BACKGROUND:Primary dysmenorrhea is common among women of reproductive age. Non-steroidal anti-inflammatory drugs and oral contraceptives are effective treatments, although the failure rate is around 20-25%. Therefore additional evidence-based treatments are needed. In recent years, the use of smartphone applications (apps) has increased rapidly and may support individuals in self-management strategies.

OBJECTIVE:We aimed to investigate the effectiveness of app-based self-acupressure in women with menstrual pain.

MATERIALS AND METHODS:A two-armed randomized pragmatic trial was conducted from December 2012 to April 2015 with recruitment until August 2014 in Berlin, Germany, among women aged 18-34 years with self reported cramping pain≥6 on a numeric rating scale (NRS) for the worst pain intensity during the previous menstruation. After randomization women performed either app-based self-acupressure (n=111) or followed usual care only (n=110) for six consecutive menstruation cycles. The primary outcome was the mean pain intensity (NRS 0-10) on the days with pain during the third menstruation. Secondary outcomes included worst pain intensity during menstruation, duration of pain, 50% responder rates (reduction of mean pain by at least 50%), medication intake, sick leave days and body efficacy expectation assessed at the 1st, 2nd, 3rd, and 6th menstruation cycle.

RESULTS:We included 221 women (mean age 24.0 (sd 3.6) years). The mean pain intensity difference during the third menstruation was statistically significant in favor for acupressure (acupressure: 4.4 95% CI [4.0; 4.7]; usual care 5.0 [4.6; 5.3]; mean difference -0.6 [-1.2; -0.1], p=0.026). At the sixth cycle, the mean difference between the groups -1.4 [-2.0; -0.8] (p<0.001) reached clinical relevance. At the third and sixth menstruation cycle, responder rate was 37% and 58% respectively in the acupressure group in contrast to 23% and 24% in the usual care group. Moreover, the worst pain intensity (group difference -0.6 [-1.2; -0.02] and -1.4 [-2.0; -0.7]), the number of days with pain (-0.4 [-0.9; -0.01] and -1.2 [-1.6; -0.7]) and the proportion of women with pain medication at the third and sixth menstruation cycle (odd ratio 0.5 [0.3; 0.9] and 0.3 [0.2; 0.5]) was lower in the acupressure group. At the third cycle hormonal contraceptive use was more common in the usual care group than in the acupressure group (odds ratio 0.5 [0.3;0.97]), but not statistically significant different at the sixth cycle (odds ratio 0.6 [0.3;1.1]). The number of sick leave days and body efficacy expectation (self-efficacy scale) did not differ between groups. On a scale from 0-6, mean satisfaction with the intervention at the third cycle was 3.7 (sd 1.3), recommendation of the intervention to others 4.3 (1.5), appropriateness of acupressure for menstrual pain 3.9 (1.4), and application of acupressure for other pain 4.3 (1.5). The intervention was safe and after the sixth cycle two third of the women (67.6%) still applied acupressure on all days with pain.

CONCLUSION:Smartphone app delivered self-acupressure resulted in a reduction of menstrual pain compared to usual care only. Effects were increasing over time and adherence was good. Future trials should include comparisons to other active treatment options.

INTRODUCTION:Military service is a stressful environment. Methods to reduce stress may result in the mental health promotion of military forces. There are various methods for relieving anxiety. Acupressure is one of them. Hence, this study was carried out to explore effects of acupressure at the P6 and LI4 acupressure points on the anxiety level of army soldiers.

METHODS:A randomised double-blind design was undertaken. A total of 120 Iranian army soldiers were randomly assigned to three groups, namely P6, LI4 and control. The P6 and LI4 acupressure points are effective in lowering the anxiety level. In the intervention groups, acupressure was applied at the P6 and LI4 points three times for 10 min at 30 min intervals. In the control group, the thumb pad, which is not an acupressure point, was pressed. The anxiety level of the subjects was measured before the intervention and 30 min after the last intervention. The instruments included a demographics questionnaire and the State-Trait Anxiety Inventory.

RESULTS:There was no significant difference between the three groups with respect to the anxiety level in the preintervention phase. However, the mean anxiety score in the P6 group decreased significantly from 53.35±9.7 to 49.02±9.3 (p=0.005). The mean anxiety score in the LI4 group also decreased significantly from 53.37±8.39 to 45.47±8.16 (p<0.001). In the control group, there was no significant difference between the preintervention and postintervention phases (p=0.16). In the postintervention phase, the analysis of variance test showed a significant difference between the three groups in terms of the anxiety level (p=0.04).

