Global advances in integrative medicine and health最新文献

Background: Online yoga offers significant potential for healthcare systems. As efforts to incorporate online yoga in healthcare settings have grown, research in this area has mostly focused on the perspectives of patients and clinicians. Although yoga teachers are crucial to the implementation and delivery of telehealth yoga (tele-yoga), their views on this topic have not yet been adequately considered. This study examined the perspectives of Veterans Health Administration (VA) yoga teachers regarding a VA Office of Rural Health-funded multi-site tele-yoga implementation study.

Objectives: This qualitative study aims to explore VA yoga teachers' perspectives and experiences with regards to implementing and delivering synchronous, remote, group yoga-for-wellness classes via video-based telehealth and provide lessons learned.

Methods: A qualitative study was conducted with 13 yoga teachers from 6 different VA healthcare systems included in a multi-site tele-yoga implementation study. Interviews covered experience with teaching in an online format, program implementation and delivery, and equity considerations. Interviews were conducted and recorded using Microsoft Teams. Transcripts were coded using MAXQDA 2022 and analyzed via thematic content analysis.

Results: VA tele-yoga teachers identified 4 categories impacting tele-yoga implementation and delivery: (1) equipment and information technology needs; (2) physical space (particularly for teachers teaching onsite in a hospital or clinic setting); (3) accessibility and safety; and (4) administrative responsibilities and end-user support. Findings highlight key considerations and potential solutions for teachers and healthcare settings, and resources needed to provide a safe, accessible, and effective experience for participants.

Conclusion: Learning from tele-yoga teachers' experiences at VA can inform best practices for teaching yoga to groups in a synchronous, remote, online format within healthcare settings. The ways in which VA tele-yoga teachers surmounted barriers and harnessed opportunities for success can inform program recommendations as tele-yoga programs expand across VA and become incorporated in other healthcare systems and facilities.

Background and objectives: This study investigated a potentized, oral homeopathic SARS-CoV-2 nosode (BiosimCovex) for safety, efficacy, and immunogenicity against COVID-19 infection.

Methods: A phase III, multicentre, randomised, double-blind, placebo-controlled trial was conducted at 13 sites in India. 2671 unvaccinated, RT-PCR and SARS-CoV-2 antibody-negative participants were randomized 2:1 to receive 6 doses over 3 days of BiosimCovex (1781) or placebo (890). SARS-CoV-2 prevention efficacy was assessed through RT-PCR. Efficacy was defined as 100 x (1-IRR), where IRR is the ratio of positive RT-PCR test rates in the BiosimCovex compared to the placebo group. A two-sided Clopper-Pearson 95% confidence interval was adjusted for surveillance time. Immunogenicity was measured by SARS-CoV-2 antibody conversion at days 15, 30, 45, and 60. Safety was assessed through symptom questionnaires and laboratory studies every 15 days. Illness burden was assessed through symptom diaries.

Results: Maximum efficacy occurred at day 45 and was 50.06% overall, 71.88% in individuals aged 18-40 years; and 61.57% in females. By day 45, there were 23 positive RT-PCR cases per group (BiosimCovex 1.3%; placebo 2.6%, P = 0.007). A total of fifty-nine positive RT-PCR cases occurred, with thirty-three (1.86%) in the BiosimCovex and twenty-six (2.94%) in the placebo group, for a relative risk (RR) of 0.63 at the end of the study over 60 days. Antibody conversion increased over time, with 48.4% becoming antibody positive by day 60 in the treatment group compared to 13.4% in the placebo group (P < 0.001). All 169 (6.33%) mild adverse events resolved without sequelae (6.52% in treatment; 5.96% in placebo). There was a significant reduction in symptom duration (P = 0.0085) in the treatment group for those who became ill.

Conclusions: A potentized oral nosode was safe and appeared to prevent SARS-CoV-2 infection and be immunogenic over 60 days. Effectiveness was highest at day 45 in females and in the 18- to 40-year-old age group.

Background: There is a marked absence of supportive care programs to address the significant distress experienced by young children with Sickle Cell Disease (SCD) and their parents. Active Music Engagement (AME) is an evidence-based music therapy intervention that uses dyadic music play to mitigate interrelated parent-child distress during cancer treatment. The purposes of this study were to explore the cultural relevance of AME for Black children and parents and its potential utility during SCD treatment.

Methods: We conducted a three-phase qualitative study that included interviews with five Black parents of children (ages 3-8 years) with SCD, interviews with four additional parents/children after experiencing a music therapist facilitated AME experience and focus group sessions with a three member Black Music Therapist Advisory Board. We used thematic analysis to analyze data and synthesized findings across all three phases.

