Non-pharmacological Methods Research Articles

Physical exercise and cognition in older adults, a scientific approach scanty reported in Latin America and Caribbean populations.

The advancement of public services, including the increased accessibility of health services, has led to a rise in life expectancy globally. As a result, aging populations are becoming more prevalent, raising concerns about cognitive decline. Fortunately, non-pharmacological methods, such as physical exercise, have been shown to mitigate the effects of aging on the brain. In this perspective article, we examined meta-analyses on the impact of physical exercise on cognition in older adults. The results indicate that combined exercise (i.e., aerobic plus strength training), has a significant positive effect on overall cognition and executive function. However, we found a lack of scientific studies on this topic in Latin American and Caribbean countries. Therefore, there is a pressing need for research to identify the feasibility of physical exercise interventions to improve cognitive skills in older adults from these regions.

EFEKTIVITAS PEMBERIAN TERAPI RELAKSASI OTOT PROGRESIF TERHADAP PENURUNAN TEKANAN DARAH PADA PASIEN HIPERTENSI : LITERATURE REVIEW

Background:Hypertension is a health problem that is still penetrating in various parts of the world, even more widespread along with the times. The disease is characterized by an increase in blood pressure reaching 140/90 mmHg or more. One way to reduce high blood pressure is to use non-pharmacological treatment methods, one of which is progressive muscle relaxation therapy. This approach focuses attention on the muscles by identifying tense ones and then reducing those tensions to achieve a sense of relaxation. Thus, blood pressure and heart rate can decrease significantly Objective: to assess how effective progressive muscle relaxation therapy is in reducing blood pressure in individuals suffering from hypertension with a literature study approach. Method: This research utilizes the literature study method using secondary data sources, namely articles obtained from three trusted databases, namely Google Scholar, Researchgate, and Onesearch. The criteria used as a reference for selecting articles to be reviewed include publication time in the last 5-10 years, using Indonesian or English, being original, available in full text form, and indexed. From the selection process, a total of 10 articles were considered worthy of review, consisting of five articles in Indonesian and five articles in English. This research focused on a comprehensive literature review of both languages to gain an in-depth understanding of the research topic. Thus, it is expected that this research can make a significant contribution to the understanding and development of science and technology in a broader context. By using a literature study approach and a rigorous selection process for the articles reviewed, it is hoped that this research can provide a comprehensive and accurate understanding of the issues discussed in this study. Results: In ten articles that have been compiled, it is explained that the use of progressive muscle relaxation therapy has the potential to reduce systolic and diastolic blood pressure in individuals suffering from hypertension. Conclusion: progressive muscle relaxation therapy is effective in reducing blood pressure in hypertensive patients, based on the arguments outlined earlier.

ANALYSIS OF DIFFERENCES IN THE EFFECTIVENESS OF GIVING RED BEET JUICE (BETA VULGARIS L) AND CUCUMBER JUICE (CUCUMIS SATIVUS) ON REDUCING BLOOD PRESSURE IN HYPERTENSIVE PATIENTS

Hypertension is a serious health issue worldwide, leading to cardiovascular diseases like heart attack, heart failure, stroke, and kidney disease. To prevent hypertension, a combination of pharmacological and non-pharmacological methods is necessary, including adopting a healthy lifestyle and consuming herbal plants. For instance, cucumber juice therapy and a mix of beetroot and pineapple juice are commonly used. This study aims to compare the effects of red beet juice and cucumber juice on the blood pressure of hypertensive patients in Drien Tujoh Village, Tripa Makmur District, Nagan Raya Regency in 2023. The research involved 30 hypertensive patients over 35 years old, divided into two groups. The results showed a significant difference in blood pressure before and after the intervention with beetroot juice and cucumber juice. This indicates that both interventions can help lower blood pressure in hypertensive patients.

