Global advances in integrative medicine and health最新文献

Introduction: Chronic pain is a complex and pervasive issue that disproportionately affects marginalized and underserved populations, driven in part by healthcare access barriers. Chronic pain affects multiple domains of life, warranting the need for accessible, holistic, whole-person, evidence-based care. The Heals on Wheels (HoW) program's multidisciplinary team developed and implemented community-based integrative pain care workshops for underserved communities throughout Hennepin County, Minnesota.

Methods: The 4-week curriculum included 60-120 minute-long weekly workshops hosted by community organizations. A pre- and post-workshop weekly progress sheet questionnaire explored perceptions of pain, overall state, favorite moments, and future suggestions. Responses were analyzed thematically.

Results: Throughout 2022-2025, 13 workshop series occurred with 9 different community organizations. Total attendance was 369 (average 7.10/session) with 265 weekly progress sheets completed by 163 unique individuals (71.82%). Average pre-visit pain was 5.40; post-visit was 3.26 (-2.14). Themes of before group state were: 1) Stable (2) Health Concerns (3) Overwhelm and (4) Hope. Themes after group were: (1) Relaxed, calmer, tired (2) Improvement, relief (3) Gratitude, hope and (4) Neutral. Roughly 1/10 participants highlighted the importance of sharing stories. Themes for future suggestions were mainly expressions of positive feedback; other themes included wanting more time, session structure, and specific activities.

Conclusion: The HoW workshops are feasible as an innovative and accessible community-based integrative pain care model.

Background: Patients with pulmonary Mycobacterium avium-intracellulare complex (MAC) disease who cannot receive standard antimicrobial therapy have limited treatment options. Jiinshihoto, a Kampo formula (traditional Japanese herbal medicine) that is effective for chronic cough and depressive symptoms, has not been evaluated in this population.

Objective: To evaluate the physical, immunological, and psychiatric effects of Jiinshihoto in patients with pulmonary MAC who were ineligible for standard antimicrobial treatment.

Methods: This single-center, open-label, prospective study was conducted from March 2018 to January 2020. Patients who were not eligible for standard treatment for pulmonary MAC disease were enrolled. Jiinshihoto (3.0 g) was administered three times per day for 12 months. The primary endpoints were 3-month changes in chronic obstructive pulmonary disease assessment test (CAT) scores, body weight, and natural killer (NK) cell activity. Secondary endpoints were 3-month changes in self-rating depression scale (SDS) scores. This study was registered in the UMIN-Clinical Trials Registry (UMIN000033590).

Results: In total, 24 patients were enrolled. The mean age was 68 years, and 74% were female; the mean body mass index was 19.3 kg/m². Of these, 23 patients completed the 3-month follow-up. For the primary endpoints at 3 months, no significant changes were observed in CAT scores (from 11.2 to 11.0, P = .87), body weight (from 48.6 to 48.8 kg, P = .32), or NK cell activity (from 42.6% to 43.9%, P = .58). SDS scores showed significant improvement at 3 months (from 42.2 to 38.5, P = .032) and 12 months (from 42.2 to 40.4, P = .034).

Conclusion: Jiinshihoto did not improve respiratory symptoms, weight, or NK cell activity in patients with pulmonary MAC ineligible for standard treatment but may be beneficial for depressive symptoms.

Objective: To explore experiences with learning yoga through synchronous, online instruction among midlife and older women participating in a trial of therapeutic yoga for urinary incontinence.

Methods: We conducted an embedded qualitative study and assessed process outcomes within a multi-site randomized controlled trial of a group-based therapeutic pelvic floor yoga program vs physical conditioning program for midlife and older women with urinary incontinence. Participants were recruited from the San Francisco Bay Area from 2019 to 2022. The trial included twice-weekly small group instruction delivered via telehealth using the videoconference platform Zoom. Questionnaires and semi-structured interviews were used to assess satisfaction and explore experiences of learning yoga in an online format. Data were analyzed using descriptive statistics and a hybrid deductive/inductive qualitative thematic analysis approach.

