OBJECTIVES: Despite increased use of integrative medicine in cancer therapy, little data exist on its efficacy. This prospective, randomized, pilot trial sought to evaluate the feasibility of combined modality integrative medicine (CM-IM) in women with ovarian cancer (OvCA) and evaluate its effects on quality of life (QoL), chemotherapy toxicity and immunologic profiles. METHODS: Women with newly diagnosed OvCA requiring chemotherapy were offered enrollment. Those randomized to the experimental arm received hypnosis, therapeutic massage and healing touch with each cycle of chemotherapy. The control arm received chemotherapy without CM-IM. All patients completed QoL questionnaires prior to cycles 1, 3 and 6, and 6-months after chemotherapy. Immunologic profiles were measured. Statistical analysis was based on intent-to-treat. Student's t-test and Fischer's exact-test were used to determine differences. RESULTS: Forty-three women enrolled. All women randomized to CM-IM were successfully treated. There were no statistical differences between the groups in age, stage, grade, histologic cell type, CA125 levels, or surgical cytoreductive status. There was no difference in overall QoL measurements. Re-hospitalization rates, treatment delays, anti-emetic use, and infection rates were similar. Immunologic profiles revealed no difference between arms for WBC or salivary IgA levels. Women receiving CM-IM had consistently higher levels of CD4, CD8 and NK cells, although this did not reach statistical significance. CONCLUSIONS: Prospective clinical evaluation of integrative medicine for women with gynecologic malignancy is feasible. This first, pilot study of CM-IM in gynecologic oncology demonstrated no improvement in QoL or chemotherapy toxicity. Integrative medicine-associated improvements in immunologic profiles warrant further investigation.

Gynecol Oncol. 2011 Aug 22 Judson PL, Dickson EL, Argenta PA, Xiong Y, Geller MA, Carson LF, Ghebre R, Jonson AL, Downs LS Jr. H. Lee Moffitt Cancer Center & Research Institute, Department of Women's Oncology, USA.

Neurofeedback treatment has been demonstrated to reduce inattention, impulsivity and hyperactivity in children with attention deficit/hyperactivity disorder (ADHD). However, previous studies did not adequately control confounding variables or did not employ a randomized reinforcer-controlled design. This study addresses those methodological shortcomings by comparing the effects of the following two matched biofeedback training variants on the primary symptoms of ADHD: EEG neurofeedback (NF) aiming at theta/beta ratio reduction and EMG biofeedback (BF) aiming at forehead muscle relaxation. Thirty-five children with ADHD (26 boys, 9 girls; 6-14 years old) were randomly assigned to either the therapy group (NF; n = 18) or the control group (BF; n = 17). Treatment for both groups consisted of 30 sessions. Pre- and post-treatment assessment consisted of psychophysiological measures, behavioural rating scales completed by parents and teachers, as well as psychometric measures. Training effectively reduced theta/beta ratios and EMG levels in the NF and BF groups, respectively. Parents reported significant reductions in primary ADHD symptoms, and inattention improvements in the NF group were higher compared to the control intervention (BF, d (corr) = -.94). NF training also improved attention and reaction times on the psychometric measures. The results indicate that NF effectively reduced inattention symptoms on parent rating scales and reaction time in neuropsychological tests. However, regarding hyperactivity and impulsivity symptoms, the results imply that non-specific factors, such as behavioralcontingencies, self-efficacy, structured learning environment and feed-forward processes, may also contribute to the positive behavioural effects induced by neurofeedback training.

Eur Child Adolesc Psychiatry. 2011 Sep;20(9):481-91. Epub 2011 Aug 13. Bakhshayesh AR, Hänsch S, Wyschkon A, Rezai MJ, Esser G. Department of Psychology, Faculty of Humanities, Yazd University, Yazd, Iran.

Blisters are skin lesions characterized by accumulation of fluid between the layers of the skin. Their severity varies from the common blisters caused by friction to severe autoimmune and congenital bullous disorders, some of them currently without treatment in conventional medicine or requiring drugs with potentially severe side-effects. This article reports cases of blistering diseases successfully treated with homeopathic medicines, which represent an alternative for the treatment of such disorders.

Homeopathy. 2011 Jul;100(3):168-74. Jurj G, Waisse S. Asociatia Româna de Homeopatie Clinica, Timisoara, Romania.

This study investigated the proposition of relaxation offered by performing the Muslim prayers by measuring the alpha brain activity in the frontal (F3-F4), central (C3-C4), parietal (P3-P4), and occipital (O1-O2) electrode placements using the International 10-20 System. Nine Muslim subjects were asked to perform the four required cycles of movements of Dhuha prayer, and the EEG were subsequently recorded with open eyes under three conditions, namely, resting, performing four cycles of prayer while reciting the specific verses and supplications, and performing four cycles of acted salat condition (prayer movements without any recitations). Analysis of variance (ANOVA) tests revealed that there were no significant difference in the mean alpha relative power (RP(a)) between the alpha amplitude in the Dhuha prayer and the acted conditions in all eight electrode positions. However, the mean RP(a) showed higher alpha amplitude during the prostration position of the Dhuha prayer and acted condition at the parietal and occipital regions in comparison to the resting condition. Findings were similar to other studies documenting increased alpha amplitude in parietal and occipital regions during meditation and mental concentration. The incidence of increased alpha amplitude suggested parasympathetic activation, thus indicating a state of relaxation. Subsequent studies are needed to delineate the role of mental concentration, and eye focus, on alpha wave amplitude while performing worshipping acts.

