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Background and Purpose: Despite the lack of proven efficacy, opioids historically have been used for the treatment of noncancer back pain. A variety of other effective therapeutic options for pain management are becoming more available over time. In 2016, Oregon implemented a unique and novel policy to improve evidence-based back pain care and promote safer and more effective opioid prescribing through the state's Medicaid program, the Oregon Health Plan. This article examines the ways providers adapted to providing care for patients with back pain in the context of COVID-19 and to better understand the challenges faced by and adaptations made by providers. Methods: We conducted focus groups with clinicians and physical pain treatment modality practitioners (PPTMPs). In total, 129 providers participated in one of six focus groups, including 74 clinicians (54%) and 55 PPTMPs (42%). Reflexive thematic analysis was used to construct themes or units of meaning across data. Results: Focus groups revealed concerns about PPE shortages, telemedicine challenges, communication barriers, and profession-specific responses to COVID-19, which hindered patient care and referrals. Focus groups also highlighted some advantages related to increased insight into patients' lives, which enhanced treatment. Care during COVID-19 has resulted in continued patient interest in telehealth and telemedicine. Conclusion: Optimizing use of these technologies for health conditions, such as back pain, adds to treatment options for patients and gives providers a more holistic understanding of patients' lives, the challenges they may face, and how that impacts their treatment. [ABSTRACT FROM AUTHOR]

Background: Early studies during the COVID‐19 pandemic suggested dental occupations were among the highest risk for exposure to SARs‐CoV‐2 because of multiple factors increasing exposure, including close proximity to unmasked patients and performance of aerosol‐generating procedures. However, to date, few studies have investigated COVID‐19 deaths in United States dental occupations, and compared COVID‐19 deaths among healthcare occupations. Methods: We analyzed 2020 mortality data collected by the National Center for Health Statistics' National Vital Statistics System. Multivariable logistic regression was used to generate odds ratios (ORs) and 95% confidence intervals for COVID‐19 as the underlying cause of death in relation to occupation in working‐age decedents (≤65 years), after adjusting for age, sex, race/ethnicity, education, and medical conditions associated with severe COVID‐19. Results: Dental occupations did not have significantly higher risk for COVID‐19 death when compared to all other occupations combined. Among healthcare occupations with frequent, direct patient‐ or client interactions, LPNs and LVNs, and speech and language pathologists had significantly elevated adjusted ORs for COVID‐19 death when compared to dentists, dental hygienists, or dental assistants. Similarly, nurse practitioners had significantly higher ORs for COVID‐19 mortality than dentists or dental hygienists, and approached significance when compared to dental assistants. Conversely, massage therapists and other health diagnosing and treating practitioners had significantly lower adjusted ORs for COVID‐19 death compared with dental occupations. Conclusion: Our study highlights potential differences in work‐related transmission of SARs‐CoV‐2 and subsequent COVID‐19 deaths in healthcare occupations, and furthers a previously limited understanding of COVID‐19 deaths in healthcare occupations in 2020, before COVID‐19 vaccine availability. Our results indicate that dental occupations were not among the highest, nor lowest risk, healthcare occupations for COVID‐19 deaths in 2020, despite their known risks of direct exposure. [ABSTRACT FROM AUTHOR]

Objective: This comprehensive review aimed to assess perineal management strategies during labor and their effectiveness in preventing perineal tears while enhancing maternal well-being. Methods: A three-part review was conducted, covering labor pain causes and management, perineal tears and episiotomy, and preventive strategies with a focus on warm compresses. Existing literature and studies were synthesized to offer a holistic perspective on perineal management. Results: Understanding Labor Pain: Labor pain arises from uterine contractions, perineal and cervical stretching, and pelvic pressure. Management options, including pharmacological and nonpharmacological techniques, such as massage, hydrotherapy, and acupuncture, effectively alleviate pain. Perineal Tears and Episiotomy: Perineal tears, including Obstetric Anal Sphincter Injuries (OASIS), are frequently linked to instrumental delivery, prolonged labor, and fetal positioning. Episiotomy, while at times necessary, carries specific indications and potential complications. Preventive Strategies with Warm Compresses: Studies consistently demonstrate the effectiveness of warm compresses applied during the second stage of labor in reducing perineal tears and enhancing perineal integrity, thereby decreasing the need for sutures. Conclusion: Effective perineal management during labor is essential to ensure maternal well-being and reduce the risk of perineal trauma. Nonpharmacological pain management techniques provide viable options, while perineal tears and episiotomy complications emphasize the importance of preventive strategies. Warm compresses, thoughtfully applied during labor, consistently contribute to maintaining perineal integrity. Nurses play a pivotal role in implementing these strategies, offering holistic care, and ensuring safe and satisfying childbirth experiences. [ABSTRACT FROM AUTHOR]

