The Study of 'Preparation Guidelines' Towards Phetchabun Government Officers and Health Massage Establishments

The purpose of research was to study practices, barriers, and solutions of Phetchabun health massage establishments under COVID-19 situation. Non-participant observation, informal interview, in-depth interview, and participation observation were carried out respectively. Purposive sampling was used with 15 health consumer protection officers in charge;11 district level, 2 provincial level, 2 regional level as well as each representative of 11 districts. Results after implementation of "Preparation Guidelines for Health Spa, Health Massage, and Beauty Massage to Promote Health Tourism During COVID-19 Pandemic" were categorized into two sections. Firstly, the practices, barriers, and solutions of government officer performances included preparation for reopening, monitoring of the provider practices, and performance report. Secondly, the provider operations consisted of doing "Self-Assessment of Health Establishment", logging-in webpage before reopening, and practices for clients included screening and report of patients under investigation, establishment monitor, service, and establishment cleaning. In summary, the preparation guidelines were purposed to reopen their business with numerous contents and messages written by official language, it caused establishment providers and practitioners difficultly understood when applying. LINE Application and making calls were easy and accessible methods for their communication to reach current data and to ensure exact information. Various encouragements and having compliments were also considerable to form trust and confidence among them, they also raised their proud.Copyright © 2023, World Informations Syndicate. All rights reserved.

Applying the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents to Misophonia: A Case Example

Misophonia is a condition in which individuals suffer a wide range of intense emotions in response to sound triggers. Emotions such as anxiety, irritability, and disgust may lead individuals to engage in avoidance behaviors to escape or suppress sound triggers. Transdiagnostic treatment may serve as a practical intervention for misophonia as it addresses a broad scope of emotions and physiological sensations. This paper presents the first reported case example of misophonia treated with a transdiagnostic treatment protocol, the Unified Protocol for Emotional Disorders in Adolescents (UP-A). In this case, the UP-A was efficacious in treating a client with autism spectrum disorder, comorbid misophonia and anxiety symptoms. The client evidenced reliable change in misophonia and related problems. Future research should investigate the efficacy of the UP-A in a larger sample of youth with misophonia, as well as assess mechanisms of change in transdiagnostic treatment of this disorder in youth.Copyright © 2022 Society of Clinical Child & Adolescent Psychology.

Self-quarantine: Deepening natural encounter during COVID-19

The word "quarantine" might conjure up negative associations;for instance, a youth may be given "time-out" as punishment for unruly behavior. A time-out creates space for reflection on one's actions and strips away the positive reinforcement linked to social stimulation. This chapter has two sections. The first section, "Mortality and Ecocide", explores the existential ramifications of how COVID self-quarantine suddenly and dramatically eliminated work hours for workers who were viewed as nonessential. The second section, "Symbolism and Deepening of Existential Encounter", delves into personal mythology study to further understand the human situation on the planet in relation to fear of death and the need for power. The chapter explores how human behavioral changes due to dysfunction correspond with the human meaning-making process and how we construct personal myths. Becker's exposition on death anxiety suggests that, in part, humans crave to unveil the meaning of life to mitigate the existential tension at times caused by the inevitability of death. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Clinical applications of transcutaneous auricular neurostimulation for opioid use disorder and pain

