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• Pain negatively influences staff-patient interactions. • Non-pharmacological intervention use positively influences staff-patient interactions. • Staff should be cognizant of possible pain among patients during daily interactions. • Exploring ways to promote non-pharmacological intervention use is important. This study examines the clinical factors associated with the quality of interactions between staff and hospitalized older patients with dementia. Following examination of bivariate associations, we conducted multiple linear regression in a sample of 140 hospitalized older patients with dementia who participated in the final cohort of an intervention study implementing Family-centered Function-focused Care (Fam-FFC). On average, the participants (male = 46.1%, female = 52.9%) were 81.43 years old (SD = 8.29) and had positive interactions with staff (mean QUIS score = 5.84, SD = 1.36). Accounting for 17.8% of variance in the model, non-pharmacological intervention use (b= 0.170; p<.001) and pain (b= -0.198; p<.01) were significantly associated with the quality of staff-patient interactions. To optimize care of hospitalized patients with dementia, staff should be encouraged to use non-pharmacological interventions. It is also important for staff to assess pain among the patients with dementia and prioritize pain management. [ABSTRACT FROM AUTHOR]

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For many children, hospitalization can lead to a state of increased anxiety. Being away from home, the invasive procedures undertaken, and the uncertainty of the outcome cause an uncomfortable situation in anticipation of real or imagined hazards. This systematic review aims to assess current evidence on the types of non-pharmacological interventions used and their impact on children’s anxiety or distress levels when they visit the hospital for planned or unplanned admissions. The Databases PubMed, Psych INFO, and Google Scholar were queried for papers published from January 2000 to March 2023 reporting the use of non-pharmacological interventions interacting with children in hospital or clinical environments and confirmed with saliva cortisol levels. A total of nine studies were retrieved. Across these studies, four different strategies of non-pharmacological interventions were used. Anxiety and distress were found to be reduced in the majority of the studies as confirmed with salivary cortisol. Overall, there is evidence that non-pharmacological interventions hold a promising role in reducing levels of anxiety or distress in children as confirmed with saliva cortisol. However, research on saliva cortisol as a tool of anxiety measurement requires higher quality studies to strengthen the evidence base.

Cognitive dysfunction refers to the functional impairment in one or more cognitive domains, mostly occurs in older adults. Cognitive dysfunction can commonly be divided into subjective cognitive decline (SCD), mild cognitive impairment (MCI) and dementia, depending on the degree of cognitive impairment. People with SCD or MCI have a higher risk of dementia, which seriously affects their quality of life, and imposes a huge burden on families and society. Numerous studies have demonstrated that physical activity is one effective non-pharmacological intervention for cognitive dysfunction, but there are no uniform standards for physical activity programs for cognitive dysfunction worldwide, and China still has no physical activity guidelines based on the values and preferences of older adults with cognitive dysfunction, partially impeding the dissemination and application of relevant evidence. In view of this, we developed a guideline containing eight recommendations that is applicable in China, namely the Clinical Practice Guideline on Non-pharmacological Interventions for Older Adults with Cognitive Dysfunction: Physical Activity, by the use of existing evidence, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework combined with values and preferences of Chinese older adults with cognitive dysfunction. This guideline will contribute to the reduction of the incidence of cognitive dysfunction, and preventing or slowing the progression of cognitive dysfunction to dementia.

The older adults are high risk population for malnutrition. Malnutrition is closely associated with numerous adverse clinical outcomes, which may seriously affect the physical health and life quality of the older adults, causing heavy burdens on families and society. Therefore, it is of great importance to take effective measures to improve malnutritionin the older adults, and non-pharmacological interventions have been proved to be important measures to improve nutritional status. However, there is no domestic clinical practice guideline for non-pharmacological interventions specifically for malnourished older adults. Therefore, nutrition experts from China Gerontological Nursing Alliance, National Center for Gerontology and National Clinical Research Center for Geriatric Disorders developed the guideline based on the Grading of Recommendation Assessment, Development and Evaluation (GRADE) including 9 recommendations of non-pharmacological intervention formal nourished older adults through a comprehensive search and analysis of the latest domestic and international literature on malnutrition in the elderly, in order to improve malnutrition and quality of life in the older adults. This guideline focuses on malnourished older adults who can be fed orally and enteral nutrition, parenteral nutrition is not covered by the scope of this guideline.

This letter responds to the recent Australian survey by Harris and Lee (Australas J Dermatol, 2024, doi: 10.1111/ajd.14361) on the use of oral benzodiazepines for anxiety management in Mohs micrographic surgery (MMS). While commending the authors' efforts, we provide additional perspectives on current practices, recent evidence and safety considerations. We highlight the alignment with U.S. practices, discuss a recent randomized controlled trial supporting diazepam's efficacy and emphasize the importance of non‐pharmacological interventions. The letter also addresses the need for flumazenil availability and calls for standardized guidelines and further research to optimize patient care in MMS. [ABSTRACT FROM AUTHOR]

Abstract INTRODUCTION Older adults experiencing subjective cognitive decline (SCD) have a higher risk of dementia. Reducing this risk through behavioral interventions, which can increase emotional well‐being (mindfulness and compassion) and physical activity, is crucial in SCD. METHODS SCD‐Well is a multicenter, observer‐blind, randomized, controlled, superiority trial. Three hundred forty‐seven participants (mean [standard deviation] age: 72.7 [6.9] years; 64.6% women) were recruited from memory clinics in four European sites to assess the impact of an 8‐week caring mindfulness‐based approach for seniors (CMBAS) and a health self‐management program (HSMP) on mindfulness, self‐compassion, and physical activity. RESULTS CMBAS showed a significant within‐group increase in self‐compassion from baseline to post‐intervention and both a within‐ and between‐group increase to follow‐up visit (24 weeks). HSMP showed a significant within‐ and between‐group increase in physical activity from baseline to post‐intervention and to follow‐up visit. DISCUSSION Non‐pharmacological interventions can differentially promote modifiable factors linked to healthy aging in older adults with SCD.

This editorial published in Frontiers in Psychology discusses non-pharmacological interventions for individuals at risk of or living with dementia. It emphasizes the importance of finding effective solutions to prevent disability and loss of independence in older individuals. The editorial explores various interventions such as transcranial direct current stimulation, housework, performing arts programming, photobiomodulation, light therapy, social activity, and music-based interventions. It presents a selection of articles that cover these interventions and their potential benefits for individuals with dementia. The editorial concludes by highlighting the need for further research and the significance of non-pharmacological interventions in improving the quality of life for individuals with dementia. The document also includes references to additional articles and sources related to healthy and pathological aging, measuring healthy aging, and dementia, providing valuable information and perspectives for researchers and individuals interested in these topics. The World Health Organization's fact sheet on dementia is also included as a resource for further information. [Extracted from the article]

