Full Title: Effects of music on anxiety and pain in children with cerebral palsy receiving acupuncture: A randomized controlled trial

OBJECTIVES: To study the effects of music on anxiety and pain in children with cerebral palsy receiving acupuncture daily in a clinical setting. DESIGN: A randomized controlled trial. SETTING: Acupuncture Unit at Shenzhen Hospital of Traditional Chinese Medicine in Shenzhen City of China. PARTICIPANTS: Sixty children with cerebral palsy undergoing acupuncture. METHODS: Intervention: Children listened to their favorite music or a blank disc for 30min. Measurements: (1) the modified Yale preoperative anxiety scale for children's anxiety (mYPAS); (2) children's hospital of eastern Ontario pain scale (CHEOPS) and Wong-Baker faces pain rating scale (FACES) for pain intensity; (3) vital signs including mean arterial blood pressure (MAP), heart rate (HR) and respiratory rate (RR). RESULTS: An independent sample t-test showed significantly lower mYPAS scores in the music group 30min after the intervention compared with the control group (t=4.72, P=0.00). Significant differences between groups were found in mYPAS scores (F=4.270, d.f.=1, P=0.043, Partial eta(2)=0.069) and over treatment duration (F=143.421, d.f.=1.521, P=0.000, Partial eta(2)=0.712). A significant interaction was also found (F=4.298, d.f.=1.521, P=0.025, Partial eta(2)=0.069). LSD's post hoc testing confirmed that the mYPAS scores significantly increased from the baseline to 1min (P=0.000, 95% CI 14.913, 20.257) and then gradually decreased from 1 to 30min (P=0.000, 95% CI -18.952, -13.714). For pain intensity scores, a highly significant time effect was found in both the CHEOPS (F=87.347, d.f.=2, P=0.000, Partial eta(2)=0.601) and FACES (F=225.871, d.f.=1.822, P=0.000, Partial eta(2)=0.796), and a significant interaction effect was found as well (F=4.369, d.f.=2, P=0.015, Partial eta(2)=0.070; F=5.859, d.f.=1.822, P=0.005, Partial eta(2)=0.092). However, no significant difference between groups was present (F=2.343, d.f.=1, P=0.131, Partial eta(2)=0.039; F=3.738, d.f.=1, P=0.058, Partial eta(2)=0.061). Significant differences between groups were found in MAP and HR (P<0.05) and over time (P<0.05), but no significant effects in RR were apparent (P>0.05). A significant interaction effect was found in HR (P<0.05), but not in MAP or RR (P>0.05). CONCLUSIONS: This study demonstrates that listening to music while receiving acupuncture can relieve anxiety among children with cerebral palsy; however, no effect was observed in terms of pain reduction. Further research is needed to explore the types of music which best impact an individual's treatment. Whether music results in fewer accidents and side effects of acupuncture should be investigated. Music can be considered as adjunctive therapy in clinical situations that may be anxiety-provoking for children.

Int J Nurs Stud. 2009 Jun 2. Yu H, Liu Y, Li S, Ma X. Department of Acupuncture and Moxibustion, Traditional Chinese Medicine Hospital of Shenzhen, No. 1, Fu-hua Road, Fu-tian District, Shenzhen 518000, Guangdong Province, China.

Kevin first turned his attention to Hypnosis in 1987. After years of study became a qualified Hypnotherapist in may 1994, since then has continued to study new ways that Hypnosis and other related therapies can help people to over come there fears, stress, Anxities, unwanted habbits etc. Hypotherapy has the potentail to help if not remove the symptoms of a wide variety of conditions. Hypnotherapy can also help with personal development such as personal performance improvement. In 2007 Kevin decided to make his own self help CDs Using his experience of one to one therapy sessions and transferring this knowledge on to his own range of Improve your life therapy Cds. Kevin also offers free personal help and advice on how to gain the most from using Hypnosis and his CDs.

For more information visit www.fenland-hypnotherapy.co.uk.

Full Title: Standardized hypnosis treatment for irritable bowel syndrome: the North Carolina protocol

The North Carolina protocol is a seven-session hypnosis-treatment approach for irritable bowel syndrome that is unique in that the entire course of treatment is designed for verbatim delivery. The protocol has been tested in two published research studies and found to benefit more than 80% of patients. This article describes the development, content, and testing of the protocol, and how it is used in clinical practice.

Int J Clin Exp Hypn. 2006 Jan;54(1):51-64. Palsson OS. Division of Digestive Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. opalsson@med.unc.edu

BACKGROUND: Acupuncture has been used in the treatment of substance-related disorders for the past 30 years. However, a systematic review to assess the effect of various types of acupuncture for alcohol dependence has not yet been performed. The present systematic review assessed the results of randomized controlled trials (RCTs). METHODS: Nineteen electronic databases, including English, Korean, Japanese, and Chinese databases, were systematically searched for RCTs of acupuncture for alcohol dependence up to June 2008 with no language restrictions. The methodological qualities of eligible studies were assessed using the criteria described in the Cochrane Handbook. RESULTS: Eleven studies, which comprised a total of 1,110 individual cases, were systematically reviewed. Only 2 of 11 trials reported satisfactorily all quality criteria. Four trials comparing acupuncture treatment and sham treatments reported data for alcohol craving. Three studies reported that there were no significant differences. Among 4 trials comparing acupuncture and no acupuncture with conventional therapies, 3 reported significant reductions. No differences between acupuncture and sham treatments were found for completion rates (Risk Ratio = 1.07, 95% confidence interval, CI = 0.91 to 1.25) or acupuncture and no acupuncture (Risk Ratio = 1.15, 95% CI = 0.79 to 1.67). Only 3 RCTs reported acupuncture-related adverse events, which were mostly minimal. CONCLUSIONS: The results of the included studies were equivocal, and the poor methodological quality and the limited number of the trials do not allow any conclusion about the efficacy of acupuncture for treatment of alcohol dependence. More research and well-designed, rigorous, and large clinical trials are necessary to address these issues.

