CONTEXT: The safety of patients consulting with practitioners of complementary and alternative medicine (CAM) partially depends on practitioners' competence, and thus the standard of undergraduate education. OBJECTIVES: Describe undergraduate homeopathy courses in Europe, student/graduate numbers and whether there were differences between recognised/accredited and non-recognised/non-accredited courses. METHODS: Cross sectional survey of current homeopathy undergraduate education in Europe in 2008. Data from 145 (94.8%) out of 153 identified courses were collected. Eighty-five (55.6%) responded to a questionnaire survey. For others some data was extracted from their websites. Only data from the questionnaire survey is used for the main analysis. FINDINGS: The average course in the questionnaire survey had 47 enrolled students and 142 graduates, and lasted 3.6 years part-time. An estimated 6500 students were enrolled and 21,000 had graduated from 153 identified European undergraduate homeopathy courses. Out of 85 courses most had entry requirements and provided medical education (N = 48) or required students to obtain this competence elsewhere (N = 33). The average number of teaching hours were 992 (95% confidence interval (CI) 814, 1170) overall, with 555 h (95%CI 496, 615) for homeopathy. Four out of five courses were recognised/accredited. Recognised/accredited part-time courses lasted significantly longer than non-recognised/non-accredited courses (difference 0.6 years, 95%CI 0.0-1.2, P = 0.040), and offered significantly larger numbers of teaching hours in homeopathy (difference 167 h, 95%CI 7-327, P = 0.041). CONCLUSIONS: About 6500 currently enrolled students are doing undergraduate homeopathy education in Europe and 21,000 have graduated from such courses over a period of about 30 years. Undergraduate homeopathy education in Europe is heterogeneous. Recognized/accredited courses are more extensive with more teaching hours.

Homeopathy. 2011 Oct;100(4):253-8. Viksveen P, Steinsbekk A. Lindeveien 55, 4314 Sandnes, Norway.

OBJECTIVE: The authors propose a diathesis-stress model to describe how pathological dissociation may arise from an interaction between innate hypnotizability and traumatic experience. METHOD: To support the proposition that pathological dissociation may reflect autohypnotic process, the authors highlight clinical and research data indicating parallels between controlled hypnotic dissociative states and uncontrolled pathological dissociative symptoms and summarize evidence of hypnotizability in persons with psychiatric disorders that manifest these symptoms. The authors present this evidence by examining dissociative symptomatology in four psychological domains: perception, behavior and will, affect, and memory and identity. In addition, modern cognitive and neuropsychological models of dissociation are briefly reviewed. RESULTS: Several lines of evidence converge in support of the role of autohypnosis in pathological dissociation. There is considerable evidence that controlled formal hypnosis can produce a variety of dissociations of awareness and control that resemble many of the symptoms in uncontrolled pathological dissociative conditions; and it is possible to discern in dissociative pathology the features of absorption, dissociation, and suggestibility/automaticity that characterize formal hypnotic states. There is also accumulating evidence of high levels of hypnotic capacity in all groups with dissociative symptomatology that have been systematically assessed. In addition, the widespread and successful therapeutic use of hypnosis in the treatment of many dissociative symptoms and conditions (and the potential for hypnosis to induce dissociative symptomatology) also supports the assumption that hypnosis and pathological dissociation share an underlying process. CONCLUSIONS: High hypnotizability may be a diathesis for pathological dissociative states, particularly under conditions of acute traumatic stress.

Am J Psychiatry. 1996 Jul;153(7 Suppl):42-63. Butler LD, Duran RE, Jasiukaitis P, Koopman C, Spiegel D. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Calif, USA.

Ursula James is a Visiting Teaching Fellow, Oxford University Medical School and a Honorary Lecturer St Georges Medical School. Ursula and her team teach clinical hypnosis in 12 UK medical schools including Oxford and Cambridge. Her books include The clinical hypnosis textbook (Radcliffe Medical Press, and You can be amazing – transform your life with hypnosis (Random House). Her TV series for Channel 5 in the UK using her groundbreaking technique for couples will be aired in July 2007.

For more information visit: www.UrsulaJames.com

Neglect patients are not aware of stimuli in the contralesional space. We aimed to simulate neglect-like behaviour in healthy participants, by asking them to orient their visuospatial attention in two conditions: non-hypnotic suggestion and post-hypnotic suggestion. Results showed that directing visuospatial attention to one side of space caused neglect of stimuli in the opposite side of space, but only when participants were under post-hypnotic suggestion. Furthermore, directing visuospatial attention to the right side of space caused more neglect of left-sided stimuli than directing visuospatial attention to the left side of space did for right-sided stimuli. We propose that post-hypnotic suggestion can be a useful tool for (de)activating neurocognitive mechanisms underlying visuospatial awareness, a function that is fundamental for our survival. The use of post-hypnotic suggestion could be applied to the study of many domains of cognitive neurosciences (e.g., neurocognitive rehabilitation).

Neuropsychologia. 2011 Aug 30. Priftis K, Schiff S, Tikhonoff V, Giordano N, Amodio P, Umiltà C, Casiglia E. Department of General Psychology, University of Padova, Italy; Laboratory of Neuropsychology, IRCCS San Camillo Hospital, Lido-Venice, Italy.

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 utilisation 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 hospitalised. 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 hospitalised. Acute headache medication was frequently overused, while prophylactic medication was rarely used. Thus, avoidance of acute headache medication overuse 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 Ayurvedic treatment for rheumatoid arthritis: Cross-sectional experiential profile of a longitudinal study.

