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The Coronavirus pandemic (COVID-19) and its concomitant social isolation have affected older citizens more than any other sector of the population. This article describes the theoretical and practical principles of a short-term tele-therapy intervention model developed and implemented as a pilot project during the Coronavirus pandemic to support older residents of the community, who faced a variety of needs stemming from the lockdowns and social isolation. The intervention was developed and directed in collaboration with faculty members from a university school of social work and social workers from the municipal social services in Israel, and was conducted by first year social work students as part of their first field experience. This intervention combined Perlman’s model of problem solving, a telephone crisis intervention model and a strengths-based approach. Participants and students indicated that they benefitted from the programme and felt that the therapeutic relationships were meaningful. These outcomes and reports suggest that this type of intervention is successful and can be applied to older people during other crises or in other populations, communities and countries as part of the field experience of social work students.

Preschool children are children aged between 3-6 years, while at 4-6 years they usually attend kindergarten programs. It is hoped that they have been able to master several skills that require fine motor skills, such as using playdough by cutting in accordance with the fine motor development that must be achieved.This study aimed to determine the effect of playing therapy by using playdough with patterns cutting toward improving fine motor skills in preschool children in the Kedurang Health Center Work Area. This research design used a quasi experiment. A sample of 15 preschool children was taken by purposive sampling. The results of test analysis in the pre and post therapy intervention group playing playdough obtained a p-value of 0.000. There is a significant effect after playing playdough therapy on improving fine motor skills in preschool children. It is expected that the PAUD Nurul Amal Kab. South Bengkulu, the working area of the Kedurang Public Health Center, can be more creative in using learning methods such as playdough so that children's fine motor skills are more stimulated.Keywords:Â Preschool children, fine motor skills, Playdough

This study examined the preliminary acceptability and efficacy of an intensive, group-based, disorder-specific cognitive behavioural therapy (CBT) intervention for adolescents with social anxiety disorder (SAD). Fourteen Australian adolescents with SAD (78.6% female, M age = 13.93 years) and their parents completed the program plus measures of treatment satisfaction, and provided feedback. Clinical interviews and surveys were administered pre-treatment, post-treatment, and at 6-month follow-up to determine diagnostic status and assess related variables. Post-treatment satisfaction scores were very high for adolescents and parents. Post-treatment, 32.3% of participants no longer met criteria for SAD diagnosis, increasing to 42.9% at follow-up. Participants showed sizeable reductions in comorbid diagnoses, significant improvements in global functioning, social anxiety symptoms, and internalising symptoms from pre- to post-treatment (maintained at follow-up), and significant improvements in social skills and social competence from pre-treatment to follow-up. This study supports the use of an intensive CBT program for adolescents with SAD.

70-94% of acute stroke patients have an increase in blood pressure. Relaxation can be done to treat hypertension. Relaxation in Islam uses zikr (remembering Allah SWT). The purpose of this study was to determine the effect of zikr on reducing blood pressure in acute stroke patients. The research design was quasi-experimental, with two group pretest-posttest design with a control group. The experimental group was given the zikr therapy intervention. The sample of the study was acute stroke patients in the Nervous Room of RSUP Dr. M. Djamil Padang. There were 40 samples, 20 people in the experimental group and 20 people in the control group obtained by purposive sampling. Data collection is September to November 2020 by measuring the patient's blood pressure before and after the intervention. The data is processed manually. Analysis of data with non-parametric Mann Whitney test. The results showed that there was no difference between systolic blood pressure before treatment in the intervention group and the control group (p = 0.976), but there was a difference after treatment (p = 0.000). There was no difference between diastolic blood pressure before treatment in the intervention group and the control group, (p = 0.294), but there was a difference after treatment (p = 0.000). The study concludes that zikr therapy can reduce systolic and diastolic blood pressure in acute stroke patient. It is recommended to the head of the Nerve room to apply zikr therapy in acute stroke patients.

To evaluate potential effects and satisfaction of dignity therapy among patients with hematologic neoplasms in the Chinese cultural context. Sixty-six patients with hematologic neoplasms were randomly assigned into either a dignity therapy group (N = 32) or control group (N = 34). The primary outcomes were level of hope and spiritual well-being, as measured according to the Herth Hope Index and the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, at baseline (T0), 1-week follow-up (T1), and 4-week follow-up (T2). Satisfaction with dignity therapy was assessed using a 5-grade marking system at T1. Among the 66 participants, 61 remained at 1-week follow-up and 57 remained at 4-week follow-up. Group differences were found in the total score and the scores of each dimension of spiritual well-being and level of hope at T1 and T2 (p

Background:Self-esteem is a common factor in many mental health problems, including anxiety and depression. A cognitive behavioural therapy (CBT)-based protocol called ‘Overcoming Low Self-Esteem’ is available; the use of this protocol in a group format has been associated with improvements in self-esteem. However, it is unclear whether improvements persist after the end of a group-based version of this programme.Aims:We aimed to assess whether changes in self-esteem, anxiety and depression persist 3 months after the end of a group version of the Overcoming Low Self-Esteem programme.Method:Using data from the National Health Service in Fife, Scotland, we analysed whether there were improvements on self-report measures of self-esteem, anxiety and depression from the beginning of the group to the end of the group and at a follow-up session 3 months later.Results:Significant improvements in self-esteem, anxiety and depression are maintained at 3 months follow-up.Conclusions:The Overcoming Low Self-Esteem group seems to be associated with improved self-esteem, anxiety and depression. However, further research from randomised controlled trials is needed to establish a causal link between the programme and improved psychological outcomes.