Alcohol Clin Exp Res. 2009 Aug;33(8):1305-13. Cho SH, Whang WW. Department of Neuropsychiatry, Hospital of Korean Medicine, Kyung Hee University Medical Center, Seoul, Korea. chosh@khu.ac.kr

By Kathy Sexton-Radek and Gina M. Graci

While nearly one-third of our life is spent in slumber, many individuals underestimate the value and function of sleep. It is estimated that one in eight adults will experience discomfort and report lower quality of life rating due to a poor night of sleep. Frequently, our conversations include subjective ratings of "how well or how poor" we slept the previous night because so much of our alertness, ability to concentrate, and ability to function revolves around the length and quality of sleep.

[More]

Full Title: Winter depression recurrence one year after cognitive-behavioral therapy, light therapy, or combination treatment

The central public health challenge in the management of seasonal affective disorder (SAD) is prevention of depression recurrence each fall/winter season. The need for time-limited treatments with enduring effects is underscored by questionable long-term compliance with clinical practice guidelines recommending daily light therapy during the symptomatic months each year. We previously developed a SAD-tailored group cognitive-behavioral therapy (CBT) and tested its acute efficacy in 2 pilot studies. Here, we report an intent-to-treat (ITT) analysis of outcomes during the subsequent winter season (i.e., approximately 1 year after acute treatment) using participants randomized to CBT, light therapy, and combination treatment across our pilot studies (N=69). We used multiple imputation to estimate next winter outcomes for the 17 individuals who dropped out during treatment, were withdrawn from protocol, or were lost to follow-up. The CBT (7.0%) and combination treatment (5.5%) groups had significantly smaller proportions of winter depression recurrences than the light therapy group (36.7%). CBT alone, but not combination treatment, was also associated with significantly lower interviewer- and patient-rated depression severity at 1 year as compared to light therapy alone. Among completers who provided 1-year data, all statistically significant differences between the CBT and light therapy groups persisted after adjustment for ongoing treatment with light therapy, antidepressants, and psychotherapy. If these findings are replicated, CBT could represent a more effective, practical, and palatable approach to long-term SAD management than light therapy.

Behav Ther. 2009 Sep;40(3):225-38. Epub 2008 Nov 3. Rohan KJ, Roecklein KA, Lacy TJ, Vacek PM. Department of Psychology, University of Vermont, John Dewey Hall, 2 Colchester Avenue, Burlington, VT 05405-0134, USA. kelly.rohan@uvm.edu

by Louise LeBrun

Our world is not about to change, it already has changed! We can no longer simply presume that what was, still is; and that what we once held to be true can still be relied upon to continue to be true. From the more obvious effects in our physical world of global climate change to the more subtle changes in our thoughts - our beliefs about ourselves, our world and our ability to move effectively through that world - we know intuitively that something is moving and we're right in the middle of it all!

[More]

BACKGROUND: By enabling individuals to self-regulate their brainwave activity in the field of optimal performance in healthy individuals, neurofeedback has been found to improve cognitive and artistic performance. Here we assessed whether two distinct EEG neurofeedback protocols could develop surgical skill, given the important role this skill plays in medicine. RESULTS: National Health Service trainee ophthalmic microsurgeons (N = 20) were randomly assigned to either Sensory Motor Rhythm-Theta (SMR) or Alpha-Theta (AT) groups, a randomized subset of which were also part of a wait-list 'no-treatment' control group (N = 8). Neurofeedback groups received eight 30-minute sessions of EEG training. Pre-post assessment included a skills lab surgical procedure with timed measures and expert ratings from video-recordings by consultant surgeons, together with state/trait anxiety self-reports. SMR training demonstrated advantages absent in the control group, with improvements in surgical skill according to 1) the expert ratings: overall technique (d = 0.6, p < 0.03) and suture task (d = 0.9, p < 0.02) (judges' intraclass correlation coefficient = 0.85); and 2) with overall time on task (d = 0.5, p = 0.02), while everyday anxiety (trait) decreased (d = 0.5, p < 0.02). Importantly the decrease in surgical task time was strongly associated with SMR EEG training changes (p < 0.01), especially with continued reduction of theta (4-7 Hz) power. AT training produced marginal improvements in technique and overall performance time, which were accompanied by a standard error indicative of large individual differences. Notwithstanding, successful within session elevation of the theta-alpha ratio correlated positively with improvements in overall technique (r = 0.64, p = 0.047). CONCLUSION: SMR-Theta neurofeedback training provided significant improvement in surgical technique whilst considerably reducing time on task by 26%. There was also evidence that AT training marginally reduced total surgery time, despite suboptimal training efficacies. Overall, the data set provides encouraging evidence of optimised learning of a complex medical specialty via neurofeedback training.

BMC Neurosci. 2009 Jul 24;10:87. Ros T, Moseley MJ, Bloom PA, Benjamin L, Parkinson LA, Gruzelier JH. Department of Psychology, Goldsmiths, University of London, London, UK. t.ros@gold.ac.uk

Reviewed by Adele Ryan McDowell, PhD

Harvard-trained neurosurgeon and founder of the American Holistic Medical Association, C. Norman Shealy, M.D., Ph.D. has created a documentary film, "Medical Renaissance Series: The Secret Code." It is well worth a viewing.

