Qigong for the Emotional Exhaustion in Nurses: Implications of a Prospective Randomized Controlled Trial in the COVID-19 Pandemic.

Introduction: Burnout is commonly understood as resulting from chronic stress at work. It may have several consequences for the well-being and health of the worker. As a dimension of burnout, emotional exhaustion appears to be predicted mostly by work overload, interpersonal conflicts, and the inadequate use of skills. Emotional exhaustion is considered to be the affective component of burnout and may cause depersonalization. Burnout seems to be highly prevalent among nurses and more so during the COVID-19 pandemic. To address the new demands that the pandemic has placed on health care systems, nurses must be provided specific training in stress coping techniques. Qigong is an applied psychophysiological feedback technique that can be done independently by the practitioner; it enables the user to learn how to control their bodily functions and processes. As such, the objective of this study is to understand if qigong can be used as a complementary therapy for emotional exhaustion in nurses and if it can be implemented during critical events such as the COVID-19 pandemic. Method: A total of 44 nurses aged between 27 and 54 years (90.9% female), with high levels of emotional exhaustion, were randomized into intervention and control groups. The "white ball" system of qigong, led by a traditional Chinese medicine specialist, was taught to participants in the intervention group for 4 weeks. After this period, participants had 4 weeks for self-practice. The Maslach Burnout Inventory was used to capture the nurses' level of emotional exhaustion at the beginning and end of the experimental period, as well as after the 4-week self-practice period. Results: The results showed that 70% of the participants in the intervention group had significantly decreased emotional exhaustion levels, which reduced from high to either moderate (55%) or low (15%) after the experimental phase. Moreover, these benefits were maintained after the 4 weeks of self practice. Conclusion: The results of this study suggest that qigong may be used as a complementary tool to mitigate burnout (including that induced by COVID-19) among nurses, thus improving health care services and capacity.

Updated Organic Composition and Potential Therapeutic Properties of Different Varieties of Olive Leaves from Olea europaea.

Olea europaea L. folium merits further exploration of the potential of its substrates for therapeutic supplements. Quantitative and qualitative analyses were conducted on samples of Madural, Verdeal, and Cobrançosa elementary leaves and leaf sprouts (mamões) collected in the region of Valpaços, Portugal. Organic analysis assessed the moisture content, total carbohydrates, ash, protein, and fat contents, total phenolic content (TPC), vitamin E, and fatty acid (FA) profiles. Moisture content was determined through infrared hygrometry and TPC was determined by a spectrophotometric method. Concerning organic analysis, all leaf samples showed similar moisture content, though Cobrançosa's leaf sprouts and Verdeal's elementary leaves had slightly lower contents. Meanwhile, these cultivars also showed a higher TPC, α-tocopherol isomer, and fatty acid composition (FAC). FAC in all samples exhibited higher contents of PUFA and SFA than MUFA, with a predominance of linolenic and palmitic acids. Organic analyses of Cobrançosa's leaf sprouts and Verdeal's elementary leaf extracts allow for the prediction of adequate physiological properties regarding neuroinflammatory, neurobehavioral, metabolic, cardiovascular, osteo-degenerative, anti-ageing, pulmonary, and immunological defense disorders. These physiological changes observed in our preliminary in silico studies suggest an excellent nutraceutical, which should be borne in mind during severe pandemic situations.

Can Qigong Be a Tool to Assist Students in Handling COVID-19's Resulting Academic Stress?

The recent COVID-19 pandemic has increased students' stress as they may feel under increased pressure to have a good performance and compensate for the disruption to their education. Improving attention levels and learning capacity may assist in ameliorating academic performance. Qigong is a traditional Chinese medicine technique that appears to have positive effects on the management of mental health and may provide tools for coping with stressful situations. This paper explores data obtained while conducting a previous study and includes an excess of data from a total of 44 participants who were previously divided into an experimental Qigong group and a sham Qigong control group. The improvements in specific auditory processing and reaction times may indicate benefits in attention and learning capacity. These improvements were more pronounced in the experimental Qigong group compared to the sham Qigong group. Qigong may be able to assist in improving students' academic performance and can be easily integrated into physical education classes. It could also assist students to cope with the increased academic pressure resulting from the COVID-19 pandemic context.