Appl Psychophysiol Biofeedback. 2011 Oct 1. Doufesh H, Faisal T, Lim KS, Ibrahim F. Medical Informatics and Biological Micro-electro-mechanical Systems (MIMEMS) Specialized Laboratory, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia.

Introduction: Acupuncture has been used for treating various gastrointestinal (GI) diseases. However, the mechanism of acupuncture remains unclear. Methods: The aim of this article is to review the published literature on the mechanism of acupuncture on neuromodulation in the gut. Results: Acupuncture treatment involves the insertion of thin needles into the skin and underlying muscle and the subsequent stimulation of the needles manually or electrically. Thus, acupuncture stimulates the somatic afferent nerves of the skin and muscles. The somatic sensory information from the body is carried to the cortex area of the brain. Somatic sensory fibers also project to the various nuclei at the brain stem and hypothalamus. Via somato-autonomic reflex, acupuncture modulates various biomechanical responses, such as prokinetic, antiemetic, and anti-nociceptive effects. Conclusion: According to traditional Chinese medicine, "Acupuncture is believed to restore the balance of Yin and Yang." This can be translated into the Western medicine terminology that "Acupuncture modulates the imbalance between the parasympathetic and sympathetic activity." Acupuncture may be effective in patients with functional GI disorders because of its effects on GI motility and visceral pain.

Neuromodulation. 2011 Jan;14(1):8-12. doi: 10.1111/j.1525-1403.2010.00295.x. Takahashi T. Department of Surgery, Medical College of Wisconsin and Zablocki VA Medical Center, Milwaukee, WI, USA.

Resting state fMRI (functional magnetic resonance imaging) acquisitions are characterized by low-frequency spontaneous activity in a default mode network (encompassing medial brain areas and linked to self-related processes) and an anticorrelated "extrinsic" system (encompassing lateral frontoparietal areas and modulated via external sensory stimulation). In order to better determine the functional contribution of these networks to conscious awareness, we here sought to transiently modulate their relationship by means of hypnosis. We used independent component analysis (ICA) on resting state fMRI acquisitions during normal wakefulness, under hypnotic state, and during a control condition of autobiographical mental imagery. As compared to mental imagery, hypnosis-induced modulation of resting state fMRI networks resulted in a reduced "extrinsic" lateral frontoparietal cortical connectivity, possibly reflecting a decreased sensory awareness. The default mode network showed an increased connectivity in bilateral angular and middle frontal gyri, whereas its posterior midline and parahippocampal structures decreased their connectivity during hypnosis, supposedly related to an altered "self" awareness and posthypnotic amnesia. In our view, fMRI resting state studies of physiological (e.g., sleep or hypnosis), pharmacological (e.g., sedation or anesthesia), and pathological modulation (e.g., coma or related states) of "intrinsic" default mode and anticorrelated "extrinsic" sensory networks, and their interaction with other cerebral networks, will further improve our understanding of the neural correlates of subjective awareness.

Prog Brain Res. 2011;193:309-22. Demertzi A, Soddu A, Faymonville ME, Bahri MA, Gosseries O, Vanhaudenhuyse A, Phillips C, Maquet P, Noirhomme Q, Luxen A, Laureys S. Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium.

Individuals who experience stroke undergo a critical rehabilitation process with the aid of professionals including physical, occupational, and speech therapists, as well as primary care from nursing staff. However, the extent of the role that music can play in facilitating the rehabilitation process is unknown. Board-certified music therapists are employed in several capacities within the rehabilitation environment. There is a need for nursing professionals in this area to better understand the role a music therapist may play and how they can assist clients in using music in a therapeutically beneficial way. The purpose of this article is to educate nurses about music therapy and provide evidence for the therapeutic use of music in the rehabilitation setting for victims of stroke.

Rehabil Nurs. 2011 Sep-Oct;36(5):200-4, 215. Knight AJ, Wiese N. University of North Dakota, Grand Forks, ND, USA. Andrew.knight@und.edu

Osteoarthritis of the knee is a major cause of disability among adults worldwide. Important treatment options include nonpharmacologic therapies, and especially symptom management strategies in which patients take an active role. Among these, mind-body therapies may have particular promise for alleviating the distressful symptoms associated with osteoarthritis of the knee. However, systematic reviews are lacking. The objective of this paper is to review English-language articles describing clinical studies evaluating the effects of patient-driven mind-body therapies on symptoms of knee osteoarthritis. Eight studies, representing a total of 267 participants, met the inclusion criteria. Interventions included tai chi, qigong, and yoga. Collectively, these studies suggest that specific mind-body practices may help alleviate pain and enhance physical function in adults suffering from osteoarthritis of the knee. However, sample sizes are small, rigorous investigations are few, and the potential benefits of several mind-body therapies have not yet been systematically tested. Additional high-quality studies are needed to clarify the effects of specific mind-body therapies on standardized measures of pain, physical function, and related indices in persons with osteoarthritis of the knee, and to investigate possible underlying mechanisms.

Curr Rheumatol Rev. 2009 Nov 1;5(4):204-211. Selfe TK, Innes KE. Department of Community Health, West Virginia University School of Medicine, Morgantown, WV, USA.

For more than 25 years David Sollars has entertained, educated and inspired audiences with his experiences in personal development. He's witnessed the power of the human spirit through his integrative medical practice FirstHealth of Andover and marvels at the dynamic potential in all of us to overcome life's challenges. David is an international author, speaks on topics ranging from Integrative Medicine to personal development, serves on non-profit boards with his wife Diane and is a national consultant for businesses and insurance companies implementing wellness initiatives. David expresses his passion for seizing leadership moments in our lives through his inspirational stories from clinic practice.