CONCLUSIONS:Acupressure can reduce soldiers' anxiety at the acupressure points, especially at the LI4 point. It is recommended that this simple and cost-effective intervention be used to relieve soldiers' anxiety in stressful situations.

TRIAL REGISTRATION NUMBER:20150715023216N4.

AIM: This paper presents the findings of a study that assessed the effects of acupressure at the Sanyinjiao point on symptoms of primary dysmenorrhoea among adolescent girls. BACKGROUND: Dysmenorrhoea is the most common gynaecological disorder among adolescents. Traditional Chinese acupressure derived from acupuncture is a non-invasive technique. Despite renewed interest in the use of acupressure, relatively few studies have been undertaken to examine its effects on primary dysmenorrhoea. METHODS: An experimental study was conducted between December 2000 and August 2001. Participants were female students attending a technical college in Taiwan. None of the 69 participants had a prior history of gynaecological disease or secondary dysmenorrhoea, and all were rated higher than five for pain on a visual analogue scale from 0 to 10. The experimental group (n = 35) received acupressure at Sanyinjiao (above the ankle) while the control group (n = 34) rested for 20 min, while the control group underwent rest in the school health centre for 20 min without receiving acupressure. Fifty participants (30 experimental, 20 control) completed the 4-6-week follow-up session. Five instruments were used to collect pretest and post-test data at each session: (1) Visual Analogue Scale for pain; (2) the Short-Form McGill Pain Questionnaire; (3) the Menstrual Distress Questionnaire; (4) the Visual Analogue Scale for anxiety; and, for the experimental group only, (5) the Acupressure Self-Assessment Form. Data were analysed using the chi-square test, two-sample t-test and repeated measures two-way anova. RESULTS: Acupressure at Sanyinjiao during the initial session reduced the pain and anxiety typical of dysmenorrhoea. In the self-treatment follow-up session, acupressure at Sanyinjiao significantly reduced menstrual pain but not anxiety. Thirty-one (87%) of the 35 experimental participants reported that acupressure was helpful, and 33 (94%) were satisfied with acupressure in terms of its providing pain relief and psychological support during dysmenorrhoea. CONCLUSION: The findings suggest that acupressure at Sanyinjiao can be an effective, cost-free intervention for reducing pain and anxiety during dysmenorrhoea, and we recommend its use for self-care of primary dysmenorrhoea.

BACKGROUND: Complementary and alternative therapies may be adopted as nursing interventions to alleviate dysmenorrhea and improve productivity, creativity, work performance, and quality of life. OBJECTIVES: This study aimed to evaluate the efficacy of San Yin Jiao (SP6) acupressure as a non-pharmacologic nursing intervention for dysmenorrhea and identify its effects on temperature changes in two related acupoints as an explanatory mechanism of chi circulation. DESIGN: A non-equivalent control group pre and post-test design was employed to verify the effects of SP6 acupressure on skin temperature and dysmenorrhea. SETTING AND PARTICIPANTS: Young college women with primary dysmenorrhea were recruited from classrooms at two universities in Korea and 58 eligible participants were allotted to either a SP6 acupressure group or placebo group that received light touch on the SP6 acupoint. METHODS: The experimental group received acupressure treatment within the first 8h of menstruation, and severity of dysmenorrhea and skin temperature changes in the Zhongwan (CV2) and Qugu (CV12) acupoints were assessed prior to and 30 min, 1, 2, and 3h following treatment. RESULTS: There was a significant difference in severity of dysmenorrhea between the two groups immediately after (F=18.50, p=0.000) and for up to 2h (F=8.04, p=0.032) post treatment. Skin temperature was significantly elevated at 30 min after acupressure at the suprapubic CV2 acupoint in the experimental group compared to the control group. Temperature elevation was also noted at the epigastric CV12 acupoint post treatment but group differences were not significant, indicating that SP6 acupressure relieves dysmenorrhea primarily by temperature elevation in the CV2 pathway. CONCLUSIONS: Acupressure to the SP6 meridian can be an effective non-invasive nursing intervention for alleviation of primary dysmenorrhea, with effects lasting 2h post treatment.

BACKGROUND:This study explored the effects of acupressure on fatigue of lung cancer patients undergoing chemotherapy.