BackgroundWith the continuous development of clinical medicine, an increasing number of non-pharmacological interventions have been applied for the treatment of knee osteoarthritis (KOA), with the results of several recent randomized controlled trials (RCTs) showing that a variety of externally-applied, non-pharmacological interventions (EANPI) can improve symptoms and inflammation in patients with KOA. However, the relative benefits and disadvantages of non-drug therapies remain uncertain, and an optimal treatment strategy has not yet been determined.ObjectiveThis study applied network meta-analysis (NMA) to compare and rank the effectiveness of EANPI on the short- and long-term clinical symptoms and inflammatory cytokine levels in patients with KOA.MethodsTwo independent researchers searched online databases and performed manual retrieval of related citations to identify RCTs that met the selection criteria for the network meta-analysis. These researchers retrieved studies indexed from database inception to August 2023 and performed data extraction and assessment of the risk of bias.ResultsThe analysis included 80 RCTs involving 8440 participants and nine externally-applied, non-pharmacological therapies, namely extracorporeal shock wave, radiofrequency, acupotomy, laser therapy, Tuina therapy, kinesio taping, electroacupuncture, platelet-rich plasma injection, and ozone therapy. The treatment courses ranged from 1 to 12 weeks, with follow-up periods ranging from 4 to 24 weeks. The results of the NMA indicated that each non-drug therapy was superior to sham intervention in improving all outcome indicators. Except for the visual analog scale (VAS) and Western Ontario MacMaster (WOMAC) pain outcomes, all non-drug therapies had better efficacy than pharmacological treatments. For short-term VAS and tumor necrosis factor-alpha (TNF-α), extracorporeal shock wave performed better than other therapies (90.2% and 85.2% respectively). Radiofrequency therapy may be the most promising method to reduce long-term VAS, short- and long-term WOMAC pain, and interleukin (IL)-1β level (84.8%, 97.8%, 90.1%, 94.8% respectively). Tuina therapy may be a significant choice for short- and long-term outcomes of WOMAC function and range of motion (ROM).ConclusionsThe results of the comprehensive comparison of the outcome indicators in 9 different EANPI indicated that radiofrequency and Tuina therapy were more effective and consistently ranked high in improving clinical symptoms in the short and long term. Radiofrequency is effective at relieving pain, and Tuina therapy can be given priority for treatment when hypofunction is the main symptom. EANPI to improve pain symptoms may be related to the regulation of inflammatory cytokine levels, which may be a potential mechanism of action.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?, identifier CRD42023464177.

Obesity is one of the main risk factors for progression of chronic kidney disease (CKD). Weight loss interventions have limited efficacy in patients with pre-dialysis CKD. Our objective is to test the efficacy of a cognitive behavioral therapy program for obesity management in patients with CKD. We will conduct a randomized controlled intervention trial to evaluate the effects of cognitive behavioral therapy for obesity on weight loss, change in proteinuria, weight maintenance, quality of life, depression symptoms, and anxiety symptoms in patients with CKD. The duration of the intervention will be 16 weeks. The primary study outcomes will be body mass index (BMI) and proteinuria. CKD patients will be randomized into two groups: an intervention group with cognitive behavioral therapy, sessions with a dietitian and a kinesiologist, and a control group with sessions with a dietitian and a kinesiologist, without cognitive behavioral therapy. Study outcomes will be assessed at baseline, immediately after the 16-week intervention, 3 months after the end of the intervention, and 12 months after the end of the intervention. This study will be the first to evaluate the efficacy of cognitive behavioral therapy for obesity in patients with CKD. We expect that our results will contribute to new ways of non-pharmacological treatment of CKD. Clinical trial registration: ClinicalTrials.Gov, NCT05927337.

The COVID-19 pandemic had a devastating impact on the world, causing widespread illness and death. Focusing on prevention strategies to limit the spread of the disease remains essential. Despite the advent of vaccines, maintaining a vigilant approach to prevention remains paramount. We reviewed effective strategies to prevent COVID-19 transmission, including various prevention measures and interventions and both established practices and unresolved issues that have been addressed in meta-analyses, literature reviews, or in the health care context. Standard precautions are the cornerstone of infection control, with hand hygiene and mask use as key components. The use of surgical masks is recommended to prevent droplet transmission, while eye protection is recommended in combination with masks. In terms of room occupancy, ventilation is critical in reducing the risk of transmission in poorly ventilated environments. Chemical disinfection of indoor air with Triethylene glycol-based products can provide safe additional protection. Since viral RNA detection on surfaces does not necessarily indicate infectivity, the risk of transmission by surface contact remains low if surfaces are properly maintained and hand hygiene is practiced regularly. Thus, prevention of SARS-CoV-2 transmission requires a multifaceted approach, including reducing particle emissions from infected persons by wearing masks, eliminating aerosols by ventilation and air treatment, ensuring physical separation, and protecting exposed persons with masks and eye protection. [ABSTRACT FROM AUTHOR]

Perception is a primary role of cognition, and perception itself changes with dementia. Behaviour changes also, because people respond to what they percieve. A transdisciplinary. approachmethod of transgressing disciplinary boundaries to integrate understandings from the sciences, medicine, the caring professions, the arts, indigenous perspectives and the perspectives of the people living with dementia (PLWD) themselves. A key is found in the ecological theories of perception, which in themselves fill an uncertain space between the disciplines. The theories promise to mitigate the symptomatology of dementia, problematic behaviour and improve the sense of wellbeing for PLWD passively and non-invasively, if only carers of PLWD were to use them. [ABSTRACT FROM AUTHOR]

Migraine is a complex neurological disorder that affects a significant portion of the population. Conventional therapies for migraines have limitations and drawbacks, necessitating the exploration of novel therapeutic strategies. This review paper provides an overview of emerging therapeutic approaches for migraines, focusing on both pharmacological and non-pharmacological interventions. The review begins with an introduction that highlights the background and significance of the topic. It emphasizes the need for advancements in migraine treatment and the potential impact of emerging therapeutic strategies on patient care. The pathophysiology of migraines is discussed, providing a brief overview of the underlying mechanisms, key neurochemicals, and pathways involved. Additionally, the current understanding of migraine triggers is explored, shedding light on factors that can initiate or exacerbate migraine attacks. The paper then delves into the conventional therapies used for migraine management. An overview of commonly used treatments is provided, along with a discussion of their limitations and drawbacks. The need for the development of novel therapeutic strategies is emphasized, considering the challenges faced by existing therapies. Recent advances in migraine research are reviewed, highlighting the scientific advancements in the field. Novel insights into the pathophysiology of migraines are discussed, along with the identification of potential therapeutic targets. These advancements have the potential to reshape our understanding of migraines and guide the development of more targeted and effective treatments. Non-pharmacological approaches for migraine management are explored, including a comprehensive review of complementary and alternative therapies. The evidence-based review highlights the potential benefits of lifestyle modifications, such as dietary changes, sleep optimization, and exercise, in reducing migraine frequency and severity. Emerging pharmacological therapies are examined, focusing on the overview of novel pharmacological agents under investigation. The analysis of clinical trials and their outcomes provides insights into the efficacy and safety of these emerging therapies. The discussion also encompasses emerging drug classes and their mechanisms of action, shedding light on the potential of targeted treatments for migraines. The review concludes with a discussion of the future perspectives and challenges in migraine research. The potential implications of personalized medicine approaches are explored, considering the role of genetics and biomarkers in guiding treatment decisions and optimizing therapeutic interventions. The recommendations for future research and development highlight the need for further investigations into the underlying mechanisms of migraines, prospective studies evaluating combination therapies, and the ethical considerations associated with personalized medicine approaches. In summary, this review paper provides a comprehensive overview of the emerging therapeutic strategies for migraines. It highlights the advancements in understanding the pathophysiology of migraines, the potential of non-pharmacological interventions, and the promise of emerging pharmacological therapies. The paper emphasizes the importance of personalized medicine approaches in guiding treatment decisions and optimizing patient outcomes. The insights and recommendations provided in this review can contribute to the advancement of migraine research and improve patient care in the future. [ABSTRACT FROM AUTHOR]

