FULL TITLE: Functional magnetic resonance imaging of hippocampal activation during silent mantra meditation.

OBJECTIVES: The objective of the present study was to investigate whether moderately experienced meditators activate hippocampus and the prefrontal cortex during silent mantra meditation, as has been observed in earlier studies on subjects with several years of practice. METHODS: Subjects with less than 2 years of meditation practice according to the Kundalini yoga or Acem tradition were examined by functional magnetic resonance imaging during silent mantra meditation, using an on-off block design. Whole-brain as well as region-of-interest analyses were performed. RESULTS: The most significant activation was found in the bilateral hippocampus/parahippocampal formations. Other areas with significant activation were the bilateral middle cingulate cortex and the bilateral precentral cortex. No activation in the anterior cingulate cortex was found, and only small activation clusters were observed in the prefrontal cortex. CONCLUSIONS: In conclusion, the main finding in this study was the significant activation in the hippocampi, which also has been correlated with meditation in several previous studies on very experienced meditators. We propose that the hippocampus is activated already after moderate meditation practice and also during different modes of meditation, including relaxation. The role of hippocampal activity during meditation should be further clarified in future studies, especially by investigating whether the meditation-correlated hippocampal activity is related to memory consolidation.

J Altern Complement Med. 2010 Dec;16(12):1253-8. Engström M, Pihlsgård J, Lundberg P, Söderfeldt B. Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden. maria.engstrom@liu.se

FULL TITLE: Integrative care for the management of low back pain: use of a clinical care pathway.

BACKGROUND: For the treatment of chronic back pain, it has been theorized that integrative care plans can lead to better outcomes than those achieved by monodisciplinary care alone, especially when using a collaborative, interdisciplinary, and non-hierarchical team approach. This paper describes the use of a care pathway designed to guide treatment by an integrative group of providers within a randomized controlled trial. METHODS: A clinical care pathway was used by a multidisciplinary group of providers, which included acupuncturists, chiropractors, cognitive behavioral therapists, exercise therapists, massage therapists and primary care physicians. Treatment recommendations were based on an evidence-informed practice model, and reached by group consensus. Research study participants were empowered to select one of the treatment recommendations proposed by the integrative group. Common principles and benchmarks were established to guide treatment management throughout the study. RESULTS: Thirteen providers representing 5 healthcare professions collaborated to provide integrative care to study participants. On average, 3 to 4 treatment plans, each consisting of 2 to 3 modalities, were recommended to study participants. Exercise, massage, and acupuncture were both most commonly recommended by the team and selected by study participants. Changes to care commonly incorporated cognitive behavioral therapy into treatment plans. CONCLUSION: This clinical care pathway was a useful tool for the consistent application of evidence-based care for low back pain in the context of an integrative setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT00567333.

BMC Health Serv Res. 2010 Oct 29;10:298. Maiers MJ, Westrom KK, Legendre CG, Bronfort G. Northwestern Health Sciences University, 2501 W 84th St Bloomington, MN 55431, USA. mmaiers@nwhealth.edu

FULL TITLE: Dissociated control as a signature of typological variability in high hypnotic suggestibility.

This study tested the prediction that dissociative tendencies modulate the impact of a hypnotic induction on cognitive control in different subtypes of highly suggestible individuals. Low suggestible (LS), low dissociative highly suggestible (LDHS), and high dissociative highly suggestible (HDHS) participants completed the Stroop color-naming task in control and hypnosis conditions. The magnitude of conflict adaptation (faster response times on incongruent trials preceded by an incongruent trial than those preceded by a congruent trial) was used as a measure of cognitive control. LS and LDHS participants displayed marginally superior up-regulation of cognitive control following a hypnotic induction, whereas HDHS participants' performance declined. These findings indicate that dissociative tendencies modulate the influence of a hypnotic induction on cognitive control in high hypnotic suggestibility and suggest that HS individuals are comprised of distinct subtypes with dissimilar cognitive profiles.

Conscious Cogn. 2010 Dec 13. Terhune DB, Cardeña E, Lindgren M. Department of Psychology, Lund University, Box 213, 22100 Lund, Sweden.

FULL TITLE: Chiropractic utilization in BMX athletes at the UCI World Championships: a retrospective study.

OBJECTIVE: To examine paramedical (chiropractic, physiotherapy and massage therapy) utilization among high-level BMX athletes following sport-related injury at the 2007 UCI World Championships. METHODS: Retrospective analysis was conducted on a dataset from international male and female BMX athletes (n = 110) who sustained injury in training and competition at the 2007 BMX World Championships. RESULTS: Fifty percent of individuals aged 8-17 presented to a chiropractor versus 32% to physiotherapists and 18% to massage therapists. There was a significant difference in paramedical practitioner choice when comparing the sample across the different locations of injury. Specifically, the proportion of individuals presenting for treatment to chiropractors (84%) was much higher than to physiotherapists/massage therapists (16%) for spine or torso complaints. CONCLUSION: Utilization of chiropractors by BMX athletes may be higher than utilization of other paramedical professionals as suggested by this study. Chiropractors appear to be the paramedical practitioner of choice in regards to spine and torso related complaints.

J Can Chiropr Assoc. 2010 Dec;54(4):250-6. Konczak CR. Resident: College of Chiropractic Sports Sciences (Canada), Email: drclarkkonczak@gmail.com.

