Global advances in integrative medicine and health最新文献

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.

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.