Non-pharmacological Approaches Research Articles

Effectiveness of Nonpharmacological Measures on Improving Headache Score, Strength, Pain, and Quality of Life in Cervicogenic Headaches: A Systematic Review.

Cervicogenic headache (CGH) is a common condition affecting a significant portion of the population and is effectively managed through various interventions, including nonpharmacological approaches. Physical therapy plays a crucial role in CGH management, with numerous studies supporting its effectiveness. This systematic review aimed to evaluate the effectiveness of specific nonpharmacological physical therapy interventions for CGH. A comprehensive search was conducted across various databases (PubMed, Medline, PEDro, and Cochrane Library) for randomized controlled trials (RCTs) published between January 2017 and January 2023 investigating the effectiveness of specific nonpharmacological physical therapy interventions for CGH. We employed manual searches to capture potentially missed studies. Independent reviewers screened all studies based on predefined eligibility criteria. Extracted data included methodology, specific interventions, outcome measures (headache score, strength, pain, and quality of life (QOL)), and study conclusions. Eight RCTs were identified as meeting all inclusion criteria and were thus included in the data synthesis. The findings from these trials revealed a diverse range of nonpharmacological physical therapy interventions, including but not limited to manual therapy, exercise therapy, and multimodal approaches. Specifically, the interventions demonstrated significant improvements in headache scores, strength, pain levels, and overall QOL among individuals with CGH. These results underscore the multifaceted benefits of physical therapy in managing CGH and highlight its potential as a comprehensive treatment option. This review identified eight relevant RCTs investigating nonpharmacological interventions for CGH. Despite the promising findings, this review acknowledges several limitations, including the limited sample size and the heterogeneity of interventions across studies. These limitations emphasize the necessity for further research to elucidate optimal intervention strategies and refine treatment protocols. Nevertheless, the comprehensive analysis presented herein reinforces the pivotal role of physical therapy in not only alleviating pain but also enhancing function and improving the QOL for individuals suffering from CGH.

Effect of Yoga Therapy on Insomnia Severity and Systolic Blood Pressure in Aged Women: A 12-Week Intervention Study Conducted in Kerala.

This study aimed to investigate the effects of a 12-week yoga therapy intervention on insomnia severity and systolic blood pressure in older women experiencing insomnia. A sample of 30 participants, aged between 60 and 70 years, underwent interventions, starting with an initial full-day workshop followed by 60-minute sessions held six days per week in the mornings. Women screening positive for insomnia using the Insomnia Severity Index Questionnaire were eligible for participation. The majority of participants were aged between 60 and 65 years, with a slight majority residing with a spouse. Economically, the group exhibited a diverse distribution, with a significant proportion classified as middle class. Educationally, the group also displayed a varied profile, with a range of educational qualifications. Pretests and post-tests were conducted to assess outcomes. The results revealed a significant reduction in Insomnia Severity Scores, with a mean decrease of 5.17 (±1.05), indicating a substantial effect size, from an initial average of 23.03 (±2.47) to 17.87 (±2.61) after the intervention. Similarly, there was a significant decrease in systolic blood pressure, with scores declining by a mean of 9.67 (±6.87), demonstrating a considerable effect size, from an average of 140.33 (±8.65) to 130.67 (±7.52). These findings suggest that yoga therapy holds promise as a non-pharmacological approach for alleviating insomnia symptoms and reducing systolic blood pressure in older women experiencing insomnia.

