Journal of Integrative and Complementary Medicine最新文献

Objective: Nonpharmacological (alternative) interventions (NPIs) for pain relief during vaginal delivery have gained popularity, as adjuncts to pharmacological interventions or as primary treatment. Methods: We searched PubMed/Medline, EMBASE, and Ovid Discovery for observational trials published through May 2024. This meta-analysis examined the effectiveness and safety of some NPIs for labor pain management using the Meta-Mar online software. NPIs, including massage, virtual reality, heat therapy, hydrotherapy, and aromatherapy, were compared with placebo or routine care (RC). The random-effects model was used for the meta-analysis due to significant variations in methodology among the included studies, including intervention duration, patient age, and intervention approaches. The quality of the included studies was assessed using the Cochrane risk of bias 2 (RoB 2). Network analysis was used to determine which NPIs were most associated with pain intensity and labor duration outcomes. Results: Of the 7,542 selected studies, 41 met the inclusion criteria. Compared with RC, heat therapy (standardized mean difference [SMD] = -1.26; 95% confidence interval [CI]: -1.84, -0.69; p < 0.001) and massage (SMD = -0.69; 95% CI: -1.14, -0.23; p = 0.017) reduced pain intensity during the first stage of labor. Compared with placebo, aromatherapy increased pain intensity during the first stage of labor (SMD = 0.23; 95% CI: 0.00, 0.45; p = 0.048). Compared with RC, heat therapy (SMD = -1.26; 95% CI: -1.84, -0.69; p < 0.001) and aromatherapy (SMD = -0.15; 95% CI: -0.18, -0.11; p < 0.01) reduced pain intensity during the first stage of labor in primiparous women. Compared with placebo, massage (SMD = -1.05; 95% CI: -3.19, -1.10; p < 0.01) reduced pain intensity during the first stage of labor in primiparous women. Compared with RC, NPIs were more effective in reducing pain intensity during the first stage of labor in both developing and developed countries. Virtual reality and heat therapy reduced the duration of the first stage of labor compared with RC. The current NPIs were more effective in reducing the duration of the second stage of labor in developing countries compared with RC. The incidence of emergency cesarean sections was higher in virtual reality (32%), massage (36%), and hydrotherapy (29%) and lower in aromatherapy (18%) than in RC. Most studies were of low quality with a high risk of bias. Conclusions: The present NPIs, such as heat therapy and massage, may reduce pain intensity and labor duration. However, the increased rate of emergency cesarean section and the high risk of bias indicated that caution should be exercised when interpreting these findings.

Introduction: It is well established that there is a significant health gap between Indigenous and non-Indigenous Australians, with access to health care being a contributing factor. Aboriginal Health in Aboriginal Hands (AHAH) is an allied health service based at an Indigenous community center. Its objectives are to provide allied health services that are not commonly accessed by members of the Indigenous community. The aims of this study were to investigate stakeholders' perceptions of the service and alignment with the principles of delivering allied health services to Indigenous communities. Methods: Participants were recruited from two distinct groups: (1) Those who had developed, administered, and provided the services (n = 4); and (2) recipients of the services (n = 8). Perceptions of AHAH were collected via individual "yarnings," which involved answering broad questions regarding the service. Data were analyzed using thematic inductive analysis. Results: Both groups perceived that the "cultural appropriateness" of the setting was essential for its success. This included: its location at an Indigenous community center; the central roles of Indigenous people within the service; being affordable; being welcoming; and being accessible. Another positive attribute was that it provided the opportunity for community members to attain related training and qualifications in areas such as "sports therapy." Both groups perceived that the service could be expanded in terms of more weekly sessions and the inclusion of other allied health services. Staff were aware that while allied health students on placement at the center had undergone some "cultural awareness training," more was needed. Discussion: Overall, the AHAH service was perceived to align with the five dimensions of accessibility, approachability, acceptability, availability, and affordability, and was being delivered in accordance with the principles of engaging with Aboriginal communities (lore, love, look, listen, learn, lead, and land), which were key attributes contributing to its popularity and success.