AIM: The primary aim was to study the effect of naturopathy and yoga interventions in treatment of mild to moderate hypertension. DESIGN: The variables of interest were measured at the beginning and end of the intervention using a pre-post design. SETTING: The study was conducted by INYS medical research society in Jindal Nature Cure Institute, Bangalore. SUBJECTS: A total of 104 subjects, already diagnosed with mild to moderate hypertension and on treatment with antihypertensive medicines were included in study. INTERVENTIONS: The intervention consisted of various inpatient administration of different naturopathy treatments, yoga therapies, low calorie and low sodium diet for 21 days. Antihypertensive medicines were withdrawn for some patients in one week based upon response to the treatment. OUTCOME MEASURES: The outcome measures were values of diastolic and systolic blood pressure and body weight. Subjects were followed for a period of one year after every 3 months. RESULTS: After starting nonpharmacological approach of naturopathy and yoga, Systolic blood pressure came down from mean of 139.6 to 129.6 where as it came down from 91.2 to 86.1 for diastolic blood pressure. At the same time favorable effect was also seen in other variables like lipid profile and body weight. At the end of one year out of 57 patients who came for follow-up, 14 cases were found to have blood pressure within normal ranges without any medication over the previous 12 months. CONCLUSION: Naturopathy and yoga therapy can be considered as a valuable nonpharmacoloical approach in treatment of hypertension.

Complement Ther Clin Pract. 2011 Feb;17(1):9-12. Murthy SN, Rao NS, Nandkumar B, Kadam A. INYS Medical Research Society, Jindal Naturecure Institute, Jindal Nagar, Bangalore 560073, India.

FULL TITLE: The effect of chair massage on muscular discomfort in cardiac sonographers: a pilot study.

BACKGROUND: Cardiac sonographers frequently have work-related muscular discomfort. We aimed to assess the feasibility of having sonographers receive massages during working hours in an area adjacent to an echocardiography laboratory and to assess relief of discomfort with use of the massages with or without stretching exercises. METHODS: A group of 45 full-time sonographers was randomly assigned to receive weekly 30-minute massage sessions, massages plus stretching exercises to be performed twice a day, or no intervention. Outcome measures were scores of the QuickDASH instrument and its associated work module at baseline and at 10 weeks of intervention. Data were analyzed with standard descriptive statistics and the separation test for early-phase comparative trials. RESULTS: Forty-four participants completed the study: 15 in the control group, 14 in the massage group, and 15 in the massage plus stretches group. Some improvement was seen in work-related discomfort by the QuickDASH scores and work module scores in the 2 intervention groups. The separation test showed separation in favor of the 2 interventions. CONCLUSION: On the basis of the results of this pilot study, larger trials are warranted to evaluate the effect of massages with or without stretching on work-related discomfort in cardiac sonographers. TRIAL REGISTRATION: NCT00975026 ClinicalTrials.gov.

BMC Complement Altern Med. 2010 Sep 16;10:50. Engen DJ, Wahner-Roedler DL, Nadolny AM, Persinger CM, Oh JK, Spittell PC, Loehrer LL, Cha SS, Bauer BA. Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. wahnerroedler.dietlind@mayo.edu.

FULL TITLE: Chronic low-back pain modulation is enhanced by hypnotic analgesic suggestion by recruiting an emotional network: a PET imaging study.

This study aimed to characterize the neural networks involved in patients with chronic low-back pain during hypnoanalgesia. PET was performed in 2 states of consciousness, normal alertness and hypnosis. Two groups of patients received direct or indirect analgesic suggestion. The normal alertness state showed activations in a cognitive-sensory pain modulation network, including frontotemporal cortex, insula, somatosensory cortex, and cerebellum. The hypnotic state activated an emotional pain modulation network, including frontotemporal cortex, insula, caudate, accumbens, lenticular nuclei, and anterior cingulate cortex (ACC). Direct suggestion activated cognitive processes via frontal, prefrontal, and orbitofrontal cortices, while indirect suggestion activated a widespread and more emotional network including frontal cortex, anterior insula, inferior parietal lobule, lenticular nucleus, and ACC. Confirmed by visual analog scale data, these results suggest that chronic pain modulation is greater with hypnosis, which enhances both activated networks.

Int J Clin Exp Hypn. 2011 Jan;59(1):27-44. Nusbaum F, Redouté J, Le Bars D, Volckmann P, Simon F, Hannoun S, Ribes G, Gaucher J, Laurent B, Sappey-Marinier D. University of Lyon II, Laboratoire Santé-Individu-Société, 5 avenue Pierre Mendès France – Bâtiment K – 69500 Bron, France. f.nusbaum@wanadoo.fr

Acupuncture is used widely in oriental medicine. But it is difficult to stimulate continuously or intermittently in daily life with conventional acupuncture. An acupoint stimulation device using focused ultrasound has been developed. Because the device size is about 6 mm in diameter, it can be easily put on the skin during daily life. Appropriate stimulation intensity and pattern can be chosen by changing driving voltage and pattern. In this paper, we stimulated acupoints with this device and measured the blood flow volume of brachial artery. As a result, the blood flow volume increased significantly as well as acupuncture. Because the device stimulate acupoints with intactness of skin, advantages of this device is free from infection and fear and pain by insertion of acupuncture needles.

Conf Proc IEEE Eng Med Biol Soc. 2010;1:1258-61. Tsuruoka N, Watanabe M, Seki T, Matsunaga T, Hagaa Y. Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan.

A Book Review by Judith E. Pearson, PhD

Thinking Therapeutically, by Tom Barber and Sandra Westland affords a rare look into the minds of two seasoned hypnotherapists, as they relate case studies and comment on one another's work. This book is ideal for beginning hypnotherapists and for those who wonder about a therapist's internal process during the external therapeutic conversation.