Background: The treatment for Parkinson's disease (PD) consumes a lot of manpower and financial resources. Non-pharmacological alternative motor-/sensory-based interventions are optimized for the rehabilitation of PD patients. Mindfulness-based therapy shows ideal efficacy, but the diversity of the therapy brings difficulties to the selection of clinicians and patients. Methods: Network meta-analysis in the Bayesian framework was used to evaluate the efficacy of non-pharmacological alternative motor-/sensory-based interventions in improving motor and non-motor symptoms in PD patients. Results: A total of 58 studies (2,227 patients) were included. Compared with the non-intervention group, qigong was associated with improved outcomes in the Timed Up and Go (TUG) test (mean difference (MD) -5.54, 95% confidence interval (CI) -8.28 to -2.77), and UPDRS-I (MD -15.50, 95% CI -19.93 to -7.63). Differences between non-pharmacological alternative motor-/sensory-based interventions were not significant for PDQ-39, UPDRS-I, or UPDRS-II; however, qigong was superior to dance (MD -3.91, 95% CI -6.90 to -0.95), Tai Chi (MD -3.54, 95% CI -6.53 to -0.69), acupuncture (MD -6.75, 95% CI -10.86 to -2.70), music (MD -3.91, 95% CI -7.49 to -0.48), and exercise (MD -3.91, 95% CI -6.49 to -1.33) in the TUG test. Conclusion: This network meta-analysis supports mindfulness-based therapy (e.g., qigong, yoga, and Tai Chi) as a preferred non-pharmacological alternative motor-/sensory-based intervention for PD rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is frequent. While two network meta-analyses assessed the impact of pharmacological interventions to prevent CSA-AKI, none focused on non-pharmacological interventions. We aim to assess the effectiveness of non-pharmacological interventions to reduce the incidence of CSA-AKI. Methods: We searched PubMed, Embase, Central and clinical trial registries from January 1, 2004 (first consensus definition of AKI) to July 1, 2023. Additionally, we conducted manual screening of abstracts of major anesthesia and intensive care conferences over the last 5 years and reference lists of relevant studies. We selected all randomized controlled trials (RCTs) assessing a non-pharmacological intervention to reduce the incidence of CSA-AKI, without language restriction. We excluded RCTs of heart transplantation or involving a pediatric population. The primary outcome variable was CSA-AKI. Two reviewers independently identified trials, extracted data and assessed risk of bias. Random-effects meta-analyses were conducted to calculate risk ratios (RRs) with 95% confidence intervals (CIs). We used the Grading of Recommendations Assessment, Development, and Evaluation to assess the quality of evidence. Results: We included 86 trials (25,855 patients) evaluating 10 non-pharmacological interventions to reduce the incidence of CSA-AKI. No intervention had high-quality evidence to reduce CSA-AKI. Two interventions were associated with a significant reduction in CSA-AKI incidence, with moderate quality of evidence: goal-directed perfusion (RR, 0.55 [95% CI 0.40–0.76], I2 = 0%; Phet = 0.44) and remote ischemic preconditioning (RR, 0.86 [0.78–0.95]; I2 = 23%; Phet = 0.07). Pulsatile flow during cardiopulmonary bypass was associated with a significant reduction in CSA-AKI incidence but with very low quality of evidence (RR = 0.69 [0.48; 0.99]; I2 = 53%; Phet < 0.01). We found high quality of evidence for lack of effect of restrictive transfusion strategy (RR, 1.02 [95% CI 0.92; 1.12; Phet = 0.67; I2 = 3%) and tight glycemic control (RR, 0.86 [95% CI 0.55; 1.35]; Phet = 0.25; I2 = 26%). Conclusions: Two non-pharmacological interventions are likely to reduce CSA-AKI incidence, with moderate quality of evidence: goal-directed perfusion and remote ischemic preconditioning. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to provide a general overview of mental health randomized controlled trials (RCTs) and summarize the temporal trends in terms of the number of studies, median sample sizes, and median effect sizes using data collected from the Cochrane Database of Systematic Reviews (CDSR). Methods: Using data collected from the CDSR, the temporal trends are compared in terms of the number of studies, median sample sizes, and median effect sizes between two broad categories of interventions: pharmacological RCT (ph-RCT) and non-pharmacological RCT (nph-RCT), and in conjunction with major mental disorder categories. Results: Chronologically, the number of mental health RCTs reported in publications has increased exponentially from 1955 to 2020. While ph-RCT comprised a majority of mental health RCTs in the earlier years, the proportion of nph-RCTs increased more quickly over time and markedly exceeded ph-RCT after 2010. The median sample size for all 6,652 mental health RCTs was 61, with 61 for ph-RCT and 60 for nph-RCT. Over time, the median fluctuated but an increasing trend was observed over the past 60+ years. The median of the effect size, measured by Pearson's r, for overall RCTs was 0.18, and nph-RCT (0.19) had a larger median effect size compared to ph-RCT (0.16). Over the years, the nph-RCT had a larger median effect size than the ph-RCT. Differences in the median effect sizes among the categories of mental disorders were also noted. Schizophrenia had the most RCTs, with a median Pearson's r value of 0.17. Mood disorder had the second largest number of RCTs and a median Pearson's r value of 0.15. Neurotic/stress-related mental disorder had the third largest number of RCTs with the highest median Pearson's r being 0.23. Conclusions: This study provides meaningful information and filled the knowledge gap in mental health RCTs. [ABSTRACT FROM AUTHOR]

Philosophers have recently questioned the methodological status of agent-based modeling. Meanwhile, this methodology has been central to various studies of the COVID-19 pandemic. Few agent-based COVID-19 models are accessible to philosophers for inspection or experimentation. We make available a package for modeling the COVID-19 pandemic and similar pandemics and give an impression of what can be achieved with it. In particular, it is shown that by coupling an agent-based model to a standard optimizer we are able to identify strategies for implementing non-pharmacological interventions that flexibly lower or raise social activity, depending on how the outbreak develops, while balancing various desiderata that cannot be fully satisfied together. The simulation outcomes to be presented testify to the power of agent-based modeling and thereby help to push back against the recent philosophical critique of this methodology. [ABSTRACT FROM AUTHOR]

