Non-pharmacological Methods Research Articles

The comparison of effectiveness of acupressure on Spleen 6 and Hugo points on the severity of postpartum pain: A randomized clinical trial.

Postpartum pain poses a significant challenge for new mothers. Various nonpharmacological methods are employed to manage postpartum pain. This study aimed to compare the effectiveness of acupressure on Spleen 6 and Hugo points on the severity of postpartum pain. In this parallel randomized trial study, 68 eligible primiparous women who had vaginal deliveries and experienced postpartum pain at Farabi Hospital in Malekan (a city in East Azarbaijan Province in Iran) were selected according to inclusion/exclusion criteria and then allocated to the Hugo (n = 34) and Spleen 6 (n = 34) acupressure groups using a randomized block design (six blocks). The data collection process took place from November 2022 to April 2023. The participants were blinded; however, the analysts and investigators were not blinded. Acupressure interventions were applied bilaterally for 20 min, consisting of 10 s of pressure followed by 2 s of rest. Pain intensity was assessed using a visual pain scale before, immediately after, and 1 h after the intervention. In total, 68 participants fulfilled the study. Data were analyzed using Statistical Package for the Social Sciences version 25 with chi-square, Mann-Whitney, and Friedman tests. Both groups exhibited a statistically significant reduction in postpartum pain intensity across all periods (p < 0.001). Although there was a significant difference in pain intensity between the groups before the intervention (p = 0.039), this distinction was not observed immediately and 1 h after the intervention (p ≥ 0.05). Both Hugo and Spleen's 6 acupressure interventions reduced postpartum pain intensity. No significant adverse events or side effects were observed. Acupressure on Spleen 6 and Hugo points helped decrease the severity of postpartum pain in primiparous women who had vaginal deliveries. Healthcare providers are encouraged to consider acupressure for postpartum pain management.

Acoustic Stimulation to Improve Slow-Wave Sleep in Alzheimer's Disease: A Multiple Night At-Home Intervention

ObjectivesTo investigate the efficacy of closed-loop acoustic stimulation (CLAS) during slow-wave sleep (SWS) to enhance slow-wave activity (SWA) and SWS in patients with Alzheimer's disease (AD) across multiple nights and to explore associations between stimulation, participant characteristics, and individuals’ SWS response. DesignA 2-week, open-label at-home intervention study utilizing the DREEM2 headband to record sleep data and administer CLAS during SWS. Setting and participantsFifteen older patients with AD (6 women, mean age: 76.27 [SD = 6.06], mean MOCA-score: 16.07 [SD = 6.94]), living at home with their partner, completed the trial. InterventionPatients first wore the device for two baseline nights, followed by 14 nights during which the device was programmed to randomly either deliver acoustic stimulations of 50 ms pink noise (± 40 dB) targeted to the slow-wave up-phase during SWS or only mark the wave (sham). ResultsOn a group level, stimulation significantly enhanced SWA and SWS with consistent SWS enhancement throughout the intervention. However, substantial variability existed in individual responses to stimulation. Individuals received more stimulations on nights with increased SWS compared to baseline than on nights with no change or a decrease. In individuals, having lower baseline SWS correlated with receiving fewer stimulations on average during the intervention. ConclusionCLAS during SWS is a promising nonpharmacological method to enhance SWA and SWS in AD. However, patients with lower baseline SWS received fewer stimulations during the intervention, possibly resulting in less SWS enhancement. Individual variability in response to stimulation underscores the need to address personalized stimulation parameters in future research and therapy development.

Education of Birth Ball Training as Therapy to Relieving Labor Pain

Labor pain arises because of the mother's physical and psychological response. Emotions become unstable due to anxiety and fear which worsen the condition of labor pain. The pain experienced by the mother during labor can give rise to fear which makes her anxious and often leads to panic attacks. This condition causes a physiological response that can disrupt the condition of the uterus when it contracts so that the impact of labor will last a long time. Usually, the mother who is about to give birth will find it difficult to adjust to the conditions of labor pain, so that uterine contractions cannot be controlled which causes the first stage to lengthen and the fetus to be disturbed. A prolonged labor process is a type of birth complication that is worrying, complicated, and unpredictable. A non-pharmacological method that can reduce labor pain is birth ball therapy. Research that has been conducted has found that birth ball exercises affect reducing labor pain. PkM is implemented through educational activities where there are 30 PkM participants. The results of the PkM implementation show that the PkM participants have been successfully educated through this PkM activity so that they can apply birth ball exercises to reduce labor pain in mothers. Due to the implementation of this PkM activity, it is hoped that there will be an increase in the knowledge of midwives who play a role in initial level services to provide appropriate steps in dealing with labor pain in mothers using complementary therapy, and birth ball exercises.