Covid 19 has brought many changes in human life. Currently, the campus is implementing an online learning system, aka online (in the network). This has an impact on final year students who are writing a thesis which will usually cause stress when compiling a thesis. Therefore, progressive muscle relaxation can reduce stress and learn how to relax tense muscles. The purpose of this study was to determine whether progressive muscle relaxation therapy can relieve or reduce stress levels in final year students. The research design used was quasi experimental. The research design used "pre test post test with control group design." The sample size obtained in this study was 30 respondents with a sampling technique carried out in the form of probability sampling with non-equivalent control group techniques. The data analysis used was the Wilcoxon test data analysis with a significance level of α = 0.05. If the value of ρ

Objectives This study aimed to evaluate the effects of a 16-week creative expression intervention program (CrExp) on the event-related potential (ERP) and task reaction time (RT) in older individuals with mild cognitive impairment (MCI). Methods This study is a randomized controlled clinical trial conducted in the Memory Center of Fujian Provincial hospital. Thirty-six MCI patients were randomly distributed into two groups. One group underwent a 16-week creative expression program (CrExp, n = 18) and the other performed as a control group (CG, n = 18) by general social activities. The amplitude and latency of event-related potential (ERP-P300) from the central (Cz), parietal (Pz), frontal (Fz) cortices and task reaction time (RT) were assessed at baseline, post-interventi on, and 24-week follow-up. Results The CrExp group showed greater differences than CG of P300 latency in Cz (F = 4.37, P = 0.015), Pz (F = 2.78, P = 0.009), Fz (F = 6.45, P = 0.031) brain area after 16 weeks of intervention and in Fz (F = 3.23, P = 0.028), Cz (F = 3.79, P = 0.024), and Pz (F = 5.60, P = 0.036) at 24 weeks follow-up. Also, we analyzed the task reaction time between two groups and found that a shorten reaction time at post-intervention (F = 4.47, P = 0.011) and 24 weeks follow-up (F = 3.12, P = 0.007) in the CrExp group. However, there was no difference in P300 amplitude in either brain area between the two groups. Conclusion The electrophysiological results of the creative expression cognitive therapy group were more obvious than those of the general cognitive therapy group, and the latency and task reaction time may be considered as supported parameters in diagnosing the effects during non-drug therapy intervention in clinical practice.

Este artigo avalia os níveis de ansiedade e depressão dos estudantes de graduação e pós-graduação de universidade pública no sul do país antes e após participação em Terapia Comunitária Integrativa. Utilizamos a pesquisa experimental, com desenho pré/pós-teste com intervenção da Terapia Comunitária Integrativa, desenvolvida em 2018/2019, com uso da Escala de “Hospital Anxiety and Depression” e análise realizada por programa estatístico R Core Team e Teste de Wilcoxon. Pode-se observar diminuição estatisticamente significativa dos escores de provável ansiedade e depressão em aproximadamente 30% dos estudantes da graduação como para pós-graduação, o que traz o potencial da terapia comunitária integrativa para manejo destas patologias além de promover a saúde, autoconhecimento, fortalecimento de vínculos. A Terapia Comunitária Integrativa diminuiu os níveis de ansiedade e de depressão nos estudantes. Desse modo, pode ser considerada, uma ferramenta importante para auxílio ao cuidado de saúde no ambiente estudantil universitário.

The purpose of this study is to find an optimal rehabilitation therapy intervention, especially in this study, by comparing the effects of applying both virtual reality (VR) programs and microwave diathermy (MWD) at the same time. The subjects of this study participated 19 college students in their 20s. The subjects were randomly divided into two groups. The first group received MWD (male:2 female:8) and VR ankle training, while the second group (male:2 female:7) received only the VR training. The interventions were conducted three times a week for four weeks. Biodex Balance System® is a tool to measure balance degree in this study. The MWD (PM-800S, ITO, Japan) intervention was conducted by setting the frequency of 2450㎒ and the output of 100W before the implementation of the VR exercise program. The exercise in this study was conducted using the Nintendo Wii Fit Plus program for VR exercise. Comparison of the results of the groups that implemented MWD and VR at the same time and those that implemented VR only are as follows. In the static balance, VR groups were significantly lower in all directions such as overall, anterior-posterior, and medial-lateral (p .05). If the therapist does not properly perform the examination when applying MWD for FAI, the effect might not be significant. VR exercise programs can also be used to improve the balance of FAI, although it has limitations.

Ethical challenges can arise when providing group therapy to adults living with communication impairments. In addition to the ethical challenges that may be encountered when conducting one-to-one therapy intervention, practitioners must also consider dilemmas that are specific to group therapy. This article considers the principles and rules of the American Speech-Language-Hearing Association (ASHA) Code of Ethics via a series of clinical vignettes that illustrate four ethical challenges that may be encountered when providing group therapy: acquiring sufficient clinical competency to conduct group therapy; handling issues related to client confidentiality; resisting external pressure to provide groups solely for financial gain and/or other administrative efficiencies; and handling practitioner–client boundaries.

