Global advances in integrative medicine and health最新文献

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.

Mounting evidence suggests that the long-term effects of trauma and adversity are rooted not only in psychological distress, but in persistent dysregulation of the body's stress response and its associated neuroendocrine systems. This physiological dysregulation has emerged as a critical contributor to health outcomes, yet remains under-addressed in conventional clinical care. Emotional states are integrated with core physiological functions through dynamic, bidirectional autonomic signaling between the heart, lungs, brainstem, limbic system, and higher cortical areas. This interconnected network enables conscious regulation of breathing, heart rhythms and emotions to influence autonomic and higher cortical functions. Research has demonstrated that heart rhythm patterns become more ordered during HeartMath's^® self-regulation techniques. This stable, high-oscillatory pattern, termed "coherence", can be observed using heart rate variability biofeedback and induced through slow, deep breathing or experiencing regenerative emotions such as gratitude. Coherence is a state of physiological and emotional regulation that reflects increased vagal activity and synchronization across organ systems, promoting more efficient function. In addition to reductions in perceived stress, research has demonstrated improvements in energy, anxiety, mood, sleep, and cognitive performance with daily coherence practice over weeks. Gradually, coherent heart rhythm patterns can become a more familiar set-point for the body through repeated afferent input to the brain, supporting the emergence of a healthier, more regulated physiological baseline. This narrative review explores HeartMath as an emerging non-pharmacological intervention with therapeutic potential for emotional and physiological dysregulation, highlighting evidence and mechanisms by which coherence shifts the body toward a healthier, more resilient state.

Purpose: Fear of cancer recurrence (FCR) is highly common and, if poorly managed, can be distressing and impairing. We developed a virtual, mind-body resiliency intervention for fear of cancer recurrence in survivorship (IN FOCUS), which was shown to be feasible and improved FCR post-intervention. This report aimed to describe coping processes associated with FCR and effects of IN FOCUS on coping over time.

Method: A single-blinded, 2-arm, randomized controlled trial was conducted from July 2021 to March 2022 comparing IN FOCUS (8 weekly, 90-minute, synchronous virtual group classes teaching cognitive behavioral techniques, relaxation training, meditation, adaptive health behaviors, and positive psychology skills) to usual care (synchronous virtual community group support referral) among cancer survivors with non-metastatic disease and clinically elevated FCR (FCR Inventory severity ≥16). Measures included coping styles (Brief COPE) and perceived coping skills (Measure of Current Status-Part A). Intent-to-treat analyses with separate general linear mixed models were used to identify group-by-time effects (Cohen's d; 0.5 a medium effect, 0.8 a large effect) from baseline through 2 months and 5 months.

Results: Sixty-four survivors enrolled (age M = 52 years, time since completing primary cancer treatment M = 5 years). By 5 months, survivors randomized to IN FOCUS (vs usual care) demonstrated multiple effects on coping in the medium to large range. Compared to usual care, IN FOCUS increased problem-focused coping, such as using instrumental support (d = 0.60), planning (d = 0.60), positive reframing (d = 0.48), and active coping (d = 0.45). Similarly, IN FOCUS improved emotion-focused coping, specifically venting (d = 0.70), acceptance (d = 0.58), humor (d = 0.50), and religion (d = 0.48). IN FOCUS also enhanced survivors' coping confidence (d = 0.79), relaxation skills (d = 0.57), and assertiveness (d = 0.46). Avoidance-focused coping and awareness of physical tension exhibited less robust changes by 5 months.

Conclusions: Cancer survivors can enhance multiple aspects of coping with FCR through interventions such as IN FOCUS that teach mind-body resiliency techniques.

Background: There is surging interest in workplace mindfulness programs to address employee stress, resilience, and performance, however, significant gaps in knowledge remain around feasibility, acceptability, effectiveness, and predictors of therapeutic change.

Objective: This study evaluated whether a brief, 4-session Mindfulness Skills Course (MSC) for university employees, covered by the institution's wellness benefits, was effective in reducing stress, increasing mindfulness, improving feelings toward oneself and others, and increasing work performance.

Methods: Prospective observational cohort study design. Participants completed self-report surveys before and after the MSC. Class attendance and home mindfulness practice were recorded to assess feasibility and adherence. Paired t-tests and Pearson correlations were used to evaluate program effectiveness and predictors of change.