CONTEXT: Allopathic and Ayurvedic physicians collaborated on a study of traditional medicine, which was sponsored by the World Health Organization. AIMS: The aim of the study was to test the efficacy and safety of Ayurvedic treatment for rheumatoid arthritis (RA). SETTINGS AND DESIGN: This study was conducted at the Ayurvedic Trust, Coimbatore, India. MATERIALS AND METHODS: In this unique study of classical Ayurvedic treatment for RA, allopathic physicians enrolled a total of 290 patients with a confirmed diagnosis of RA over a 7-year period, and once every 6 weeks evaluated Ayurvedic treatment outcomes on the basis of American Rheumatism Association criteria: grip strength, walking time, number of swollen and painful joints, joint count, functional class, erythrocyte sedimentation rate, and rheumatoid factor. Ayurvedic physicians administered individualized treatment, closely adhering to principles set forth in classical Ayurvedic texts. The duration of treatment varied from 1 to 6 months. STATISTICAL ANALYSIS USED: Due to limitations in computer technology in the 1970s, the data were not computerized. Therefore, data for 12 months at a time were analyzed, using repeated measures t-test. Measures of central tendency (means) and probability values were reported. Results from the patients enrolled and discharged at the end of the first year of the study (N = 33) are presented in this paper. RESULTS: There was statistically significant improvement in all parameters from admission to discharge. CONCLUSIONS: The results indicated that classical Ayurvedic treatment was effective in this first cohort of patients who completed treatment. Even patients with severe functional limitations showed significant improvement. Although there was no control group, the results are positive enough to warrant further study of classical Ayurvedic treatment for RA in controlled trials.

Int J Ayurveda Res. 2011 Jan;2(1):8-13. Krishna KP. BAMS, Ayurvedic Trust, Trichy Road, Ramanathapuram, Coimbatore, Tamil Nadu, India.

BACKGROUND: This article explores the evidence base of efficacy and effectiveness of 'energy healing' for cancer patients. The term 'energy healing' refers to a wide variety of therapies which are based on the premise that the healer transfers energy to the patient. Among the most researched forms of energy healing are reiki, therapeutic touch and healing touch. MATERIAL AND METHODS: PubMed, AMED, JStor, Social Science Citation Index and PsycInfo databases were searched, and articles were rated according to the SIGN (Scottish Intercollegiate Guidelines Network) quality scale. Six quantitative and two qualitative studies on the efficacy and effectiveness of energy healing for cancer patients met the inclusion criteria. RESULTS: None of the studies are of a size or quality that allows to draw reliable conclusions. The results of the studies are, however, interesting and should be considered when developing new studies and hypotheses on working mechanisms. CONCLUSION: The existing research does not allow conclusions regarding the efficacy or effectiveness of energy healing. Future studies should adhere to existing standards of research on the efficacy and effectiveness of a treatment, and given the complex character of potential outcomes, cross-disciplinary methodologies may be relevant. To extend the scope of clinical trials, psychosocial processes should be taken into account and explored, rather than dismissed as placebo.

Forsch Komplementmed. 2011;18(3):146-54. Agdal R, v B Hjelmborg J, Johannessen H. Institute of Public Health, University of Southern Denmark, J.B. Winslows Vej 9B st.th., Odense, Denmark. ragdal@health.sdu.dk

Full Title: Synthesis of fuzzy logic for prediction and medical diagnostics by energy characteristics of acupuncture points.

A great number of reflexologies use ancient concepts that do not coincide with modern medical terminology of anatomy, physiology, and biophysics, substantially reducing the trust of today's physicians in this direction of their profession. Recently, several mathematical models of internal and biological active points of meridian structures interaction have been proposed. These models allowed specification of diseases for which reflex diagnostics and reflex therapy methods are most effective and also increased the efficacy of these procedures. Good results for the prediction and early diagnosis of diseases from the reaction energy of biologically active points (acupuncture points) are obtained using fuzzy logic decision making.

J Acupunct Meridian Stud. 2011 Sep;4(3):175-82. Al-Kasasbeh R, Korenevskiy N, Ionescou F, Alshamasin M, Kuzmin A. Faculty of Engineering Technology, Al-Balqa Applied University, Jordan.

Abstract The authors describe 3 studies in which hypnosis itself is not studied but instead used to create anomalous states in the laboratory that can be studied under controlled conditions. The 1st article is a comprehensive review of programmatic research using hypnosis to elicit and study clinically relevant delusions. The 2nd article reviews studies comparing the brain activity of hysterical/dissociative patients with nonpatients hypnotized and given suggestions for sensory-motor and cognitive anomalies typical of the clinical syndromes. The authors conclude that the hypnosis analogues are relevant and revealing. The 3rd article describes a single experiment using hypnosis to elicit distressing and intrusive memories, typical of acute anxiety disorders. Findings with hypnotic subjects are in keeping with those from patients suffering intrusive memories. Across all 3 papers, hypnosis is shown to be a viable and helpful tool for experimental psychopathology.

Int J Clin Exp Hypn. 2011 Oct-Dec;59(4):469-76. Nash MR, Wong A. a University Of Tennessee , Knoxville , USA.

Full Title: Complementary and alternative medicine (CAM) among hospitalised patients: Reported use of CAM and reasons for use, CAM preferred during hospitalisation, and the socio-demographic determinants of CAM users.