Anxiety is a psychological response that is often experienced by patients with chronic renal failure undergoing hemodialysis. The purpose of this study was to determine the effect of Dhikr therapy on anxiety levels in chronic kidney failure patients undergoing hemodialysis at RSUD Dr. Drajat Prawiranegara attack in 2019. This type of research is quasi-experimental without control, with 72 respondents selected using purposive sampling technique. The results of univariate analysis showed that in the first measurement before getting therapeutic intervention Dhikr most respondents condition that is anxious as many as 10 respondents (55.6%). After getting the Dhikr therapy intervention, the condition of the respondents’ anxiety level experienced a change to a mild anxiety level of 9 (50%). The result of bivariate analysis is p value 0.000 with α

Purpose To improve clinical outcomes for fallers aged 65 and over presenting to the emergency department through earlier therapy intervention and multidisciplinary focussed assessments. The intended benefits to the older person and service were for:Older adult fallers to be referred more quickly for a therapy assessment.Older adults to spend less time immobile on an emergency department trolley.Timely multidisciplinary discharge plans being formulated in line with national guidelines.Increased numbers of older adults receiving holistic comprehensive geriatric assessments. Methods The quality improvement project was carried out using the Plan, Do, Study, Act (PDSA) cycle. Three iterative PDSA cycles were carried out over the course of the project to deliver simple, proactive interventions developed as a result of local baseline data analysis as well as stakeholder and root cause analysis. These interventions were all aimed at increasing the visual presence of the therapy team within the emergency department. Results The project resulted in an increased referral speed of fallers aged 65 and over for assessment, which led to increased numbers of older adult fallers receiving holistic, multidisciplinary assessments. 120% more adult fallers were seen in January 2019 compared to the previous year, and 58% more fallers were seen in February 2019 compared to 2018. The earlier intervention by the therapy team also led to more older adults up and moving sooner, which had positive effects in terms of maintaining their dignity. Conclusions The quality improvement project found that more older adults aged 65 and over admitted to the emergency department with a fall can receive holistic, multidisciplinary assessments through the introduction of small, simple interventions aimed at increasing the proactivity and overall visual presence of the physiotherapy team. The team are providing care to a larger number of older adults, improving their functional independence, dignity and quality of life and giving them an overall more positive experience. The ED model of care is traditionally nursing and medical led but what this improvement project shows it that it is essentially the collaborative nature of the multidisciplinary team that can lead to better clinical outcomes for older adults attending the emergency department.

Background: Postpartum depression is a non-psychotic depressive disorder with the criteria for diagnosis being that it can start early at four weeks postpartum. This can occur in the first year postpartum. Postpartum depression can result in deep sorrow and even the risk of suicide.Method: The sources of the articles used were from a search of the Scopus, PubMed and Proquest databases with the keywords “postpartum depression, nursing intervention, psychology and postpartum”. The search was restricted articles ranging from 2014 until 2018. After the articles were obtained, then the articles were reviewed until the stage of making a systematic review.Result: The systematic review resulted in 15 of 19 choices of interventions that can be used to prevent and reduce the symptoms of postpartum depression. The results found that an internet cognitive behavior therapy intervention is very significant in terms of preventing and reducing the symptoms of postpartum depression. Nursing interventions are packaged in a variety of programs proven to reduce the postpartum depression variables and actions needed to prevent and reduce the symptoms of postpartum depression significantly.Conclusion: Based on the results of the analysis of the 15 journals from the results of the study, internet cognitive behavior therapy intervention is recommended to prevent and reduce postpartum depression. This intervention can be developed practically and easily.

This case report assesses gaze stability, postural control, and balance pre- and post-physical therapy intervention, including vestibular rehabilitation, in a 4-year-old child with posterior fossa syndrome following gross total resection of a juvenile astrocytoma brain tumor.The child in this case study had improved balance and gaze stability, as determined by the Pediatric Balance Scale and the Dynamic Visual Acuity test upon completion of the 10-week intervention. STATEMENT OF CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE:: This case provides preliminary support of the need for vestibular screening in children with a diagnosis of posterior fossa syndrome. The success of the intervention suggests that vestibular rehabilitation exercises can be modified for use in preschool-aged children, and the specific intervention outlined in this case report can be easily replicated in a variety of treatment settings.

While virtual reality games have shown a lot of potential for rehabilitation, research on creative virtual therapy is still growing. Considering many possibilities for therapeutic interventions in VR, we can create activities with an appropriate balance between intensity level of therapy intervention with enjoyment and entertainment. In this paper, we propose a creative line art drawing game in an immersive VR environment as a tool for enjoyable upper extremity physical therapy. To examine the validity of the proposed virtual therapy system, we conduct a human-subjects experiment in a mixed design varying the drawing content (Easy vs. Hard; a between-subjects factor) and the user’s position (Seated vs. Standing; a within-subjects factor). Our results with 16 non-clinical participants (8 females) show that the change of drawing content objectively influenced their drawing performance, e.g., the completion time and the number of mistakes, while they did not feel the difference in the difficulty level between the contents subjectively. Interestingly, participants reported more enjoyment from drawing the Hard content than the Easy content, and more substantial body stretches in the Seated setting than the Standing setting. Here, we present the main effects of the study factors and the correlations among the objective and subjective measures, while discussing implications of the findings in the context of enjoyable and customizable physical therapy using the creative VR drawing game.