Highlighting the effects of high-intensity interval training on the changes associated with hypertrophy, apoptosis, and histological proteins of the heart of old rats with type 2 diabetes

T2DM is known to cause disturbances in glucose homeostasis and negative changes in the heart muscle, while aging and diabetes are recognized risk factors for CVD. Given this, our study aims to investigate a method for controlling and managing CVDs induced by T2DM in elderly populations. To achieve this, we categorized 40 rats into 5 groups, including HAD (n = 8), HA (n = 8), AD (n = 8), AHT (n = 8), and ADT (n = 8). The exercise protocol consisted of eight weeks of HIIT (three sessions per week) performed at 90–95% of maximal speed. Following cardiac tissue extraction, we assessed the levels of IGF-1, PI3K, and AKT proteins using Western blot technique, and analyzed the histopathological variations of the heart tissue using H&E, Sudan Black, and Masson’s trichrome tissue staining. The histological findings from our study demonstrated that T2DM had a significant impact on the development of pathological hypertrophy and fibrosis in the heart tissue of elderly individuals. However, HIIT not only effectively controlled pathological hypertrophy and fibrosis, but also induced physiological hypertrophy in the AHT and ADT groups compared to the HA and AD groups. Results from Sudan Black staining indicated that there was an increase in lipid droplet accumulation in the cytoplasm of cardiomyocytes and their nuclei in the HA and AD groups, while the accumulation of lipid droplets decreased significantly in the AHT and ADT groups. In both the AHT group and the ADT group, a single HIIT session led to a reduction in collagen fiber accumulation and fibrotic frameworks. Our research also revealed that diabetes caused a significant elevation in the levels of IGF-1, PI3K, and AKT proteins, but after eight weeks of HIIT, the levels of these proteins decreased significantly in the training groups. Overall, our findings suggest that HIIT may be a suitable non-pharmacological approach for improving histological and physiological changes in elderly individuals with T2DM. However, we recommend further research to examine the impact of HIIT training on both healthy and diseased elderly populations.

How can clinicians enhance self-efficacy beliefs in osteoarthritis? An overview of systematic reviews with meta-analysis.

This overview of reviews aimed to synthesize the effectiveness of non-pharmacological approaches to enhance self-efficacy in people with osteoarthritis. The CINAHL, Embase, PsycINFO, PubMed, SPORTDiscus, and the Cochrane Library databases were searched from inception to December 2023. We considered systematic reviews with meta-analysis of randomized clinical trials evaluating any non-pharmacological intervention. We used AMSTAR 2 to assess the methodological quality of reviews. The overlap between reviews was calculated. We included eight systematic reviews with meta-analysis evaluating 30 different clinical trials. Overall, mind-body exercises, psychological interventions, and self-management strategies may improve arthritis self-efficacy. Specifically, the meta-analyses showed tai chi exercises, coping skills training, and the arthritis self-management program are more effective than controls to enhance arthritis self-efficacy in people with hip and/or knee osteoarthritis. In addition, inconsistent results were detected across meta-analyses regarding the effectiveness of multidisciplinary interventions. Finally, the degree of overlap between all reviews was moderate (CCA = 6%) and many included reviews reported most of the items of AMSTAR 2. Tai chi exercises, coping skills training, and the arthritis self-management program may be beneficial for enhancing arthritis self-efficacy. Open Science Framework Registration: https://doi.org/10.17605/OSF.IO/VX2T6 .

Effect of Morning and Afternoon Exercise on the Improvement of Endothelial Dysfunction in Type-2 Diabetes Mellitus Patients

Introduction: Endothelial dysfunction, an early precursor to cardiovascular complications in Diabetes Mellitus (DM) patients, can be effectively managed through exercise, a non-pharmacological approach. However, it is significant to consider the timing of exercise as it can influence the benefits obtained in the management of vascular complications. This is because various systems in the body, including endothelial function, undergo fluctuations according to the circadian rhythm. This study aimed to explore the differences between morning and afternoon exercise in improving vascular endothelial dysfunction in the production of endothelial Nitric Oxide Synthase (eNOS) and Endothelin-1 (ET-1). Methods: Twenty two Type-2 Diabetes Mellitus (T2DM) patients were randomly divided into morning and afternoon exercise groups, and they were administered 10 weeks of Persadia diabetes gymnastics treatment. Before treatment, venous blood was taken as pre-exercise data, and after 10 weeks, it was obtained again for post-exercise examination. The examined data consisted of blood glucose, eNOS, and ET-1 levels. The data was processed statistically using the t-test. Results: eNOS level increased significantly in both samples at 6.66 ± 0.56 ng/ml and 5.46 ± 0.9 ng/ml (p<0.001). However, the increment was higher in the morning group. Whereas, the level of ET-1 decreased significantly in both samples at 58.08 ± 4.01 pg/ml vs. 34.84 ± 4.75 pg/ml (p<0.001), but the decrement was greater in the morning group. Conclusion: This study indicates that morning exercise is more influential in improving endothelial dysfunction by increasing the eNOS enzyme and significantly decreasing ET-1 in T2DM patients.