Mental Health Benefits of a Traditional Vegetative Biofeedback Therapy Online Program during the COVID-19 Lockdown: A Controlled Trial

Mandatory lockdown resulting from a pandemic may be effective against the physical impact of the virus;however, the resulting mental strains can lead to the development of several mental disturbances. Taijiquan and Qigong are considered traditional vegetative biofeedback therapies that allow the practitioner to control the functions and processes of the body through specific movements or stances, breathing techniques, and meditative exercises. This study aims to understand if these techniques can be applied as an online distance therapeutic option to reduce the psychological impact of home confinement and social distancing. Sixty-four participants were recruited and allocated to three groups. The experienced and novice Taijiquan and Qigong participants’ groups received the intervention for 8 weeks while the control group did not receive any intervention. The outcomes were psychological well-being and psychological distress levels and were assessed by the Mental Health Inventory and a written interview. The experienced Taijiquan and Qigong participants achieved significant improvements in psychological well-being and psychological distress. Novice Taijiquan and Qigong participants achieved a significant improvement in anxiety levels. Additionally, the control group showed a significant decrease in psychological well-being. This study suggests that this distance online program of Taijiquan and Qigong is feasible and may benefit the mental health of participants during a lockdown.

Can Yoga, Qigong, and Tai Chi Breathing Work Support the Psycho-Immune Homeostasis during and after the COVID-19 Pandemic? A Narrative Review.

Breathing is crucial in life; nevertheless, the healthcare community often overlooks the health potential of breathing techniques. Conscious manipulation of breathing to achieve specific health goals is found in yoga, Qigong and Tai Chi. This paper reviews the value of breathing exercises as a foremost mechanism for promoting, recuperating and maintaining health. Practices involving breathing techniques are described, and their prophylactic or therapeutic characteristics are explored. The main goals of this review are: (i) to summarize the evidence supporting the hypothesis that breathing practices have a significant beneficial impact on human health; (ii) to provide a deeper understanding of traditional biofeedback practices, particularly yoga, Qigong and Tai Chi, and outline their focus on breathing techniques; (iii) to outline specific immune-related responses, relevant for COVID-19 disorders; and (iv) to call for committed attention and action from the scientific community and health agencies in promoting the implementation of a practical and costless health program based on breathing techniques. This review shows the health potentials of breathing practices and exercises, which, by having a high benefit-cost ratio, could be selected and implemented as a primary standard routine in public health programs.

Mental Health Benefits of a Traditional Vegetative Biofeedback Therapy Online Program during the COVID-19 Lockdown: A Controlled Trial.

Mandatory lockdown resulting from a pandemic may be effective against the physical impact of the virus; however, the resulting mental strains can lead to the development of several mental disturbances. Taijiquan and Qigong are considered traditional vegetative biofeedback therapies that allow the practitioner to control the functions and processes of the body through specific movements or stances, breathing techniques, and meditative exercises. This study aims to understand if these techniques can be applied as an online distance therapeutic option to reduce the psychological impact of home confinement and social distancing. Sixty-four participants were recruited and allocated to three groups. The experienced and novice Taijiquan and Qigong participants' groups received the intervention for 8 weeks while the control group did not receive any intervention. The outcomes were psychological well-being and psychological distress levels and were assessed by the Mental Health Inventory and a written interview. The experienced Taijiquan and Qigong participants achieved significant improvements in psychological well-being and psychological distress. Novice Taijiquan and Qigong participants achieved a significant improvement in anxiety levels. Additionally, the control group showed a significant decrease in psychological well-being. This study suggests that this distance online program of Taijiquan and Qigong is feasible and may benefit the mental health of participants during a lockdown.

Qigong for the Emotional Exhaustion in Nurses: Implications of a Prospective Randomized Controlled Trial in the COVID-19 Pandemic.

Introduction: Burnout is commonly understood as resulting from chronic stress at work. It may have several consequences for the well-being and health of the worker. As a dimension of burnout, emotional exhaustion appears to be predicted mostly by work overload, interpersonal conflicts, and the inadequate use of skills. Emotional exhaustion is considered to be the affective component of burnout and may cause depersonalization. Burnout seems to be highly prevalent among nurses and more so during the COVID-19 pandemic. To address the new demands that the pandemic has placed on health care systems, nurses must be provided specific training in stress coping techniques. Qigong is an applied psychophysiological feedback technique that can be done independently by the practitioner; it enables the user to learn how to control their bodily functions and processes. As such, the objective of this study is to understand if qigong can be used as a complementary therapy for emotional exhaustion in nurses and if it can be implemented during critical events such as the COVID-19 pandemic. Method: A total of 44 nurses aged between 27 and 54 years (90.9% female), with high levels of emotional exhaustion, were randomized into intervention and control groups. The "white ball" system of qigong, led by a traditional Chinese medicine specialist, was taught to participants in the intervention group for 4 weeks. After this period, participants had 4 weeks for self-practice. The Maslach Burnout Inventory was used to capture the nurses' level of emotional exhaustion at the beginning and end of the experimental period, as well as after the 4-week self-practice period. Results: The results showed that 70% of the participants in the intervention group had significantly decreased emotional exhaustion levels, which reduced from high to either moderate (55%) or low (15%) after the experimental phase. Moreover, these benefits were maintained after the 4 weeks of self practice. Conclusion: The results of this study suggest that qigong may be used as a complementary tool to mitigate burnout (including that induced by COVID-19) among nurses, thus improving health care services and capacity.