Vojta therapy has been reported as clinically beneficial for strength, movement and gross motor activities in individual cases and is being included within the second of three levels of evidence in interventions for cerebral palsy. The goal of this study is to understand the effect of Vojta therapy on the gross motor function.Our clinical trial followed a one group, pre-post design to quantify rates of changes in GMFM-88 after a two-months period undergoing Vojta therapy.A total of 16 patients were recruited. Post-intervention acceleration rates of GMFM-88-items acquisition (0.005; p0.001) and Locomotor Stages (1.063; p0.0001) increased significatively following Vojta the-rapy intervention.In this study, Vojta therapy has shown to accelerate the acquisition of GMFM-88-items and Loco-motor Stages in children with cerebral palsy younger than 18 months. Because functional training was not utilised, and other non-Vojta therapy intervention did not influence the outcome, Vojta therapy seems to activate the postural control required to achieve uncompleted GMFM-88-items.Egyedi esetekben klinikailag jelentős javulásról számolnak be Vojta-módszer alkalmazásával a bruttó motoros funkció, az izomerő és a mozgás területén; a módszer a második és harmadik szintű evidenciákkal alátámasztott kezelési formák közé került a cerebralis paresis terápiájában. A vizsgálat célja a Vojta-módszer bruttó motoros funkcióra gyakorolt hatásának megértése volt.Klinikai vizsgálatunk egyetlen csoportos, pre-poszt adatgyűjtésen alapuló elrendezést alkalmazott a bruttó motoros funkció változásának mérésére a GMFM-88 (Gross Motor Function Measure-88) eszköz alkalmazásával két hó­na­pos időtartamú Vojta-terápia kapcsán.Tizenhat beteget vontunk be a vizsgálatba. A kezelés után szignifikáns mértékben gyorsult a GMFM-88-pontszámok növekedése (0,005; p0,001) és a lokomotoros fejlettségi stádiumok elérése (1,063; p0,0001). Következtetés – Vizsgálatunk eredménye szerint 18 hónaposnál fiatalabb, cerebralis paresisben szenvedő gyerme­kek esetén a Vojta-módszer elősegíti a GMFM-88-pont­számok növekedését és a lokomotoros fejlettségi stádiumok elérését. Mivel funkcionális edzést nem alkalmaztunk, és egyéb kezelést sem használtunk a Vojta-módszeren kívül, a GMFM-88-pontszámok növekedésében megnyilvánuló javuló eredményeket a Vojta-módszer posturalis kontrollt aktiváló hatásának tulajdoníthatjuk.Vizsgálatunk eredménye szerint 18 hónaposnál fiatalabb, cerebralis paresisben szenvedő gyerme­kek esetén a Vojta-módszer elősegíti a GMFM-88-pont­számok növekedését és a lokomotoros fejlettségi stádiumok elérését. Mivel funkcionális edzést nem alkalmaztunk, és egyéb kezelést sem használtunk a Vojta-módszeren kívül, a GMFM-88-pontszámok növekedésében megnyilvánuló javuló eredményeket a Vojta-módszer posturalis kontrollt aktiváló hatásának tulajdoníthatjuk.

Preclinical experiments to analyze the trabecular space of spongy bones using small animals are required for the evaluation and treatment of patients with osteoporosis (OP). We performed ovariectomy to create OP models. A total of four mice were used. Ovariectomized group (OVX, n = 2) in which both ovaries were resected at random, and the sham operated group (SHAM, n = 2) performed surgery without resecting the ovaries. We propose a study that enables OP analysis by analyzing tibia microstructures of OVX and SHAM using synchrotron radiation (SR). SR imaging is a technology capable of irradiating an extremely small object in the order of several tens of nanometers using a nondestructive method at the microscopic level. Unlike previous imaging diagnoses (staining, micro-CT [Computed Tomography]) it was possible to preserve the real shape and analyze bone microstructures in real-time and analyze and evaluate spongy bones to secure data and increase the reliability of OP analysis. We were able to confirm the possibility of OP diagnosis through experimental animals for spongy bone damage related to bone mineral density. Therefore, we aimed to provide a rehabilitation and medicine therapy intervention method through basic research on the evaluation of OP diagnosis through human-based segmentation of challenging spongy bones while supplementing the limitations of existing imaging methods. RESEARCH HIGHLIGHTS: We present an analysis of osteoporosis through spongy bone using phase-contrast X-ray source. Unlike existing methods, it is possible to analyze the internal microstructure of the tibia with this method. This is an objective mechanism for OP and a basis for rehabilitation.

Lung cancer is the most common cause of cancer-related deaths, with most patients dying with distant metastases. Circulating tumor cells (CTCs) are cancer cells that have disseminated into the peripheral blood from primary or metastatic sites and present great potentials as prognostic biomarkers for guiding individualized treatment in lung cancer. To date, various methods have been developed to capture CTCs in peripheral blood, and some approaches for the detection of CTC in lung cancer have shown both high sensitivity and specificity. The CTC analyses offer much promise as a real-time ‘liquid biopsy’ for prognosis evaluation and therapy intervention in lung cancer. In this Review, we present and discuss the current status of CTC detection and applications in lung cancer.