Results: Questionnaire results showed 96% of respondents (n = 51) rated their overall experience with online yoga as "good to excellent.'' Interview participants (n = 24) identified key challenges including navigating technology, configuring home environments, limited social connection, and not being in the physical presence of the yoga teacher. However, these challenges were offset by facilitators such as convenience, privacy, and perceived mind-body benefits, including improved incontinence symptoms. Effective teaching strategies contributing to a positive experience included detailed verbal instructions, visual demonstrations, solicitation of questions, and individualized feedback.

Conclusion: Synchronous, videoconference-based yoga instruction was effective at engaging midlife and older women in managing urinary incontinence. The online format provided convenience and privacy, making therapeutic yoga more accessible. Tailored teaching strategies and technical support significantly enhanced learning and satisfaction. This study suggests the potential for broader application of online therapeutic yoga programs for specific health conditions.

Background: While mind-body movement interventions such as qi gong, tai chi, and yoga are recommended in clinical practice guidelines for several common health conditions, implementation of these interventions within healthcare settings is rare. A systematic synthesis of implementation determinants-commonly referred to as barriers and facilitators-is needed to increase adoption or other implementation outcomes such as reach or sustainability within healthcare systems. Thus, the objective of this review is to: (1) identify determinants of qi gong, tai chi, and yoga for health conditions; and (2) evaluate whether determinants differ by intervention type, health condition, implementation setting, or implementation outcome.

Methods: In this systematic review, we will include original research articles in English that identify determinants to adoption of qi gong, tai chi, and yoga by adults with health conditions. We will search MEDLINE, EMBASE, Web of Science, CINAHL, PsycInfo, Google Scholar, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and WHO Clinical Trials database from inception. We will code determinants identified in each article using a codebook informed by the Consolidated Framework for Implementation Research (CFIR). We will report on how determinants relate to intervention type, health condition (e.g., low back pain, fall prevention), implementation settings (e.g., primary care clinic, community organization), or implementation outcome (e.g., adoption, sustainability). Study quality will be assessed using the Mixed Methods Appraisal Tool.

Discussion: Findings will inform implementation strategies by identifying context-specific determinants that influence uptake of qi gong, tai chi, and yoga for health conditions. Results will provide practical insights to guide clinicians, researchers, and health systems in integrating mind-body movement interventions within diverse healthcare and community settings.

Conclusion: This review will generate a comprehensive synthesis of implementation determinants to support the use of qi gong, tai chi, and yoga in evidence-based care for health conditions.

Background: Rutin is a plant-derived flavonoid with reported biological activities, but its effect on blood coagulation parameters has not been clearly characterized under in-vitro conditions.

Objective: This study aimed to evaluate the in-vitro anticoagulant activity of rutin in human blood by measuring changes in clotting time (CT), prothrombin time (PT), and activated partial thromboplastin time (aPTT) at increasing concentrations, compared with baseline control values.

Materials and methods: Rutin (1-6 mg/mL) was added to human blood samples, and standard CT, PT, and aPTT assays were used to measure coagulation parameters. Heparin and Phosphate-buffered saline (PBS) were used as controls.

Results: In a concentration-dependent manner, rutin significantly increased activated partial thromboplastin time (aPTT), prothrombin time (PT), and clotting time (CT) compared with the PBS control, with the most pronounced effects observed at higher concentrations (4 and 6 mg/mL; P < 0.05 vs control). At 6 mg/mL, CT increased to 11.42 ± 1.11 minutes, PT to 21.33 ± 3.28 seconds, and aPTT to 57.20 ± 9.31 seconds.

Conclusion: Rutin exhibits significant in vitro anticoagulant activity, supporting its potential as a natural anticoagulant candidate.

Background: Radiodermatitis is a common skin injury in patients undergoing radiotherapy, especially in cases of head and neck cancer, and may impair treatment adherence and the patient's quality of life. Therefore, the search for effective and low-cost interventions for the prevention and management of radiodermatitis is essential. In this context, Calendula- and Chamomile-based creams have been considered in oncological care.