PURPOSE: This paper reports a study to examine hospitalised patients' frequency and patterns of CAM use, their reasons for CAM use, their preferences of CAMs during hospitalisation, and the association between patients' socio-demographic variables and use of each individual CAM/CAM domain. METHODS: A convenience sample of 353 patients hospitalised in 19 surgical wards at four metropolitan hospitals completed a questionnaire on CAM use and socio-demographic variables. RESULTS: The response rate was 73.5%, and over 90% of the sample acknowledged using CAMs. Non-herbal supplements (60.3%) and massage therapy (45%) were the most frequently used CAMs, with biologically based therapies (68.8%) as well as mind-body interventions (65.4%) being the most often used CAM domains. About 1 in 10 patients (9.6%) used CAMs from all five domains. With the exception of herbal-botanical therapies, self-prayer for health reasons/spiritual healing and music therapy, all CAMs were mainly used on an 'only when needed' basis. The most common reason nominated for using CAMs was that '[it] fits into my way of life/philosophy' (26%). The majority of patients declared interest in and support for the hospital providing CAMs. Patients were most inclined to choose therapies categorised as manipulative and body-based methods (65.4%) for use in hospital. Massage therapy (53.5%) and non-herbal supplements (43.1%) were the top two CAMs favoured for use in hospital. CAM use was also dependent of socio-demographic data (age, gender, marital status, place of residence, education level, religion, and income in hospitalised patients). CONCLUSION: The use of CAMs is pervasive amongst surgical in-patients, making it feasible to initially assess these patients for CAM use and provide them with clinically approved CAMs where possible. Notwithstanding that CAM use is fairly predictable by socio-demographic variables, further studies should be directed to know the variables useful for predicting the use of each CAM approach.

Complement Ther Clin Pract. 2011 Nov;17(4):199-205. Shorofi SA. School of Nursing & Midwifery, Flinders University, GPO Box 2100, Adelaide 5001, Australia.

It has been suggested that hypnosis techniques may have the potential to enhance eyewitness memory in forensic investigations. However, laboratory research shows that increases in recall with hypnosis techniques are often associated with decreases in accuracy, false confidence in incorrect information, and increased suggestibility to leading questions and misleading post-event information. These problems limit the usefulness of hypnosis as an interviewing procedure. However, in practical investigations, many factors associated with hypnosis, apart from the hypnotic induction itself, might lead to memory enhancement compared with standard police interviews. For example, hypnotic interviewers, because of their psychological, clinical, and interpersonal skills, may be better interviewers than police officers. They may use effective interviewing strategies such as those associated with the "cognitive interview"; a procedure which has the potential to enhance recall by approximately 35% without the problems of memory distortion associated with hypnosis. It is concluded, therefore, that a cognitive interview procedure should be used in preference to hypnosis.

Behav Sci Law. 1998 Winter;16(1):115-29. Kebbell MR, Wagstaff GF. Department of Psychology, University of Liverpool, U.K.

Hyperthyroidism is a frequent veterinary problem, particularly in elderly cats. Homeopathic treatment and other integrative modalities were provided for four hyperthyroid cats whose owners did not want conventional treatment. Symptomatic homeopathic treatment with Thyroidinum was helpful in one cat. All cats were prescribed an appropriate individualized homeopathic remedy. All four cats showed resolution of clinical signs; three attained normal thyroid hormone levels. Three cats later received acupuncture and/or herbal medicines; two cats later received symptomatic homeopathic remedies. Two cats are thriving after over 3.5 and 4.25years of treatment; two were euthanized for unrelated problems after 3 and 4years of treatment. Homeopathic and complementary therapies avoid the potential side effects of methimazole and surgical thyroidectomy, they are less costly than radioactive iodine treatment, and they provide an option for clients who decline conventional therapies.

Homeopathy. 2011 Oct;100(4):270-4. Chapman SF. The Animal Medical Center of Watkins Park, PO Box 426, Cheltenham, MD 20623, USA.

Dr. Bensky has been actively involved in the practice, teaching, and translation of East Asian medicine and osteopathic medicine for over thirty years. His training has included a Diploma in Chinese Medicine from the Macau Institute of Chinese Medicine (1975), a Doctor of Osteopathy from the Michigan State University College of Osteopathic Medicine (1982), and a Ph.D. from the China Academy of Chinese Medical Sciences (2006).

The primary modalities that he uses are a variety of osteopathic manipulative approaches, acupuncture, and Chinese herbal medicines. It is important to remember that in all of these forms of medicine, the actual treatment is usually the patient's response to the what the practitioner does, not what the practitioner does directly. The focus of the treatment is on the getting the organism to regain its normal balance by engaging it in a dialogue through providing information and (usually) gentle forms of stimulation.

For this reason, not only is it not a good idea to be treated too frequently, but there are often things that patients need to do in their daily lives in order to get the optimal response. This can include physical activities and exercises, dietary or lifestyle changes. Often it will be helpful to make sure that you have a healthy approach towards life.

For more information visit: danbensky.com.

