and to reduce parent/caregiver anxiety is small to moderate; however, the quality/certainty of evidence is very low to low. Therefore, further studies on the topic that overcome the current limitations need to be conducted in order to collect more robust data in favor of implementing the intervention in pediatric oncology.

Neuropathic component of chronic musculoskeletal pain in patients with post-COVID-19: A cross-sectional study

Objectives: This study aimed to evaluate the neuropathic component of chronic musculoskeletal pain in post-coronavirus disease 2019 (COVID-19) and examine the relationship between neuropathic pain and clinical and demographic characteristics. Patients and methods: This cross-sectional study included 163 adult patients (85 females, 78 males; mean age: 41.7±4.3 years; range, 22 to 50 years) with post-COVID-19 musculoskeletal pain between February 1, 2021, and April 30, 2021. Demographic and clinical characteristics, including age, sex, affected site, duration, and severity of post-COVID-19 musculoskeletal pain using the Visual Analog Scale (VAS), as well as a neuropathic component of pain using the Leeds assessment of neuropathic symptoms and signs (LANSS), were collected. The most common post-COVID-19 symptoms, presence of hospitalization, and length of hospital stay during active COVID-19 infection were recorded from the patient records. Results: The mean duration and severity of pain were 7.85±1.53 months and 5.09±1.95, respectively. Half of the patients were hospitalized, and the mean length of hospital stay was 12.15±18.06 days. The most common pain sites were upper and lower back pain, followed by leg and arm pain. A total of 92 (56.4%) patients had previously received pharmacological or nonpharmacological treatment for post-COVID-19 musculoskeletal pain. Based on the LANSS (scores >12), 31 (19%) patients had neuropathic pain. There was a significant correlation between the presence of neuropathic pain and pulmonary involvement/symptoms. The presence and length of hospital stay were correlated with LANNS scores (p<0.05). The frequency, LANSS scores, and VAS-pain scores of the patients with and without neuropathic pain were similar between male and female patients (p>0.05). Conclusion: The neuropathic component of chronic musculoskeletal pain may be common, as one-fifth of our patients had neuropathic pain as assessed by the LANNS. Therefore, the awareness of post-COVID-19 chronic neuropathic musculoskeletal pain should be increased. We believe that focusing on the identification of pain phenotypes would provide adequate and tailored chronic neuropathic musculoskeletal pain management in the post-COVID-19 period.

INTERVENTION OF 5-FINGER HYPNOTIC RELAXATION TECHNIQUE IN COMPREHENSIVE MIDWIFERY CARE FOR FOR A MULTIPAROUS WOMAN WITH PREGNANCY-RELATED ANXIETY

During the third trimester of pregnancy, women often experience various discomforts, including anxiety. One non-pharmacological treatment to alleviate this anxiety is the Five-Finger Hypnosis technique. At Clinic "A" in 2023, out of 143 pregnant women, 50 in the third trimester reported experiencing anxiety. This study aims to evaluate the effectiveness of midwifery care using the Five-Finger Hypnosis technique to reduce anxiety in third-trimester pregnant women. Data collection methods included interviews, observations, and documentation review. The subject of this study was Mrs. "L," a G1P0A0 patient at 35 weeks and 6 days of gestation, who reported anxiety during pregnancy. The results showed that comprehensive midwifery care was conducted normally without complications. Mrs. "L" received the Five-Finger Hypnosis intervention six times: on the first day of her clinic visit and again on the 3rd, 6th, 8th, 11th, and 14th days following her initial visit. After these sessions, her anxiety significantly decreased, and she reported feeling more comfortable and relaxed. This study concludes that comprehensive midwifery care, including the Five-Finger Hypnosis technique, was effective in reducing anxiety for Mrs. "L." Such care can be beneficial in minimizing potential complications during pregnancy, childbirth, the newborn period, postpartum, and contraceptive services. Keywords: Anxiety, 5 finger hypnosis, Midwifery care

Dialysate sodium and short-term blood pressure variability in patients with intradialytic hypertension: a randomized crossover study.