High-intensity combination exercise has the highest effect on increasing serum irisin and interleukin 6 levels in women with obesity.

Lifestyle, overnutrition, socioeconomic status, environmental conditions, and genetics are factors that cause obesity. Lifestyle modification with a nonpharmacological approach based on physical exercise is the starting point inovercoming obesity. However, physical exercise with the appropriate and effective intensity for obese subjects is still debated. Therefore, this study aims to prove the effect of intensity differences with aerobic-resistance combination exercise on increasing irisin and IL-6 levels in obese women. A total of 32 obese women were selected as subjects and administered the interventions of low-intensity combination exercise (Q2), moderate-intensity combination exercise (Q3), and high-intensity combination exercise (Q4). ELISA was used to measure irisin and IL-6 levels in all samples. Statistical analysis used one-way ANOVA and Turkey's-Honest Significant Difference (HSD) post hoc test. The mean Δ IL-6 levels in the control groups (Q1), Q2, Q3, and Q4 were 0.27±2.54, 2.07±2.55, 5.99±6.25, and 7.98±2.82 pg/mL with (p=0.015). The mean Δ irisin levels were 0.06±0.81 ng/mL in Q1, 0.59±0.67 ng/mL in Q2, 1.99±1.65 ng/mL in Q3, 4.63±3.57 ng/mL in Q4 with (p=0.001). This study proved that all three types of combined exercise intensity increased myokine levels, suchas irisin and IL-6. However, high-intensity combination exercise provided the most optimal improvement in myokine levels in obese women. Future studies are needed to design long-term exercise programs specifically for obese adolescent women using the findings from this study.

The Effect of Benson Relaxation and Dhikr on Decreasing Pain Scale in Active Phase I Delivery Mothers at Yosi Trihana Independent Midwifery Practice

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Pain management uses pharmacological and non-pharmacological approaches, to reduce pain by treating accompanying symptoms. One of the non-pharmacological pain treatments is Benson relaxation therapy and dhikr. Benson relaxation therapy is a non-pharmacological strategy that combines relaxation techniques with the patient's belief system. It aims to reduce pain and encourage calmness by focusing on Allah SWT and releasing all emotions to the mother. The purpose of this study was to determine the effect of Benson relaxation and dhikr on reducing the pain scale in mothers inpartu kala I active phase. The research method used is quantitative with a pre-experimental research design, with the type of research one group pre-post test. The research location was at the Yosi Trihana Independent Practice Midwife, Klaten Regency, Central Java. They were carried out in November 2023 to January 2024. The population used was all active mothers inpartu active phase I. The sampling technique was total sampling, so the research sample was 30 respondents. The research instrument used the Numeric Rating Scale (NRS) pain scale. Data analysis was performed using the Wilcoxon test, which was processed using SPSS software version 20.0. The results showed a significant relationship with a p-value = (0.000). There is a decrease in the intensity of pain experienced during the labour process in Yosi Trihana's Independent Midwife Practice. These findings indicate that benzene relaxation and dhikr significantly impact reducing pain levels during labour. It is recommended that nurses and other health workers use dhikr relaxation as a non-pharmacological technique to reduce pain during labour. </em><em></em></p><p> </p></td></tr></tbody></table></div><strong><em>Keywords: Benson Relaxation, Dhikr, Pain Intensity Scal</em></strong>

Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator.