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Homeopathy is a frequently used complementary and alternative medicine (CAM) treatment. We present results comparing responses of homeopathy users (HUs) and users of other forms of CAM (NHUs) in pediatric oncology (PO) in Germany. Differences between these two groups (usage, associated demographic characteristics, previous experience with CAM) are investigated. 186 (45.2%) of the 367 CAM users were exposed to homeopathy. The treatment duration amounted to a median of 601 days for HUs and 282 days for NHUs. Parents with p (127; 76.5%) also used homeopathy for their child's cancer. Nonmedical practitioners played a considerably greater role as source of information than did treating physician. In the majority HUs received their prescriptions from nonmedical practitioners (56%; 29.4% of NHUs). HUs communicate more frequently with their physicians about the CAM-use (77.7% versus 65.2%) and recommend CAM more often than NHUs (94% versus 85.6%). Homeopathy is the most frequently used CAM treatment in PO in Germany. HUs sustain treatment and therapies considerably longer than NHUs. Most families who had used homeopathy before their child was diagnosed with cancer also used homeopathy for the treatment of their child's cancer. Compared to other CAM treatments, patient satisfaction with homeopathy appears to be very high.

Evid Based Complement Alternat Med. 2011;2011:867151. Längler A, Spix C, Edelhäuser F, Kameda G, Kaatsch P, Seifert G. Department of Pediatric and Adolescent Medicine, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany.

FULL TITLE: Effect of foot massage to decrease physiological lower leg oedema in late pregnancy: a randomized controlled trial in Turkey.

This study aims to evaluate the effect of foot massage for decreasing physiological lower leg oedema in late pregnancy. Eighty pregnant women were randomly divided into two groups; study group had a 20 min foot massage daily for 5 days whereas the control group did not receive any intervention beyond standard prenatal care. The research was conducted between March and August 2007 in Manisa Province Health Ministry Central Primary Health Care Clinic 1, in Manisa, Western Turkey. Compared with the control group, women in the experimental group had a significantly smaller lower leg circumference (right and left, ankle, instep and metatarsal-phalanges joint) after 5 days of massage. The results obtained from our research show that foot massage was found to have a positive effect on decreasing normal physiological lower leg oedema in late pregnancy.

Int J Nurs Pract. 2010 Oct;16(5):454-60. doi: 10.1111/j.1440-172X.2010.01869.x. Coban A, Sirin A. Department of Midwifery, Aydin School of Health, Adnan Menderes University, Aydin, Turkey. ayden.coban@adu.edu.tr

FULL TITLE: The Attentional Resource Allocation Scale (ARAS): psychometric properties of a composite measure for dissociation and absorption.

BACKGROUND: Differences in attentional processes have been linked to the development and maintenance of psychopathology. Shifts in such processes have been described by the constructs Dissociation and Absorption. Dissociation occurs when external and/or internal stimuli are excluded from consciousness due to discrepant, rather than unitary, manifestations of cognitive awareness [Erdelyi MH. 1994: Int J Clin Exp Hypnosis 42:379-390]. In contrast, absorption can be conceptualized by a focus on limited stimuli, to the exclusion of other stimuli, because of unifying, rather than discrepant, manifestations of cognitive awareness. The Dissociative Experiences Scale [DES; Bernstein EM, Putnam FW. 1986: J Nerv Ment Dis 174:727-735] and Tellegen Absorption Scale [TAS; Tellegen A, Atkinson G. 1974: J Abnorm Psychol 83:268-277] are common measures of each construct; however, no factor analyses are available for the TAS and despite accepted overlap, no one has assessed the DES and TAS items simultaneously. Previous research suggests the constructs and factor structures need clarification, possibly including more parsimonious item inclusion [Lyons LC, Crawford HJ. 1997: Person Individ Diff 23:1071-1084]. The purpose of this study was to evaluate the factor structure of the DES and TAS and create a psychometrically stable measure of Dissociation and Absorption. METHODS: This study included data from an undergraduate (n=841; 76% women) and a community sample (n=233; 86% women) who each completed the DES and TAS. RESULTS: Exploratory factor analyses [Osborne JW (ed). 2008: Best Practices in Quantitative Methods. Los Angeles: Sage Publications Inc.] with all DES and TAS items suggested a 15-item 3-factor solution (i.e., imaginative involvement, dissociative amnesia, attentional dissociation). Confirmatory factor analyses resulted in excellent fit indices for the same solution. CONCLUSIONS: The items and factors were conceptualized in line with precedent research as the Attentional Resource Allocation Scale (ARAS). Comprehensive results, implications, and future research directions are discussed.

Depress Anxiety. 2010 Aug;27(8):775-86. Carleton RN, Abrams MP, Asmundson GJ. University of Regina, Saskatchewan, Canada.

Jean-Martin Charcot proposed the radical hypothesis that similar brain processes were responsible for the unexplained neurological symptoms of 'hysteria', now typically diagnosed as 'conversion disorder' or 'dissociative (conversion) disorder', and the temporary effects of hypnosis. While this idea has been largely ignored, recent cognitive neuroscience studies indicate that (i) hypnotisability traits are associated with a tendency to develop dissociative symptoms in the sensorimotor domain; (ii) dissociative symptoms can be modelled with suggestions in highly hypnotisable subjects; and (iii) hypnotic phenomena engage brain processes similar to those seen in patients with symptoms of hysteria. One clear theme to emerge from the findings is that 'symptom' presentation, whether clinically diagnosed or simulated using hypnosis, is associated with increases in prefrontal cortex activity suggesting that intervention by the executive system in both automatic and voluntary cognitive processing is common to both hysteria and hypnosis. Nevertheless, while the recent literature provides some compelling leads into the understanding of these phenomena, the field still lacks well controlled systematically designed studies to give a clear insight into the neurocognitive processes underlying dissociation in both hysteria and hypnosis. The aim of this review is to provide an agenda for future research.

J Neurol Neurosurg Psychiatry. 2010 Sep 30. Bell V, Oakley DA, Halligan PW, Deeley Q. Institute of Psychiatry, King's College London, London, UK.