Protocol for neonatal pain assessment and management: Application of the ALPS Neo scale in routine care

Background and objectives. Neonatal pain research has advanced, disproving earlier beliefs that neonates cannot feel pain due to immature nervous systems. Incomplete myelination slows but does not prevent pain conduction. Pain responses start around 7.5 weeks post-conception, with pain receptors throughout the body by 20 weeks. Pain pathways are established by 22 weeks, but full modulation develops by 32 weeks, making preterm infants more sensitive. Nociceptors detect pain through A-delta (sharp pain) and C-fibers (dull pain). Tissue damage releases chemicals that lower the pain threshold. Pain is classified as nociceptive, somatic, or visceral and can be acute or chronic. Early pain exposure affects later responses. Validated pain scales for neonates include COVERS, PIPP, NIPS, NFCS, and ALPS Neo. Current practice emphasizes preventing and treating pain to minimize stress. Materials and methods. This study at Life Memorial Hospital will analyze patients over 1 month and over 6 months, with ethical approval obtained beforehand. Inclusion criteria: neonates with a gestational age over 35 weeks, birth weight over 2000 grams, needing routine care. Exclusion criteria: neonates needing respiratory support/sedation or with abnormal neurological exams. We will use the ALPS Neo pain assessment scale for its reliability and ease of integration into daily care, aiming to reduce pain or stress duration. Patients will be scored on facial expression, breathing, extremity tone, hand/foot activity, and activity level. Scores of 3-5 will prompt non-pharmacological interventions. Scores above 5 will require frequent reassessments and possible pharmacological intervention. The medical team will be trained on the ALPS Neo scale and non-pharmacological pain reduction methods. Pain from procedures like vaccinations will be assessed during the first two days of life. Initially, control patients will be evaluated without interventions. Over the next 6 months, patients will receive non-pharmacological interventions, including non-nutritive sucking, sucrose, Kangaroo Mother Care, swaddling, and maternal milk or formula. Our group aims to establish an evidence-based protocol for pain assessment and management and to use it in prospective research in which the objectives would be to use a pain scale for more accurate pain data from procedures, identify and reduce the most painful procedures, evaluate and improve the effectiveness of pain management strategies. Conclusions. This observational study at Life Memorial Hospital will use the ALPS Neo pain assessment scale to improve neonatal pain management within the Kangaroo Mother Care program. By comparing a 1-month control group with a 6-month group, we aim to identify and reduce procedural pain. The ALPS Neo scale will enable precise pain assessment and targeted non-pharmacological interventions, potentially guiding future pain management strategies. The choice of ALPS Neo, which is familiar to our team, will ease training and implementation. Success may lead to exploring scales with objective measures, though ALPS Neo will initially drive our improvements in pain management.

Effectiveness of progressive muscle relaxation on sleep disturbance in athletes

Background: Athletes have general complaints about sleep disturbance which is important for body recovery, healthy brain and body functions, tissue wear and tear, and the body's immune system. Objective: To determine the effectiveness of Progressive Muscle Relaxation (PMR) on sleep disturbance in athletes. Methodology: N=24 athletes aged 18 to 36 years participating in a competition were included in a randomized controlled trial. Athletes who were training for a competition, aged between 18 -and 36 years, and athletes with sleep disturbance score (SDS) falling above 4 on the Athletic Sleep Screening Questionnaire were included. Athlete sleep screening questionnaire (ASSQ) was used to assess sleep disturbance score (SDS). Athletes were randomly assigned to the experimental (n=12) and control (n=12) groups. The experimental group was given progressive muscle relaxation and re-assessed the next day for SDS. Results: The pre-post analysis showed that progressive muscle relaxation reduced the athletes' sleep disturbance score significantly one day after the intervention with a large effect size (p=0.006 Cohen's d= 1.44) in the experimental group. The mean of the mean differences of SDS of both groups were compared which showed a group had a significantly improved sleep disturbance score compared to a control group with a large effect size. (Mean= 1.41 ±1.44 v/s 0.00±1.85, p≤ 0.01, Cohen's d= 1.66). Conclusion: Progressive Muscle Relaxation exercises can be a non-pharmacological method to help athletes sleep by simple head-to-toe muscles contract and relax technique. Clinical Trail No: NCT05695092

