FULL TITLE: Heart rate biofeedback fails to enhance children's ability to identify time spent in moderate to vigorous physical activity.

Physical activity recommendations for children in several countries advise that all young people should accumulate at least 60min of moderate to vigorous physical activity every day. Perceiving physical activity intensity, however, can be a difficult task for children and it is not clear whether children can identify their levels of moderate to vigorous physical activity in accordance with the recommended guidelines. This study aimed to (1) explore whether children can identify time spent in moderate to vigorous physical activity; and (2) investigate whether heart rate biofeedback would improve children's ability to estimate time spent in moderate to vigorous physical activity. Thirty seven children (15 boys and 22 girls, mean age 12.6 years) wore data recording Polar E600 heart rate monitors during eight physical education lessons. At the end of each lesson children's estimated time in zone was compared to their actual time in zone. During a six lesson Intervention phase, one class was assigned to a biofeedback group whilst the other class acted as the control group and received no heart rate biofeedback. Post-Intervention, students in the biofeedback group were no better than the control group at estimating time spent in zone (mean relative error of estimation biofeedback group: Pre-Intervention 41±32% to Post-Intervention 28±26%; control group: Pre-Intervention 40±39% to Post-Intervention 31±37%). Thus it seems that identifying time spent in moderate to vigorous physical activity remains a complex task for children aged 11-13 even with the help of heart rate biofeedback.

J Sci Med Sport. 2010 Nov 17. Conley MM, Gastin PB, Brown H, Shaw C. Deakin University, School of Exercise and Nutrition Sciences, Australia.

ABSTRACT: Traditional Chinese medicine (TCM) is widely used in the European Union (EU) and attracts intense research interests from European scientists. As an emerging area in Europe, TCM research requires collaboration and coordination of actions. Good Practice in Traditional Chinese Medicine Research in the Post-genomic Era, also known as GP-TCM, is the first ever EU-funded 7th Framework Programme (FP7) coordination action, aiming to inform the best practice and harmonise research on the safety and efficacy of TCM through interdisciplinary exchange of experience and expertise among clinicians and scientists. With its increasingly large pool of expertise across 19 countries including 13 EU member states, Australia, Canada, China, Norway, Thailand and the USA, the consortium provides forums and collaboration platforms on quality control, extraction technology, component analysis, toxicology, pharmacology and regulatory issues of Chinese herbal medicine (CHM), as well as on acupuncture studies, with a particular emphasis on the application of a functional genomics approach. The project officially started in May 2009 and by the time of its conclusion in April 2012 a Europe-based academic society dedicated to TCM research will be founded to carry on the mission of GP-TCM.

Chin Med. 2010 Dec 14;5(1):42. Uzuner H, Fan TP, Dias A, Guo DA, El-Nezami HS, Xu Q.

Full Title: How large are the nonspecific effects of acupuncture? A meta-analysis of randomized controlled trials.

BACKGROUND: While several recent large randomized trials found clinically relevant effects of acupuncture over no treatment or routine care, blinded trials comparing acupuncture to sham interventions often reported only minor or no differences. This raises the question whether (sham) acupuncture is associated with particularly potent nonspecific effects. We aimed to investigate the size of nonspecific effects associated with acupuncture interventions. METHODS: MEDLINE, Embase, Cochrane Central Register of Controlled Clinical Trials and reference lists were searched up to April 2010 to identify randomized trials of acupuncture for any condition, including both sham and no acupuncture control groups. Data were extracted by one reviewer and verified by a second. Pooled standardized mean differences were calculated using a random effects model with the inverse variance method. RESULTS: Thirty-seven trials with a total of 5754 patients met the inclusion criteria. The included studies varied strongly regarding patients, interventions, outcome measures, methodological quality and effect sizes reported. Among the 32 trials reporting a continuous outcome measure, the random effects standardized mean difference between sham acupuncture and no acupuncture groups was -0.45 (95% confidence interval, -0.57, -0.34; I2 = 54%; Egger's test for funnel plot asymmetry, P = 0.25). Trials with larger effects of sham over no acupuncture reported smaller effects of acupuncture over sham intervention than trials with smaller nonspecific effects (? = -0.39, P = 0.029). CONCLUSIONS: Sham acupuncture interventions are often associated with moderately large nonspecific effects which could make it difficult to detect small additional specific effects. Compared to inert placebo interventions, effects associated with sham acupuncture might be larger, which would have considerable implications for the design and interpretation of clinical trials.