By Coach Cary Bayer

The medium is the message. Marshall McCluhan

One of the first things that a journalist writing for a newspaper learns is to ask and get answers for the five key questions. These are who, what, when, where, and how. In a previous column, you learned what to say in an ad; in another one, you learned how to say what you want to say in an ad; and in this one, you'll learn where to say what you want to say in an ad.

The ad that I'm referring to is one of two types: either the retail-oriented ad (the half-price special for new clients, or its buy one, get one free cousin), or the image ad that positioned you uniquely in the marketplace. While there's an art to how to communicate in an ad, there's not a precise science to where to communicate--even though media specialists in advertising agencies ply their sophisticated computers and demographic and psychographic analyses trying to make it as scientific as possible. For an alternative healer promoting a discount-pricing ad to attract new clients, there's a bit of trial and error that will probably be necessary.

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Full TitlePromoting Sleep by Nursing Interventions in Health Care Settings: A Systematic Review.

Background: Sleep disturbances are common problems among individuals in hospitals and institutions. Although several studies have explored this phenomenon, there is still a lack of knowledge about the effectiveness of sleep-promoting nursing interventions. This systematic review aims to describe and evaluate the effectiveness of sleep-promoting nursing interventions in health care settings. Approach: A systematic review was performed. In June 2009, a literature search was carried out in the following databases: Academic Search Elite, CINAHL, the Cochrane Library and MedLine/PubMed. Fifty-two references were identified and after critical appraisal, nine studies were selected. A compilation of the results and the outcomes of the interventions were carried out. Furthermore, the evidence strength of the interventions was assessed. Findings: Little evidence for the nursing interventions, sleep hygiene, music, natural sound and vision, stimulation of acupoints, relaxation, massage and aromatherapy is found. However, large effect size of interventions were found when using massage, acupuncture and music, natural sounds or music videos. The use of sleep hygiene and relaxation, on the other hand, produced only small effects. Conclusion: The lack of high evidence strength for the nursing interventions together with the uncertainty about their effects calls for more research before implementing these interventions into clinical practice.

Worldviews Evid Based Nurs. 2010 Oct 12. doi: 10.1111/j.1741-6787.2010.00203.x. Hellström A, Willman A. Amanda Hellström, Doctoral Student, School of Health Science, Blekinge Institute of Technology, Karlskrona, and Department of Health Sciences, Lund University, Lund; Cecilia Fagerström, Senior Lecturer, School of Health Science, Blekinge Institute of Technology, Karlskrona; Ania Willman, Professor, School of Health Science, Blekinge Institute of Technology, Karlskrona, all in Sweden.

Diana Moore (Lighteacher) is a Reiki Master, Psychic Counselor, Channeler, Certified Hypnotherapist, Co-Founder of the Foundation for Metaphysical Studies (Dallas, Texas); Founder of Consiousness Relationship Counseling (Counseling without Blame), Founder of Past Life Energy Relationship Tracing Technique, Life Coach, Channeler and Facilitator of the Lightwork Class. She is in the process of publishing a book in which she has channeled recipes or techniques for use by everyone in life in order to assist one to heal their lives and create more time, energy and empowerment in one's life. She began channeling St. Peter at four years of age and now channels Archangel Michael, Jesus, Mother Mary as well as other ascended masters and angelic beings.

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Ever since the classic work of Ebbinghaus (1885/1964), the default view in scientific psychology has been that memory declines over time. Less well-known clinical and laboratory traditions suggest, however, that memory can also increase over time. Ballard (1913) demonstrated that, actually, memory simultaneously increases and decreases over time and thus has not 1 but 2 tendencies. When more than 1 recall test is administered, a later test invariably shows loss of some items remembered earlier (oblivescence), but later tests also invariably show that previously unremembered items are recovered in later tests (reminiscence). Depending on a number of factors (e.g., the stimulus used), the overall balance between reminiscence and oblivescence may be positive (hypermnesia) or negative (amnesia). Modern multitrial recall studies have extensively documented hypermnesic memory in single laboratory sessions and, also, although less frequently, over periods of days, weeks, and even months. With hypermnesic memory now established, hypnosis has been shown not to add anything to regular hypermnesia. This article presents an integration of the scattered literatures, which now, after a century of experimental and clinical effort, coheres into a solid empirical picture, with numerous implications (e.g., for the recovered memory controversy, eyewitness testimony, repression, and subliminal perception).

Am Psychol. 2010 Oct;65(7):623-33. Erdelyi MH. Department of Psychology, Brooklyn College, Brooklyn, NY 11210-2889, USA. iyledre@comcast.net

Differences and points of contact between osteopathy and yoga as regards their history and practical application are outlined. Both seek to promote healing. Yoga seeks the attainment of consciousness; osteopathy aims for providing support to health. One fundamental difference is the personal involvement of the individual in yoga. Teacher and student alike are challenged to re-examine the attitudes of mind they have adopted toward their lives. Osteopathy generally involves a relatively passive patient while the osteopath is active in providing treatment. Practical examples are used to highlight points of contact between yoga and osteopathy. The text includes a discussion of the importance of physicality and a description of ways of using it in healing processes. Furthermore, processes of attaining consciousness are outlined. Possible reductionist misconceptions in yoga and osteopathy are also pointed out. Fundamental attitudes and focus that complement each other are presented, taking the concept of stillness as a particular example.

J Bodyw Mov Ther. 2011 Jan;15(1):92-102. Liem T. Osteopathie Schule Deutschland, Institute of Integrative Morphology, Frahmredder 16, 22393 Hamburg, Germany. tliem@osteopathie-schule.de

FULL TITLE: Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study.

