Healing The Healers: Different Ways Healthcare Professionals Can Manage Their Chronic Pain 

Tablet with the text Pain Management on the displayWritten By Lucy Peters

Around 30% of physicians experience chronic physical illness and pain, with 82% experiencing concomitant chronic mental concerns, according to a study of 248 physicians conducted by the University of Ottawa. As such, there needs to be some changes occurring in the field of medicine — especially when it comes to the concept of chronic pain management. So, to this end, what are a few different ways that healthcare professionals can manage chronic pain?

Chronic Pain-Specific Medication

A study conducted by the University of Colorado Denver School of Medicine found that healthcare practitioners limit or avoid controlled pain medications due to their practice guidelines and regulations. Despite this, the discomfort that comes with chronic pain can become so debilitating that they achieve relief through chronic pain-specific medication that’s over the counter or prescribed, such as Oxycodone, Ibuprofen and Morphine. But for doctors who are not comfortable relying on medication, thankfully, there are other options to pursue.

Alternative Care

Chronic pain affects a substantial number of nurses. A study by Gaziantep University found that 84.2% of nurses experience chronic lower back pain of moderate severity. Instead of using any medication, they have found that turning to alternative care like chiropractic adjustment and acupuncture provide relief. Those that undergo chiropractic adjustments reported in a JAMA Open Network’s published study that after six sessions, they have less pain intensity, higher satisfaction in their care, less disability, and more mobility.

Physical Therapy And Exercise

Medical professionals are constantly in motion, and chronic pain hinders this. The pain may also cause a lack of physical activity that opens the gates to other health issues. As such, physical activity is necessary. Aerobic exercises are an effective way to treat chronic pain, according to a study conducted by the Thurston Arthritis Research Center. They found that walking or stationary cycling are moderate impact activities that relieve pain.

Psychiatric Support

Chronic pain is an emotional and mental battle, according to Linda Girgis, MD. She shared her story of being a practicing doctor that got into an accident that left her with a displaced, comminuted proximal humerus fracture. This event effectively made her a chronic pain patient for the rest of her natural life. She soon realized that chronic pain takes a rather strong emotional and mental toll, as the pain made her normal activities no longer possible, and her patients did not care about her pain — only the inconvenience her condition had caused them.

This is precisely why the study conducted by the Department of Psychiatry of George Washington University found that psychological interventions for chronic pain are necessary. Psychiatric support for medical professionals that suffer from chronic pain can help them recalibrate their perspectives and process their pain in a safe and healthy environment.

Living with chronic pain can feel like a continuous battle—especially for the very professionals that are tasked with looking after the health of others. This is why there need to be further studies on managing pain and improving the way the topic of chronic pain in healthcare professionals is addressed. As soon as there is an established way to fully heal the healers from their chronic pain, the better the field of healthcare will be as a whole.


Holistic Integrative Specialist Program Article on Cancer and Alternative Treatments

Cancer is a difficult disease to treat. It is the plague of the modern era.  In treating it, many utilize conventional methods, but complimentary and alternative methods can also be useful in overall treatment plans.  Complimentary treatments can help prevent future cancer and also help with current treatments.  These type of extra treatments need to be used in concert with conventional treatments and arranged only through professional guidance.

Alternative and Conventional medicine can work together under professional guidance. Please also review our Holistic Integrative Specialist Program


The article, “Let’s Talk About Complementary & Alternative Care for Cancer” by Erin Boyle looks at complimentary medicine and treatments that can be used in concert with conventional treatments of cancer.  She states,

“Complementary medicine is used in addition to conventional cancer care. It can include products, practices, and healthcare systems outside of mainstream medicine. These methods don’t “cure” cancer, but work in conjunction with conventional cancer treatments to help in a variety of ways, including pain management and emotional support. ”

To read the entire article, please click here

Please also review our Holistic Integrative Specialist Program and see if it meets your academic and professional arguments.  The program is online and independent study.



Holistic Integrative Specialist Program Article on Complimentary Therapy

Holistic and Alternative care is becoming more mainstream.  It is very useful for those who mix complementary practices.  The worth of these other practices like all medicines are not guaranteed but they do have a history of success.  It is important though to understand their nature and which ones play a certain role in health.  Somethings should not be mixed and others can be very complimentary to conventional medicine.  Some practices are more preventative, while others deal more with chronic issues than acute.