Fracture of acromion is uncommon because of its unique anatomical structure and location. Usually it heals by itself using conservative therapy intervention, and a subject’s shoulder can get back to its functional performance without surgical approach. However, rare cases may not recover due to pseudarthrosis taking place, surgical avoidance plus using noninvasive tools to manage acromion pseudarthrosis with the application of extracorporeal shockwave therapy at medium to high intensity is the author's motivation to report this condition. Likewise, to our knowledge, there is no published literature using extracorporeal shockwave therapy specific to acromion. A case of 36 old male, active, and alert had been referred to the physical therapy outpatient clinic for high density extracorporeal shockwave therapy to manage the acromion pseudarthrosis after going on range of motion and strengthening rehabilitation program for seven months. After having six sessions of extracorporeal shockwave therapy, the acromion nonunion fracture unified, with complete patient recovery. The pain was stopped. The range of motion became full, with the restoration of the shoulder's functional abilities.

This Study aoims to deremine the effect of PMR ( Progresive Muscle Relaxtation) therapy, PMR (Progesive Muscle Relaxtation) and Anfas Remembrance to reduce PAPP Khodijah students' anxiety, and to find out the difference in PMR, PMR and Dzikir Anfas Therapy which is more effective than the two therapies reduce anxiety levels. The method used is by using the Quasi experimental research design pretest and post test with control group. With Progressive Muscle Relaxation therapy intervention with Progressive Muscle Relaxation and Anfas dhikr as a control group. Each group consisted of 5 participants, within one week the research was conducted at PAPP Khodijah. The results of the study obtained Based on the results of the Mann Whitney U test on the gain score changes in the value of anxiety the progressive group muscle relaxtation, PMR and Anfas Dhikr were Z = -623, P = 0.548 (P≥0.05). This explains that both PMR and PMR groups and Dzikir Anfaz did not have a significant difference.

All inpatient children receiving pediatric palliative care consults at a free-standing children's hospital.To explore the impact of massage therapy on pediatric palliative care patients' symptom burden and medication use pattern, to describe the impact of massage therapy on family caregiver distress, and to report on bedside nursing staff perception of massage therapy for children and their families.A 1-time point, single-center exploratory study offering 10-minute bedside massage to children receiving palliative care and 10-minute massage to their family caregivers.A total of 135 massages were provided to children and their caregivers. Difference in child Face, Legs, Activity, Cry, Consolability scale (FLACC) score was detectable (Massage therapy is a potentially meaningful intervention for pediatric palliative care patients with noted impact on symptom burden, benefit to family caregivers, and acceptance by nursing staff.

Character as an important result of education seeks so that individuals can understand and behave properly in accordance with moral values in their lives. The character building strategy has been implemented even applied in several researches and studies in universities. One effort to build the right character is done for students through the implementation of ongoing guidance of character values and manifested in behavior. The Real-Life Story (RELIST) model as one of the positive therapeutic interventions is felt to be more appropriately applied also in developing individual character identification of character strengths related to the development of individual strengths or strengths, through a series of structured and systematic activities.

Research Objectives To describe older adults’ ability to bear weight post hip surgery using a wearable pressure insole sensor. It was hypothesized that the pressure insole sensor would detect a decrease in weightbearing ability as pain increased. Design This descriptive study detailed the weight-bearing ability of older adults for up to 14 postoperative days. Setting The study was conducted at a hip fracture unit located in an inpatient hospital setting. Participants Ten older adults who had sustained either neck of femur or intertrochanteric fracture and had undergone hemiarthroplasty or proximal femoral nail antirotation surgery participated in this study. All participants had a premorbid score of 100 on the Modified Barthel Index and had no cognitive impairment. Interventions The older adults were asked to wear a pair of pressure insole sensors once a day during their daily therapy session for up to 14 postoperative days. The maximum and mean weight-bearing load were measured during standing and walking. Main Outcome Measures Weight-bearing ability was measured by wearing a wireless device system consisting of (a) an air-filled sensor pad worn as a sandal, (b) a logger unit connected to the sensor pad via an air tube and secured to the calf using Velcro, and (c) a computer software that processed data transmitted wirelessly from the logger unit and recorded the weight-bearing load graphically in weight units across each step during ambulation. Results Three older adults, who had undergone a hemiarthroplasty, tolerated a maximum load close to 100% of their body weight, and was able to progress from walking with a walking frame to a quad stick. Although a high maximum load was achieved, older adults’ mean weight-bearing load on their injured limb remained lower compared to their non-injured limb especially in those who had reported more pain. Conclusions Early weight-bearing recovery of older adults can be monitored using pressure insole sensor and facilitated through better pain control and enhanced therapy intervention. Author(s) Disclosures The author declares no conflict of interest.

The aim of the study was to explain the effect of effriction and frirage massage therapy, with a therapyduration of 10 minutes and 15 minutes in helping to reduce movement pain around the injured joint, theinjured joint was the ACL ligament which was injured for 1 month and 2 months but pain in the surroundingmuscles. ACL at the time of massage therapy was still felt by injured patients. This study was an experimentby providing 2 types of therapy, namely effriction and frirage therapy. Each therapy is a combination of twomassage method to get maximum results in reducing pain during flexion and extension of the thigh muscles.With a factorial design with a sample size of 64 people with the criteria to be the sample, namely purposivesampling with injury for 1 month and 2 months. Physical assessment test instruments for pain with an analogvisual scale are used to map changes and decreases in pain before treatment and after therapy and changesin range of motion in the knee to support the healing process assisted by these therapeutic method duringthe effriction massage therapy intervention. Subjective reporting on the level and function of pain is alsodocumented. The results of the study for the homogeneity test mean that the data are homogeneous, andthere is a significant difference between the 1 month and 2 month injuries. It was obtained that for massagetherapy with an effriction treatment, the duration of the injury was 1 month with a duration of 10 minutes oftherapy, which experienced a significant reduction in pain by 0.047 and for effriction therapy with a durationof 15 minutes, it had a significance of 0.049 so that for effriction therapy the duration of the injury was 1month and for frirage therapy the duration of the injury was 1 month. months with 15 minutes of therapy inthis group alone experienced a significant reduction. So that for 1 month there was no interaction betweenthe independent variables and the dependent variable for the duration of 2 months there was an interactionbecause many factors influenced the reduction of pain and must be described in other studies. Effrictionmassage therapy is determined as a complementary therapy that is effective in helping to reduce pain reliefin knee injuries, especially for 1 month injuries with a duration of 10 minutes and 15 minutes and frirage cansignificantly reduce pain in the injury duration of 1 month with a therapy duration of 15 minutes, and thetype for this therapy there was a non-significant reduction in injury duration of 2 months.