Mr. Sollars is the founder of FirstHealth of Andover, an Integrative Medical group practice, which has served the Southern New Hampshire and Merrimack Valley region for over a decade. He holds a Master's degree in Oriental Medicine and is certified in both Shiatsu and Tui-Na Oriental massage. He graduated from The New England School of Acupuncture (NESA).

He is the author of the The Complete Idiot's Guide to Homeopathy and The Complete Idiot's Guide to Acupuncture and Acupressure. He has been a contributing editor for such books as Coping with Mild Traumatic Brain Injury, The Root of Chinese Qigong, and Eight Pieces of Brocade--Improving and Maintaining Health. Mr. Sollars is a senior editor for Natural Standard, a medical research writing collaborative, whose group published Herb & Supplement, Evidence Based Clinical Reviews and Herb & Supplement, The Clinical Bottom Line.

For more information visit: www.firsthealthofandover.com.

Full Title: Spinal manipulative therapy for elderly patients with chronic obstructive pulmonary disease: a case series.

OBJECTIVE: The objective of this case series is to report the results of spinal manipulative therapy (SMT) for people with chronic obstructive pulmonary disease (COPD) who were older than 65 years. METHODS: The study design was a prospective case series. Six patients of a long-term care center who were older than 65 years and having COPD underwent a course of 12 SMT sessions over a 4-week period. Each SMT session consisted of manually applied spinal manipulation and instrument-assisted spinal manipulation delivered by a doctor of chiropractic. Lung function measurements were recorded at baseline and at 2 and 4 weeks. The occurrence and type of any adverse events (AEs) related to SMT were recorded at each SMT session. RESULTS: One male and 5 female patients took part in the study. The average age was 79.1 years (range, 68-89 years). There was a clinically significant increase in forced expiratory volume in the first second after SMT in 4 of the 6 patients at 2 weeks. This was sustained in only 1 patient at 4 weeks. No clinically significant changes were observed for forced vital capacity at 2 or 4 weeks. One hundred forty-four manually applied spinal manipulations and 72 instrument-assisted spinal manipulations were administered during the intervention period. No major or moderate AEs were reported. Only minor AEs were reported after 29% of the intervention sessions, with 1 AE being reported for each patient. All AEs resolved within 48 hours. CONCLUSIONS: This case series offers preliminary evidence that SMT may have the potential to benefit lung function in patients with COPD who are older than 65 years.

J Manipulative Physiol Ther. 2011 Jul-Aug;34(6):413-7. Dougherty PE, Engel RM, Vemulpad S, Burke J. New York Chiropractic College, Seneca Falls, NY 13148, USA. pdougherty@nycc.edu

The objective of this study is to determine the effects of 12 weeks of lavender aromatherapy on self-reported sleep and heart rate variability (HRV) in the midlife women with insomnia. Sixty-seven women aged 45-55 years, with a CPSQI (Chinese version of Pittsburgh Sleep Quality Index) greater than 5, were recruited from communities in Taiwan. The experimental group (n = 34) received lavender inhalation, 20?min each time, twice per week, for 12 weeks, with a total of 24 times. The control group (n = 33) received health education program for sleep hygiene with no intervention. The study of HRV was analyzed by time- and frequency-domain methods. Significant decrease in mean heart rate (HR) and increases in SDNN (standard deviation of the normal-to-normal (NN) intervals), RMSDD (square root of the mean squared differences of successive NN intervals), and HF (high frequency) of spectral powers analysis after lavender inhalation were observed in the 4th and 12th weeks of aromatherapy. The total CPSQI score of study subjects was significantly decreased in the experimental group (P < 0.001), while no significant difference was observed across the same time period (P =0.776) in the control group. Resting HR and HRV measurements at baseline 1 month and 3 months after allocation showed no significant difference between the experimental and control groups. The study demonstrated that lavender inhalation may have a persistent short-term effect on HRV with an increase in parasympathetic modulation. Women receiving aromatherapy experienced a significant improvement in sleep quality after intervention. However, lavender aromatherapy does not appear to confer benefit on HRV in the long-term follow up.

Evid Based Complement Alternat Med. 2012;2012:740813. Chien LW, Cheng SL, Liu CF. Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan.

by Tim Brunson, PhD

The recent cliché-like interest in the application of mindfulness practices within psychotherapy is now being extended to the exploration of its similarities and differences with clinical hypnotherapy. At best this is a difficult and frustrating stretch as it almost always entails a more than simplistic understanding of Buddhism. Furthermore, considering the half-dozen or so rather conflicting definitions of the word hypnosis, any analysis runs the risk of using an antiquated understanding of the field. So, this normally results in an oversimplification of Buddhist mindfulness being compared to a rather incomplete understanding of hypnosis.

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This paper reviews the evidence for mind-body therapies (eg, relaxation, meditation, imagery, cognitive-behavioral therapy) in the treatment of pain-related medical conditions and suggests directions for future research in these areas. Based on evidence from randomized controlled trials and in many cases, systematic reviews of the literature, the following recommendations can be made: 1) multi-component mind-body approaches that include some combination of stress management, coping skills training, cognitive restructuring and relaxation therapy may be an appropriate adjunctive treatment for chronic low back pain; 2) multimodal mind-body approaches such as cognitive-behavioral therapy, particularly when combined with an educational/informational component, can be an effective adjunct in the management of rheumatoid and osteoarthritis; 3) relaxation and thermal biofeedback may be considered as a treatment for recurrent migraine while relaxation and muscle biofeedback can be an effective adjunct or stand alone therapy for recurrent tension headache; 4) an array of mind-body therapies (eg, imagery, hypnosis, relaxation) when employed pre-surgically, can improve recovery time and reduce pain following surgical procedures; 5) mind-body approaches may be considered as adjunctive therapies to help ameliorate pain during invasive medical procedures.