Background: Namaste Care offers practical skills for healthcare providers, volunteers, and families to meaningfully engage individuals with dementia in activities (e.g., music, massage, reminiscing, socialization, aromatherapy, snacks). A hospital-based specialized dementia care unit for patients with mid- to late-stage dementia offered an adapted version of the Namaste Care program, which was called Meaningful Moments. The aim of this study was to assess the acceptability and preliminary effects of this novel approach using trained volunteers for older adults with mid- to late-stage dementia. Methods: A mixed methods multiphase design was used. Qualitative description was used to explore acceptability of the Meaningful Moments program delivered over 6 months through focus groups (e.g., charge nurses, therapeutic recreationists, nurses, social workers) and individual interviews with one volunteer and two family members. A prospective pre-post-test study design was used to evaluate the preliminary effects of the program for patients with dementia and family members. Outcomes included quality of life, neuropsychiatric symptoms, and pain for patients with dementia and family carer role stress and the quality of visits for families. Data were collected from June 2018 to April 2019. Descriptive analyses of participants' characteristics were expressed as a mean (standard deviation [SD]) for continuous variables and count (percent) for categorical variables. Focus group and individual interview data were analyzed using thematic analysis. The generalized estimating equations (GEE) method was used to assess change in the repeated measures outcome data. Results: A total of 15 patients received the Meaningful Moments interventions. Families, staff, and volunteers perceived that patients experienced benefits from Meaningful Moments. Staff, volunteers, and families felt fulfilled in their role of engaging patients in the Meaningful Moments program. Individualized activities provided by volunteers were perceived as necessary for the patient population. There were no statistically significant improvements in patient outcomes. There was a statistically significant decline in family carer role stress. Conclusions: Using a one-on-one approach by volunteers, patients experienced perceived benefits such as improved mood and opportunities for social interactions. There is a need for tailored activities for older adults with advanced dementia through practical strategies that can offer benefit to patients. [ABSTRACT FROM AUTHOR]

Introduction: Recent years have seen rapid changes to traditional, complementary, and integrative medicine (TCIM) practices in Australia associated with increased interest in TCIM during the COVID-19 pandemic and reorganization of practice delivery methods. This study aimed to update the understanding of the current TCIM workforce in Australia. Methods: Representatives of six TCIM professional organizations developed a survey for e-mail distribution to members. The anonymous online Qualtrics survey was based on previous surveys to identify workforce trends over time. Survey data were analyzed descriptively using Qualtrics and STATA statistical software (version 16). Results: Responses were recorded from 1921 participants. Respondents were predominantly female (79.7%); 71.8% were aged over 45 years. Remedial massage therapists represented 32.1% and naturopaths represented 23.7% of respondents. Highest qualifications were diplomas (37.7%), bachelor's degrees (28.9%), and advanced diplomas (21.8%). Metropolitan locations accounted for 68.1% of practices. Solo private practice was the main practice setting (59.8%); 13.8% practiced in group private practice with TCIM practitioners; and 10.6% practiced with allied health practitioners. Approximately three quarters of respondents (73.9%) saw 0–5 new clients per week; 42.2% had 0–5 follow-up consultations per week. Collaboration rates with TCIM practitioners, other non-TCIM practitioners, and general medical practitioners (GPs) were 68.7%, 24.4%, and 9.2%, respectively. A total of 93% did not suspect an adverse event from their treatment in the past year. Businesses of 75.9% of respondents were reportedly affected by the pandemic. Discussion: Comparisons with previous surveys show ongoing predominance of female practitioners, an aging workforce, a high proportion of remedial massage and naturopathy practitioners, and an increasingly qualified TCIM workforce. There was little change in the very low number of adverse events suspected by practitioners, number of consultations per week, and low levels of income of most TCIM practitioners compared with the average income in Australia. Respondents collaborated at similar rates as in the past; however, more with TCIM practitioners than with GPs. [ABSTRACT FROM AUTHOR]