To investigate the potential effectiveness of "medical clowns" on preoperative, intraoperative, and postoperative anxiety of children undergoing various dental treatments and also its effect on the operator's stress levels in a dental setup. A total of 170 pediatric patients, aged 4-8 years, indicated for preventive therapy, extractions, restorative, and endodontics were included and divided into two groups [group I-audiovisual (A-V) aids; group II-medical clowns], group of 85 patients each after recording Modified yale preoperative scale. Both pre- and postoperatively, Frankl's behavior score was recorded for each patient. During treatment, the face, legs, activity, cry, consolability (FLACC) pain scale, and dental operator's stress level were recorded. Intervention of medical clowns positively influenced children during dental treatment by increasing their pain threshold. The majority of children showed positive Frankl rating scales after dental treatment. Also, the operator's stress was significantly reduced, which led to enhanced treatment outcomes. Humor yields the power of healing, distracts pediatric patients, reduces their anxiety, and alleviates their pain, conferring the patients with a sense of laughter, creativity, and care.Therefore, medical clowns in pediatric dentistry can prove to be serviceable and valuable as a nonpharmacological approach to behavior management. Aggarwal P, Mathur S, Chopra R. Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator. Int J Clin Pediatr Dent 2024;17(1):59-66.

Retrospective evaluation of Penguin Cold Caps for chemotherapy-induced alopecia

BackgroundScalp cooling is an increasingly recognized non-pharmacologic approach to minimize chemotherapy-induced alopecia (CIA). Several commercially available machine-based and manual scalp cooling systems are available; however, literature reports of effectiveness are highly variable. The purpose of this study was to determine real-world tolerability and subjective effectiveness of a manual cold capping system in minimizing CIA across a variety of patient race and hair types. This study was a single-institution review of outcomes from manual cold capping.MethodsWe identified retrospective cohort of adult patients who presented to discuss cold capping between January 14, 2019, and March 31, 2022. Data collected from medical records included demographics, decision to pursue/continue cold capping, diagnoses, chemotherapy regimens, hair characteristics (length, thickness, coarseness, type), and subjective perception of percentage of hair retained. Those with successful vs. unsuccessful cold capping (≥ 50% vs. < 50% of hair retained) were compared based on the patient-level factors of interest.FindingsA total of 100 patients initiated cold capping during the study period, and 95% of them completed cold capping. The majority of patients who started cold capping completed it. The median-reported percentage of hair maintained was 75%, and 82/89 (92.1% of patients) had favorable results, defined as ≥ 50% of hair retained. The only patient-level factor associated with favorable response was chemotherapy regimen, with fewer patients receiving doxorubicin-containing regimens having successful hair retention compared to other chemotherapy types (71.4% successful results vs. 95.7% for those receiving paclitaxel-containing regimens and 96.6% for those receiving docetaxel-containing regimens (p = 0.018). There was no difference in success based on patient race/ethnicity or hair characteristics.InterpretationThe overall effectiveness (92.1%) in this study is consistent to higher than many literature reports. One possible reason for the high success in our cohort is compliance with cold capping protocols, meaning applying the cap in the appropriate manner and wearing the cap for the prescribed durations, which may impact effectiveness.