Norm Shealy, often called Dr. Wizard by his colleagues given his 10 inventions and inventive strategies, is man who likes to solve problems and understand why. Shealy brings his all-things-are-possible thinking to this 92 minute DVD as he explores alternative healing methodologies through case studies, successful patient interviews, and conversations with some of his cutting edge colleagues, including Carl Hammerschlag, M.D., Gladys McGarey, M.D., Caroline Myss, Ph.D., Belleruth Naparstek, Ph.D., Morris Netherton, Ph.D., John Sewell, D.D. and others.

[More]

Full Title: Neural reorganization underlies improvement in stroke-induced motor dysfunction by music-supported therapy

Motor impairments are common after stroke, but efficacious therapies for these dysfunctions are scarce. By extending an earlier study on the effects of music-supported therapy, behavioral indices of motor function as well as electrophysiological measures were obtained before and after a series of therapy sessions to assess whether this new treatment leads to neural reorganization and motor recovery in patients after stroke. The study group comprised 32 stroke patients in a large rehabilitation hospital; they had moderately impaired motor function and no previous musical experience. Over a period of 3 weeks, these patients received 15 sessions of music-supported therapy using a manualized step-by-step approach. For comparison 30 additional patients received standard rehabilitation procedures. Fine as well as gross motor skills were trained by using either a MIDI-piano or electronic drum pads programmed to emit piano tones. Motor functions were assessed by an extensive test battery. In addition, we studied event-related desynchronization/synchronization and coherences from all 62 patients performing self-paced movements of the index finger (MIDI-piano) and of the whole arm (drum pads). Results showed that music-supported therapy yielded significant improvement in fine as well as gross motor skills with respect to speed, precision, and smoothness of movements. Neurophysiological data showed a more pronounced event-related desynchronization before movement onset and a more pronounced coherence in the music-supported therapy group in the post-training assessment, whereas almost no differences were observed in the control group. Thus we see that music-supported therapy leads to marked improvements of motor function after stroke and that these are accompanied by electrophysiological changes indicative of a better cortical connectivity and improved activation of the motor cortex.

Ann N Y Acad Sci. 2009 Jul;1169:395-405. Altenmüller E, Marco-Pallares J, Münte TF, Schneider S. Institute of Music Physiology and Musicians' Medicine, University of Music and Drama Hannover, Hannover, Germany.

In August 2009, the International Hypnosis Research Institute announced the availability of two new certifications. These are the Mind/Body Integration and Advanced Neuro-Noetic Hypnosis^TM certifications. Both are currently available only in a distance learning format. They are designed to help integrative health care professionals improve their ability to enhance client and patient healing. These certifications and their individual courses are intended to appeal to a wide range of professionals. These include medical doctors, dentists, nurses, social workers, psychologists, hypnotherapists, counselors, chiropractors, massage therapists, and others.

The Mind/Body Integration certification program covers theory that is based upon leading-edge research and provides participants with numerous demonstrations and exercises, which they are encouraged to begin using immediately. The intent is for students to appreciate the good evidence-based science foundation of the theories presented and quickly see results as techniques are applied to real cases. The program is based upon a realization that clinicians must have a high level of competence when communicating with the mind's of their patients. Therefore, this program relies on the most effective and proven ideas including direct suggestion, permissive methodologies, and advanced neurologically-based interventions. Even though the course is designed to accommodate experienced hypnotherapists, those with little or no experience with hypnosis and guided imagery will find how easy it is to apply the presented demonstrations. This certification includes 36 lessons organized in 4 courses.

The Advanced Neuro-Noetic Hypnosis^TM certification builds upon the skills presented in the four Mind/Body Integration courses. The focus of this certification is on developing clinical competency in three major areas, which includes performance enhancement, resolving mental pathologies, and improving physical healing. This certification concentrates on the student mastering advanced theory and effectively applying the lessons learned in real-life therapeutic settings. The program moves from concept to application, which includes improving session design. The uniqueness of the curriculum is that it applies rather advanced neurological and mind/body integration concepts to everyday clinical situations. This certification includes a total of 78 lessons organized into 12 courses. The 36 Mind/Body Integration courses are included in this program. Students who complete this program will receive both certifications.

Certification candidates enroll in individual courses. Upon completion of each course they are informed of their progress toward final certifications. Institute members receive a 25% discount off of the tuition for each course. Additionally, renewing members who have free course eligibility may take individual certification courses at no charge.

For more information, please visit Mind/Body Integration Certification Program and Advanced Neuro-Noetic Hypnosis^TM Certification.

Patricia is a Certified Clinical Hypnotherapist and Professional Speaker specializing in behavior modification, self-improvement seminars and motivational training. She has a B.S. in Clinical Hypnotherapy and is a Ph.D. candidate with American Pacific University with additional Certifications/Training in Medical and Immune System Hypnotherapy, Hypnotic Anesthesiology, EEG Biofeedback, Addictions Hypnotherapy, Neuro-Linguistic Programming, Metaphysical Counseling, and Fitness and Nutrition. She is a Certified Manager with over 700 hours training in management, leadership, supervisory, and interpersonal skills through the James Madison University, Virginia. Patricia also enjoys speaking to groups and organizations, tapping into her previous 20 year career as a professional singer, actor, dancer, published songwriter and autho.