BMC Med. 2010 Nov 23;8:75. Linde K, Niemann K, Schneider A, Meissner K. Institute of General Practice, Technische Universität München, Orleansstrasse 47, D-81667 Munich, Germany. klaus.linde@lrz.tum.de

FULL TITLE: On the history of dissociative identity disorders in Germany: the doctor Justinus Kerner and the girl from Orlach, or possession as an "exchange of the self".

The history of hypnosis is closely linked to the theme of possession; one such link is that the forerunner of hypnosis, animal magnetism, replaced exorcism in 1775 when Franz Anton Mesmer testified against Father Johann Joseph Gassner's exorcism. Modern authors have noted remarkable similarities between states of possession and dissociation. The treatment of possession by animal magnetism and exorcism represents the special romantic-magnetic therapy of the German medical doctor Justinus Kerner in the early 19th century. This article describes the man, his methods, and his thinking and presents one of his most famous case studies, the girl from Orlach, which, by today's standards, was a true case of dissociative identity disorder (DID). This article describes how contemporary principles of treatment were used and controversial issues about the nature and causes of DID were discussed 175 years ago.

Int J Clin Exp Hypn. 2011 Jan;59(1):82-102. Peter B. University of Munich, Germany. Burkhard-Peter@t-online.de

by Tim Brunson, PhD

When a person or organization becomes dissatisfied with the current condition of their heath, happiness, or detect that they are not reaching their potential – provided that there is sufficient motivation – then transformation is pursued. However, the probability of achieving rapid, substantial, and lasting change is not always assured. The lure of returning to the old status quo is often too great – despite the often extremely negative consequences. However, both throughout history and in contemporary times there have been and are countless examples of those who have mastered the art of change. Over the past 30 years I have been a student of this topic. As a result I have concluded that those who achieve change to the point of realizing mastery have three requirements in common. These involve effective modeling, following efficient methods, and pursuing change with a sense of purpose.

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Perioperative patient anxiety is a pervasive problem that can have far-reaching effects. Among these effects are increased postoperative pain, increased risk for infection, and longer healing times. Many factors affect perioperative patient anxiety, including the need for surgery, perceived loss of control, fear of postoperative pain, and alteration of body image. This systematic review of current literature was undertaken to identify evidence-based interventions for decreasing patient anxiety in perioperative practice. According to the current research literature, perioperative education and music therapy can be used to successfully reduce surgical patients' anxiety.

AORN J. 2010 Oct;92(4):445-57; quiz 458-60. Bailey L. Inova Fairfax Hospital Ambulatory Surgery Center, Fairfax, VA, USA.

Full Title: Effects of homeopathic medicines on mood of adults with histories of coffee-related insomnia.