PATIENTS AND METHODS:For this experimental study, 57 subjects were randomly assigned to three groups: acupressure with essential oils (n=17), acupressure only (n=24), and sham acupressure (n=16). Acupoints were Hegu (LI4), Zusanli (ST36), and Sanyingjiao (SP6). All subjects received acupressure once every morning for 5 months, with each acupoint pressed for 1 min. Fatigue, functional status, anxiety, depression, and sleep quality were measured before initial chemotherapy (T0), on Day 1 of third chemotherapy (T1), and on Day 1 of sixth chemotherapy (T2). Outcome differences between groups were analyzed at T0, T1, and T2 by general estimating equations.

RESULTS:After controlling for baseline outcome values, age, and adherence to acupressure, subjects who received acupressure with essential oils and acupressure had significantly less fatigue in daily living activities and sleep better quality at T1 than subjects who received sham acupressure. Subjects who received acupressure with essential oils had significantly better sleep quality at T2 than the sham acupressure group. Subjects who received acupressure with or without essential oils had greater odds of better functional status at T1 than the sham group.

CONCLUSION:It is plausible that acupressure with or without essential oils helps lung cancer patients undergoing chemotherapy reduce cancer-related fatigue and increase activity level. Further study is wanted to test this hypothesis.

AIM AND OBJECTIVES: To examine a comparison between Hegu and Sanyinjiao matched points and Hegu, Zusanli single point on adolescent girls' menstrual distress, pain and anxiety perception. BACKGROUND: Primary dysmenorrhoea is a major cause of temporary disability, with a prevalence ranging from 60-93%, depending upon the population and study. No one has yet compared the effects of single point and multiple point acupressures. Design. A single blind randomised experimental study was used. METHODS: Adolescents (n = 134) randomly assigned to experimental groups Zusanli (n = 30), Hegu (n = 33) and Hegu-Sanyinjiao Matched Points (n = 36) received acupressure intervention protocol for 20 minutes, while the control group (n = 35) did not receive any acupressure intervention. Four instruments were used to collect data: (1) the Visual Analog Scale for Pain; (2) the Menstrual Distress Questionnaire Short Form; (3) the Short-Form McGill Pain Questionnaire and (4) the Visual Analog Scale for Anxiety. RESULTS: During the six-month follow-up, acupressure at matched points Hegu and Sanyinjiao reduced the pain, distress and anxiety typical of dysmenorrhoea. Acupressure at single point Hegu was found, effectively, to reduce menstrual pain during the follow-up period, but no significant difference for reducing menstrual distress and anxiety perception was found. Zusanli acupressure had no significant effects of reducing menstrual pain, distress and anxiety perception. CONCLUSION: This controlled trial provides preliminary evidence that six-month acupressure therapy provides female adolescents with dysmenorrhoea benefits. RELEVANCE TO CLINICAL PRACTICE: Acupressure is an effective and safe non-pharmacologic strategy for the treatment of primary dysmenorrhoea. We recommend the use of acupressure for self-care of primary dysmenorrhoea at Hegu and Sanyinjiao matched points and single point Hegu, as pressure placement at these points is easy for adolescent girls to learn and practice.

BACKGROUND:Students in 2-year registered nurse to Bachelor of Science in nursing (RN-BSN) programs usually work full-time and study part-time. Sleep disturbance, anxiety, and depression are known to be common health problems among these students. Prior research has described the effectiveness of auricular acupressure (AA) in reducing sleep disturbance and improving mood.

PURPOSE:The aim of this study was to evaluate the effect of using a 4-week AA program that adheres to a magnetic pellet on the shenmen acupoint on sleep quality, anxiousness, and depressed moods in nursing students with sleep disturbance.

METHODS:This study used a one-group, quasi-experimental design with repeated measures. Eligible students were recruited from an RN-BSN program offered by a university in northern Taiwan, and all were currently experiencing sleep disturbance. A 4-week AA intervention that applied a magnetic pellet on the shenmen acupoint was used. The Pittsburgh Sleep Quality Index, Beck Anxiety Inventory, and Beck Depression Inventory-II were used to measure sleep quality and mood outcomes each week during the 4-week intervention. Improvements in sleep quality, anxiety, and depressed moods were analyzed using the generalized estimating equation.