Purpose of Review: To critically review recent research in the development of non-pharmacological interventions to improve cognitive functioning in individuals with Alzheimer's disease (AD) or Parkinson's disease (PD). Recent Findings: Cognitive interventions can be grouped into three categories: cognitive stimulation (CS), cognitive training (CT), and cognitive rehabilitation (CR). CS confers temporary, nonspecific benefits and might slightly reduce dementia risk for neurologically healthy individuals. CT can improve discrete cognitive functions, but durability is limited and real-world utility is unclear. CR treatments are holistic and flexible and, therefore, most promising but are difficult to simulate and study under rigorous experimental conditions. Summary: Optimally effective CR is unlikely to be found in a single approach or treatment paradigm. Clinicians must be competent in a variety of interventions and select those interventions best tolerated by the patient and most relevant to their needs and goals. The progressive nature of neurodegenerative disease necessitates that treatment be consistent, open-ended in duration, and sufficiently dynamic to meet the patient's changing needs as their disease progresses. [ABSTRACT FROM AUTHOR]

Purpose: Late in 2019, the corona virus outbreak caused complex economic issues and substantially impacted the global economy. Governments resorted to nonpharmaceutical interventions, such as social isolation and mandatory quarantines to combat the ever-increasing spread of this virus. These restrictions, which are referred to as a non-vaccine intervention, have been criticized by some economists, and this led to the formation of the topic of the government's actions against the spread of the virus. What effect has it had on the economy and especially macro–variables? In the economic cycle, the imposition of restrictions and quarantine and measures like these have caused a decrease in the supply of labor, a decrease in the activity of enterprises, their production and the gross domestic production. Considering the possibility of the economic costs of these interventions imposed on the economies of countries, the current research attempts to investigate the economic effects of non-pharmacological measures taken during the period of the COVID-19 spread in a number of developed and developing nations. Methodology: This study aims to examine the impact of non-pharmaceutical government interventions on the gross domestic production (GDP) of developing and developed nations during the period of 2020 to 2022. This is done with seasonal data, and, for each country, the panel generalized moments model (Panel GMM) is utilized. Therefore, the following model is estimated for each group of countries: 𝐿n 𝐺𝑑𝑝𝑖𝑡 = 𝛽1𝐿𝑛𝐺𝑑𝑝𝑖𝑡−1 + 𝛽2𝐿𝑛𝑂𝑝𝑒𝑛𝑖𝑡 + 𝛽3𝐿𝑛𝑇𝑜𝑢𝑟𝑖𝑠𝑚𝑖𝑡 + 𝛽4𝐿𝑛𝑆𝑡𝑟𝑖𝑛𝑖𝑡 + 𝛽5𝐿𝑛𝑁𝑒𝑤𝑐𝑖𝑡 + 𝜀𝑖𝑡, where Gdp represents 𝐺𝐷𝑃 at constant prices in 2015, 𝑂𝑝𝑒𝑛 represents the degree of trade openness, 𝑇𝑜𝑢𝑟𝑖𝑠𝑚 represents the number of tourists, 𝑆𝑡𝑟𝑖𝑛 represents the government stringency index, and 𝑁𝑒𝑤𝑐 represents the number of new COVID cases. Findings and Discussion: The results of the panel GMM estimation indicate that the previous-period GDP had a positive and significant effect on the current-period GDP in both developed and developing countries. The degree of trade openness has a positive and significant effect on the GDP in both developed and developing countries, such that a one-percent increase in the trade openness raises the GDP by 0.026% in developed countries and by 0.634% in developing countries. The results from both categories of the studied countries indicate that the number of tourists entering the country had a positive and statistically significant effect on the GDP. In developed countries, a one-percent increase in the number of incoming tourists results in a 0.107% increase in the GDP, while, in developing countries, it results in a 0.03% increase in the GDP. The government austerity index, which is used to evaluate the economic costs of non-pharmaceutical interventions during the COVID-19 pandemic, has had a negative and significant impact on the GDP of both developed and developing countries. This indicates that government austerity has a negative and significant effect on economic growth. It is that non-medicinal government interventions to control the epidemic have resulted in a decline in the gross domestic production of countries. The findings indicate that a one-percent increase in the government austerity index decreases the GDP by 0.03 percent in established nations and by 0.001 percent in developing ones. This difference in the estimated coefficient indicates that the austerity index had a greater negative impact on the GDP of developed nations. The variable coefficient for the number of newly infected individuals differs in developed and developing nations. In developed nations, this coefficient is negative and statistically significant. The number obtained for this coefficient in this group of countries indicates that, as predicted, a one-percent increase in the number of new cases of COVID-19 has resulted in a 0.001% decrease in the GDP, whereas, in developing countries, a one-percent increase in the number of new cases of the disease has resulted in a 0.009% increase in the GDP. Conclusion and Policy Implications: Due to the rapid global spread of COVID-19, the government's role in controlling and overcoming this situation has been undeniable and indispensable. Therefore, it is recommended that governments stimulate aggregate demand and increase their expenditure (G) through various monetary and financial channels, such as lowering interest rates, providing packages and support facilities, and reducing taxes. Since effective vaccines were not yet discovered at the beginning of the spread of this virus and, therefore, it was necessary and natural for governments to adopt preventative austerity measures, it is suggested that, in such critical times, governments could be warned to increase information regarding the economic cost and negative effects of non-pharmaceutical measures on the country. The results of this research provide policymakers with the possibility of future epidemics of comparable or even greater magnitude than COVID-19. This index measures the economic costs incurred by the government during these times. It suggests that, by understanding and analyzing such costs in similar circumstances, organizations can modify their strategies or develop support mechanisms to reduce the cost and external effects of such actions. [ABSTRACT FROM AUTHOR]

This study aimed to examine trajectories of cancer specific stress (CSS) over the course of a year, starting at the beginning of chemotherapy, and identify psychosocial factors that predicted trajectory class membership. Growth Mixture Modeling was used to identify distinct trajectories of CSS. Multinomial regression examined potential psychosocial predictors of trajectory membership. In the 4-class solution, all four trajectories demonstrated a decrease in CSS over the year but with differing intercepts and magnitudes of slopes. These were characterized as recovery, resilience, chronic, and severely chronic. The recovery group reported significantly higher insomnia scores than the resilient group. The chronic group reported significantly higher insomnia, higher depression, lower social support, and lower optimism than the resilient group. The chronic group reported significantly lower social support and higher depression than the recovery group. The findings provide information about psychosocial risk factors for CSS that can be screened for early intervention following diagnosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate and rank the evidence for the efficacy of non‐pharmacological interventions in relieving pain after cardiac surgery using comprehensive comparisons. Background: Although several previous systematic reviews and meta‐analyses showed that non‐pharmacological interventions effectively control and reduce pain after cardiac surgery, none quantitatively compared the effect of these different types of interventions. Design: Systematic review and Bayesian network meta‐analysis based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses for Network Meta‐Analysis guidelines. Methods: Six databases were searched from inception to April 2021 to collect all published evidence from randomised clinical trials. One author extracted the relevant information from the eligible trials; a second author independently reviewed the data. Before analysing the extracted data, two investigators independently assessed the quality of the included studies. Conventional meta‐analysis was conducted using either fixed‐ or random‐effects models according to statistical heterogeneity. The Bayesian network meta‐analysis was conducted using the consistency model. Results: We identified 42 randomised clinical trials comparing 14 groups with 4253 patients. Transcutaneous electrical nerve stimulation, acupressure, music and massage were effective for pain relief, with transcutaneous electrical nerve stimulation being associated with the best probability of successful pain relief after cardiac surgery (cumulative ranking curve surface, 0.97; probability, 77.03%). Acupressure (cumulative ranking curve surface, 0.79; probability, 30.69%) was the second‐best option. However, there was no evidence that any pair‐up intervention significantly reduced opioid use or anxiety. Conclusions: These findings suggest that transcutaneous electrical nerve stimulation, acupressure, music and massage may effectively alleviate postoperative cardiac pain, with transcutaneous electrical nerve stimulation representing the best choice for pain relief. Relevance to clinical practice: The results of this network meta‐analysis can guide patients after cardiac surgery and healthcare providers to make optimal decisions in managing postoperative cardiac pain. Trial registration: PROSPERO CRD42021246183. [ABSTRACT FROM AUTHOR]