Alternative medication and therapy can play a big role in your health. Please also review our Holistic Integrative Specialist Program


The article, “The Complete Guide to Complementary and Alternative Therapy” by Kat Nicholls discusses the importance of Holistic care and complimentary medicines.  She states,

“Anything that doesn’t fit under conventional or ‘standard’ medical care can be called a complementary or alternative therapy (or complementary and alternative medicine, CAM). These practices, products and therapies include approaches that have been used throughout history such as aromatherapy, yoga and ayurveda.”

To read the entire article, please click here

Please also review our Holistic Integrative Specialist Program and see if it matches your academic and professional goals

In the meantime, if investigating alternative therapies, be sure to consult your primary physician and also work with a Holistic Integrative Specialist who can guide you in the proper direction.



Holistic Integrative Specialist Article on Aging and Holistic Medicine

Aging is part of living.  Living a healthy life ensures aging is a process that does not excel at a fast right.  With good exercise, safe diet and preventative measures, holistic living can help retain youth longer and help one be optimal for the age they are.  There is never a guarantee in life, but the odds are always higher when one takes his or her own health into their own hands.  If blessed with longevity or disease resistance or not, one who cares for his or her body and utilizes a holistic life style to his or her own advantage will age better than if they did not


How can a healthier and holistic life benefit you and aging? Please also review our Holistic Integrative Specialist Certification program


The article, “Holistic Medicine Ensures a Better Life While Aging” from Industry Global News looks at how aging can be a smoother process through Holistic care

To read the article, please click here

One can learn more about the advantages of a healthy life style and aging by reviewing our Holistic Integrative Specialist and Healthcare Life Coaching blogs.  One can also if a nurse enroll into the Holistic Integrative Specialist Certification.  The program is online and independent study.  The certification lasts for four years and can be renewed.  Please review the program and see if it matches your academic and professional goals.


Holistic Integrative Specialist Article on Primary and Holistic Care

More and more holistic and preventative medicines are being incorporated into primary care. Primary physicians and healthcare professionals are seeing the benefits of many of these practices when used in a safe and complimentary way with conventional medicine.  With their approval, so comes providers who cover and pay for these services.


Primary care is beginning to take a closer more holistic approach to care. Please also review our Holistic integrative specialist program


Professionals who are well equipped with the knowledge of both types of practices are becoming more and more important as patients seek more preventative and holistic methods of care.  These Holistic Integrative Specialists can play key roles in primary practices.

The article, “Providing Holistic Preventive Health with Advanced Primary Care” by Emily Sokol looks deeper into this joining of forces.  She states,

“Providers cannot furnish holistic care without addressing social determinants of health. Factors such as the environment, socioeconomic status, and access to healthy food options account for 60 percent of an individual’s health.”

Through this, primary care is looking more and more at the entirety of the person as well when dealing with a person’s health.  To read the entire article, please click here

Please also review our Holistic Integrative Specialist Program and see if it meets your academic and professional goals.


Holistic Integrative Specialist Article and Pain Management

Pain is a constant in life.  Whether mental, emotional or physical, it is present in some form, most of one’s days.  While this is unfortunate, it is also true.  Pain is part of humanity’s reality in the fallen and temporal reality.  How one deals with pain determines one’s ability to survive and be successful.  Coping strategies are critically important, but for numerous years, physical pain in particular has been blanketed with prescription based drugs.

People deal with pain everyday in their lives. Learning how to cope with that pain is essential. Holistic Integrative Specialists can help one find alternative and less addictive ways to deal with pain


Prescription based drugs, especially opioid based, have shown case histories of long term negative effects on individuals.  Many individuals face addiction as a result of long term exposure to these drugs.  Physicians over prescribed opioid based drugs for surgery and chronic pains.  As a result, we now face the addiction epidemic over pain killers.

In response, severe restrictions have been employed against the use of these drugs.  Unfortunately this severe response has left those in the middle once again at the mercy of pain.  Limited pain killers are now not available for post operation.   The excess and abuse prior has now laid a foundation for a severe lack of good pain killers for those who need them.  Until common sense and moderation returns, many individuals suffer with over the counter pain killers to deal with post operation or sometimes chronic situations.  It is a true shame for those who suffer pain as a result of substance abuse and excessive prescribing by physicians.

