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Background: Although patients with venous leg ulcers are involved in ulcer management, little is known about why and how these patients self-treat their ulcers without direct supervision by health professionals. Yet patients’ knowledge of ulcer management can be important for achieving ulcer closure and/or preventing recurrence. This study thus investigates the effects of an educational intervention on knowledge of self-care among patients with venous leg ulcers, mainly on wound dressing practice, compression therapy, physical activity and nutrition. Methods and participants: This research was conducted in three outpatient hospitals in central Croatia. An educational brochure was made and distributed to patients; patients were surveyed about caring for venous leg ulcers before the brochure was distributed and after 3 months. Results: In total, 208 patients were involved in the study: 112 in the experimental group and 96 in the control group. The educational intervention increased awareness of compression therapy, knowledge of recurrence prevention, appropriate lifestyle habits, and warning signs related to venous leg ulcers. Conclusions: Patient education on illness and self-care is necessary to achieve positive effects in self-care knowledge. In this study, patients learned how to change dressings, learned how to improve their lifestyle, and were empowered to deal with their illness.

Expression of Concern: Medical Acupuncture issues an Expression of Concern pertaining to a published article in the October 2021 issue of the journal entitled, “Self-Administration of Auricular Acu...

Background: The rapid growth of the elderly population poses a huge challenge for people to access medical services. The key to get rid of the dilemma is for patients to go firstly to primary medical institutions. Existing studies have identified numerous factors that can affect patients’ health institution choice. However, we currently know little about the role of Internet use in the patients’ medical decisions. The objective of this study is to explore health-seeking behavior and institution choice under the background of the Internet era from the perspective of older adults, and to analyze whether the Internet could guide patients to the appropriate medical institution so as to accomplish hierarchical treatment. Methods: The dataset comprises 9416 people aged 45 or above from the China Health and Retirement Longitudinal Survey (CHARLS), which, through multistage cluster sampling, was conducted in 2011, 2013, and 2015. Logistic regression, PSM, and FE model are used to estimate the influence of Internet use on the health care decision-making behavior. Results: Internet use has a significant positive impact on the self-treatment of common diseases (β = 0.05, p < 0.05). In terms of medical institution choices, those who use Internet are more inclined to choose top-level hospitals than community health service institutions to treat common diseases (β = 0.06, p < 0.01). Conclusions: The Internet has lowered the obstacles to learning about common ailments, resulting in a substitution impact of self-treatment for hospital care. However, Internet use may aggravate older adults’ perception of the risk of disease, which exacerbates the tendency of going to higher-level medical institutions for medical treatment. The finding of the study is useful for further rational planning and utilization of the Internet in order to guide patients to appropriate medical institution, which helps to improve the efficiency of the overall medical and health services.

Many patients with immunodeficiencies require lifelong immunoglobulin replacement therapy (IgRT). In a multicenter, randomized, open-label, crossover, non-inferiority 3-month-trial, we compared the impact of the subcutaneous immunoglobulin Gammanorm® administered via pump or syringe (rapid push). Primary endpoint was the life quality index (LQI), secondary endpoints were QoL (SF36v2), satisfaction (TSQM-11), disease and treatment burden (PRISM), incidence of infections and adverse events (AE), treatment costs, and IgG levels. 28/30 patients completed the study. Most of the endpoints were comparable. Drug administrations with rapid push were more frequent, but reduced total time expenditure and some costs. Of the TSQM-11/LQI/SF36 components only "treatment interference with daily activities" was superior with pump and two QoL domains with rapid push. Both delivery devices showed favorable safety. Rapid push was preferred by 34.5% of patients. It proved to be an efficacious and cost-effective alternative to pumps adding to patient choice and increasing flexibility during long-term IgRT.