Introduction: Behavioural and psychological symptoms of dementia (BPSD) are considered integral parts of dementia. While pharmacotherapy is reserved for severe symptoms of BPSD, the associated adverse effects can be detrimental. Therefore, non-pharmacological intervention is recommended as the first line of treatment in the management of BPSD. This study aimed to explore the non-pharmacological approaches for the management of BPSD and the strategies and barriers to implementing them in secondary care facilities in Malaysia. Methods: A qualitative study design was employed. Data were collected through observations and semi-structured interviews of 12 caregivers and 11 people with dementia (PWD) at seven secondary care facilities. Observations were written in the field notes, and interviews were audio-recorded and transcribed. All data were subjected to thematic analysis. Results: Some personalised non-pharmacological interventions, such as physical exercise, music therapy, reminiscence therapy and pet therapy, were conducted in several nursing care centres. Collaborative care from the care providers and family members was found to be an important facilitating factor. The lack of family support led to care providers carrying additional workload beyond their job scope. Other barriers to non-pharmacological interventions were cultural and language differences between the care providers and PWD, inadequate staff numbers and training, and time constraints. Conclusion: Although non-pharmacological approaches have been used to some extent in Malaysia, continuous education and training of healthcare providers and the family members of PWD is needed to overcome the challenges to their successful implementation. [ABSTRACT FROM AUTHOR]

Abstract Background COVID-19 caused the largest pandemic of the twenty-first century forcing the adoption of containment policies all over the world. Many studies on COVID-19 health determinants have been conducted, mainly using multivariate methods and geographic information systems (GIS), but few attempted to demonstrate how knowing social, economic, mobility, behavioural, and other spatial determinants and their effects can help to contain the disease. For example, in mainland Portugal, non-pharmacological interventions (NPI) were primarily dependent on epidemiological indicators and ignored the spatial variation of susceptibility to infection. Methods We present a data-driven GIS-multicriteria analysis to derive a spatial-based susceptibility index to COVID-19 infection in Portugal. The cumulative incidence over 14 days was used in a stepwise multiple linear regression as the target variable along potential determinants at the municipal scale. To infer the existence of thresholds in the relationships between determinants and incidence the most relevant factors were examined using a bivariate Bayesian change point analysis. The susceptibility index was mapped based on these thresholds using a weighted linear combination. Results Regression results support that COVID-19 spread in mainland Portugal had strong associations with factors related to socio-territorial specificities, namely sociodemographic, economic and mobility. Change point analysis revealed evidence of nonlinearity, and the susceptibility classes reflect spatial dependency. The spatial index of susceptibility to infection explains with accuracy previous and posterior infections. Assessing the NPI levels in relation to the susceptibility map points towards a disagreement between the severity of restrictions and the actual propensity for transmission, highlighting the need for more tailored interventions. Conclusions This article argues that NPI to contain COVID-19 spread should consider the spatial variation of the susceptibility to infection. The findings highlight the importance of customising interventions to specific geographical contexts due to the uneven distribution of COVID-19 infection determinants. The methodology has the potential for replication at other geographical scales and regions to better understand the role of health determinants in explaining spatiotemporal patterns of diseases and promoting evidence-based public health policies.

Abstract Background Promoting physical activity (PA) in different populations experiencing sleep disturbance may increase population PA levels and improve sleep. This scoping review aimed to examine the effect of various PA intervention strategies on sleep across different populations, identify key sleep outcomes, and analyze knowledge gaps by mapping the relevant literature. Methods For this study, we systematically searched articles published till March 2022 from PubMed, Web of Science, Cochrane Library, and Embase databases for randomized clinical trials (RCTs) regarding the effect of physical activity on sleep. Two authors extracted key data and descriptively analyzed the data. Thematic analysis was used to categorize the results into themes by all authors. Arksey and O’Malley’s scoping review framework was used to present the findings. Results Twenty-one randomized controlled trials out of 3052 studies were finally included with 3677 participants (2852 females (78%)). Five trials were conducted in healthy working-age adults with sleep disturbance but without the diagnosis of insomnia, five in healthy older adults, two in perinatal women, four in patients with cancer, three in mental illness related subjects, and another two in other disease-related areas. PA interventions were diverse, including walking, resistance training, aerobic exercise, housework, water exercise, basketball, smartphone/tablet "apps", web, online videos or wearable actigraphy, and self-determined exercise. Three major themes were identified: (1) Sleep environment may be important to address prior to instituting PA interventions, (2) All types of PA were effective for improving sleep in all populations studied, (3) Self-tolerated PA is safe for improving sleep in the elderly and in co-morbid or perinatal populations. Conclusions PA is effective and safe for improving sleep in both healthy and co-morbid populations with sleep disturbance by increasing daily activity levels using a variety of strategies, even low intensity, such as housekeeping, sit-to-stand repetitions, along with encouraging PA through web pages, videos, and self-goal setting apps. In addition, this scoping review identifies the need for further therapeutic research and future exploration in populations with sleep initiation or sleep maintenance disturbance.

Abstract Aim To review and analyse the evidence on the efficacy and safety of non‐pharmacological interventions for preterm infants to relieve endotracheal suctioning (ES) pain. Design A systematic review per the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Methods Six databases were searched with a retrieval strategy. Parallel and crossover randomized controlled trials reporting non‐pharmacological interventions for relieving ES pain in preterm infants were identified from inception to 1 September 2021. The protocol was published in PROSPERO (CRD42021276058). Results Ten studies were retrieved, including nine different non‐pharmacological interventions. Seven studies reported that non‐pharmacological interventions in relieving pain were more effective than conventional care during ES, and three trials reported its safety. Due to the heterogeneity of pain assessment tools, time of assessment and population, only Facilitated tucking had sufficient evidence that it is a safe and effective non‐pharmacological intervention.

Abstract Background There is increasing intervention activities provided during pharmacist-led diabetes management. Nevertheless, there is an unclear definition of the activities involved during the intervention. Thus, this study aimed to describe the type of intervention strategies and service model provided during pharmacist-led type 2 diabetes management and service outcomes. Methods This study utilized the scoping review methodology of the Joanna Briggs Institute Reviewers’ Manual 2015. Articles on pharmacist-led diabetes management focusing on the service content, delivery methods, settings, frequency of appointments, collaborative work with other healthcare providers, and reported outcomes were searched and identified from four electronic databases: Ovid Medline, PubMed, Scopus, and Web of Science from 1990 to October 2020. Relevant medical subject headings and keywords, such as “diabetes,” “medication adherence,” “blood glucose,” “HbA1c,” and “pharmacist,” were used to identify published articles. Results The systematic search retrieved 4,370 articles, of which 61 articles met the inclusion criteria. The types of intervention strategies and delivery methods were identified from the studies based on the description of activities reported in the articles and were tabulated in a summary table. Conclusion There were variations in the descriptions of intervention strategies, which could be classified into diabetes education, medication review, drug consultation/counseling, clinical intervention, lifestyle adjustment, self-care, peer support, and behavioral intervention. In addition, most studies used a combination of two or more intervention strategy categories when providing services, with no specific pattern between the service model and patient outcomes.