OBJECTIVE: The purpose of this study was to compare the clinical efficacy of spinal manipulation against microdiskectomy in patients with sciatica secondary to lumbar disk herniation (LDH). METHODS: One hundred twenty patients presenting through elective referral by primary care physicians to neurosurgical spine surgeons were consecutively screened for symptoms of unilateral lumbar radiculopathy secondary to LDH at L3-4, L4-5, or L5-S1. Forty consecutive consenting patients who met inclusion criteria (patients must have failed at least 3 months of nonoperative management including treatment with analgesics, lifestyle modification, physiotherapy, massage therapy, and/or acupuncture) were randomized to either surgical microdiskectomy or standardized chiropractic spinal manipulation. Crossover to the alternate treatment was allowed after 3 months. RESULTS: Significant improvement in both treatment groups compared to baseline scores over time was observed in all outcome measures. After 1 year, follow-up intent-to-treat analysis did not reveal a difference in outcome based on the original treatment received. However, 3 patients crossed over from surgery to spinal manipulation and failed to gain further improvement. Eight patients crossed from spinal manipulation to surgery and improved to the same degree as their primary surgical counterparts. CONCLUSIONS: Sixty percent of patients with sciatica who had failed other medical management benefited from spinal manipulation to the same degree as if they underwent surgical intervention. Of 40% left unsatisfied, subsequent surgical intervention confers excellent outcome. Patients with symptomatic LDH failing medical management should consider spinal manipulation followed by surgery if warranted.

J Manipulative Physiol Ther. 2010 Oct;33(8):576-84. McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Chiropractor, National Spine Care, Calgary, Alberta, Canada. gmcmorland@nationalspinecare.com

FULL TITLE: The effect of preferred music on mood and performance in a high-cognitive demand occupation.

Mild positive affect has been shown in the psychological literature to improve cognitive skills of creative problem-solving and systematic thinking. Individual preferred music listening offers opportunity for improved positive affect. The purpose of this study was to examine the effect of preferred music listening on state-mood and cognitive performance in a high-cognitive demand occupation. Twenty-four professional computer information systems developers (CISD) from a North American IT company participated in a 3-week study with a music/no music/music weekly design. During the music weeks, participants listened to their preferred music "when they wanted, as they wanted." Self-reports of State Positive Affect, State Negative Affect, and Cognitive Performance were measured throughout the 3 weeks. Results indicate a statistically significant improvement in both state-mood and cognitive performance scores. "High-cognitive demand" is a relative term given that challenges presented to individuals may occur on a cognitive continuum from need for focus and selective attention to systematic analysis and creative problem-solving. The findings and recommendations have important implications for music therapists in their knowledge of the effect of music on emotion and cognition, and, as well, have important implications for music therapy consultation to organizations.

J Music Ther. 2010 Summer;47(2):137-54. Lesiuk T. University of Miami, USA.

FULL TITLE: Interprofessional education through shadowing experiences in multi-disciplinary clinical settings.

ABSTRACT: The World Health Organization has recently added Interprofessional Education (IPE) to its global health agenda recognizing it as a necessary component of all health professionals' education. We suggest mandatory interprofessional shadowing experiences as a mechanism to be used by chiropractic institutions to address this agenda. IPE initiatives of other professions (pharmacy and medicine) are described along with chiropractic. This relative comparison of professions local to our jurisdiction in Ontario, Canada is made so that the chiropractic profession may take note that they are behind other health care providers in implementing IPE.Interprofessional shadowing experiences would likely take place in a multi-disciplinary clinical setting. We offer an example of how two separate professions within a Family Health Team (FHT) can work together in such a setting to enhance both student learning and patient care. For adult learners, using interprofessional shadowing experiences with learner-derived and active objectives across diverse health professional groups may help to improve the educational experience. Mandatory interprofessional shadowing experiences for chiropractors during their training can enhance future collaborative practice and provide success in reaching a goal common to each profession - improved patient care.

Chiropr Osteopat. 2010 Dec 2;18:31. Riva JJ, Lam JM, Stanford EC, Moore AE, Endicott AR, Krawchenko IE. Department of Family Medicine, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Hamilton, ON, Canada. rivaj@mcmaster.ca.

Full Title: Involvement of the mechanoreceptors in the sensory mechanisms of manual and electrical acupuncture.

The modalities of acupuncture can be broadly classified into manual acupuncture (MA) and electroacupuncture (EA). Although MA has been reported to cause winding of tissue around the needle and subsequent activation of the sensory mechanoreceptors and nociceptors, the sensory mechanisms of acupuncture stimulation are not fully understood. To test the hypothesis that the involvement of the mechanoreceptors in the sensory mechanism is different in MA and EA, we examined the effects of a stretch-activated channel blocker gadolinium on the hemodynamic responses to hind limb MA and EA in anesthetized rats (n=9). Gadolinium significantly attenuated the MA-induced bradycardic response (-22±5 vs. -10±3bpm, P<0.05) and tended to attenuate the MA-induced depressor response (-30±5 vs. -18±4mmHg, P=0.06). On the other hand, gadolinium significantly attenuated both the EA-induced bradycardic (-22±5 vs. -9±4bpm, P<0.01) and depressor responses (-32±6 vs. -15±5mmHg, P<0.01). These results indicate that the mechanoreceptors are involved in the sensory mechanisms for both MA and EA.

Auton Neurosci. 2010 Dec 15. Yamamoto H, Kawada T, Kamiya A, Miyazaki S, Sugimachi M. Division of Cardiology, Department of Medicine, Faculty of Medicine, Kinki University, Osaka, Japan.