Treatment of Gout in Patients with CrCl ≤30 mL/min and/or on Hemodialysis: A Review

Gout is highly prevalent in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), owing to impaired uric acid excretion. However, treating gout in this population is challenging due to concerns about medication safety and efficacy with reduced kidney function. This review examines the evidence of various pharmacologic and non-pharmacologic approaches to managing gout in CKD/ESRD. For acute gout flares, there is insufficient evidence to guide optimal dosing of NSAIDs, colchicine, and corticosteroids in advanced CKD. The risks generally outweigh the benefits of NSAIDs and colchicine. Corticosteroids appear safer but require individual risk-benefit assessments. Interleukin-1 inhibitors show promise, but larger studies are needed. For long-term urate lowering, xanthine oxidase inhibitors like allopurinol and febuxostat are preferred over probenecid and other uricosurics. However, studies specifically evaluating urate-lowering therapies in CKD are scarce, resulting in conflicting expert guidelines. Starting with low allopurinol doses and gradual titration can mitigate the risks. Higher allopurinol doses may be needed to reach urate targets in some CKD patients. Febuxostat’s safety in advanced CKD remains debated. Optimal gout management in dialysis patients is also unclear, including when to continue urate-lowering therapy. Overall, gout is often suboptimally treated in CKD/ESRD, highlighting the need for more research to guide therapy in this population. Improving management can significantly reduce the burden of these comorbid diseases.

COVID-19 and Alzheimer's disease: Impact of lockdown and other restrictive measures during the COVID-19 pandemic.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection initially results in respiratory distress symptoms but can also lead to central nervous system (CNS) and neurological manifestations, significantly impacting coronavirus disease 2019 (COVID-19) patients with neurodegenerative diseases. Additionally, strict lockdown measures introduced to curtail the spread of COVID-19 have raised concerns over the wellbeing of patients with dementia and/or Alzheimer's disease. The aim of this review was to discuss the overlapping molecular pathologies and the potential bidirectional relationship between COVID-19 and Alzheimer's dementia, as well as the impact of lockdown/restriction measures on the neuropsychiatric symptoms (NPS) of patients with Alzheimer's dementia. Furthermore, we aimed to assess the impact of lockdown measures on the NPS of caregivers, exploring its potential effects on the quality and extent of care they provide to dementia patients.We utilized the PubMed and Google Scholar databases to search for articles on COVID-19, dementia, Alzheimer's disease, lockdown, and caregivers. Our review highlights that patients with Alzheimer's disease face an increased risk of COVID-19 infection and complications. Additionally, these patients are likely to experience greater cognitive decline. It appears that these issues are primarily caused by the SARS-CoV-2 infection and appear to be further exacerbated by restrictive/lockdown measures. Moreover, lockdown measures introduced during the pandemic have negatively impacted both the NPSs of caregivers and their perception of the wellbeing of their Alzheimer's patients. Thus, additional safeguard measures, along with pharmacological and non-pharmacological approaches, are needed to protect the wellbeing of dementia patients and their caregivers in light of this and possible future pandemics.

Mitigating cellular aging and enhancing cognitive functionality: visual arts-mediated Cognitive Activation Therapy in neurocognitive disorders.

The growing phenomenon of population aging is redefining demographic dynamics, intensifying age-related conditions, especially dementia, projected to triple by 2050 with an enormous global economic burden. This study investigates visual arts-mediated Cognitive Activation Therapy (CAT) as a non-pharmacological CAT intervention targets both biological aging [leukocyte telomere length (LTL), DNA methylation age (DNAmAge)] and cognitive functionality. Aligning with a broader trend of integrating non-pharmacological approaches into dementia care. The longitudinal study involved 20 patients with mild to moderate neurocognitive disorders. Cognitive and functional assessments, and biological aging markers -i.e., LTL and DNAmAge- were analyzed before and after CAT intervention. Change in LTL was positively correlated with days of treatment (p =0.0518). LTL significantly elongated after intervention (p =0.0269), especially in men (p =0.0142), correlating with younger age (p =0.0357), and higher education (p =0.0008). DNAmAge remained instead stable post-treatment. Cognitive and functional improvements were observed for Copy of complex geometric figure, Progressive Silhouettes, Position Discrimination, Communication Activities of Daily Living-Second edition, Direct Functional Status (p < 0.0001) and Object decision (p =0.0594), but no correlations were found between LTL and cognitive gains. Visual arts-mediated CAT effectively mitigates cellular aging, especially in men, by elongating LTL. These findings underscore the potential of non-pharmacological interventions in enhancing cognitive and functional status and general well-being in dementia care. Further research with larger and longer-term studies is essential for validation.