Abstract Background Older people with dementia (PWD) in nursing homes (NHs) tend to have decreased cognitive function, which may cause behavioral and psychological symptoms of dementia (BPSDs) and hinder activities of daily living (ADLs). Therefore, taking measures against the cognitive decline of PWD in NH and, in turn, the decline of BPSDs and ADLs is crucial. The purpose of this study was to test whether a multimodal non-pharmacological intervention (MNPI) is effective in maintaining and improving global cognitive function, BPSDs, and ADLs in PWD in NHs. Methods An intervention study using a single-case AB design was conducted in three subjects in NHs. During the non-intervention phase, participants underwent follow-up assessments, and during the intervention phase, they participated in an MNPI. The ABC Dementia Scale (which concurrently assesses ADLs [“A”], BPSDs [“B”], and cognitive function [“C”]) was used for the assessment. Results One of the three patients showed improvement in dementia severity, global cognitive function, ADLs, and BPSDs. However, the other two participants showed no improvement following the MNPI, although the possibility of a maintenance effect remained. Conclusion Although there is room for improvement of the MNPI, it may be effective in maintaining and improving cognitive function, ADLs, and BPSD, in PWD in NHs. Trial registration The University Hospital Medical Information Network Clinical Trials Registry ( http://www.umin.ac.jp/ , No. UMIN000045858, registration date: November 1, 2021).

Sickle cell crises (SCC) are recurrent, severe pain episodes experienced by people living with sickle cell disease (SCD). Non-pharmacological interventions have been recommended for SCC pain management however, little is known about the impact of these interventions on SCC pain. This scoping review aims to systematically identify evidence on the use and effectiveness of non-pharmacological interventions for pain management during SCC in the pediatric population. Studies were eligible if they are published in English and focusing on the use of any non-pharmacological interventions on pain during SCC in pediatric patients. Nine databases were searched including Medline, CINAHL and PsychInfo. Also, the reference lists of relevant studies were searched. The database searching yielded 1517 studies. After the title and abstract screening, 1348 studies were excluded, and 169 full texts were retrieved and screened. One study was identified through handsearching. Finally, 27 articles were included in this scoping review. Across all studies, 27 different non-pharmacological interventions were identified. There were inconsistent results regarding the effectiveness of virtual reality, guided imagery, and cognitive-behavioral interventions in experimental studies. The most common interventions used at home were prayer, massage, and distraction. The main interventions used in hospitals were prayer and fluid intake, but this was explored by a few studies. Pediatric SCD patients use numerous non-pharmacological interventions to manage pain during SCC. However, the impact of many interventions on SCC pain has not been empirically investigated. Further research is necessary to establish the effectiveness of non-pharmacological interventions on SCC pain. • Various non-pharmacological interventions are used to manage pain during sickle cell crises. • Evidence supporting the effectiveness of these interventions on sickle cell crisis pain is limited. • The main non-pharmacological interventions used in hospitals for sickle cell crisis pain were fluid intake and prayer. • Research disparities exist across countries on the use of these interventions in pediatric patients with sickle cell disease. [ABSTRACT FROM AUTHOR]

• Pharmacological treatment for agitation can lead to adverse outcomes. • Non-pharmacological interventions are best practice for managing agitation symptoms. • Individualized music listening programs reduce agitation in patients with dementia. • This project highlights need for further study in patients with dementia in acute care. The sudden change in environment with hospitalization in patients with dementia can provoke feelings of agitation. Listening to music can be an effective intervention to decrease agitation because the part of the brain recognizing music is unaffected by dementia, and music can elicit feelings of happiness. This project aimed to reduce agitation in patients with Alzheimer's disease and related dementias (ADRD) by implementing an individualized music listening program. The sample included 21 patients diagnosed with ADRD admitted to a medical-surgical unit at a community hospital. The four-item Pittsburgh Agitation Scale (PAS) was completed by clinical staff to document the degree to which their patient exhibited four types of agitated behavior. A paired t-test yielded a statistically significant (p<0.001) decrease in total scores from pre-test (M =4.83, SD =2.10) to post-test (M =1.38, SD =1.40). The findings demonstrate that implementing an individualized music listening program reduces agitation in patients with ADRD. [ABSTRACT FROM AUTHOR]

Background. We aimed to evaluate the effects of public health measures taken during the COVID-19 pandemic on respiratory viruses. Methods. The study was conducted between February 1, 2021 and December 1, 2022. Patients aged 1 month to 18 years hospitalized for infectious diseases were tested for SARS-CoV-2 and respiratory viruses by multiplex PCR. Results. Of the total 1173 patients, 56.2% were male and 43.8% were female, and 47.5% of the patients were under 24 months of age. The viruses detected were SARS-CoV-2 31.9%, human rhinovirus/enterovirus 19.4%, respiratory syncytial virus (RSV) 9.3%, parainfluenza virus 7%, adenovirus 6%, seasonal coronavirus 5.2%, bocavirus 3.8%, influenza 3.1%, and metapneumovirus 2.8%. Among the patients, 386 were hospitalized with lower respiratory tract infections, 238 with upper respiratory tract infections, 202 to evaluate fever etiology, 111 with acute gastroenteritis and 236 with other diagnoses. Of these patients, 113 were admitted to the intensive care unit. Intensive care unit admission rates were statistically significantly higher for bocavirus and RSV, in those hospitalized between July 1, 2021 and July 1, 2022 (first period when schools were held full-time face-toface at all grades) and in children aged 1-24 months. Conclusions. Public health measures taken during the COVID-19 pandemic have affected the seasonal distribution of respiratory viruses and the severity of illness in children. [ABSTRACT FROM AUTHOR]

