Differential relations between breathing retraining, in vivo exposure, and imaginal exposure homework completion and treatment outcomes in veterans receiving prolonged exposure for PTSD

OBJECTIVES

Limited research exists that outlines the predictive relevance of the treatment components of prolonged exposure (PE) for post-traumatic stress disorder (PTSD) on PTSD and depression symptom outcomes. The goal of the present study was to investigate relations between participant completion of breathing retraining, in vivo exposure, and imaginal exposure exercises and symptom outcomes.

METHODS

A total of 58 participants completed a trial of PE as part of a larger trial on peer involvement and treatment adherence. Diagnostic and self-report measures were completed throughout treatment. Participants also recorded weekly completion of breathing retraining, in vivo exposure, and imaginal exposure exercises. Pearson correlations and hierarchical regression analyses were used to investigate relations between average weekly treatment component completion and treatment outcomes, controlling for relevant variables.

RESULTS

Although breathing retraining and in vivo exposures were associated with PTSD outcomes in the correlational findings, use of breathing retraining, in vivo exposures, and imaginal exposures were not reliably associated with PTSD symptom outcomes when controlling for other variables in the regression analysis. However, when investigating changes in comorbid symptoms of depression, greater use of breathing retraining was associated with decreased symptoms of depression at posttreatment.

CONCLUSIONS

Present findings demonstrate the differential relations between participation in various PE treatment components and posttreatment symptom outcomes. The importance of breathing retraining in addressing comorbid depressive symptoms is discussed, with emphasis on potentially increasing relaxation and positive activities more broadly to encourage further treatment benefits.

A Pilot Randomized Controlled Trial Among People Recovering from Mental Illness: A Tailored Mindfulness-Based Intervention versus Relaxation Training

BACKGROUND

This study assessed the potential effectiveness, acceptability and feasibility of a tailored mindfulness-based intervention (MBI, REMIND 2.0) for personal recovery among people with mental illness during the COVID-19 pandemic.

METHODS

In this pilot mixed methods randomized controlled trial, participants were assigned to either the MBI (n = 14) or the relaxation training (RT) (n = 14). Quantitative measures were used to assess primary outcomes, including personal recovery, mindfulness, self-compassion, resilience, and secondary outcomes, including depression, stress, anxiety, positive and negative moods, quality of life and general health at baseline (T0), post-intervention (T1) and one-month follow-up (T2). Quantitative interviews were conducted to explore the experiences and perceptions toward the MBI.

RESULTS

Results indicated significant group and time interactions for all outcomes except anxiety and stress. MBI participants showed significant improvements in all outcomes at T1, which were maintained at T2, except for positive mood. RT participants showed a significant decline in resilience but significant improvements in all secondary outcomes at T1, but all outcomes significantly declined at T2, except for anxiety and stress. MBI participants were receptive toward the programme in all aspects of personal recovery.

CONCLUSIONS

The tailored MBI is a potentially effective, feasible and acceptable approach to facilitate personal recovery among people with mental illness. Differences between MBI and RT are discussed.

Coarse-Grained Simulations on Polyethylene Crystal Network Formation and Microstructure Analysis

Understanding and characterizing semi-crystalline models with crystalline and amorphous segments is crucial for industrial applications. A coarse-grained molecular dynamics (CGMD) simulations study probed the crystal network formation in high-density polyethylene (HDPE) from melt, and shed light on tensile properties for microstructure analysis. Modified Paul-Yoon-Smith (PYS/R) forcefield parameters are used to compute the interatomic forces among the PE chains. The isothermal crystallization at 300 K and 1 atm predicts the multi-nucleus crystal growth; moreover, the lamellar crystal stems and amorphous region are alternatively oriented. A one-dimensional density distribution along the alternative lamellar stems further confirms the ordering of the lamellar-stack orientation. Using this plastic model preparation approach, the semi-crystalline model density (ρcr) of ca. 0.913 g·cm-3 and amorphous model density (ρam) of ca. 0.856 g·cm-3 are obtained. Furthermore, the ratio of ρcr/ρam ≈ 1.06 is in good agreement with computational (≈1.096) and experimental (≈1.14) data, ensuring the reliability of the simulations. The degree of crystallinity (χc) of the model is ca. 52% at 300 K. Nevertheless, there is a gradual increase in crystallinity over the specified time, indicating the alignment of the lamellar stems during crystallization. The characteristic stress-strain curve mimicking tensile tests along the z-axis orientation exhibits a reversible sharp elastic regime, tensile strength at yield ca. 100 MPa, and a non-reversible tensile strength at break of 350%. The cavitation mechanism embraces the alignment of lamellar stems along the deformation axis. The study highlights an explanatory model of crystal network formation for the PE model using a PYS/R forcefield, and it produces a microstructure with ordered lamellar and amorphous segments with robust mechanical properties, which aids in predicting the microstructure-mechanical property relationships in plastics under applied forces.

How to use MRI in cardiac disease with diastolic dysfunction?

Left ventricular (LV) diastolic dysfunction (DD) is an initially asymptomatic condition that can progress to heart failure, either with preserved or reduced ejection fraction. As such, DD is a growing public health problem. Impaired relaxation, the first stage of DD, is associated with altered LV filling. With progression, reducing LV compliance leads to restrictive cardiomyopathy. While cardiac magnetic resonance (CMR) imaging is the reference for LV systolic function assessment, transthoracic echocardiography (TTE) with Doppler flow measurements remains the standard for diastolic function assessment. Rather than simply replicating TTE measurements, CMR should complement and further advance TTE findings. We provide herein a step-by-step review of CMR findings in DD as well as imaging features which may help to identify the underlying cause.

Influence of Nucleation on Relaxation, Molecular Cooperativity, and Physical Stability of Celecoxib Glass

Although nucleation is considered the first step in the crystallization of glass materials, the structure and properties of the nuclei are not understood well. Influence of nucleation on the structure and dynamics of celecoxib glass was evaluated in this study. The nuclei for Form III were induced by annealing the glass at freezing temperature, and their impact on the relaxation behavior was investigated using thermal analysis and broadband dielectric spectroscopy to find accelerated α relaxation and suppressed β relaxation. In addition, observed after nucleation was a decrease in cooperativity of the molecular motion, presumably because of the appearance of void spaces in the glass structure. During long-term isothermal crystallization studies, crystal growth to Form III was accelerated in the presence of the nuclei, whereas this effect was less remarkable when a different crystal form dominated the crystallization behavior. These observations should provide more detailed insights into the nucleation mechanism and impact of nucleation on molecular dynamics including physical stability of pharmaceutical glasses. In addition, discussed is the remarkable acceleration of the crystallization rate of the celecoxib glass just below its Tg, which could be understood by diffusionless crystal growth.

The Use of Immersive Virtual Reality in Sensory Sessions on a Specialist Dementia Unit: Service Evaluation of Feasibility and Acceptability

This service evaluation reviewed inclusion of Immersive Virtual Reality (iVR) relaxation activities as part of routine occupational therapy sensory sessions on a specialist dementia unit. Twenty-five sessions were completed over 13 wk with 14 participants. Nine participants chose to engage in multiple sessions. Feasibility was assessed through participant engagement and tolerability. Modal first session length was in the range 30 s to 2 min. This increased to over 2 min on second sessions. There was a lack of significant adverse effects measured by direct questioning, neuropsychiatric assessment before vs. after sessions and adverse incident reporting. Acceptability was assessed via structured review of user and staff feedback which noted positive experiences such as relaxation, openness to discussion, reminiscence, wider engagement and interest in future use. Further work is required to explore efficacy and use in other settings.

Combined nuclear magnetic resonance methods in quality control of lubricants in green energy production

NMR methods were applied for lubricant analysis. Different factors influence the real aging of lubricants on diverse length scales and are captured by NMR. Chemical conversion of additives is addressed by NMR spectroscopy. High-field NMR experiments allow the identification and quantification of chemical components and are transferred to benchtop devices. Molecular dynamics and contaminations like fuel or abrasion are addressed via NMR relaxation and diffusion. Quality parameters were extracted via suitable data analysis of NMR raw data, which allow the detection of aging and indicate changes in the oil composition. At the same time, the methodology is optimized to the conditions in quality control. The feasibility is shown the example of a series of lubricants from applications in regenerative energy production, namely, wind turbine oils and biogas motor oils.

Hypnosis in psychotherapy, psychosomatics and medicine. A brief overview

Aspects of hypnosis and its application in psychotherapy, psychosomatics and medicine are examined and contextualized in the 250-year history of hypnosis. Imagination as an essential element of hypnotic treatments appeared as early as 1784 as an argument rejecting the theory of animal magnetism of Franz Anton Mesmer. In somnambulism of German romanticism, another proto-form of hypnosis after 1800, concepts of the mind-body problem were dealt with, which still characterize the understanding of unconscious mental processes today. Hypnosis was at the beginning of psychoanalysis, but was not pursued further by Sigmund Freud from 1900 onwards. Nevertheless, there were some hypnoanalytical approaches in the 20th century, as well as attempts to integrate hypnosis into behavior therapy. Techniques of imagination and relaxation combine both; in particular findings from cognitive psychology explain processes of both hypnosis and cognitive behavioral therapy. The influence of social psychology brought a new perspective to the debate about the nature of hypnosis, which continues to this day: is hypnosis to be understood as a special state of consciousness or is it a completely normal, mundane interaction? The experiments that were carried out to support one side or the other were also dependent on the hypnotizability of the subjects involved, as the more difficult hypnotic phenomena such as paralysis, hallucinations or identity delusions can only be demonstrated by highly hypnotizable subjects. The fact that these are not mere compliance reactions has now been proven by many studies using imaging techniques. But even those who are moderately hypnotizable benefit from hypnosis rituals. Variables postulated by socio-cognitive hypnosis researchers, such as motivation and expectation, are relevant, as is a good "hypnotic rapport." Practical application of hypnotherapy today is characterized by the innovative techniques and strategies developed by Milton H. Erickson. Research into the effectiveness of hypnosis in the field of psychotherapy and psychosomatics still leaves much to be done. The situation is different in the field of medical hypnosis, where there are considerably more studies with a satisfactory design and verifiable effects. However, the impact in practical application in everyday medical practice is still low. Newer developments such as virtual reality and artificial intelligence are being looked at with critical interest.