The Effects of COVID-19 Lockdown on the Perception of Physical Activity and on the Perception of Musculoskeletal Symptoms in Computer Workers: Comparative Longitudinal Study Design.

Lockdown resulting from the pandemic led to a change in the health habits of the computer workers community. Sedentary work, together with less active lifestyles, aggravated by the COVID-19 pandemic leads to impacts on physical activity (PA) and can contribute to the development of musculoskeletal symptoms (MSS). Aim(s): Understand the effects of lockdown on the perception of physical activity levels and on the perception of frequency of musculoskeletal symptoms, over periods of 12 months and 7 days, in computer workers. Methods: Longitudinal comparative study between 2019 (M1) and 2021 (M2), over 18 months, in 40 volunteer participants. The inclusion criteria were full-time workers aged between 18 and 65 and the exclusion criteria included diagnosis of non-work-related medical conditions. In addition to a socio-demographic questionnaire, the Nordic musculoskeletal questionnaire (NMQ) was used to evaluate the MSS and the International Physical Activity Questionnaire (IPAQ), was used to analyse the perception of the level of PA. These questionnaires were used in two assessment stages (M1 and M2). McNemar test and Wilcoxon paired test were used to evaluate the effect of lockdown on the perception of PA, and on the perception of frequency of musculoskeletal symptoms. Results: The MSS prevalence in the previous 12 months increased significantly in the neck (M1: 45.0%, M2: 62.5%, p = 0.046), in the shoulders (M1: 37.5%, M2: 55.0%, p = 0.033), and in the hands/wrists (M1: 25.0%, M2: 45.0%, p = 0.019). The mean pain score increased in the shoulders (1.43 ± 2.24, 2.35 ± 2.55, p = 0.003) and in the elbows (0.18 ± 0.59, 0.60 ± 1.34, p = 0.015). No differences were found in the PA between M1 and M2, but the weekly mean sitting time increased from 4.75 ± 2.26 to 6.26 ± 2.65 (p < 0.001). Conclusion: After 18 months it became clear that MSS perception increased mainly in the neck, shoulders and hands/wrists with a significant increase in pain intensity in the shoulder and elbow regions. The weekly sitting time increased significantly. Further studies are needed in order to determine the impact of teleworking in a pandemic context. But multifactor behind these results should be taken into account by health institutions and those responsible for the Prevention of Occupational Risks in Computer Workers in order to adopt educational strategies for the promotion of Physical activity (PA), in these workers.

Positive Effects of an Online Workplace Exercise Intervention during the COVID-19 Pandemic on Quality of Life Perception in Computer Workers: A Quasi-Experimental Study Design.

Computer workers' sedentary work, together with less active lifestyles, aggravated by the COVID-19 pandemic, represents a high risk for many chronic diseases, leading to a decrease in health-related quality of life (QoL). Workplace exercises consist of a set of physical exercises, implemented during work breaks, that have multiple benefits for workers' health. AIM: To assess the impact of online workplace exercises on computer workers' perception of quality of life. METHODS: Quasi-experimental study with two groups: a control group (n = 26) and an intervention group (n = 13). The inclusion criteria were that participants must be aged between 18 and 65 years old and the exclusion criteria included diagnosis of non-work-related medical conditions. The interventions consisted of workplace exercises, which were applied for 17 consecutive weeks, each session lasting 15 min, three times a week. The exercise programme, performed online and guided by a physiotherapist, consisted of mobility exercises, flexibility and strength exercises, with the help of a TheraBand® for elastic resistance. The control group were not subjected to any intervention. A socio-demographic questionnaire and the Health Survey Questionnaire (SF-36v2) were used in two assessment stages (M0-baseline and M1-final of intervention). A mixed ANOVA with interaction time*group was used to evaluate the effect of the exercise programme. RESULTS: A good perception of the QoL was obtained in both stages. The exercise programme had a positive effect in the domains of Pain (ptime*group = 0.012, η2p = 0.158), Physical Function (ptime*group = 0.078, η2p = 0.082), Physical Performance (ptime*group = 0.052, η2p = 0.098), and Emotional Performance (ptime*group = 0.128, η2p = 0.061). CONCLUSION: After 17 weeks of workplace exercises, it became clear that the intervention group positively increased their QoL perception, with this improvement being significant in the Pain domain, which resulted in an improvement in their health condition. Therefore, further studies are needed to determine the optimal exercise for CWs, with detailed exercise types, different intensities and focused on various health conditions.