Results: 190 employees enrolled for the in-person course during the first year of roll-out. Of those, 164 (86%) completed pre-course surveys, 134 (82%) attended at least three class sessions, and 123 (75%) completed the post-course surveys and program evaluation. Paired samples t-tests showed improvements for perceived stress, mindfulness, and relational wellbeing with moderate to large effect sizes (d = .44 - .78; P's < .001). Self-perceived work performance increased with a small effect (d = .33; P < .001). More frequent home meditation practice was positively correlated with a larger increase in mindfulness (r = .20; P < .05). Increased mindfulness correlated with reduced stress (r = -.55), greater positive emotions towards self (r = .38), and reduced negative emotions towards self (r = -.40) and others (r = -.42) (all P's < .001). Reduced stress was correlated with increased perceived work performance (r = -.22; P < .05). Higher baseline stress levels predicted greater increases in mindfulness (β = .37, R² = .14, P < .001), while lower baseline mindfulness predicted greater reduction in stress (β = .27, R² = .07, P < .01).

Conclusion: Taken together, these results support the feasibility and effectiveness of a brief, 4-wk, employer-sponsored mindfulness skills course, which may be most helpful for individuals with higher stress and lower trait mindfulness.

Background: Some practitioner-delivered (eg, acupuncture) and self-directed (eg, yoga) complementary and integrative health (CIH) therapies are evidence-based for chronic pain management. Providers often follow recommendations to encourage patients to take active roles in their health care by using self-directed therapies in addition to CIH therapies they deliver. Doing so might be more effective than using practitioner-delivered CIH therapies alone, however we are unaware of studies qualitatively examining this issue.

Objective: As part of our VA pragmatic study APPROACH (Assessing Pain, Patient-Reported Outcomes and Complementary and Integrative Health) among 6453 veterans with chronic musculoskeletal pain, we qualitatively examined patients' narrative reports of CIH therapy use to explore how using practitioner-delivered CIH therapies with and without self-directed CIH therapies affected their health and well-being.

Methods: We conducted qualitative telephone interviews with 125 patients at six VA medical centers from March 2022 March 2023, asking if their use of CIH therapies affected several health conditions: depression, anxiety, pain, fatigue, sleep, quality of life, and self-empowerment to take care of one's own health. We used deductive and inductive thematic analysis.

Results: Half or more of reported CIH therapies helped their pain, quality of life, depression, sleep, and self-empowerment to take care of their own health, but few reported the therapies affected fatigue. Using a combination of practitioner-delivered and self-directed CIH therapies appeared more helpful than using only practitioner-delivered therapies for depression, anxiety, quality of life, fatigue, and self-empowerment. However, for pain or sleep, similar percentages of patients reported using a combination or only practitioner-delivered CIH therapies helped.

Conclusions: Using a combination of practitioner-delivered CIH therapies appear more helpful than using only practitioner-delivered therapies for most examined health conditions, except they appeared similarly helpful for pain and sleep. Chiropractors, acupuncturists and massage therapists might want to encourage patients to participate in self-directed therapies.

Background: Mindfulness-Based Cognitive Therapy (MBCT) reduces depression relapse, yet graduates have expressed a need for structured guidance post-program to maintain mindfulness practice and sustain benefits. To address this, we created MBCT for Depression-Taking it Further (MBCT-D-TiF).

Objective: To refine and pilot test feasibility and acceptability of MBCT-D-TiF.

Methods: We collected qualitative focus group data to inform refinements and quantitative data to pilot test feasibility and acceptability of MBCT-D-TiF. In round one, participants received MBCT-D-TiF (n = 14), consisting of 4 weekly and then monthly sessions delivered via group videoconferencing. In round two (n = 20), participants were randomized 1:1 to MBCT-D-TiF or waitlist control. Surveys were completed at baseline, 1 and 4 months by all participants. We explored participants' experiences with MBCT-D-TiF in two focus groups (n = 7 in each) conducted via videoconferencing. We used descriptive statistics and mixed linear models to analyze quantitative data and thematic content analysis to analyze qualitative data.

Results: MBCT-D-TiF participants (n = 25) attended all weekly sessions (100%) and at least 75% of the monthly sessions (76%); found the weekly sessions very or extremely helpful (77.1%), and the monthly sessions very or extremely helpful (66.7%). The following themes emerged: (1) the importance of the group for participants' social connection, support, and practice community that enhanced their meditative experience, helped improve their mental health, and facilitated accountability; (2) MBCT-D-TiF provided mental health benefits, including tools to lessen the negative impact of depression and anxiety, increase connections to the world, and enhance positive experiences; (3) participants' home practices were reinvigorated during the weekly MBCT-D-TiF sessions, but fell short of their goals thereafter.

Conclusion: MBCT-D-TiF was well attended and rated very or extremely helpful by most participants, supporting its feasibility and acceptability. Qualitative data showed that additional steps to help participants sustain home practice are needed, offering a target for refinement and further testing.

Background: Pain is a significant complication following cardiac surgery. While pharmacological treatments are standard, non-pharmacological interventions like music offer a promising, low-cost adjunct for pain management.

