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Introduction Daytime tiredness is a risk factor for poor health and well-being in the short and long term and is often associated with sleep problems, stress-related mental health complaints and decreased school functioning. This study investigates the effect of an 8 month dance intervention study on daytime tiredness, alertness, sleep duration, sleep quality and school satisfaction. Methods Randomized controlled intervention study that included a total of 112 girls aged 13–18 years old with stress-related somatic and mental health problems. Dance intervention with focus on enjoyment were performed semiweekly for 8 months. Questionnaire-based measurements regarding self-reported daytime tiredness, alertness, school satisfaction, sleep duration and quality were evaluated at baseline and at 8-, 12- and 20- month follow-ups. Results Daytime tiredness decreased significantly in the dance group compared to control group at all follow-ups. Alertness increased significant within the dance group, but there were no significant difference compared to the controls. Significant improvements were found in all sleep quality items within the dance group, between groups only one significant result was found. No conclusive changes in sleep duration were observed. School satisfaction increased significantly in the dance intervention group; however, its significance compared to that of the control group faded after adjustment for differences between groups at baseline. Conclusions This study suggests that a dance intervention focusing on enjoyment can be effective in decreasing daytime tiredness. This study also adds to the growing body of evidence for the benefits of using nonpharmacological interventions to decrease stress-related problems among adolescents.

Objectives Interpreting a randomized trial requires access to more than the main results paper. We aimed to determine the (1) proportion of trials referring to the protocol in the trial report and their accessibility, (2) proportion of protocols accessible from trial registry entry and by trial registration number search, and (3) types of additional publications associated with trial reports. Study Design and Setting A previously gathered sample of randomized trials of nonpharmacological interventions published in 2009 was used. Trial reports and registry entries were searched for protocol mentions and obtained when possible. Related publications were identified using citation searching. Results Of 133 trials, 96 (72%) mentioned the protocol within the report, 61 (64%) contained details about protocol acquisition, with 48 (36%) protocols obtainable. Of the 129 registered trials, 32 (25%) had protocols obtainable from registry entry. Citation tracking identified 1,030 related publications, most common were secondary analyses and qualitative studies. Conclusion Trial protocols facilitate good trial conduct and interpretation. However, they are often not linked to the main report or registry and can be difficult to obtain. Many trials have related publications that are inconsistently linked. Trial registries and registration numbers could facilitate the threading of articles related to a trial, but currently do not.

Due to a significant increase in the number of infants diagnosed with neonatal abstinence syndrome and the lengthy hospitalization often required for their pharmacologic treatment, a comprehensive understanding of the factors that influence healthcare providers' behaviors in implementing nonpharmacological interventions for infants with neonatal abstinence syndrome is needed. The Whittemore and Knafl methodology guided an integrative review of literature on the current knowledge of the individual and contextual factors that influence healthcare providers’ behaviors in implementing nonpharmacological interventions that decrease the length of stay for infants with neonatal abstinence syndrome through the lens of the Theoretical Domains Framework. Results of this review may provide knowledge to inform future interventions and assist in the development and implementation of best practice standards, clinical practice guidelines, and protocols to improve the care of this vulnerable and rapidly-growing patient population: the neonatal abstinence syndrome maternal-infant dyad.

Nonpharmacological treatment of insomnia in older persons has been associated with reduced insomnia symptoms and increased psychological wellbeing. This systematic review and meta-analysis examined whether nonpharmacological interventions can promote wellbeing indicators in older persons who experience insomnia symptoms and investigated the components of these interventions. Twenty studies met inclusion criteria. Psychological wellbeing outcomes included symptoms of depression, anxiety, mental health-related quality of life, and fatigue. Interventions significantly reduced depression and fatigue symptoms in most of the studies that included these outcomes. Findings of our qualitative analysis suggest that mindfulness-based interventions in particular can potentially reduce depression symptoms in older persons with insomnia symptoms. Meta-analyses of studies that included psychological wellbeing outcomes showed small-medium weighted mean effects indicating reductions in symptoms of depression, anxiety, and fatigue. The results suggest that nonpharmacological interventions for older persons with insomnia symptoms can potentially reduce depression and fatigue symptoms and highlight interventions that may be particularly valuable for this purpose.