Administration Effect of Lemon Aroma Therapy on Pain Reduction with Women in the 1st Active Phase

Pain during labor is a natural process caused by cervical dilatation, hypoxia of the uterine muscles during contractions, ischemia of the uterine corpus, stretching of the lower uterine segment, and compression of the cervical nerves. If labor pain occurs pathologically, it can trigger complications in pregnancy, one of which is prolonged labor. Data from the World Health Organization (WHO) in 2020 show that the maternal mortality rate is still high, with 295,000 women dying due to complications during pregnancy and childbirth. Prolonged labor is one of the fifth causes of maternal death in the world, accounting for 8.5% of cases. Pain can be relieved pharmacologically and non-pharmacologically, with one non-pharmacological method being lemon aromatherapy. This study aims to determine the effect of lemon aromatherapy on reducing pain intensity in the active phase of the first stage of labor at Painan Hospital in 2023.This research used a quasi-experimental design with a non-equivalent control group pretest-posttest. The study was conducted in July 2023, using both primary and secondary data. The sample consisted of 30 respondents selected through total sampling techniques. Data analysis was performed using Wilcoxon and Mann-Whitney non-parametric statistical analysis techniques.The results of the study showed that most participants in the intervention group experienced controlled severe pain before and after the intervention, while the control group mostly experienced moderate pain before the intervention and uncontrolled severe pain after the intervention. The Mann-Whitney test indicated a significant difference in pain intensity between the intervention and control groups, with a p-value of 0.000 < α (0.05), leading to the rejection of the null hypothesis.The researchers recommend that health services provide support to mothers experiencing pain during labor to ensure a comfortable birthing process.

The Benefits and Barriers of Providing Non-Pharmacological Pain Relief to Women in Labour during COVID-19: A Qualitative Study of Midwives in South Africa

Pregnancy is an exceptional event in a woman’s life. As a result of the intense pain associated with childbirth, women require encouragement and support during this crucial phase. Midwives play a crucial role in the maternal care paradigm, managing labour pain alongside ensuring the mother and baby’s safety during the labour process. This study explored midwives’ perspectives concerning the utilisation and barriers of non-pharmacological labour pain reduction methods during COVID-19 in Matjhabeng Municipality hospitals in South Africa’s Free State Province. Ten midwives participated in a semi-structured interview wherein the audio was recorded and transcribed verbatim. The data were analysed using Tesch’s approach for open-coding data analysis. Midwives’ experiences with non-pharmacological therapeutic options for relieving labour pain were varied. They used mobilisation techniques, warm bathing, deep breathing exercises, back massaging, and psychological support. Midwives affirmed that non-pharmacological labour pain interventions were poorly implemented because of staff shortages, heavy workload, and COVID-19 regulations at the time. In efforts to address the obstacles in managing labour pain and alleviate the pain of women during labour, midwives recommended the provision of education and advocacy, the employment of additional midwives and auxiliary staff, and improvement in hospital infrastructure. Due to staff shortages, heavy workloads, and COVID-19 restrictions that limit birth companions, non-pharmacological pain reduction methods are not properly implemented. Health education; employing additional midwives, professional doulas, and students; and improving health infrastructure are midwives’ concerns. Prioritising midwife training in non-pharmacological labour pain management is crucial for delivering the best possible care during childbirth.

Multi-Think Transformer for Enhancing Emotional Health

The smart healthcare system not only focuses on physical health but also on emotional health. Music therapy, as a non-pharmacological treatment method, has been widely used in clinical treatment, but music selection and generation still require manual intervention. AI music generation technology can assist people in relieving stress and providing more personalized and efficient music therapy support. However, existing AI music generation highly relies on the note generated at the current time to produce the note at the next time. This will lead to disharmonious results. The first reason is the small errors being ignored at the current generated note. This error will accumulate and spread continuously, and finally make the music become random. To solve this problem, we propose a music selection module to filter the errors of generated note. The multi-think mechanism is proposed to filter the result multiple times, so that the generated note is as accurate as possible, eliminating the impact of the results on the next generation process. The second reason is that the results of multiple generation of each music clip are not the same or even do not follow the same music rules. Therefore, in the inference phase, a voting mechanism is proposed in this paper to select the note that follow the music rules that most experimental results follow as the final result. The subjective and objective evaluations demonstrate the superiority of our proposed model in generation of more smooth music that conforms to music rules. This model provides strong support for clinical music therapy, and provides new ideas for the research and practice of emotional health therapy based on the Internet of Things.

Impact of Pulsed Electromagnetic Field Therapy and Aerobic Exercise on Patients Suffering With Hypertension: A Systematic Review.