BACKGROUND: Experimental research on the effects of homeopathic treatments on impaired plants was last reviewed in 1990. OBJECTIVES: To compile a systematic review of the existing literature on basic research in homeopathy with abiotically stressed plants using predefined criteria. METHODS: The literature search was carried out on publications that reported experiments on homeopathy using abiotically stressed whole plants, seeds, plant parts and cells from 1920 to 2010. Outcomes had to be measured by established procedures and statistically evaluated. Using of a Manuscript Information Score (MIS) we identified those publications that provided sufficient information for proper interpretation (MIS=5). A further evaluation was based on the use of adequate controls to investigate specific effects of homeopathic preparations and on the use of systematic negative control experiments. RESULTS: A total of 34 publications with abiotically stressed plants was identified, published between 1965 and 2010. The 34 publications described a total of 37 experimental studies. Twenty-two studies included statistics, 13 had a MIS=5, 8 were identified with adequate controls and 4 with negative control experiments. Significant and reproducible effects with decimal and centesimal potencies were found, including dilution levels beyond Avogadro's number. One experimental model was independently assessed by another research team and yielded inverted results compared to the original trial. CONCLUSIONS: Abiotically stressed plant models seem to be a useful approach to investigate homeopathic basic research questions, but more experimentation and especially more independent replication trials are needed. Systematic negative control experiments should be implemented on a routine basis to exclude false-positive results.

Homeopathy. 2011 Oct;100(4):275-87. Jäger T, Scherr C, Shah D, Majewsky V, Betti L, Trebbi G, Bonamin L, Simões-Wüst AP, Wolf U, Simon M, Heusser P, Baumgartner S. Institute of Complementary Medicine KIKOM, University of Bern, Switzerland; Research Institute of Organic Agriculture, Frick, Switzerland.

Defendants commonly claim amnesia for their criminal actions especially in cases involving extreme violence. While some claims are malingered or result from physiological factors, other cases may represent genuine partial or complete amnesia resulting from the psychological distress and/or extreme emotion associated with the perpetration of the crime. Fifty Canadian homicide offenders described their memories of their homicide, a non-homicide violent offense, and their most positive adulthood life experience. Self-reported and objective measures of memories for these events revealed that homicides were recalled with the greatest level of detail and sensory information. Although dissociative tendencies were associated with a self-reported memory loss, objective measures of memory quality did not reflect this perceived impairment, suggesting a failure of meta-memory. Recollections of positive life events were superior to those of non-homicidal violence, possibly due to greater impact and meaning attached to such experiences. Findings suggest that memory for homicide typically is enhanced by the powerful emotion associated with its perpetration.

Int J Law Psychiatry. 2009 Sep-Oct;32(5):329-34. Epub 2009 Jul 31. Woodworth M, Porter S, Ten Brinke L, Doucette NL, Peace K, Campbell MA. University of British Columbia - Okanagan, Canada. Michael.Woodworth@ubc.ca

by Tim Brunson, PhD

In 1953, in what is probably the most famous cartoon quotation, Pogo stated that "We have met the enemy and he is us." No other utterance so closely conveys my misgivings and concerns about the struggle between the clinical approach to hypnotherapy and the rather idealistic one, which is too much en vogue in contemporary practices. My initial training and the numerous certifications previously received from four well-established international hypnotherapy associations clearly stated that I possessed clinical credentials. Yet upon further reflection and after being challenged in 2006 by a group of medical doctors to reconcile my accomplishments with relevant scientific literature, I started questioning how my colleagues – and even those in the medical and psychology professions – were using the word clinical in regards to hypnotherapy. This pondering continued during my successful efforts to complete a PhD dissertation on neurology and hypnosis. During that process I was expected to clarify, validate, and cite my various statements and claims. Many of my concerns emanate from those efforts.

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Rayma Ditson-Sommer, Ph.D has a lengthy background in psychology, wellness facilitation, neurotherapy, biofeedback, peak performance training, specialized education, early childhood development and education, neuropsychology, music therapy and research. She holds degrees from Columbia University, New York City; Texas Woman's University, Denton, Texas; and Indiana University, Bloomington, Indiana, with year-long internships at Southwestern Medical School, Menninger Clinic, and Topeka State Hospital. Dr. Ditson-Sommer has help professorships at the University of Wisconsin, Texas Woman's University, and Viterbo College, with Consultantships at Arizona State University, the University of Arizona, and Southern Methodist University.

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Abstract The rate, intensity, and selectivity of hypnotic focused analgesia (HFA) were tested with dental pulp stimulation. Thirty-one healthy subjects were hypnotized, and hypnotic suggestions were given for anesthesia of the right mandibular arch. A posthypnotic suggestion of persisting analgesia was also given. The pain threshold of the first premolar was bilaterally measured before, during, and after hypnosis using a pulp tester. During hypnosis, the pain threshold increased significantly (p < .0001) for both sides. The posthypnotic right pain threshold was also significantly (p < .0015) higher than in the basal condition.

Int J Clin Exp Hypn. 2011 Oct-Dec;59(4):454-68. Facco E, Casiglia E, Masiero S, Tikhonoff V, Giacomello M, Zanette G. a University of Padua , Italy.

Aim: To review current studies on the effectiveness of neurofeedback as a method of treatment of the core symptoms of autism spectrum disorders (ASD). Method Studies were selected based on searches in PubMed, Ovid MEDLINE, EMBASE, ERIC, and CINAHL using combinations of the following keywords: 'Neurofeedback' OR 'EEG Biofeedback' OR 'Neurotherapy' OR 'Mu-Rhythm' OR 'SMR' AND 'Autism' OR 'Autism Spectrum Disorder' OR 'Pervasive Developmental Disorder'. Results The existing evidence does not support the use of neurofeedback in the treatment of ASD. Studies with outcomes in favour of neurofeedback might be showing an improvement in comorbid attention-deficit-hyperactivity disorder symptoms rather than a true improvement in core ASD symptoms. Interpretation Limitations of this review are those inherent in the studies available, including small sample size, short duration, variable diagnostic criteria, and insufficient control interventions, all causing a lack of generalizability.