BACKGROUND/AIMS: The purpose of this within-subjects feasibility study was to determine whether two different homeopathic remedies, Nux Vomica (NV) and Coffea Cruda (CC), exert effects on subjective mood ratings in healthy adults with a history of coffee-induced insomnia. The impact of individual personality traits, anxiety sensitivity or Type A cynical hostility, and homeopathic constitutional type (HTYPE-NV, HTYPE-CC), on remedy effects was examined to evaluate differential responsivity, in accord with clinical claims. SUBJECTS AND METHODS: Young adults of both sexes (ages 18-31) with above-average scores on standardized personality scales for either cynical hostility or anxiety sensitivity, and a history of coffee-induced insomnia, participated in the month-long study. At-home polysomnographic recordings were obtained on successive pairs of nights once per week for a total of 8 recordings (nights 1, 2, 8, 9, 15, 16, 22, 23). Subjects (N = 59) received placebo pellets on night 8 (single-blind) and verum pellets in 30c doses of one of two homeopathic remedies, NV or CC, on night 22 (doubleblind). Subjects completed the Profile of Mood States Scales at bedtime. RESULTS: The remedies produced differential effects on anger and overall mood, with improved mood following CC administration. A similar trend for depression was observed. Anxiety sensitive subjects experienced less tension following CC, whereas hostile subjects receiving CC became more tense. The high HTYPE-CC receiving CC experienced less vigor. The high HTYPE-CC receiving NV experienced more vigor.

Forsch Komplementmed. 2010 Oct;17(5):250-7. Brooks AJ, Bell IR, Howerter A, Jackson N, Aickin M. Department of Psychology, the University of Arizona, Tucson, AZ 85721, USA. brooksaj@email.arizona.edu

By Coach Cary Bayer

Some business development experts encourage you to create an elevator speech of 30 to 60 seconds so that you can tell anyone in a short descent or ascent what you do, so that you can elevate your business by adding your fellow passenger to your client roster. Such advice is wise indeed.

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FULL TITLE: Hypnotic responsiveness: expectancy, attitudes, fantasy proneness, absorption, and gender.

This study examines the effect of providing information linking participants' attitudes toward hypnosis with later hypnotic performance. Using total scale scores from McConkey's Opinions About Hypnosis scale, as well as subscale scores, the authors found a weak association between attitudes and performance among 460 student participants; however, the correlation was unaffected by prehypnotic information specifically connecting attitudes and performance. A brief, 3-item measure of hypnotic expectancies generated the strongest correlation with hypnotic responsiveness. The authors also found that the association between fantasy proneness and hypnotizability was unaffected by the order of scale administration. Finally, the study highlighted gender differences across measures of fantasy proneness, absorption, expectancy, and hypnotizability.

Int J Clin Exp Hypn. 2011 Jan;59(1):103-21. Green JP, Lynn SJ. The Ohio State University, Lima, OH 45804, USA. green.301@osu.edu

Olfactory stimuli are used in aromatherapy to enhance mood, well-being and work efficiency. Nevertheless, the impact of fragrances on cognitive performance in humans is not well understood. The present investigation aimed to evaluate the effects of 1,8-cineol, jasmine absolute ether, linalyl acetate and peppermint essential oil on human vigilance performance. The odorants were administered by means of inhalation and, except for peppermint essential oil, were tested at 2 different dosages. Performance in a standard visual vigilance task was measured in terms of speed and accuracy and subjective ratings of the odorants were assessed in terms of pleasantness, intensity, arousal and stress. We hypothesized that 1,8-cineol, jasmine absolute ether and peppermint essential oil would improve vigilance performance, whereas linalyl acetate would impair such performance. Comparison of the performances of the seven independent experimental groups with that of a control group did not show any of the expected effects. In contrast, inhalation of linalyl acetate decreased reaction times. Within-group analyses, however, revealed significant interactions between subjective ratings of the odorants and task performance. The results of the present investigation emphasize the high impact of subjective factors on the modulation of attentional functions by olfactory stimuli in humans.

Nat Prod Commun. 2010 Sep;5(9):1441-6. Heuberger E, Ilmberger J. Department of Clinical Pharmacy and Diagnostics, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria. eva.heuberger@univie.ac.at

FULL TITLE: Chair massage for treating anxiety in patients withdrawing from psychoactive drugs.