Increased blood pressure (BP) variability (BPV) is associated with high cardiovascular risk in hemodialysis. Patients with intradialytic hypertension (IDH) also exhibit an increased cardiovascular risk compared to hemodialysis patients without this condition. The impact of non-pharmacological BP-lowering interventions on BPV in this population remains unknown. This analysis evaluated the effect of low (137mEq/L) compared to standard (140mEq/L) dialysate sodium concentration on short-term BPV in patients with IDH. In a randomized cross-over manner, 29 IDH patients underwent 4 hemodialysis sessions with low (137mEq/L) followed by 4 sessions with standard (140mEq/L) dialysate sodium or vice versa. 48h ambulatory BP measurement was performed from the start of the 4th session on each dialysate sodium. BPV indices during the 48 h, 24 h, day-time and night-time periods were calculated. Mean 48h BP was 5.3/2.6 mmHg lower with low compared to standard dialysate sodium concentration, (p = 0.005/p = 0.007 respectively). All 48 h systolic BPV indices examined showed non-significant differences between low and standard dialysate sodium (SBP-SD: 16.99 ± 5.39 vs. 16.98 ± 4.33 mmHg, p = 0.982; SBP-wSD: 15.93 ± 5.02 vs. 16.12 ± 4.16 mmHg, p = 0.769; SBP-ARV: 11.99 ± 3.67 vs. 11.45 ± 3.35 mmHg, p = 0.392; SBP-CV: 12.36 ± 3.65 vs. 11.92 ± 3.18%, p = 0.302, with low vs. standard dialysate sodium, respectively). Diastolic BPV indices were numerically, but not statistically, lower with low dialysate sodium. Overall, significant differences were observed in some comparisons with a trend for lower BPV during day-time 2 and higher BVP during night-time 2 with low dialysate sodium. In conclusion, low dialysate sodium concentration does not affect BPV levels in patients with IDH. Future research should explore alternative interventions to reduce BP and BPV in this high-risk population.

Systematic review protocol to determine the most effective pharmacological and non-pharmacological interventions for the management of acute methamphetamine toxicity

IntroductionThis study describes the protocol for a systematic review. The systematic review will address experiences of managing methamphetamine intoxication, specifically violence and agitation related to intoxication, in the emergency department...

The journey of pain management for fibromyalgia patients: A ten year experience from Tunisia

IntroductionFibromyalgia often deteriorates the quality of life of patients on physical, emotional, socio-familial, and professional levels. Aim of the workTo describe the characteristics of fibromyalgia patients and to assess the impact of fibromyalgia on their quality of life. Patients and methodsA questionnaire was provided to the fibromyalgia patients at the pain management center of Tunis, during the last ten years and the sociodemographic data, journey characteristics and satisfaction regarding the quality of their care were recorded and the impact of fibromyalgia on the quality of life was assessed using the Fibromyalgia Impact Questionnaire (FIQ). ResultsThe work included 110 patients, 93 females and 13 males (F:M 7.2:1) and a mean age of 52 ± 12 years. 65 % reported an initial pain visual analog scale (VAS) ≥ 7. The mean consultation and diagnostic delays were 75 ± 30 and 44 ± 28 months, respectively. 94 % of patients were initially misdiagnosed, despite consulting more than two different physicians. The mean FIQ total was 77.5 ± 13.Age, female gender, and manual professions were related to a more impaired physical impact of fibromyalgia (p = 0.02; p = 0.01; p = 0.03, respectively). Patients whose fibromyalgia trigger was persistent stress (n = 50) reported more impaired FIQ (p = 0.001). Patients with shorter consultation and diagnostic delays reported more improvement (p = 0.001 and p = 0.01, respectively). Patients treated with tricyclic antidepressants and vitamins felt significantly improved (p = 0.02 and p = 0.002). Non-pharmacological treatments included physical therapy, yoga, acupuncture, and thermal baths. ConclusionsThe quality of life in fibromyalgia patients is frequently impaired, and the journey is complex and ambivalent.

A IMPORTÂNCIA NA MUDANÇA NO ESTILO DE VIDA PARA PACIENTES COM DIABETES MELLITUS TIPO 2 E HIPERTENSÃO ARTERIAL SISTÊMICA: UM RELATO DE CASO