Impact of Sacral Lumbal Massage on Pain and Head Decline During First Stage of Labor

Introduction: Labor pain varies in intensity, with many women experiencing high levels during delivery. This study aims to evaluate the effectiveness of sacral massage on pain intensity and fetal head descent during the first stage of labor. Method: A quantitative study was conducted with a sample of laboring mothers divided into intervention and control groups. Participants were selected using purposive sampling, with criteria including mothers aged 20-35 years, active first-stage labor, good maternal and fetal health, cephalic presentation, and uncomplicated labor. The intervention involved lumbar-sacral massage for 20 minutes, repeated once, with intervals of 5-10 minutes. The control group received relaxation through breathing exercises. The study took place from January to March 2024. Data were analyzed using the Wilcoxon and t-tests with a significance level of 0.05. Results: The intervention group significantly reduced labor pain (pre: 6.90, post: 3.70, p=0.000). There was no significant difference in fetal head descent duration between groups (p = 0.05). Conclusion: Lumbar sacral massage is an effective non-pharmacological method for reducing labor pain and is recommended for pain management in midwifery practice.

The impact of musical intervention on pain and anxiety levels during percutaneous nephrostomy tube replacement: a randomized controlled trial

Objective: Percutaneous nephrostomy tube replacement (PNTR) is a significant and frequently performed outpatient urological procedure. Patients undergoing this procedure often experience pain and anxiety. Various non-pharmacological methods are currently utilized to alleviate pain and anxiety. The objective of this study is to investigate the effects of music on pain and anxiety during PNTR . Materials and Methods: A prospective randomized controlled trial was conducted in patients undergoing PNTR at Loei Hospital from May 1, 2023, to September 30, 2023. A total of 104 patients were randomly assigned to two groups: group 1, where patients did not listen to music during the procedure, and group 2, where patients listened to their preferred choice of music. Demographic data, vital signs, Visual Analog Scale (VAS) pain levels, State-Trait Anxiety Inventory-State Anxiety (STAI-SA), and willingness to repeat procedures were compared. Results: The VAS pain scores in the music group were significantly lower than in the non-music group during and after PNTR (2.5 vs 5, p &lt; 0.005 and 0 vs 3, p &lt; 0.001, respectively). Moreover, the STAI-SA levels in the music group were significantly lower post-procedure (32.98±5.61 vs 39.98±6.18, p &lt; 0.001), and the willingness to repeat the procedure was significantly higher (41 vs 22, p &lt; 0.001). Conclusion: The results of this study indicate that listening to a preferred choice of music during PNTR has the potential to reduce pain, and anxiety, and increase the willingness of patients to repeat procedure. The intervention of music serves as a cost-effective, safe, and side effect-free non-pharmacological approach to facilitate patient outcome in PNTR.

Efektifitas Cairan Kayu Manis Terhadap Penyembuhan Luka Perineum Derajat 2 Pada Ibu Nifas di TPMB Kuswatun Faizah Jakarta Barat