This, however, is the true reality that exists today.  Pain medications are used rarer and in little doses.  They are also reserved only for the most severe cases.  While this is in some ways good, it is not necessarily good for the average person who does not misuse pain medications but needs them short term or even some who are not classified as severe enough with their chronic situation.

In response, many individuals trying to cope with pain have looked for alternative ways to face it.  With minimal pain medication available, they look to supplement with a variety of holistic and alternative practices. Fortunately, many of these practices have proved productive and many individuals have found relief from pain.

Chiropractic service has become one of the more mainstream holistic practices to reduce pain and heal the problem at its core.  This practice helps realign the spine and other skeletal structures.  It is also employs massage therapy and other aroma therapies utilized with massage.  The usage of these practices on a consistent basis have proven to help many people not only cope with pain but also find a solution to the source of the pain.

In addition, others have looked towards acupuncture and other pain reliefs.  In the search, they have discovered some pains are a source of energy displaced.  Acupuncture, EFT, and some massage therapies are able to properly re-channel emotional, mental and physical pain.  In addition to these uses, others have employed hynotherapy as a way for the mind to overcome the pain of the body.

Meditation and other physical forms of therapy are also very productive.  Many have employed meditation, or physical exercises such as yoga to help heal the body.  Instead of dealing with daily inflammation.  Individuals utilize yoga and other stretching therapies to find healing and reduction of pain.

Holistic Integrative Specialists can also offer a wide variety of suggestions regarding herbal remedies that reduce inflammation and also promote healthy healing.  With so many options for pain management and the lack of strong and potentially addictive medication, it is no wonder that so many have looked into and put so much energy into these alternative practices.

A Holistic Integrative Specialist can look at a variety of practices to help. From EFT to Hypnotherapy and merely herbal remedies, a Holistic Integrative Specialist can be an important guide


The American Institute of Health Care Professionals offers a variety of alternative methods to help alleviate pain.  Qualified professionals can become certified in a variety of programs that can train them in alternative practices to help others overcome physical, emotional and mental pain.  All of the programs are online and independent study and offer four year certifications in the practice to those who qualify.

The American Institute of Health Care Professionals offers certifications in Hypnotherapy, Meditation Instructor, and EFT specialist.  It also offers a wider program to healthcare professionals who are interested in Holistic Integrative practices.  This particular program is primarily offered to nurses or other higher licensed healthcare professionals who look to guide individuals to a more healthy and holistic life style.

It is very important with so many individuals looking into holistic and alternative methods to have a trained and guiding voice.  Healthcare professionals trained in Western Medicine can better understand the needs of a patient and also guide them to the proper alternative practices.  It can be very dangerous to employ various new methods without first consulting a healthcare professional.  Many things need to be understood.

One needs to see how these herbal supplements, or practices will affect the individual.  Some medications may not mix or some may have health issues which prevent them from practicing alternative therapies.  One’s healthcare professional can guide one through these processes but a Holistic Integrative Specialist can not only see if the alternative practice is safe for the particular situation but also guide one to a better option.

This type of guidance is important as so many individuals continue to search for alternative answers to their pain but may not understand things.  This type of self doctoring can be very dangerous to one’s health.  A Holistic Integrative Specialist can help individuals make wise and informed decisions regarding their health.

Please review our Holistic Integrative Health Specialist Program and see if it matches your academic and professional goals.  Within time, one will be able to confidentially interweave one’s medical knowledge with alternative practices and help guide individuals through the process of finding pain relief.

Holistic Integrative Specialist Program Article on Eastern Medication

Sometimes Western medications are limited.  Other medications from other cultures may have less side effects, or be better long term for one’s recovery.  Eastern medications are sometimes wise to explore with the proper professional guidance regarding your diagnosis.

Eastern medication when utilized properly can help individuals through illness. One must be guided by a healthcare professional to avoid dangers

Healthcare professionals who are certified in holistic integrative medication can be a great source in guiding one through the various different types of medicine.

The article, “How Eastern Medicine Can Improve Your Life” through businessmirror states

Eastern medicine has been going mainstream in the last few years. It’s moved beyond simply being a fringe medical practice in the western world, and has become widely accepted as a relevant and effective alternative medicine. This comes as no surprise to practitioners in India and China; Eastern medicine, including Ayurvedic medicine and Traditional Chinese medicine (TCM), is steeped in thousands of years of history, study and practice.