Hypertension is a major preventable risk factor for cardiovascular disease. This reviewevaluates the effects of pulsed electromagnetic field (PEMF) therapy and aerobic exercise on blood pressure (BP) levels in hypertensive patients. This study incorporated research conducted between 2012 and 2020 that was found through a systematic literature search. The measures used to estimate the improvement in BP include the BP measurements, quality-of-life (QOL) scale, and plasma nitric oxide (NO) level. The examination of the review comprised eight studies. These encompassed studies involving individuals with a systolic BP (SBP) above 140 mmHg and a diastolic BP (DBP) above 90 mmHg; those falling within the age range of 40 to 60 years, including both genders; and patients on antihypertensive medications. The review of selected articles concluded that PEMFtherapy and aerobic exercise positively impact BP among individuals with hypertension. Aerobic exercises of moderate intensity including brisk walking, jogging, and cycling type of aerobic exercises help reduce BP and maintain patients' physical fitness. PEMF therapy is a complementary approach that affects the biological system and potential health, positively impacting BP. Results indicate that PEMF therapy can be a nonpharmacological method to manage BP in clinical populations. More thorough research is necessary to understand the best dosage, long-term effects, and comparison between PEMF therapy and aerobic exercise.

The Management of Spinal and Epidural Anesthesia-Related Hypotension in the United States During Cesarean Childbirth.

This study delves into the prevalence of spinal anesthesia-induced hypotension during cesarean (c-section) childbirth, focusing on existing treatments and their efficacy. Currently, neuraxial analgesia is the most efficient method for alleviating pain during c-sections, but its major side effect, hypotension, necessitates a thorough understanding of the available treatment options. A scoping review was conducted using PubMed and Rayyan, with inclusion criteria being English peer-reviewed articles from the last five years, involving nulligravida/primigravida women under 35 years old in the United States. The research reveals various treatments to mitigate spinal anesthesia-induced hypotension. Norepinephrine and epinephrine have demonstrated effectiveness in maintaining blood pressure while reducing adverse maternal outcomes following delivery. When comparing fixed-rate infusions of norepinephrine to phenylephrine, norepinephrine demonstrated lower rates of bradycardia (p=0.004), thereby reducing the necessity for bolus atropine rescue (p=0.01). Furthermore, the use of colloid solutions during c-sections significantly decreased the incidence of hypotension when compared to crystalloid solutions (p<0.00001). Non-pharmacological methods, such as lower extremity wrapping and elevation, exhibited higher systolic and diastolic blood pressures, along with higher usage of ephedrine when compared to control groups. Pharmacological treatments proved more effective than non-pharmacological interventions in preventing maternal hypotension during c-sections. Notably, colloid preloading emerged as the most effective approach, helping to maintain maternal blood pressure, cardiac output, and heart rate while also minimizing the amount of ephedrine required and reducing anesthesia-related adverse effects. However, the study suggests the need for further investigations to determine the optimal dosage for colloid preloading. This research provides valuable insights into enhancing maternal well-being during c-sections by addressing the issue of neuraxial anesthesia-induced hypotension.

Post-Traumatic Stress Disorder In Children And Non-Pharmacological Therapies Strategies In Iran: A Review Study

Purpose and Background: Post-traumatic stress disorder (PTSD) is a set of symptoms that appear after a severe traumatic stress. Children and adolescents experience an increase in potentially traumatic experiences. Many children subsequently develop mental health problems. Method: A broad search was conducted in scientific databases and search engines such as Science Direct, PubMed, Cochrane, Medline, SID, Scopus, CINAHL, OVID, Iran Doc, and Magiran with Using the keywords “post-traumatic stress disorder”, “non-pharmacological coping strategies”, “children” alone or in combination with each other and their English equivalent was done. Articles that were published between 2000 and 2023 and were more related to the main focus of the research topic were selected.After a comprehensive review, nine studies that met the purpose of this study were selected. Findings: The most important non-pharmacological treatment strategies in children included relaxation and hypnosis, acupuncture, neurofeedback, saikokeishikankyoto (a herbal preparation) and exercise (yoga). Conclusion: Therefore, the use of non-pharmacological methods as one of the effective methods in the treatment of these children’s disorders can improve the quality of life of the family of these patients and the patient himself, as a result, administrators should encourage the patients’ families by using non-pharmacological methods.