Introduction: The incidence of mothers experiencing grade 2 perineal injuries at TPMB Kuswatun Faizah West Jakarta is quite high, namely 30 people (91%) out of 33 mothers gave birth. Healing of perineal wounds degree 2 in postpartum mothers, namely by non-pharmacological methods using Cinnamon Liquid is very effective. Cinnamon Liquids contain lots of eugenol which helps speed up wound healing and can reduce pain. To determine the effectiveness of Cinnamon Liquid on the Healing of 2nd Degree Perineal Wounds in Post-partum Mothers at TPMB Kuswatun Faizah West Jakarta. Methods: This research uses a real experimental (true experimental) and the design used is the two-group pre-test-post-test design. The sampling technique used was total sampling, namely 30 postpartum mothers were divided into 15 post-partum mothers as intervention and 15 post-partum mothers as control. Data techniques included univariate analysis using frequency distribution and bivariate analysis using SPSS 20 program statistical calculations. Results: The results of this study showed that there is a significant effect on the healing of grade 2 perineal wounds in postpartum mothers between the experimental group and the control group with the statistical test results p-value 0,000 &lt; α (0,05). Discussion: There is a significant effect of using cinnamon liquid on the healing of grade 2 perineal wounds in postpartum mothers so that healing is faster and optimal. It is hoped that the use of cinnamon liquid in the healing of second-degree perineal wounds in post-partum women can be implemented in the treatment of perineal wounds especially to accelerate the healing of second-degree perineal wounds in post-partum women.

Pain experiences of nephrolithiasis patients planned for percutaneous nephrolithotomy: A qualitative study

AbstractThis study was carried out to determine the pain experienced by nephrolithiasis patients scheduled for PNL and the methods of coping with pain. The qualitative descriptive study was conducted with 22 patients aged between 23 and 75 years who experienced pain due to nephrolithiasis. The data were collected between January and November 2023 using the “Personal Information Form” and “Semi‐structured Interview Form”. The content analysis was used to investigate the pain experienced by patients. Patients reported the character of pain as pulling, stabbing, scratching, swelling, pressing, and indescribable, and the intensity of the pain as the most severe pain experienced, unbearable, and killing. Patients reported the effects of the pain as tiring, immobilized, breathtaking, and appetite suppressant. The methods used by the patients were categorized under two themes: pain‐orientated and directed at the source of pain. In addition to pharmacological methods to cope with pain, patients reported hot application and distraction techniques. Patients also reported using some herbs in addition to the medical treatments recommended by the physician to reduce kidney stones to cope with the pain they experienced. In line with these results, the subjective nature of pain should not be forgotten during pain assessment, which is one of the most important steps in controlling the pain of patients with renal colic due to nephrolithiasis, and pain should be evaluated in all its dimensions. Considering that patients also use nonpharmacological methods to control this severe pain, these methods should be questioned.

Medical weight loss in older persons with obesity.

The prevalence of individuals with obesity or overweight has steadily increased over the past decades both worldwide, and in the United States. This trend is also evident in the older adult population, which has experienced a continuous rise in the number of individuals with overweight or obesity. This is relevant due to the impact of obesity in older adults' quality of life, physical function, morbidity, and healthcare costs. This review aims to provide practical guidance and currently available approaches for healthcare professionals in managing this population. Both non-pharmacological methods such as intensive behavioural therapy, nutritional interventions, and physical activity, as well as anti-obesity medications, are discussed, with a focus on their potential positive and negative effects in older adults. Additionally, bariatric therapy is evaluated, including current procedures available and the associated results and risks in the older population.

Effectiveness of facilitated tucking on reducing pain during heel stick in neonates: a randomized controlled experimental study.

Pain in neonates is associated with adverse neurodevelopmental outcomes in the later days of life. Facilitated tucking is a nonpharmacological method of pain relief. The study aims to compare the effect of facilitated tucking in pain reduction in neonates. This was a randomized controlled experimental study conducted in the neonatal ward of a tertiary care center. There were 25 neonates randomized each in the experimental and control groups (total of 50), based on computer-generated random tables. The experimental group was placed in a facilitated tucking position during heel stick, while the control group was kept in the usual position, as done routinely. A self-structured questionnaire and Neonatal Infant Pain Scale were used. The main outcome measures were the mean Neonatal Infant Pain Scale score, and change in preprocedure and postprocedure heart rate and oxygen saturation in the two groups. Ethical clearance and informed written consent were sought. Neonates in the experimental group had significantly lesser pain (less Neonatal Infant Pain Scale score) than the neonates in the control group (P<0.001). There was also a significant increment in the mean heart rate and a decrease in the oxygen saturation after the procedure in the control group, indicating significantly more pain perception (P<0.001) in the control group. Facilitated tucking was found to be effective in reducing the pain during heel stick procedures in neonates.