Nurse-Implemented Music Therapy to Reduce Anxiety in Community-Dwelling Individuals with Severe Mental Illness: A Pilot Study

Anxiety is an important and recurrent problem in people with severe mental illness (SMI). The aim of this work is to measure the effectiveness of the Music Therapy nursing intervention in reducing anxiety in outpatients diagnosed with SMI (bipolar disorder and schizophrenia). The intervention was structured over five weeks (ten 1-h sessions, twice weekly). Objective measures (blood pressure, heart rate, and respiratory rate) and subjective measures (anxiety response and the subjective perception of relaxation) were taken before and after every session. Our results show that this nursing intervention entails an objective reduction of the respiratory rate ((-4.5, -0.5) breaths per minute), the heart rate ((-5.80, -2.13) bpm), and it evidences a reduction in the subjective perception of anxiety (16.08% mean reduction in state anxiety). Considering all the sessions, the subjective perception of relaxation increased 97.33% of the time. This study provides evidence that the Music Therapy intervention can effectively promote relaxation and reduce anxiety symptoms in people with SMI. This study was retrospectively registered at Clinical Trials with Protocol Identifier NCT06315049.

Association of Digital Engagement With Relaxation Tools and Stress Level Reduction: Retrospective Cohort Study

BACKGROUND

Stress is an emotional response caused by external triggers and is a high-prevalence global problem affecting mental and physical health. Several different digital therapeutic solutions are effective for stress management. However, there is limited understanding of the association between relaxation components and stress levels when using a digital app.

OBJECTIVE

This study investigated the contribution of relaxation tools to stress levels over time. We hypothesized that participation in breathing exercises and cognitive behavioral therapy-based video sessions would be associated with a reduction in stress levels. We also hypothesized a significant reduction specifically in participants' perceived sense of burden and lack of productivity when engaged with breathing exercises and video sessions.

METHODS

Stress levels were evaluated in a real-world data cohort using a behavioral health app for digital intervention and monitoring change. This retrospective real-world analysis of users on a mobile platform-based treatment followed users (N=490) who started with moderate and above levels of stress and completed at least 2 stress assessments. The levels of stress were tracked throughout the first 10 weeks. A piecewise mixed effects model was applied to model the trajectories of weekly stress mean scores in 2 time segments (1-6 weeks and 6-10 weeks). Next, a simple slope analysis was used for interpreting interactions probing the moderators: breathing exercises and video sessions. Piecewise mixed-effects models were also used to model the trajectories of specific perceived stress item rates in the stress questionnaire in the 2 segments (1-6 weeks and 6-10 weeks) and whether they are moderated by the relaxation engagements. Simple slope analysis was also used here for the interpretation of the interactions.

RESULTS

Analysis revealed a significant decrease in stress symptoms (β=-.25; 95% CI -0.32 to -0.17; P<.001) during the period of 1-6 weeks of app use that was maintained during the period of 6-10 weeks. Breathing exercises significantly moderated the reduction in stress symptoms during the period of 1-6 weeks (β=-.07; 95% CI -0.13 to -0.01; P=.03), while engagement in digital video sessions did not moderate stress scores. Engagement in digital video sessions, as well as breathing exercises, significantly moderated the reduction in perceived sense of burden and lack of productivity during weeks 1-6 and remained stable during weeks 6-10 on both items.

CONCLUSIONS

This study sheds light on the association between stress level reduction and specific components of engagement in a digital health app, breathing exercises, and cognitive behavioral therapy-based video sessions. Our findings provide a basis for further investigation of current and moderating factors that contribute to the personalization of digital intervention. In addition, results may aid in developing a more comprehensive understanding of how digital intervention tools work for mental health and for whom they are most effective.

Mobile-Delivered Mindfulness Intervention on Anxiety Level Among College Athletes: Randomized Controlled Trial

BACKGROUND

College athletes are a group often affected by anxiety. Few interventional studies have been conducted to address the anxiety issues in this population.

OBJECTIVE

We conducted a mobile-delivered mindfulness intervention among college athletes to study its feasibility and efficacy in lowering their anxiety level and improving their mindfulness (measured by the Five Facet Mindfulness Questionnaire [FFMQ]).

METHODS

In April 2019, we recruited 290 college athletes from a public university in Shanghai, China, and 288 of them were randomized into an intervention group and a control group (closed trial), with the former (n=150) receiving a therapist-guided, smartphone-delivered mindfulness-based intervention and the latter receiving mental health promotion messages (n=138). We offered in-person instructions during the orientation session for the intervention group in a classroom, with the therapist interacting with the participants on the smartphone platform later during the intervention. We used generalized linear modeling and the intent-to-treat approach to compare the 2 groups' outcomes in dispositional anxiety, precompetition anxiety, and anxiety during competition, plus the 5 dimensions of mindfulness (measured by the FFMQ).

RESULTS

Our intent-to-treat analysis and generalized linear modeling found no significant difference in dispositional anxiety, precompetition anxiety, or anxiety during competition. Only the "observation" facet of mindfulness measures had a notable difference between the changes experienced by the 2 groups, whereby the intervention group had a net gain of .214 yet fell short of reaching statistical significance (P=.09). Participants who specialized in group sports had a higher level of anxiety (β=.19; SE=.08), a lower level of "nonjudgemental inner experience" in FFMQ (β=-.07; SE=.03), and a lower level of "nonreactivity" (β=-.138; SE=.052) than those specializing in individual sports.

CONCLUSIONS

No significant reduction in anxiety was detected in this study. Based on the participant feedback, the time availability for mindfulness practice and session attendance for these student athletes in an elite college could have compromised the intervention's effectiveness. Future interventions among this population could explore a more student-friendly time schedule (eg, avoid final exam time) or attempt to improve cognitive and scholastic outcomes.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR1900024449; https://www.chictr.org.cn/showproj.html?proj=40865.

Autonomous sensory Meridian response as a physically felt signature of positive and negative emotions

Introduction

Current research on Autonomous Sensory Meridian Response (ASMR) assumes that ASMR is always accompanied by contentment, and it is distinct from frisson due to positive emotions. Thus, research investigations tend to limit their scope to solely focusing on the sensation of relaxation that ASMR induces. This study explores whether it is possible to have a different emotional experience and still perceive ASMR, testing the theory of ASMR as an amplifier of pre-existing emotion instead of a determination of positive affect.

Methods

The emotional arousal and valence, and mood changes of 180 ASMR-capable and incapable individuals were analysed using questionnaires after altering the affective interpretation associated with auditory ASMR (tapping) with visual priming to examine whether the primed emotion (fearful, relaxing, or neutral) could be amplified.

Results

It was found that an ASMR response occurred in all priming conditions, including the fear priming group. No significant difference was found in the emotional outcome or mood of the neutral and relaxing priming groups. Upon comparison with ASMR-incapable individuals, both the relaxing and neutral priming groups demonstrated the same affect, but greater potent for ASMR-capable. Individuals who appraised ASMR after visual fear priming demonstrated a significant decrease in positive emotional valence and increased arousal.

Conclusion

The findings suggest that ASMR occurs in both positive and negative emotional situations, suppressing contentment induction if ASMR stimuli are interpreted negatively and amplifying contentment when interpreted positively. While more research is needed, the results highlight that ASMR and frisson might describe the same phenomenon, both a physically felt signature of emotion. Therapeutic usage of ASMR should carefully select appropriate stimuli that emphasise contentment to avoid potential health risks associated with negative emotions until a further understanding of ASMR's affective parameters has been established.

The effects of yoga and progressive muscle relaxation exercises on premenstrual syndrome: a randomized controlled trial

In this study, university students with premenstrual syndrome (PMS) were evaluated for their responses to the practices of yoga and progressive muscle relaxation (PMR) to combat PMS, and the depression, anxiety, and stress associated with it. A total of 68 students participated in a randomized controlled trial. They were divided into four parallel groups: a yoga intervention group (n = 17), a PMR intervention group (n = 17), a yoga and PMR intervention group (n = 17), and a control group (n = 17). Data were collected between April 2022 and June 2022, from students who practiced only yoga, who practiced only PMR, and who practiced both yoga and PMR. A Personal Information Form, the PMS Scale, and the Depression, Anxiety, and Stress Scale were used as measurement tools. The yoga and yoga + PMR groups had lower scores for the PMS Scale in the posttest than the other groups (p < .05). Depression, anxiety, and stress sub-dimension mean scores were lower in the yoga, PMR + yoga, and PMR groups compared to the control group (p < .05). The results suggest that yoga and PMR interventions are beneficial non-pharmacological treatments for PMS, depression, anxiety, and stress.Clinical Registration Name, Registration Number, Registration Date: The Effects of Yoga and Progressive Muscle Relaxation Exercises on Premenstrual Syndrome, NCT05396976, April 5, 2022.