Dev Med Child Neurol. 2011 Jul 14. doi: 10.1111/j.1469-8749.2011.04043.x. Holtmann M, Steiner S, Hohmann S, Poustka L, Banaschewski T, Bölte S. LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics of the Ruhr University Bochum, Hamm, Germany Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany Department of Women's and Children's Health, Karolinska Institutet Centre of Neurodevelopmental Disorders, Karolinska Institutet, Stockholm, Sweden.

Pharmacovigilance is the outcome of a natural and implied willingness of a physician to ensure safety to his patient. This is a discipline in medicine which pragmatises the principle of first do no harm towards a wider and systematic application in clinical practice. It is however important to understand that despite of its huge potential in ensuring a safe practice of medicine through knowledge of avoidable causes of adversities, its path has never been easy. Applying principles of pharmacovigilance into the realm of traditional medicine particularly to Ayurveda is even more difficult for the issues of why and how of pharmacovigilance in light of historical practice and anecdotal evidences of safety in Ayurveda. Application of pharmacovigilance in Ayurveda thereby demands a careful and thoughtful observation of its needs and its methods of application in order to maximize its impacts to ensure the patient safety to every extent possible.

Int J Ayurveda Res. 2011 Jan;2(1):48-52. Rastogi S. Department of Kaya Chikitsa, State Ayurvedic College, Lucknow, Uttar Pradesh, India.

OBJECTIVE: The objective of this systematic review was to assess the effectiveness of yoga as a treatment option for any type of pain. METHOD: Seven databases were searched from their inception to February 2011. Randomized clinical trials were considered if they investigated yoga in patients with any type of pain and if they assessed pain as a primary outcome measure. The 5-point Jadad scale was used to assess methodological quality of studies. The selection of studies, data extraction and quality assessment were performed independently by two reviewers. RESULTS: Ten randomized clinical trials (RCTs) met the inclusion criteria. Their methodological quality ranged between 1 and 4 on the Jadad scale. Nine RCTs suggested that yoga leads to a significantly greater reduction in pain than various control interventions such as standard care, self care, therapeutic exercises, relaxing yoga, touch and manipulation, or no intervention. One RCT failed to provide between group differences in pain scores. CONCLUSIONS: It is concluded that yoga has the potential for alleviating pain. However, definitive judgments are not possible.

Complement Ther Med. 2011 Oct;19(5):281-7. Posadzki P, Ernst E, Terry R, Lee MS. Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter, United Kingdom.

Full Title: Complementary and Alternative Medicine for Patients with Chronic Fatigue Syndrome: a Systematic Review.

ABSTRACT: BACKGROUND: Throughout the world, patients with chronic diseases/illnesses use complementary and alternative medicines (CAM). The use of CAM is also substantial among patients with diseases/illnesses of unknown etiology. Chronic fatigue syndrome (CFS), also termed myalgic encephalomyelitis (ME), is no exception. Hence, a systematic review of randomised controlled trials of CAM treatments in patients with CFS/ME was undertaken to summarise the existing evidence from RCTs of CAM treatments in this patient population. METHODS: Seventeen data sources were searched up to 13th August 2011. All randomised controlled trials (RCTs) of any type of CAM therapy used for treating CFS were included, with the exception of acupuncture and complex herbal medicines; studies were included regardless of blinding. Controlled clinical trials, uncontrolled observational studies, and case studies were excluded. RESULTS: A total of 26 RCTs, which included 3,273 participants, met our inclusion criteria. The CAM therapy from the RCTs included the following: mind-body medicine, distant healing, massage, tuina and tai chi, homeopathy, ginseng, and dietary supplementation. Studies of qigong, massage and tuina were demonstrated to have positive effects, whereas distant healing failed to do so. Compared with placebo, homeopathy also had insufficient evidence of symptom improvement in CFS. Seventeen studies tested supplements for CFS. Most of the supplements failed to show beneficial effects for CFS, with the exception of NADH and magnesium. CONCLUSIONS: The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted.

BMC Complement Altern Med. 2011 Oct 7;11(1):87. Alraek T, Lee MS, Choi TY, Cao H, Liu J.

Full Title: Complementary and Alternative Medicine for Patients with Chronic Fatigue Syndrome: a Systematic Review.

ABSTRACT: BACKGROUND: Throughout the world, patients with chronic diseases/illnesses use complementary and alternative medicines (CAM). The use of CAM is also substantial among patients with diseases/illnesses of unknown etiology. Chronic fatigue syndrome (CFS), also termed myalgic encephalomyelitis (ME), is no exception. Hence, a systematic review of randomised controlled trials of CAM treatments in patients with CFS/ME was undertaken to summarise the existing evidence from RCTs of CAM treatments in this patient population. METHODS: Seventeen data sources were searched up to 13th August 2011. All randomised controlled trials (RCTs) of any type of CAM therapy used for treating CFS were included, with the exception of acupuncture and complex herbal medicines; studies were included regardless of blinding. Controlled clinical trials, uncontrolled observational studies, and case studies were excluded. RESULTS: A total of 26 RCTs, which included 3,273 participants, met our inclusion criteria. The CAM therapy from the RCTs included the following: mind-body medicine, distant healing, massage, tuina and tai chi, homeopathy, ginseng, and dietary supplementation. Studies of qigong, massage and tuina were demonstrated to have positive effects, whereas distant healing failed to do so. Compared with placebo, homeopathy also had insufficient evidence of symptom improvement in CFS. Seventeen studies tested supplements for CFS. Most of the supplements failed to show beneficial effects for CFS, with the exception of NADH and magnesium. CONCLUSIONS: The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted.