• Large inter-protocol variability in the effectiveness of tDCS occurs across distinct montages. • Different electrode locations help approximate current direction effectiveness outcomes at distinct locations. • Individualized protocols could minimize variability in tDCS application in individuals with the symptoms of chronic migraine. Given the prevalence and complicated pathophysiology of migraine, unknown or varied mechanisms of action of available monotherapies or add-on therapies, and their broad range of adverse effects, it is imperative to manage migraine symptoms using a non-invasive, multifunctional, and alternate monotherapy with no negative impacts. We used a single-blind, randomized, sham-controlled design with baseline, post-test, and 24-weeks follow-up measurements to assess the efficacy of transcranial Direct Current Stimulation (tDCS) in chronic migraine. A total of 150 participants were randomly assigned to the five groups (i.e., allocation ratio of 1:1:1:1:1). Each group received tDCS-intervention for 11 consecutive-weeks (25 sessions; each session = two consecutive montages; each montage = a 20 min duration, 2000 μA intensity). The multivariate analysis of variance showed significant (p <.05) reductions in chronic migraine symptoms in the four intervention groups. Compared with the sham (η2 < 0.18) and other protocols (two = η2 > 0.42; three = η2 > 0.40 ; four = η2 > 0.51), protocol one [l. anode at the right ventrolateral prefrontal cortices, cathode at the left dorsomedial and superior frontal gyrus—first montage; anode at the right primary motor area, cathode at the medial crosstalk of hemispheres—second montage] showed a larger effect size (η2 > 0.59) in the present trial. With the applied protocols of the present trial, tDCS can be used as an effective intervention for the prophylactic and therapeutic treatment of chronic migraine. However, while the second protocol was the least effective, the first was the most effective at reducing migraine symptoms. To our knowledge, the present trial is the first study to cover the gaps of the earlier ones, including the parameters like the site of stimulation, electrode range distribution and field intensity, number of sessions, session design, and sample size. [ABSTRACT FROM AUTHOR]

Aims and objectives: To compare and rank the effectiveness of non‐pharmacological interventions for symptoms of Overactive Bladder (OAB) in network meta‐analysis. Background: Overactive Bladder affects many patients, which often generates bothersome symptoms and debilitates the quality of life. Non‐pharmacological therapies have been widely used in OAB. However, due to insufficient evidence, it remains unclear which strategies are most suitable for OAB. Methods: We integrated randomised controlled trials (RCTs), which were searched up to 1 January 2021, from 8 databases (PubMed, Embase, Cochrane library, Web of Science, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc). Studies that met the eligible criteria were assessed the risk of bias. Then, network meta‐analyses were conducted by STATA, R, and OpenBUGS. The review followed PRISMA statement. Results: A total of 24 studies comprising 2347 patients with OAB were included in this review, most of which were low to moderate risk of bias. The results of network meta‐analysis implied that electric stimulation (ES) was the most effective intervention to reduce voided frequency and nocturia frequency of OAB. Conclusions: Electric stimulation ranked the best in the management of OAB, and future studies should pay more attention to ES. [ABSTRACT FROM AUTHOR]

Exercise Induced Laryngeal Obstruction (EILO) is characterised by breathlessness, cough and/or noisy breathing particularly during high intensity exercise. EILO is a subcategory of inducible laryngeal obstruction where exercise is the trigger that provokes inappropriate transient glottic or supraglottic narrowing. It is a common condition affecting 5.7–7.5% of the general population and is a key differential diagnosis for young athletes presenting with exercise related dyspnoea where prevalence rates go as high as 34%. Although the condition has been recognised for a long time, little attention, and awareness of the condition results in many young people dropping out of sporting participation due to troublesome symptoms. With evolving understanding of the condition, diagnostic tests and interventions, this review looks to present the current available evidence and best practice when managing young people with EILO. [ABSTRACT FROM AUTHOR]

For many children, hospitalization can lead to a state of increased anxiety. Being away from home, the invasive procedures undertaken, and the uncertainty of the outcome cause an uncomfortable situation in anticipation of real or imagined hazards. This systematic review aims to assess current evidence on the types of non-pharmacological interventions used and their impact on children's anxiety or distress levels when they visit the hospital for planned or unplanned admissions. The Databases PubMed, Psych INFO, and Google Scholar were queried for papers published from January 2000 to March 2023 reporting the use of non-pharmacological interventions interacting with children in hospital or clinical environments and confirmed with saliva cortisol levels. A total of nine studies were retrieved. Across these studies, four different strategies of non-pharmacological interventions were used. Anxiety and distress were found to be reduced in the majority of the studies as confirmed with salivary cortisol. Overall, there is evidence that non-pharmacological interventions hold a promising role in reducing levels of anxiety or distress in children as confirmed with saliva cortisol. However, research on saliva cortisol as a tool of anxiety measurement requires higher quality studies to strengthen the evidence base. [ABSTRACT FROM AUTHOR]

Participation in psychosocial enrichment activities, such as music and arts programming, have shown potential to delay or reduce functional decline - without adverse effects that can be associated with pharmaceuticals. The performingarts programming described in this community case study was inspired by a community music program called B-Sharp Music Wellness, located in Phoenix, Arizona, which involved small groups of musicians who provided symphony performances for people with dementia. Our community programming sought to engage people with dementia and their informal care partner (typically a spouse) in existing performing-arts programs in their local community, providing social hours and season tickets for either symphony, dance (ballet), or non-musical theater performances. This case study describes the program history and design, including outcomes and lessons learned from the program evaluation of the last full season (2018-19) and partial season (2019-20), when the program was halted due to the COVID-19 pandemic. Program outcomes suggest strategies for, and benefits of, design for performing-arts programs as psychosocial interventions in other communities. [ABSTRACT FROM AUTHOR]

While cognitive impairment has traditionally been conceptualized from a medical model, the study examines the potential ability for non-pharmacological, evidence-based interventions to sustain the brain health of cognitively impaired aging adults living in institutional settings. This cross-sectional study included thirty older adults living in a nursing home setting, including aged 65 years and older in a metropolitan region. Participants reported engaging in several non-pharmacological physical and social activities. Non-parametric testing was used to examine differences between pretest and posttest for several outcomes: MoCA average 16.56 (SD = 3.585), range [9,21], CLOX significantly increased between pre [average of.83 (SD =.707)] and post [2 (SD = 1.044)] intervention, UCLA increased from 8.33 (SD = 6.979) to 10.93 (SD = 9.294) indicating participants were found to have significantly decreased cognitive impairment. Current evidence and future directions for assessing the effectiveness of noninvasive, non-pharmacological, cost-effective interventions and preventions for healthy brain aging are discussed. [ABSTRACT FROM AUTHOR]

This review aimed to examine the available evidence about non-pharmacological interventions (NPIs) aimed at improving sleep quality in older adults without insomnia or dementia. Methods: Studies on NPIs targeting older adults' sleep were searched in the PsycInfo, PubMed and Scopus databases, with no restriction on publication year up to September 2021. Studies on NPIs for older adults with no diagnosed sleep disorders were included, while those on pharmacological therapies and/or concerning pathological samples were excluded. The risk of bias was assessed using tools based on Joanna Briggs' criteria. The data extracted were meta-analyzed using random effects models for subgroups of NPIs. Results: Of the 1,893 records identified, 31 studies on NPIs (N = 2,224; range of mean ages: 60-78 years) were analyzed. All NPIs improved self-reported sleep quality, albeit to a different extent (physical activity: d=.97 − 95% CI=.62, 1.32-; psychological/psychoeducational, or NPIs that combined more than one sleep-targeting activity: d range:.21 to.97). Only the NPIs based on physical activity improved objectively-measured sleep, d=.31 (.04,.57). The methodological quality of most studies was limited. Conclusion: The most often used NPIs targeting sleep rely on physical activity and sensory stimulation with promising results on sleep quality for the former. More data are needed on psychological/psychoeducational NPIs and combined interventions in order to test their effectiveness. The methodological weaknesses of the available studies suggest they their findings should be interpreted with caution. Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2022.2056879 [ABSTRACT FROM AUTHOR]

Diabetic neuropathic pain (DNP) is one of the common and severe late-stage complications of diabetes mellitus, which could greatly influence the patients’ quality of life. Patients with DNP often experience spontaneous pain and evoked pain such as mechanical allodynia and thermal hyperalgesia, meaning that their physical and psychological health are severely impaired. Unfortunately, the mechanisms of DNP remain highly elusive, so substantial breakthrough in effective DNP targeted treatments is still clinically challenging. This article will hence summarise the main mechanisms currently known to underlie DNP pathogenesis, along with describing some of the current and potential treatment methods against diabetic neuropathic pain.