Symposium title: Addressing chronic pain and the opioid epidemic using auricular neuromodulation Symposium description: Our proposed symposium integrates a diverse group of scientist and clinician experts (Drs. Cunningham, Wilkes, Khodaparast, Badran) who have committed to exploring the anti-nociceptive and opioid sparing effects of auricular neuromodulation to progress toward non-opioid interventions for chronic pain and opioid use disorders. The demand for chronic pain therapies has increased at an unprecedented rate over the last several decades, contributing in part to a surge in prescription and illicit opioid demand. Countless patients were escalated to prolonged, high-dose opioid regimens over years of treatment. By 2014, 5.4% of U.S. adults were estimated to use prescription opioids on a long-term basis. As the harms of opioid proliferation became increasingly clear, a dramatic paradigm shift occurred in which these drugs are now perceived as more dangerous than beneficial for chronic pain. New clinical guidelines highlight the risks of high-dose regimens as well as the limited benefits, particularly insufficient analgesia and hyperalgesia, associated with long-term use. According to this new perspective, the preferred therapeutic modality for many patients is to safely taper, or even completely stop, using opioids. Transcutaneous auricular neurostimulation (tAN) is a novel therapeutic paradigm that includes stimulation of both the auricular branch of the vagus nerve and auriculotemporal nerve (branch of trigeminal). tAN therapy results in clinically significant reductions in opioid withdrawal symptoms associated with opioid detoxification and tapering. Either adjunctive vagal or trigeminal stimulation modulates pain transmission suggesting overlapping common effector pathways, possibly targeting the endogenous opioid system, which could lead to a synergistic therapeutic benefit for pain. This symposium will explore the scientific basis for this hypothesis across targeted and interconnected topics, including fundamental neuropharmacological mechanisms underlying pain and opioids, clinical challenges of tapering opioids, managing opioid withdrawal symptoms with tAN, and the prospects for tAN to deliver a safe alternative treatment option for pain disorders. The United States is experiencing an epidemic for prescription and non-prescription opioids, which have continued to rise since the 1990s. During 2015, approximately 2.1 million people were severely dependent on prescription opioids, and 513,000 on heroin. In 2020, the Centers for Disease Control reported 93,331 substance use overdose deaths. The continuing increase in opioid-related deaths from 2015 (18%) to 2020 (60%) is partly attributed to the mental health crisis during the Covid-19 pandemic. Aside from pain mitigation, individuals with opioid use disorder (OUD) may be motivated to continue drug-seeking by both the positive reinforcement of the euphoric effects of opioids and the negative reinforcement of opioid withdrawal symptoms due to cessation. Alternative approaches for OUD are a major priority for government agencies given the substantial impact on health, social, and economic welfare. Transcutaneous auricular neurostimulation (tAN) is a non-invasive form of vagus and trigeminal neuromodulation that was recently proven to be an efficacious non-pharmacologic based treatment for reducing opioid withdrawal symptoms. In 2021, tAN therapy received FDA clearance as an adjunctive treatment for opioid withdrawal symptoms in adults. tAN therapy was also proven safe and effective in reducing symptoms of neonatal opioid withdrawal syndrome (NOWS) in neonates. tAN as an adjuvant was safe, well-tolerated, while facilitating the successful rapid weaning of oral morphine and decreasing length of stay in the neonatal ICU. Based on these preliminary findings, tAN therapy is currently in two NIH-funded pivotal clinical trials to: 1) evaluate the long-term effects of tAN on opioid use relapse prevention and cravings in adults with OUD, and 2) determine f tAN therapy can reduce withdrawal symptoms and reduce morphine length of treatment for neonates with NOWS. Lastly, we will explore how tAN could be utilized as neuromodulatory approach for opioid sparing, and ultimately pain mitigation. Research Category and Technology and Methods Clinical Research: 12. Vagus Nerve Stimulation (VNS) Keywords: Vagus Nerve Stimulation, Opioid Use Disorder, Pain, NeurostimulationCopyright © 2023

Increasing Food Consumption With an Antecedent and Reinforcement-Based Treatment Generalized Via Telehealth

We report a case with a 7-year-old girl with autism spectrum disorder and anxiety disorder who had severe restrictive eating leading to various medical concerns raised by her pediatrician. Following medical consultation and a descriptive functional assessment, a therapist implemented behavioral intervention consisting of a visual cue, choice, and differential reinforcement of alternative behaviors. The intervention was focused on both in-home meals and telehealth consultation during mealtimes, as the COVID-19 pandemic necessitated moving to remote consultation for continued treatment. The success of this study has long-standing implications for the benefits of positive feeding interventions and telehealth as well as parental training strategies.

Problematic social media use is statistically predicted by using social media for coping motives and by positive reinforcement processes in individuals with high COVID-19-related stress levels.