Clin J Pain. 2004 Jan-Feb;20(1):27-32. Astin JA. California Pacific Medical Center Research Institute, San Francisco, CA, USA. john@integrativearts.com

Rupert Sheldrake is a biologist and author of more than 75 scientific papers and ten books. A former Research Fellow of the Royal Society, he studied natural sciences at Cambridge University, where he was a Scholar of Clare College, took a double first class honours degree and was awarded the University Botany Prize. He then studied philosophy at Harvard University, where he was a Frank Knox Fellow, before returning to Cambridge, where he took a Ph.D. in biochemistry. He was a Fellow of Clare College, Cambridge University, where he carried out research on the development of plants and the ageing of cells. At Clare College he was also Director of Studies in biochemistry and cell biology.

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Virtual reality (VR) has been used to manage pain and distress associated with a wide variety of known painful medical procedures. In clinical settings and experimental studies, participants immersed in VR experience reduced levels of pain, general distress/unpleasantness and report a desire to use VR again during painful medical procedures. Investigators hypothesize that VR acts as a onpharmacologic form of analgesia by exerting an array of emotional affective, emotion-based cognitive and attentional processes on the body's intricate pain modulation system. While the exact neurobiological mechanisms behind VR's action remain unclear, investigations are currently underway to examine the complex interplay of cortical activity associated with immersive VR. Recently, new applications, including VR, have been developed to augment evidenced-based interventions, such as hypnosis and biofeedback, for the treatment of chronic pain. This article provides a comprehensive review of the literature, exploring clinical and experimental applications of VR for acute and chronic pain management, focusing specifically on current trends and recent developments. In addition, we propose mechanistic theories highlighting VR distraction and neurobiological explanations, and conclude with new directions in VR research, implications and clinical significance.

Pain Manag. 2011 Mar;1(2):147-157. Li A, Montaño Z, Chen VJ, Gold JI. Children's Hospital Los Angeles, Departments of Anesthesiology Critical Care Medicine & Radiology, 4650 West Sunset Boulevard, MS#12, Los Angeles, CA 90027, USA.

The role of sensory awareness in movement control is receiving increasing interest in sports and clinical literature as a feed-forward and feedback mechanism. The aim of the study was to assess the feasibility and effect of training in sensory awareness on dexterity in healthy adults. 29 healthy students were randomly allocated to a single-group, sensory awareness lesson with the dominant hand, the same lesson with the nondominant hand, or to a sham control group. Dexterity measures included the Purdue Pegboard Test, a grip-lift manipulandum, and perceived changes using a questionnaire. The sensory awareness lesson with the dominant hand produced a statistically significant improvement in mean dexterity compared to the control group, but not between the other two pairs of groups. The sensory awareness training paradigm is feasible and a single session improved dexterity in healthy adults.

Percept Mot Skills. 2011 Jun;112(3):783-98. Bitter F, Hillier S, Civetta L. International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia.

RATIONALE: Patients treated with homeopathy may respond to infrequently used or even 'new' medicines. But does the introduction of an unlimited number of (new) medicines improve homeopathy? Do new medicines solve old problems? METHODS: 1. Consensus meetings to evaluate best cases. 2. Patient outcome study in 10 Dutch practices. RESULTS: Good cases are scarce for many medicines, random variance is an important source of uncertainty. 50 Medicines are responsible for 72% of all successful prescriptions. There is no difference in effectiveness of frequently and less frequently used medicines. Confirmation bias is found for a few well-known symptom-medicine combinations. CONCLUSION: 'New' and infrequently medicines are as effective as 'old' frequently used medicines. Improving the use of frequently used medicines is more effective in improving results than seldom used medicines. Large numbers are required and old mistakes should be avoided developing new medicines. A research agenda for improving the use of homeopathic medicines is imperative.

Homeopathy. 2011 Jul;100(3):175-82. Rutten AL. Commissie Methode en Validering VHAN, Dutch Association of Homeopathic Physicians, The Netherlands. lexrtn@concepts.nl

Full Title: Combined Therapy Using Acupressure Therapy, Hypnotherapy, and Transcendental Meditation versus Placebo in Type 2 Diabetes.

Type 2 diabetes is one of the most widespread diseases in the world. The main aim of this research was to evaluate the effect of combined therapy using acupressure therapy, hypnotherapy, and transcendental meditation (TM) on the blood sugar (BS) level in comparison with placebo in type 2 diabetic patients. We used "convenience sampling" for selection of patients with type 2 diabetes; 20 patients were recruited. For collection of data, we used an identical quasi-experimental design called "nonequivalent control group." Therapy sessions each lasting 60-90min were carried out on 10 successive days. We prescribed 2 capsules (containing 3g of wheat flour each) for each member of the placebo group (one for evening and one for morning). Pre-tests, post-tests, and follow-up tests were conducted in a medical laboratory recognized by the Ministry of Health and Medical Education of Iran. Mean BS level in the post-tests and follow-up tests for the experimental group was reduced significantly in comparison with the pre-tests whereas in the placebo group no changes were observed. Combined therapy including acupressure therapy, hypnotherapy, and TM reduced BS of type 2 diabetic patients and was more effective than placebo therapy on this parameter.

J Acupunct Meridian Stud. 2011 Sep;4(3):183-6. Bay R, Bay F. Department of Family Medicine, University Sains Malaysia (USM), Malaysia.

Full Title: Management of primary chronic headache in the general population: the Akershus study of chronic headache.