Results: Five themes and fourteen sub-themes emerged from the analysis. Theme One described the SCD experience as a dynamic journey. Theme Two offered insights into the prevalence and function of music within Black families. Themes Three, Four, and Five offered specific recommendations to improve the AME experience for Black families. Results indicated high prevalence and diversity of music in Black lives, and the importance of culture to support AME engagement. Therapists endorsed theoretical principles that inform the structure and tailored delivery of AME, with therapist and parent recommendations centered on the importance of providing experiences that affirm Black families' values, culture, histories, and natural forms of expression. Black families and therapists also acknowledged the importance of shared cultural knowledge when receiving and providing care.

Conclusions: These findings support the potential utility of AME to reduce stress experienced by young children with SCD and their parents, and the importance of ongoing collaboration between Black families, Black therapists and non-Black team members, prioritizing the input and engagement of Black families, alongside the leadership of Black therapists.

Background: Low back pain is the leading cause of disability worldwide. Multidisciplinary approaches to chronic pain can support resilience in recovery of functioning. The ancient arts of t'ai chi and qigong have been touted for centuries as multimodal approaches to health and healing. An RCT of an on-line t'ai chi and qigong program for individuals with chronic low back pain found clinically significant improvements in pain, physical function, and quality of life. The program consisted of the integrated practice of t'ai chi movement and the stillness of qigong practice. Meditations in the program focused on developing positive mental attitudes to support resilience in managing the emotional challenges of pain and disease.

Objective: The purpose of the current qualitative study aimed to better understand participants' experiences during the online Heal and Strengthen the Spine with T'ai Chi and Qigong (HSSTQ) program.

Methods: Written feedback was received from 96 program participants, and semi-structured interviews were completed with 20 participants. Interviews were transcribed and coded based upon the written feedback and interview questions. A thematic narrative was developed from the coded segments of texts and reviewed by participants in a member check.

Results: Three interlocking themes characterized the experiences of participants in the program: (1) participants learned skills to relieve back pain including moderation in movement; (2) the holistic nature of the program enabled a range of benefits for participants beyond pain reduction; and (3) personal healing experience, the enthusiasm of the instructor, the program itself, and available staff resources motivated individuals to participate.

Conclusion: The conclusion from this study and the initial RCT is that a virtually delivered integrated tai chi, qigong, and meditation program may be a viable treatment option for adults with low back pain.

Background: Racial and ethnic disparities in healthcare in the United States have been well described. Despite the growing presence of Chinese patients in the U.S. healthcare system, medical education largely lacks formal training in Chinese cultural sensitivity and traditional Chinese medicine (TCM). This study aims to explore physician experiences and identify strategies for delivering elucidate themes in physician experiences and identify strategies for delivering culturally sensitive, equitable care to ethnically Chinese patients living in America.

Methods: A qualitative study was conducted using purposive and snowball sampling, with semi-structured interviews with 7 academic and 12 community physicians in Southern California who met the following criteria: (1) general practice or community physicians with >25% of their patient population being ethnically Chinese or (2) specialists working with >10% ethnically Chinese patients at any of their medical practices.

Results: Physicians reported significant cultural differences in patient-provider relationships, family involvement in medical decision-making, communication styles, perceptions of biomedical and integrative therapies, and attitudes toward sensitive health topics. A majority of participants observed that many ethnic Chinese patients use TCM alongside conventional treatments but often do not disclose this to their physicians. Recommendations for improving culturally sensitive care included increasing the availability of Chinese-speaking providers, incorporating structured exposure to ethnic Chinese patients in medical training, and offering formal education on Chinese language, health beliefs, and TCM principles for healthcare professionals.

Discussion: Physicians highlighted the need for systems-level, educational, and individual-level interventions to mitigate health disparities in Chinese American communities. Integrating physician perspectives on cultural health practices into medical education and clinical training may enhance patient trust, improve adherence to treatment, and bridge gaps in culturally sensitive care for ethnically Chinese patients in the United States. Furthermore, acknowledging and incorporating TCM in patient-centered care could foster a more holistic and culturally congruent healthcare approach.

Background: While some evidence suggests psychosocial and physical health benefits of Bharatanatyam (eg, Indian Classical Dance), no study has explored the lived experiences of Bharatanatyam dancers themselves and the value they place on this practice for their own well-being.

Objective: Using a qualitative methodology, the purpose of this study is to explore Bharatanatyam dancers' perceptions of this practice and its impact on their lives.