It is important to understand the relationship between stress and problematic use of social media (PUSM). However, no study to our knowledge has yet investigated the longitudinal relationship between perceived stress and PUSM via positive and negative reinforcement processes. The present study investigated relationships between COVID-19-pandemic-related stress and PUSM and possible moderating effects of motives for using social media (positive and/or negative reinforcement) during and following a COVID-19-pandemic-related lockdown. Six-hundred-and-sixty participants initially completed a survey including self-report measures of PUSM, COVID-19-pandemic-related stress, and motives for using social media (i.e., for negative reinforcement involving coping and conformity or positive reinforcements involving enhancement and social motives). During the COVID-19 outbreak recovery period, 117 participants again completed the survey. Bayesian analyses revealed that PUSM was associated with higher COVID-19-pandemic-related stress levels and use of social media for coping, conformity, and enhancement purposes. Longitudinally, PUSM symptom worsening was associated with increased use of social media for coping motives regardless of levels of perceived stress. Use of social media for conformity and enhancement purposes moderated relationships between stress levels during lockdown and PUSM symptoms worsening after lockdown. Our findings corroborate the hypothesis that negative reinforcement processes may be key factors in PUSM symptom worsening regardless of perceived stress. Concurrently, high levels of stress may worsen PUSM through positive reinforcement processes.

Impact of COVID-19 on the morale of healthcare professionals who cared for the migrant workers in Singapore: A qualitative approach

Background: Coronavirus Disease 2019 (COVID-19) has affected healthcare professionals (HCPs) worldwide. Current literature shows that COVID-19 has contributed to psychological distress among HCPs, which suggests that the morale of HCPs could be implicated as well. This requires further investigation because morale among HCPs is important in delivery of care and is linked to outcomes such as work productivity and patient satisfaction. Aims: This study thus aims to explore the experiences of frontline HCPs and examine how COVID-19 impacts their morale. Methods: Eleven HCPs who cared for the migrant workers residing in a local COVID-19 hotspot in Singapore were recruited. Semi-structured face-to-face interviews were conducted. Interview recordings were transcribed verbatim. Transcripts were subsequently analyzed using principles of thematic analysis. Results: Four main themes emerged: motivators, challenges, support, and leadership. Motivators included HCPs' professional obligation to help others and gain personal experience. Altruism was also a key motivator. HCPs faced difficulties interacting with the migrant workers, feared contagion, and struggled with rapidly changing workflows. Many expressed empathy for the migrant workers' predicament. Peer and social support, and effective leadership were morale boosters and might have cushioned any negative experiences, as all HCPs had overall high morale despite the numerous challenges they faced. Discussion: HCPs drew support from their peers, family, and the public. Fostering peer support networks can thus be an essential strategy in maintaining morale and minimizing HCP distress during a pandemic. Appreciation and recognition of HCPs can increase confidence and also act as a form of positive reinforcement, which further enhances work motivation. Visible leaders who worked alongside the HCPs in the dormitory created a sense of camaraderie that boosted morale among HCPs and motivated them. Competent leadership and having a clear direction can help buffer against uncertainty and frequent policy changes during a pandemic. Conclusions: Peer and social support, and effective leadership have potential protective effects on HCPs' morale against negative experiences faced during the COVID-19 pandemic. Recommendations for future studies: More qualitative studies exploring the morale of HCPs during a pandemic is indicated for comparison among different social and cultural contexts.