Aim: This study is based on a registered trial (TCTR20241119007), in which the primary outcome was visual fatigue. The current study aims to evaluate the effects of specialized Thai yoga facial massage (STYFM) on heart rate variability (HRV) as a physiological marker associated with autonomic regulation. Methods: This two-arm randomized controlled trial was conducted at Khon Kaen University, Thailand, from January to February 2025. Thirty-two individuals with computer vision syndrome were randomly assigned to receive either a 4-week program of self-administered STYFM or eyes-closed seated rest under identical conditions without tactile or auditory stimulation. Each session lasted 10 to 15 min and took place 10 times per week. Physiological parameters, including HRV, heart rate (HR), and peripheral oxygen saturation (SpO₂), were assessed at the baseline, mid-intervention, and post-intervention. Data were analyzed using linear mixed models with Bonferroni correction. Results: The STYFM intervention significantly improved autonomic regulation compared to the control group. Participants in the STYFM group showed notable increases in HRV parameters, including the standard deviation of normal-to-normal intervals (p < 0.001), root mean square of successive differences (p < 0.001), the percentage of successive RR intervals differing by more than 50 ms (p < 0.001), total power (p = 0.004), low-frequency power (LF, p = 0.049), and high-frequency power (HF, p < 0.001). The LF/HF ratio decreased but was not statistically significant (p = 0.194). Additionally, the STYFM group demonstrated significantly higher peripheral oxygen saturation (p < 0.001) and reduced HR (p < 0.001), with no adverse events reported. Conclusion: This analysis suggests that STYFM significantly improved HRV, increased SpO2, and reduced HR, indicating enhanced parasympathetic modulation and improved autonomic regulation. Since this study represents a preliminary study of a larger clinical trial, it is important to note that the outcome data for the registered primary endpoint (visual fatigue score) will be reported in a separate publication.

Objective: The objective of this scoping review was to analyze research using yoga, meditation, and mindfulness (YMM) as a treatment for traumatic brain injury (TBI). Introduction: The rationale for this review was to provide an understanding of the methodology and outcome measures used in studies that include YMM as TBI treatment. There are currently no reviews that investigate how all three of these modalities are used in TBI treatment. This review is meant to draw attention to how this research is done and potentially improve future research study design. Inclusion Criteria: Criteria for studies included in this review were developed according to the participants, concept, and context framework. Specifically, participants must have experienced a TBI, the TBI had to be treated with yoga, mindfulness, meditation, or some combination of the three, subjects could not exclusively have had acquired brain injury such as stroke or Alzheimer's disease, and the study must have been published in the English language. Methods: PubMed, Google Scholar, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, PsyArXiv, ProQuest, and LoveYourBrain were searched for articles that met our criteria. A total of 72 articles were extracted to address 15 variables. Results: The majority of studies used either a pre-post or exploratory study design with no more than 29 female Caucasian subjects in the age range of 45-54 years. Most subjects participated in the study one month since their mild to severe TBI. In order to treat TBI symptoms, most studies used mindfulness, with the treatment done in person. Sessions of treatment typically occurred on a weekly basis for 10-30 min over 7-8 weeks. Outcome measures used to determine efficacy of treatment were primarily quality of life, followed by cognitive function and depression. Most studies were conducted in the United States after 2010 in the journal Brain Injury with no type of funding. Conclusions: Studies using YMM for treatment of TBI are typically done on a single type of population with a wide range of outcome variables and no control group. Future research may aim to include a control group and a variety of outcome measures consistent with those used in previous studies for result comparisons.

Background: Pain during dental injections can negatively impact children's perception of dental visits. Various methods have been explored to reduce this pain. Aim: This study aimed to assess the effect of sweet aromatherapy on injection pain associated with infiltration anesthesia for primary maxillary molars in 7-9-year-old children. Design: In this randomized, double blind controlled clinical trial, 48 children (7-9 years old) requiring infiltration anesthesia for maxillary molars were randomly allocated to three groups (n = 16 each) (I) control group receiving anesthetic injection in an unscented room; (II) anesthetic injection in a room saturated with 2% sweet vanilla scent, and (III) anesthetic injection simultaneous with exposure to 2% sweet vanilla scent for 30 sec. Subjective pain was measured using the Wong-Baker Faces Pain Rating Scale, while objective pain was assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) behavioral scale. Heart rate (HR) and blood oxygen saturation (SpO₂) were also recorded as physiological indicators. Data were analyzed using SPSS version 25. Results: The FLACC scores and HR in the intervention groups was significantly lower than that in the control group (P = 0.05). Regarding SpO₂, only the difference between the control and saturated room groups was statistically significant (P < 0.05). There was no statistically significant difference in Wang-Baker score between groups (P > 0.05). Conclusion: Two percent sweet vanilla scent can be a successful distraction method to reduce injection pain during infiltration anesthesia for maxillary molars in children aged 7-9 years. Further research in different age groups with a larger sample size seems necessary to strengthen the evidence.