For more information visit: http://www.uphypnosis.com

Full Title: Acupuncture in acute herpes zoster pain therapy (ACUZoster) - design and protocol of a randomised controlled trial

ABSTRACT: BACKGROUND: Acute herpes zoster is a prevalent condition. One of its major symptoms is pain, which can highly influence patient's quality of life. Pain therapy is limited. Acupuncture is supposed to soften neuropathic pain conditions and might therefore act as a therapeutic alternative. Objective of the present study is to investigate whether a 4 week semi-standardised acupuncture is non-inferior to sham laser acupuncture and the anticonvulsive drug gabapentine in the treatment of pain associated with herpes zoster. METHODS: Three-armed, randomised, placebo-controlled trial with a total follow-up time of 6 months. Up to estimated 336 patients (interim analyses) with acute herpes zoster pain (VAS > 30 mm) will be randomised to one of three groups (a) semi-standardised acupuncture (168 patients); (b) gabapentine with individualised dosage between 900 3600 mg/d (84 patients); (c) sham laser acupuncture. Intervention takes place over 4 weeks, all patients will receive analgesic therapy (non-opioid analgesics: metamizol or paracetamol and opioids: tramadol or morphine). Therapy phase includes 4 weeks in which group (a) and (c) consist of 12 sessions per patient, (b) visits depend on patients needs. Main outcome measure is to assess the alteration of pain intensity before and 1 week after treatment sessions (visual analogue scale VAS 0-100 mm). Secondary outcome measure are: alteration of pain intensity and frequency of pain attacks; alteration of different aspects of pain evaluated by standardised pain questionnaires (NPI, PDI, SES); effects on quality of life (SF 36); analgesic demand; alteration of sensoric perception by systematic quantitative sensory testing (QST); incidence of postherpetic neuralgia; side effects and cost effectiveness. Credibility of treatments will be assessed. DISCUSSION: This study is the first large-scale randomised placebo controlled trial to evaluate the efficacy of acupuncture compared to gabapentine and sham treatment and will provide valuable new information about the clinical and physiological effects of acupuncture and gabapentine in the treatment of acute herpes zoster pain. The study has been pragmatically designed to ensure that the study findings can be implemented into clinical practice if acupuncture can be shown to be an effective treatment strategy in acute herpes zoster pain. Trial registration: NCT00885586.

BMC Complement Altern Med. 2009 Aug 12;9(1):31. Fleckenstein J, Kramer S, Hoffrogge P, Thoma S, Lang PM, Lehmeyer L, Schober GM, Pfab F, Ring J, Weisenseel P, Schotten KJ, Mansmann U, Irnich D.

by Tim Brunson, PhD

The purpose of any therapeutic session is to relieve the discomfort and suffering of another person and return them to a state of happiness and contentment. This typically involves a presenting problem – although the clinician may uncover other issues that must be addressed initially. The structure of the session is critical to its success. In this article I will share with you a process which I currently employ with many of my hypnotherapy clients.

For the purpose of this article it may be helpful to regard the person seeking help as a patient. Regardless of the traditional and preferred terminology of a particular helping profession, the word patient denotes a person who is experiencing an "enduring situation that is causing discomfort." Realizing this and having a compassionate attitude is helpful.

I must warn you that there are three major mistakes that clinicians often make during a session. The first is to allow an uncontrolled and unstructured session to exacerbate – rather than alleviate – the presenting problem. Secondly, the clinician may tend to use the session to address their own unresolved issues. A session with a paying client is not the appropriate time to conduct self-therapy. And third – and related – a session may be seen as an opportunity to address the clinician's ego issues through inappropriately impressing the patient as to their importance and value. The session must be all about the patient and be considered successful only if it reaches the therapeutic intent.

[More]

Full Title: Changes in mismatch negativity across pre-hypnosis, hypnosis and post-hypnosis conditions distinguish high from low hypnotic susceptibility groups

The role of alterations in mismatch negativity (MMN) in hypnosis was examined by recording MMN of the auditory ERP at frontal (F3, Fz, and F4) and mastoid (M1 and M2) placements. Frontal MMN is believed to reflect activity in right anterior cortical generators, whereas MMN at mastoid leads reflects generators located bilaterally in the temporal auditory cortex. MMN recordings were obtained in 11 low and 12 high hypnotically susceptible participants in three successive blocks; pre-hypnosis, hypnosis and post-hypnosis. Frontal (but not temporal) MMN showed a significant quadratic trend across testing conditions. It increased during hypnosis and then dropped post-hypnosis for both susceptibility groups. Linear trends for frontal and temporal MMN showed directly opposite patterns of change in the interaction between hypnotic susceptibility and testing blocks. Frontal MMN built up linearly over the test blocks in high relative to low susceptibility participants. Temporal MMN showed the reverse pattern and increased linearly across test conditions in those with low relative to high hypnotic susceptibility.

Brain Res Bull. 2005 Oct 30;67(4):298-303. Jamieson GA, Dwivedi P, Gruzelier JH. Imperial College London, UK. gjamieso@pobox.une.edu.au

BACKGROUND: The present maintenance study investigated whether the reduction in hypochondriacal complaints after initial treatment with CBT or paroxetine sustained during a follow-up period and whether psychiatric severity at pretest predicted the course of hypochondriacal symptoms. METHOD: A naturalistic follow-up period of 18 months after a 16-week RCT consisting of 33 patients initially allocated to a CBT condition and 29 patients to a paroxetine condition. The main outcome measure was the Whiteley Index. RESULTS: The initial treatment effect of CBT and paroxetine sustained during the follow-up period. No significant differences between CBT and paroxetine were found. Treatment course could not be predicted by psychiatric comorbidity. CONCLUSION: CBT and paroxetine are both effective treatments for hypochondriasis in the long term.