Background: In physiotherapy, the classic muscle–bone concept is used to translate basic and clinical anatomy. By defining the anatomical structures from superficial to deeper layers which frame the ArthroMyoFascial complex, our aim is to offer clinicians a comprehensive concept of within the muscle–bone concept. Method: This study is a narrative review and ultrasound observation. Results: Based on the literature and ultrasound skeletonization, the ArthroMyoFascial complex is defined. This model clarifies fascial continuity at the joint level, describing anatomical structures from skin to deeper layers, including superficial fascia, deep fascia, myofascia including skeletal muscle fibers, and arthrofascia all connected via connective tissue linkages. This model enhances the understanding of the muscle–bone concept within the larger ArthroMyoFascial complex. Conclusion: The ArthroMyoFascial complex consists of multiple anatomical structures from superficial to deeper layers, namely the skin, superficial fascia, deep fascia, myofascia including muscle fibers, and arthrofascia, all linked within a connective tissue matrix. This model indicates that it is a force-transmitting system between the skin and the bone. This information is crucial for manual therapists, including physiotherapists, osteopaths, chiropractors, and massage therapists, as they all work with fascial tissues within the musculoskeletal domain. Understanding fascia within the muscle–bone concept enhances clinical practice, aiding in therapeutic testing, treatment, reporting, and multidisciplinary communication, which is vital for musculoskeletal and orthopedic rehabilitation. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: This study was carried out to investigate the effect of low-frequency pulsed electrotherapy combined with acupoint massage on postpartum urinary retention (PUR). Methods: The patients were divided into control group, intervention group 1, and intervention group 2 according to the nursing method. The control group received conventional postpartum care, intervention group 1 received conventional postpartum care and low frequency pulsed electrotherapy, and intervention group 2 received conventional postpartum care, low-frequency pulsed electrotherapy, and Shuidao point massage. The bladder function, comfort score, and quality of life score before and after intervention were compared among the three groups. Results: The bladder function, comfort level, and quality of life of intervention group 1 and intervention group 2 after nursing were significantly better than those of the control group. In addition, intervention group 2 had better bladder function than intervention group 1, with lower residual urine volume and higher bladder compliance. In the Kolcaba score, the mental dimension of intervention group 2 was significantly higher than that of intervention group 1. In terms of QOL scores, the social function, physical function, and state of material life scores of intervention group 2 were significantly higher than those of intervention group 1. Conclusions: Low-frequency pulsed electrotherapy combined with acupoint massage can significantly improve the bladder function, comfort, and quality of life of patients with PUR. [ABSTRACT FROM AUTHOR]

• CUMS induced depression-related behaviors in adolescent rats. • CUMS decreased the hippocampal expressions of IGF-1, GR and BDNF. • Traditional pediatric massage (TPM) prevented depression in adolescent rats. • TPM enhanced the hippocampal expressions of IGF-1, GR and BDNF. • TPM had a better anti-depressant effect than back stroking and fluoxetine. This study aimed to investigate the anti-depressant effect of traditional pediatric massage (TPM) in adolescent rats and its possible mechanism. The adolescent depression model in rats was established by using chronic unpredictable mild stress (CUMS). All rats were randomly divided into five groups (seven per group), including the groups of control (CON), CUMS, CUMS with TPM, CUMS with back stroking massage (BSM) and CUMS with fluoxetine (FLX). The tests of sucrose preference, Morris water maze and elevated plus maze were used to evaluate depression-related behaviors. Plasma corticosterone (CORT) level was measured by ELISA. The gene and protein expressions of glucocorticoid receptor (GR), brain-derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1) were measured by RT-qPCR and IHC respectively. The results showed that CUMS induced depression-related behaviors in the adolescent rats, along with decreased weight gain and reduced hippocampal expressions of GR, IGF-1 and BDNF. TPM could effectively prevent depression-related behaviors in CUMS-exposed adolescent rats, manifested as increasing weight gain, sucrose consumption, ratio of open-arm entry, times of crossing the specific quadrant and shortening escape latency. TPM also decreased CORT level in plasma, together with enhancing expressions of GR, IGF-1 and BDNF in the hippocampus. These results may support the clinical application of TPM to prevent and treat adolescent depression. [ABSTRACT FROM AUTHOR]

Background: Quality of life (QOL) is frequently utilized in clinical medicine and research to assess a patient's health status and treatment effectiveness. Objectives: This study investigates the impact of vocational training on the QOL of visually impaired individuals. Methods: We employed the brief Taiwan version of the World Health Organization QOL Questionnaire (WHOQOL-BREFTW) to assess four domains: physical, psychological, social, and environmental, using a nonequivalent pretest–posttest control group design. The experimental group participated in 6 months of vocational training, including life and career reconstruction. After completing the vocational training, the average QOL score for the experimental group was 3.34 ± 0.18, while the control group had a score of 3.10 ± 0.85. The generalized estimating equation (GEE) results revealed a notable improvement of 10.81 (1.10) in the posttest overall QOL scores compared to the pretest scores in the control group. Conclusion: Vocational training significantly improves the overall QOL for visually impaired individuals. It is noteworthy that the psychological, social relationship, and physical health domains of WHOQOL-BREF TW exhibited the most significant improvements. This emphasizes the following: 1. professional knowledge and technical learning can enhance the abilities of the visually impaired. 2. The improvement in QOL occurs primarily at physical, psychological, and social levels. These levels involve maintaining physical health, reducing dependence on medical care, and enhancing self-care abilities for life reconstruction. 3. Integrating electronics with directional action can help to mitigate the risks associated with outdoor activities. [ABSTRACT FROM AUTHOR]