Advancing Pain Management Protocols for Intrauterine Device Insertion: Integrating Evidence-Based Strategies Into Clinical Practice.

The discomfort and anxiety associated with the intrauterine device (IUD) insertion process is a significant barrier to its adoption as a form of contraception despite its high efficacy. This study aimed to classify and identify methods for minimizing pain and anxiety in IUD implantation in women below the age of 49. A search of publications from online databases, PubMed and Google Scholar, revealed 14 articles that met the inclusion criteria. An analysis of the selected studies showed that several pharmacological and non-pharmacological measures effectively minimized patient discomfort associated with IUD insertion. Of the 14 studies, 12 evaluated pharmacological methods for pain management in IUD insertion, while two studies assessed non-pharmacological methods. The results showed that although the IUD is more effective than other forms of contraceptives, fear of pain related to the insertion process is one of the most significant barriers to the use of an IUD among women. Most studies identified pharmacological methods of pain management for IUD insertion, highlighting a need for more research on non-pharmacological methods to improve patient experiences and reduce associated fears.

Exercise and endometriosis-is there a promising future? A narrative review.

Endometriosis is the leading cause of chronic pelvic pain in women of reproductive age with debilitating effects on quality of life, yet no cure exists. Exercise yields the potential in providing women with a non-invasive, non-pharmacological method of symptom control. Present up-to-date knowledge regarding how exercise may contribute to the management of endometriosis-related symptoms. Discuss: 1. The pathophysiology surrounding exercise and endometriosis. 2. The role of exercise in endometriosis symptom control. Scientific literature has alluded to exercise being a favourable factor in the management of endometriosis-related symptoms. Moreover, current clinical guidelines for endometriosis fail to reflect the aforementioned benefits of exercise. A search strategy using the terms 'endometriosis', 'endometriomas', 'exercise', and 'physical activity' was devised. Pubmed, Medline, Cochrane reviews, and Embase were reviewed. Interventional studies, within-subjects studies, randomised-control trials, systematic reviews, meta-analysis, cohort studies, publication since 2000. Non-English publications, non-human studies. Numerous studies have suggested positive effects for endometriosis patients who performed exercise exclusively or in conjunction with other therapies. Improvements in pain levels, quality of life, anxiety, and depression were noted. Current research outlines promise regarding the potential benefit of exercise prescribing in patients with endometriosis as well as a synergy between exercise and hormonal therapies for the management of endometriosis-related symptoms. However, the current paucity of high-quality robust studies investigating these aspects of endometriosis management is an apparent obstacle to progression in this area. For clinicians to incorporate exercise in managing endometriosis, clear recommendations regarding advice and benefits are needed.

Cross-cultural adaptation, reliability, and validity of the Turkish version of the Exercise Therapy Burden Questionnaire for individuals with chronic diseases.

Chronic diseases, which caused 36 million deaths in 2008, are the most common cause of death worldwide. Exercise is one of the non-pharmacological treatment methods. Although exercise benefits are well known, more than half of the population does not exercise due to the burden of exercise. The objectives of the current study were to evaluate the Turkish version of the Exercise Therapy Burden Questionnaire (ETBQ-T) and to investigate its reliability and validity. A total of 100 participants (female: 69, male: 31) who were diagnosed with at least one chronic disease participated in the translation validity and reliability analysis of the study. Cross-cultural adaptation of the ETBQ-T was performed according to Beaton's guidelines. The ETBQ-T, the European Quality of Life 5 Dimensions (EQ-5D), pain, satisfaction, and self-efficacy were applied for convergent validity. The ETBQ-T was retested to examine its reliability after 7 days. The internal consistency and reliability were excellent (intraclass correlation coefficient=0.959; Cronbach's α=0.919). The standard error of measurement was reported as 5.35. The minimum detectable difference was also demonstrated at 1.35. The ETBQ-T had a good correlation with pain (r=0.545, p<0.001), satisfaction (r=-501, p<0.001), and self-efficacy (r=-0.579, p<0.001). However, the correlation of the ETBQ-T with EQ-5D (r=0.340, p=0.001) was weak. A factor was extracted, accounting for 58.289% of the total variation. There were no floor or ceiling effects. The ETBQ-T is a reliable and valid tool to evaluate the exercise burden in the Turkish population with chronic disease.