J Behav Ther Exp Psychiatry. 2009 Sep;40(3):487-96. Epub 2009 Jun 28. Greeven A, van Balkom AJ, van der Leeden R, Merkelbach JW, van den Heuvel OA, Spinhoven P. Faculty of Social Sciences, Department of Clinical, Health and Neuropsychology, Leiden University, Leiden, The Netherlands. greeven@fsw.leidenuniv.nl

by Derrick Lonsdale, MD

The present concept involving disease is to "make a diagnosis". The specific disease is then named in much the same way as we might use in collecting alpine flowers or stamps. It is recognized by a constellation of symptoms and signs and the "proof" is believed to come from the laboratory. If there is overlap between several diseases we go about making a "differential diagnosis", perhaps the best example being collagen diseases. The only trouble with this is that Mother Nature does not understand our classification and did not construct the model by which we diagnose. This is not the only error in our thinking. With the exception of antibiotics designed to "kill the enemy", we try to find a "cure" for each and every disease as it is described. We now have a fantastic array of potentially poisonous substances that are so numerous that they have to be catalogued in the Physicians Desk Reference, a tome that almost exceeds the dimensions of a volume of Encyclopedia Brittanica. Even with the acknowledged concept of antibiotics we have come to recognize their limitations and dangers. Louis Pasteur, on his death bed, said "I was wrong: it is the terrain that matters". He had recognized that the body could only exist in a hostile environment by initiating a defensive strategy that is an innate part of our evolution. So is an entirely new model required? Should we be content with merely treating symptoms?

[More]

A great number of clinical studies merging traditional Chinese medicine (TCM) and Western medicine have proved the complementary healing effects of qi-gong in medical science. Traditional Chinese respiration exercises help to regulate our mind, body and breathing and coordinate our internal organs, remove toxins and enhance immunity. Domestic and foreign studies indicate that qi-gong can relieve chronic pain, reduce tension, increase activities of phagocytes in coenocytes, improve cardiopulmonary function, improve eyesight, influence the index of blood biochemistry, etc. Due to the obvious healing effects of qi-qong therapy, through introducing qi-gone concepts and related medical research, this paper aims to inspire health care workers to integrate qi-qong therapy into medical treatments and nursing care, or to carry out further studies in order to make good the shortfall in provision of holistic medicine and nursing in the interests of the quality of patient care.

Hu Li Za Zhi. 2005 Jun;52(3):65-70. Li TY, Yeh ML. Tri-Service General Hospital.

Master Hypnotist Nancy hunter is a clinical member of the Ontario Society of Psychotherapists (OSP), a Master Practitioner of classic and advanced Ericksonian hypnosis, certified with the National Guild of Hypnotherapists (NGH). Nancy is also a registered Canadian Art Therapist (RCAT) - registered with the Canadian Art Therapy Association (CATA) and Master NLP Practitioner. Nancy is available in person for Therapy Sessions in Toronto, Canada.

[More]

OBJECTIVE: To summarize scholarly literature that describes practice, utilization, and/or policy of chiropractic services within international active duty and/or veteran health care environments. DATA SOURCES: PubMed, the Cumulative Index to Nursing and Allied Health Literature, and the Index to Chiropractic Literature were searched from their starting dates through June 2009. REVIEW METHODS: All authors independently reviewed each of the articles to verify that each met the inclusion criteria. Citations of included papers and other pertinent findings were logged in a summary table. RESULTS: Thirteen articles were included in this study. Integration of chiropractic care into military or veteran health care systems has been described in 3 systems: the United States Department of Defense, the United States Department of Veterans Affairs, and the Canadian Forces. CONCLUSION: Chiropractic services seem to be included successfully within military and veteran health care facilities. However, there is a great need for additional written evaluation of the processes, policies, practices, and effectiveness of chiropractic services in these environments.

J Can Chiropr Assoc. 2009 Aug;53(3):194-204. Green BN, Johnson CD, Lisi AJ, Tucker J. Chiropractic Division, Department of Physical and Occupational Therapy, Naval Medical Center San Diego, MCAS Miramar Branch Medical Clinic, PO Box 452002, San Diego, CA 92145-2002. Email: bart.green@med.navy.mil.

We investigated the hypothesis that inducing a dissociative response (detachment) in healthy volunteers while they were watching a trauma film would lead to increased numbers of intrusive memories of the film during the following week. Hypnotized participants were given suggestions to dissociate during part of the film, and to watch the rest of the film normally from their own perspective. The order of these conditions, and the section of film watched under the two conditions, were counterbalanced. As predicted, watching the film under both conditions led to increases in dissociation. Explicit suggestions to dissociate were generally effective in inducing higher levels of dissociation. Contrary to prediction, there were no more intrusive memories of sections of the film for which participants had received dissociation suggestions. Implications of our results for views of the relationship between peri-traumatic dissociation and intrusive memories are discussed.

J Trauma Dissociation. 2006;7(4):91-113. Holmes EA, Oakley DA, Stuart AD, Brewin CR. Royal Society Dorothy Hodgkin Fellow, University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, UK. emily.holmes@psych.ox.ac.uk

by Marta Luzim, MS

Everyone wants to be happy. As children, and still as adults, we want to believe Jiminy Cricket's lullaby, "When you wish upon a star makes no difference who you are, when you wish upon a star your dreams really do come true."

"The Secret," a movie produced by Rhonda Byrne of Prime Time Productions which was featured on the Oprah Winfrey show, introduced a panel of philosophers, scientists, visionaries and entrepreneurs that teach "The Secret's" basic tenet of creating one's personal reality.