Çocuklarda Postoperatif Dönemde Ağrı Tedavisinde Nonfarmakolojik Yöntemlerin Kullanımının İncelenmesi: Sistematik Bir İnceleme

Background: The aim of this study was to examine the non-pharmacological methods used by nurses in postoperative pain management in pediatric patients aged 0-18 years and the effectiveness of the methods used in reducing the level of pain.&#x0D; Material and Methods: In this descriptive study, the research population consisted of studies that were accessed from the National Thesis Center database by using the keywords "pediatric", "pain", "surgical", "postoperative", "non-pharmacological" in different combinations in the literature search and that examined non-pharmacological methods used for pain management in the postoperative period in pediatric patients between the ages of 0-18 years in the last seven years and were conducted in experimental design. This systematic review was carried out using the PRISMA flowchart steps.&#x0D; Results: A total of 1185 individuals, including 905 children and 280 parents, took part in 11 studies. The mean age of the children in the studies was 6.6 years (min-max). The most preferred scale to measure pain in the postoperative period was the Wong Baker Facial Pain Scale (7 studies). Non-pharmacologic methods used in the studies included distraction (5 studies), therapeutic play (3 studies), distraction and therapeutic play (1 study), massage therapy (1 study) and music therapy (1 study).&#x0D; Conclusion: Different non-pharmacological methods used in the postoperative period are effective in reducing pain levels in children.&#x0D; Practice implications: It is possible for pediatric nurses to use non-pharmacological methods to reduce pain in the postoperative period. Further research is needed to determine the effectiveness of these interventions on pain.

Effects of the Specialized Preoperative Waiting Room on Preoperative Anxiety in Pediatric Patients

Preoperative anxiety is a common event-related psychological disorder, which increases the perioperative risk, especially among children. The aim of this study is to establish a specialized waiting room for pediatric patients and investigate the efficiency on preoperative anxiety. This is a single center, open label, randomized controlled trial. Eligible children were randomly allocated into the routine waiting group (control group) and the specialized waiting group (study group). The Children&amp;apos;s Emotional Manifestation Scale (CEMS), crying times, separation emotion, the degree of coordination, satisfaction score of parents, and quality of postoperative recovery were collected and analyzed. A total of 150 children were included and analyzed. Patients in the study group had lower CEMS score, less crying times, better separation emotion and coordination degree, and better recovery quality on the 1&amp;lt;sup&amp;gt;st&amp;lt;/sup&amp;gt; postoperative day than those in the control group (&amp;lt;i&amp;gt;p&amp;lt;/i&amp;gt;&amp;lt;0.05). However, the recovery quality on the 3&amp;lt;sup&amp;gt;rd&amp;lt;/sup&amp;gt; or 7&amp;lt;sup&amp;gt;th&amp;lt;/sup&amp;gt; postoperative day was comparable between the groups (&amp;lt;i&amp;gt;p&amp;lt;/i&amp;gt;&amp;gt;0.05). Besides, the guardians in the study group gave higher scores to the preoperative waiting procedure (&amp;lt;i&amp;gt;p&amp;lt;/i&amp;gt;&amp;lt;0.05). Our specialized waiting room for pediatric patients is an effective non-pharmacological method to alleviating preoperative anxiety, increasing parents’ satisfaction score, and enhancing recovery quality of the 1&amp;lt;sup&amp;gt;st&amp;lt;/sup&amp;gt; postoperative day.

COVID-19 and older people’s wellbeing in northern KwaZulu-Natal – the importance of relationships

Background The COVID-19 pandemic and the non-pharmacological prevention methods have affected the wellbeing of older people. In this paper we focus on the wellbeing, and vulnerability, of older people in rural northern KwaZulu-Natal, South Africa during the first year of the pandemic. Methods We conducted monthly in-depth interviews for up to four months with 26 people aged 60 years and older. A total of 87 interviews were conducted by telephone, because of restrictions on face-to-face contact, and digitally recorded. After transcription and translation, the data were coded thematically, with analysis guided by a wellbeing theoretical framework. Results Having access to food, to healthcare and to somewhere they felt safe to stay, was essential for everyone. For many managing expenses became more of a struggle as adult children who had lost their source of employment came home to stay. However, despite the shortages of money, the importance of relationships, whether they are familial or the close community of neighbours, was highlighted in the accounts of many participants. Older people not only got help with day-to-day life from others, but also found solace in the company of others. The sense of community, from family and neighbours, helped to ease some of the stress experienced because of the lockdowns. Conclusions The COVID-19 pandemic and the restrictions imposed to limit the spread of the virus impacted the wellbeing of older adults in rural KwaZulu-Natal. Our findings show how the importance of relationships with family and friends contributed to nurturing wellbeing for older people.

