Midwives' experiences and perceptions in treating victims of sex trafficking: A qualitative study.

AIM: To explore the experiences and perceptions of midwives in the treatment of sex trafficking victims. DESIGN: The study was qualitative with a hermeneutic-phenomenological approach, using semi-structured interviews and focus groups. METHODS: Two focus groups and six interviews were carried out on 14 midwives in primary care, delivery and emergency rooms. Data were collected in three hospitals in Spain in June 2021. ATLAS.ti 9 software was used to conduct a content analysis of the focus group and interview data. RESULTS: The results revealed two primary themes and six subthemes. The two primary themes were (i) sex trafficking: a camouflaged reality on the invisible spectrum, and (ii) a thirst for attention in the aftermath of violence. Representative quotations were used to illustrate both the main themes and the subthemes. CONCLUSIONS: This study provides new insight into midwives' experiences treating sex trafficking victims. Professionals view this type of violence as a silent issue that negatively impacts victims' health and livelihood. However, a number of different factors stand in the way of correctly identifying and treating victims. Therefore, healthcare workers must be provided with practical tools and continuous professional development on this topic. IMPACT: This study indicates the importance of the midwives' key role in identifying and assisting victims of sex. Not only do measures in the healthcare setting, such as on-going specific-related content training or up-to-date protocols, need to be implemented to ensure proper care for those affected by sexual exploitation, but also focusing on suspicious characteristics and reducing obstacles to patient communication will help bring the true situation to light and better respond to patients' priority needs.

A randomized controlled trial investigating the effects of craniosacral therapy on pain and heart rate variability in fibromyalgia patients.

CONTEXT: Fibromyalgia is a prevalent musculoskeletal disorder associated with widespread mechanical tenderness, fatigue, non-refreshing sleep, depressed mood and pervasive dysfunction of the autonomic nervous system: tachycardia, postural intolerance, Raynaud's phenomenon and diarrhoea. OBJECTIVE: To determine the effects of craniosacral therapy on sensitive tender points and heart rate variability in patients with fibromyalgia. DESIGN: A randomized controlled trial. SUBJECTS: Ninety-two patients with fibromyalgia were randomly assigned to an intervention group or placebo group. INTERVENTIONS: Patients received treatments for 20 weeks. The intervention group underwent a craniosacral therapy protocol and the placebo group received sham treatment with disconnected magnetotherapy equipment. MAIN MEASURES: Pain intensity levels were determined by evaluating tender points, and heart rate variability was recorded by 24-hour Holter monitoring. RESULTS: After 20 weeks of treatment, the intervention group showed significant reduction in pain at 13 of the 18 tender points (P < 0.05). Significant differences in temporal standard deviation of RR segments, root mean square deviation of temporal standard deviation of RR segments and clinical global impression of improvement versus baseline values were observed in the intervention group but not in the placebo group. At two months and one year post therapy, the intervention group showed significant differences versus baseline in tender points at left occiput, left-side lower cervical, left epicondyle and left greater trochanter and significant differences in temporal standard deviation of RR segments, root mean square deviation of temporal standard deviation of RR segments and clinical global impression of improvement. CONCLUSION: Craniosacral therapy improved medium-term pain symptoms in patients with fibromyalgia.

Eficacia de un programa de masaje y ejercicio sobre el índice tobillo/brazo y presión sanguínea en pacientes con diabetes mellitus tipo 2 y enfermedad arterial periférica: ensayo clínico aleatorizado / Efficacy of a massage and exercise programme on the ankle-brachial index and blood pressure in patients with diabetes mellitus type 2 and peripheral arterial disease: a randomized clinical trial

Fundamento y objetivo: La diabetes mellitus tipo 2 es una enfermedad con una elevada prevalencia y puede favorecer la aparición de enfermedad arterial periférica. El objetivo del presente estudio fue analizar la eficacia de un programa de ejercicios y masaje reflejo del tejido conjuntivo sobre el índice tobillo/brazo y los valores de presión arterial de pacientes con diabetes mellitus tipo 2 y enfermedad arterial periférica. Pacientes y método: Se realizó un estudio experimental con grupo control placebo. Se asignaron de forma aleatorizada 66 pacientes diabéticos tipo 2 con enfermedad arterial periférica en estadio II-b de Leriche-Fontaine a un grupo de intervención (ejercicio y masaje) y a un grupo control placebo (programa de magnetoterapia simulada). Las dimensiones de medida fueron la presión arterial e índice tobillo/brazo. Resultados: Finalizadas las 10 semanas de tratamiento, en el grupo de intervención se obtuvieron diferencias significativas (p<0,05) en el índice tobillo/brazo derecho e izquierdo y en la presión arterial sistólica y diastólica en el miembro inferior derecho e izquierdo. Conclusiones: Un programa combinado de ejercicios y masaje mejora la presión arterial y el índice tobillo/brazo en pacientes diabéticos tipo 2 con enfermedad arterial periférica (AU)

Background and Objective: Type 2 diabetes mellitus is a highly prevalent disease that can favour the development of peripheral arterial disease. The objective of this study was to analyse the efficacy of a massage and exercise programme on the ankle-brachial index and arterial pressure of patients with diabetes mellitus type 2 and peripheral arterial disease. Material and Methods: An experimental study with placebo control group was performed. Sixty-six type 2 diabetes patients with Leriche-Fontaine stage II peripheral arterial disease were randomly assigned to an intervention (exercise and massage) or placebo control (simulated magnetotherapy) group. Study variables were arterial pressure and ankle-brachial index. Results: After 10 weeks of treatment, significant (P<0.05) differences between the intervention and placebo groups were found in right and left ankle-brachial index values and in systolic and diastolic pressures in right and left lower extremities. Conclusions: A combined programme of exercise and massage improves arterial blood pressure and ankle brachial index values in type 2 diabetics with peripheral arterial disease (AU)

[Efficacy of a massage and exercise programme on the ankle-brachial index and blood pressure in patients with diabetes mellitus type 2 and peripheral arterial disease: a randomized clinical trial]. / Eficacia de un programa de masaje y ejercicio sobre el índice tobillo/brazo y presión sanguínea en pacientes con diabetes mellitus tipo 2 y enfermedad arterial periférica: ensayo clínico aleatorizado.

BACKGROUND AND OBJECTIVE: Type 2 diabetes mellitus is a highly prevalent disease that can favour the development of peripheral arterial disease. The objective of this study was to analyse the efficacy of a massage and exercise programme on the ankle-brachial index and arterial pressure of patients with diabetes mellitus type 2 and peripheral arterial disease. MATERIAL AND METHODS: An experimental study with placebo control group was performed. Sixty-six type 2 diabetes patients with Leriche-Fontaine stage II peripheral arterial disease were randomly assigned to an intervention (exercise and massage) or placebo control (simulated magnetotherapy) group. Study variables were arterial pressure and ankle-brachial index. RESULTS: After 10 weeks of treatment, significant (P<0.05) differences between the intervention and placebo groups were found in right and left ankle-brachial index values and in systolic and diastolic pressures in right and left lower extremities. CONCLUSIONS: A combined programme of exercise and massage improves arterial blood pressure and ankle brachial index values in type 2 diabetics with peripheral arterial disease.