Pluridisciplinary approaches in global postural rehabilitation

The global postural imbalances relationship is frequently encountered in recent medical practice, requiring multidisciplinary approaches to bring patients to function as close as possible according to the physiological limit. About half of the world’s population experi-ences pain and dysfunction induced by postural imbalances during their lifetime. This re-port aimed to assess the nonpainfull and currative effect of the electropuncture technique complemented by massage and active postural kinetotherapy of global posture imbalances and acute or chronical pain at various levels. This research provide an insight into the re-port of evidence available for the analgesic uses of TENS in postural defects. Correlations regarding imbalances at various levels was found in various studies regarding analyze or diagnosis, without addressing the non-invasive multidisciplinary treatment. In these stud-ies, we are hoping to raise the non-invasive reabilitation treatment and increase their use in pathologies with involves global postural imbalances. The discomfort and pain experi-enced by people with generalized postural disorder on a daily basis can have a negative impact on quality of life and, if left untreated, can lead to significant worsening of the con-dition over time. Global rehabilitation with non-invasive and non-pharmacological meth-ods, without adverse effects, including electropuncture (TENS) applied to the refferal points in conjunction with proprioceptive kinetotherapy techniques, massage and psycho-therapy is the path to the success of occlusion-postural rehabilitation with significant re-sults on painful suffering global postural imbalances. Keywords: global posture, postural imbalance, correlation, rehabilitation, multidisciplinary, electropuncture

Non-pharmacological methods and techniques used in the therapy of children diagnosed with adhd. Study of literature

Attention deficit and hyperactivity disorder (ADHD) is seen as a long-lasting and chal-lenging condition that affects various areas of life, such as academic and career success, relationships, and daily activities. Both the mind and the muscles jump from one task to another, failing to complete the activity, and thus difficulties arise in carrying out activities such as writing, tying shoelaces, riding a bicycle and more. Banal activities we would say, but essential for a normal lifestyle. Medical recovery has a signifiant contribution in relieving symptoms and treating many pathologies, in both physical and mental relaxation. Moreover, it has been shown countless times that physical activity reduces stress, mainly based on muscle relaxation and improving cognitive and motor function through the development of neural functions. More and more children are diagnosed with this disorder, but, not enough attention is paid to these cases, which is one of the reasons why we chose to address this topic. The paper aims to analyze studies carried out in recent years in different countries on motor impairments and other complications that can present children with ADHD, but also the way that balneophysiokinetotherapy has a positive effect in their therapy, being an essential form of therapy, alongside the psychological or medicinal one. The studies analyzed confirm the benefits of physical exercise for children diagnosed with ADHD, showing visible effects on both the motor skills of the children and their lev-els of agitation and attention deficit. Although movement therapy is widely used in this condition, there are no protocols standardizing the type, duration, and intensity of exer-cise programs used. Occupational therapy, massage, and yoga have been noted for their beneficial effects on patients diagnosed with ADHD. Keywords: ADHD, hyperactivity, therapy

Non-invasive neuromodulatory therapies applied in trigeminal neuralgia

Background: Estimates reveal that about 1 in 15,000 patients suffer from pain impulses from trigeminal neuralgia. Annually there are 5-6 new cases registered per 100,000 inhab-itants, with an increased frequency in women with a ratio of 3/2:W/M. It is revealed that the first manifestations appear at the ages between 40 and 60, but in recent decades cases have appeared at younger ages, starting even with 21. Given the high intensity of pain in the trigeminal pathology, significantly disabling pain for long periods of time, effective noninvasive approaches are required to reduce pain, reduce the frequency of exac-erbations and bring patients to a functioning state as close as possible to the physiological limit. Material and method: A low frequency pulsatile magnetic field is a non-pharmacological and non-invasive method which is widely used in a multitude of medi-cal conditions by medical and paramedical professionals for the management of chronic or acute pain. This original research aims to provide an insight view into the review of evi-dence available for the analgesic non-invasive therapy uses of the pulsed magnetic field. The before and after examinations the therapy have included a general assessment of the functional status, an assessment of pain severity. Result: With this study we hope to demonstrate the increased efficiency of the non-invasive rehabilitation methods with ap-plication in trigeminal neuralgia pathology that qualitatively affects the daily life of the pa-tients experiencing trigeminal neuralgia. Conclusion: Non-invasive rehabilitation in trigem-inal neuralgia registers remarkable results, similar to drug approaches, the major benefit being the absence of adverse effects both during treatment and late, in the long term. It in-creases the quality of life of patients, the frequency of relapses and the intensity of the pain-ful stimulus from the first treatment sessions.. Keywords: trigeminal, neuromodulation, pain, neuralgia, magnetotherapy, non-invasive