Differing Approaches to Pain Management for Intrauterine Device Insertion and Maintenance: A Scoping Review.

Intrauterine devices (IUDs) are considered a reliable contraceptive option for women,but they can come with side effects. There is a disconnect in standard guidelines for IUD insertion within and without the U.S. The objective of this review was to address a gap in the literature regarding official procedures for pain management during IUD implantation.This scoping review was initiated using keywords to extract relevant articles from multiple databases: U.S. National Library of Medicine National Institutes of Health (PubMed), MEDLINE (Ovid), and Excerpta Medica dataBASE (EMBASE, Ovid). Initially, 457 articles were identified and after a rigorous screening and selection process, 37 articles were chosen to be further assessed to ascertain if they met the study's inclusion criteria. Those 37 articles were further evaluated fully to check for relevancy. From that process, 19 articles were chosen for the review, and all passed quality assessment evaluations using the JB Appraisal Tools. To best address the research question, the data from the 19 articles were divided into three categories: 1) circumstantial factors, 2) non-pharmacological methods, and 3) pharmacological methods. Circumstantially, women with previous vaginal deliveries experienced the lowest pain during the procedure, and nulligravid (never pregnant) women experienced the most pain. Lower pain scores were reported by lactating women compared to non-lactating. Black women experienced the most anticipated pain compared to other races. Regarding non-pharmacological methods, different insertion techniques, tools, and the use of a cold compress were found to not affect the level of pain during IUD insertion. Lastly, it was shown that pharmacological methods such as lidocaine gel, lidocaine paracervical block, and lidocaine combined with either diclofenac or prilocaine decreased pain scores at different time stamps of the procedure. Also, oral ketorolac and a vaginal combination of misoprostol and dinoprostone helped reduce pain.Findings from this scoping review revealed a lack of uniformity across practices when performing IUD insertions, possibly due to differences in procedures across circumstantial factors, non-pharmacological methods, and pharmacological methods. More research is needed to investigate the intricacies of pain with IUD insertion. Moving forward, especially following a potential increase in the use of IUDs after the reversal of Roe v. Wade, establishing this gap may lead to a more refined standardized protocol to mitigate pain with IUD insertions.

Study of the mechanism of action of sand therapy on atherosclerosis based on the two-phase flow-Casson model.

Sand therapy is a non-pharmacological physiotherapy method that uses the natural environment and resources of Xinjiang to treat through the heat transfer and magnetic effects of sand. Employing the two-phase flow-Casson blood flow model, we investigate the mechanism of atherosclerosis prevention via sand therapy, offering a biomechanical theoretical rationale for the prevention of atherosclerosis through sand therapy via the prism of computational fluid dynamics (CFD). Sand therapy experiments were conducted to obtain popliteal artery blood flow velocity, and blood was considered as a two-phase flow composed of plasma and red blood cells, and CFD method was applied to analyze the hemodynamic effects of Casson's blood viscosity model before and after sand therapy. (1) The blood flow velocity increased by 0.24 m/s and 0.04 m/s at peak systolic and diastolic phases, respectively, after sand therapy; the axial velocity of blood vessels increased by 28.56% after sand therapy. (2) The average red blood cell viscosity decreased by 0.00014 Pa ⋅ s after sand therapy. (3) The low wall shear stress increased by 1.09Pa and the high wall shear stress reached 41.47Pa after sand therapy. (4) The time-averaged wall shear stress, shear oscillation index and relative retention time were reduced after sand therapy. The increase of blood flow velocity after sand therapy can reduce the excessive deposition of cholesterol and other substances, the decrease of erythrocyte viscosity is beneficial to the migration of erythrocytes to the vascular center, the increase of low wall shear stress has a positive effect on the prevention of atherosclerosis, and the decrease of time-averaged wall shear stress, shear oscillation index and relative retention time can reduce the occurrence of thrombosis.

Labour pain relief practice by maternal health care providers at a tertiary facility in Kenya: An institution-based descriptive survey.