CONTEXT: Therapeutic massage has been proven to be an effective, nonpharmacologic, alternative for managing state and trait anxiety in a variety of clinical situations. However, no controlled study has investigated this effect in an addiction treatment setting. AIM: The aim of this study was to investigate the effectiveness of chair massage for reducing anxiety in persons participating in an inpatient withdrawal management program for psychoactive drugs. DESIGN: The design was a randomized, controlled clinical trial conducted from June 2008 to January 2009. SUBJECTS: Eighty-two (82) adult patients received inpatient treatment for psychoactive drug withdrawal (alcohol, cocaine, and opiates). SETTING: This study was conducted at the Withdrawal Management Services at the Capital District Health Authority, Halifax, Nova Scotia. INTERVENTIONS: Subjects were randomly assigned to receive chair massage (n?=?40) or a relaxation control condition (n?=?42). Treatments were offered for 3 consecutive days. Standard counseling and pharmacologic management were also offered concurrently to patients in all conditions. MEASUREMENTS: The primary outcome measure was anxiety assessed using the Spielberger State-Trait Anxiety Inventory (STAI). State and trait anxiety scores were determined immediately prior to and following each treatment intervention. RESULTS: Analysis of STAI scores showed a significant reduction in state and trait anxiety for both interventions (p? J Altern Complement Med. 2010 Sep;16(9):979-87. Black S, Jacques K, Webber A, Spurr K, Carey E, Hebb A, Gilbert R. Addiction Prevention and Treatment Services, Capital District Health Authority, Dartmouth, Nova Scotia, Canada.

by Tim Brunson, PhD

So-called skepticism in self-styled scientific circles almost always fails to meet the rigorous standards to which they hold those whom they criticize. The quick-draws and loose tongues of these pontifical authorities violate their own rules of conduct. Therefore, many ideas, which are later assumed to be scientifically proven, are too quickly dismissed long before they become the next dogma to which future ideas are scrutinized. Innovations such as Newtonian Physics, Einstein's Theory of Relativity, and neuroplasticity are currently held concepts, which once were targeted by those who claimed to be the gate keepers of intellectual progress. Fortunately, these innovations weathered the gauntlet of narrow minded guardians of Dogma. However, in reviewing the reasoning that skeptics commonly employ as they unilaterally and with little justification label that with which they have considerable discomfort as being "pseudo-scientific," I have always been amazed by their hypocrisy. It is so obvious to anyone who has ever been trained in the scientific method that their total lack of reasoning fails to employ such.

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A Book Review by Tim Brunson, PhD

When I first learned of the upcoming publication of Neuro-Hypnosis: Using Self-Hypnosis to Activate the Brain for Change by C. Alexander Simpkins and Annellen M. Simpkins, I was thrilled. Together the title and a statement in the book's introduction implied that the authors had written about how the mind can be deliberately used to change the brain. As this is a theme of much of my writings, I was encouraged by the fact that others were independently recognizing the power that we humans have in affecting lasting change. However, after an exhaustive reading I have concluded that this is yet another Ericksonian-oriented "what is hypnosis" primer as well as an interesting and entertaining self-help book. My hopes and expectations were not met.

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Even though Emotional Freedom Technique (EFT) has been around since 1997 when it was created by Gary Craig, it's only been in the last few years that it has started really getting a lot of popular exposure. Superstar singer Madonna is rumored to be a big fan of EFT. Sir Laurence Olivier, an award winning actor, used it. And, singer Michael Ball does a tapping session to calm his nerves before going on stage each night and has been seen doing it on a daytime TV chat show. Pop star Lily Allen, famous for songs such as LdN and The Fear, is understood to use the technique for weight loss. American PGA players have been spotted using it when golfing. And, Norwegian pole-vaulter Rens Blom credited his unexpected 2005 World Championship Gold to its powers.