Background: Low back pain (LBP) is common, costly, and disabling. This study assesses a novel and simple LBP evaluation method and its merit in guiding the direction of a self-treatment exercise. Methods: Randomized open-label intention is used to treat the study. Consecutive patients with LBP ≥ three months and pain ≥ 5/10 were evaluated in a Vancouver clinic with the sacroiliac forward flexion test (SIFFT) by comparing the height of posterior superior iliac spines using a level. Those with asymmetry ≥ 5 mm were offered participation. The assistant, who generated and encrypted the randomization, assigned participants: group 1 learned a two-minute, SIFFT-derived, sacroiliac-leveling exercise (SIFFT-E) as needed for LBP relief; group 2 used a pelvic stabilization belt as needed to prevent LBP, and group 3 continued the usual care. After one month, all participants used SIFFT-E and belt as needed for one month. The identifier number of this article in Clinicaltrials.gov is #NCT03888235. The trial is closed. Our primary outcome measure was the Oswestry disability index (ODI) (decrease) from baseline to one and two months. We also followed SIFFT improvement (decrease). Findings: Of 72 LBP patients, 62 (86%) had ≥ 5 mm asymmetry. From zero to one month, the 21 (one dropout) SIFFT-E participants outperformed the 20 usual care participants for ODI improvement (12.5 ± 14.8 vs. -3.4 ± 14.9 points; mean difference 15.9 [CI 6.7-25.0]; P = 0.002 with number needed to treat (NNT) of 3.0 for ODI improvement ≥ 11). Belt use results were intermediate. At two months, after all the 62 participants used the exercise and belt as needed, combined ODI improvements were clinically significant (12.0 ± 18.4 points), and SIFFT asymmetry was reduced by 8.6 ± 8.6 mm. Five (8%) exercise and 12 (19%) belt wearers experienced mild side effects. Interpretation: Sacroiliac asymmetry appears to be frequent. SIFFT may be clinically useful as an evaluation tool for prescribing a simple self-directed corrective exercise as seen by clinically significant improvements in function and asymmetry.

While the world faces an unprecedented situation with the pandemic, other chronic diseases such as chronic pain continue to run their course. The social distancing and restrictive displacement imposed by the pandemic situation represents a new barrier to access to pain management and tends to reinforce chronification process. Given this context, complementary and alternative medicine (CAM) might offer new opportunities to manage CP, notably with a hand-touch method, such as self-Reiki therapy. Although Reiki administered by a practitioner has shown promising results to reduce pain and psychological distress, and to improve quality of life, self-Reiki practice needs evidence-based medicine to be disseminated. Overall, self-Reiki could bring positive results in addition to, and without interfering with, conventional medicine approaches in patients experienced chronic pain.

Joanne Sloots,1 Mirthe Bakker,1 Job van der Palen,1,2 Michiel Eijsvogel,1 Paul van der Valk,1 Gerard Linssen,3 Clara van Ommeren,1 Martijn Grinovero,4 Monique Tabak,5,6 Tanja Effing,7 Anke Lenferink1,8 1Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands; 2Department of Research Methodology, Measurement & Data Analysis, University of Twente, Enschede, the Netherlands; 3Department of Cardiology, Hospital Group Twente, Almelo and Hengelo, the Netherlands; 4Amiko Digital Health Limited, London, UK; 5eHealth Group, Roessingh Research and Development, Enschede, the Netherlands; 6Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, the Netherlands; 7College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; 8Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social sciences, Technical Medical Centre, University of Twente, Enschede, the NetherlandsCorrespondence: Joanne SlootsDepartment of Pulmonary Medicine, Medisch Spectrum Twente, Koningsplein 1, Enschede, 7512 KZ, the NetherlandsTel +31651660063Email J.Sloots@mst.nlBackground: Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) often coexist and share periods of symptom deterioration. Electronic health (eHealth) might play an important role in adherence to interventions for the self-management of COPD and CHF symptoms by facilitating and supporting home-based care.Methods: In this pilot study, an eHealth self-management intervention was developed based on paper versions of multi-morbid exacerbation action plans and evaluated in patients with both COPD and CHF. Self-reporting of increased symptoms in diaries was linked to an automated decision support system that generated self-management actions, which was communicated via an eHealth application on a tablet. After participating in self-management training sessions, patients used the intervention for a maximum of four months. Adherence to daily symptom diary completion and follow-up of actions were analyzed. An add-on sensorized (Respiro®) inhaler was used to analyze inhaled medication adherence and inhalation technique.Results: In total, 1148 (91%) of the daily diaries were completed on the same day by 11 participating patients (mean age 66.8 ± 2.9 years; moderate (55%) to severe (45%) COPD; 46% midrange left ventricular function (LVF) and 27% reduced LVF). Seven patients received a total of 24 advised actions because of increased symptoms of which 11 (46%) were followed-up. Of the 13 (54%) unperformed advised actions, six were “call the case manager”. Adherence to inhaled medication was 98.4%, but 51.9% of inhalations were performed incorrectly, with “inhaling too shortly” (< 1.25 s) being the most frequent error (79.6%).Discussion: Whereas adherence to completing daily diaries was high, advised actions were inadequately followed-up, particularly the action “call the case manager”. Inhaled medication adherence was high, but inhalations were poorly performed. Future research is needed to identify adherence barriers, further tailor the intervention to the individual patient and analyse the intervention effects on health outcomes.Keywords: telemedicine, chronic conditions, self-treatment, disease management, dry powder inhalers