Although pain relief is a crucial component of modern obstetric care, it remains a poorly established service in sub-Saharan countries such as Kenya. Maternal health care providers have an extensive role to play in meeting the analgesic needs of women during childbirth. This study sought to examine the practice of labour pain relief among Kenyan maternal health care providers. This was an institution-based, cross-sectional, descriptive survey. The study included midwives, obstetricians, and anaesthesiologists (n = 120) working at the second-largest tertiary facility in Kenya. A structured, self-administered questionnaire was used. The labour pain relief practice, knowledge, attitude, and perceived barriers to labour pain management were described. One hundred and seventeen respondents participated in the study representing a response rate of 97.5%. More than half of maternal health care providers routinely provided the service of labour pain relief (61.5%). Sixty-four (88.9%) respondents reported providing pharmacological and non-pharmacological methods, while 11.1% provided only pharmacological ones. The most common pharmacological method prescribed was non-opioids (12.8%). The most preferred non-pharmacological method of pain management was touch and massage (93.8%). Regional analgesia was provided by 3.4% of the respondents. More than half of the respondents (53%) had poor knowledge of labour pain relief methods. Almost all (94%) of the respondents had a positive attitude towards providing labour pain relief. Non-availability of drugs and equipment (58.1%), lack of clear protocols and guidelines (56.4%), and absence of adequate skilled personnel (55.6%) were reported as the health system factors that hinder the provision of labour analgesia. More than half of maternal health care providers routinely relieve labour pain. Epidural analgesia is still relatively underutilized. There is a need to develop institutional labour pain management protocols to meet the analgesic needs of women during childbirth.

Non-pharmacological methods of treating chronic non-specific neck pain, possibilities of radiofrequency denervation: A review

Chronic non-specific neck pain (CNSNP), or cervicodynia, is a common pathology that significantly reduces the quality of life of patients. It is believed to be based on degenerative and dystrophic changes in the spine, as well as myofascial pain syndrome. Currently, a comprehensive approach is used in the treatment of CNSNP, including kinesitherapy, ergotherapy, manual therapy, and cognitive-behavioral therapy. In case of ineffectiveness of conservative patient management methods, radiofrequency denervation is used, which is an effective and safe procedure for reducing the severity of pain syndrome. The results of the use of radiofrequency denervation in CNSNP are discussed.

Electric massage chairs reduce labor pain in nulliparous patients: a randomized crossover trial

BACKGROUND: Labor pain varies significantly among pregnant women, ranging from mild to extremely distressing. Non-pharmacologic pain relief methods during vaginal birth are increasingly popular, either as a complement to pharmacologic agents or at times as the primary method of pain relief. Multiple trials have reported that manual or by-hand massage reduces labor pain. The effectiveness of full-body mechanical massage using electric massage chairs on labor pain remains unexplored.OBJECTIVE: To evaluate mechanical massage using electric massage chair on labor pain in nulliparous women.STUDY DESIGN: A randomized counterbalanced crossover trial was conducted in a university hospital in Malaysia from August 2022 to February 2023. Eligible nulliparas in labor with a minimum labor pain score of 5 (0-10 numerical rating scale) were enrolled. Participants were randomized to 30 minutes on the massage chair with mechanical massage followed by 30 minutes on the massage chair without mechanical massage, or the other way around in massage sequence. The primary outcome was change in pain score comparing pain with and without mechanical massage as a paired comparison for the entire trial participants. Secondary outcomes were across arms analyses of maternal and neonatal outcomes. The paired t-test, t test, Mann- Whitney U test, Chi square test and Fisher exact test were used as appropriate for the data.RESULTS: 208 women were randomized; 104 to each intervention. Data was available from 204 participants (103 randomized to massage first and 101 to no massage first). The primary outcome of change in labor pain score (0-10 Numerical Rating Scale, NRS) after massage and no massage (all participants included after crossover, paired t-test analysis) was mean±standard deviation 4.51±2.3 vs 5.38±2.1 mean difference - 0.87 (95% CI -1.14 to -0.59), p<0.001, a significant reduction in pain score after electric chair mechanical massage compared to no massage. On the across randomized arms secondary analyses, labor pain score after their first massage chair session was 4.35±2.52 (randomized to massage first, received massage as initial intervention) vs 5.66±1.73 p<0.001 (randomized to no massage first, received no massage as initial intervention) mean difference -1.31 (95% CI -1.91 to -0.748), a significant reduction after mechanical massage. Other distal maternal outcomes (mode of delivery, labor analgesia, duration of labor and maternal agreement that mechanical massage is effective for labor pain) and neonatal outcomes (Apgar score at 1 and 5 minutes, cord artery blood pH and base excess, and neonatal admission) were not different across randomized arms.CONCLUSION: Mechanical massage using an electric massage chair significantly reduces labor pain, offering a potential non-pharmacologic pain management option during labor.