Negative body experience is a core characteristic of eating disorders, and poses a serious risk factor for its development, maintenance and relapse. This underlines the importance of specific therapeutic attention to body experience. In the past ten years a body-oriented treatment protocol with the focus on positive body exposure, called 'Protocol Positive body experience' has been developed. The aim of this paper is to describe the scientific basis of the protocol and to give an impression of its content and structure, illustrated by clinical case vignettes. An important and innovative aspect of the protocol is to enhance not only aesthetic, but also functional and tactile body experience. The protocol enables body-oriented therapists and psychomotor therapists to treat negative body experience in an evidence-based way and facilitates further research to validate the effect of positive body exposure.

Background Behavioral obesity interventions using an acceptance‐based therapy (ABT) approach have demonstrated efficacy for adults, yet feasibility and acceptability of tailoring an ABT intervention for adolescents remains unknown. Objective This study assessed the feasibility and acceptability of an ABT healthy lifestyle intervention among diverse adolescent cisgender girls with overweight/obesity (OW/OB). Methods Adolescent cisgender girls aged 14–19 with a BMI of ≥85th percentile‐for‐sex‐and‐age were recruited for participation in a single‐arm feasibility study. The primary outcomes were recruitment and retention while the secondary outcome was change in BMI Z‐score over the 6‐month intervention. Exploratory outcomes included obesity‐related factors, health‐related behaviors, and psychological factors. Results Recruitment goals were achieved; 13 adolescents (>60% racial/ethnic minorities) participated in the intervention, and 11 completed the intervention (85% retention). In completers (n = 11), a mean decrease in BMI Z‐score of −0.15 (SD = 0.34, Cohen's d = −0.44) was observed. Improvements were also noted for change in percentage of 95th percentile (d = −0.35), percent body fat (d = −0.35), quality of life (d = 0.71), psychological flexibility (d = −0.86), and depression (d = −0.86). Conclusions These preliminary findings suggest an ABT healthy lifestyle intervention tailored for adolescent cisgender girls with OW/OB may be an acceptable treatment that could lead to improvements in BMI Z‐score, obesity‐related measures, and psychological outcomes.

Insomnia predicts the onset of depression, commonly co-presents with depression and often persists following depression remission. However, these conditions can be challenging to treat concurrently using depression-specific therapies. Cognitive behavioural therapy for insomnia may be an appropriate treatment to improve both insomnia and depressive symptoms. We examined the effects of a fully-automated digital cognitive behavioural therapy intervention for insomnia (Sleepio) on insomnia and depressive symptoms, and the mediating role of sleep improvement on depressive symptoms in participants from two randomized controlled trials of digital cognitive behavioural therapy for insomnia. We also explored potential moderators of intervention effects. All participants met criteria for probable insomnia disorder and had clinically significant depressive symptomatology (PHQ-9 ≥ 10; n = 3,352). Individuals allocated to treatment in both trials were provided access to digital cognitive behavioural therapy. Digital cognitive behavioural therapy significantly improved insomnia (p

Background As people living with HIV infection require lifelong treatment, nonadherence to medication will reduce their chance of maintaining viral suppression and increase the risk of developing drug resistance and HIV transmission. Objective This study aimed to evaluate the efficacy of a mobile app, Mobile Interactive Supervised Therapy (MIST), for improving adherence to oral HIV medications among HIV-infected adults in Singapore. Methods We conducted a two-group pilot randomized controlled trial (RCT) with a process evaluation, in which 40 HIV-infected participants with once-daily medication regimes were recruited from a public tertiary hospital in Singapore and randomly assigned equally to either the intervention (receiving MIST and routine care) or control (receiving routine care only) groups. The intervention lasted for 2 months. The outcome of antiretroviral therapy (ART) adherence was measured by a 7-day recall self-report (SR), pill count (PC), an electronic medical device—Medication Event Monitoring System (MEMS)—and a mobile app—MIST (for the intervention group only). In total, 20 participants from the intervention group were interviewed at the end of the intervention to assess the acceptability of MIST. Data were collected at baseline and at 1-month and 2-month postintervention. Results All participants had excellent medication adherence at baseline (median 100, IQR 100-100). The use of MIST did not result in a significant improvement in ART adherence when measured by the SR, PC, and MEMS, as compared with the control group at 1-month (P values >.99, .86, and .74, respectively) and 2-month (P values=.80, .84, and .82, respectively) postintervention. ART adherence also did not improve in each group over the same period. MIST was perceived to be a beneficial tool based on the process evaluation results. Conclusions Although MIST did not enhance medication adherence to HIV treatments, mainly owing to the ceiling effect, it was perceived to be beneficial among the participants of this study. Our process evaluation provided useful data to further develop MIST for bigger and long-term mobile phone app–assisted intervention RCTs in the future. Trial Registration ClinicalTrials.gov NCT03794648; https://clinicaltrials.gov/ct2/show/NCT03794648