Introduction: Inadequate lifestyle habits, such as poor diet, physical inactivity, and visceral obesity, are directly related to chronic non-communicable diseases like diabetes and systemic arterial hypertension, as well as cardiovascular outcomes. Objective: To report the case of a patient with hypertension and diabetes with poor adherence to non-pharmacological treatment. Methodology: Case report developed in the PIESC Axis of the 7th semester of the Medical Course, involving a 58-year-old male patient with systemic arterial hypertension and diabetes for 20 years. Results: The patient, with a history of stroke and family history of diabetes, has a diet high in salt, fat, and carbohydrates, and does not regularly consume fruits and vegetables. He does not engage in physical activities and is a smoker. During the physical examination, he presented with blood pressure of 135/85 mmHg, heart rate of 88 bpm, body mass index of 30.8, and fasting blood glucose of 200 mg/dl. The importance of lifestyle changes was reinforced, and medication doses were adjusted. Conclusion: The patient has high-risk factors, such as hypertension, age over 55, and a history of smoking. Adherence to non-pharmacological treatment is essential to control modifiable risk factors and improve long-term adherence. Reducing body mass index and abdominal circumference, along with a healthy diet, is crucial. Regular physical activity and diet play an essential role in controlling diabetes. It is crucial for health professionals to emphasize the importance of treatment adherence and the quality of life of patients.

Trajectories of cardiovascular ageing - from molecular mechanisms to clinical implementation.

Due to its peculiar structure and function, the cardiovascular system is particularly vulnerable to the detrimental effects of ageing. Current knowledge about the molecular mechanisms of ageing revealed the processes actively promoting ageing, e.g. progressive telomeres shortening, and the mechanisms opposing it, e.g. endogenous production of antioxidant substances. This knowledge can be used to measure biological age at a cellular and molecular level and to interfere with it by pharmacological or non-pharmacological interventions. Biological ageing is determined by the simultaneous occurrence of independent hallmarks, which encompass a wide range of biological processes, from genomic changes to systemic inflammation and dysbiosis. This narrative review will summarize the role of ageing hallmarks in the cardiovascular system, how they can be measured and what are the possible interventions to counteract their effects.

Italian report on RARE epilepsies (i-RARE): A consensus on multidisciplinarity.

Rare and complex epilepsies encompass a diverse range of disorders characterized by seizures. We aimed to establish a consensus on key issues related to these conditions through collaboration among experienced neurologists, neuropediatricians, and patient advocacy representatives. Employing a modified Delphi method, a scientific board comprising 20 physicians and 4 patient advocacy representatives synthesized existing literature with their expertise to formulate statements on contentious topics. A final 32-member expert panel, representing diverse regions of Italy, validated these statements through a two-round voting process, with consensus defined as an average score ≥7. Sixteen statements reached a consensus, emphasizing the necessity for epidemiological studies to ascertain the true prevalence of rare epilepsies. Etiology emerged as a crucial factor influencing therapeutic strategies and outcome prediction, with particular concern regarding prolonged and tonic-clonic seizures. The importance of early implementation of specific drugs and non-pharmacological interventions in the treatment algorithm for developmental and epileptic encephalopathies (DEEs) was underscored. Multidisciplinary care involving experts with diverse skills was deemed essential, emphasizing non-seizure outcomes in adolescence and adulthood. This national consensus underscores the imperative for personalized, comprehensive, and multidisciplinary management of rare epilepsies/DEEs. It advocates for increased research, particularly in epidemiology and therapeutic approaches, to inform clinical decision-making and healthcare policies, ultimately enhancing patients' outcomes. The modified Delphi method is broadly used to evaluate debated topics. In this work, we sought the consensus on integrated and social care in epilepsy management. Both representatives of high-level epilepsy centers and patients' caregivers were directly involved.

Efficacy of non-pharmacological treatments for knee osteoarthritis: A systematic review and network meta-analysis

PurposeThis study aims to conduct a network meta-analysis to compare the clinical efficacy of seven distinct non-pharmacological therapies for knee osteoarthritis. We hope that our research findings can provide reference for clinical practitioners in formulating treatment plans. MethodsThrough a computer-based search, we systematically retrieved randomized controlled trials (RCTs) on non-pharmacological therapies for knee osteoarthritis from eight databases, including CNKI, Wanfang, VIP, PubMed, Web of Science, Embase, Scopus, and The Cochrane Library. Following screening, data extraction, and methodological quality assessment, relevant data were included and analyzed using R 4.2.3 software. ResultsA comprehensive analysis of 24 RCTs involving 2582 patients encompassed seven diverse non-pharmacological therapies. The efficacy rankings, based on Visual Analog Scale (VAS) scores, were as follows: shock wave therapy > needle-knife > laser therapy > acupuncture > ultrasound > exercise > transcutaneous electrical nerve stimulation. Similarly, based on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total scores, the efficacy rankings were as follows: shock wave therapy > needle-knife > laser therapy > acupuncture > ultrasound > transcutaneous electrical nerve stimulation > exercise. Among the three WOMAC subscales, the efficacy rankings for non-pharmacological therapies were as follows: For stiffness: laser therapy > exercise > shock wave therapy > acupuncture > needle-knife > ultrasound > transcutaneous electrical nerve stimulation; For daily activities: shock wave therapy > laser therapy > needle-knife > acupuncture > ultrasound > transcutaneous electrical nerve stimulation > exercise; For pain: shock wave therapy > needle-knife > laser therapy > acupuncture > exercise > transcutaneous electrical nerve stimulation > ultrasound. ConclusionBased on the currently limited research, we can prioritize the use of shockwave therapy to treat patients with knee osteoarthritis. However, it is essential to emphasize that further rigorous and well-designed randomized controlled trials are necessary to validate the conclusions drawn from this study.