The incidence of trauma has been high and is considered to have increased throughout the years. This study aimed to describe the pain intensity and pain-management strategies of hospitalized trauma patients. Ninety-five adults presenting trauma with full consciousness, and who were admitted to surgical wards were recruited. Outcomes were assessed in a 3-day follow-up of pain and pain management from January to February 2016 by using questionnaires for interviews. Data were analyzed using descriptive statistics and repeated measures ANOVA. Preliminary research found that hospitalized trauma patients perceived mild to severe pain intensity. The trend of pain at its worst, pain at its least, average pain, and current pain decreased from Day 1 to day 3, which were statistically and significantly different (p < .001). The pain management often used by patients were: praying (84.2%), slow and deep breathing (78.9%), and at an attempt at toleration (46.3%). The least frequent method of pain management included immediately informing nurses about the pain (15.8%), reading (15.8%), and changing position (17.9%). Besides the pharmacological and nonpharmacological interventions received from physicians and nurses, strategies were crucial to alleviating pain in hospitalized trauma patients related to cultural context.

Currently, the only widely available tool for controlling the SARS-CoV-2 pandemic is nonpharmacological interventions (NPIs). Coronavirus aerosols are around 0.3–2 µm in diameter (0.9 m in mass). The present study used artificial intelligence such as gene expression programming (GEP) and genetic algorithms (GA) were used to predict and optimize the diameter of Nylon-6,6 nanofibers via electrospinning for protection against coronavirus. It is suggested that using the controlled experimental conditions such as concentration of nylon-6,6 (16% wt/v), applied voltage (26 kV), working distance (18 cm) and injection rate (0.2 mL/h) have resulted the diameter of nylon-6,6 nanofibers about 55.8 nm. Coronavirus face masks could use the obtained diameter and electrostatic interaction between viral particles and naofibers as active layers.

Polypharmacy is a common clinical issue that affects half of all older adults living in the United States, and it is associated with adverse drug events (ADEs), poor outcomes, unplanned healthcare utilization, and increased healthcare costs. Older adults have a high risk of both polypharmacy and inappropriate medication use given normal changes of aging that influence pharmacokinetics and pharmacodynamics, the presence of multiple medical conditions, and complex treatment regimens used to treat them. Nurses play a key role in reducing polypharmacy and inappropriate medication use in older adults through identification of adverse drug events, promoting the use of nonpharmacological interventions in place of medications, and providing essential patient education to older adults about medications and their side effects.

Older adults account for half of intensive care unit (ICU) admissions and ICU days, and approximately 2 in 5 older adults in the ICU have preexisting cognitive impairment (PCI). PCI identification is important for risk stratification and may influence ICU utilization and decision-making surrogacy. PCI is overlooked in more than half of patients without screening; however, screening instruments can identify PCI in less than 5 minutes. Management of PCI in the ICU involves addressing associated neuropsychiatric symptoms. Nonpharmacological interventions should be considered the mainstay of treatment; psychotropics may be considered, although available data on their efficacy is limited.

This review discusses nonpharmacological interventions for the management of hypertension in people with diabetes. Interventions that focus on controlling weight, reducing salt intake, eating according to the Dietary Approaches to Stop Hypertension guidelines, partaking in regular physical activity, ceasing smoking and self-measuring of blood pressure can lower blood pressure in the population with diabetes. Other positive outcomes resulting from these lifestyle changes are improved glycemia levels and cardiac function and reduction in overall cardiovascular risk.