[More]

Real-time functional magnetic resonance imaging (fMRI) affords the opportunity to explore the feasibility of self-regulation of functional brain networks through neurofeedback. We localised emotion networks individually in thirteen participants using fMRI and trained them to upregulate target areas, including the insula and amygdala. Participants achieved a high degree of control of these networks after a brief training period. We observed activation increases during periods of upregulation of emotion networks in the precuneus and medial prefrontal cortex and, with increasing training success, in the ventral striatum. These findings demonstrate the feasibility of fMRI-based neurofeedback of emotion networks and suggest a possible development into a therapeutic tool.

Neuroimage. 2009 Jul 29. Johnston SJ, Boehm SG, Healy D, Goebel R, Linden DE. Bangor Imaging Unit, Wolfson Centre for Clinical and Cognitive Neuroscience, School of Psychology, Bangor University, Bangor, UK.

by Coach Cary Bayer

Earlier this year, I was teaching a series of classes in our nation's capital and, wanting to get some fresh fruit for a post-seminar snack, I went into a Giant grocery store in Silver Spring, Maryland. Unlike just about every other supermarket and retail outlet that I've ever walked through throughout this vast nation of ours, it, surprisingly, did not have a customer relations department. But don't be shocked. That's because this Giant had already awakened its own inner giant: it has a Solutions Center. The difference is quite palpable. Customer relations is what stores offer; solutions are what customers desire. Going into a store that sports its own department for solving your problems is a fresh breeze that would make anyone a loyal and devoted customer.

[More]

OBJECTIVE: To explore the perceptions of group music therapy among elderly nursing home residents in Taiwan. METHODS: Focus group methodology was used to explore the perceptions of elderly participants about their experience of group music therapy. Verbatim transcripts of audiotaped interviews were analysed by content analysis. RESULTS: In total, 3 focus groups were held with 17 wheelchair-bound elderly residents. Analysis of participants' perceptions of group music therapy revealed two major themes: (1) strength derived from the group dynamic and (2) enhanced quality of life. The first theme included three subthemes: (1) sense of energy, (2) distraction from suffering, and (3) confirmation as a person. The second major theme included four subthemes: (1) variety added to life, (2) motivation to exercise, (3) learning positive behaviour, and (4) greater life satisfaction. CONCLUSION: Elderly, wheelchair-bound residents of a nursing home in Taiwan positively viewed their experiences with our group music therapy programme, particularly its active component. The findings of this study suggest that healthcare providers should consider integrating group music therapy into their programmes for elderly nursing home residents and design the therapy to add variety to their life, give them a sense of autonomy by having them choose their preferred musical activities, and improve their cognitive function.

Complement Ther Med. 2009 Aug;17(4):190-5. Epub 2009 Apr 29. Chen SL, Lin HC, Jane SW. Department of Nursing, Hung Kuang University, Taiwan. slchen@sunrise.hk.edu.tw

Ron Eslinger performs a short induction and session using the hypnosis technique of glove anesthesia on a pregnant subject. Using nothing but the power of her mind he puts a pretty good clamp on her.

For more information visit www.eslinger.net.

by Tim Brunson, PhD

The first step to mastering anything is to load your brain with as much relevant information regarding that endeavor. This is especially true for mastering the game of golf. While practice appears to be the key, it takes a tremendous dedication to the sport to spend sufficient time on the golf course to attain a respectable level of expertise. So, if you are a business professional who can only play a round once or twice a week, you may find yourself constantly lagging behind many of your friends. Fortunately, there are other solutions. This is where I come in.

[More]

Full Title: Acupuncture as a treatment for functional dyspepsia: design and methods of a randomized controlled trial

ABSTRACT: BACKGROUND: Acupuncture is widely used in China to treat functional dyspepsia (FD). However, its effectiveness in the treatment of FD, and whether FD-specific acupoints exist, are controversial. So this study aims to determine if acupuncture is an effective treatment for FD and if acupoint specificity exists according to traditional acupuncture meridians and acupoint theories. DESIGN: This multicenter randomized controlled trial will include four acupoint treatment groups, one non-acupoint control group and one drug (positive control) group. The four acupoint treatment groups will focus on: (1) specific acupoints of the stomach meridian; (2) non-specific acupoints of the stomach meridian; (3) specific acupoints of alarm and transport points; and (4) acupoints of the gallbladder meridian. These four groups of acupoints are thought to differ in terms of clinical efficacy, according to traditional acupuncture meridians and acupoint theories. A total of 120 FD patients will be included in each group. Each patient will receive 20 sessions of acupuncture treatment over 4 weeks. The trial will be conducted in eight hospitals located in three centers of China. The primary outcomes in this trial will include differences in Nepean Dyspepsia Index scores and differences in the Symptom Index of Dyspepsia before randomization, 2 weeks and 4 weeks after randomization, and 1 month and 3 months after completing treatment. DISCUSSION: The important features of this trial include the randomization procedures (controlled by a central randomization system), a standardized protocol of acupuncture manipulation, and the fact that this is the first multicenter randomized trial of FD and acupuncture to be performed in China. The results of this trial will determine whether acupuncture is an effective treatment for FD and whether using different acupoints or different meridians leads to differences in clinical efficacy. Trial registration number: Clinical Trials.gov Identifier: NCT00599677.

Trials. 2009 Aug 23;10(1):75. Zheng H, Tian XP, Li Y, Liang FR, Yu SG, Liu XG, Tang Y, Yang XG, Yan J, Sun GJ, Chang XR, Zhang HX, Ma TT, Yu SY.