OBJECTIVE: The authors investigated the potential effectiveness of biofeedback as a complementary treatment for PTSD. DESIGN: This exploratory study used heart variability biofeedback and determined its efficacy in treating PTSD through the use of two rating instruments, The Post-traumatic Stress Disorder Checklist (PCL)-Military version and the Zung Self-Rating Depression Scale. Active duty service members deployed to Iraq or Afghanistan were alternatively assigned to a treatment as usual control group and treatment as usual with the addition of biofeedback. The authors administered the two instruments before treatment and at the conclusion of three weeks of biofeedback therapy. RESULTS: Biofeedback did not produce a measurable improvement. A one way repeated measures analysis of variance (ANOVA) was used to examine change in PCL scores over time. There was a main effect for time, F(1, 36)=11.98, p<.001, indicating a decrease in PCL scores from baseline to three weeks for both the control and treatment group. Results demonstrated a nonsignificant main effect of group, F(1, 36)=.1.79, p=ns, and a nonsignificant group by time interaction, F(1, 36)=.2.59, p=ns. Similarly, for depression, results showed a significant main effect for time, F(1, 33)=10.26, p<.003, indicating a decrease in Zung scores from baseline to three weeks for both the control and treatment group. Results demonstrated a nonsignificant main effect of group, F(1, 33)=.385, p=ns, and a nonsignificant group by time interaction, F(1, 33)=3.52, p=ns. CONCLUSION: The addition of biofeedback did not produce a measurable improvement in PTSD or depression scores in this exploratory study.

Complement Ther Med. 2010 Dec;18(6):256-9. Lande RG, Williams LB, Francis JL, Gragnani C, Morin ML. Psychiatric Continuity Service, Department of Psychiatry, Walter Reed Army Medical Center, Washington, DC, United States. rglande@act85.com

Full Title: An investigation into the effectiveness of traditional Chinese acupuncture (TCA) for chronic stress in adults: A randomised controlled pilot study.

AIMS: The aim of this exploratory, pragmatic randomised controlled trial was to investigate the effectiveness of traditional Chinese acupuncture (TCA), using an individually targeted treatment protocol delivered by a traditionally trained Chinese acupuncturist. The trial examined the treatment of chronic stress as perceived and reported by the participants, with all its diversity of presenting symptoms, rather than using a cohort approach based on a single stress-related symptom. METHODS: Participants (n=18) with high self-reported stress levels were randomised into 3 groups. Group 1 received weekly TCA for 5 weeks; group 2 received weekly attention only (practitioner present and participant supine) for 5 weeks and group 3 acted as a waiting list control. The Perceived Stress Scale 14 (PSS-14) and the Measure Yourself Medical Outcome Profile (MYMOP) were completed before and after a 5-week intervention. RESULTS: After 5 weeks, group 1 reported significant changes in MYMOP profile score and both MYMOP reported symptoms (p<0.05); group 2 had significant changes in MYMOP profile score and 1 symptom (p<0.05); group 3 showed no changes. The PSS-14 scores decreased in all 3 groups, but the difference between pre- and post-study within and between the groups did not reach significance in this small study. In addition, there were self-reports of improvements for group 1 for other health problems encountered during treatment. LIMITATIONS AND CONCLUSIONS: The lack of clarity concerning the definition of stress makes it complex to investigate. This pilot study suggests that TCA may be successful in treating the symptoms of stress, through a combination of specific and non-specific effects; but may not relate directly to how a person perceives their stress.

Complement Ther Clin Pract. 2011 Feb;17(1):16-21. Huang W, Howie J, Taylor A, Robinson N. London South Bank University, London SE1 OAA, UK.

by Tim Brunson, PhD

Just about every aspect of human communication alters the frequency of a person's brainwaves and results in various parts of the brain activating, idling, or being inhibited. When this results in a type of focused attention during which certain mental resistances are reduced and selective imagination is enhanced, we can say that a hypnotic process has occurred. Clearly, this can happen on purpose when a skilled clinical – or stage – operator communicates with the intention of creating such a result. However, the truth is that this happens unintentionally all the time. When a hypnotic process is in employed for the express purpose of achieving a desired secondary gain – such as improving health or happiness, as well as achieving self-actualization – we can regard it hypnotherapy. But, does every endeavor that produces a hypnotic effect warrant the label "hypnotherapy" or its recognition as a new school of hypnotherapy ? Such is the case when considering what is popularly called Ericksonian Hypnotherapy.

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FULL TITLE: A randomized controlled trial of the effects of hypnosis with 3-D virtual reality animation on tiredness, mood, and salivary cortisol.

Case studies suggest hypnosis with a virtual reality (VR) component may be an effective intervention; although few follow-up randomized, controlled trials have been performed comparing such interventions with standard hypnotic treatments. Thirty-five healthy participants were randomized to self-hypnosis with VR imagery, standard self-hypnosis, or relaxation interventions. Changes in sleep, cortisol levels, and mood were examined. Self-hypnosis involved 10- to 20-min. sessions visualizing a healthy immune scenario. Trait absorption was also recorded as a possible moderator. Moderated regression indicated that both hypnosis interventions produced significantly lower tiredness ratings than relaxation when trait absorption was high. When trait absorption was low, VR resulted in significantly higher engagement ratings, although this did not translate to demonstrable improvement in outcome. Results suggest that VR imagery may increase engagement relative to traditional methods, but further investigation into its potential to enhance therapeutic efficacy is required.

Int J Clin Exp Hypn. 2011 Jan;59(1):122-42. Thompson T, Steffert T, Steed A, Gruzelier J. Department of Psychology & Counselling, University of Greenwich, London, UK. t.thompson@gre.ac.uk

A Book Review by Tim Brunson, PhD

When a person experiences a problem integrating one or more disturbing or life-threatening events, clinicians have a wide range of tools with which to assist their recovery. The phenomena, which is called a trauma, is the topic covered by a new book by psychologist Robin Shapiro, PhD. In The Trauma Treatment Handbook: Protocols Across the Spectrum, she addresses practically all protocols currently available – to include pharmacology. I tend to agree with the charge made in the preface by trauma authority Daniel Siegel, MD as to the lack of scientific research regarding many of the presented modalities. However, I also concur that due to the complexity of traumas the various approaches warrant significant discussion. In this volume Shapiro has done so brilliantly.