An assessment of the opinion of a certain cohort of the population on the role of drug advertising in the choice of non-prescription drugs for self-treatment was conducted. According to the questionnaire survey, it has been established that advertising affects the choice of drug for self-treatment 26.0% of the polled. Despite the fact that the majority of respondents indicate that there is no influence of drug advertising, 62.8% of them buy self-medication drug sabout which they learned from advertising. Thus, our scientific hypothesis about the presence of the direct influence of drug advertising on the commitment of patients to pharmacotherapy is confirmed. The majority of respondents (90.0%) do not consider advertising of drugs to be effective and safe, and 61.0% say that drug advertising contains contradictory and incomprehensible information. Almost all respondents (88.0%) are convinced that drug advertising is not always objective and fair. At the same time, according to 50.0% of respondents, the volume of drug advertising in Ukraine should be reduced, 22.0% of respondents believe that advertising of drugs should be prohibited.

We examined the effects of the self-natural posture exercise (SNPE) program on changes in physical self-concept and perception of pain reduction among 114 individuals with chronic pain, sampled from a larger group of individuals who completed the SNPE program. Participants' physical self-concept and perception of their level of pain were measured 4 times (baseline and at 4, 8, and 12 weeks during the SNPE program). The effects of the SNPE on changes in these 2 variables were examined using latent curve model analysis. The program improved the muscle power, subjective health, and flexibility subdomains of physical self-concept, and led to a decrease in perceived pain. The effect of the SNPE on perceived pain was greater for individuals who spent longer sitting each day, and who had suffered from chronic pain for longer. These findings suggest that the SNPE program might be a useful method for the self-treatment of chronic pain.

Objective Migraine is a common disorder affecting more than 10% of the population. The prevalence of migraine among physicians and, in particular, among headache specialists is widely unknown as is the impact of suffering from migraine on the attitudes towards migraine and on treatment recommendations of physicians. We designed a survey among headache specialists and neurologists and compared the results to general pain specialists and general practitioners. Methods A standardized interview in randomly selected samples of these four groups of physicians was performed. The interview included data on the prevalence of migraine and other primary headache disorders in the physician groups, self-report on their own treatment, attitudes towards migraine, and treatment recommendations for migraine. The prevalence rates were also compared to an age- and sex-matched German general population sample. Results The lifetime prevalence of migraine was higher in headache specialists (53.0%) than in general neurologists (43.0%), pain specialists (21.7%), general practitioners (19.3%), and in the general age- and sex-matched population (16.8%). Cluster headache prevalence was high in neurologists (1.9%) and in headache specialists (1.3%); episodic tension-type headache prevalence was significantly lower in general practitioners (19.5%). One reason, among others, was that being a migraine (or cluster headache) patient more often prompted the sufferers to become a specialist in neurology. Physicians with migraine rated the biopsychosocial concept of lower importance for migraine than did physicians without migraine. The self-treatment of migraine in physicians differs from the treatment recommendations to the patients. For example, only 36.4% of the headache specialists with migraine take triptans whereas 94.4% recommend triptans to their patients. Conclusions We conclude that being a headache specialist or a neurologist is associated with an increased migraine or cluster headache prevalence. This personal history of migraine leads to a more somatic view of migraine as a disorder and to different treatment recommendations as compared to self-treatment.