RESULTS:Thirty-six participants with a mean age of 32 years were enrolled as participants. After adjusting for confounding factors, continuous and significant improvements in sleep quality, anxiety, and depressed mood (p<.05) were observed throughout the intervention, with 4-week improvements in sleep quality, anxiety, and depressed mood averaging 26.7%, 43.5%, and 25%, respectively.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE:This study showed the efficacy of using a 4-week AA that applies a magnetic pellet on the shenmen acupoint in terms of improving sleep quality, anxiousness, and depressed mood in RN-BSN students experiencing sleep disturbances. Especially, the emotional mood of participants improved significantly as early as the first week. The 4-week AA for reducing sleep disturbance, and improving students' anxiety, and depressed moods may be applied on primary healthcare.

BACKGROUND:Several recent studies have documented the effects of massage and acupressure in reducing labor pain and labor time and in satisfaction with the delivery. However, few studies have investigated the comparative effects of these two therapies.

PURPOSE:The aim of this study was to compare the effects of massage and acupressure on labor-related pain management, duration, and satisfaction with delivery.

METHODS:This randomized controlled trial (n = 120) included three intervention groups (massage only, acupressure only, and massage + acupressure) and one control group, in which patients received no massage or acupressure treatment. A personal information form, Pregnant Watch Form, and Visual Analog Scale (VAS) were used to collect data. Frequency and percentage calculations, chi-square test, Student's t test, Tukey's honestly significant difference test, and one-way variance analysis were used for data analysis.

RESULTS:In the latent phase of labor, the mean VAS scores of the massage-only group and massage + acupressure group were lower (4.56± 1.36 and 4.63 ± 1.52, respectively) than that of the control group (6.16 ± 1.46; p<.01). In the active and transition phases, the mean VAS scores of the massage-only group, acupressure-only group, and massage + acupressure group were significantly lower than that of the control group (p<.01 and p<.001, respectively). During postpartum, the mean VAS score of the massage + acupressure group was lower (2.30± 0.70) than that of the control group (2.96 ± 0.72; p = .003). Cervical dilatation completion time and 1- and 5-minute Apgar scores were similar among all of the groups (p>.05). The three intervention groups reported relatively more positive feelings than the control group, and all three of the interventions were found to be effective in improving satisfaction.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE:The results of this study indicate that the dual application of massage and acupressure is relatively more effective than either therapy applied alone and that massage is more effective than acupressure.

PURPOSE: The purpose of this study was to identify effects of the SP-6 acupressure on dysmenorrhea, and level of cortisol, epinephrine and norepinephrine in the college students. METHOD: Data were collected from May 1 to August 31, 2002. A total of 58 students from two universities participated in the study. Both groups were pretested before the intervention for three variables, the intensity of dysmenorrhea, level of cortisol, epinephrine and norepinephrine. Then, SP-6 acupressure was provided for 20 minutes for students in the experimental group. The instruments used in this study included the Visual Analogue Scale developed by Johnson(1974), Menstrual Attitudes Questionnaire Scale developed by Brooks-Gunn&Ruble(1980), and Stress scale developed by Cheun and Kim(1990). RESULT: There were statistically significant differences in the intensity of dysmenorrhea at the time immediately after, 30 minutes after, one hour after, and two hours after the intervention. The experimental group had a lower intensity than the control group. There was a statistically significant difference in level of norepinephrine at the time 30 minutes after the intervention with the experimental group. CONCLUSION: The SP-6 acupressure reduced the subjective perception of dysmenorrhea and the levels of norepinephrine. It was found out that the lasting period of 20 minutes of the SP-6 acupressure was two hours for college students.

AIM:To determine whether acupressure can prevent or relieve the adverse drug reactions (ADRs) of anti-tuberculosis drugs.

BACKGROUND:People receiving drug treatment for TB often experience ADRs that may cause them to stop taking their medication. Acupressure is a form of traditional Chinese medicine that can be applied to alleviate or prevent disease symptoms.

DESIGN:A double-blinded, repeated-measures clinical trial in hospitals in Taiwan was carried out from April 2015 - May 2017.

METHODS:Convenience sampling was used to select 32 people (15 for the experimental group and 17 for the control group) aged>20 years who were taking anti-tuberculosis drugs. The people were randomized to receive 4-week of true acupressure and 4-weeks of sham acupressure. Acupressure therapy was given by a researcher in all cases. Both groups received treatment once per day on weekdays, with 15 min for each acupressure session. Outcomes (gastrointestinal irritation and adverse skin reactions) were assessed according to the people feedback and the physicians' recordings during the treatment course, and during monthly follow-up visits for 6 months thereafter.