Unveiling the Mysteries of Contrast-Induced Acute Kidney Injury: New Horizons in Pathogenesis and Prevention.

The utilization of contrast media (CM) in clinical diagnostic imaging and interventional procedures has escalated, leading to a gradual increase in the incidence of contrast-induced acute kidney injury (CI-AKI). Presently, the scarcity of effective pharmacological treatments for CI-AKI poses significant challenges to clinical management. Firstly, we explore the pathogenesis of CI-AKI in this review. Beyond renal medullary ischemia and hypoxia, oxidative stress, cellular apoptosis, and inflammation, emerging mechanisms such as ferroptosis, release of neutrophil extracellular traps (NETs), and nitrosative stress, which offer promising avenues for the management of CI-AKI, are identified. Secondly, a comprehensive strategy for the early prevention of CI-AKI is introduced. Investigating the risk factors associated with CI-AKI is essential for the timely identification of high-risk groups. Additionally, exploring early sensitive biomarkers is crucial for early diagnosis. A synergistic approach that combines these sensitive biomarkers, CI-AKI risk factors, and disease risk prediction models enhances both the accuracy and efficiency of early diagnostic processes. Finally, we explore recent pharmacological and non-pharmacological interventions for the management of Cl-AKI. Beyond the traditional focus on the antioxidant N-acetylcysteine (NAC), we look at active compounds from traditional Chinese medicine, including tetramethylpyrazine (TMP), salvianolic acid B (Sal B), as well as emerging preventive medications like N-acetylcysteine amide (NACA), alprostadil, and others, which all showed potential benefits in animal and clinical studies for CI-AKI prevention. Furthermore, innovative strategies such as calorie restriction (CR), enhanced external counterpulsation (EECP), and mesenchymal stem cell therapy are highlighted as providing fresh insights into Cl-AKI prevention and management.

Nursing intervention in older adults with insomnia

Introduction. Aging is loosely related to the chronological age of the person and in turn to the loss of physical, functional, psychological and social capacities. Sleep is a physiological process of fascination and of vital importance for the comprehensive health of the human being, the aging process alters the stages of sleep, which in the long term has side effects and represents economic costs for those older adults who are prescribed with pharmacological treatments. The amount of sleep remains constant throughout adult life, which is why doctors recommend that older adults sleep 7 to 8 hours a day to meet their sleep needs. There are sleep problems in older adults and one of them is insomnia, which is reflected in their daily lives, which is why music therapy appears as a non-pharmacological treatment to help reduce insomnia. Objetive. To evaluate the effect of nursing intervention in older adults with insomnia. Methodology. This research is quantitative, quasi-experimental in design, longitudinal and descriptive in scope. It was carried out in a period between April 2024-June 2024, in the province of Tungurahua, Canton Ambato, Parroquia La Matriz, Neighborhood Ciudadela España. The sample was 21 older adults from the Hogar de Ancianos Sagrado Corazón de Jesús, who met the inclusion and exclusion criteria. Results. The results obtained in this research demonstrate that music therapy as a nursing intervention has positive effects on older adults with insomnia. Conclusion. With the application of the Athens Test before and after the music therapy sessions, a significant improvement was shown in various aspects of sleep, such as difficulty falling asleep, nocturnal awakenings and total sleep duration.