To read the entire article, please click here

Please also review our Holistic Integrative Specialist Program and see if it matches your academic and professional goals

Holistic Interactive Practitioner Program Article on Holistic Medication and Treatment

Alternative practices and holistic remedies usually treat causes more than symptoms.  In many ways they are also more preventive but in some cases can be utilized for treatment.  With all the confusion of what alternative or holistic medicine to use, it is important to coordinate any additional alternative practices or medicines with your primary care giver.  It is also important to discuss with a Holistic Interactive Practitioner about what medications are best and which ones should not be used with each other.  Nurses make excellent potential Holistic caregivers.

Please review the program and see if it meets your academic and professional goals.

The article, “Treating the Causes, Not the Symptoms” by Sheila Julson states,

“Complementary (also called integrative) medicine is when a non-mainstream practice is used in conjunction with conventional medicine. Alternative medicine uses non-mainstream practices in place of conventional medicine. They’re often referred to together as Complementary and Alternative Medicine (CAM) and have a similar objective: to find and treat the underlying causes of health problems rather than to just address symptoms.”

To read the entire article, please click here

In the meantime, if interested, please review our Holistic Interactive Practitioner Program and see if it meets your professional goals.

Integrative Holistic Healthcare Specialist Program Article on Holistic Care

Holistic medicine is considered by some to be taboo while many others find its benefits to be extraordinary.   There should be a healthy balance in utilizing various  holistic medicines and avoiding others.  Some may be snake oil in disguise while other uses may have true traditional and successful uses.

Please review our Integrative Holistic Healthcare Specialist Program and see if it meets your academic and professional goals

Holistic medicine in itself seeks to treat the entirety of the human person.  It looks at mind, body and spirit.   Holistic practitioners believe that optimal health is through balance.  The body has many inter dependent parts.  If one part of the body is imbalanced, then that can cause multiple health issues. (1)

Holistic medicine in many ways is a life style.  It involves eating properly, utilizing herbs and other practices to achieve ultimate balance.  Some of the remedies are long term or preventative while others over time can help cure disease.  Ultimately, Holistic medicine believes all people have innate healing abilities and that over time one can find healing through a variety of treatments that treat the totality of the body.  Holistic medicine does not just look to alleviate symptoms but to also find a cure. (2)

Holistic practitioner look to change the over life style of their patients.  They emphasize patient education, exercise and change of diet.  They also emphasize utilization of complimentary alternative practices such as acupuncture, massage therapy, chiropractic, homeopathy and naturopathy. (3)

In essence, Holistic practitioners look to help their patients by unlocking healing and restoring balance. Optimal health is more than just the absence of sickness but a true search for the best lifestyle at every mental, physical and spiritual level. (4)

This is why holistic lifestyles are a acquired habit.  They are not fads that come and go but are a commitment to health.  It involves a serious understanding of diet and how herbs and various foods affect the body.  Food and healthy eating is so critical to health.  The diets of many Americans exist on fast food.  Bad foods drain the body and lead to sickness.

In addition to better diet, exercise is critical.  Strengthening weaknesses and giving the body the exercise it needs is essential to good health.  Through good diet and exercise, one can begin to find the balance they need.   Sickness, however, can still occur.  This is where understanding proper diet for a particular sickness is essential.

Does this mean, one should abandon more acute methods and symptom relieving medications of the West?  Absolutely not.  In fact, many Holistic practitioners work with other medical providers or are educated in both fields.  They see the importance of complementing alternative and Western procedures and medications together.

Many individuals are diagnosed with life threatening diseases.  It is important to consult Western professionals but to also utilize the guidance of alternative medications.  Many lose hope and turn to only alternative practices, but a wise practitioner will compliment both.   A Holistic Nurse Specialist has the capability to help guide a patient to proper alternative medications.  A Holistic Nurse Specialist understands how alternative medications and practices interact with Western medicine.  They can be an excellent guide in between the doctor visits.

This is not to say one should rebuke the guidance of the primary physician but should keep him informed of any alternative or holistic medications.  This ensures ones overall safety and ensures that the individual may be able to utilize all beneficial practices.  Many doctors and primary physicians are becoming more and more in tune with holistic practices and can offer advice and guidance.