RESULTS:Both groups typically experienced gastrointestinal irritation and adverse skin reactions within 2 months of beginning anti-tuberculosis drug treatment. The 4-weeks intervention involving relevant acupressure points successfully relieved both types of side effects in both immediate and delayed manner.

CONCLUSIONS:When correctly implemented, acupressure can prevent and relieve the ADRs of anti-tuberculosis drugs, and motivate people to complete their treatment course.

AIM: Insomnia is a major problem which decreases life quality. Many causes are involved with it and anxiety is often associated. The underlying mechanism is not completely understood, even though different factors seem to be associated. Among them melatonin and its circadian rhythm is thought to have an important role. In addition, acupressure and acupuncture are known to ameliorate insomnia and anxiety, when a specific wrist point is stimulated (HT 7 Shenmen). With these bases, the aim of the present study has been to evaluate the efficacy of an acupressure device, ''H7-insomnia control'', positioned on HT 7 points, during the night, in terms of general health and anxiety levels, together with the evaluation of sleep quality and the urinary melatonin metabolite 6-hydroxymelatonin sulphate determination, in a number of insomniacs. METHODS: Forty patients with insomnia were divided into two groups and randomly received either the H7 or placebo treatments, in a double-blind protocol, for 20 nights. Before and after treatments every subject answered a series of questionnaires (General Health Questionnaire 28 items; State-Trait Anxiety Inventory; Pittsburgh Sleep Quality Index) and collected 24 h urines, divided into two samples of 12 h each. Urinary melatonin metabolite was then determined using a RIA method. RESULTS: Data obtained indicate that the device H7-insomnia control is efficacious to ameliorate quality of sleep and reduce anxiety levels in insomniacs, at a higher extent than in the placebo group. In addition, the 24 hours urinary melatonin metabolite rhythm, obtained at the end of treatment, was considered as being normal in a higher percentage of H7-treated patients, with respect to the placebo group. CONCLUSION: It is plausible to hypothesize that the wrist acupressure device might be considered a valid tool, without adverse effects since it does not contain pharmaceutical products, that is able to naturally ameliorate sleep quality in insomniacs, acting through a not jet completely clarified mechanism, that may involve melatonin.

It is well established that the telomeres at the ends of chromosomes are composed of long arrays of (TTAGGG)n x (CCCTAA)n that form a nucleoprotein complex required for the replication and protection of chromosome ends. Throughout the cell cycle, telomeres also contain a protein component related to the proto-oncogene Myb that is known as TRF1 (telomere TTAGGG repeat binding factor 1) that binds to the duplex array of TTAGGG repeats in the telomere. Previous studies have shown that TRF1 appears to play a role in controlling the length of telomeres by acting as an inhibitor of telomerase. The amount of each of the TRF1(C-19)&TRF1(N-19) was identical to the amount of telomere of the same organ of the same apparently normal individual. Using synthesized basic unit of TTAGGG, as well as CCCTAA, as separate reference control substances for the Bi-Digital O-Ring Test of Resonance Phenomenon between 2 identical substances, we were able to non-invasively measure the approximate amount of TTAGGG and CCCTAA units, in both normal and cancerous human cells. We examined about 30 apparently normal subjects (both Asian and Caucasian in both sex). The subjects' ages ranged from infancy to 76 years. Each subject was first examined using TTAGGG as a control substance and then examined using CCCTAA as a control substance. The amount of telomere in various cancer tissues are almost always higher than that of normal tissue of the same organ. The measured amounts of both TTAGGG and CCCTAA were found to be in an average of 1500-1600 ng for human fetus or infancy and decreased with the advance of age in both sex with the exception of the heart, brain, eyes (retina), testes, and ovaries, which usually remain at the level of the infant, or reduced very little. Individuals in the same age group had a similar range of amounts of both TTAGGG and CCCTAA in the same organ of the same individual, (except for those with unusually low telomeres often had chronic degenerative diseases, and those who had exceptionally high telomere levels often had excellent physical conditions or mental acumen). The amounts of measured TTAGGG and CCCTAA molecules before and after acupuncture on St. 36 in adenocarcinomas and small cell carcinoma coexisting in the lung of a 54-yr.-old Asian male were: telomere in adenocarcinoma decreased from 950 ng to 750 ng and telomere in small cell carcinoma decreased from 770 ng to 600 ng. When the cancer treatment is effective, the amount of telomere is reduced towards the value of the normal internal organ. We found that acupuncture on St.36 on apparently normal subjects increased the telomere levels up to a maximum of more than 2 times their telomere levels prior to the treatment, depending on the method of treatment, but frequently increases were between 60% to 100%. Strong Shiatsu performed on St. 36 produced a somewhat lesser effect than acupuncture. We also determined the amounts of TTAGGG and CCCTAA molecules non-invasively in 3 mummified Egyptian sisters from the 8th Century BC on exhibit at the Museo Egizio in Turin, Italy in order to estimate their approximate ages (at the time of death). The amounts of body telomere were 500 ng, 550 ng, and 750 ng. For the prehistoric Iceman (about 3350 B.C. to 3310 B.C) discovered in 1991 in the Italian Otzal Alps at about 3,200 meters altitude, estimated body telomere was about 400 ng and telomere in brain and heart was 1600 ng, similar to that of a contemporary human being. Although these studies are preliminary, the findings may have potential applications not only in anti-aging, cancer treatments, and pathophysiology of brain and heart, but also for the estimation of the difference in the ages of cadavers studied in archeology and forensic medicine.