Primary chronic headaches cause more disability and necessitate high utilization of health care. Our knowledge is based on selected populations, while information from the general population is largely lacking. An age and gender-stratified cross-sectional epidemiological survey included 30,000 persons aged 30-44 years.

Respondents with self-reported chronic headache were interviewed by physicians. The International Classification of Headache Disorders was used. Of all primary chronic headache sufferers, 80% had consulted their general practitioner (GP), of these 19% had also consulted a neurologist and 4% had been hospitalized. Co-occurrence of migraine increased the probability of contact with a physician. A high Severity of Dependence Scale score increased the probability for contact with a physician. Complementary and alternative medicine (CAM) was used by 62%, most often physiotherapy, acupuncture and chiropractic. Contact with a physician increased the probability of use of CAM. Acute headache medications were taken by 87%, while only 3% used prophylactic medication. GPs manage the majority of those with primary chronic headache, 1/5 never consults a physician for their headache, while approximately 1/5 is referred to a neurologist or hospitalized. Acute headache medication was frequently overused, while prophylactic medication was rarely used. Thus, avoidance of acute headache medication over use and increased use of prophylactic medication may improve the management of primary chronic headaches in the future.

J Headache Pain. 2011 Oct 13. Kristoffersen ES, Grande RB, Aaseth K, Lundqvist C, Russell MB. Head and Neck Research Group, Research Centre, Akershus University Hospital, 1478 Lørenskog, Oslo, Norway.

Full title: The efficacy of hypnosis as an intervention for labor and delivery pain: a comprehensive methodological review.

This paper presents a comprehensive methodological review of research on the efficacy of hypnosis for reducing labor and delivery pain. To be included, studies were required to use a between-subjects or mixed model design in which hypnosis was compared with a control condition or alternative intervention in reducing labor pain. An exhaustive search of the PsycINFO and PubMed databases produced 13 studies satisfying these criteria. Hetero-hypnosis and self-hypnosis were consistently shown to be more effective than standard medical care, supportive counseling, and childbirth education classes in reducing pain. Other benefits included better infant Apgar scores and shorter Stage 1 labor. Common methodological limitations of the literature include a failure to use random assignment, to specify the demographic characteristics of samples, and to use a treatment manual.

Clin Psychol Rev. 2011 Aug;31(6):1022-31. Landolt AS, Milling LS. University of Hartford, West Hartford, CT, USA.

Full Title: Effects of music therapy on depression and duration of hospital stay of breast cancer patients after radical mastectomy.

BACKGROUND: Breast cancer remains the most important cancer among women worldwide. The disease itself and treatment may have a profound impact on the patients' psychological well being and quality of life. Depression is common in breast cancer patients and affects the therapeutic effects as well as prolongs the duration of hospital stay. However, few studies reported the effectiveness of music therapy on depression and duration of hospital stay of female patients with breast cancer after radical mastectomy. METHODS: One hundred and twenty subjects were recruited to this clinical trial and randomly allocated to two groups. The experimental group (n = 60) received music therapy on the basis of routine nursing care, whereas the control group (n = 60) only received the routine nursing care. The whole intervention time was from the first day after radical mastectomy to the third time of admission to hospital for chemotherapy. Data of demographic characteristics and depression were collected by using the General Questionnaire and Chinese version of Zung Self-rating Depression Scale (ZSDS) respectively. One pre-test (the day before radical mastectomy) and three post-tests (the day before discharge from hospital, the second and third admission to hospital for chemotherapy) were utilized. Duration of hospital stay was calculated from the first day after radical mastectomy to the day of discharged from hospital. RESULTS: The mean depression score of all subjects was 37.19 ± 6.30. Thirty-six cases (30%) suffered from depression symptoms, with 26 (72.2%) mild depression cases, 9 (25.0%) moderate depression cases, and 1 (2.8%) severe depression case. After music therapy, depression scores of the experimental group were lower than that of the control group in the three post-tests, with significant differences (F = 39.13, P < 0.001; F = 82.09, P < 0.001). Duration of hospital stay after radical mastectomy of the experimental group ((13.62 ± 2.04) days) was shorter than that of the control group ((15.53 ± 2.75) days) with significant difference (t = -4.34, P < 0.001). CONCLUSIONS: Music therapy has positive effects on improving depression of female patients with breast cancer, and duration of hospital stay after radical mastectomy can be reduced. It is worthy of applying music therapy as an alternative way of nursing intervention in clinical nursing process of caring female patients with breast cancer.

Chin Med J (Engl). 2011 Aug;124(15):2321-7. Zhou KN, Li XM, Yan H, Dang SN, Wang DL. School of Nursing, Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.

The metabolic syndrome, affecting a substantial and increasing percentage of the worldwide population, is comprised of a cluster of symptoms associated with increased risk of type 2 diabetes, cardiovascular disease, and other chronic conditions. Mind-body modalities based on Eastern philosophy, such as yoga, tai chi, qigong, and meditation, have become increasingly popular worldwide. These complementary therapies have many reported benefits for improving symptoms and physiological measures associated with the metabolic syndrome. However, clinical trial data concerning the effectiveness of these practices on the syndrome as a whole have not been evaluated using a systematic and synthesizing approach. A systematic review was conducted to critically evaluate the data from clinical trials examining the efficacy of mind-body therapies as supportive care modalities for management of the metabolic syndrome. Three clinical trials addressing the use of mind-body therapies for management of the metabolic syndrome were identified. Findings from the studies reviewed support the potential clinical effectiveness of mind-body practices in improving indices of the metabolic syndrome.

J Nutr Metab. 2011;2011:276419. Epub 2011 May 18. Anderson JG, Taylor AG. Center for the Study of Complementary and Alternative Therapies, University of Virginia School of Nursing, P.O. Box 800782, Charlottesville, VA 22908-0782, USA.