BMC Complement Altern Med. 2011 Oct 7;11(1):87. Alraek T, Lee MS, Choi TY, Cao H, Liu J.

Abstract The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.

Int J Clin Exp Hypn. 2011 Oct-Dec;59(4):424-40. Huet A, Lucas-Polomeni MM, Robert JC, Sixou JL, Wodey E. a UFR d'Odontologie de l'Université de Rennes 1 , France.

Music performance anxiety (MPA) affects many individuals independent of age, gender, experience, and hours of practice. In order to prevent MPA from happening or to alleviate it when it occurs, a review of the literature about its prevention and treatment was done. Forty-four articles, meeting evidence-based medicine (EBM) criteria, were identified and analyzed. Performance repertoire should be chosen based on the musician's skill level, and it should be practiced to the point of automaticity. Because of this, the role of music teachers is essential in preventing MPA. Prevention is the most effective method against MPA. Several treatments (psychological as well as pharmacological) have been studied on subjects in order to determine the best treatment for MPA. Cognitive-behavioral therapy (CBT) seems to be the most effective, but further investigation is desired. Some musicians, in addition to CBT, also take beta-blockers; however, these drugs should only be prescribed occasionally after analyzing the situation and considering the contraindications and possible side effects. Despite these conclusions, more randomized studies with larger, homogeneous groups of subjects would be desirable (according to the EBM criteria), as well as support for the necessity of both MPA prevention and optimized methods of treatment when it does occur.

Med Probl Perform Art. 2011 Sep;26(3):164-71. Brugués AO. Prat de la Riba, 84 7°-4, 25004 Lleida, Spain. Tel +34 626203052. youns84@hotmail.com.

Hypnotherapy has many uses in pediatrics, and its value, not only as a adjunct but also as a primary therapy for certain conditions, justifies its inclusion in pediatric training programs. Suggestion and expectation have long been related to therapeutic outcomes in medicine, but not all physicians know how to apply them constructively and systematically in communication with patients. In pediatrics there is a tendency to overlook opportunities in which hypnosis might be the treatment of choice. Because children engage in imagination and fantasy easily without the cognitive inhibitions of adults, they are able to use hypnosis more readily than adults. More research into the imaginative skills of children may facilitate understanding of learning mechanisms and make it possible for professionals to prevent the loss of the natural imaginative capacities in children and, therefore, enhance the ability of mature members of society to use these skills. In addition to reduction of specific symptoms through hypnotherapy, children benefit by the sense of mastery which they acquire, a sense which is surely needed to overcome the feelings of hopelessness, loss of control, and depression induced by many diagnostic and therapeutic procedures in medicine.

Pediatrics. 1978 Aug;62(2):228-33. Olness K, Gardner GG.

Full Title: Obsessive-compulsive tendencies and undermined confidence are related to reliance on proxies for internal states in a false feedback paradigm.

BACKGROUND AND OBJECTIVES: We have previously hypothesized that obsessive-compulsive (OC) tendencies are associated with a general lack of subjective conviction regarding internal states, which leads to compensatory seeking of and reliance on more discernible substitutes (proxies) for these states (Lazarov, A., Dar, R., Oded, Y., & Liberman, N. (2010). Behaviour Research and Therapy, 48, 516-523). This article presents two studies designed to provide further support to this hypothesis by using false biofeedback as a proxy for internal states. METHODS: In Study 1 we presented high and low OC participants with pre-programmed false feedback showing either increasing or decreasing levels of muscle tension. In Study 2 we presented similar false feedback on level of relaxation to non-selected participants, half of which received instructions that undermined their confidence in their ability to assess their own level of relaxation. RESULTS: In Study 1, high OC participants were more affected by false biofeedback when judging their own level of muscle tension than were low OC participants. In Study 2, undermined confidence participants were more affected by false biofeedback when judging their own level of relaxation as compared to control participants. LIMITATIONS: Our findings are based on a non-clinical, highly functioning, largely female student sample and their generalization to OCD requires replication with a sample of OCD patients. CONCLUSIONS: These results provide converging evidence for our hypothesis by replicating and extending our previous findings. We discuss the implication of our hypothesis for the understanding and treatment of OCD and outline directions for future research.

J Behav Ther Exp Psychiatry. 2011 Jul 22;43(1):556-564. Lazarov A, Dar R, Liberman N, Oded Y. Department of Psychology, Tel Aviv University, Tel Aviv 69978, Israel.

Dorothea Hover-Kramer, Ed.D., RN, CNS, D.CEP has been a psychotherapist in private practice for over 30 years and combines her career as a psychologist with a background as a clinical nurse specialist. She co-founded the International Association for Comprehensive Energy Psychology (ACEP), served as past president and was instrumental in designing and implementing its certification program. She is now a designated diplomate in comprehensive energy psychology (D.CEP).