Exercise Interventions for the Prevention and Treatment of Anthracycline-Induced Cardiotoxicity in Women with Breast Cancer: A Systematic Review

Abstract Purpose Anthracyclines have been one of the standard therapies for breast cancer (BC), and dose-related cardiotoxicity is one serious side effect. Exercise is an effective strategy for the prevention and management of BC, endorsed by experts in both exercise and oncology. However, there is a great deal of confusion about the effectiveness of exercise on anthracycline-induced cardiotoxicity and the exercise prescription (i.e., timing, type, and intensity) for cardiotoxicity, which limits its application in clinical settings. The aim of this article is to review the safety of exercise in BC patients receiving anthracyclines and its effectiveness in preventing cardiotoxicity. Methods Six electronic databases were searched using terms related to exercise, BC, anthracyclines, and cardiotoxicity for retrieving clinical randomized controlled trials in either Chinese or English. A summary of the included literature was also provided. Results Of 202 records screened, 10 were eligible. A total of 434 BC patients (stage I–IIIC, mean age ranged from 43.5 to 52.4 years) were included. The main findings were that: (1) Acute (a single bout) moderate-to-vigorous aerobic exercise could prevent NT-proBNP elevation beyond the threshold of acute myocardial injury; (2) Long-term (&gt; 8 weeks) moderate-to-high intensity aerobic exercise (continuous or interval) could improve or maintain left ventricular ejection fraction and cardiorespiratory fitness in BC patients. However, the optimal timing, type, and intensity of exercise for people with BC to prevent cardiotoxicity remain unclear. Conclusion Moderate-to-vigorous intensity exercise may be an effective non-pharmacological approach to mitigate cardiotoxicities induced by anthracyclines in women with BC. However, the optimal exercise prescription for preventing cardiotoxicity remains unclear.

Nursing interventions to promote dyspnea self-management of complex chronic patients: An integrated review

ObjectivesChronic dyspnea, a distressing symptom in patients with complex chronic conditions, is linked to higher risks of mortality. This study aimed to identify nursing interventions that could improve self-management for complex chronic patients, thereby enhancing control over chronic dyspnea. The findings intend to guide nursing care strategies that promote self-management among this population. MethodsWe searched the databases Medline, Scopus, Web of Science, CINAHL, Cochrane Database of Systematic Reviews (CDSR), and Joanna Briggs Institute (JBI) databases were searched in December 2023. We included adult patients with complex chronic conditions with chronic dyspnoea. The team screened articles collaboratively, using Rayyan software. A qualitative appraisal was performed according to JBI Critical Appraisal Checklist tools. The review protocol is registered under the number CRD42023456021. ResultsOur review included 18 studies that explored a variety of interventions for chronic dyspnea. We identified pharmacological interventions (such as oxygen therapy and inhalation treatments) and non-pharmacological approaches (including educational programs, breathing exercises, fluid intake management, body awareness techniques, peer support, emotional intelligence training, and the use of web applications). Those interventions empower patients, improve their ability to fulfill life roles, mitigate emotional distress, and improve overall quality of life. Nursing care can be crucial in enabling individuals to achieve independence and autonomy in self-care. ConclusionsPromoting self-management for chronic dyspnea in complex chronic patients requires a holistic approach, encompassing multidisciplinary interventions, individualized self-care education, peer engagement, and technological support. Current research on self-management inadequately addresses interventions targeting patient behaviour change. It highlights the need to delve deeper into the self-management process. Further research is needed to expand the evidence base and refine these interventions.