Effectiveness of Red Ginger (Zingiber officinale var. Rubrum) Foot Hydrotherapy in Lowering Blood Pressure among Pregnant Women with Hypertension

Pregnancy hypertension is one of the complications of pregnancy. One nonpharmacological treatment to reduce hypertension is the foot hydrotherapy method with red ginger (Zingiber officinale var. rubrum). The essential oil content of red ginger provides a warm effect and spicy aroma so that blood vessels widen and blood flow becomes smooth. The research aims to determine the effectiveness of red ginger foot hydrotherapy in lowering blood pressure among pregnant women with hypertension. This one-group pretest-posttest pre-experimental study design was conducted at the Talaga Community Health Centre, West Java, from May 2023 to July 2023. The sample was 32 pregnant women with hypertension. Bivariate analysis test using paired t-test. The average systolic blood pressure measurement results for pregnant women before the intervention were 154.09 mmHg, and after the intervention was given 140.22 mmHg, there was a decrease of 13.87 mmHg. The average diastole for pregnant women before the intervention was 100.22; after the intervention, it was 91.62, resulting in a reduction of around 8.6 mmHg. The paired t-test with a p-value <0.001 shows the effectiveness of foot hydrotherapy with red ginger in reducing blood pressure in pregnant women with hypertension. Red ginger using the foot hydrotherapy method has been proven effective in lowering blood pressure in pregnant women. To reduce the risk factors for pregnancy with hypertension, pharmacological and nonpharmacological therapy is a solution that needs to be considered. This research can become a reference for evidence-based midwifery practice in providing midwifery care.

Weighted Blankets as a Sleep Intervention: A Scoping Review.

Sleep disorders are associated with a range of health conditions, with poor sleep often further exacerbating individuals' health, well-being, and ability to participate in daily occupations. Weighted blankets offer a potentially simple nonpharmacological sleep intervention option. To summarize available literature on instrumentation and outcomes associated with overnight use of weighted blankets for therapeutic purpose. A scoping review following the PRISMA review guidelines was conducted. Sources included MEDLINE, Cochrane Library, CINAHL, PsycINFO, Scopus, Embase, and Google. Included studies reported on overnight use of weighted blankets. Critical appraisal of studies was conducted with standardized tools. Eighteen studies met the inclusion criteria. Positive outcomes were reported for adults, including improved sleep, reduction in medication use, and improved mood. Sleep outcomes were mixed for children and adolescents but included improved occupational performance. Methodological quality of included studies regarding effectiveness was variable. Ten studies included details of the intervention, whereas only one study reported on implementation. No specific guidelines for use were included. Weighted blankets are used as a sleep intervention for individuals across the life span experiencing a range of health conditions. Currently, there is more evidence of effectiveness with adults, although parents are favorable regarding weighted blanket use for children. Implementation and recommendation of weighted blankets are typically led by occupational therapists, with knowledge of the intervention facilitating use. This review provides information to inform occupational therapists' clinical decision-making and continued implementation of weighted blankets for individuals with sleep problems. Plain-Language Summary: This scoping review summarizes what is known about the use of weighted blankets as a sleep intervention for people of all ages. There is more evidence for overnight use of weighted blankets for adults, with improvements reported in sleep, mood, medication use, and pain. Although there is little evidence of improvement in sleep for children, some children show improvement in everyday functioning, and parents report positive outcomes from overnight use of weighted blankets. These findings suggest that occupational therapists should consider offering or recommending weighted blankets as a sleep intervention option for people of all ages, alongside consideration of individuals' preferences. Development of practice guidelines that incorporate current research findings is urgently needed to support occupational therapists' use of weighted blankets.

Exploring Traditional Antipyretic Practices: Shallot Poultice (Allium cepa L.) for Fever Management in Infants

Fever is a common symptom in infants, often causing distress to both the child and caregivers. While pharmacological interventions like acetaminophen are widely used, concerns about potential side effects and the growing interest in natural remedies have led to a resurgence in exploring traditional practices. The use of shallot poultice for fever management has been documented in various cultures, but its efficacy and safety require rigorous scientific evaluation. This study aimed to investigate the antipyretic effect of shallot poultice in infants and contribute to evidence-based decision-making in pediatric fever management. A quasi-experimental study with a pretest-posttest control group design was conducted. Infants aged 0-12 months presenting with fever (≥37.5°C) at a primary healthcare center were recruited. Eligible infants were randomly assigned to either the intervention group (receiving shallot poultice application) or the control group (receiving standard care). The primary outcome was the change in body temperature after 30 minutes of intervention. Secondary outcomes included parental satisfaction and adverse events. A total of 60 infants were enrolled (30 per group). The intervention group demonstrated a statistically significant reduction in body temperature compared to the control group (p < 0.05). Parental satisfaction was high in both groups, with no significant difference observed. No adverse events related to the shallot poultice were reported. Shallot poultice appears to be a safe and effective non-pharmacological intervention for reducing fever in infants. These findings support the potential integration of this traditional practice into holistic fever management strategies. Further research is warranted to explore the underlying mechanisms and long-term effects.