The development of effective and safe treatments for osteoarthritis (OA), the most common chronic joint disease, is one of the main challenges facing modern medicine. Despite the fact that there are many drugs and non-drug therapies, the treatment of OA is not always successful, especially in terms of long-term prognosis. This is determined by the heterogeneity of OA, different phenotypes of this disease, as well as by a significant variability in its course, which complicates individual therapy choice. In this situation, a well-informed patient can become an effective physician assistant. Thus, the patient can control his/her condition in accordance with the responsible self-treatment principles: to assess therapy results and disease exacerbations, to maintain muscle tone and the necessary level of motor activity, to carry out therapeutic exercises, as well as to independently stop short-term increased pain episodes with over-the-counter analgesics. One of the most popular over-the-counter painkillers used worldwide is naproxen administered in low doses. This drug has proven to be an effective analgesic with good tolerability, standing out among all nonsteroidal anti-inflammatory drugs having a minimal risk for cardiovascular events. Teraliv 275 mg, a new over-thecounter formulation of naproxen, has currently emerged in Russia now. It seems that this medication will become an essential element of therapy for OA within the concept of responsible self-medication.

Ethnopharmacological relevance Mexico ranks second in the world for obesity prevalence. In Mexico, obese and overweight subjects commonly seek alternative treatments for weight-loss, including the use of herbal products. Aim of the study The main objective of this study was to evaluate the prevalence of self-medication with herbal products for weight-loss among overweight and obese subjects residing in four states (Guanajuato, San Luis Potosi, State of Mexico, and Mexico City) from central Mexico. In addition, the factors related to self-medication among patients were studied. Materials and methods A total of 1404 overweight and obese subjects were interviewed. A chi-square test examined associations between socio-demographic and socio-economic information, and self-medication with herbal products for weight-loss. Results The prevalence of self-medication was 42.9% among the participants who used herbal products for weight-loss. The female gender was the strongest factor (OR: 2.20 (1.75–2.77) associated with self-medication for weight-loss, followed by a low educational level (elementary and middle school) [OR: 1.80 (1.31–2.44)], and a middle-socioeconomic status [OR: 1.75 (1.21–2.52)]. The main herbal products used for weight-loss were based on: i) green tea, Camellia sinensis (12.7% of frequency), ii) aceitilla, Bidens odorata (6.6%), and iii) soybean, Glycine max (5.3%). In addition, 65% of the respondents considered herbal products ineffective for weight-loss after 6 months of use. Conclusion Due to the high incidence of overweight and obesity in Mexico, there is a high prevalence (42.9%) of self-medication using natural products for weight-loss, particularly in women from Central Mexico. This study indicates the important need to educate patients about the harmful effects of consuming these products.

This research investigates associations between cognitive test anxiety (CTA) and use of alcohol, tobacco, cannabis, and medical and non-medical prescription stimulants (MNPS) among undergraduate students in Israel. A structured, self-report, anonymous questionnaire was distributed to 814 undergraduate students in Israel. According to the test anxiety questionnaire, 16.6% of participants were found to experience CTA. CTA was higher among users of MNPS than among students who did not use MNPS. Students with CTA were 2.21 times more likely to engage in use of MNPS than students who did not have CTA (OR 2.21, 95% CI: 1.50-3.26; P 0.001). A significant association was found between CTA and use of MNPS among the entire sample and among non-medical use of prescription stimulants (NPS). In addition, a significant negative correlation was found between CTA and attitudes toward cannabis and MNPS, such that students with higher CTA had more positive attitudes towards MNPS. A logistic regression model was found to be significant, predicting about 24.7% of the variance in MNPS use. Counseling services for students should be focused on consulting and treatment programs for students with CTA. In addition, preventive educational programs should be formed to target substance habits, especially NPS use.

