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The Gut–Sleep Connection in Irritable Bowel Syndrome
No full textSleep quality and sleep disorders are recognized as factors influencing the risk and severity of irritable bowel syndrome (IBS). This review examines the recent evidence linking IBS with sleep disruption and disorders including obstructive sleep apnea, insomnia, circadian rhythm disorders, and restless legs syndrome (RLS). A PubMed search identified studies evaluating the prevalence and mechanisms that may be underlying these associations. This review found an increased risk of IBS among individuals with poor sleep, with up to one-third of IBS patients reporting sleep disturbances. Insomnia, RLS, and circadian rhythm misalignment are linked to heightened IBS risk, with RLS showing a bidirectional relationship. Poor sleep also predicts next-day symptom severity in IBS, while the reverse association is not supported by current evidence. Proposed mechanisms underlying these associations include dysregulation of the gut-brain axis, microbiome changes, dopaminergic dysfunction, hyperalgesia, and psychological factors. Evidence suggests that improving sleep may reduce IBS symptom burden, highlighting the potential value of incorporating sleep management into IBS care. However, a lack of randomized controlled trials limits the ability to establish causality, underscoring the need for further research
Orthostatic Hypotension in Older Adults and its economic impact on the healthcare system: A Systematic Literature Review
No full textABSTRACT
Orthostatic Hypotension (OH) has been shown to lead to poor quality of life, falls, and death. Literature suggests that falls from OH may be preventable, therefore opportunities to reduce its associated cost to the healthcare system exist. This literature review aims to evaluate the importance of diagnosing and treating OH in older adult patients. OH is the drop in blood pressure upon changing to an upright position. This acute hemodynamic drop in blood pressure causes hypoperfusion in the brain, leading to dizziness, syncope, and falls. An extensive literature search for publications in PubMed and Cumulative Index in Nursing and Allied Health Literature (CINAHL) databases primarily within the past 5 years, revealed the impact of falls on the healthcare system, diagnosis and types of OH, and treatment to prevent recurrence. The findings show that the costs of falls on the healthcare system continue to rise. The evidence suggests that there is a high prevalence of older adults with OH in all settings including hospitals, long-term care facilities, and the community. Diagnosing patients with falls can be life-saving and improve their quality of life
A Review of Probiotics and the Incidence of Gastrointestinal Disturbances with Antibiotic Therapy
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Undertreatment of Acute Pain in Patients on Opioid Agonist Medications for Opioid Use Disorder: An Exploration of Causes and Remedies
No full textHow Protests from 1913 to 1920 Led to the 19th Amendment
No full textThe women’s suffrage movement from 1913 to 1920 was a time of intense protest and activism in the United States, as women fought resolutely for the right to vote. Following years of very little progress through petitions and lobbying, suffragists started adopting more visible tactics to draw attention to their cause. Organizations like the National Woman’s Party, led by Alice Paul, organized pickets, marches, and hunger strikes, which challenged both the government’s reluctance to allow women to vote and societal norms at the time. These protests, many of which were held in front of the White House, increased public attention, exposing the lengths women were willing to go to achieve equality. The persistence of these activists, often at the expense of facing violence and possibly being arrested, ultimately helped to shift public and government opinion, leading to the ratification of the 19th Amendment in 1920
Series Nightmare
No full textThis series of oil paintings, titled Nightmare, was created to visually capture a surreal dream the artist experienced many years ago. The series unfolds in a sequence, beginning with And the Dream Drowns You, followed by The Bathtub, Run, The Ballroom, and concluding with Wake Up. Through its unsettling imagery and messy brushstrokes, the work evokes a deep sense of unease, reflecting the eerie quality of the dream itself. Surrealism serves as a powerful vehicle for conveying the elusive nature of dreams—something words can scarcely describe. For the artist, painting becomes the most authentic way to express, \u27This is what I saw in my dream.\u27 The Nightmare series thus functions as a visual repository of a haunting memory
Guided Mental Imagery in ACL Rehabilitation: Impact on Functional Outcomes: A Critically Appraised Topic
No full textGuided Mental Imagery in ACL Rehabilitation: Impact on Functional Outcomes
Clinical Scenario: Anterior cruciate ligament (ACL) injuries are common and debilitating, often requiring extensive rehabilitation. While traditional rehabilitation focuses on physical recovery, evidence suggests that psychological interventions, such as guided mental imagery (GMI), can enhance functional outcomes.
Focused Clinical Question: In patients recovering from ACL reconstruction, how does incorporating GMI into rehabilitation impact functional outcomes (range of motion, pain reduction, and return-to-sport timelines) over a 12-week period?
Summary of Key Findings: A systematic review identified several studies supporting GMI integration into ACL rehab. Patients who incorporated GMI showed improved neuromuscular activation, reduced pain, greater confidence, and quicker return-to-sport times. GMI activates motor pathways critical for recovery and reduces reinjury anxiety, which is common in ACL rehabilitation. Mental imagery has proven effective in improving motor control and proprioception, addressing both physical deficits and psychological barriers, like fear of reinjury. Furthermore, GMI boosts adherence to rehab programs, helping patients remain motivated throughout their recovery.
Due to the complexity of ACL recovery, which requires neuromuscular control for knee stability, GMI offers a non-physical way to reinforce essential movement patterns. It helps reduce anxiety around reinjury and boosts confidence in knee stability, ultimately promoting faster recovery.
Clinical Bottom Line: Guided mental imagery is a simple, cost-effective tool to enhance both physical and mental recovery in ACL rehabilitation. It aids muscle activation, reduces fear of reinjury, and keeps athletes engaged in their rehab. Clinicians should incorporate GMI into rehab programs to improve functional outcomes.
Strength of Recommendation: Based on the available evidence, GMI has a moderate to strong recommendation (grade 1-2 evidence) for improving ACL rehab outcomes.
Key Words: Psychological interventions, functional recovery, return to sport, ACL rehabilitation, imagery use.
Word Count: 28
The relationship between Lynchburg area OB-GYN physician exercise recommendations, physical activity status, and depression in postpartum women.
No full textIntroduction: Postpartum depression (PPD) significantly impacts maternal well-being and infant care, necessitating effective and accessible interventions. This study examines the role of physical activity as a potential therapeutic modality for PPD, addressing the current gap in the routine integration of exercise recommendations within obstetric care. Specifically, this research investigates the provision of exercise guidance by Lynchburg area OB-GYN physicians to pregnant and postpartum patients, assesses the current physical activity levels of postpartum mothers, and explores the correlation between maternal mental health and overall mood. We hypothesize that OB-GYN recommendations on exercise will lead to a positive correlation between regular physical activity and reduced PPD symptoms, supporting the integration of exercise into standard postpartum care protocols. This research aims to provide actionable recommendations for healthcare providers, emphasizing the benefits of physical activity as a holistic approach to PPD management.
Methods: This study will collect primary data through a survey administered to postpartum women within 1 year of birth and treated within the Lynchburg area OB-GYN physician network. The surveys will capture demographic information (age, ethnicity, county, delivery type, bed rest history, and trimester if bed rested) self-reported physical activity patterns (frequency, duration) OB-GYN physician provision of exercise recommendations (Yes or No), and Perceived Stress Scale