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by Joyce-Anne Locking

If you had to name the most valuable thing in your life at this moment, you may come up with all sorts of different answers. You may name loved ones, friendships or material things such as cars, houses or bank accounts. Perhaps you might think of objects of art, private yachts, or summer get aways. Some may name pets, pianos or possessions.

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What does music have to do with hypnotherapy and change work? The answer has to do with how powerful music can be – whether guiding a listener in a certain direction or enhancing his or her emotions.

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Oncology acupuncture is a new and emerging field of research. Recent advances from published clinical trials have added evidence to support the use of acupuncture for symptom management in cancer patients. Recent new developments include (1) pain and dysfunction after neck dissection; (2) radiation-induced xerostomia in head and neck cancer; (3) aromatase inhibitor-associated arthralgia in breast cancer; (4) hot flashes in breast cancer and prostate cancer; and (5) chemotherapy-induced neutropenia in ovarian cancer. Some interventions are becoming a non-pharmaceutical option for cancer patients, while others still require further validation and confirmation. Meanwhile, owing to the rapid development of the field and increased demands from cancer patients, safety issues concerning oncology acupuncture practice have become imperative. Patients with cancer may be at higher risk developing adverse reactions from acupuncture. Practical strategies for enhancing safety measures are discussed and recommended.

Curr Treat Options Oncol. 2010 Dec;11(3-4):141-6. Lu W, Rosenthal DS. Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, SW560, 44 Binney Street, Boston, MA 02115, USA. Weidong_lu@dfci.harvard.edu

BACKGROUND: Music therapy is a promising approach widening the potential applications of psychotherapy. Music influences both, psychologic and physiologic parameters, and children are especially responsive to this form of therapy. Many aspects of its action mechanisms remain to be elucidated, underscoring the need for evidence-based medicine (EBM) for clinical use of music therapy. AIMS: This review seeks to highlight some of the issues of music therapy research and to initiate a discussion about the need for international multicenter cooperation to bring scientifically sound evidence of the benefits of music therapy in pediatric patients. METHODS: Scientific bibliographic databases were searched for randomized controlled trials on use of music therapy for children. Identified articles were evaluated according to criteria for scientific quality. RESULTS: Twenty-eight studies were identified. Most of the trials were biased by the number of participants, and some trials showed the need to improve design of control groups. Indeed, the novelty of this area of study has produced a large number of different studies (with variability in diagnoses, interventions, control groups, duration, and/or outcome parameters), and there is a need for a more homogeneous and systematic approach. Available studies highlight the need to address reproducibility issues. CONCLUSIONS: This analysis identifies the need for a subsequent series of clinical studies on the efficacy of music in the pediatric population, with more focus on eligibility criteria with respect to EBM and reproducibility.

J Altern Complement Med. 2010 Oct;16(10):1089-95. Mrázová M, Celec P. Department of Child Psychiatry, Charles University, 2nd Medical School, Prague, Czech Republic.

William Mitchell is the founder of the Mitchell Institute for Professional Hypnosis and Personal Motivation Hypnosis Clinics and Pastor First Baptist Church, Stonington, IL.

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In the last year there has been a great deal of public debate about homeopathy, the system of alternative medicine whose main principles are that like cures like and that potency increases relative to dilution. The House of Commons Select Committee on Science and Technology concluded in November 2009 that there is no evidence base for homeopathy, and agreed with some academic commentators that homeopathy should not be funded by the NHS. While homeopathic doctors and hospitals are quite commonplace, some might be surprised to learn that there are also many homeopathic dentists practising in the UK. This paper examines the statements made by several organisations on behalf of homeopathic dentistry and suggests that they are not entirely ethical and may be in breach of various professional guidelines.

Br Dent J. 2010 Nov 27;209(10):493-6. Shaw D. Dental School, Faculty of Medicine, University of Glasgow, 378 Sauchiehall Street, Glasgow, G2 3JZ. david.shaw@.glasgow.ac.uk

Aging skin is a leading concern of most men and women seeking cosmetic dermatologic consultation. Various in-office procedures as well as topical at-home regimens, are generally prescribed to reduce the signs of aging, but relatively few provide immediate clinical benefit. A novel sonic infusion system that combines sonic micro-massage with an anti-aging serum was studied to determine its immediate effect on a wide range of patients with periocular rhytides. Clinical improvement of periocular rhytides was achieved after a single sonic infusion treatment (30 seconds/eye). Patients with more severe rhytides and those older than 40 years of age showed the best clinical results.

J Drugs Dermatol. 2010 Sep;9(9):1121-4. Shah S, Alster TS. Washington Institute of Dermatologic Laser Surgery, Washington, DC 20005, USA.

Parasomnias are undesirable physical or experiential events that occur in and around sleep. Treatments include reassurance in some cases, various forms of cognitive-behavioral therapy (CBT), and pharmacologic agents. Cognitive restructuring, imagery rehearsal, relaxation, hypnosis, desensitization, and anticipatory awakenings are some of the common CBT and nonpharmacologic interventions. Medications that are used belong to a wide variety of pharmacologic classes, such as alpha-blockers (prazosin), tricyclic antidepressants (imipramine and clomipramine), selective serotonin reuptake inhibitors, benzodiazepines (diazepam and clonazepam), anticonvulsants (topiramate and gabapentin), desmopressin acetate, and anticholinergic agents (oxybutynin and tolterodine). Data on efficacy are only available from randomized trials on CBT and prazosin for nightmares and on pharmacologic and alarm therapy for enuresis. No large-scale randomized trials are available to assess the efficacy of the other treatments, and most data come from anecdotal case reports, case series, or small open-label trials.