Methods: Bharatanatyam dancers with at least 10 years of experience participated in a 60-minute recorded Zoom interview about their experience, history, and relationship with Bharatanatyam, with a focus on how it may have impacted their well-being. Using a Grounded Theory approach, research team members engaged in open coding to create an initial codebook from the first transcript, and then took an interrater reliability test (Kappa >.70) before coding subsequent transcripts. Group-based axial coding was used to create higher-order categories and themes from the original codes. Saturation was documented.

Results: In total, 15 Bharatanatyam dancers were interviewed, resulting in 206 unique codes. Saturation was met for 82% of the codes. Axial coding yielded 27 higher-order categories, and five overarching themes: (1) "Foundations of Bharatanatyam", which highlighted important aspects of the practice (2) "Heightened Connections" across emotional, spiritual, community, and cultural areas, (3) "Improvements in Mind/Body/Spirit" highlighting increased emotional, physical, cognitive, and energetic wellbeing, (4) "Motivations and Challenges for the Practice" such as perceived benefits and practice barriers, and (5) "Processes of Practice" highlighting the dynamic and stylistic nature of the art form.

Conclusion: This study offers evidence that Bharatanatyam plays a role in a dancer's well-being through heightened connection and improvement in physical and mental health; knowledge which can help transform its role from a mere artform to a creative healthcare modality.

Background: Slow breathing exercises have been shown to reduce blood pressure and sympathetic tone acutely, though long-term effects are not well documented.

Objective: Assess changes in blood pressure and autonomic measures from before and after 12 weeks of yoga-based slow breathing.

Methods: We conducted a secondary analysis to assess changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and autonomic tone as measured by spectral analysis of heart rate variability after 12 weeks of yoga-based slow breathing among 99 healthy participants. Participants were randomized to 2 different slow breathing techniques, length of inhale = exhale (I = E) vs length of inhaleI), to examine if breath ratio produced differential effects.

Results: The baseline average SBP and DBP was 105 ± 11 and 67 ± 8 mmHg respectively. Among the 11 participants with elevated blood pressure, SBP/DBP was 126 ± 11.0/80 ± 5 mmHg. SBP and DBP decreased significantly (-2.4 ± 7.3 and -1.6 ± 5.5 mmHg, respectively) at 12 weeks among all participants. Blood pressure among slow breathing participants with elevated baseline SBP >120 mmHg and/or DBP >80 mmHg reduced further (-10.3 ± 7.9 and -3.8 ± 5.5 mmHg, respectively). In our regression model, baseline SBP was associated with further decreases in SBP from baseline to 12 weeks. There were no significant differences in BP changes by breath ratio group. No significant changes were observed from baseline to 12 weeks in autonomic tone as measured with spectral analyses. Nor were there any observed correlations between changes in blood pressure and autonomic tone.

Conclusion: 12-weeks of slow breathing exercises were associated with clinically significant reduction of blood pressure in the absence of statistically significant changes in autonomic tone as measured by heart rate variability. Further research is warranted regarding the mechanisms and clinical efficacy of slow breathing on blood pressure regulation.

In the 1980s, H. Pylori was discovered as the root cause of peptic ulcer disease and revolutionized treatment. Previously, this illness was treated as a somatoform illness, associated with Type A personalities. Similarly, there is now overwhelming evidence that the root cause of IBS (Irritable Bowel Syndrome) originates from the development of bacterial dysbiosis, yet diagnosis and treatment are not routinely offered to patients. Instead, patients are offered palliative measures. A paradigm shift for IBS management is urgently needed.

Background: Therapeutic music has been shown to reduce stress and anxiety, while boosting mood and overall well-being in numerous settings. Building on the success of Vanderbilt University Medical Center's (VUMC) Therapeutic Music Program, and in collaboration with AARP Tennessee and the Blair School of Music at Vanderbilt, a community-based therapeutic music program was introduced, focusing on community assisted living centers and Veteran audiences.

Objective: To evaluate the experience and perceptions of Veteran and senior citizens to live therapeutic music performances in order to guide future program development and music selection.

Methods: Performances were held at a local Veterans Affairs Medical Center and assisted living facilities, involving 42 participants. Student musicians performed music pieces with violin, piano, saxophone, and vocals. After each performance, audience members completed an anonymous survey.

Results: Survey results revealed that 93% (n = 39) of participants recognized music as a significant or moderately significant part of their lives. Most participants enjoyed a wide variety of instruments and genres (60%, N = 24). Participants appreciated the live performance, vocal pieces, and the atmosphere it created.

Conclusions: Data on preferred genres and instruments can guide the selection of musicians for other therapeutic programs. Furthermore, insights into the most enjoyable parts of the performance can inform customization of future music performances to help better address the needs of different audiences.