Objective: The purpose of our study is to evaluate the efficacy of paroxetine in poststroke depression (PSD) patients by conducting a meta-analysis. Methods: We searched Web of Science (science and social science citation index), PubMed, the Cochrane Central Register of Controlled Trials, Embase up to August 2019. Randomized controlled trials that paroxetine compared to other antidepressants or control treatments as monotherapy for patients with PSD. Results: This review identified a total of 4 studies including 212 patients. This meta-analysis presented that paroxetine exhibits beneficial efficacy than routine treatment in PSD patients in terms of the reducing score of Hamilton Depression Scale (HAMD). Control treatment is more effective than paroxetine. No significant advantage was found with paroxetine. Conclusions: The efficacy of paroxetine maybe not very significant compared to other pharmacological and nonpharmacological interventions. Further high quality and large sample size studies are needed to evaluate the efficacy and safety of paroxetine in treating PSD in future.

Research examining nonpharmacological interventions for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) has expanded in recent years and provides patients with more treatment options. Mindfulness-based training is an example of an intervention that is gaining promising preliminary empirical support and is increasingly administered in clinical settings. The aim of this review is to provide a rationale for the application of mindfulness to individuals diagnosed with ADHD, describe the current state of the empirical basis for mindfulness training in ADHD, and summarize a treatment approach specific to adults diagnosed with ADHD: the Mindful Awareness Practices (MAPs) for ADHD Program. Two case study examples are provided to demonstrate relevant clinical issues for practitioners interested in this approach. Directions for future research, including mindfulness meditation as a standalone treatment and as a complementary approach to cognitive-behavioral therapy, are provided.

Brown fat is present and metabolically active in adults, and is involved in physiologic and pathologic processes. Brown fat activation can seriously interfere with correct [(18)F]fluorodeoxyglucose-PET image interpretation if not recognized, although this can be overcome through identification of typical uptake patterns, pharmacological and nonpharmacological interventions to reduce brown fat uptake, and hybrid PET/computed tomography and PET/magnetic resonance imaging technologies. Advanced quantitative PET imaging techniques may be used to quantify total brown fat volume and metabolic activity for assessment prior to and following various interventions, likely contributing to further understanding of brown fat.

Background The ophthalmological examination of premature infants, which is essential for the detection of retinopathy of prematurity (ROP), can be painful and distressing for the infant. Various researchers have investigated the benefits of topical anesthesia, oral sucrose, and nonpharmalogical intervention for pain relief. The purpose of this study is to review the current state of knowledge on the effectiveness of these approaches. Methods A literature search was performed with MEDLINE (January 1980 to January 2011) and the Cochrane Central Register of Controlled Trials, Issue 1 of 4 (January 2011), to determine the currently available evidence on methods of pain relief for premature infants undergoing ROP examination. Results Most studies supported the use of topical proparacaine, which marginally decreased pain without any side effects. Oral sucrose did not significantly reduce pain scores during ROP examinations, and withholding feeding before the examination was not beneficial. Infants given pacifiers had lower pain scores than those without pacifiers, and infants who were nested experienced less distress during and after the procedure. Conflicting data existed on the benefits of different examination techniques, but the insertion of a lid speculum appeared to be the most uncomfortable aspect of the screening examination. Conclusions Topical anesthetics marginally reduce pain during eye examination in premature infants. Contrary to standard practice, it appears that patients are more comfortable if they are fed before the examination, and there is no benefit of oral sucrose. Nonpharmacological interventions, including sucking on a pacifier and nesting, may also be beneficial.

The present research determined if articles describing attempts to improve the behavior of people with autism reported whether or not participants were receiving medication and, if so, whether an interaction between the intervention and the medication was mentioned. Fifty-one articles published from 2004 through 2008 were examined. Information regarding medication was provided in 18% of these articles, none of which mentioned an interaction. Very little is known regarding interactions between nonpharmacological interventions and psychotropic (or other) medications, but some studies demonstrate that interactions can occur. Given this possibility, and the fact that information regarding medications received by participants is easy to obtain and report, it appears worthwhile to include this information in published articles.