Neurol Clin. 2010 Nov;28(4):1089-106. Attarian H. Department of Neurology, Stritch School of Medicine, Loyola University Chicago, Maguire Building, Room 2700, 2160 South First Avenue, Maywood, IL 60153, USA. hattarian@lumc.edu

The purpose of this study was to examine possible relationships between personality, burnout level, longevity, and demographic variables among professional music therapists. The Sixteen Personality Factor Questionnaire (16PF) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) were used to test personality and burnout. Subjects were 137 professional music therapists from all seven American Music Therapy Association (AMTA) regions with an overall average longevity of 17.85 years. The 16PF showed the personality traits that most describe music therapists are emotional sensitivity, reasoning, apprehension, warmth, openness to change, self-reliance, extraversion, anxiety, abstractedness, rule-consciousness, and self-control. Logistic regressions showed that the personality factor of anxiety (p < .007) significantly predicts the MBI-HSS subscale of emotional exhaustion and the personality factor of dominance (p < .01) significantly predicts the MBI-HSS subscale of personal accomplishment. While no personality factor significantly predicts the MBI-HSS subscales of depersonalization, social boldness (p < 0.07) and vigilance (p < .09) strongly contributed to this relationship. Logistic regressions also showed that highest degree earned is significantly (p < .000) predictive of longevity. Since the overall burnout level was in the average range, in essence this study described the profile of music therapists who are staying and thriving in the profession.

J Music Ther. 2010 Summer;47(2):155-79. Vega VP. Loyola University, New Orleans, USA.

Full Title: Aromatherapy alleviates endothelial dysfunction of medical staff after night-shift work: preliminary observations.

Night-shift work causes mental stress and lifestyle changes, and is recognized as a risk of cardiovascular diseases associated with impaired endothelial function. Aromatherapy is becoming popular as a complementary therapy that is beneficial for mental relaxation. The purpose of this study was to investigate the effect of aromatherapy on the endothelial function of medical staff after night-shift work. This study consisted of 19 healthy medical personnel (19 men, mean age 32±7 years), including 11 physicians and 8 technicians. Aromatherapy was performed for 30?min by inhalation of the essential oil of lavender. Flow-mediated dilation (FMD) of the brachial artery was measured three times in each subject: on a regular workday, and after night-shift work before and immediately after aromatherapy. A control study was performed to assess the effect of a 30-min rest without aromatherapy. The mean value of sleep time during night-shift work was 3.3±1.3?h. FMD after night-shift work was lower than on a regular workday (10.4±1.8 vs. 12.5±1.7%, P<0.001), which improved after aromatherapy (11.8±2.5%, P=0.02 vs. before aromatherapy). FMD was stable in the control study (10.1±1.9 vs. 10.1±2.2%, P=0.9). This study demonstrated that night-shift work impaired endothelial function in medical staff, an effect that was alleviated by short-term aromatherapy.Hypertension Research advance online publication, 25 November 2010; doi:10.1038/hr.2010.228.

Hypertens Res. 2010 Nov 25. Shimada K, Fukuda S, Maeda K, Kawasaki T, Kono Y, Jissho S, Taguchi H, Yoshiyama M, Yoshikawa J. Department of Medicine, Cardiovascular Division, Osaka Ekisaikai Hospital, Osaka, Japan.

FULL TITLE: Effects of self-hypnosis training and cognitive restructuring on daily pain intensity and catastrophizing in individuals with multiple sclerosis and chronic pain.

Fifteen adults with multiple sclerosis were given 16 sessions of treatment for chronic pain that included 4 sessions each of 4 different treatment modules: (a) an education control intervention; (b) self-hypnosis training (HYP); (c) cognitive restructuring (CR); and (d) a combined hypnosis-cognitive restructuring intervention (CR-HYP). The findings supported the greater beneficial effects of HYP, relative to CR, on average pain intensity. The CR-HYP treatment appeared to have beneficial effects greater than the effects of CR and HYP alone. Future research examining the efficacy of an intervention that combines CR and HYP is warranted.

Int J Clin Exp Hypn. 2011 Jan;59(1):45-63. Jensen MP, Ehde DM, Gertz KJ, Stoelb BL, Dillworth TM, Hirsh AT, Molton IR, Kraft GH. University of Washington, Seattle, USA. mjensen@u.washington.edu

FULL TITLE: Impact of Relaxation Training According to Yoga in Daily Life(R) System on Perceived Stress After Breast Cancer Surgery.

The purpose of this pilot study was to gather information on the immediate and short-term effects of relaxation training according to Yoga In Daily Life(®) (YIDL) system on the psychological distress of breast cancer patients. 32 patients at the Institute for Oncology of Ljubljana were randomized to the experimental (N = 16) and to the control group (N = 16). Both groups received the same standard physiotherapy for 1 week, while the experimental group additionally received a group relaxation training sessions according to YIDL(®) system. At discharge the experimental group was issued with audiocassette recordings containing the similar instructions for relaxation training to be practiced individually at home (for further 3 weeks). An experimental repeated measures design was used to investigate the differences over 1 month period in stress levels, changes in mental health and psychological parameters. Measures were obtained at three time points during the study period: baseline, at 1 week, and at 4 weeks, by blinded investigators using standardized questionnaires General Health Questionnaire-12 (GHQ-12), Rotterdam Symptom Checklist (RSCL) psychological subscale, Perceived Stress Scale (PSS). Patients who received relaxation training reported feeling significantly less distressed during hospitalization and after discharge-period than did the controls that did not receive relaxation training. The results indicate that relaxation training according to Yoga in Daily Life(®) system could be useful clinical physiotherapy intervention for breast cancer patients experiencing psychological distress. Although this kind of relaxation training can be applied to clinical oncology in Slovenia, more studies need to be done.

Integr Cancer Ther. 2010 Dec 14. Kovacic T, Kovacic M. Centre for Education, Work and Care Dobrna.