In order to explore the best treatment and rehabilitation outcome of post-infection inflammation by reducing wound infection and postoperative complications, 54 patients undergoing general surgery are divided into 2 groups to investigate rehabilitation intervention in the treatment of Infection of surgical incision. Results showed that there was no significant difference in operation time and neck drainage volume between the experimental group and the control group. C-reactive protein level of the experimental group was lower than that of the control group on days 1 and 3 after surgery. The C-reactive protein levels of the experimental group was lower than that of the control group at 12, 24, 48 and 48 h after operation. There was no significant difference in the pain score between the experimental group and the control group at 72 h after operation. The anxiety score of the experimental group was lower than that of the control group before and after operation and the satisfaction of the experimental group was higher than that of the control group. In the control group, in terms of hospitalization costs and hospitalization time, the experimental group was lower than the control group and the therapeutic effect of inflammatory infection was lower than that of the experimental group. Rehabilitation intervention needed to be carried out during the treatment of surgical incision infection and inflammation. It could reduce physical and mental discomfort of the patients and allow quick recovery as well as relieve the pain after operation, alleviate anxiety, and improve the patient satisfaction, shorten hospitalization time and reduce hospitalization expenses.

This study aimed to explore participants' experiences after undertaking an Internet-based cognitive behavioural therapy intervention (ICBT) for tinnitus.Semi-structured telephone interviews were conducted 6-8 months after participants undertook the ICBT intervention. Qualitative thematic analysis was used to interpret the interview data.A purposeful sampling strategy was used to identify a diverse range of participants. Semi-structured interviews were carried out with 15 participants. The mean age was 58.5 years, 7 men and 8 women participated.The analysis generated the following main themes: (1) expectations and motivation for doing the intervention, (2) experiences of the intervention, (3) intervention engagement and (4) intervention effects. Most participants' expectations were hopeful that the intervention would lessen the impact of their tinnitus. Aspects of the intervention that were beneficial, as well as difficult, were identified together with the impact they had on engagement. Intervention effects were evident on both tinnitus and activities of daily life.The benefits described by participants indicate the potential of ICBT as an alternate form of intervention delivery. The difficulties that hampered engagement need to be addressed to enhance the application and to optimise the clinical acceptability of ICBT for tinnitus.

Background Many young adults with cerebral palsy (CP) face limited participation in activities, including employment and independent living. Physical therapy during the transition period can help to support participation through promotion of self-care, ambulation, and functional mobility. Thus, ensuring appropriate access to physical therapy services for young people who can benefit from them before, during, and after transition is imperative. Objective The objective of this study was to identify factors contributing to the utilization of physical therapy services for youth with CP both during and after secondary school. Design The design was a deidentified secondary analysis of the National Longitudinal Transition Study 2 (NLTS2). Methods Multivariate regression models were run to examine demographic and disability characteristics influencing utilization of physical therapy services for youth with CP both during and after secondary school. Results The total weighted population sample included 35,290 young people with CP. When all youth were in secondary school, 59.4% of the youth utilized physical therapy services; however, once all youth were out of school, only 33.7% of them were reported to have utilized physical therapy since leaving secondary school. For young people with difficulties accessing general disability support services, demographic characteristics, including sex, race, income, and parent education status, influenced use of physical therapy services in addition to disability characteristics. Limitations This population sample included only young people in special education with Individual Education Plans (IEPs) and may not generalize to young people with CP in general education settings. Conclusions Frequency of physical therapy services decreases drastically once young adults with CP leave secondary school. Future work should examine this trend in more depth to identify therapy intervention strategies to optimize participation in young adult life for persons with CP.

Background The National Institute for Health and Clinical Excellence (NICE) guidance recommends Cognitive Behavioural Therapy (CBT) as part of multidisciplinary occupational mental health interventions for people with long-term or recurrent short-term sickness absence from work (NICE, 2009). Despite this, there is a paucity of data for both randomised trials for CBT and literature that supports the transferability of CBT into occupational environments. Aims This service evaluation aimed to evaluate the clinical effectiveness of CBT by analysing data from a partnership scheme between a local authority and a local heath board using a routine employee population. Methods A clinical cohort of 81 employees referred through the partnership scheme completed CBT over a 5-year period via a CBT nurse therapist. A sample of 76 employees was included in the evaluation who completed pre-/post-measures to establish outcome. Of these, 30 were followed up at a 3-year point, completing the same measures. Results Each of the clinical measures yielded significant outcomes at 95% confidence intervals, and large effect sizes using Cohen’s d both at post-test and follow-up. No significant difference was shown between post-treatment and follow-up outcomes. CBT was demonstrated to be clinically effective within an occupational mental health setting. Conclusions In conclusion, partnership schemes with a focus on mental health between public sector agencies can have a positive outcome for the funding agency as well as individual employees.