Mic Hunter holds Minnesota licenses as a Psychologist, and Marriage and Family Therapist.

His educational background included a bachelor's degree in psychology, a Master of Arts degree in human development, a Master of Science degree in education, and a doctoral degree in clinical psychology.

He holds the rank of Adjunct Program Associate Professor in both the Human Development and Educational Administration Departments of Saint Mary's University of Minnesota.

Dr. Hunter has been sought out by the print and broadcast media for interviews over one hundred times. He has presented throughout North America to professional audiences and the general public over two hundred times. He serves as reviewer for The Journal of Child Sexual Abuse, The Journal of Menss Studies, The Journal of Interpersonal Violence, and Violence Against Women. In addition to articles, Mic is the author, co-author, or editor of eight books including: Abused Boys: The Neglected Victims of Sexual Abuse, and The Ethical Use of Touch in Psychotherapy.

Full Title: Complementary and alternative treatment for neck pain: chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais.

Of the multitude of treatment options for the management of neck pain, no obvious single treatment modality has been shown to be most efficacious. As such, the clinician should consider alternative treatment modalities if a modality is engaging, available, financially feasible, potentially efficacious, and is low risk for the patient. As evidence-based medicine for neck pain develops, the clinician is faced with the challenge of which treatments to encourage patients to pursue. Treatment modalities explored in this article, including chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais, represent reasonable complementary and alternative medicine methods for patients with neck pain.

Phys Med Rehabil Clin N Am. 2011 Aug;22(3):521-37, ix. Plastaras CT, Schran S, Kim N, Sorosky S, Darr D, Chen MS, Lansky R. Department of Physical Medicine and Rehabilitation, Penn Spine Center, University of Pennsylvania, Philadelphia, PA 19104, USA. Christopher.plastaras@uphs.upenn.edu

Full Title: Aromatherapy massage on the abdomen for alleviating menstrual pain in high school girls: a preliminary controlled clinical study.

This study investigated the alleviating effects of aromatherapy massage and acetaminophen on menstrual pain in Korean high school girls. Subjects were divided into two groups: the aromatherapy massage (treatment) group (n = 32) and the acetaminophen (control) group (n = 23). Aromatherapy massage was performed on subjects in the treatment group. The abdomen was massaged once using clary sage, marjoram, cinnamon, ginger, and geranium in a base of almond oil. The level of menstrual pain was assessed using a visual analogue scale at baseline and twenty-four hours afterward. The reduction of menstrual pain was significantly higher in the aromatherapy group than in the acetaminophen group. Using multiple regression, aromatherapy massage was found to be more highly associated with reduction in the level of menstrual pain than acetaminophen. These finding suggest that aromatherapy massage may be an effective treatment for menstrual pain in high school girls. However, it could not be verified whether the positive effects derived from the aromatherapy, the massage, or both. Further rigorous studies should be conducted using more objective measures.

Evid Based Complement Alternat Med. 2012;2012:187163. Epub 2011 Sep 22. Hur MH, Lee MS, Seong KY, Lee MK. Department of Nursing, Eulji University, Daejeon 301-746, Republic of Korea.

Full Title: Top-down and bottom-up mechanisms in mind-body medicine: development of an integrative framework for psychophysiological research.

It has become increasingly evident that bidirectional ("top-down and bottom-up") interactions between the brain and peripheral tissues, including the cardiovascular and immune systems, contribute to both mental and physical health. Therapies directed toward addressing functional links between mind/brain and body may be particularly effective in treating the range of symptoms associated with many chronic diseases. In this paper, we describe the basic components of an integrative psychophysiological framework for research aimed at elucidating the underlying substrates of mind-body therapies. This framework recognizes the multiple levels of the neuraxis at which mind-body interactions occur. We emphasize the role of specific fronto-temporal cortical regions in the representation and control of adverse symptoms, which interact reciprocally with subcortical structures involved in bodily homeostasis and responses to stress. Bidirectional autonomic and neuroendocrine pathways transmit information between the central nervous system and the periphery and facilitate the expression of affective, autonomic, hormonal, and immune responses. We propose that heart rate variability (HRV) and markers of inflammation are important currently available indices of central-peripheral integration and homeostasis within this homeostatic network. Finally, we review current neuroimaging and psychophysiological research from diverse areas of mind-body medicine that supports the framework as a basis for future research on the specific biobehavioral mechanisms of mind-body therapies.

Explore (NY). 2010 Jan;6(1):29-41. Taylor AG, Goehler LE, Galper DI, Innes KE, Bourguignon C. Center for the Study of Complementary and Alternative Therapies, School of Nursing, University of Virginia, Charlottesville, VA, USA. agt@virginia.edu

Geoffrey Knight is an experienced hypnotherapist of over fourteen years standing, who was trained at the Institute of Clinical Hypnosis (ICH) in London, regarded as the leading hypnotherapy and NLP teaching college in the United Kingdom. He was on the teaching staff of the ICH. He had a successful practice in London before settling permanently in Portland, Oregon. He has established a busy general practice in Southwest Portland, and he offers therapy for any presenting problems where he knows and believes hypnotherapy can help. He is a Certified Pediatric Hypnotist, certified by Donald Mottin under the auspices of the National Guild of Hypnotists.

Full title: Hypnotherapeutic treatment approaches in children and adolescents suffering from functional abdominal pain.