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Although the use of yoga as a complementary therapy is common in palliative care, there is little evidence regarding current practice to inform service provision and research. The aim was to explore and compare yoga classes offered by palliative care services in New Delhi and London. Semi-structured qualitative interviews were conducted with yoga teachers and participants at two services and analysed thematically. Participants were: in Delhi eight family carers, three patients, and two teachers; in London six patients, one teacher, and one assistant. Six key themes are described: content of classes, symptoms and problems, preconceptions and the meaning of yoga, effects of yoga, challenges, and recommendations. This is the first study to examine the experiences of patients and carers practising yoga in palliative care settings. Recommendations include supporting and educating yoga teachers working with this population, and the need for robust trials.

Int J Palliat Nurs. 2010 Nov;16(11):548-54. Selman L, Higginson IJ. Department of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom. lucy.selman@kcl.ac.uk

FULL TITLE: Experimental study on mechanical vibration massage for treatment of brachial plexus injury in rats.

OBJECTIVE: To investigate the curative effect of the self-made mechanical vibration massage instrument for treatment of brachial plexus injury in rats and to explore its mechanism. METHODS: Brachial plexus injury models were made in 144 Wistar rats and one week after natural healing of the wound, they were randomly divided into 3 groups, mechanical vibration treatment group (MV group), nerve growth factor treatment group (NGF group) and model group, 48 rats in each group. Then again, the each group was randomly divided into 4 subgroups, 7-day group, 14-day group, 21-day group and 28-day group, 12 rats in each subgroup. The MV group were treated by mechanical vibration at acupoints on three-yang and three-yin channels of the hand with the mechanical vibration massage instrument; The NGF group were treated with injection of NGF into musculus pectoralis major on the affected side; And the model group were normally fed with no treatment. After treatment for 7, 14, 21 and 28 days, the diameter of both forelimbs were measured, the electrophysiological examination on the brachial plexus in vitro and the ultrastructure observation with electron microscope on the affected side were carried out, the motor nerve conduction velocity (MNCV) and motor nerve action potential (MNAP) of the brachial plexus on the affected side, NGF content of submaxillary gland as well as muscular Na+, K(+)-ATPase activity were determined respectively. RESULTS: The different rates of the forelimb diameter in the MV group and the NGV group on the 14th d, 21st d and 28th d were better than those in the model group (P < 0.05 or P < 0.001), and in the MV group were better than those in the NGF group on the 21st d and the 28th d (P < 0.05). MNCV in the MV group and the NGV group on the 21st d and 28th d was better than that in the model group (P < 0.05 or P < 0.001), and in the MV group was better than that in the NGF group on the 28th d (P < 0.05). MNAP in the MV group and the NGV group on the 14th d, 21st d and 28th d was better than that in the model group (P < 0.05 or P < 0.001), and in the MV group was better than that in the NGF group on the 21st d and 28th d (P < 0.05). The NGF mean gray index of submaxillary gland in the model group was higher than that in the MV group and the NGF group on the 7th d (P < 0.05); in the NGF group and the model group was higher than that in the MV group on the 14th d (P < 0.05); and in the NGF group and the MV group was higher than that in the model group on the 21st d and 28th d (P < 0.05). Na+, K(+)-ATPase activity in the model group and the MV group was higher than that in the NGF group (P < 0.05) on the 14th d, and in the MV group was higher than that in the model group on the 28th d (P < 0.05). CONCLUSION: As compared with the NGF group and the model group, mechanical vibration treatment can effectively accelerate repair of injured brachial plexus, slow down atrophy of skeletal muscle, and promote secretion of NGF in submaxillary gland.

J Tradit Chin Med. 2010 Sep;30(3):190-5. Mei RJ, Xu YY, Li Q. Institute of Acupuncture and Moxibustion, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, China.

There is growing interest in mind-body therapies as adjuncts to mainstream cancer treatment, and an increasing number of patients turn to these interventions for the control of emotional stress associated with cancer. Increased research funding has enabled many such interventions to be evaluated for their efficacy, including studies of mind-body interventions to reduce pain, anxiety, insomnia, anticipatory, and treatment-related nauseas, hot flashes, and improved mood. Mind-body treatments evaluated for their utility in oncology include relaxation therapies, biofeedback, meditation and hypnosis, yoga, art and music therapy, tai chi, and qigong. Although studies are not always methodologically sound and results mixed, a growing number of well-designed studies provide convincing evidence that mind-body techniques are beneficial adjuncts to cancer treatment. The evidence is sufficient to recommend further investigation and adoption of these techniques in mainstream oncology care.