Jan van Breemen (1874-1961) was a pioneer of international cooperation among rheumatologists. He played a crucial role in the establishment of the International Organisation for the Investigation of Rheumatism in 1919, which later became the International League Against Rheumatism. Van Breemen also founded the Physiotherapy Association in Amsterdam and the Physiotherapy Institute, which became the Jan van Breemen Institute. His work was recognized with an honorary doctorate from Charles University in Prague and honorary membership in the Polish Society of Rheumatology. Van Breemen's contributions to international collaboration among rheumatologists continue to be important today. [Extracted from the article]

Prior studies of legal violence concerning minority groups in the United States are often linked to Immigration Law. Drawing primarily from 30 interviews with Thai massage business owners in Los Angeles, this article reveals how the implementation of local and federal regulations and laws regarding massage businesses constitutes legal violence. Using Crenshaw's structural, political, and representational intersectionality, this article demonstrates how Thai women's race, ethnicity, and gender affect their experiences in countering the state regulations. The analysis focuses on two interrelated areas of Thai massage business owners' and Thai massage therapists' lives--the strict government surveillance of Thai massage business operations and the enforcement of professional certification. This legal violence toward Thai massage owners and massage therapists is rooted in a legal system that aims to protect consumers. Nevertheless, the effect of legal violence is not limited to undocumented Thai immigrants but also affects Thai American citizens and legal permanent residents. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic was a time of rapid change and uncertainty, with individual jurisdictions within countries implementing a variety of preventative measures. At the onset of the pandemic, as little was known about how COVID-19 was transmitted, restrictions, such as lockdowns, were implemented to prevent further spread of this virus. In many jurisdictions, massage therapists were deemed as nonessential for a period. This disruption to their livelihood, as a professional group and without autonomy to decide, was unprecedented. This prompted the question as to whether this experience had impacted massage therapists' professional identity. Methods: A sequential explanatory mixed methods design was used and massage therapists in Australia and Canada were recruited to participate. Results from a quantitative questionnaire completed by 649 respondents and from 31 semistructured interviews from a subset of the questionnaire participants were used in the mixed analysis. Results: Massage therapists, impacted by the pandemic, experienced a discord between what it means to be a massage therapist, providing patient-centered care and the public health initiatives implemented during the pandemic. This discord occurred in multiple situations and the type of discord was influenced by a number of factors, including how therapists identified themselves within the workforce (i.e., as a health care provider or a service provider). Conclusion: This study sought to understand how the COVID-19 pandemic impacted massage therapists' professional identity. Massage therapists reported that the pandemic impacted their professional identity through a lack of congruence and discord between their identity-constituting beliefs and what it means to be a massage therapist. The sequela to this discord was therapists experiencing different types of moral distress and or moral injury. Future research is needed to determine the longer-term impacts of COVID-19 on massage therapists. [ABSTRACT FROM AUTHOR]

The International Consortium on Manual Therapies (ICMT) is a grassroots interprofessional association open to any formally trained practitioner of manual therapy (MT) and basic scientists promoting research related to the practice of MT. Currently, MT research is impeded by professions' lack of communication with other MT professions, biases, and vernacular. Current ICMT goals are to minimize these barriers, compare MT techniques, and establish an interprofessional MT glossary. Practitioners from all professions with training in manual therapies were encouraged by e-mail and website to participate (). Video conferences were conducted at least bimonthly for 2.5 years by profession-specific and interprofessional focus groups (FGs). Members summarized scopes of practice, technique descriptions, associated mechanisms of action (MOA), and glossary terms. Each profession presented their work to the interprofessional FG to promote dialogue, understanding and consensus. Outcomes were reported and refined at numerous public events. Focus groups with representatives from 5 MT professions, chiropractic, massage therapy, osteopathic, physical therapy and structural integration identified 17 targeting osseous structures and 49 targeting nonosseous structures. Thirty-two techniques appeared distinct to a specific profession, and 13 were used by more than 1. Comparing descriptions identified additional commonalities. All professions agreed on 4 MOA categories for MT. A glossary of 280 terms and definitions was consolidated, representing key concepts in MT. Twenty-one terms were used by all MT professions and basic scientists. Five terms were used by MT professions exclusive of basic scientists. Outcomes suggested a third to a half of techniques used in MT are similar across professions. Additional research is needed to better define the extent of similarity and how to consistently identify those approaches. Ongoing expansion and refinement of the glossary is necessary to promote descriptive clarity and facilitate communication between practitioners and basic scientists. [ABSTRACT FROM AUTHOR]