The effects of biological crowders on fibrillization, structure, diffusion, and conformational dynamics of α-synuclein

α-synuclein is an intrinsically disordered protein (IDP) whose aggregation in presynaptic neuronal cells is a pathological hallmark of Lewy body formation and Parkinson's disease. This aggregation process is likely affected by the crowded macromolecular cellular environment. In this study, α-synuclein was studied in the presence of both a synthetic crowder, Ficoll70, and a biological crowder composed of lysed cells that better mimics the biocomplexity of the cellular environment. 15 N-1 H HSQC NMR results show similar α-synuclein chemical shifts in non-crowded and all crowded conditions implying that it remains similarly unstructured in all conditions. Nevertheless, both HSQC NMR and fluorescence measurements indicate that, only in the cell lysate, α-synuclein forms aggregates over a timescale of 48 h. 15 N-edited diffusion measurements indicate that all crowders slow down the α-synuclein's diffusivity. Interestingly, at high concentrations, α-synuclein diffuses faster in cell lysate than in Ficoll70, possibly due to additional soft (e.g., electrostatic or hydrophobic) interactions. 15 N-edited relaxation measurements show that some residues are more mobile in cell lysate than in Ficoll70; the rates that are most different are predominantly in hydrophobic residues. We thus examined cell lysates with reduced hydrophobicity and found slower dynamics (higher relaxation rates) in several α-synuclein residues. Taken together, these experiments suggest that while cell lysate does not substantially affect α-synuclein structure (HSQC spectra), it does affect chain dynamics and translational diffusion, and strongly affects aggregation over a timescale of days, in a manner that is different from either no crowder or an artificial crowder: soft hydrophobic interactions are implicated.

BitterDB database analysis plus cell stiffness screening identify flufenamic acid as the most potent TAS2R14-based relaxant of airway smooth muscle cells for therapeutic bronchodilation

Rationale: Bitter taste receptors (TAS2Rs) are abundantly expressed in airway smooth muscle cells (ASMCs), which have been recognized as promising targets for bitter agonists to initiate relaxation and thereby prevent excessive airway constriction as the main characteristic of asthma. However, due to the current lack of tested safe and potent agonists functioning at low effective concentrations, there has been no clinically approved TAS2R-based drug for bronchodilation in asthma therapy. This study thus aimed at exploring TAS2R agonists with bronchodilator potential by BitterDB database analysis and cell stiffness screening. Methods: Bitter compounds in the BitterDB database were retrieved and analyzed for their working subtype of TAS2R and effective concentration. Compounds activating TAS2R5, 10, and 14 at < 100 μM effective concentration were identified and subsequently screened by cell stiffness assay using optical magnetic twisting cytometry (OMTC) to identify the most potent to relax ASMCs. Then the compound identified was further characterized for efficacy on various aspects related to relaxation of ASMCs, incl. but not limited to traction force by Fourier transform traction force microscopy (FTTFM), [Ca2+]i signaling by Fluo-4/AM intensity, cell migration by scratch wound healing, mRNA expression by qPCR, and protein expressing by ELISA. The compound identified was also compared to conventional β-agonist (isoproterenol and salbutamol) for efficacy in reducing cell stiffness of cultured ASMCs and airway resistance of ovalbumin-treated mice. Results: BitterDB analysis found 18 compounds activating TAS2R5, 10, and 14 at < 100 μM effective concentration. Cell stiffness screening of these compounds eventually identified flufenamic acid (FFA) as the most potent compound to rapidly reduce cell stiffness at 1 μM. The efficacy of FFA to relax ASMCs in vitro and abrogate airway resistance in vivo was equivalent to that of conventional β-agonists. The FFA-induced effect on ASMCs was mediated by TAS2R14 activation, endoplasmic reticulum Ca2+ release, and large-conductance Ca2+-activated K+ (BKCa) channel opening. FFA also attenuated lipopolysaccharide-induced inflammatory response in cultured ASMCs. Conclusions: FFA as a potent TAS2R14 agonist to relax ASMCs while suppressing cytokine release might be a favorite drug agent for further development of TAS2R-based novel dual functional medication for bronchodilation and anti-inflammation in asthma therapy.

Direct observation of NMR transverse relaxation in nanopatterned clusters of iron oxide particles

PURPOSE

We aim to verify predictions showing T2 relaxation rate of nanoparticle clusters and its dependence on spacing, size, geometry, and pulse sequence.

METHODS

We performed a laboratory validation study using nanopatterned arrays of iron oxide nanoparticles to precisely control cluster geometry and image diverse samples using a 4.7T MRI scanner with a T2 -weighted fast spin-echo multislice sequence. We applied denoising and normalization to regions of interest and estimated relative R2 for each relevant nanoparticle array or nanocluster array. We determined significance using an unpaired two-tailed t-test or one-way analysis of variance and performed curve fitting.

RESULTS

We measured a density-dependent T2 effect (p = 8.9976 × 10-20 , one-way analysis of variance) and insignificant effect of cluster anisotropy (p = 0.5924, unpaired t-test) on T2 relaxation. We found negative quadratic relationships (-0.0045[log τD ]2 -0.0655[log τD ]-2.7800) for single nanoparticles of varying sizes and for clusters (-0.0045[log τD ]2 -0.0827[log τD ]-2.3249) for diffusional correlation time τD  = rp 2 /D. Clusters show positive quadratic relationships for large (3.8615 × 10-6 [dpp /rp ]2 -9.3853 × 10-5 [dpp /rp ]-2.0393) and exponential relationships for small (-2.0050[dpp /rp ]0.0010 ) clusters. Calculated R2 peak values also align well with in silico predictions (7.85 × 10-4  ms compared with 1.47 × 10-4 , 4.23 × 10-4 , and 5.02 × 10-4  ms for single iron oxide nanoparticles, 7.88 × 10-4  ms compared with 5.24 × 10-4  ms for nanoparticle clusters).

CONCLUSION

Our verification affirms longstanding in silico predictions and demonstrates aggregation-dependent behavior in agreement with previous Monte Carlo simulation studies.

Personalized Virtual Reality Compared With Guided Imagery for Enhancing the Impact of Progressive Muscle Relaxation Training: Pilot Randomized Controlled Trial

BACKGROUND

Empirical evidence has shown that virtual reality (VR) scenarios can increase the effects of relaxation techniques, reducing anxiety by enabling people to experience emotional conditions in more vivid settings.

OBJECTIVE

This pilot randomized controlled study aims to investigate whether the progressive muscle relaxation technique (PMRT) associated with a personalized scenario in VR promotes psychological well-being and facilitates the recall of relaxing images more than the standard complementary intervention that involves the integration of PMRT and guided imagery (GI).

METHODS

On the basis of a longitudinal, between-subject design, 72 university students were randomly exposed to one of two experimental conditions: (1) standard complementary procedure (PMRT and GI exposure) and (2) experimental procedure (PMRT and personalized VR exposure). Individuals were assessed by a therapist before and after 7 training sessions based on measures investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data were also collected.

RESULTS

Differences in changes between the 2 groups after the in vivo PMRT session conducted by the psychotherapist (T1) were statistically significant for state anxiety (F1,67=30.56; P<.001) and heart rate (F1,67=4.87; P=.01). Individuals in the VR group obtained lower scores both before (t67=-2.63; P=.01; Cohen d=0.91) and after (t67=-7.23; P<.001; Cohen d=2.45) the relaxation session when it was self-administered by participants (T2). A significant reduction in perceived state anxiety at T1 and T2 was observed for both groups (P<.001). After the VR experience, individuals reported feeling higher engagement in the experience than what was mentioned by participants in the GI group (F1,67=2.85; P=.03; ηp2=0.15), and they experienced the environment as more realistic (F1,67=4.38; P=.003; ηp2=0.21). No differences between groups regarding sense of presence were found (F1,67=1.99; P=.11; ηp2=0.11). Individuals exposed before to the VR scenario (T1) referred to perceiving the scenario recalled in-imagination at T2 as more realistic than what those in the GI group experienced (F1,67=3.21; P=.02; ηp2=0.12). The VR group had lower trait anxiety levels than the GI group after the relaxation session during session 7 (T2; t67=-2.43; P=.02).

CONCLUSIONS

Personalized relaxing VR scenarios can contribute to improving relaxation and decreasing anxiety when integrated with PMRT as a complementary relaxation method.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05478941; https://classic.clinicaltrials.gov/ct2/show/NCT05478941.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/44183.

Development and Evaluation of a Smartphone-Based Chatbot Coach to Facilitate a Balanced Lifestyle in Individuals With Headaches (BalanceUP App): Randomized Controlled Trial

BACKGROUND

Primary headaches, including migraine and tension-type headaches, are widespread and have a social, physical, mental, and economic impact. Among the key components of treatment are behavior interventions such as lifestyle modification. Scalable conversational agents (CAs) have the potential to deliver behavior interventions at a low threshold. To our knowledge, there is no evidence of behavioral interventions delivered by CAs for the treatment of headaches.

OBJECTIVE

This study has 2 aims. The first aim was to develop and test a smartphone-based coaching intervention (BalanceUP) for people experiencing frequent headaches, delivered by a CA and designed to improve mental well-being using various behavior change techniques. The second aim was to evaluate the effectiveness of BalanceUP by comparing the intervention and waitlist control groups and assess the engagement and acceptance of participants using BalanceUP.

METHODS

In an unblinded randomized controlled trial, adults with frequent headaches were recruited on the web and in collaboration with experts and allocated to either a CA intervention (BalanceUP) or a control condition. The effects of the treatment on changes in the primary outcome of the study, that is, mental well-being (as measured by the Patient Health Questionnaire Anxiety and Depression Scale), and secondary outcomes (eg, psychosomatic symptoms, stress, headache-related self-efficacy, intention to change behavior, presenteeism and absenteeism, and pain coping) were analyzed using linear mixed models and Cohen d. Primary and secondary outcomes were self-assessed before and after the intervention, and acceptance was assessed after the intervention. Engagement was measured during the intervention using self-reports and usage data.