Electroacupuncture and acupuncture in the treatment of anxiety - A double blinded randomized parallel clinical trial.

BACKGROUND: The estimated number of people living with anxiety disorders worldwide is around 264 million and is estimated to have worsened with the recent pandemic of COVID-19. Acupuncture has shown to have excellent therapeutic effects in reducing anxiety. DESIGN: Double-blinded randomized controlled clinical trial with 56 participants (21-82 years) with anxiety diagnosed by 3 different anxiety scales (BAI, GAD-7 and OASIS). A 30-min acupuncture session was applied once a week for 10 weeks. AIMS: Evaluate the effectiveness of acupuncture and electroacupuncture in the treatment of anxiety to verify if: (1) People with high anxiety report reduced scores after 5 and 10 sessions; (2) Salivary cortisol levels accompanied the reduced scores; (3) Electroacupuncture treatment is more effective than acupuncture; (4) the treatments is independent of anxiolytic medication. METHODS: Volunteers were randomized into 3 groups (control, acupuncture, and electroacupuncture). The results were analyzed by anxiety scales and salivary cortisol tests. RESULTS: The findings show an improvement in anxiety, assessed by BAI, GAD-7 and OASIS, after the 5th session of acupuncture (p < 0.05) and electroacupuncture (p < 0.05) and the 10th session for both techniques (p < 0.001). The salivary cortisol values measured in the morning followed this pattern (p < 0.05), although the reduction of the night cortisol values was not statistically significant. Electroacupuncture and acupuncture show similar efficacy. The positive effect after the treatments is independent of anxiolytic medication (p < 0.001). CONCLUSION: Acupuncture and electroacupuncture are effective in treating anxiety on their own or as adjuncts to pharmacological therapy. TRIAL REGISTRATION NUMBER: NºP445-08/2017 (Unidade de Investigação em Ciências da Saúde).

The MHC Class II Transactivator CIITA: Not (Quite) the Odd-One-Out Anymore among NLR Proteins.

In this review, we discuss the major histocompatibility complex (MHC) class II transactivator (CIITA), which is the master regulator of MHC class II gene expression. CIITA is the founding member of the mammalian nucleotide-binding and leucine-rich-repeat (NLR) protein family but stood apart for a long time as the only transcriptional regulator. More recently, it was found that its closest homolog, NLRC5 (NLR protein caspase activation and recruitment domain (CARD)-containing 5), is a regulator of MHC-I gene expression. Both act as non-DNA-binding activators through multiple protein-protein interactions with an MHC enhanceosome complex that binds cooperatively to a highly conserved combinatorial cis-acting module. Thus, the regulation of MHC-II expression is regulated largely through the differential expression of CIITA. In addition to the well-defined role of CIITA in MHC-II GENE regulation, we will discuss several other aspects of CIITA functions, such as its role in cancer, its role as a viral restriction element contributing to intrinsic immunity, and lastly, its very recently discovered role as an inhibitor of Ebola and SARS-Cov-2 virus replication. We will briefly touch upon the recently discovered role of NLRP3 as a transcriptional regulator, which suggests that transcriptional regulation is, after all, not such an unusual feature for NLR proteins.

A review of properties, nutritional and pharmaceutical applications ofMoringa oleifera:integrative approach on conventional and traditional Asian medicine

Moringa oleiferaL. from the Moringaceae family is a perennial tree widely cultivated in many tropic regions and easily grown even in adverse conditions.M. oleiferais also known as the miracle tree, which for centuries has been indicated for traditional medicine. With no reports of side effects, in doses achievable by ingestion, different parts ofM. oleiferais used to treat several conditions, such as malnutrition, diabetes, blindness, anemia, hypertension, stress, depression, skin, arthritis, joints and kidney stones disorders. This plant also showed capacity of helping in maintenance of the cardiovascular system health, blood-glucose levels and providing anti-oxidant, anti-inflammatory and anti-cancer activity as well as the regulation of urinary tract and lactation in nursing women. The seed and leaves powder has water purification properties through flocculation. It also supplements the food in the human diet and in the fortification of livestock feed, especially in developing countries. So,M. oleiferaproperties have also been applied to cosmetic and byproducts industries due to the high nutritive and protective properties of its seed oil. According to the holistic or traditional medicine,M. oleiferahas very relevant therapeutic properties and applications depending on the constitution, somatic and psychological needs of patients. It is usually referred as a natural product that can treat different physical and psychological health aspects, offering an energetic action and structural rebuilder of the body and promoting emotions of highly positive attitudes towards life. The high and specific immunological potential ofM. oleiferaleads us to suggest an in-depth study to assess the hypothesis of conferring a supportive effect against Covid-19 disease.