Curr Treat Options Oncol. 2010 Dec;11(3-4):128-40. Elkins G, Fisher W, Johnson A. Mind-Body Medicine Research Laboratory, Department of Psychology and Neuroscience, Baylor University, 77 Cottonwood Drive, Waco, TX 76706, USA. Gary_Elkins@baylor.edu

FULL TITLE: Chiropractic treatment and the enhancement of sport performance: a narrative literature review.

A literature search and narrative review was carried out with the intent of determining the current level of knowledge regarding the chiropractic treatment of athletes for the purpose of sport performance enhancement. Of the fifty-nine relevant articles retrieved, only 7 articles of variable quality were obtained which specifically investigated/discussed chiropractic treatment and its involvement in sport performance enhancement. The role of the chiropractor in sport, unsubstantiated claims of performance enhancement, theories of how chiropractic treatment may influence sport performance, and the available evidence for the benefit of chiropractic treatment on sport performance are reviewed and discussed. Areas and directions for future studies are postulated. At this time there is insufficient evidence to convincingly support the notion that treatment provided by chiropractors can directly improve sport performance.

J Can Chiropr Assoc. 2010 Dec;54(4):210-21. Miners AL. Assistant Professor/Clinician, Division of Clinical Education, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario M2H 3J1; email: aminers@cmcc.ca.

OBJECTIVE: This case report describes the rare presentation of an osteochondroma arising from the anterior body of C4. This is the first known reported case of an osteochondroma arising from the anterior vertebral body of C4. CLINICAL FEATURES: A 24-year-old male sought consultation with his primary care physician for neck pain. The patient was then referred for cervical radiography and for chiropractic evaluation and treatment. An osseous lesion was noted arising from the C4 vertebra. Osteochondroma was suspected; however, chondrosarcoma could not be ruled out. After orthopedic consultation, osteochondroma was the confirmed diagnosis with the lesion likely incidental to the chief complaint. INTERVENTION AND OUTCOME: The patient underwent 12 chiropractic treatments for 8 weeks including thoracic and cervical high-velocity, low-amplitude spinal manipulation, interferential current, therapeutic ultrasound, stretching, and therapeutic exercise of the paraspinal musculature. Reevaluation revealed the patient experienced no pain with occupational duties, activities of daily living, and improved sleep quality. He was discharged with a home stretching and strengthening regimen targeting the thoracic and cervical paraspinal musculature. Follow-up at 6 months revealed no return of symptoms. CONCLUSION: We described the first case of an osteochondroma arising from the anterior aspect of the C4 vertebral body. The clinical evaluation, differential diagnosis, imaging workup, and treatment are addressed. This case also demonstrates that an asymptomatic osteochondroma of the cervical spine may be a relative, not an absolute, contraindication for high-velocity, low-amplitude spinal manipulation.

J Manipulative Physiol Ther. 2010 Nov-Dec;33(9):711-5. Reckelhoff KE, Green MN, Kettner NW. Department of Radiology, Logan College of Chiropractic, Chesterfield, Mo 63006-1065, USA.

Classical studies of mammalian movement control define a prominent role for the primary motor cortex. Investigating the mouse whisker system, we found an additional and equally direct pathway for cortical motor control driven by the primary somatosensory cortex. Whereas activity in primary motor cortex directly evokes exploratory whisker protraction, primary somatosensory cortex directly drives whisker retraction, providing a rapid negative feedback signal for sensorimotor integration. Motor control by sensory cortex suggests the need to reevaluate the functional organization of cortical maps.