RESULTS

A total of 198 participants (mean age 38.7, SD 12.14 y; n=172, 86.9% women) participated in the study (intervention group: n=110; waitlist control group: n=88). After the intervention, the intention-to-treat analysis revealed evidence for improved well-being (treatment: β estimate=-3.28, 95% CI -5.07 to -1.48) with moderate between-group effects (Cohen d=-0.66, 95% CI -0.99 to -0.33) in favor of the intervention group. We also found evidence of reduced somatic symptoms, perceived stress, and absenteeism and presenteeism, as well as improved headache management self-efficacy, application of behavior change techniques, and pain coping skills, with effects ranging from medium to large (Cohen d=0.43-1.05). Overall, 64.8% (118/182) of the participants used coaching as intended by engaging throughout the coaching and completing the outro.

CONCLUSIONS

BalanceUP was well accepted, and the results suggest that coaching delivered by a CA can be effective in reducing the burden of people who experience headaches by improving their well-being.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00017422; https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00017422.

Glycan Shape, Motions, and Interactions Explored by NMR Spectroscopy

Glycans in the form of oligosaccharides, polysaccharides, and glycoconjugates are ubiquitous in nature, and their structures range from linear assemblies to highly branched and decorated constructs. Solution state NMR spectroscopy facilitates elucidation of preferred conformations and shapes of the saccharides, motions, and dynamic aspects related to processes over time as well as the study of transient interactions with proteins. Identification of intermolecular networks at the atomic level of detail in recognition events by carbohydrate-binding proteins known as lectins, unraveling interactions with antibodies, and revealing substrate scope and action of glycosyl transferases employed for synthesis of oligo- and polysaccharides may efficiently be analyzed by NMR spectroscopy. By utilizing NMR active nuclei present in glycans and derivatives thereof, including isotopically enriched compounds, highly detailed information can be obtained by the experiments. Subsequent analysis may be aided by quantum chemical calculations of NMR parameters, machine learning-based methodologies and artificial intelligence. Interpretation of the results from NMR experiments can be complemented by extensive molecular dynamics simulations to obtain three-dimensional dynamic models, thereby clarifying molecular recognition processes involving the glycans.

The Domain and Structural Characteristics of Ferroelectric Copolymers Based on Vinylidene Fluoride Copolymer with Tetrafluoroethylene Composition (94/6)

This paper presents data on the macroscopic polarization of copolymer films of vinylidene fluoride with tetrafluoroethylene obtained with a modified apparatus assembled according to the Sawyer-Tower Circuit. The kinetics of the polarization process were analyzed taking into consideration the contributions of both bound and quasi-free (impurity) charges. It was shown that an "abnormal" decrease in conductivity was observed in fields near the coercive fields. This could be associated with the appearance of deep traps of the impurity charge carriers formed by the polar planes of β-phase crystals. The conductivity data obtained from the charge and current responses differed. It was concluded that chain segments contributing to polarization with sufficiently low fields were present in the amorphous phase. A comparison showed that the average size of β-phase crystals (crystals of X-ray diffraction reflection width) was almost one order of magnitude lower than the domain size obtained using piezoresponse force microscopy (PFM). The analysis of the fast-stage dielectric response before and after polarization indicated that as the external polarizing field increased in the ferroelectric polymer chains, conformational transitions occurred according to the T3GT3G- → (-TT-)n и TGTG → (-TT-)n types. This was accompanied by an increase in the effective dipole moment in the amorphous phase chains. The analysis of the IR spectroscopy data obtained in transmission and ATR modes revealed a difference in the conformational states of the chains in the core and surface parts of the film.

Post-synthesis Oxidation of Superparamagnetic Iron Oxide Nanoparticles to Enhance Magnetic Particle Imaging Performance

This study investigates the impact of post-synthesis oxidation on the performance of superparamagnetic iron oxide nanoparticles (SPIONs) in magnetic particle imaging (MPI), an emerging technology with applications in diagnostic imaging and theranostics. SPIONs synthesized from iron oleate were subjected to a post-synthesis oxidation treatment with a 1% Oxygen in Argon mixture. MPI performance, gauged via signal intensity and resolution using a MOMENTUM™ scanner, was correlated to the nanoparticles' physical and magnetic properties. Post-synthesis oxidation did not alter physical attributes like size and shape, but significantly enhanced magnetic properties. Saturation magnetization increased from 52% to 93% of the bulk value for magnetite, leading to better MPI performance in terms of signal intensity and resolution. However, the observed MPI performance did not fully align with predictions based on the ideal Langevin model, indicating the need for considering factors like relaxation and shape anisotropy. The findings underscore the potential of post-synthesis oxidation as a method to fine-tune magnetic properties of SPIONs and improve MPI performance, and the need for reproducible synthesis methods that afford finely tuned control of nanoparticle size, shape, and magnetic properties.

Differential Effects of Classical vs. Sports Massage on Erector Spinae and Upper Trapezius Muscle Stiffness: A Shear-Wave Elastography Study in Young Women

Classical and sports massages are commonly used interventions, but their comparative effects on muscle stiffness remain unclear. Classical massage is more general and uses light to moderate pressure, and its main purpose is relaxation. Sports massage, on the other hand, is more specialized and targets the unique needs of massaged individuals using moderate to firm pressure. This study aimed to evaluate the impacts of classical and sports massages on the stiffness of the erector spinae (ES) and upper trapezius (UT) muscles. Fifteen recreationally active young women, aged 22.9 ± 1.2 years, underwent a randomized cross-over study (with three conditions). Participants received either a five-minute classical or sports massage or a passive rest as a control on distinct days. Muscle stiffness was assessed using shear-wave elastography. The ES shear modulus displayed a significant time effect (p < 0.001; η2 = 0.515) without noticeable differences between the conditions, and the time × massage-type interactions approached statistical significance (F = 2.014; p = 0.073). There was also a large and statistically significant effect of the time on the UT (F = 11.127; p < 0.001; η2 = 0.443). We could not prove that classical and sports massages reduced muscle stiffness. The absence of significant differences might be attributed to the specific intervention parameters (massage duration of 5 min) and the small, only young women sample size. Given some tendencies towards significant effects, larger sample sizes are needed to further investigate this research question.

Fracture and relaxation in dense cornstarch suspensions

Dense suspensions exhibit the remarkable ability to switch dynamically and reversibly from a fluid-like to a solid-like, shear-jammed (SJ) state. Here, we show how this transition has important implications for the propensity for forming fractures. We inject air into bulk dense cornstarch suspensions and visualize the air invasion into the opaque material using time-resolved X-ray radiography. For suspensions with cornstarch mass fractions high enough to exhibit discontinuous shear thickening and shear jamming, we show that air injection leads to fractures in the material. For high mass fractions, these fractures grow quasistatically as rough cavities with fractured interfaces. For lower mass fractions, remarkably, the fractures can relax to smooth bubbles that then rise under buoyancy. We show that the onset of the relaxation occurs as the shear rate induced by the air cavity growth decreases below the critical shear rate denoting the onset of discontinuous shear thickening, which reveals a structural signature of the SJ state.

Patterned Sensory Enhancement, a Music Rehabilitation Therapy for Elderly Patients with Neuromotor Deficit during the COVID-19 Pandemic: A Pilot Study

(1) Background: The Patterned Sensory Enhancement (PSE) technique refers to a music-based rehabilitation therapy strategy used in neurological pathologies. (2) Methods: This study aims at developing a music-drill protocol for recovery in elderly patients with neuromuscular degenerative pathologies. Each music drill is based on a number of specific music-composition parameters. The conclusions represent suggestions for further enhancing the PSE technique through collaborations between the rehabilitation team and the musicians involved due to the importance of the music stimuli used as a therapy. (3) Results: The music-composition parameters used in this study relate to the existence of music homogeneity factors such as the key signature and rhythm; the importance of the major scale and the tonal system in general; the obvious music suggestions of movement, repetition or absence of movement; the importance of rhythm; the introduction of musical instruments in order to harmonize the music material as much as possible; the connection between PSE music along with patients' musical taste and the musical recording as a therapy during patient outcare; (4) Conclusions: The therapy efficiency was observed by measurements taken before and after the therapeutic intervention by means of a Takei dynamometer. The present study asserts that for a patient undergoing the PSE technique, the researcher should compose personalized music material adapted to each patient's peculiarities.

Unveiling Carrier Relaxation Mechanism in Protonated/Deprotonated Carbon Dots and Their Solvent Effects via Ultrafast Spectroscopy

The intricate nature of the surface structure of carbon dots (CDs) hinders a comprehensive understanding of their emission behavior. In this study, we employ two types of CDs created through acid-alkali treatments, one with surface protonation and the other with surface deprotonation, with the objective of investigating the impact of these surface modifications on carrier behavior using ultrafast spectroscopy techniques. TEM, XRD, FTIR and Raman spectra demonstrate the CDs' structure, featuring graphitic core and abundant surface functional groups. XPS confirms the successful surface modifications of CDs via protonation and deprotonation. Ultrafast transient absorption (TA) spectroscopy reveals that deprotonation modification may decelerate the relaxation process, thereby increasing the visible PL quantum yields (PLQY). Conversely, protonation may accelerate the relaxation process due to the induced low-energy absorption band, resulting in self-absorption and reduced PLQY. Furthermore, TA analysis of CDs in mixed solvents with different proportions of ethanol shows the beneficial effect of ethanol in decelerating the relaxation process, leading to an increased PLQY of 33.7 % for deprotonated CDs and 22.1 % for protonated CDs. This study illuminates the intricate relationship between surface deprotonation/protonation modifications and carrier behavior in CDs, offering a potential avenue for the design of high-brightness CDs for diverse applications.