A survey of UK public health system maternity care providers has found that there is inconsistent and conflicting advice regarding infant skincare in the country. The survey revealed that there is no consensus on when to bathe newborns, with recommendations ranging from delaying the first bath for 24 hours to delaying it for up to 2 weeks. There is also variation in recommendations regarding the use of cleansing products and the removal of vernix. The study emphasizes the need for standardized and evidence-based guidelines for infant skincare in the UK. [Extracted from the article]

Fibromyalgia is challenging to diagnose and manage as patients present with a heterogeneous array of symptoms and there is a poor understanding of the underlying causes. The decades of research and refinement summarised in this article have improved our understanding of the disease as well as the criteria for diagnosis. This allows us to tailor the diagnosis and management to the individual according to their personal experience of the condition. [ABSTRACT FROM AUTHOR]

Introduction: Patient care depends on collaborative practice. Debate remains as to the best approach to providing education for collaboration, with educational interventions often far removed from the realities of the clinical workplace. Understanding the approaches used for collaboration in clinical practice could inform practical strategies for training. For internal medicine trainees, this involves collaboration with other professions but also with other specialties. This study aimed to explore the approaches that internal medicine trainees use for interprofessional collaboration and the ways that these approaches vary when internal medicine trainees interact with different healthcare provider groups. Methods: Following ethical approval and participant consent, interprofessional communication workshops between August 2020 and March 2021 were audio recorded and transcribed verbatim. Workshops involved groups of internal medicine trainees discussing collaboration challenges and the approaches they use in clinical practice. This framework analysis study used the interprofessional collaboration framework described by Bainbridge and Regehr (building social capital, perspective taking and negotiating priorities and resources), and cross-referenced the categorised data with the healthcare groups that trainees collaborate with, to look for patterns in the data. Results: Seventeen workshops, involving 100 trainees, were included. Trainees described relationship building, perspective taking and negotiating priorities and resources. Relationship building was a modification to the original framework domain of building social capital. Themes of power and civility transcended domains with evidence of using hierarchy as leverage when negotiating and employing civility as a tactical approach throughout. Discussion: This bi-dimensional analysis highlights patterns of perspective taking when collaborating with other specialties and professions, and the approaches to negotiation of courting favour and coercion when interacting with other specialties. This study provides evidence of the strategies currently utilised by internal medicine trainees, with different healthcare groups, and presents a modified framework which could inform the development of training for collaboration. [ABSTRACT FROM AUTHOR]

Context: Injury prevention programs for the lower extremities are effective in team-sport athletes. Objective: To identify barriers and facilitators among professional ice hockey players and staff members for adhering to an injury prevention program. Design: Cross-sectional survey. Setting and Participants: A questionnaire about barriers and facilitators related to knowledge/perceptions, beliefs, adoption, and habits about injury prevention was filled out by Swiss professional male ice hockey players and staff members. Main Outcome Measures: Frequencies of ratings were calculated and binary logistic regression analysis was applied to predict a relationship between a high/low perceived benefit of an injury prevention program and player characteristics. Results: Knowledge, perceived benefit, and relevance of injury prevention as well as awareness of high risk of injuries in ice hockey were identified as important facilitators. Players' habit of exercise performance was identified as a barrier. Program understanding of staff members was identified as a facilitator and barrier. No significant relationships were observed between a high/low perceived benefit of an injury prevention program and age (P =.85), nationality (P =.53), level of education (P =.63), National League experience (P =.50), or occurrence of lower-extremity injuries in the previous season (P =.10). Conclusions: Players and staff members clearly rated perceived benefits of an injury prevention program, which can be considered an important facilitator of the uptake and adoption of such a program in ice hockey teams. Players should be educated about well-performed injury prevention exercises. Staff members should be educated about the aim of a regular injury prevention program. An injury prevention program might be implemented in players of all ages, levels of education, and experience in the National League, irrespective of previous injuries. Identified barriers and facilitators should be addressed when implementing an injury prevention program in a setting of professional ice hockey teams in the future. [ABSTRACT FROM AUTHOR]