Ormond McGill was known as the "Dean of American Hypnotists. He has an international reputation for his books on hypnotism, meditation and mysticism. Prominent in the field of hypnotism for over 50 years, he is author of The Encyclopedia of Genuine Stage Hypnotism; A Better Life Through Conscious Self-Hypnosis; The Art of Stage Hypnotism; Hypnotism and Meditation; Power Hypnosis Hypnotherapy and his autobiography The Secrets of Dr. Zombi: The autobiography of Ormond McGill.

For more information visit www.ormondmcgill.com.

Full Title: Clinical effectiveness of a cognitive behavioral group treatment program for anxiety disorders: a benchmarking study

Previous research has established efficacy of cognitive behavioral therapy (CBT) for anxiety disorders, yet it has not been widely assessed in routine community clinic practices. Efficacy research sacrifices external validity to achieve maximum internal validity. Recently, effectiveness research has been advocated as more ecologically valid for assessing routine clinical work in community clinics. Furthermore, there is a lack of effectiveness research in group CBT. This study aims to extend existing research on the effectiveness of CBT from individual therapy into group therapy delivery. It aimed also to examine outcome using not only symptom measures, but also measures of related symptoms, cognitions, and life quality and satisfaction. Results from a cohort of patients with various anxiety disorders demonstrated that treatment was effective in reducing anxiety symptoms to an extent comparable with other effectiveness studies. Despite this, only 43% of individuals showed reliable change, and 17% were 'recovered' from their anxiety symptoms, and the post-treatment measures were still significantly different from the level of anxiety symptoms observed in the general population.

J Anxiety Disord. 2009 Oct;23(7):950-7. Epub 2009 Jun 18. Oei TP, Boschen MJ. School of Psychology, The University of Queensland, Brisbane, Australia. oei@psy.uq.edu.au

Full Title: Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis

Since the first reports of neurofeedback treatment in Attention Deficit Hyperactivity Disorder (ADHD) in 1976, many studies have investigated the effects of neurofeedback on different symptoms of ADHD such as inattention, impulsivity and hyperactivity. This technique is also used by many practitioners, but the question as to the evidence-based level of this treatment is still unclear. In this study selected research on neurofeedback treatment for ADHD was collected and a meta-analysis was performed. Both prospective controlled studies and studies employing a pre- and post-design found large effect sizes (ES) for neurofeedback on impulsivity and inattention and a medium ES for hyperactivity. Randomized studies demonstrated a lower ES for hyperactivity suggesting that hyperactivity is probably most sensitive to nonspecific treatment factors. Due to the inclusion of some very recent and sound methodological studies in this meta-analysis, potential confounding factors such as small studies, lack of randomization in previous studies and a lack of adequate control groups have been addressed, and the clinical effects of neurofeedback in the treatment of ADHD can be regarded as clinically meaningful. Three randomized studies have employed a semi-active control group which can be regarded as a credible sham control providing an equal level of cognitive training and client-therapist interaction. Therefore, in line with the AAPB and ISNR guidelines for rating clinical efficacy, we conclude that neurofeedback treatment for ADHD can be considered "Efficacious and Specific" (Level 5) with a large ES for inattention and impulsivity and a medium ES for hyperactivity.

Clin EEG Neurosci. 2009 Jul;40(3):180-9. Arns M, de Ridder S, Strehl U, Breteler M, Coenen A. Brainclinics Diagnostics, Nijmegen, The Netherlands. martijn@brainclinics.com

Hypnosis treatment often improves irritable bowel syndrome (IBS), but the costs and reliance on specialized therapists limit its availability. A 3-month home-treatment version of a scripted hypnosis protocol previously shown to improve all central IBS symptoms was completed by 19 IBS patients. Outcomes were compared to those of 57 matched IBS patients from a separate study receiving only standard medical care. Ten of the hypnosis subjects (53%) responded to treatment by 3-month follow-up (response defined as more than 50% reduction in IBS severity) vs. 15 (26%) of controls. Hypnosis subjects improved more in quality of life scores compared to controls. Anxiety predicted poor treatment response. Hypnosis responders remained improved at 6-month follow-up. Although response rate was lower than previously observed in therapist-delivered treatment, hypnosis home treatment may double the proportion of IBS patients improving significantly across 6 months.

Int J Clin Exp Hypn. 2006 Jan;54(1):85-99. Palsson OS, Turner MJ, Whitehead WE. Division of Digestive Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. opalsson@med.unc.edu

by Adele Ryan McDowell, PhD

Like Oprah, I have spent my life dealing with weight and have recently regained once-lost avoirdupois. I hate that. I end up hating myself and then it's that all-too-familiar battle of up and down, Monday is a new start, last hoorah Sundays and so forth in a addictive cycle that has its roots in both biochemistry and emotion.

Decades ago, in my college economics class, there was a discussion of the "paradox of saving." As the name would suggest, the more you tried to save, the more you spent. I think the same holds true for dieting. In other words, the more you try to diet, the more you gain. And these days, science pretty much confirms that thinking given the preponderance of yo-yo dieting.

[More]

Full Title: Neurologic music therapy improves executive function and emotional adjustment in traumatic brain injury rehabilitation

This study examined the immediate effects of neurologic music therapy (NMT) on cognitive functioning and emotional adjustment with brain-injured persons. Four treatment sessions were held, during which participants were given a pre-test, participated in 30 min of NMT that focused on one aspect of rehabilitation (attention, memory, executive function, or emotional adjustment), which was followed by post-testing. Control participants engaged in a pre-test, 30 min of rest, and then a post-test. Treatment participants showed improvement in executive function and overall emotional adjustment, and lessening of depression, sensation seeking, and anxiety. Control participants improved in emotional adjustment and lessening of hostility, but showed decreases in measures of memory, positive affect, and sensation seeking.