Weak elastic energy of irregular curves

A weak notion of elastic energy for (not necessarily regular) rectifiable curves in any space dimension is proposed. Our [Formula: see text]-energy is defined through a relaxation process, where a suitable [Formula: see text]-rotation of inscribed polygons is adopted. The discrete [Formula: see text]-rotation we choose has a geometric flavour: a polygon is viewed as an approximation to a smooth curve, and hence its discrete curvature is spread out into a smooth density. For any exponent [Formula: see text] greater than 1, the [Formula: see text]-energy is finite if and only if the arc-length parametrization of the curve has a second-order summability with the same growth exponent. In that case, moreover, the energy agrees with the natural extension of the integral of the [Formula: see text]th power of the scalar curvature. Finally, a comparison with other definitions of discrete curvature is provided. This article is part of the theme issue 'Foundational issues, analysis and geometry in continuum mechanics'.

Beam Effects on Atomic Dynamics in Metallic Glasses Studied With Electron Correlation Microscopy

Electron correlation microscopy (ECM) is used to investigate atomic dynamics in metallic glasses (MG) close to metastable equilibrium. It temporally correlates diffracted intensities of a time series of dark-field images to deduce a metric for structural decays. The measurement parameters, such as time and temperature, must be chosen according to the material of interest. In this work, ECM was extended to measurements at room temperature. To ensure, or select, a time window with quasi-thermodynamic equilibrium/steady-state measurement conditions, two-time correlation functions of diffracted intensities were calculated. The dynamics at room temperature are partly driven by the electron beam, thus affecting the material and the results. A systematic analysis of the influence of the electron beam is presented, revealing an inverse relation between electron dose rate and intensity correlation decay times at 300 kV acceleration voltage. However, the underlying dynamical mechanisms, described by a stretching exponent, are found to be independent of the applied electron dose rate for a Pd40Ni40P20 MG. An extrapolation of the results to infinite long measurement times and zero dose rate agrees with X-ray photon correlation spectroscopy data and justifies the application of beam-driven ECM at room temperature to study the dynamics of disordered systems.

The Influence of Single-Walled Carbon Nanotubes on the Aging Performance of Polymer-Modified Binders

The use of polymer-modified binders in asphalt concrete makes it possible to increase the efficiency and durability of highways. However, at present, there is an important and unresolved problem in this area, making it impossible to fully exploit the potential of modified binders. This is a tendency of aging processes that leads to the premature destruction of the pavement. In many literary sources, it is reported that reasons are related to the peculiarity of the chemical composition and occur at the submicron level. Therefore, the influence of single-walled carbon nanotubes has been studied for a better understanding of aging processes. The aging processes of the RTFOT (rolling thin film oven test) and PAV (pressure aging vessel) modified with SBS (styrene-butadiene-styrene) polymer, single-walled carbon nanotubes, and waste industrial oil were simulated in a laboratory furnace. Microstructural features were studied using the method of infrared spectral analysis. The dependences of viscoelastic properties on the component composition of binders were investigated. The optimal content of single-walled carbon nanotubes (0.001%), SBS (styrene-butadiene-styrene) polymer (3.5%), and waste industrial oil (4%) in the binder composition was established, which synergistically improved the performance of the modified binder from PG (52-22) (performance grade) to PG (64-34). It was established that single-walled carbon nanotubes provide improvement in the durability parameter ∆Tc binder by 150%, improved relaxation properties at low temperatures, and resistance to fatigue damage.

The relaxation effect of autonomous sensory meridian response depends on personal preference

Background

Autonomous sensory meridian response (ASMR) is a sensory response such as tingling and pleasantness from audiovisual stimuli. ASMR videos come in a wide variety of types, and personal preferences are biased. There are many reports of the effects os ASMR on sleep onset, anxiety relief, and other relaxation effects. However, prior task-oriented studies have used ASMR videos provided by the experimenter. We hypothesized that ASMR movies of a personal preference would show significantly increased activity in the nucleus accumbens, frontal cortex, and insular cortex, which are brain areas associated with relaxation. Therefore, the purpose of this study was to elucidate the neuroscientific basis for the relaxation effects of ASMR videos that match someone's personal preferences.

Methods

This study included 30 healthy individuals aged ≥18 years. ASMR enthusiasts were included as the target population due to the need to have a clear preference for ASMR videos. A control video (1 type) and ASMR videos (20 types) were used as the stimulus tasks. Among the ASMR videos, those with high and low evaluation scores were considered liked and dislikedASMR videos, respectively. Functional magnetic resonance imaging was performed while the participants viewed a block design with a resting task in between. The data were analyzed using Statistical Parametric Mapping 12 to identify the areas activated by control, disliked, and liked ASMR videos.

Results

Emotion-related areas (the amygdala, frontal cortex, and insular cortex) not activated by control and unliked ASMR videos were activated only by liked ASMR videos.

Conclusion

The amygdala, frontal cortex, and insular cortex may be involved in the limbic dopamine circuits of the amygdala and middle frontal gyrus and the autonomic balance of the left and right insular cortices. This suggests the potential of positive mood and its use as a treatment for patients with anxiety and depression. These results suggest that the use of ASMR videos to match individual preferences may induce relaxation and have beneficial effects on depression and other disorders, and also support the introduction of ASMR videos in mental health care.

Investigating the Cardiovascular Benefits of Dapagliflozin: Vasodilatory Effect on Isolated Rat Coronary Arteries

Dapagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, is an antidiabetic medication that reduces blood glucose. Although it is well known that dapagliflozin has additional benefits beyond glycemic control, such as reducing blood pressure and lowering the risk of cardiovascular events, no sufficient research data are available on the direct effect of dapagliflozin on cardiovascular function. Thus, in this study, we investigated the direct vascular effect of dapagliflozin on isolated rat coronary arteries. The left descending coronary arteries of 13-week-old male Sprague Dawley rats were cut into segments 2-3 mm long and mounted in a multi-wire myography system to measure isometric tension. Dapagliflozin effectively reduced blood vessel constriction induced by U-46619 (500 nM) in coronary arteries regardless of the endothelium. Treatment with an eNOS inhibitor (L-NNA, 100 μM), sGC inhibitor (ODQ, 5 μM), or COX inhibitor (indomethacin, 3 μM) did not affect the vasodilation induced by dapagliflozin. The application of a Ca2+-activated K+ channel (KCa) blocker (TEA, 2 mM), voltage-dependent K+ channel (KV) blocker (4-AP, 2 mM), ATP-sensitive K+ channel blocker (KATP) glibenclamide (3 μM), and inward-rectifier K+ channel (KIR) blocker (BaCl2, 30 μM) did not affect the dapagliflozin-induced vasodilation either. The treatment with dapagliflozin decreased contractile responses induced by the addition of Ca2+, which suggested that the extracellular Ca2+ influx was inhibited by dapagliflozin. Treatment with dapagliflozin decreased the phosphorylation level of the 20 kDa myosin light chain (MLC20) in vascular smooth muscle cells. In the present study, we found that dapagliflozin has a significant vasodilatory effect on rat coronary arteries. Our findings suggest a novel pharmacologic approach for the treatment of cardiovascular diseases in diabetic patients through the modulation of Ca2+ homeostasis via dapagliflozin administration.

Differences in Relaxation and Imagery among NCAA Division I Sport Types

Athletes use psychological skills such as imagery and relaxation to decrease stress, cope with competitive anxiety, and achieve an optimal state of arousal. There is conflicting literature on how team and individual sport athletes use these skills, with some saying that individual sport athletes have better capabilities and others saying team sport athletes use imagery more frequently. The current study analyzed sport type differences in the use of relaxation and performance imagery among NCAA Division I (DI) athletes. This study included 117 NCAA DI athletes, including team sport (n = 72) and individual sport (n = 45). Participants completed a modified version of The Deliberate Relaxation for Sport Survey through Qualtrics. Results indicated there is a statistically significant difference in the type of relaxation technique used based on the individual's sport type. Team sport athletes used muscle relaxation (p = 0.034), eastern relaxation (p = 0.014), and stretching (p = 0.020) more frequently than individual sport athletes. Additionally, individual sport athletes used performance imagery more often for mental focus than team sport athletes (p = 0.012). There were no differences between sport types in the level of deliberate practice of relaxation and performance imagery. Athletes used a variety of methods to learn both imagery and relaxation skills and have been using these for an average of four years. The majority of participants (n = 67) did not work with a sport psychology professional, but their school has one. This study supports the use of individualized intervention programs to help athletes use relaxation and imagery in the most effective ways for their performances.

The effectiveness of pretreatment video-based psychoeducation for patients with breast cancer

OBJECTIVES

This study confirms the effectiveness of pretreatment video-based psychoeducation on stress management and relaxation in reducing depression, anxiety, and uncertainty among patients with breast cancer.

METHODS

We conducted a nonrandomized trial with 86 pretreatment patients with breast cancer who were divided equally into intervention and control groups, and stratified according to cancer stages and patient ages. Omitting the excluded participants, 35 intervention group and 36 control group participants were asked to complete the Hospital Anxiety and Depression Scale and Universal Uncertainty in Illness Scale (UUIS) before the psychoeducational intervention (baseline, hereafter "BL ") as well as 1 and 3 months later. Then, a 2 group (intervention and control groups) × 3 time points (BL and 1 and 3 months post-intervention) mixed models repeated measures (MMRM) analysis was implemented.