Virtual Reality Behavioral Activation for Adults With Major Depressive Disorder: Feasibility Randomized Controlled Trial

Background: Major depressive disorder (MDD) is a global crisis with increasing incidence and prevalence. There are many established evidence-based psychotherapies (EBPs) for depression, but numerous barriers still exist;most notably, access and dissemination. Virtual reality (VR) may offer some solutions to existing constraints of EBPs for MDD. Objective: We aimed to examine the feasibility, acceptability, and tolerability of using VR as a method of delivering behavioral activation (BA) for adults diagnosed with MDD during a global pandemic and to explore for signs of clinical efficacy by comparing VR-enhanced BA (VR BA) to a standard BA treatment and a treatment as usual control group for individuals diagnosed with MDD. Methods: A feasibility trial using a 3-armed, unblinded, randomized controlled pilot design was conducted. The study took place remotely via Zoom telehealth visits between April 8, 2020, and January 15, 2021. This study used a 3-week, 4-session protocol in which VR BA participants used a VR headset to complete their BA homework. Feasibility was measured using dropout rates, serious adverse events, completion of homework, an adapted telepresence scale, the Simulator Sickness Questionnaire, the Brief Agitation Measure, and an adapted Technology Acceptance Model. Efficacy was assessed using the Patient Health Questionnaire–9. Results: Of the 35 participants assessed for eligibility, 13 (37%) were randomized into VR BA (n=5, 38%), traditional BA (n=4, 31%), or a treatment as usual control (n=4, 31%). The mean age of the 13 participants (5/13, 38% male;7/13, 54% female;and 1/13, 8% nonbinary or third gender) was 35.4 (SD 12.3) years. This study demonstrated VR BA feasibility in participants with MDD through documented high levels of acceptability and tolerability while engaging in VR-induced pleasurable activities in conjunction with a brief BA protocol. No adverse events were reported. This study also illustrated that VR BA may have potential clinical utility for treating MDD, as the average VR BA participant’s clinical severity decreased by 5.67 points, signifying a clinically meaningful change in severity from a moderate to a mild level of depression as per the Patient Health Questionnaire–9 score. Conclusions: The findings of this study demonstrate that VR BA is safe and feasible to explore for the treatment of MDD. This study documented evidence that VR BA may be efficacious and justifies further examination in an adequately powered randomized controlled trial. This pilot study highlights the potential utility that VR technology may offer patients with MDD, especially those who have difficulty accessing real-world pleasant activities. In addition, for those having difficulty accessing care, VR BA could be adapted as a first step to help people improve their mood and increase their motivation while waiting to connect with a health care professional for other EBPs. Trial Registration: ClinicalTrials.gov NCT04268316;https://clinicaltrials.gov/ct2/show/NCT04268316 International Registered Report Identifier (IRRID): RR2-10.2196/24331

Unfree and at high risk: Understanding child labour and occupational risks from the viewpoint of those involved

Why do young workers suffer many times the injury rate of adults? We cannot answer this question without first understanding how children of poor families, such as those making bricks, become child laborers. We are learning that the process of transitioning into work starts early in life, at the same time as children are learning language, culture, religion, and morality. This lead to the development of a worldview that legitimizes child labor in the eyes of its victims, also tends to overlook or accept the health risks it entails. Yet emerging data indicate that, in addition to the excessive physical loads the children are expected to carry, there is the heavy psychological load of responsibility towards younger siblings and disabled family members. This load is not diminishing as child labour rates overall are increasing. Current research being undertaken with underprivileged communities in Pakistan is exploring potential points of intervention, for example, determining to what extent children are ‘socialized into work’ by their parents and siblings or alternatively by their own experiences and mistakes, as well as the factors which provide positive reinforcement. It seeks points of intervention from the regulatory angle as well. Why are basic health and safety laws so widely ignored? The upheaval of COVID 19 on top of a steady trend toward increased global production and communication are putting pressure on both young workers and those who employ them. Health professionals must document the effects of these changes on young workers’ health and design counter-measures that are adapted to local social environment.

Why Older Adults Should Quit Tobacco and How They Can

There are proven health benefits in quitting tobacco use in older adult smokers. Quitting tobacco use can lessen the risk of cognitive decline and brain atrophy, and prevent polypharmacy arising from the management of complex morbidities associated with smoking. Healthcare staff play an important role in helping older adult smokers to abstain from smoking. Multiple approaches can be used to deliver evidence-based tobacco cessation treatments to the geriatric population. With ongoing support from healthcare teams, older adults who smoke can improve their chance of successfully quitting tobacco use, resulting in better quality of life.