It is well established that the telomeres at the ends of chromosomes are composed of long arrays of (TTAGGG)n x (CCCTAA)n that form a nucleoprotein complex required for the replication and protection of chromosome ends. Throughout the cell cycle, telomeres also contain a protein component related to the proto-oncogene Myb that is known as TRF1 (telomere TTAGGG repeat binding factor 1) that binds to the duplex array of TTAGGG repeats in the telomere. Previous studies have shown that TRF1 appears to play a role in controlling the length of telomeres by acting as an inhibitor of telomerase. The amount of each of the TRF1(C-19)&TRF1(N-19) was identical to the amount of telomere of the same organ of the same apparently normal individual. Using synthesized basic unit of TTAGGG, as well as CCCTAA, as separate reference control substances for the Bi-Digital O-Ring Test of Resonance Phenomenon between 2 identical substances, we were able to non-invasively measure the approximate amount of TTAGGG and CCCTAA units, in both normal and cancerous human cells. We examined about 30 apparently normal subjects (both Asian and Caucasian in both sex). The subjects' ages ranged from infancy to 76 years. Each subject was first examined using TTAGGG as a control substance and then examined using CCCTAA as a control substance. The amount of telomere in various cancer tissues are almost always higher than that of normal tissue of the same organ. The measured amounts of both TTAGGG and CCCTAA were found to be in an average of 1500-1600 ng for human fetus or infancy and decreased with the advance of age in both sex with the exception of the heart, brain, eyes (retina), testes, and ovaries, which usually remain at the level of the infant, or reduced very little. Individuals in the same age group had a similar range of amounts of both TTAGGG and CCCTAA in the same organ of the same individual, (except for those with unusually low telomeres often had chronic degenerative diseases, and those who had exceptionally high telomere levels often had excellent physical conditions or mental acumen). The amounts of measured TTAGGG and CCCTAA molecules before and after acupuncture on St. 36 in adenocarcinomas and small cell carcinoma coexisting in the lung of a 54-yr.-old Asian male were: telomere in adenocarcinoma decreased from 950 ng to 750 ng and telomere in small cell carcinoma decreased from 770 ng to 600 ng. When the cancer treatment is effective, the amount of telomere is reduced towards the value of the normal internal organ. We found that acupuncture on St.36 on apparently normal subjects increased the telomere levels up to a maximum of more than 2 times their telomere levels prior to the treatment, depending on the method of treatment, but frequently increases were between 60% to 100%. Strong Shiatsu performed on St. 36 produced a somewhat lesser effect than acupuncture. We also determined the amounts of TTAGGG and CCCTAA molecules non-invasively in 3 mummified Egyptian sisters from the 8th Century BC on exhibit at the Museo Egizio in Turin, Italy in order to estimate their approximate ages (at the time of death). The amounts of body telomere were 500 ng, 550 ng, and 750 ng. For the prehistoric Iceman (about 3350 B.C. to 3310 B.C) discovered in 1991 in the Italian Otzal Alps at about 3,200 meters altitude, estimated body telomere was about 400 ng and telomere in brain and heart was 1600 ng, similar to that of a contemporary human being. Although these studies are preliminary, the findings may have potential applications not only in anti-aging, cancer treatments, and pathophysiology of brain and heart, but also for the estimation of the difference in the ages of cadavers studied in archeology and forensic medicine.