IntroductionLow- and middle-income countries have rapidly increasing numbers of people with dementia, yet little evidence on family caregiving interventions. We tested the preliminary efficacy and feasibility of a family caregiving intervention in northern Vietnam.MethodsNine clusters comprising 60 family caregivers were randomized to a culturally adapted version of a four- to six-session, multicomponent intervention delivered in-home over 2 to 3 months, or enhanced control. Eligible caregivers were ≥18 years of age and scored ≥6 on the Zarit Burden Inventory (ZBI).ResultsFifty-one caregivers (85%) completed the study. Using analysis of covariance with 3-month assessment as the outcome and baseline assessment as a covariate, intervention group caregivers had an average ZBI (primary outcome) score 1.2 standard deviation (SD) lower (P = .02) and Patient Health Questionnaire-4 (psychological distress) score 0.7 SD lower (P = .03) than controls.DiscussionIn the first study of its kind in Vietnam, a culturally adapted, manualized, family caregiver intervention was both efficacious and feasible.

Abstract Objective To investigate the effect of non-pharmacological interventions to improve sleep quality during pregnancy. Data sources A search was made in the NCBI/PubMed, ClinicalTrials.gov, Embase, BVS, and Web of Science databases. There were no limitations regarding language, sample size, and type of non-pharmacological intervention. We have included prospective clinical trials between July 2014 and July 2019. Selection of studies This study was registered in the Prospective International Registration of Systematic Reviews (PROSPERO) database was performed. Publication bias was also assessed with funnel plots. the primary outcome was the total score in the Pittsburgh Sleep Quality Index (PSQI) before and after intervention. Risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were used for assessing methodological quality. From the 28 retrieved studies, we have selected 8 for qualitative analysis and 6 for meta-analysis. Data collection Two independent reviewers performed the study selection. In the case of disagreement, a third senior reviewer was consulted. The study was initially assessed based on the title, followed by abstract. Lastly, the full text was assessed to be included. Data Synthesis A significant improvement on the sleep quality (PSQI score) was observed when all interventions were grouped (MD = -3.03, 95%CI -4.15 to -1.92, n= 623, i2= 84%, p< 0.001). Analysis by subgroup (music listening: MD = -1.96, 95% CI -3.27 to -0.65, n= 207, i2= 67%, p= 0.003 and other interventions: MD = -3.66, 95% CI -4.93 to -2.40, n= 416, i2 = 80%, p< 0.001) showed an improvement, with high heterogeneity. Risk of bias has shown performance and detection bias for almost studies, and GRADE evidence was very low for all analyzed variables. Conclusion Non-pharmacological interventions—listening to music, physical exercise, relaxation exercises, lettuce seed, sleep hygiene, and acupressure—are effective for improving sleep quality during pregnancy.

ABSTRACT Background Aim Discussion Conclusion The effects of inhaled aromatherapy on sleep quality in critically ill patients in the intensive care unit (ICU) have been widely studied. Specific essential oil combinations have been highlighted for their potential to promote sleep in these patients.To offer additional insights and future directions for the application of aromatherapy in improving sleep quality among critically ill patients, considering the current evidence and addressing gaps in research.While certain blends of essential oils, such as lavender, Matricaria recutita, and neroli, have shown promise, other studies have produced mixed results regarding the optimal aromatherapy interventions. Integrating aromatherapy with other non‐pharmacological approaches, such as earplugs, eye masks, or music, may offer enhanced sleep benefits. Further research is needed to evaluate aromatherapy's effects on specific populations, such as intubated patients, and to assess feasibility, cost‐effectiveness, and potential adverse effects.Aromatherapy shows promise for improving sleep quality in critically ill patients but should be integrated with other evidence‐based, non‐pharmacological interventions. Addressing research gaps is crucial for developing comprehensive strategies to enhance sleep quality in ICU settings. [ABSTRACT FROM AUTHOR]

BackgroundThe lockdown imposed during the COVID-19 pandemic led to social isolation and prevented patients with dementia from receiving a suite of non-pharmacological interventions (NPIs) that prevent cognitive decline. This discontinuation of NPIs could substantially affect the mental health status of people with dementia in social care settings, such as adult day care centers (ADCs).ProposeThe study aimed to evaluate the effects of the COVID-19 lockdown on mental health and cognitive impairment in patients with dementia who could not attend their usual ADCs and did not receive our NPIs, based on World Health Organization (WHO) Guidelines.MethodsObservational, longitudinal, retrospective study carried out in an adult day center in Spain and reported it in accordance with the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) statement. Cognitive status was assessed using the Mini-Mental State Examination (MMSE) in 80 patients attending the ADC of the “Leonese Association of Dementia Patients” (León, Spain), who had been evaluated with this instrument before the COVID-19 lockdown.ResultsWe observed a 0.4-point decrease in MMSE score/month (IQR = 1.4) during lockdown versus a 0.1-point decrease/month (IQR = 0.3) before this period (p = 0.038). Notably, this translated to >10-point decreases in MMSE score/year in 33.8% of participants during lockdown versus 5.5% earlier (p

Background: Schizophrenia is a severe, chronic, neuropsychiatric disorder, with a complex, yet to be elucidated aetiology. The altered connectivity responsible for the wide range of symptoms in schizophrenia, stemming from genetic, metabolic, as well as environmental factors, has had researchers focusing on the identification of more and more “players” carrying certain specificity for the disease. One of these factors is the brain-derived neurotrophic factor (BDNF) - the most abundant growth factor in the central nervous system (CNS) and most frequently researched. Here, we set to explore the evidence pertaining to a correlational change in serum BDNF levels while individuals with schizophrenia undergo a non-pharmacological/psychotherapeutic intervention. Methods: We performed a systematic search of studies evaluating BDNF changes as a result of psychotherapeutic interventions in schizophrenia, in four databases: APA PsycInfo, Pubmed, Medline and EBSCO. The keywords “schizophrenia”, “psychotherapy OR psychosocial”, and “BDNF OR brain-derived neurotrophic factor” were searched for on all databases. Results: The search yielded 46 titles and abstracts, of which 10 met the criteria for inclusion. The interventions consisted in neurofeedback, auditory training, cognitive remediation and lifestyle changes and behaviour therapy, as well as exercise. Serum BDNF levels were assessed systematically, showing significant increases as a result of the interventions in all studies, except three, where other changes are discussed. Conclusions: The studies discussed in this review support, overall, the idea of an increase in BDNF levels, as well as cognitive and clinical improvements secondary to non-pharmacological interventions. Several limitations and future directions are discussed.