While holistic medication is about long term life health choices and better life styles, it is not a quick fix.  While it can help the body overcome and heal itself, it is not always a guarantee.  Prevention and long term healing are usually the outcomes.  It involves a commitment by the patient to change and alter life styles for a long and healthy life.

When someone is terminal or facing a possible life altering illness, a person utilizing holistic practices needs to understand that his or her long term health is connected with a new life style.  A life style that is committed to certain exercise, diet and types of food.  When this is accepted, possible healing can occur.  Many times it depends on the severity of the illness and how far along one has dealt with it.  Some cases can be reversed through healthy living and working with a primary physician.

The American Institute of Health Care Professionals acknowledges the importance of Holistic alternatives.  It understands that Holistic practices are key to overall health.  This is why the American Institute of Health Care Professionals is committed to so many alternative programs.  Ranging from Hypnotherapy to Emotional Freedom Techniques, the Institute realizes the power of the body to heal itself.  Medication is more than just Western concepts but a totality of human experience.  Alternative as well conventional methods when used under guidance can be effective in treatments.

Nurses and other healthcare professionals are great candidates to become certified Integrative Holistic Healthcare Specialists

The Holistic Nursing Specialist Program offered by the American Institute of Health Care Professionals offers a chance for nurses and other healthcare professionals to earn a certification in Holistic practices.  As a Holistic Specialist, one can help patients explore the many alternative herbs and medications.  A Holistic Healthcare Specialist can ensure that alternative practices are utilized in a safe fashion.

This is important because some practices, herbs or medications may contradict each other.  One should never delve into the medications without professional guidance.  Holistic and alternative medications are no exception.  It is hence critical to consult professional opinion and guidance to any health plan one may embark upon.  Certified Holistic Healthcare Specialists can be that guiding hand.

The certification for Holistic Integrative Nurse Specialist can help professionals earn a certification to help others utilize alternative practices safely.  The program is online and offers core courses within the discipline of Holistic Health.  After completing the core courses, the professional applies for a four year certification.  The certification can be renewed.  The program is independent study and is an excellent format for working professionals to achieve certification.

The certification will give a healthcare professional the needed knowledge and expertise within the field of Holistic practices.  The first three courses deal completely with issues surrounding Holistic medicine and health and the other courses deal with spiritual and emotional wellness.

If you are a nurse or healthcare professional and would like to learn more about AIHCP’s Integrative Holistic Healthcare Specialist Program then please review and see if it matches your academic and professional goals.



  1. https://www.webmd.com/balance/guide/what-is-holistic-medicine#1
  2. Ibid
  3. Ibid
  4. https://ahha.org/selfhelp-articles/principles-of-holistic-medicine/



Passion Flower: Does it Really Calm Anxiety?



By: D. L. Flarey, Ph.D, RN, ANP-BC

Passionflower is mostly known for its calming qualities; it has an extensive history of use in calming those who are stressed and nervous. Passion flower was used by Native Americans for its sedative qualities, and was used in Europe as early as the 16th century for its ability to support a calm, positive state of mind. Current analysis has confirmed these practices, indicating passionflower’s calmative quality is due to a flavonoid called chrysin. Chrysin is thought to help regulate GABA (gamma-aminobutyric acid), a neurotransmitter in the brain and nervous system that manages nerve excitability. (1)

Passion flower was initially identified by the Spanish while exploring Peru. Its name was derived from the concept that the blossom was a symbol of Christ’s passion and also it was an indication of His favor of their exploration. The different parts of the flower petal are described as expressions pertaining to the passion of Jesus Christ, for instance, the crown of thorns being actually symbolized by the hair like fibers numbering in the hundreds in each petal. (2)


Calming Anxiety

According to the research, passion flower has typically been administered for nervous anxiety, insomnia, pain, restlessness, anger, and hysteria. The ability for passion flower to support these disorders is believed to be the result of the substance benzoflavone, chrysin, and the pyrone derivative maltol. (3)

Chrysin is a monoflavonoid, regarded to be the principal active component made from Passion Flower. In laboratory settings, specialists have demonstrated that Chrysin functions as a partial agonist of the core benzodiazepine receptors in the brain. Although the exact system of action is not precisely understood, it is thought that the blend of Flavonoids in Passion Flower contribute to its efficiency as an anxiolytic, helping to promote relaxation, alleviate stress and ease intermittent anxiety and panic triggered by emotionally charged tension. (4)