For more information visit: secondchancedream.com.

The HomBRex database includes details of about 1500 basic research experiments in homeopathy. A general overview on the experiments listed in the HomBRex database is presented, focusing on high dilutions and the different settings in which those were used. Though often criticised, many experiments with remedies diluted beyond Avogadro's number demonstrate specific effects. A total of 830 experiments employing high potencies was found; in 745 experiments of these (90%), at least one positive result was reported. Animals represent the most often used model system (n=371), followed by plants (n=201), human material (n=92), bacteria and viruses (n=37) and fungi (n=32). Arsenicum album (Ars.) is the substance most often applied (n=101), followed by Sulphur (Sulph.) and Thuja (Thuj.) (n=65 and 48, respectively). Proving, prophylactic and therapeutic study designs have all been used and appear appropriate for homeopathy basic research using high dilutions. The basic research data set to support specific effects unique to high dilutions and opposite to those observed with low dilutions is, to date, insufficient.

Homeopathy. 2011 Oct;100(4):288-92. Clausen J, van Wijk R, Albrecht H. Karl und Veronica Carstens-Stiftung, Am Deimelsberg 36, 45276 Essen, Germany.

Albert C. Bottari, PhD, FBHA, a Certified Hypnotherapist and a healthcare provider of more than thirty years, is a lifetime member of the International Medical and Dental Hypnotherapy Association[R] and a contributor to Subconsciously Speaking as well as other professional journals. He is an International Medical and Dental Hypnotherapy Association[R] Board Member and a Diplomat of the International Medical and Dental Hypnotherapy Association.

Abstract The purpose of this pilot project was to test the feasibility of hypnosis as a preoperative intervention. The unique features of this study were: (a) use of a standardized nurse-delivered hypnosis protocol, (b) intervention administration immediately prior to surgery in the preoperative holding area, and (c) provision of hypnosis to breast cancer surgery patients receiving general anesthesia. A mixed-method design was used. Data collected from the intervention group and historical control group included demographics, symptom assessments, medication administration, and surgical, anesthesia, and recovery minutes. A semi-structured interview was conducted with the intervention group. A reduction in anxiety, worry, nervousness, sadness, irritability, and distress was found from baseline to postintervention while pain and nausea increased. The results support further exploration of the use of nurse-led preoperative hypnosis.

Int J Clin Exp Hypn. 2011 Oct-Dec;59(4):406-23. Lew MW, Kravits K, Garberoglio C, Williams AC. a City of Hope , Duarte , California , USA.

BACKGROUND: Following colorectal cancer (CRC) surgery, up to 60% of patients experience post-surgery bowel dysfunction (PSBD). This retrospective review aimed to evaluate biofeedback therapy with regard to patients' symptoms of fecal incontinence (FI) and stool frequency. METHODS: Patients with symptoms including frequency, urgency, FI, incomplete evacuation, failure to respond to dietary, medication or standard pelvic floor exercises (= 6 months) underwent biofeedback therapy between 2003 and 2006. Patients attended 3-4 sessions 1 week apart incorporating: anorectal function assessment; Fecal Incontinence Quality of Life (FIQL) and severity questionnaires; suggested coping strategies; dietary advice; bowel, food and exercise diary training; relaxation breathing; evacuation techniques; anal and pelvic floor muscle exercises using computerized visual feedback; and were reassessed at a final session following 4 weeks of home practice. RESULTS: Nineteen CRC PSBD patients [anterior resection (3); ultra-low anterior resection (10); segmental colectomy (2); and proctocolectomy (4)], mean age: 64.1 (95% CI: 47.0-81.3) years, participated. FIQL scales improved significantly for lifestyle, coping and embarrassment but not depression. Incontinence severity and number of bowel motions significantly decreased. Satisfaction with results of therapy was high. Subjective bowel control rating improved. FIQL scores further improved 2 years later. CONCLUSION: The holistic biofeedback protocol for PSBD in CRC patients is successful in the short and medium term.

Tech Coloproctol. 2011 Sep;15(3):319-26. Bartlett L, Sloots K, Nowak M, Ho YH. Faecal Incontinence Research Group, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, QLD, 4811, Australia. Lynne.Bartlett@my.jcu.edu.au

OBJECTIVE: To assess the effectiveness of a homeopathic ear drop for treatment of otalgia in children with acute otitis media (AOM). METHODS: Children with AOM were enrolled in the study at the time of diagnosis and randomized to receive either standard therapy alone or standard therapy plus a homeopathic ear drop solution that was to be used on as needed basis for up to 5 days. Parents of children in both treatment groups rated the severity of 5 AOM symptoms twice daily for 5 days in a symptom diary. A symptom score was computed for each assessment with lower scores denoting less severe symptoms. Parents of children randomized to receive ear drops also recorded information regarding symptoms being treated and response to treatment. RESULTS: A total of 119 eligible children were enrolled in the study; symptom diaries were received from 94 (79%). Symptom scores tended to be lower in the group of children receiving ear drops than in those receiving standard therapy alone; these differences were significant at the second and third assessments (P = 0.04 and P = 0.003, respectively). In addition, the rate of symptom improvement was faster in children in the ear drop group compared with children in standard therapy alone group (P = 0.002). The most common reason for administration of ear drops was ear pain, recorded for 93 doses; improvement was noted after 78.4% of doses for this indication. There were no significant side effects related to use of the ear drops. CONCLUSIONS: This study suggests that homeopathic ear drops were moderately effective in treating otalgia in children with AOM and may be most effective in the early period after a diagnosis of AOM. Pediatricians and other primary health care providers should consider homeopathic ear drops a useful adjunct to standard therapy.