The Application of Cognitive Behavioral Therapy for Adolescent Patients With Endometriosis: A Topical Review

Recent advances and interest in nonpharmacological treatment approaches for various chronic pain conditions in adolescent patients have increased. Cognitive behavioral therapy (CBT) is widely regarded as the leading nonpharmacological treatment for chronic pain, encompassing gynecological conditions associated with chronic pelvic pain, such as endometriosis. Adolescents with endometriosis often present with different symptoms than adults and frequently report more comorbid psychiatric disorders than the general public. This review aims to (1) justify the application of CBT interventions in the context of adolescent patients with endometriosis; (2) integrate and analyze existing empirical evidence and reviews; (3) highlight the advantages, constraints, and future research directions in CBT for this demographic; and (4) introduce a novel biopsychosocial conceptual model. This model intricately considers the interplay of thoughts, emotions, behaviors, and physical symptoms specific to adolescents with endometriosis, providing a foundation for targeted CBT interventions. This holistic approach recognizes the multifaceted nature of their experience, paving the way for comprehensive and effective nonpharmacological therapeutic strategies. Given the nuanced and intricate nature of endometriosis in adolescents, there is a pressing need for innovative conceptual models and clinical trials of behavioral interventions explicitly designed for this demographic.

Psychosocial correlates of physical activity in cancer survivors: a systematic review and meta-analysis.

Physical activity (PA) is a non-pharmacological approach to optimize health benefits in cancer survivors and is recommended as part of care. However, most cancer survivors fail to meet PA recommendations. The current systematic review and meta-analysis aimed to identify psychosocial correlates of free-living PA in cancer survivors. Three electronic databases were searched (PubMed, PsycINFO, and SportDiscus). Meta-analyses were conducted for psychosocial correlates tested ≥ 3 times. Sixty-four articles were included. Eighty-eight different free-living PA correlates were identified. Meta-analyses (n = 32 studies) tested 23 PA correlates, of which 16 were significant (p < 0.05). Larger effect sizes (0.30 < ES > 0.45) were found for exercise self-efficacy, perceived behavioral control, intention, lower perceived barriers for exercise, enjoyment, perceived PA benefits, and attitudes. Small-to-moderate effects (0.18 < ES < 0.22) were found for subjective norms, physical functioning, quality of life, depression, and mental health. These findings were generally in line with narrative results. This systematic review highlights important psychosocial correlates of free-living PA that can be targeted in future PA promotion interventions for cancer survivors. Constructs mainly from SCT and TPB were the most studied and appear to be associated with free-living PA in this population. However, we cannot currently assert which frameworks might be more effective. Further studies of better methodological quality, per correlate and theory, exploring longer-term associations and across different types of cancer, are needed. Having higher exercise self-efficacy, perceived behavioral control, intention, enjoyment and perceived PA benefits, more positive attitudes towards PA, and lower perceived barriers for exercise, can help increase PA in cancer survivors.

Development and Usability Testing of Virtual Reality (VR)-Based Reminiscence Therapy for People with Dementia

AbstractThe prevalence of dementia is increasing due to a longer life expectancy and an ageing population. Cognitive impairment affects patients’ daily lives and places a financial and healthcare burden on them and their families. Reminiscence therapy (RT) is a non-pharmacological approach that has been found to enhance the quality of life for older adults with or without dementia. There is an urgent need for more functional and effective treatments, such as virtual reality (VR), which are becoming increasingly popular. VR in RT is a relatively new field, and this paper proposes a conceptual model for developing proof-of-concept virtual reality-based reminiscence therapy (VR-RT) for people with dementia, based on the 4Is: immersion, interaction, imagination, and impression. This model is intended to offer an alternative therapeutic experience for older adults with dementia. This paper demonstrates VR-RT in accordance with the results from the proposed 4Is model, to depict different periods of the olden days of scenes, such as restoring the historical objects and appearance of the citizens. The proposed VR-RT is then evaluated with the occupational therapists (OTs) through pilot testing. The findings reveal that VR-RT based on the proposed model may elicit a positive attitude and motivation in older adults with dementia. The proposed 4Is model serves to offer essential features for VR development, followed by a survey to identify suitable reminiscence materials and themes tailored to older adults with dementia. A pilot test with OTs revealed that VR-RT has the potential to improve the conditions of people with dementia. The research contributes valuable insights and lays the groundwork for future development of VR-RT for people with dementia.