Functional abdominal pain significantly impairs day-to-day function. It is one of the most frequent somatic complaints among children and adolescents. For most of those affected, despite some indication of their possible presence, physiological factors fail to explain the symptoms adequately. The increased level of psychological symptoms suggests that the focus should be on behavioural and psychological aspects. Brief hypnotherapeutic treatment methods show encouraging results. A review of the current literature; potential mechanisms of effective intervention and their practical applicability are discussed.

Prax Kinderpsychol Kinderpsychiatr. 2011;60(5):386-400. Gulewitsch MD, Schlarb AA. Universität Tübingen, Fachbereich Psychologie.

Homeopathy has been provided by the National Health Service in the UK for over 60 years, funded largely by taxpayer's money. However, in recent years, its provision has come under much criticism questioning its true value. Taking a neutral stance, arguments both for and against the provision of homeopathy on the NHS is presented. It includes issues such as the evidence and safety profile of homeopathy, but also takes into account costs and benefits of homeopathy in a wider perspective. Overall, the provision of homeopathy is justified as long as there is a need within the population, occupying a complementary role alongside conventional medicine.

Homeopathy. 2011 Jul;100(3):183-6. Ng DY. College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. dyn605@bham.ac.uk

Physicians have long used the power of suggestion informally in their practice as a means of motivating patients and boosting compliance. Recent research shows that formal use of hypnosis can be a valuable primary or adjunctive therapy, especially in children. Children are more in touch with innate imagery processes than adults and consequently can learn and use self-hypnosis easily, particularly to control autonomic responses. Hypnotherapy has proven useful in habit and behavior disorders, psychophysiologic disorders, pain control, anxiety control, cellular growth, and chronic conditions. The cases reported here illustrate the effectiveness of this process in children. Before hypnotherapy can be used clinically, the physician should become certified by an association approved by the American Medical Association and know when hypnotherapy is indicated and how long it should be continued.

Postgrad Med. 1986 Mar;79(4):95-100, 105. Olness KN.

Full Title: What Factors Are Influencing Preferences Toward Conventional Versus Complementary and Alternative Medical Clinic Advertisements?

Abstract Objectives: The present study aimed to determine whether health service advertisements are perceived differently depending on advertising conventional or complementary and alternative medicine clinics. Methods: A total of 42 adults (male=21, female=21) recruited through advertisements in Seoul, South Korea participated in this study. A standardized health service advertisement was designed with three controlled visual components such as (1) medical treatment information, (2) medical practitioner, and (3) medical facilities and it was shown to subjects while their eye movements were tracked and they were asked to rate their preferences for the different advertisements and their separate components. A multiple regression analysis was performed to see the correlation of the preferences for each of the three visual components with the overall preference rating of each health service advertisement. Results: Preferences for the advertisement depended mostly on the preference for the medical treatment information, whereas advertisements for complementary and alternative medical clinics depended also on the preference for the medical practitioner. Conclusions: These results imply that the same health service advertisement will be perceived differently depending on whether it advertises Western or Oriental medical clinics.

J Altern Complement Med. 2011 Oct 6. Shin HW, Chang DS, Lee H, Kang OS, Lee H, Park HJ, Chae Y. Acupuncture & Meridian Science Research Center, College of Oriental Medicine, Kyung Hee University , Seoul, Republic of Korea .

OBJECTIVE: To examine the effect of Meditation training on patients with adjustment disorder with anxiety and depression. METHOD: In a pre-test/post-test control group design, patients (N = 30) with adjustment disorder with mixed anxiety and depression, were screened through a Clinical Global Impression-severity/Improvement Scale, Beck's Anxiety, Beck's Depression Inventory, and Global Assessment of Functioning. Sessions of meditation training (28 weeks) were held using the model of Yoga Meditation. The difference of means (pre- and post-assessment) was tested using a paired t-test method. RESULTS: Experimental group and control groups were similar at base line, whereas after concluding the 28th week of meditation practice a significant mean difference (t value: CGI-S 2.47 > .05; CGI-I2.82 > 0.05; BAI 17.58 > 0.05; BDI 10.13 > 0.05; GAF 12.29 > 0.05) was found between both groups. There was an incremental change in selected assessment parameters in both groups. But changes were more significant in pre- and post-assessment of experimental group.

Complement Ther Clin Pract. 2011 Nov;17(4):241-5. Srivastava M, Talukdar U, Lahan V. Department of Holistic Medicine, H.I.H.T. University, Swami Ram Nagar, Jollygrant Doiwala, Dehradun 248140, Uttarakhand, India.

BACKGROUND: Recent systematic reviews on psychological therapies of fibromyalgia syndrome (FMS) did not consider hypnosis/guided imagery (H/GI). Therefore we performed a systematic review with meta-analysis of the efficacy of H/GI in FMS. METHODS: We screened ttp://ClinicalTrials.gov, Cochrane Library, MEDLINE, PsycINFO and SCOPUS (through December 2010). (Quasi-) randomized controlled trials (CTs) comparing H/GI with controls were analyzed. Outcomes were pain, sleep, fatigue, depressed mood and health-related quality of life (HRQOL). Effects were summarized using standardized mean differences (SMD). RESULTS: Six CTs with 239 subjects with a median of 9 (range 7-12) H/GI-sessions were analysed. The median number of patients in the H/GI groups was 20 (range 8-26). Three studies performed follow-ups. H/GI reduced pain compared to controls at final treatment (SMD -1.17 [95% CI -2.21, -0.13]; p = 0.03). H/GI did not reduce limitations of HRQOL at final treatment (SMD -0.90 [95% CI -2.55, 0.76]; p = 0.29) compared to controls. Effect sizes on fatigue, sleep and depressed mood at final treatment and follow-up and on pain and HRQOL at follow-up were not calculated because of limited data available. The significant effect on pain at final treatment was associated with low methodological and low treatment quality. CONCLUSION: Further studies with better treatment quality and adequate methodological quality assessing all key domains of FMS are necessary to clarify the efficacy of H/GI in FMS.