RESULTS

Analysis confirmed interaction between 2 group × 3 time points for depression, anxiety, and UUIS. Multiple comparisons revealed that each score in the intervention group was significantly lower 1 and 3 months post-intervention compared to BL. Meanwhile, in the control group, the depression score was significantly higher at 3 months post-intervention compared to pre-intervention. The anxiety scores and UUIS of the same group were not significantly different between 1 and 3 months post-intervention. The effect size values 3 months post-intervention were -0.57 for depression, -0.25 for anxiety, and 0.05 for uncertainty.

SIGNIFICANCE OF RESULTS

Pretreatment psychoeducation reduced depression, anxiety, and uncertainty in the intervention group of patients with breast cancer compared to the control group. The effect sizes at 3 months post-intervention were moderate for depression and small for anxiety. These results suggest the effectiveness of psychoeducation for patients with breast cancer, using videos on stress management and relaxation, early at the pretreatment stage.

Spending time in the forest or the field: qualitative semi-structured interviews in a randomized controlled cross-over trial with highly sensitive persons

Introduction

The effects of spending time in forests have been subject to investigations in various countries around the world. Qualitative comparisons have been rarely done so far.

Methods

Sixteen healthy highly sensitive persons (SV12 score ≥ 18) aged between 18 and 70 years were randomly assigned to groups spending 1 h in the forest and in the field at intervals of one week. Semi-structured interviews were conducted after each intervention and analyzed using a mixed-methods approach of content analysis and grounded theory.

Results

Both natural environments induced feelings of inner calmness, inner cleansing, joy, freedom, connectedness, strengthening qualities, and heightened body awareness. The forest environment additionally offered emotional shelter, and showed advantages in promoting inner strength and self-concentration.

Discussion

People with previous negative experiences in the forest may feel safer in fields because of the wider view and better overview. Important preconditions are enough time and the absence of a judgmental authority. The two environments induced in part different but also similar emotions which might be useful to promote psychological well-being differentially.

The Effects of Mindfulness on Lactation: An Integrative Review

Background: It is well-known that stress and high levels of cortisol can negatively impact lactation outcomes. Mindfulness techniques are also known to be effective at reducing stress, and there has been some research into the effects of these techniques on breastfeeding. However, there has not yet been an integrative review examining the outcomes of the research carried out on this subject in the past 10 years. Objectives: The objective of this integrative review was to assess the effect of mindfulness techniques on lactation. This includes the effects on maternal stress, both perceived and physiologic, milk composition and volume, as well as the effects on the infants. Methods: The electronic databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Scopus, and Cochrane were searched using the key terms "meditate, meditation, relaxation or mindfulness" and "breastfeeding or lactation." Results: Nine articles met the inclusion criteria. Six key themes were identified. Mindfulness techniques reduce perceived and physiologic maternal stress and increase infant growth, particularly in the late preterm early term infant population. Infant behavior was also impacted by maternal mindfulness techniques as well as maternal milk volume, expression, and breastfeeding/pumping frequency. However, the effectiveness of mindfulness techniques is dose dependent. Conclusions: Mindfulness techniques are a simple and practical tool for postpartum breastfeeding people that have the potential to improve both lactation and infant outcomes.

Guided imagery for anxiety disorder: Therapeutic efficacy and changes in quality of life

Background

Patients with anxiety disorder were showing severity of anxiety symptoms as well as poor quality of life. Guided imagery (GI) provides immediate relaxation, and improves the severity of anxiety symptoms and the quality of life of patients with anxiety disorder. Anxiety is a basic emotion that is required as a motivation for everyday work of life. Anxiety presents a complex cognitive, affective, physiological, and behavioral response that is related to future harm (real or perceived).

Aim

To study the efficacy of GI intervention on patients with anxiety disorder and their quality of life.

Materials and Methods

This longitudinal, interventional study was done in a state institute of mental health, psychiatric unit on 20 patients (outpatients) with anxiety disorder, diagnosed according to diagnostic criteria of research ICD-10 DCR. Patients were assessed using a sociodemographic and clinical data sheet, Hamilton anxiety scale, and World Health Organization QOL instrument, short-form (WHOQOL-BREF), Hindi version.

Results

Patients with anxiety disorder in the experimental group improved as compared with the control group significantly. The mean QOL-BREF score was also improved after intervention in the intervention group.

Conclusion

GI intervention helps reduce the severity of anxiety symptoms and improve the quality of life in patients with anxiety disorder.

Assessment of In Vitro Airway Smooth Muscle Relaxant Activity of Rhus coriaria L. Fruit Ethanolic Extract and Its Possible Mechanisms

Rhus coriaria L. (Anacardiaceae), also known as Sumac, is commonly used as a spice, flavoring agent, and as a traditional medicinal herb. This includes also the traditional use for treating asthma, catarrh, and common colds. The accumulating evidence supports its cardioprotective, antidiabetic, neuroprotective, anticancer, gastroprotective, antibacterial, anti-inflammatory, antiviral, antioxidant, and respiratory effects. However, there are no previous studies that have shown its effects and mechanism in the airway smooth muscle tone, and therefore, the aim of our study was to investigate the in vitro pharmacological action of R. coriaria L. extract (RCE) on the rat isolated tracheal and bronchial preparations by exploring its relaxant activity and mechanism of action. The direct relaxant effect of RCE (0.1-0.7 mg/mL) was tested in the rat bronchi and trachea rings precontracted by carbachol (CCh). In addition, the pretreatment with RCE (1 mg/mL) was tested on the bronchial and tracheal reactivity induced by CCh, potassium chloride (KCl), or CaCl2. In addition, the cyclooxygenase inhibitor indomethacin and the nitric oxide synthase inhibitor N(G)-nitro-l-arginine methyl ester (L-NAME), respectively, were used for exploring the mechanisms of RCE-induced relaxation and reduction of reactivity. Our findings demonstrated that RCE induced a concentration-dependent relaxation and a significant reduction of reactivity, significantly reduced with either indomethacin or L-NAME. In addition, RCE decreased the responsiveness to KCl and affected the extracellular Ca2+-induced contraction in the tissues with added CCh or KCl in Ca2+-free Krebs-Henseleit solution. In summary, we have shown that RCE displayed relaxant activities in the in vitro airway smooth muscles, and the possible mechanisms seems to involve the prostaglandin, nitric oxide, and Ca2+ pathways. Taken together, our findings indicate the potential role of RCE in the treatment of respiratory diseases with limited airflow, or obstructive respiratory diseases, and could justify its traditional use in the respiratory diseases.

The effect of relaxation education intervention on stress, anxiety, and depression in female teachers during the COVID-19 pandemic

BACKGROUND

The high levels of job stress, anxiety, and depression among teachers, which affect their job and quality of life, necessitate using methods to cope with these issues. The present study aimed to determine the effect of relaxation education intervention on stress, anxiety, and depression in female teachers in 2020.

MATERIALS AND METHODS

This research is semi-experimental. Herein, 100 female teachers were studied. Data collection was performed using the Depression, Anxiety, and Stress Scale-42 items (DASS-42) questionnaire that was completed three times by the teachers: before the intervention, 10 days after the intervention, and 1 month following it. Relaxation education intervention was conducted online and offline based on the bioenergy economy model and by doing psychosomatic exercises. The data obtained from the questionnaire were analyzed by the independent t-test, paired t-test, and R. M. analysis of variance (ANOVA).

RESULTS

Before the intervention, there was no significant difference between the intervention and control groups in terms of stress (P = 0.385), anxiety (P = 0.168), and depression (P = 0.554) scores. The mean scores of stress, anxiety, and depression decreased significantly in the intervention group 10 days after the intervention; however, there was no significant change in the control group. The reduction in depression, stress, and anxiety remained constant in the intervention group during the 1-month follow-up. The results indicated that among the relaxation exercises, diaphragmatic breathing and meditation techniques were performed by the teachers for a longer period than other techniques.

CONCLUSION

Results obtained suggested teaching short-term relaxation techniques as highly recommended to all school teachers. These techniques include diaphragmatic breathing and meditation. They can reduce their stress, anxiety, and depression, improve their mental health, and empower them to control their tensions and negative emotions.

Acceptability, feasibility, and user satisfaction of a virtual reality relaxation intervention in a psychiatric outpatient setting during the COVID-19 pandemic

Background

The COVID-19 pandemic was particularly difficult for individuals with mental disorders. Due to governmental restrictions, face-to-face offers for psychiatric outpatients like therapies, psychoeducational groups or relaxation courses were limited. Virtual reality (VR) might be a new possibility to support these patients by providing them with a home-based relaxation tool.

Objective

The aim of this study was to evaluate the acceptability, feasibility, and user satisfaction of a supportive therapy-accompanying, relaxation VR intervention in psychiatric outpatients during the COVID-19 pandemic in Germany.

Methods

The four-weeks VR intervention consisted of regular watching of relaxing videos in the participants' home environment. Sociodemographics, feasibility (frequency of use, user-friendliness), satisfaction (Client Satisfaction Questionnaire-8), depressive symptoms (Patient Health Questionnaire-9), quality of life (abbreviated World Health Organization Quality of Life assessment), and credibility and expectancy (Credibility Expectancy Questionnaire-8) were measured in an intention-to-treat (ITT) analysis and a per-protocol (PP) analysis of completers.