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 57 years and older. A total of 86 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.

The main factors that improve gut microbiota composition

The aim is to observe and compare the main factors that can improve gut microbiota composition. Materials and methods. The literature study research was performed in PubMed and Google Scholar electronic databases. We assessed more than 300 studies, data from 65 of which were included in this review. They are presented in three tables: nonpharmacological influence on gut microbiota composition, drugs impact on gut microbiota, and medicines prescribed for gut microbiota correction. Results. On the one hand, non-pharmacological methods of gut microbiota improvement are the safest and the most traditional: healthy diet and physical activity, good sleep, avoiding stress and bad habits, but they are the most difficult for patients’ fulfillment and doctors’ observation. All listed are the components of a healthy way of life and should be followed by everybody. The most prescribed drugs have a significant influence on gut microbiota composition, so physicians should consider their effects in prescriptions. They are antibiotics, steroids and non-steroids, proton pump inhibitors, laxatives, antidepressants, etc. On the other hand, despite the diversity of available medicines (prebiotics, probiotics, paraprobiotics, postbiotics, synbiotics, and antibiotics) that can be used for gut microbiota improvement, all of them are under investigation and need further evaluation. The trendiest medicines for today are paraprobiotics and postbiotics. Paraprobiotics are represented by heat / ultraviolet / sonication Lactobacillus spp., Bifidobacterium spp., and Saccharomyces strains. Postbiotics are performed by short-chain fatty acids, secreted biosurfactants, secreted proteins, organic acids, amino acids, bacteriocins, vitamins, and peptides. Most of the data on their pharmacodynamics is based on animal studies or experimental research, so they need further investigations. Fecal gut microbiota transplantation is also an up-to-date method for multiple disease correction but is approved only for the treatment of recurrent and refractory infections caused by Clostridium difficile. Conclusions. Gut microbiota composition improvement methods are an up-to-date topic for practical medicine because gut microbiota changes are closely linked with host health status. Gut microbiota violations lead to metabolic, cardiovascular, neurological, inflammatory disorders, etc. Nowadays the healthy way of life is the best gut microbiota composition improvement method, but prebiotics, probiotics, paraprobiotics, postbiotics, synbiotics, antibiotics supplementation, and fecal microbiota transplantation also take place and have their indisputable advantages in special cases. Unfortunately, most pharmacological methods of gut microbiota modulation have a weak evidence base. Therefore, this question needs further research in appropriate patient groups with long-term monitoring.

'Giving birth on a beach': Women's experiences of using virtual reality in labour.

Birth is a normal physiological process, and many women want a natural birth. Women use a range of non-pharmacological pain relief methods to reduce labour pain intensity, to help manage labour pain and to induce relaxation. The purpose of this study was to explore the experiences of women using Virtual Reality as a non-pharmacological method of pain relief in labour. Virtual Reality has been shown to be an effective distraction technique in other acute pain settings which also reduces anxiety. This study conducted qualitative in-depth interviews postnatally with women who used Virtual Reality in labour. Thematic analysis was used to analyse the qualitative data. Nineteen women used Virtual Reality in labour. Results from interviews with nineteen women in the postnatal period identified three main themes: impact of virtual reality on experience of labour, managing the pain of labour and challenges of using virtual reality in labour. This study identified that Virtual Reality was effective as a relaxation technique and helped in pain management by the use of self-efficacy techniques. Women in this study also identified preferred virtual environments specifically to use during labour and birth. This study provides a unique and original contribution to the field of Virtual Reality in labour and birth. It also identifies Virtual Reality as an acceptable and positive experience in the management of anxiety and labour pain.