Abstract Objective: The objective of the study was to evaluate the effect of auricular acupressure in controlling intraocular pressure (IOP) in patients with glaucoma. Design: Thirty-three (33) patients were recruited through advertisement at the clinic for glaucoma. These patients were divided into the auricular acupressure group (16 patients, 28 glaucoma eyes) and the sham group (17 patients, 32 glaucoma eyes). Patients in the acupressure group received auricular acupoint (kidney, liver, and eye) stimulator tapping and regular massage twice a day for 4 weeks. Patients in the sham group received tapping at sham auricular acupoints (wrist, shoulder, and jaw) without massage stimulation. The IOP and visual acuity (VA) were assessed before and after the treatment in the first 4 weeks and followed up, up to 8 weeks. Results: After the treatment and at the 8-week follow-up, IOP and VA improved significantly in the acupressure group when compared with pretreatment (p < 0.05). The most significant IOP-lowering effect was seen at about 3-4 weeks after auricular acupressure. IOP returned to the initial level after acupressure had been discontinued for 4 weeks. Significant improvement of the uncorrected VA (UCVA) was noted at about 2-4 weeks in the acupressure group. UCVA improvement was also noted in the sham group. The difference was only significant in week 3. Improvement of the best-corrected VA was noted in both groups, but was only significant in week 2. Conclusions: Our data suggest that auricular acupressure can be used as a complementary treatment toameliorate IOP and VA for patients with glaucoma.

Importance:Fatigue is a common and debilitating late-term effect of breast cancer that is associated with poor sleep and decreased quality of life, yet therapies remain limited. Acupressure has reduced fatigue in previous small studies, but rigorous clinical trials are needed.

Objectives:To investigate if 6 weeks of 2 types of self-administered acupressure improved fatigue, sleep, and quality of life vs usual care in breast cancer survivors and to determine if changes were sustained during a 4-week washout period.

Design, Setting, and Participants:Phase 3 randomized, single-blind, clinical trial conducted from March 1, 2011, through October 31, 2014. Women were recruited from the Michigan Tumor Registry.

Interventions:Randomization (1:1:1) to 6 weeks of daily self-administered relaxing acupressure, stimulating acupressure, or usual care.

Main Outcomes and Measures:The primary outcome was change in the Brief Fatigue Inventory score from baseline to weeks 6 and 10. Secondary analyses were sleep (Pittsburgh Sleep Quality Index) and quality of life (Long-Term Quality of Life Instrument).

Results:A total of 424 survivors of stages 0 to III breast cancer who had completed cancer treatments at least 12 months previously were screened, and 288 were randomized, with 270 receiving relaxing acupressure (n = 94), stimulating acupressure (n = 90), or usual care (n = 86). One woman withdrew owing to bruising at the acupoints. At week 6, the percentages of participants who achieved normal fatigue levels (Brief Fatigue Inventory score<4) were 66.2% (49 of 74) in relaxing acupressure, 60.9% (42 of 70) in stimulating acupressure, and 31.3% (26 of 84) in usual care. At week 10, a total of 56.3% (40 of 71) in relaxing acupressure, 60.9% (42 of 69) in stimulating acupressure, and 30.1% (25 of 83) in usual care continued to have normal fatigue. At neither time point were the 2 acupressure groups significantly different. Relaxing acupressure, but not stimulating acupressure, showed significant improvements in sleep quality compared with usual care at week 6, but not at week 10. Only relaxing acupressure significantly improved quality of life vs usual care at weeks 6 and 10.

Conclusions and Relevance:Both acupressure arms significantly reduced persistent fatigue compared with usual care, but only relaxing acupressure had significant effects on sleep quality and quality of life. Relaxing acupressure offers a possible low-cost option for managing symptoms.

Trial Registration:clinicaltrials.gov Identifier: NCT01281904.

BACKGROUND:Acupressure is increasing in popularity as an alternative treatment in obstetrics and gynecology.

OBJECTIVES:To summarize and assess evidence regarding the effects of acupressure on duration of labor and mode of delivery.

SEARCH STRATEGY:Four major databases and Google Scholar were searched using terms related to labor and acupressure, without language restrictions, up to November 2015.

SELECTION CRITERIA:Randomized controlled trials were included if they examined the effect of acupressure at any acupoint during childbirth on duration of labor and/or mode of delivery.

DATA COLLECTION AND ANALYSIS:Two reviewers independently extracted data. The outcome measures were duration of labor and mode of delivery. Random-effects models were used to pool results.