Results

In total, N = 40 patients participated in the study. Most of the participants in the ITT analysis (n = 30, 75.0%) used the VR device three or 4 weeks. A majority of the N = 29 completers (PP: n = 18, 62.1%) used it all 4 weeks. Most participants used the device two or more times a week (ITT: n = 30, 83.3%; PP: n = 26, 89.7%) and described the user-friendliness as rather or very easy (ITT: n = 33, 91.7%; PP: n = 26, 89.7%). User satisfaction was high (ITT: 19.42, SD = 4.08; PP: M = 20.00, SD = 4.19) and did not correlate with participants' sex or age (all p < 0.05). Depressive symptoms and psychological quality of life improved significantly from pre-to post-intervention (ITT and PP, all p < 0.05). Higher pre-intervention credibility significantly correlated with a better outcome of satisfaction (ITT and PP), depressive symptoms, physical, psychological, and social quality of life (PP; all p < 0.05).

Conclusion

A supportive therapy-accompanying VR relaxation intervention is feasible and acceptable in a psychiatric outpatient setting. Due to the high satisfaction and user-friendliness, VR can be an easy to implement relaxation tool to support psychiatric outpatients.

Clinical trial registration

https://clinicaltrials.gov/, DRKS00027911.

How is music listening purpose related to stress recovery? - two preliminary studies in men and women

Introduction

Studies have suggested that listening to music can reduce psychological and biological responses to a stressor. However, it is unclear whether music has the same effect on stress recovery. According to field studies, people commonly use music in daily life for the specific purpose of relaxation. We explored whether individuals who generally use music for relaxation purposes show improved recovery from an acute stressor.

Methods

In two independent studies, twenty-seven healthy female participants (Mage = 24.07) (Study 1) and twenty-one healthy male participants (Mage = 23.52) (Study 2) were separated into two groups based on their frequency of using music for relaxation purposes (low vs. high). All participants underwent a lab-based psychosocial stress test. Subjective stress levels were measured using visual analogue scales. Salivary cortisol and salivary alpha-amylase were measured to assess endocrine and autonomic stress responses, respectively. Subjective stress levels and saliva samples were measured nine times throughout the stress induction and recovery procedure. Chronic stress levels were assessed using the Perceived Stress Scale and the Screening Scale of Chronic Stress.

Results

No significant differences were observed in subjective stress levels, salivary alpha-amylase activity, or cortisol concentration between the two groups in either of the two studies. Further analyses revealed that among male participants, increased use of music for relaxation purposes was related to more chronic stress levels (t (10.46) = 2.45, p = 0.03, r = 0.60), whereas female participants exhibited a trend in the opposite direction (t (13.94) = -1.92, p = 0.07, r = 0.46).

Discussion

Contrary to our expectations, the results indicate that habitual music listening for relaxation purposes is not associated with improved recovery from a stressor. However, due to the small sample size, future exploration is necessary to enhance the statistical power of the results of the study.

Development of temporal series 4D-STEM and application to relaxation time measurement

Diffraction patterns contain useful information about the materials. Recent developments in four-dimensional scanning transmission electron microscopy and the acquisition of the spatial distribution of diffraction patterns have produced significant results. The acquisition of a temporal series of diffractions is achieved for a stationary beam. However, the acquisition of spatiotemporal distribution of diffraction patterns has only been established under limited conditions. In this study, we developed a simple method that enables the recording of the spatiotemporal distribution of diffraction patterns and applied it to the relaxation time measurement that is robust to sample drift.

Effects of immersive virtual reality on sensory overload in a random sample of critically ill patients

Background

Sensory overload and sensory deprivation have both been associated with negative health outcomes in critically ill patients. While there is a lack of any clear treatment or prevention strategies, immersive virtual reality is a promising tool for addressing such problems, but which has not been repetitively tested in random samples. Therefore, this study aimed to determine how critically ill patients react to repeated sessions of immersive virtual reality.

Methods

This exploratory study was conducted in the mixed medical-surgical intermediate care unit of the University Hospital of Bern (Inselspital). Participants (N = 45; 20 women, 25 men; age = 57.73 ± 15.92 years) received two immersive virtual reality sessions via a head-mounted display and noise-canceling headphones within 24 h during their stay in the unit. Each session lasted 30-min and showed a 360-degree nature landscape. Physiological data were collected as part of the participants' standard care, while environmental awareness, cybersickness, and general acceptance were assessed using a questionnaire designed by our team (1 = not at all, 10 = extremely).

Results

During both virtual reality sessions, there was a significant negative linear relationship found between the heart rate and stimulation duration [first session: r(43) = -0.78, p < 0.001; second session: r(38) = -0.81, p < 0.001] and between the blood pressure and stimulation duration [first session: r(39) = -0.78, p < 0.001; second session: r(30) = -0.78, p < 0.001]. The participants had a high comfort score [median (interquartile range {IQR}) = 8 (7, 10); mean = 8.06 ± 2.31], did not report being unwell [median (IQR) = 1 (1, 1); mean = 1.11 ± 0.62], and were not aware of their real-world surroundings [median (IQR) = 1 (1, 5); mean = 2.99 ± 3.22].

Conclusion

The subjectively reported decrease in environmental awareness as well as the decrease in the heart rate and blood pressure over time highlights the ability of immersive virtual reality to help critically ill patients overcome sensory overload and sensory deprivation. Immersive virtual reality can successfully and repetitively be provided to a randomly selected sample of critically ill patients over a prolonged duration.

A Group Intervention Combining Self-Hypnosis and Self-Care in Oncology: Implementation in Daily Life and Perceived Usefulness

Multicomponent mind-body interventions are increasingly studied in oncology to improve patients' quality of life (QOL). However, the respective usefulness of each of their components or their long-term use by the participants are rarely assessed. In this study, 95 women with different cancer diagnoses participated in a self-hypnosis and self-care group. Different questionnaires were administrated before (T1), right after (T2), 3 to 4 months after (T3), and 1 year after (T4) the intervention. After the intervention, 97.5% of the participants regularly practiced any kind of relaxation (vs. 50% at baseline), especially hypnosis. The different components of the intervention (i.e., being in a group, hypnosis exercises during the sessions and at home, self-care tasks, and discussions during the group sessions) were all considered to be very useful (M = 6.91-7.75/10). One year after the intervention, the 10 most used techniques were mainly concrete activities to take care of oneself. This intervention seems very relevant for women who had cancer. Our results allow a first reflection about the mechanisms of action of our intervention.Registration: ClinicalTrials.gov (NCT03144154). Registered on the 1st of May 2017.

Soluble guanylate cyclase mediates the relaxation of healthy and inflamed bladder smooth muscle by aqueous nitric oxide

Introduction: Due to its chemical properties, functional responses to nitric oxide (NO) are often difficult to examine. In the present study, we established a method to produce NO in an aqueous solution and validated its capacity to evoke functional responses in isolated rat bladders. Furthermore, we compared the NO responses to the commonly used NO donor sodium nitroprusside (SNP). We also investigated the impact of ongoing inflammation on the involvement of soluble guanylate cyclase (sGC) dependent signaling in NO relaxation. Methods: A setup to produce an aqueous NO solution was established, allowing the production of an aqueous solution containing a calculated NO concentration of 2 mM. Sixty male Sprague-Dawley rats received either no treatment (controls) or cyclophosphamide (CYP; 100 mg*kg-1 i.p., 60 h prior to the experiment) to induce experimental cystitis. Bladder strip preparations were mounted in organ baths and studied at basal tension or pre-contracted with methacholine (3 μM). Aqueous NO solution (40-400 μL; 2 mM corresponding to 4-40 μM) or SNP (1-1,000 μM) was added cumulatively in increasing concentrations. Relaxation to aqueous NO was also studied in the presence of the sGC inhibitor ODQ (0.25-25 μM). The expression of sGC was investigated by immunohistochemical analysis. Results: The NO solution caused functional relaxations in both controls and inflamed bladder preparations. NO-induced relaxations were significantly greater in inflamed bladder strips at basal tension, whereas no differences were seen in methacholine pre-contracted strips. In the presence of the sGC inhibitor ODQ in a high concentration, the NO-evoked relaxations were abolished in both control and inflamed preparations. At a lower concentration of ODQ, only NO relaxations in inflamed preparations were attenuated. Immunohistochemical analysis showed that sGC was expressed in the detrusor and mucosa, with a significantly lower expression in the inflamed detrusor. Conclusion: In the present study, we found that aqueous NO solution induces relaxation of the rat detrusor by activating soluble guanylate cyclase in both control and inflamed bladder strips. Induction of inflammation conceivably leads to decreased sGC expression in the detrusor, which may explain the different susceptibility towards inhibition of sGC in inflamed versus control tissue. The use of an aqueous NO solution should be further considered as a valuable complement to the pharmacological tools currently used.