The purpose of this study was to determine if providing a sticker after a finger stick for hemoglobin check reduced pain perception among preschool-aged children. The hypothesis was: Sticker rewards influence the perception of pain as measured by the Oucher scale following a finger stick to check hemoglobin. Preschoolers from Headstart Centers in a southeastern city were recruited for the study. The age range of participants was between 3 and 5 years. The children were assigned randomly into two groups: those receiving stickers (Group I), and those not receiving a sticker (Group II). Subsequently, each participant's pain level was assessed using the Oucher scale within 1 minute of the finger stick. There was no statistically significant difference in pain scale ratings between the two groups when comparing whether or not a cartoon sticker was given t (–.937, df 128, P = .351; 95% confidence interval). This study was clinically significant in that nonpharmacological interventions were utilized in an attempt to reduce pain in young children. Future research should determine whether receiving rewards (such as a cartoon sticker, adhesive bandages, or small toys) alone or in conjunction with distraction measures are efficacious in pain reduction in younger children.

The purpose of this article is to present a model of factors that may influence a child's response to a painful procedure when parents are distraction coaches during the procedure. Nonpharmacological interventions, in particular, distraction, and parents as coaches for their children during procedures are discussed. A conceptual model is presented that illustrates the multiple factors and their possible relationships. A selected review of studies is provided that supports the inclusion of these factors in the model. The model and literature review focus on three major areas: characteristics of the child, characteristics of the parent, and procedural variables. The model presented is currently being tested in a large multisite study on the use of distraction during intravenous line insertion.

A comprehensive review of empirical findings from controlled studies of nonpharmacological treatments used either alone or in combination with pharmacological therapies for recurrent headache disorders is presented. Overall, the evidence support the value of approaches based on relaxation, biofeedback, and coping skills training. Their effects appear to be long-lasting and comparable to those obtained through the use of medications. The relative benefits, costs, and limitations of combining nonpharmacological and pharmacological treatments remain largely unknown. Efforts are being made to enhance the effectiveness of nonpharmacological interventions by focusing on subgroups of patients that have been identified as nonresponsive and learning how to tailor and combine treatment approaches. Progress in the understanding of the therapeutic mechanisms of nonpharmacological treatments remain rudimentary. Basic research is needed to shed light on the ways psychological and biological variables interact in producing migraines and tension-type headaches and to stimulate the development of more effective treatments. Clinical trials focusing on formats for treatment delivery have yielded encouraging results, but cost-benefit analyses are needed to address policy considerations for implementation of nonpharmacological treatments into mainstream health practice.

This paper reviews several recent publications concerning the use of opioids to control cancer pain and highlights the wide variation in mean daily dose. Present methods of reporting do not provide an explanation for these widely different doses used. It is essential that we understand the circumstances in which high doses are required, as higher doses are associated with greater toxicity and higher cost. Several factors that may influence the dose of opioid required are discussed. It is suggested that reporting of cancer pain, patient population, pharmacological and nonpharmacological interventions, and toxicity be standardized to allow for rational guidelines to be established for opioid use in pain due to advanced cancer.

The carefully conducted study by the Oxford group ([1][1]) reports beneficial effects of weight loss after 2 nonpharmacological interventions, diet or bariatric surgery. In case of the latter, we have made similar observations except at a much earlier time point ([2][2]). Three months after

Hypertension remains a major contributing factor for cardiovascular and cerebrovascular diseases. Optimal blood pressure (BP) control is therefore of great importance. Several nonpharmacological interventions exist to optimize BP, including the reduction of alcohol intake, weight loss, and limiting

The present study determined whether articles describing attempts to alter behavior in mentally retarded participants through nonpharmacological interventions typically specify whether participants received medication during the experiments. From 1978 through 1982, the vast majority of such articles published in the American Journal of Mental Deficiency, Behavior Modification, Behavior Therapy, the Journal of Applied Behavior Analysis, and Mental Retardation failed to specify whether participants were receiving drugs. In addition, very few articles examined pharmacological interventions or attempted to address the interaction of drug and nondrug treatments.