Global advances in integrative medicine and health最新文献

Although the United Arab Emirates was founded in 1971 as a federation of 7 emirates with Abu Dhabi serving as its capital, the peoples who have inhabited its lands since antiquity have long-standing beliefs and practices for preventing, diagnosing, and treating ill-health and for maintaining health. Traditional Emirati Medicine exists as unwritten healing practices, beliefs, and knowledge communicated through poems, stories, sayings, songs, and proverbs and Islamic teachings and literature. Research is needed to understand Traditional Emirati Medicine's scope, proper usage, efficacy, active ingredients and mechanisms of action, safety, and quality assurance, and we encourage government and non-government entities to formulate action plans and policies. A strong and up-to-date knowledgebase will inform decisions and recommendations concerning the future of Traditional Emirati Medicine including establishing best practices and health policies, regulating medicines and practitioners to protect consumers, and integration of traditional medicine and modern medicine.

Background: Mindfulness-based stress reduction (MBSR) has been shown to be beneficial for adults with inflammatory bowel disease (IBD), but little is known about its use in pediatric IBD.

Objective: This pilot study aimed to assess the feasibility and acceptability of an MBSR program delivered by live-video during the COVID-19 pandemic for youth with IBD.

Methods: Four cohorts of an 8-session MBSR program were conducted via a HIPAA-compliant, video-conferencing platform from winter 2021 to spring 2022. Mixed-methods data were collected through semi-structured focus groups, study-specific surveys, attendance data, and self-reported health-related quality of life (HRQOL) measures.

Results: Forty-six participants enrolled across 4 cohorts. Participants were 64% female, M_age=14.1 years, 36% non-Latinx White; most had Crohn's disease (81%). Participants attended an average of 7.6 of 8 classes, with 69% attending all 8 classes. Majority of participants (77%) were satisfied or very satisfied with the program. Three themes emerged from the focus groups (n=27): (1) IBD-specific benefits: reduced stress (which some identified as an IBD trigger) and connecting with IBD peers; (2) mental health benefits; and (3) virtual MBSR was feasible and well-liked, but challenges were present. Pre- vs post-program data (n = 30) showed statistically significant improvements in HRQOL (P = 0.04), HRQOL social functioning (P = 0.03), and perceived stress (P < 0.01).

Conclusion: This pilot study of live-video MBSR for youth with IBD shows feasibility and acceptability, high rates of attendance and satisfaction, and potential benefits in quality of life and stress. MBSR is a potential adjunctive therapy in pediatric IBD.

Background: Detailed intervention reporting is essential to interpretation, replication, and eventual translation of music-based interventions (MBIs) into practice. Despite availability of Reporting Guidelines for Music-based Interventions (RG-MBI, published 2011), multiple reviews reveal sustained problems with reporting quality and consistency. To address this, we convened an interdisciplinary expert panel to update and improve the utility and validity of the existing guidelines using a rigorous Delphi approach. The resulting updated checklist includes 12-items across eight areas considered essential to ensure transparent reporting of MBIs.

Methods: The purpose of this explanation and elaboration document is to facilitate consistent understanding, use, and dissemination of the revised RG-MBI. Members of the interdisciplinary expert panel collaborated to create the resulting guidance statement.

Results: This guidance statement offers: (1) the scope and intended use of the RG-MBI, (2) an explanation for each checklist item, with examples from published studies, and (3) two published studies with annotations indicating where the authors reported each checklist item.

Conclusion: Broader uptake of the RG-MBIs by study authors, editors, and peer reviewers will lead to better reporting of MBI trials, and in turn facilitate greater replication of research, improve cross-study comparisons and meta-analyses, and increase implementation of findings.

Background: Detailed intervention reporting is essential to interpretation, replication, and translation of music-based interventions (MBIs). The 2011 Reporting Guidelines for Music-Based Interventions were developed to improve transparency and reporting quality of published research; however, problems with reporting quality persist. This represents a significant barrier to advances in MBI scientific research and translation of findings to practice.

Methods: The purpose of this study was to update and validate the 2011 reporting guidelines using rigorous Delphi approach that involved an interdisciplinary group of MBI researchers; and to develop an explanation and elaboration guidance statement to support dissemination and usage. We followed the methodological framework for developing reporting guidelines recommended by the EQUATOR Network and guidance recommendations for developing health research reporting guidelines. Our three-stage process included: (1) an initial field scan, (2) a consensus process using Delphi surveys (2 rounds) and Expert Panel meetings, and (3) development and dissemination of an explanation and elaboration document.

Results: First-Round survey findings revealed that the original checklist items were capturing content that investigators deemed essential to MBI reporting; however, it also revealed problems with item wording and terminology. Subsequent Expert Panel meetings and the Second-Round survey centered on reaching consensus for item language. The revised RG-MBI checklist has a total of 12-items that pertain to 8 different components of MBI interventions including name, theory/scientific rationale, content, interventionist, individual/group, setting, delivery schedule, and treatment fidelity.

Conclusion: We recommend that authors, journal editors, and reviewers use the RG-MBI guidelines, in conjunction with methods-based guidelines (eg, CONSORT) to accelerate and improve the scientific rigor of MBI research.

Introduction: Hypertension is increasingly recognized as a biopsychosocial condition influenced by psychological distress and systemic inflammation. The potential of integrative mind-body approaches such as Heartfulness meditation and yoga to offer non-pharmacological benefits through neuroendocrine and immunomodulatory pathways is a source of hope and optimism in the field.