BACKGROUND This study was designed to study the serum metabolites of patients with liver failure. MATERIAL AND METHODS The study included 50 patients with liver failure, 30 patients with chronic hepatitis B treated with an artificial liver, 11 patients with an artificial liver, and 32 healthy controls. Clinical data were recorded, and blood samples were analyzed by gas chromatography-mass spectrometry (GC-MS). The random forest algorithm was used to construct a multidimensional scale map to preliminarily reflect the differences between samples. The data were then analyzed to obtain the correlation of different variables among samples, from which the differential metabolites were screened. RESULTS Thirty-five metabolites were identified by GC-MS. There were significant differences in serum metabolites levels before and after treatment in the liver failure group and in the chronic hepatitis group, healthy control group, and artificial liver group. Different metabolites were screened according to the importance of different variables among samples. Significant differences were found between the liver failure group, the chronic hepatitis group, and the healthy control group. In addition, there were significant differences in the liver group before and after treatment with an artificial liver, including differences in boric acid, 2-(methoxyamino)-propionic acid, glycine, l-methionine, aminopropionic acid, glyceryl monostearate, cholesterol, and other substances. CONCLUSIONS A variety of differences in metabolites were found in each group, some of which revealed possible metabolic pathways leading to differences between groups. Blood metabolomics analysis has great potential in real-time dynamic monitoring of liver failure and evaluation of artificial liver therapy.

We conducted a systematic review of the effects of a forest therapy program on adults’ immune function. We used PICO-SD (participants, interventions, comparisons, outcomes, study design) to identify key items. The participants were adults over the age of 18 and the intervention was forest therapy. Our comparisons included studies that comparatively analyzed urban groups or groups that did not participate in forest therapy intervention. Cases without control groups were also included. Immunological outcome measures were included in measuring intervention outcomes. All experimental studies, such as randomized controlled trials (RCTs), non-equivalent control group designs (non-RCTs), and one-group pretest-posttest design were included in the study design. A total of 13 studies were included for comparison. Forest therapy programs were divided into lodging-type and session-type programs. The representative measures for evaluating the effects of immune function were the number of NK cells, the cytotoxic activity of NK cells, and cytotoxic effector molecules. Most studies reported improvement in these measures when comparing values after intervention with values before the forest therapy intervention. Therefore, forest therapy has been found to be effective in improving immune function. More RCT studies on the effects of forest therapy on immune function are necessary.

Indonesia According to WHO (2017) data, there are about 35 million people affected by depression, 60 million people are affected by bipolar, 21 million are affected by schizophrenia, and 47.5 million are affected by dementia. The nursing problems that arise from the medical diagnosis of schizophrenia include hallucinations. Based on data from Mental Hospitals in Indonesia, about 70% of patients undergoing treatment in inpatient wards of mental hospitals experience hallucinations nursing problems. Data from the inpatient room of the Jambi Provincial Mental Hospital in 2018 from 12 rooms the number of patients experiencing hallucinations was 4320 patients. The management of hallucinations is through the continuous application of comprehensive nursing care, accompanied by incorrect modality therapies. one of them is Group Activity Therapy. Objective: To determine the effect of Sensory Stimulation Group Activity Therapy (TAK) on changes in the level of hallucinations in hallucinating patients in the inpatient ward of the Jambi Province Mental Hospital. Research Methodology Quantitative research with a Quasi Experiment research design that uses Pre-Test and Post-Test with Control Group with drawing stimulation therapy intervention, data collection is done by interview and observation. The statistical test in this study used the Independent T Test

OBJECTIVES: This study assessed the feasibility and acceptability of an ABT healthy lifestyle intervention among diverse adolescent cisgender girls with overweight/obesity (OW/OB). METHODS: Adolescent cisgender girls ages 14 to 19 with a BMI ≥ 85(th) percentile-for-sex-and-age were recruited for participation in a single-arm feasibility study. The primary outcomes were recruitment and retention while the secondary outcome was change in BMI Z-score over the 6-month intervention. Exploratory outcomes included obesity-related factors, health-related behaviors, and psychological factors. RESULTS: Recruitment goals were achieved; thirteen adolescents (>60% racial/ethnic minorities) participated in the intervention, and eleven completed the intervention (85% retention). In completers (n = 11), a mean decrease in BMI Z-score of −0.15 (SD = 0.34, Cohen's d = −0.44) was observed. Improvements were also noted for change in percentage of 95(th) percentile (d = −0.35), % body fat (d = −0.35), quality of life (d = 0.71), psychological flexibility (d = −0.86), and depression (d = −0.86). CONCLUSIONS: These preliminary findings suggest an ABT healthy lifestyle intervention tailored for adolescent cisgender girls with OW/OB may be an acceptable treatment that could lead to improvements in BMI Z-score, obesity-related measures, and psychological outcomes. FUNDING SOURCES: This work is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH; UL1TR001427) and WellCare Health Plans, Inc. Dr. Cardel is also supported by the National Institutes of Health National Heart, Lung, and Blood Institute (K01HL141535 and R25HL126146).

This article discusses a case study implementing a manualized financial therapy intervention in an online setting. The benefits of financial therapy are discussed, and the pros and cons of online therapy are contrasted. A description the intervention is provided. At the conclusion of the intervention, the client and other family members reported satisfaction with this form of therapy. Using financial therapy in an online format may help reduce the service barriers that are often encountered by requiring therapy sessions to be conducted in-person, thus providing wider access to low-income clients who are most in need of these types of interventions.