Objective: To evaluate the effectiveness of topical Calendula and Chamomile creams in the prevention and treatment of radiodermatitis in head and neck cancer patients undergoing radiotherapy combined with chemotherapy.

Methods: This is a protocol for a randomized, controlled, triple-blind clinical trial employing a quantitative approach. The protocol adheres to the guidelines advocated by the Consolidated Standards of Reporting Trials (CONSORT) 2025 and the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2025. A total of 99 participants will be randomly allocated into 3 groups. Data will be collected using a four-section instrument and analyzed with Microsoft Office Excel and Statistical Package for Social Sciences (SPSS) version 20.0.

Results: This study aims to validate the effectiveness of Calendula and Chamomile creams in controlling radiodermatitis and to identify the most efficient option for preventing adverse effects.

Conclusion: The findings are expected to underscore the necessity of promoting and implementing systematic, scientifically grounded protocols in oncological patient care, emphasizing a humanized approach.

Trial and protocol registration: Brazilian Registry of Clinical Trials (ReBEC), RBR-8gxt823, https://ensaiosclinicos.gov.br/rg/RBR-8gxt823.

Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder whose symptoms include menstrual disturbances, hirsutism, and female anovulatory infertility. As medicinal plants, Nigella sativa and Salvia officinalis have been used and investigated due to their broad medicinal benefits.

Objective: The aim of this study is to assess the combinatorial effect of Nigella sativa and Salvia officinalis extracts on ovarian function in PCOS-induced mice. PCOS was induced in female Balb/c using dehydroepiandrosterone (DHEA) then were treated with Nigella sativa and Salvia officinalis extracts or their combination. Control groups (normal saline, sesame oil, extracts) were included, Positive control group was metformin, a medication commonly used to treat PCOS.

Methods: Histological analysis of the ovaries were performed. Serum hormone levels: Testosterone (T) and Estradiol (E), oxidative stress markers Glutathione (GSH), Malondialdehyde (MDA), Super Oxide Dismutase (SOD), Catalase (CAT), and the proinflammatory marker interleukin-1β (IL-1β) were quantified.

Results: Nigella sativa and Salvia officinalis or their combination were able to significantly minimizing markers of PCOS as shown by decrease the number of cysts in the ovaries, decrease in serum Testosterone and Estradiol levels (50 and 55% respectively with P < 0.05), decrease MDA levels (by ∼90% with P < 0.05), normalizing the oxidative stress markers (CAT, SOD, and GSH) levels and decreasing IL-1β (by ∼40% with P < 0.05) levels compared to controls.

Conclusion: This study showed that the combined effect of Nigella sativa and Salvia officinalis was better able to treat PCOS and may replace Metformin to improve PCOS-induced abnormalities.

Background: Rural Veterans experience disproportionate rates of chronic health conditions positively affected by yoga, though preferences for yoga remain unknown in this understudied population.

Objective: To determine knowledge of and preferences for yoga in Central Appalachian Veterans.

Methods: This quality improvement study was conducted at a low-complexity VA medical center (VAMC) that primarily serves rural Veterans in Central Appalachia. Veterans attending appointments in a wide array of clinics were asked by six providers to complete a study-specific survey following their clinical care. Questions focused on knowledge of and preferences of yoga services. Quantitative items were summarized using summary statistics. Due to the brevity of open-ended questions and small sample size, a modified rapid content analysis was used to identify sentiments.

Results: Forty-nine surveys were completed. Nearly sixty percent had heard of yoga and one-third had practiced before. Approximately half of Veterans preferred a group format that was located close to their primary care clinics. Results were mixed for preferences of modality. Sixty nine percent preferred physician referral to yoga.

Conclusions: This study underscores the importance of educating patients and providers on current resources and potential benefits of yoga to enhance the use of yoga among this unique, underserved population. Use of existing resources within the VAMC, particularly the Whole Health System, may improve the reach of yoga, ultimately benefiting the health and well-being of these Veterans.