Introduction Hidradenitis Suppurativa (HS) is a chronic inflammatory disordercommonly affecting body folds. It can significantly impair quality of life due to the physical, psychological, and socialturmoil experienced by patients. Treatment remains a challenge.Limited data on the HS patient experience, such as self-treatment exists. Methods This was a single-center cross-sectional study, utilizing a paper-based survey. Surveys were mailed out to all HS patients from the dermatology clinic and completed on a voluntary basis. Demographics, disease characteristics, medical and family history, treatments tried, and life quality were documented. Results The response rate was 49.4% (41/83), with a female predominance (26/41). Eighty-five percent (35/41) were Caucasian with an average age and BMI of 39.0 ± 16.78 and 30.71 ± 7.02, respectively. In total, 24.4% (10/41), 56.0% (23/41), and 19.5% (8/41) had Hurley I, II, and III, respectively. Lesions affected the genital region (75.6%), thigh/groin (68.2%), and axilla (46.3). Almost half (49%) of patients experienced an average of 1-2 flares per month. The most bothersome symptoms were pain (92.7%), discharge (68.3%), malodor (63.4%), and itch (61%). Depression (53.7%), severe facial acne (14.6%), and hypertension (14.6%) were the most common co-morbidities. Treatments used included antibiotics (82.9%) and surgical excision (34.2%) were. Over 90% of patients reportedself-treatment of lesions by squeezing (80.5%), soaking (53.7%), and lancing (41.4%). Conclusions This study provides insight into the patient perspective of HS. We identify itch as a symptom that is not frequently associated with HS and reveal how commonly patients utilize various types of self-treatment in their experience of disease.

Aim Hirschsprung's disease is a congenital disorder requiring surgery. Most children operated on for Hirschsprung's disease experience postoperative bowel dysmotility. Although various food is known to influence bowel motility, evidence of diet's role and dietary guidelines in treatment of bowel dysfunction in Hirschsprung's disease is lacking. The aim was to explore parental experiences of dietary effects on bowel function in children with Hirschsprung's disease. Methods A qualitative study including three focus groups with ten parents of children with Hirschsprung's disease at a national Hirschsprung's disease centre. Data were analysed through content analysis. Results Parents emphasised diet as a strong influencer on their child's bowel function in Hirschsprung's disease. They expressed great concerns about their responsibility and strived hard to explore and adjust dietary habits to control the child's bowel function. Families' daily and social lives were influenced by the child's diet and bowel function. The parents desired dietary support and guidelines to improve their confidence in self-treatment of Hirschsprung's disease. Conclusion Dietary habits play a key role in parental self-treatment of bowel function in their children with Hirschsprung's disease. Dietary guidelines for patients with Hirschsprung's disease are anticipated.

Background The COVID‐19 global pandemic and the uncertainty of an effective treatment protocol have resulted in fear and anxiety, which have increased the search for natural products to prevent the disease and to manage the symptoms. Aims To discuss the negative effects of garlic used as a preventive measure against the novel coronavirus. Methods and results This study reports a case of oral mucosa burn on the dorsal surface of the tongue in a 72‐year‐old woman. The patient was using raw garlic daily during the pandemic to improve her immunological system. She scheduled a dental appointment and was assessed by teledentistry due to the pandemic, in which a detailed anamnesis was carried out. The burned area and ulceration were identified by video call and photographs. The patient was instructed to cease the habit immediately and change to a soft and non‐acid/spicy/hot diet, which resulted in a great recovery 2 days later. She was monitored for 2 weeks until her tongue was completely healed. Conclusion This case highlights the consequences of inappropriate use of natural product and how self‐treatment could negatively influence oral health. Additionally, it shows the importance of teledentistry for oral diagnosis and treatment during a pandemic.

Objectives: The purpose of this study is to investigate a modified Epley maneuver for self-treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV).Methods: The study recruited 155 patients with PC-BPPV. All patients were randomized into the Epley maneuver group (n = 77) and modified Epley maneuver group (n = 78). We analyzed the resolution rate (1 day and 1 week), residual symptoms after the maneuver, and adverse effects.Results: It was found that the modified Epley maneuver group had a higher resolution rate than that of the Epley maneuver group in the treatment of PC-BPPV after 1 day of the initial maneuver (p < 0.05). However, there was no difference in resolution rate between the Epley maneuver group and the modified Epley maneuver group in resolution rate after 1 week of the initial maneuver (p > 0.05). The modified Epley maneuver group had fewer residual symptoms than that of the Epley maneuver group 1 week after treatment of PC-BPPV (p < 0.05). Significant improvements were also observed in average DHI scores in patients who underwent the modified Epley maneuver compared to the Epley maneuver (p < 0.05). There was no significant difference in adverse effects between the two groups (p > 0.05).Conclusions: The modified Epley maneuver has a satisfactory therapeutic efficacy with less residual symptoms and could be recommended as a self-treatment for patients with PC-BPPV.