MAIN RESULTS:Thirteen studies were included in meta-analyses. Acupressure increased the chance of vaginal delivery when compared with placebo/no intervention (odds ratio [OR] 2.329, 95% confidence interval [CI] 1.348-4.024, P=0.002; risk difference [RD] 8.9%, 95% CI 2.7%-15.0%, P=0.005). Acupressure decreased the duration of the active phase by 1.310 hours (95% CI -1.738 to -0.882; P<0.001) and the second stage of labor by 5.808 minutes (95% CI -1.615 to -0.807; P<0.001).

CONCLUSIONS:Acupressure could have a role in reducing the rate of cesarean delivery and decreasing the duration of labor in parturient women. However, there is a need for more reliable randomized controlled trials.

Stroke is the fifth leading cause of death and the number one cause of long-term disability. Seventy-five percent of annual stroke victims are older than 65. Post-stroke depression (PSD) is a common consequence of stroke, with the estimated prevalence ranging from 25% to 79%. Although several studies have investigated the impact of pharmacological interventions on PSD, there is a significant gap in knowledge regarding the efficacy of nonpharmacological measures for treatment of PSD. The purpose of the current integrative literature review was to synthesize the state of knowledge on selected nonpharmacological treatments for PSD and present findings regarding the efficacy of investigated treatments. Twenty-one studies published from 1992-2016 were identified and synthesized. Results indicated that studies demonstrating improvement in depressive symptoms included ecosystem-focused therapy, life review therapy, problem solving therapy, meridian acupressure, repetitive transcranial magnetic stimulation, music therapy, exercise, light therapy, motivational interviewing, and robotic-assisted neurorehabilitation. [Res Gerontol Nurs. 2017; x(x):xx-xx.].

Our objective was to study the analgesic effect of acupoint pressure on postoperative pain in a controlled single-blind study. Forty patients undergoing knee arthroscopy in an ambulatory surgery unit in a university-affiliated hospital were randomized to receive either an active stimulation (AS) or a placebo stimulation (PS) 30 min after awakening from anesthesia. We stimulated 15 classical acupoints in the AS group, on the side contralateral to surgery, with a firm pressure and a gliding movement across the acupoint. In the PS group, 15 nonacupoints were subjected to light pressure in the same areas as the acupoints in the AS group. We assessed pain using a 100-mm visual analog scale (VAS) before sensory stimulation, after 30 and 60 min, and after 24 h. We recorded heart rate, systolic arterial pressure, and skin temperature before stimulation and after 30 and 60 min. We assessed skin blood flow with laser Doppler before stimulation and after 1 and 30 min. Sixty minutes and 24 h after AS, VAS pain scores were lower than in the placebo group (p<0.05 and 0.0001, respectively). There were no significant changes in the autonomic variables. The results indicate that pressure on acupoints can decrease postoperative pain.

OBJECTIVES:This double-blind RCT aimed to test the efficacy of self-administered acupressure for pain and physical function improvement for older adults with knee osteoarthritis (KOA).

METHODS:Community-living adults with symptomatic KOA (N=150; mean age=73) participated and were randomized to verum acupressure, sham acupressure, or usual care. Verum and sham, but not usual care, participants were taught to self-apply acupressure once daily, five days/week for eight weeks. Assessments were collected during center visits at baseline, four and eight weeks. The numeric rating scale (NRS) for pain was administered during weekly phone calls to check on the participants. Outcomes included the WOMAC pain subscale (primary), the NRS and physical function measures (secondary). Linear mixed regression was conducted to test between group differences in mean changes from baseline for the outcomes at eight weeks.

RESULTS:Compared with usual care, both verum and sham participants experienced significant improvements in WOMAC pain (mean difference: -1.27 units; 95% CI: -1.95 to -.58, and -1.24; 95% CI: -1.92 to -.55, respectively), NRS pain (-.74; 95% CI: -1.24 to -.24, and -.51; 95% CI: -1.01 to -.01, respectively) and WOMAC function (-4.83; 95% CI: -6.99 to -2.67, and -4.21; 95% CI: -6.37 to -2.04, respectively) at 8 weeks. There were no significant differences between verum and sham acupressure groups in any outcomes.

CONCLUSION:Self-administered acupressure is superior to usual care in pain and physical function improvement for older people with KOA. The reason for the benefits is unclear and placebo effects may have played a role. This article is protected by copyright. All rights reserved.