Associations between Japanese calligraphy practice and sleep quality in community-dwelling older adults: A cross-sectional Study

BackgroundSleep disturbances, such as insomnia, are common among the elderly population and have been associated with negative health outcomes. Japanese calligraphy is a traditional art practice previously associated with various health benefits, such as stress reduction and improved cognitive function; however, its association with sleep quality has not been fully explored. MethodsThis cross-sectional study included 21,207 subjects with basic attributes, health status, depressive symptoms, artistic practices, and sleep habits. Individuals who satisfied the chronic insomnia criteria were categorized into the following subtypes: sleep onset latency (SOL) insomnia, early morning awakening (EMA) insomnia, and wake after sleep offset (WASF) insomnia. The t-test, chi-square test, and logistic regression analysis were used to determine the association between Japanese calligraphy practice and sleep quality. ResultsIn this study, 17,597 elderly Japanese individuals were included, among whom 13.7 % practiced Japanese calligraphy. Regarding sleep characteristics, 32.0 % had chronic insomnia, 13.1 % had SOL insomnia, 9.1 % had EMA insomnia, and 14.2 % had WASF insomnia. Japanese calligraphy practice was associated with lower rates of chronic insomnia (odds ratio [OR] = 0.85, 95 % confidence interval (CI) = 0.76–0.95), including SOL insomnia (OR = 0.84, 95 % CI = 0.71–0.98), and EMA insomnia (OR = 0.80, 95 % CI = 0.66–0.97) but had no significant association with WASF insomnia. ConclusionsThis study suggests that Japanese calligraphy practice is associated with lower odds of insomnia, particularly SOL and EMA insomnia. Calligraphy may be an effective nonpharmacological intervention for insomnia and poor sleep quality among elderly Japanese individuals.

Telehealth Mindfulness-Based Interventions for Chronic Pain

Although mindfulness-based interventions (MBIs) are evidence-based treatments for chronic pain and comorbid conditions, implementing them at scale poses many challenges, such as the need for dedicated space and trained instructors. To examine group and self-paced, scalable, telehealth MBIs, for veterans with chronic pain, compared to usual care. This was a randomized clinical trial of veterans with moderate to severe chronic pain, recruited from 3 Veterans Affairs facilities from November 2020 to May 2022. Follow-up was completed in August 2023. Two 8-week telehealth MBIs (group and self-paced) were compared to usual care (control). The group MBI was done via videoconference with prerecorded mindfulness education and skill training videos by an experienced instructor, accompanied by facilitated discussions. The self-paced MBI was similar but completed asynchronously and supplemented by 3 individual facilitator calls. The primary outcome was pain-related function using the Brief Pain Inventory interference scale at 3 time points: 10 weeks, 6 months, and 1 year. Secondary outcomes included biopsychosocial outcomes: pain intensity, physical function, anxiety, fatigue, sleep disturbance, participation in social roles and activities, depression, patient ratings of improvement of pain, and posttraumatic stress disorder. Among 811 veterans randomized (mean [SD] age, 54.6 [12.9] years; 387 [47.7%] women), 694 participants (85.6%) completed the trial. Averaged across all 3 time points, pain interference scores were significantly lower for both MBIs compared to usual care (group MBI vs control difference: -0.4 [95% CI, -0.7 to -0.2]; self-paced vs control difference: -0.7 [95% CI, -1.0 to -0.4]). Additionally, both MBI arms had significantly better scores on the following secondary outcomes: pain intensity, patient global impression of change, physical function, fatigue, sleep disturbance, social roles and activities, depression, and posttraumatic stress disorder. Both group and self-paced MBIs did not significantly differ from one another. The probability of 30% improvement from baseline compared to control was greater for group MBI at 10 weeks and 6 months, and for self-paced MBI, at all 3 time points. In this randomized clinical trial, scalable telehealth MBIs improved pain-related function and biopsychosocial outcomes compared to usual care among veterans with chronic pain. Relatively low-resource telehealth-based MBIs could help accelerate and improve the implementation of nonpharmacological pain treatment in health care systems. ClinicalTrials.gov Identifier: NCT04526158.