Masteroppgave i klinisk sykepleie, Høgskulen på Vestlandet, campus Bergen Background: It is a known fact the demand for elective day surgery is increasing. A wide range of literature focusing on patients ‘experiences and expectations after day surgery in general could be found. However, limited literature was available for the Carpal Tunnel Syndrome (CTS) patient group regarding their experiences and expectations of self- care after day surgery. Purpose: The purpose of this master thesis is to gain an insight into the experiences and expectations of self- care, after CTS day surgery. By investigating this topic, we aim to find out what functioned well, and the challenges faced by this patient group, to achieve optimal recovery after day surgery. Method: A qualitative research method with the help of semi-structured in- depth interviews from six participants were used to carry out this study. The interviews were then transcribed and analyzed by Malteruds´ (2017), systematic text condensation. Results: Findings from the material gathered illustrates that his patient group faced challenges with self-care. Participants expressed unsatisfactory pain management, feelings of being handicapped and being ill equipped with adequate knowledge to execute various postoperative phases and activities of daily living. However, insufficient information was seen as the “key element” joining these various challenges together. Conclusion: The general feedback from the participants in this study was that day surgery was the correct choice for them, however, there is a need for improvement regarding pain relief management, support/follow-up and adequate information of the postoperative phase and rehabilitation to achieve optimal recovery. We hope the findings from our study can contribute to the implications of future practice by improving the care and information given to these individuals undergoing CTS in a day surgery setting. MKS591

Одной из самых серьезных проблем современного общества стало доступность лекарственных препаратов, их неконтролируемое и нерациональное использование. Объектом наших исследований стали посетители и сотрудники аптечных организаций г. Ростова-на-Дону. В ходе проведенных исследований было установлено, что 76 % посетителей приходят в аптеку за первичной консультацией по вопросам назначения и приема лекарственных препаратов. Так же была проанализирована профессиональная компетенция фармацевтических специалистов и установлен низкий уровень компетенции в сфере фармацевтического консультирования. На основании проведенных исследований и анализа данных нами разработан и предложен алгоритм формирования образовательного портфеля в системе НМиФО, позволяющий совершенствовать компетенции сотрудников аптечных организаций в рамках фармацевтического консультирования., The availability of medicinal drugs and their uncontrolled and irrational use have become one of the most serious problems of modern society. The subject of the current study is the visitors and employees of pharmacy organizations in Rostov-on-Don. As a result of the conducted research, the study finds that 76 % of visitors come to the pharmacy for initial prescriptions for taking medicines. The study also analyzes the professional competence of pharmaceutical specialists and establishes a low level of competence in the field of pharmaceutical consulting. Based on the conducted research and data analysis, the authors introduce an algorithm for the formation of an educational portfolio in the system of continuing medical and pharmaceutical education (NMiFO), which allows for improving the competencies of employees of pharmacy organizations in pharmaceutical consulting., Международный научно-исследовательский журнал, Выпуск 7 (109) 2021, Pages 171-175

Conversation Analysis (CA hereafter) is a method for analysing communication whose foundations lie in the work of sociologists Harvey Sacks, Emanuel Schegloff and Gail Jefferson. A CA approach offers both theory and method. Its theoretical concern is with identifying and characterising the ‘machinery’ (Sacks 1984: 27) underlying talk and social relations. Its methodological principles involve making and working with recordings of conversations—‘details of actual occurrences’—rather than using interview methods or direct observation where researchers have ‘an active and ongoing part in soliciting reports’ or are present and taking notes ‘as the observed activity unfolds’ (Potter and Shaw 2018: 189). In CA, talk is therefore treated as the topic rather than an ‘unanalysed and unexplicated methodological resource’, for research (Jefferson and Lee 1980: iii). Recordings are transcribed in preparation for analysis using standard conventions developed by Jefferson (2004) that require close attention to both what was said and how it was said.