C-type natriuretic peptide induces inotropic and lusitropic effects in human 3D-engineered cardiac tissue: Implications for the regulation of cardiac function in humans

The role of C-type natriuretic peptide (CNP) in the regulation of cardiac function in humans remains to be established as previous investigations have been confined to animal model systems. Here, we used well-characterized engineered cardiac tissues (ECTs) generated from human stem cell-derived cardiomyocytes and fibroblasts to study the acute effects of CNP on contractility. Application of CNP elicited a positive inotropic response as evidenced by increases in maximum twitch amplitude, maximum contraction slope and maximum calcium amplitude. This inotropic response was accompanied by a positive lusitropic response as demonstrated by reductions in time from peak contraction to 90% of relaxation and time from peak calcium transient to 90% of decay that paralleled increases in maximum contraction decay slope and maximum calcium decay slope. To establish translatability, CNP-induced changes in contractility were also assessed in rat ex vivo (isolated heart) and in vivo models. Here, the effects on force kinetics observed in ECTs mirrored those observed in both the ex vivo and in vivo model systems, whereas the increase in maximal force generation with CNP application was only detected in ECTs. In conclusion, CNP induces a positive inotropic and lusitropic response in ECTs, thus supporting an important role for CNP in the regulation of human cardiac function. The high degree of translatability between ECTs, ex vivo and in vivo models further supports a regulatory role for CNP and expands the current understanding of the translational value of human ECTs. NEW FINDINGS: What is the central question of this study? What are the acute responses to C-type natriuretic peptide (CNP) in human-engineered cardiac tissues (ECTs) on cardiac function and how well do they translate to matched concentrations in animal ex vivo and in vivo models? What is the main finding and its importance? Acute stimulation of ECTs with CNP induced positive lusitropic and inotropic effects on cardiac contractility, which closely reflected the changes observed in rat ex vivo and in vivo cardiac models. These findings support an important role for CNP in the regulation of human cardiac function and highlight the translational value of ECTs.

Repressive and vigilant coping styles in stress and relaxation: evidence for physiological and subjective differences at baseline, but not for differential stress or relaxation responses

Introduction

Previous research suggested differential stress reactivity depending on individuals' coping style, e.g., as classified by the model of coping modes. Specifically, stronger physiological reactivity and weaker subjective stress ratings were found for repressors than for sensitizers. However, it remains to be investigated (i) whether these findings, which are largely based on social stress induction protocols, also generalize to other stressors, (ii) whether repressors vs. sensitizers also exhibit differential stress recovery following the application of a relaxation method, and (iii) which stress reactivity and recovery patterns are seen for the two remaining coping styles, i.e., fluctuating, and non-defensive copers. The current study thus examines stress reactivity in physiology and subjective ratings to a non-social stressor and the subsequent ability to relax for the four coping groups of repressors, sensitizers, fluctuating, and non-defensive copers.

Methods

A total of 96 healthy participants took part in a stress induction (Mannheim Multicomponent Stress Test) and a subsequent relaxation intervention. Subjective ratings of stress and relaxation, heart rate (HR), heart rate variability (HRV), and blood pressure were assessed during the experiment. HR and blood pressure are markers of the sympathetic stress response that can be regulated by relaxation, while HRV should increase with relaxation. To investigate long-term relaxation effects, subjective ratings were also assessed on the evening of testing.

Results

Despite successful stress induction, no differential responses (baseline to stress, stress to relaxation) were observed between the different coping groups on any of the measures. In contrast, a strong baseline effect was observed that persisted throughout the experiment: In general, fluctuating copers showed lower HR and higher HRV than non-defensive copers, whereas repressors reported lower subjective stress levels and higher levels of relaxation during all study phases. No differences in subjective ratings were observed in the evening of testing.

Conclusion

Contrary to previous research, no differential stress reactivity pattern was observed between coping groups, which could be due to the non-social type of stressor employed in this study. The novel finding of physiological baseline differences between fluctuating and non-defensive individuals is of interest and should be further investigated in other stressor types in future research.

Immediate effect of a meditation technique on blood glucose, state anxiety and relaxation in patients with type 2 diabetes: a pilot randomized crossover study

OBJECTIVES

Type 2 diabetes mellitus (T2DM) is a major burden on global health and economy. Various Yogic techniques are found to be beneficial in the management of T2DM. Mind Sound Resonance Technique (MSRT) is one of the yoga-based meditation techniques observed to be effective in clinical settings.

METHODS

Thirty-two patients with T2DM were randomized to either MSRT or supine rest (SR) sessions on two separate days separated by a washout period of one day. Fasting blood glucose levels were measured before and immediately after the sessions. State anxiety and subjective feeling of relaxation were assessed using Spielberg's state anxiety inventory (STAI) and Visual Analogue Scale (VAS) respectively.

RESULTS

There were significant differences between MSRT and SR groups in fasting blood glucose (p=0.019), STAI scores (p<0.001) and subjective relaxation (p<0.001). Within group analyses revealed significant reductions (p<0.001) in fasting blood glucose and STAI scores, along with an increase in subjective relaxation following the practice of MSRT, whereas, non-significant changes were found following the SR session.

CONCLUSIONS

A single session of MSRT was found to reduce blood glucose levels and state anxiety along with enhanced relaxation when compared to SR.

Severity of polycystic kidney disease revealed by multiparametric MRI

PURPOSE

We aimed to compare multiple MRI parameters, including relaxation rates (R 1 $$ {R}_1 $$ ,R 2 $$ {R}_2 $$ , andR 1 ρ $$ {R}_{1\rho } $$ ), ADC from diffusion weighted imaging, pool size ratio (PSR) from quantitative magnetization transfer, and measures of exchange from spin-lock imaging (S ρ $$ {S}_{\rho } $$ ), for assessing and predicting the severity of polycystic kidney disease (PKD) over time.

METHODS

Pcy/Pcy mice with CD1 strain, a mouse model of autosomal dominant PKD, were imaged at 5, 9, and 26 wk of age using a 7T MRI system. Twelve-week normal CD1 mice were used as controls. Post-mortem paraffin tissue sections were stained using hematoxylin and eosin and picrosirius red to identify histological changes.

RESULTS

Histology detected segmental cyst formation in the early stage (week 5) and progression of PKD over time in Pcy kidneys. InT 2 $$ {T}_2 $$ -weighted images, small cysts appeared locally in cystic kidneys in week 5 and gradually extended to the whole cortex and outer stripe of outer medulla region from week 5 to week 26. Regional PSR,R 1 $$ {R}_1 $$ ,R 2 $$ {R}_2 $$ , andR 1 ρ $$ {R}_{1\rho } $$ decreased consistently over time compared to normal kidneys, with significant changes detected in week 5. Among all the MRI measures,R 2 $$ {R}_2 $$ andR 1 ρ $$ {R}_{1\rho } $$ allow highest detectability to PKD, while PSR andR 1 $$ {R}_1 $$ have highest correlation with pathological indices of PKD. Using optimum MRI parameters as regressors, multiple linear regression provides reliable prediction of PKD progression.

CONCLUSION

R 2 $$ {R}_2 $$ ,R 1 $$ {R}_1 $$ , and PSR are sensitive indicators of the presence of PKD. Multiparametric MRI allows a comprehensive analysis of renal changes caused by cyst formation and expansion.

Case report: Therapeutic potential of Flourishing-Life-Of-Wish Virtual Reality Therapy on Relaxation (FLOW-VRT-Relaxation)-a novel personalized relaxation in palliative care

In view of the global aging population and growing need of palliative care, innovative intervention for effective symptom management is of urgent need. Flourishing-Life-Of-Wish Virtual Reality Therapy (FLOW-VRT) is a brief, structured, manualized, and personalized psychological intervention with theoretical foundations based on stress coping theory, self-determination theory, flow theory, and attention restoration theory. With a specific focus on relaxation, FLOW-VRT-Relaxation intends to facilitate adaptive end-of-life coping through delivering personalized relaxation. This paper reports a case study of the application of FLOW-VRT-Relaxation, and discusses its therapeutic potential as a cost-effective method for reducing palliative symptoms by addressing patient's unmet needs. The case study is a 51-year-old Chinese female, diagnosed with advanced cervix cancer, and presented with unmet psychological (i.e., unfulfilled wishes) and physical needs (i.e., pain and fatigue) before FLOW-VRT-Relaxation. To address her unmet needs, FLOW-VRT-Relaxation was delivered by a registered clinical psychologist specialized in palliative care. Need assessment was first conducted, followed by a 10-min VR travel of Japan as her own choice. Relaxation was verbally coached during VR. Right after VR, consolidation with psychological components including psychoeducation, cognitive and emotional processing, and reminiscence intervention were delivered. The patient showed improvement in physical and psychological symptoms, lower sense of loneliness and engulfment, as well as enhanced peace after FLOW-VRT-Relaxation. The current findings provide encouraging initial support for the feasibility, acceptability, and therapeutic potential of using FLOW-VRT-Relaxation as a cost-effective, scalable and personalized VR relaxation for patients under palliative care. It is hoped that with its optimal use, FLOW-VRT-Relaxation can serve as an alternative therapeutic tool that effectively improves the end-on-life care.

The Moderated Mediation Effect of Age and Relaxation on the Relationship between the Type A Behavior Pattern and Blood Pressure in South Korea

Although it is generally known that the type A behavior pattern (TABP) is associated with high blood pressure, recent studies have not consistently supported this association. Therefore, it is important to determine which factors moderate and mediate this relationship. The purpose of this study was to verify the moderated mediation effect of age and relaxation in the relationship between TABP and high blood pressure among middle-aged adults in South Korea. This study utilized data from the Korea Health and Genome Study (KHGS) supported by the Korea National Institute of Health. The participants in the present study were 10,022 Korean adults aged 40 to 69. To identify the conditional indirect effect of TABP on blood pressure through relaxation, with a consideration of age, a moderated mediation model using SPSS PROCESS macro 3.10 was applied. As is generally known, TABP was associated with high blood pressure, but its relevance was reversed through relaxation. Moreover, this relationship was moderated by age, which is known to be the most powerful predictor of high blood pressure. The lower age group with TABP exhibited a higher relaxation, whereas the higher age group with TABP demonstrated a lower relaxation. The findings demonstrate the need for relaxation education, stress management, or counseling to help individuals recognize their behavior patterns and strengthen the willingness and motivation for relaxation, especially among elderly people with TABP, in order to manage their blood pressure effectively.