BMC Musculoskelet Disord. 2011 Jun 15;12:133. Bernardy K, Füber N, Klose P, Häuser W. Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital, Kirrberger Straße 100, D-66421 Homburg/Saar, Germany.

Full Title: De-qi, not psychological factors, determines the therapeutic efficacy of acupuncture treatment for primary dysmenorrhea.

OBJECTIVE: To study the impact of De-qi (, obtaining qi) and psychological factors on the efficacy of acupuncture treatment for primary dysmenorrhea, with an attempt to explore the relationship among De-qi, psychological factors, and clinical efficacy. METHODS: The patients with primary dysmenorrhea were randomly assigned to a group of acupuncture with manual manipulation (manipulation group, n=67) and an acupuncture group without manipulation (non-manipulation group, n=64). Pain intensity and pain duration were used as measures for evaluating the therapeutic efficacy of the acupuncture treatment. De-qi, the sensations a patient experienced during the acupuncture treatment, was scored on a 4-point scale by the subjects. In addition, the psychological factors, including belief in acupuncture, the level of nervousness, anxiety, and depression, were quantitatively assessed. The personality of the subject was assessed using the Eysenck personality questionnaire (EPQ) and 16 personality factor questionnaire (16PF). RESULTS: Complete data were obtained from 120 patients, 60 patients in each group. There were statistically significant differences in pain intensity (W=2410.0, P<0.01) and pain duration (W=3181.0, P<0.01) between the two groups. The number of De-qi acupoints (W=1150.5, P<0.01) and the average intensity of De-qi (W=1141.0, P<0.01) were significantly higher in the manipulation group as compared with their non-manipulation counterparts. The correlation coefficients between De-qi and therapeutic efficacy of acupuncture were greater than those between psychological factors and therapeutic efficacy. CONCLUSIONS: Compared with the psychological factors, De-qi contributed more to the pain-relieving effect of acupuncture in subjects with primary dysmenorrhea. Moreover, manual manipulation is a prerequisite for eliciting and enhancing the De-qi sensations, and De-qi is critical for achieving therapeutic effects.

Chin J Integr Med. 2011 Oct 12. Xiong J, Liu F, Zhang MM, Wang W, Huang GY. Institute of Integrated Traditional and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

Hypnotic and nonhypnotic suggestibility were investigated in 2 experiments. In Experiment 1, nonhypnotic suggestibility was suppressed when measured after hypnotic suggestibility, whereas hypnotic suggestibility was not affected by the order of assessment. Experiment 2 confirmed a small but significant effect of hypnosis on suggestibility when nonhypnotic suggestibility was measured first. Nonhypnotic suggestibility was correlated with absorption, fantasy proneness, motivation, and response expectancy, but only expectancy predicted suggestibility when the other variables were controlled. Behavioral response to hypnosis was predicted by nonhypnotic suggestibility, motivation, and expectancy in a model accounting for 53% of the variance. Experiential response to hypnotic suggestion was predicted only by nonhypnotic suggestibility. Unexpectedly, hypnosis was found to decrease suggestibility for a substantial minority of participants.

Braffman W, Kirsch I. Department of Psychology, University of Connecticut, Storrs 06269-1020, USA.

Hans-Ulrich Hecker, MD, is an internationally known expert in acupuncture and Chinese medicine. In his numerous publications (translated into many languages), Dr. Hecker helped make traditional Chinese medicine popular and helped to establish the acceptance of its methods for use alongside conventional medical practice in the doctor's office. Since 1990, he has been a medical specialist in general practice, homeopathy, naturopathic treatment, acupuncture, and medical quality management, and he shares his knowledge with interested colleagues. This "master of the delicate pinpricks" is the head of advanced training for acupuncture and naturopathic treatment of the Medical Association of Schleswig-Holstein. Since 1993, he has held a position as a lecturer for acupuncture and naturopathic treatment at the University Clinic, Schleswig-Holstein Campus in Kiel, Germany. Together with Dr. Kay Liebchen, he developed acutaping.

The word "suggestion" has been used in educational, scientific and medical literature in slightly different senses. In psychological medicine the use of suggestion has developed out of the earlier use of hypnotic influence.Charcot defined hypnosis as an artificial hysteria, Bernheim as an artificially increased suggestibility. The two definitions need to be combined to give an adequate account of hypnosis. Moreover, due allowance should be made for the factors of dissociation and of rapport in hypnotic phenomena.The relationships between dissociation, suggestibility, and hypnotizability.Theories of suggestion propounded by Pierre Janet, Freud, McDougall, Pawlow and others. Ernest Jones's theory of the nature of auto-suggestion. Janet explains suggestion in terms of ideo-motor action in which the suggested idea, because of the inactivity of competing ideas, produces its maximum effect. Freud explains rapport in terms of the sex instinct "inhibited in its aim" (transference) and brings in his distinction of "ego" and "ego-ideal" (or "super-ego") to supplement the theory. Jones explains auto-suggestion in terms of narcissism. McDougall explains hypnotic suggestion in terms of the instinct of self-abasement. But different instincts may supply the driving power to produce suggestion-effects in different circumstances. Such instincts as those of self-preservation (fear) and gregariousness may play their part. Auto-suggestion as a therapeutic factor is badly named. It supplements, but does not supplant the will, and makes complete volition possible.

J Pers Soc Psychol. 1999 Sep;77(3):578-87. Brown W. Proc R Soc Med. 1928 Feb;21(4):573-82.