Exercise Improves Heart Function after Myocardial Infarction: The Merits of AMPK.

AMPK is considered an important protein signaling pathway that has been shown to exert prominent cardioprotective effects on the pathophysiological mechanisms of numerous diseases. Following myocardial infarction, severe impairment of cardiac function occurs, leading to complications such as heart failure and arrhythmia. Therefore, protecting the heart and improving cardiac function are important therapeutic goals after myocardial infarction. Currently, there is substantial ongoing research on exercise-centered rehabilitation training, positioning exercise training as a significant nonpharmacological approach for preventing and treating numerous cardiovascular diseases. Previous studies have reported that exercise can activate AMPK phosphorylation and upregulate the AMPK signaling pathway to play a cardioprotective role in coronary artery disease, but the specific mechanism involved remains to be elucidated. This review discusses the role and mechanism of the exercise-mediated AMPK pathway in improving postinfarction cardiac function through existing studies and describes the mechanism of exercise-induced myocardial repair of AMPK from multiple perspectives to formulate a reasonable and optimal exercise rehabilitation program for the prevention and treatment of myocardial infarction patients in the clinic.

Benefit of Dietary Supplementation of Nutraceuticals as an Integrative Approach for Management of Migraine: Evidence From Preclinical and Clinical Studies.

To provide information from preclinical and clinical studies on the biological activity and health benefits of dietary inclusion of nutraceuticals as a safe, effective, non-pharmacological approach for the treatment of migraine. There is emerging evidence of the therapeutic benefit of nutraceuticals to inhibit oxidative stress, suppress inflammation, and prevent changes in the normal gut microbiome, which are implicated in migraine pathology. Nutraceuticals can be enriched in polyphenols, which act as molecular scavengers to reduce the harmful effects of reactive oxygen species and phytosterols that suppress inflammation. Nutraceuticals also function to inhibit dysbiosis and to maintain the commensal intestinal bacteria that produce anti-inflammatory molecules including short-chain fatty acids that can act systemically to maintain a healthy nervous system. Dietary inclusion of nutraceuticals that exhibit antioxidant, anti-inflammatory, and anti-nociceptive properties and maintain the gut microbiota provides a complementary and integrative therapeutic strategy for migraine.

Perception of Behaviour Management Techniques for Paediatric Patients among Dental Officers

Introduction: Dental anxiety can be effectively managed by applying pharmacological and non-pharmacological behavioural management therapy approaches (BMT). This study investigated the dental officers’ perception of behaviour management techniques practiced in managing paediatric dental patients in primary dental clinics. Materials and methods: A quantitative study using structured online English questionnaires among dental officers serving in primary dental care services under the Ministry of Health Malaysia (MOH Malaysia) in Sabah. The acceptability of applied behaviour management techniques was measured using Likert scale from 0 to 10. Data was analysed using SPSS version 29 and descriptive data was presented. Results: Seventy-four dental officers involved in this study (Male= 14, Female= 60). Positive verbal reinforcement, tell-show-do, and offering an exact explanation of what the findings indicate are the most widely accepted behaviour management strategies (BMT), with mean scores of 9.5, 9.1, and 8.7, respectively. The least accepted BMT among dental officers in Sabah are immobilisation with a papoose board, preventing the child from speaking during treatment, and hand over mouth (HOM), with mean scores of 4.6, 3.6, and 3.2, respectively. Conclusion: The study concludes that the most recognized BMT is positive reinforcement technique regardless of age, experience and gender. This finding provides information in the development of modules for continuous professional development training among dental officers in the Ministry of Health Malaysia.