Objective: To evaluate the effect of a music intervention on pain and vital signs during the first postoperative bed bath for patients recovering from cardiac surgery.

Methods: This study was a single-blind, randomized controlled trial involving 38 patients who had undergone Coronary Artery Bypass Grafting (CABG). Patients were allocated to either an experimental group (n = 19), which listened to self-selected music via headphones, or a control group (n = 19), which wore headphones with no audio. The primary outcome, pain, was measured using the Numerical Rating Scale (NRS) and the Wong-Baker FACES Scale (WBS) during and after the bed bath.

Results: The music intervention group demonstrated a statistically significant reduction in pain scores both during and after the bath. Compared to the control group, the experimental group's pain scores decreased by a mean of 2.41 points on the NRS (P < 0.001) and 2.11 points on the WBS (P < 0.001). Furthermore, a significant reduction in heart rate (P = 0.019) was observed in the experimental group.

Conclusion: Music intervention effectively reduced pain and stabilized heart rate during a potentially painful routine procedure in the immediate postoperative period of cardiac surgery.

Background: Paracetamol is one of the popular causes of liver injury primarily mediated by oxidative stress and increased inflammation within the liver. Bersama abyssinica has active ingredients with antioxidant activities and is traditionally used to treat liver diseases. However, its effects have not been confirmed by in vivo studies.

Objective: This study was aimed at evaluating the hepatoprotective effect of a methanolic extract of Bersama abyssinica leaf on paracetamol-induced hepatotoxicity in Swiss albino mice.

Methods: The study was conducted on thirty male Swiss albino mice, randomly grouped into six groups of five mice each; normal, negative, and positive control groups received 1 mL/kg of distilled water, paracetamol 250 mg/kg only, and silymarin (100 mg/kg) orally with paracetamol, respectively. While treatment groups I, II, and III received 200, 400, and 600 mg/kg of the Bersama abyssinica leaf methanolic extract with paracetamol 250 mg/kg, respectively. At the end of the experiment, the mice were sacrificed after being anesthetized, and blood samples were collected via cardiac puncture, and the liver was removed for histopathological investigation. Data were entered into Epi Data version 3.1 and exported to SPSS version 25 for further analysis using a one-way ANOVA.

Results: The negative control group showed higher levels of ALT, AST, ALP, GGT, and bilirubin compared to the normal control. However, significant hepatoprotective effects were noted in the treatment and positive control groups, as evidenced by the substantially reduced levels of these liver biomarkers towards the normal range. The significantly lower levels of indirect bilirubin were seen among treatment groups II and III as compared to group II. Abnormal liver architectures were observed in the negative control group; however, these changes were reversed following administration of the leaf extract.

Conclusion: The study found that the methanolic leaf extract of Bersama abyssinica exhibited hepatoprotective effects against paracetamol-induced liver injury.

Background: Chronic pain has been linked to increased awareness of but decreased accuracy in detecting internal sensations. Interoception, the sense of signals from inside the body, may be a therapeutic target to improve pain. No studies have examined the feasibility of targeting interoceptive skills within a yoga intervention for chronic pain - where direct engagement with challenging sensations may be difficult - or whether yoga improves any measure of interoception among persons with chronic pain.

Objective: The primary aim was to determine the feasibility and acceptability of a 6-week interoception-based yoga intervention in a population of mixed chronic pain. The second aim was to examine the preliminary effectiveness on 2 measures of interoception (interoceptive sensibility and interoceptive accuracy), pain and psychosocial outcomes.

Methods: This was a single-arm feasibility study. Primary outcomes were feasibility and acceptability. Secondary outcomes included self-report measures of interoceptive sensibility (Multidimensional Assessment of Interoceptive Awareness, Version 2), pain intensity, pain interference, mindfulness, spiritual well-being and physical and mental health-related quality of life. Interoceptive accuracy was assessed with heartbeat counting. All measures were collected at baseline and after 6 weeks.

Results: The 6-week interoception-based yoga intervention demonstrated feasibility and high acceptability in a sample of mixed chronic pain. Twenty-six participants consented, 24 started the intervention (mean age 42.5 years, 75% female) and 19 (79%) completed 6-week post-intervention testing. The average attendance rate was 69%. There were no serious adverse events and acceptability ratings were high (>5/7). While not powered to make conclusions, preliminary analyses revealed a statistically significant increase in interoceptive sensibility and interoceptive accuracy, and reduction in pain (p's < .05). There were no correlations between the 2 measures of interoception.

Conclusion: The intervention appears feasible and acceptable and shows promise for improving pain and multiple dimensions of interoception, especially those involved in consciously attending to the body. Future studies examining the efficacy of interoception-oriented yoga interventions for chronic pain are warranted.

Clinicaltrialsgov registration: NCT06268197 Registered February 12, 2024.