Background: Many healthy people seek to improve their health status, because they feel they lack energy or wellbeing or both. Bioenergy devices are frequently used in this self-help sector. We tested two such devices against a wait-list control group in a short-term two week randomized trial. Method: Healthy volunteers who gave informed consent were randomized to receive either one of two bioenergetic devices, Healy, or Healy coil, or had to wait to receive one for two weeks. We measured wellbeing using the WHO-5, and individual concerns using the Measure-your-own- outcome-profile (MYMOP) scaling at the beginning and after two weeks. Results: Linear Models confirmed that the two active interventions were effective over and above waiting (R2adj = .34; p < .0001). This was confirmed by the MYMOP scales. The novel Healy coil intervention was non-inferior to the Healy system. Discussion and conclusion: Bioenergy devices can improve the wellbeing and energy of healthy persons short term. A testing of these applications for medical conditions and in patients would be warranted.

During the three the coronavirus disease 2019 (COVID-19) surges in South Korea, there was a shortage of hospital beds for COVID-19 patients, and as a result, there were cases of death while waiting for hospitalization. To minimize the risk of death and to allow those confirmed with COVID-19 to safely wait for hospitalization at home, the local government of Gyeonggi-do in South Korea developed a novel home management system (HMS). The HMS team, comprised of doctors and nurses, was organized to operate HMS. HMS provided a two-way channel for the taskforce and patients to monitor the severity of patient's condition and to provide healthcare counseling as needed. In addition, the HMS team cooperated with a triage/bed assignment team to expedite the response in case of an emergency, and managed a database of severity for real-time monitoring of patients. The HMS became operational for the first time in August 2020, initially managing only 181 patients; it currently manages a total of 3,707 patients. The HMS supplemented the government's COVID-19 confirmed case management framework by managing patients waiting at home for hospitalization due to lack of hospital and residential treatment center beds. HMS also could contribute a sense of psychological stability in patients and prevented the situation from worsening by efficient management of hospital beds and reduction of workloads on public healthcare centers. To stabilize and improve the management of COVID-19 confirmed cases, governments should organically develop self-treatment and HMS, and implement a decisive division of roles within the local governments., Graphical Abstract

The virtually complete loss of intestinal worms, known as helminths, from Western society has resulted in elimination of a range of helminth-induced morbidities. Unfortunately, that loss has also led to inflammation-associated deficiencies in immune function, ultimately contributing to widespread pandemics of allergies, autoimmunity, and neuropsychiatric disorders. Several socio-medical studies have examined the effects of intentional reworming, or self-treatment with helminths, on a variety of inflammation-related disorders. In this study, the latest results from ongoing socio-medical studies are described. The results point toward two important factors that appear to be overlooked in some if not most clinical trials. Specifically, (a) the method of preparation of the helminth can have a profound effect on its therapeutic efficacy, and (b) variation between individuals in the effective therapeutic dosage apparently covers a 10-fold range, regardless of the helminth used. These results highlight current limits in our understanding of the biology of both hosts and helminths, and suggest that information from self-treatment may be critical for clinical evaluation of the benefits and limits of helminth therapy.

A chemical burn is seen in oral cavity after a noxious agent is placed in direct contact with the mucosa as a mode of self treatment or iatrogenically by dentist. Mild lesions due to less irritating agents result in mild alteration in texture, while more severe lesions (soreness to outright pain) are due to more irritating agents and because of agents of longer duration of contact. Commonly used chemicals used by patients for tooth pain are aspirin which is placed next to the offending tooth and OTC preparations. The essential oil based preparations are easily available in pharmacies or are prepared by local people. These medicaments can harm a patient if not used under medical or ayurvedic supervision as they have beneficial plant extracts, essential oils etc. A case of such self inflicted chemical burn of the oral mucosa is reported due to use of clove oil preparation available locally, used with varying amount and frequency. History of using over the counter medicaments for dental ailment should be asked when patients visit the dentist with complains of burning or white patch in mouth.