Auricular Acupressure Improve Constipation of Patients With Schizophrenia: A Pilot Randomized Controlled Study.

Background. Constipation is a common distressing problem in patients with schizophrenia that can cause complications and impair quality of life. Objective. The objective of this study was to investigate the efficacy of applying auricular acupressure (AA) treatment in improving constipation in patients with schizophrenia. Methods. A crossover randomized controlled trial design was performed from April 2022 to December 2023 at four psychiatric rehabilitation care centers. A total of 23 patients with schizophrenia received an AA intervention or usual care according to the designated treatment sequences. Measurements comprised subjective assessment of constipation by the Patient Assessment of Constipation-Symptoms (PAC-SYM) questionnaire, an objective assessment of the stool pattern rated by a Bristol stool form scale, and heart rate variability. A generalized estimating equation model was used for data analyses. Results. After completing an 8-week AA intervention stimulating the Shenmen, San Jiao, Large intestine and Rectum, the AA group exhibited lower scores in the PAC-SYM total score (difference = -12.66, ,0.001), and the subscales: abdominal (difference = -3.36, p < .001), rectal (difference = -3.51, p < .001), and stool (difference = -5.79, p < .001), compared to those receiving usual care. The cases of constipation indicated by type 1 and type 2 of the BSF scale significantly decreased after the 8-week AA intervention. Moreover, the AA group displayed more parasympathetic dominance compared to the usual care group, with a low frequency to high frequency ratio of -1.15. Conclusion. AA is an effective non-pharmacological method for improving subjective constipation symptoms and objective stool pattern in patients with schizophrenia.

The Effectiveness of Neurofeedback on Improving Social Interactions and Activity of Daily Living in Children with Autism Spectrum Disorder: A Narrative Review

Context: Impairment in social interactions and daily activities of autism spectrum disorder (ASD) patients is one of the negative and important consequences of ASD. Recently, the use of non-pharmacological methods to improve behavior and rehabilitation in patients with ASD has attracted the attention of researchers and specialist physicians. According to the mentioned topic, This study aimed to evaluate the effectiveness of neurofeedback (NF) in improving social interactions and activity of daily living (ADL) in children with ASD. Evidence Acquisition: This narrative review obtained the desired results by collecting previous similar studies related to the study's primary purpose. First, 182 articles were extracted through the search of MeSH (medical subject headings) terms associated with the particular objectives of the study in international reliable databases. Then, twenty-five studies were selected as final studies considering the inclusion and exclusion criteria. Results: The results of the present study showed that NF can help to improve the performance of children with ASD through brain waves as a new treatment method based on conditioning and reinforcement. NF helps identify cognitive problems and improve cognitive processes in autistic children by improving self-regulation of the brain. In addition, NF leads to better cognitive performance by increasing beta waves and decreasing theta waves. On the other hand, increasing beta waves increases alertness, concentration, and metabolism, which can improve cognitive and social functioning. Conclusions: Based on the results, NF has a positive and significant effect in improving social interactions and ADL in children with autism spectrum disorder. Therefore, this method should be used to improve behavioral disorders and strengthen the ADL of patients with ASD, considering the side effects of pharmacological intervention methods.

Tetrad of Narcolepsy Type 1: Treatment and Management.

Narcolepsy is a chronic condition that brings about excessive daytime sleepiness. It can be classified into two types: narcolepsy type 1 (presence of cataplexy, which is marked by weakness of muscles) and narcolepsy type 2 (without cataplexy). It is generally underdiagnosed, which results in delayed diagnosis of the condition. It has more prevalence in the United States of America as compared to India. The narcoleptic tetrad consists of excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, and hypnagogic hallucinations. Rapid eye movement (REM) sleep behavior disorder is another characteristic feature. Research about narcolepsy has been carried out for about 145-150 years, but it is only in the last 18-20 years that there has been advancement in the underlying pathophysiology, diagnosis, and, thus, availability of better treatment. Both pharmacological and non-pharmacological methods are preferred in treating narcolepsy, yet there is no cure for it. Since the knowledge regarding this condition is very limited, it is often misunderstood, and dealing with it is mentally and socially draining, often causing anxiety in the patients, feeling of social isolation, and other significant impacts on the quality of living. Raising awareness about narcolepsy is vital to prevent further medical attention delays.