Background: The Coronavirus disease-2019 (COVID-19) pandemic continues, and the death toll continues to surge. This systematic review and meta-analysis aimed to determine the efficacy of nanocurcumin on mortality in patients with COVID-19. Methods: A systematic search was performed in PubMed, Embase, Cochrane Library, and clinicaltrials.gov up to November 2024, without language restrictions. Inclusion criteria: (1) inclusion of hospitalized patients with COVID-19 who are 18 years or older; (2) polymerase chain reaction positive for severe acute respiratory syndrome coronavirus-2; and (3) use of a randomized controlled design to make a comparison of nanocurcumin with placebo. The Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias. Studies were pooled to risk ratios (RRs) and standardized mean differences (SMDs), with 95% confidence intervals (CIs). Results: Six trials (enrolling 333 participants) met the inclusion criteria. Nanocurcumin therapy showed significant improvements on mortality (RR 0.47, 95% CI 0.25-0.88; p = 0.02), interleukin-6 (IL-6) (SMD -0.30, 95% CI -0.56 to -0.04; p = 0.02), tumor necrosis factor-α (TNF-α) (SMD -0.63, 95% CI -1.16 to -0.10; p = 0.02), and IL-1β (SMD -0.88, 95% CI -1.37 to -0.39; p = 0.0004). Conclusions: Nanocurcumin significantly reduced mortality, IL-6, TNF-α, and IL-1β in hospitalized patients with COVID-19. Given the lack of safety data and concerns about the risk of bias, the use of nanocurcumin in COVID-19 requires further research.

Purpose: This study aimed to review the literature on the impact of medical cannabis (MC) on the quality of life (QoL) of cancer patients. Materials and Methods: A critical review was conducted using PubMed, Latin American and Caribbean Health Sciences Literature, Scopus, Virtual Health Library, and Embase. The inclusion criteria were access to the full content; in English, Spanish, or Portuguese; published until January 2025, relating "Cancer," "Quality of Life," and "Medical Cannabis." Of the 267 articles identified, 16 were selected for the final analysis. Results: The studies suggest that MC can improve mental health, sleep, appetite, and pain in cancer patients and decrease nausea, vomiting, and the use of other medications, such as opioids. Increased survival time and cognitive function improvements were also observed, with mild or moderate adverse effects. Both tetrahydrocannabinol and cannabidiol (full spectrum) were commonly used, with varied intervention durations. Conclusion: Despite differences and methodological limitations, including only four randomized clinical trials, which precluded systematic review or meta-analysis, findings suggest that MC may improve QoL for cancer patients by alleviating physical and psychosocial symptoms associated with cancer treatment. In contrast, some mild or moderate adverse effects may be present. Moreover, the use of MC faces challenges such as the interaction with some chemotherapy treatment. More randomized controlled trials are needed to better understand the effects of MC among oncology patients.

Introduction: The use of traditional, complementary, and integrative medicine (TCIM) has grown rapidly worldwide. The aim of this umbrella review is to provide a comprehensive synthesis of the available evidence on factors associated with TCIM use to identify the most influential factor driving the use of TCIM. This review was guided by the following research question: What is the most influential factor driving TCIM use? Methods: This review was conducted in accordance with PRISMA guidelines. International literature was systematically searched using PubMed, Embase, and manual searching of reference lists. The search was limited to peer-reviewed systematic literature reviews published between January 2005 to March 2024, in Arabic and English languages, and reported empirical research findings on factors associated with TCIM use. Results: A total of 62 review articles were included. The following five prominent factors were identified and critically analyzed: Socioeconomic status; dissatisfaction with conventional medicine; internal locus of control; being holistic, natural, and safe; and perceived usefulness. Of these, perceived usefulness, defined as the perceived benefits of a TCIM modality in meeting specific health needs or goals, was the most influential factor driving TCIM use. Discussion: The findings of this umbrella review revealed that individuals would not use a specific type of TCIM unless they perceived some benefit from its use, even if the benefit lacked supporting scientific evidence. This insight provides a foundation for researchers, health practitioners, and policymakers to advance TCIM research, clinical practice, and policy by targeting its perceived benefits. Focusing on perceived benefits can help researchers prioritize areas that are most valued by patients, leading to more impactful studies and evidence-based recommendations for practice. Understanding perceived benefits can also lead to more informed discussions between patients and health practitioners, creating a more collaborative and culturally sensitive health care environment. Furthermore, addressing perceived benefits can guide regulations to ensure the safe, effective, and ethical use of TCIM practices, leading to more effective integration of TCIM into conventional medicine as the evidence of its usefulness accumulates.