Working together, passion flower’s anxiety-soothing, sleep-promoting top qualities join abilities to give you one greatest health benefit in the end: relaxation and peace of mind. When working with different anti-anxiety natural combinations, the plant could very well possibly achieve much more for peace of mind and sleep. (5)

According to European medical data, passion flower is recognized for its effect in treating nervous restlessness, uneasiness, irritability, vegetative dystonia, agitated mind, and sleep disorders. Additionally, investigations have certainly shown improved cognitive focus levels and relief of anxiousness. (6)


Studies on Passion Flower

There actually have been research examinations completed on passion flower going back to the 1930’s which have identified it aids to induce relaxation which brings about a deeper sleep, and almost eradicates sleep loss. Its mechanism of action, however, is actually very distinct than prescription sleep drugs, thus an individual does not need to feel uneasy about an artificially prompted sleep or awakening with a drug-like experience. (2)

Animals administered doses of 150 milligrams per kilogram body weight passed even more time in open, unguarded and elevated areas during the course of a maze experiment. Also, the supplement did not necessarily lead to either a sedative or arousing effect. A report written in the March 2010 “Journal of Ethnopharmacology” found that low doses of passion flower extract reduced anxiety, while higher doses produced a sedative effect. (7)

Passion flower may also work as a mild relaxing natural treatment. The tranquil effect by itself does not typically lead to drowsiness, so it is a particularly beneficial day time tranquilizer. Moderate use supports a feeling of tranquility, without side effects, and without the likelihood of chemical dependency or habit-formation. (6)

People have indeed used passion flower typically to manage stress, and continue to do so today. A study written in the October 2001 issue of the “Journal of Clinical Pharmacy and Therapeutics” identified that passion flower was as beneficial as the pharmaceutical drug oxazepam for managing generalized anxiety disorder. An overview of research studies published in the February 2006 issue of the “British Journal of Psychiatry” reveals passion flower having potential for calmative use in many people with psychological health disorders. (8)

Passion flower typically has been less popular than Valerian Root, however, in a new study of well-known herbal calmatives in Great Britain, passion flower did slightly better than Valerian Root and took the leading honor. Passion flower is taken essentially as a calmative or nervine to combat excess anxiousness and anxiety, to tranquilize, and to induce sleep; as an anodyne, anti-spasmodic and anti-convulsant and to manage dysmenorrhea and muscle cramps. Primarily, passion flower is utilized world-wide as a light calmative that abates anxiety, nervous tension, high blood pressure, and encourages sleep. It has furthermore been utilized as an antispasmodic (or spasmolytic) in the treatment of muscle cramps, seizures, premenstrual tension, and even epilepsy. Passion flower preparations have actually been observed to eliminate nervous symptoms and cramps that restrict sleep, and to produce a tranquil and deep sleep free from constant awakenings and disturbances. The antispasmodic action is even effectively used in the treatment of respiratory asthma. Passion flower is well known for its analgesic or anodyne action. (9)

Even though investigators formerly believed that the alkaloids and flavonoids in passion flower caused its calmative and anxiolytic effect, modern studies suggest that the amino acids in the botanical herb may well be responsible. This is actually because these particular amino acids are able to increase GABA levels in the human body. (10)



Passion flower is generally regarded safe and very well tolerated by many people. There is insufficient data about negative side effects and possible pharmaceutical interactions. Passion flower may possibly interact with various other medications or treatments, so if changes to physical health develop, promptly contact a primary care physician (3) or a certified holistic nurse.



  1. https://www.pipingrock.com/passion-flower
  2. https://www.breastenhancement.org/passion-flower
  3. https://www.nhc.com/passion-flower
  4. http://www.clarocet.com/passion-flower/
  5. https://primalherb.com/how-to-calm-anxiety-improve-sleep-with-passion-flower
  6. https://www.healthyhildegard.com/passion-flower-benefits/
  7. https://healthyeating.sfgate.com/benefits-passion-flower-herbs-8818.html
  8. https://healthfully.com/110251-passion-flower-benefits.html
  9. http://www.rain-tree.com/maracuja.htm
  10. http://www.progressivehealth.com/try-passion-flower-for-insomnia-and-anxiety.htm