Homeopathy. 2011 Jul;100(3):109-15. Taylor JA, Jacobs J. Department of Pediatrics, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195, USA. uncjat@u.washington.edu

Patti Conklin is a very gifted clairvoyant and intuitive, but combine her preternatural 'knowing' with her extraordinary sight, and you have a very rare combination. Physicists tell us that our entire physical world is made up of tiny, vibrating particles and this is the world that Patti Conklin sees. Ms. Conklin also adds that it is not just the physical world that is made of vibration. We know that the visible and invisible light spectrum, from all the visible colors to the x-rays and gamma rays, are also vibrations or frequencies. These frequencies are easily detected with our own eyes (the visible spectrum) or with the appropriate instruments. Patti vision yields something even more spectacular. Patti sees the "other side" just as easily as the physical world. She can see Angels, Spirit Guides and the Universe in all of their vibrational states. Recently, Patti has received a lot of attention from individuals and medical personnel who have

For more information visit: www.PattiConklin.com

OBJECTIVES: Yoga improves cardiovascular health in both healthy individuals and those with diagnosed heart disease. This study compares changes in some cardiovascular parameters before and after the practice of Yoga in healthy medical students. METHODS: Sixty-four healthy medical students (57 females and 7 males), mean age 21.3 +/- 2.6 years, attending a Special Study Module 'Role of Dhyana Yoga in Stress Management', participated in this study. Systolic (SYS) and Diastolic (DIA) blood pressure, Heart Rate (HR), Stroke Volume (SV), Cardiac output (CO), Total Peripheral Resistance (TPR), Interbeat Interval (IBI), Left Ventricular Ejection Time (LVET), Arterial Compliance (Cwk) and Ascending Aorta Impedance (Zao) were measured before and after six weeks of yogic exercises. Various exercises included asanas (Postures), pranayama (Breathing), and dhyana (Meditation). Data were analyzed using Stata for Windows. RESULTS: Two-tailed paired t-test revealed that practice ofyoga caused significant increases in HR (p < 0.05), SV (p < 0.01), CO (p < 0.001) and Cwk (p < 0.01) and decreases in TPR (p < 0.001), IBI (p < 0.05) and Zao (p < 0.001) after practising yoga for 6 weeks as compared to before yoga practice. No significant differences were, however observed in SYS, DIA, Mean arterial blood pressure (MAP) and LVET CONCLUSIONS: Practice of yoga even for a short period showed ability to improve most of the cardiovascular functions. Regular practice of yoga for a longer period may further improve these functions and possibly result in improved management of their daily stress.

West Indian Med J. 2011 Mar;60(2):148-52. Parshad O, Richards A, Asnani M. Department of Basic Medical Sciences, Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica, West Indies.

Full Title: Attitudes towards complementary and alternative medicine in chronic pain syndromes: A questionnaire-based comparison between primary headache and low back pain.

ABSTRACT: BACKGROUND: Complementary and Alternative Medicine (CAM) is widely used and popular among patients with primary headache or low back pain (LBP). Aim of the study was to analyze attitudes of headache and LBP patients towards the use of CAM. METHODS: Two questionnaire-based surveys were applied comparing 432 primary headache and 194 LBP patients. RESULTS: In total, 84.75% of all patients reported use of CAM; with significantly more LBP patients. The most frequently-used CAM therapies in headache were acupuncture (71.4%), massages (56.4%), and thermotherapy (29.2%), in LBP thermotherapy (77.4%), massages (62.7%), and acupuncture (51.4%). The most frequent attitudes towards CAM use in headache vs. LBP: "leave nothing undone" (62.5% vs. 52.1%; p= 0.006), "take action against the disease" (56.8% vs. 43.2%; p= 0.006). Nearly all patients with previous experience with CAM currently use CAM in both conditions (93.6% in headache; 100% in LBP). However, the majority of the patients had no previous experience. CONCLUSION: Understanding motivations for CAM treatment is important, because attitudes derive from wishes for non-pharmacological treatment, to be more involved in treatment and avoid side effects. Despite higher age and more permanent pain in LBP, both groups show high use of CAM with only little specific difference in preferred methods and attitudes towards CAM use. This may reflect deficits and unfulfilled goals in conventional treatment. Maybe CAM can decrease the gap between patients' expectations about pain therapy and treatment reality, considering that both conditions are often chronic diseases, causing high burdensfor daily life.

BMC Complement Altern Med. 2011 Oct 7;11(1):89. Gaul C, Schmidt T, Czaja E, Eismann R, Zierz S.

by Coach Cary Bayer

If your bodywork client has suffered an injury--to her back in a car crash, for example--you probably have no problem recommending to her that she come back to see you in two days after the massage that you just gave her. If you do psychological counseling you wouldn't think twice about recommending to your client in a marital crisis to see you more than once a week until the crisis is settled. This is despite the fact that she might not have insurance to cover the cost of your treatment. You also don't think twice about how she might arrange her appointments to see you within 48 hours of stepping off your table--gingerly, of course, if her back is bad--or soberly if she's depressed.

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