Ann N Y Acad Sci. 2009 Jul;1169:406-16. Thaut MH, Gardiner JC, Holmberg D, Horwitz J, Kent L, Andrews G, Donelan B, McIntosh GR. Center for Biomedical Research in Music, Colorado State University, Fort Collins, Colorado 80523, USA. michael.thaut@colostate.edu

Linda Williams is certified registered nurse anesthetist in private practice in West Virginia. She is also an attorney licensed to practice law in Colorado, a consultant, and international lecturer on medical-legal issues. She has published numerous articles on legal issues for CRNAs and has appeared as an expert on healthcare issues on Dateline NBC, The Evening News with Tom Brokow, and C-Span.

[More]

We examined the effects of suggestion on Stroop interference in highly suggestible individuals. Participants completed the Stroop task with and without a suggestion to perceive Stroop words as meaningless symbols. Half the participants were given this suggestion in hypnosis, and half were given the suggestion without the induction of hypnosis. Suggestion produced a significant reduction in Stroop inhibition, accounting for about 45% of the variance in Stroop responding, regardless of whether hypnosis had been induced. These findings indicate that suggestion can at least partially overcome the automaticity associated with the Stroop effect.

Psychol Sci. 2006 Feb;17(2):91-5. Raz A, Kirsch I, Pollard J, Nitkin-Kaner Y. Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, MRI Unit in the Department of Psychiatry, Division of Child and Adolescent Psychiatry, New York, NY 10032, USA. ar2241@columbia.edu

While cognitive-behavioral therapy for IBS is quite effective, the limited availability of competent therapists and lack of access to treatment remain problematic. This paper reports on a small, randomized, controlled trial of a five week internet based cognitive-behavioral intervention for IBS with limited therapist feedback via e-mail. Fifty-four IBS patients were recruited via the internet and randomly assigned to either immediate treatment or a wait-list control group. Thirty-one subjects completed the post-treatment assessment. 77% of treatment completers also completed a 3-month follow-up assessment. Treatment completers experienced statistically and clinically significant declines in IBS symptoms and improvements in quality of life. Those gains were substantially maintained at follow-up. Treatment efficacy was partially mediated by reductions in the tendency to catastrophize the social and occupational implications of symptoms, suggesting that catastrophizing may be an important target for treatment.

Behav Res Ther. 2009 Sep;47(9):797-802. Epub 2009 May 20. Hunt MG, Moshier S, Milonova M. Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104-6241, USA. mhunt@psych.upenn.edu

By Jane Nash

Peter had walked though my door at barely 13 years old. Tall for his age and morbidly obese for his height, he needed to lose fifteen kilos and to change his shape so that he did not display 'man boobs' and not be teased at school in the changing rooms before and after sporting activities.

Because he was under 18 and also because I rarely see children, his mother had come with him. It became quickly apparent that she was displaying Kapassinian Emotional Sexuality (Behaviour traits as measured through the Emotional and Physical Behaviorist theories of George Kappas PhD.) As well as being withdrawn and awkward in her own physical presence, at her first interview she admitted to moving her son's behavior boundaries and consequence boundaries constantly due to guilt or poor time management. As a result it seemed that Peter had learned how to manipulate situations to his own benefit and within the confusion in what was and was not secure, had become a comfort eater.

[More]

Full Title: Functional capacity after traditional Chinese medicine (qi gong) training in patients with chronic atrial fibrillation: a randomized controlled trial

Evidence indicates that low energy expenditure protocols derived from traditional Chinese medicine may benefit patients with cardiac impairment; therefore, the authors carried out a randomized controlled trial to test a 16-week medically assisted qi gong training program for the physical rehabilitation of patients with stable chronic atrial fibrillation and preserved left ventricular function. Functional capacity variation was evaluated using the 6-minute walk test, which was performed at baseline, at the end of the intervention, and after 16 weeks. Thirty men and 13 women (mean age, 68+/-8 years) were randomized to the intervention protocol or to a wait-list control group. Qi gong training was well tolerated and, compared with baseline, trained patients walked an average 114 meters more (27%) at the end of treatment (P<.001) and 57 meters more (13.7%) 16 weeks later (P=.008). Control subjects showed no variation in functional capacity. These results seem promising and deserve confirmation with further research.

Prev Cardiol. 2007 Winter;10(1):22-5. Pippa L, Manzoli L, Corti I, Congedo G, Romanazzi L, Parruti G. Camillo de Lellis per la Ricera Clinica Applicata, Pescara, Italy.

by Mark Gorkin, LICSW

Expanding the Stress Response through an Organic/Poetic Mindset: "Fight and Flight" and "Freeze and Flow"

According to the leaders of a two day conference on "alternative health," language frames the essence of health and illness. For example, the workshop leaders were uncomfortable with the use of the word "stress" regarding the human condition. Stress, of course, was first defined as a property of metals, specifically an ability to withstand tension. For the instructors, stress terminology turns the body into a machine, something that can then be operated upon and repaired. With a mechanical mindset, however, the essence of the individual (also from my perspective, the team) as a living and evolving (also devolving) organism is easily lost. The human capacity for natural growth and innate healing when mind-body-spirit and the relationship with nature are in harmony can too easily be bypassed or undervalued. Before the mid-20th century takeover by "stress" terminology, the much more human notion of "grief" captured the tensions, trials, and tribulations and "sadder yet wiser" triumphs or, at least, "growing pains" of everyday life.

[More]