Objective: To evaluate the effects of a 12-week Integrated Approach of Heartfulness-based Yogic Practices and Meditation (IAHFNM & YP) on psychological distress, inflammatory cytokines and stress biomarkers in individuals with prehypertension or Stage 1 hypertension.

Methods: In this randomized controlled trial participants were allocated to either the intervention group (IAHFNM and YP) or the standard care group. Psychological distress was assessed using the Brief Symptom Inventory-18 (BSI-18). Blood samples were analyzed for cytokines (IL-6, IL-1β, TNF-α, IL-10, IL-18) and neuroendocrine stress markers (copeptin and corticotropin).

Results: The intervention group showed significant reductions in psychological distress, including anxiety, depression and somatization, as reflected by a marked decline in the Global Severity Index (P < .001). This reassures us about the study's effectiveness. Inflammatory biomarkers IL-6, IL-1β, and TNF-α significantly decreased (P < .05), while anti-inflammatory IL-10 levels increased (P < .001). Stress-related biomarkers copeptin and corticotropin also showed significant reductions (P < .001), suggesting downregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Although correlations between psychological scores and biomarkers were modest (R² < 0.12), corticotropin showed the strongest association with BSI-18 scores (r = 0.389).

Conclusion: The findings demonstrate the efficacy of Heartfulness in improving psychological well-being and modulating inflammatory and neuroendocrine markers in prehypertension and hypertension. These results support integrating mind-body practices into hypertension management. However, small sample size, limited duration, and reliance on self-reported adherence may affect generalizability. Future studies with larger cohorts, objective adherence measures, and extended follow-up are recommended to establish sustainability and underlying mechanisms.

Background: Pediatric patients with chronic illnesses face a multitude of health challenges that are often inadequately addressed by conventional, siloed medical systems. Pediatric integrative medicine (PIM), blending complementary therapies with conventional medicine, offers an interdisciplinary and comprehensive approach to addressing these complex challenges. Despite growing demand for PIM, lifestyle-oriented care, and multimodal biopsychosocial interventions, few studies have described the clinical delivery of PIM within a large academic medical center.

Objectives: To describe the demographics, clinical characteristics, and interventions utilized within a physician-led, PIM clinic at a large, pediatric academic medical center.

Methods: A retrospective review was conducted of 2677 outpatient PIM physician office visits (March 2020-September 2023) among 657 pediatric patients (birth-25 years). Data on demographics, diagnoses, interventions, and supplements were extracted from the electronic health record and summarized using descriptive statistics.

Results: Patients (mean age 12.24 ± 5.20 years) were predominantly female (56%) and White (68%). Common conditions included anxiety (59.2%), fatigue (44.4%), headache (43.1%), abdominal pain (33.6%), constipation (33.0%), nausea (31.7%), vitamin D deficiency (30.1%), myofascial pain (29.5%), and depression (26.8%). Key intervention recommendations included dietary changes (61.8%), myofascial self-care interventions (33.8%), massage therapy (21.0%), acupuncture (19.2%), pacing (18.4%), sleep hygiene (18.3%), and exercise (18.1%). Common supplements recommended included probiotics (49.9%), vitamin D (42.6%), multivitamins (41.9%), fish oil (39.4%), magnesium (32.0%), Chinese herbs (29.7%), and melatonin (22.8%).

Conclusion: PIM can provide whole-person, integrative care within a large academic medical center for pediatric populations with complex presentations. Its self-governed structure within an academic medical center facilitates broad service integration, addressing demands for comprehensive care. Future practice-based research with standardized documentation and outcome measures is needed to understand PIM's clinical effectiveness.

Objective: To assess the acceptability of a randomized single-blind trial of cognitive behavioral therapy (CBT) and whole-body hyperthermia (WBH) treatment for major depressive disorder (MDD).

Methods: All participants (N = 30) with MDD received CBT for depression and were randomized to also receive either: (1) WBH that raised core body temperature using an infrared sauna device, or (2) sham WBH of a similar duration that did not significantly raise core body temperature.

Results: Study acceptability was the primary outcome: of participants who completed the final assessment (n = 29; 96.7%), 22 (75.9%) reported that they would recommend participation to a friend or family member with MDD. Twenty-five (86.2%) participants reported that they would be likely or extremely likely to enroll in this study, given the experience they had in the study. All participants randomized to WBH correctly believed they received WBH, and 6 (43%) of participants randomized to sham WBH correctly believed they received sham WBH. Both arms achieved clinically meaningful and statistically significant reductions in depression symptoms. The average decreases in the Beck Depression Inventory-II (BDI-II) were -19.07 (SE = 2.69, P < 0.0001) in the WBH arm (80.0% no longer meeting DSM-5 criteria, 60.0% achieving 50% or greater reduction in BDI-II) and -21.10 (SE = 2.41, P<0.0001) in the sham WBH arm (92.9% no longer meeting DSM-5 criteria, 78.6% achieving 50% or greater reduction in BDI-II).

Conclusions: Study procedures were acceptable. Participants in the WBH and sham WBH groups had substantial reductions in depressive symptoms that were greater than typically seen with CBT alone. The sham WBH arm was not fully credible and may have exerted antidepressant effects, thus raising concerns about its use in future trials. Further research to test whether adding WBH to CBT results in additional antidepressant effects is warranted.