Background: Standby emergency self-treatment (SBET) is often recommended as an anti-malaria strategy for travellers to low-risk endemic areas. This self-treatment enables competent malaria therapy, if medical assistance is unavailable. The World Health Organization (WHO) recommends performing reliable diagnostic tests before starting antimalarial treatment. For the self-diagnosis of malaria in travellers, rapid diagnostic tests (RDT) can be used to confirm the infection before SBET is used. The aim of this research is to assess the use of RDT and/or SBET in travellers. Methods: We searched the databases (PubMed, Scopus, Embase, CINAHL) using terms and synonyms for ‘self-diagnosis’ and ‘self-treatment’ combined with ‘malaria’ and ‘travel’. Articles in English, French and German were included. Potential articles were screened and extracted by two authors (KU and PS). Only original articles and case reports documenting the self-use of RDT and/or SBET in travellers were included. Data were extracted using a standardised approach. We defined ‘correct use’ of RDT and SBET. Data on number and performance of RDT and SBET use, as well as malaria verification were collected in an Excel table. Five meta-analyses were performed using a random effects model and calculating pooled proportions. This systematic review was conducted according to the PRISMA guidelines and registered in PROSPERO (CRD42018108874). Results: The research resulted in 867 articles of possible relevance on RDT and 955 articles on SBET. After screening, a total of 4 articles on RDT use and 17 articles for SBET use in travellers were included in the systematic review. Most of the RDT were performed and interpreted properly by the travellers (pooled proportion 88%, 95% confidence interval (CI) from 64% to 97%), whereby the proportion of correct performance was increased after a pre-travel test run (97%). Major problems in the implementation such as pricking finger, placing blood drop, identifying lines and interpreting results could be discovered. We found data on 1025 SBET uses in studies of travellers to high-risk African countries. In these studies, the pooled proportion of SBET uses was 6% (95% CI from 2% to 13%). We found 545 SBET uses in studies of travellers to countries of mixed malaria risk. In these studies, the pooled proportion of SBET uses was 2% (95% CI from 1% to 7%). Furthermore, the evaluation showed a high proportion of correct SBET use (pooled proportion 69%, 95% CI from 35% to 90%). As a cause for incorrect use, errors in dosage (under- or overdose), disregard of minimal incubation period (< 7 days since first possible malaria exposure) and absence of fever were identified. Four cases of post-SBET severe adverse events were documented. In a third of travellers who used SBET, a Plasmodium spp. infection could be detected (pooled proportion 31%, 95% CI from 16% to 51%). Conclusions: This systematic review and meta-analysis showed that the majority of travellers were able to use RDT and SBET correctly. Standardised pre-travel instructions and specific training are indicated to increase the proportions of correct RDT and SBET use. With improved and user-friendly technology, RDT may become an integral part of SBET malaria recommendations for travellers. Combined use of RDT and SBET could be an appropriate strategy for selected subgroups of travellers to low-risk, remote malaria areas. Future research should focus on combined RDT and SBET strategies.

(1) Objectives: With an aging society in China, self-treatment now plays an important role in health care among older adults, but it can be problematic. This study aims to explore and compare the self-treatment behavior among empty and non-empty nesters. (2) Methods: Using a multi-stage stratified random cluster sampling method, a total of 4366 elderly people aged 60 and above from Shandong Province, China, were enrolled in this study. Data were collected through a structured questionnaire. Binary logistic regression was used to analyze the associated factors of self-treatment. (3) Results: The prevalence of self-treatment in empty nesters was significantly lower than that in non-empty ones (74.0% vs. 83.3%). Binary logistic regression analysis showed that higher educational level and poorer self-rated economic status were negatively associated with self-treatment in empty nesters, while unemployed and urban and rural residents&rsquo, basic medical insurance were positively associated with self-treatment in non-empty ones. (4) Conclusions: The study indicated that empty nesters had lower likelihood of self-treatment than non-empty ones. Empty nesters with better socioeconomic status were more likely to use self-treatment, by contrast, non-empty nesters with relatively poorer socioeconomic status were more inclined to self-treatment. Targeted interventions should be developed to maximize the effectiveness of self-treatment and reduce health risks.