Science. 2010 Nov 26;330(6008):1240-3. Matyas F, Sreenivasan V, Marbach F, Wacongne C, Barsy B, Mateo C, Aronoff R, Petersen CC. Laboratory of Sensory Processing, Brain Mind Institute, Faculty of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland.

OBJECTIVE: To ascertain knowledge gaps in the diagnosis and treatment of acute and chronic low back pain (LBP) in the primary care setting to prepare a scoping survey for identifying knowledge gaps in LBP management among Alberta's primary care practitioners, and to identify potential barriers to implementing a multidisciplinary LBP guideline. METHODS: English language studies, published from 1996 to 2008, comparing the clinical practice patterns of primary care practitioners with guideline recommendations were identified by systematically searching literature databases, the websites of various health technology assessment agencies and libraries, and the Internet. Data were synthesized qualitatively. RESULTS: The literature search identified 14 relevant studies. Knowledge gaps were reported among various primary care practitioner groups in the assessment of red flags, use of diagnostic imaging, provision of advice regarding sick leave and continuing activity, administration of some medications (muscle relaxants, oral steroids and opioids) and recommendation of particular treatments (acupuncture, physiotherapy, spinal manipulation, traction, ultrasound, transcutaneous electrical nerve stimulation and spinal mobilization). CONCLUSIONS: A know-do gap clearly exists among primary care practitioners with respect to the diagnosis and treatment of LBP. The information on know-do gaps will be used to construct a survey tool for unearthing the local knowledge gaps extant among Alberta's primary care practitioners, and to develop a dissemination strategy for a locally produced multidisciplinary LBP guideline, with the aim of ensuring that the know-do gaps inherent within each primary practice discipline are specifically targeted.

Pain Res Manag. 2010 Nov-Dec;15(6):392-400. Scott NA, Moga C, Harstall C.

FULL TITLE: Methodological and interpretative issues regarding the Phenomenology of consciousness inventory--hypnotic assessment procedure: a comment on pekala et al. (2010a, 2010b).

In two papers, Pekala et al. (2010a, 2010b) reviewed and empirically assessed the relationships among response expectancies, hypnotic suggestibility, spontaneous alterations in consciousness following a hypnotic induction, and hypnotic depth. We appreciate their attempt to integrate diverse facets of hypnotic responding and reconcile seemingly competing accounts of hypnosis. In addition, we applaud their complementary use of phenomenological and hypnotic suggestibility measures. However, in their attempt to develop a clinically-viable measure of hypnotic responsiveness, we believe that they have sacrificed too much, resulting in a measure with a number of important shortcomings whose empirical utility is questionable. Furthermore, their review and study gloss over a number of important distinctions. Finally, we believe that they over-interpret the relationships between their selected measures and ones previously used in the extant literature. A closer examination of variability among highly suggestible individuals, from the purview of the approach that Pekala et al. have adopted, but with a greater diversity of methods, is likely to yield a number of insights into the characteristics and determinants of hypnotic suggestibility and self-perceived hypnotic depth.

Am J Clin Hypn. 2010 Oct;53(2):109-17; discussion 119-32. Terhune DB, Cardeña E. Department of Psychology, Lund University, Sweden. devin.terhune@psychology.lu.se

Full Title: Biomedical engineering meets acupuncture - development of a miniaturized 48-channel skin impedance measurement system for needle and laser acupuncture.

BACKGROUND: Due to controversially discussed results in scientific literature concerning changes of electrical skin impedance before and during acupuncture a new measurement system has been developed. METHODS: The prototype measures and analyzes the electrical skin impedance computer-based and simultaneously in 48 channels within a 2.5×3.5 cm matrix. Preliminary measurements in one person were performed using metal needle and violet laser (405 nm) acupuncture at the acupoint Kongzui (LU6). The new system is an improvement on devices previously developed by other researchers for this purpose. RESULTS: Skin impedance in the immediate surroundings of the acupoint was lowered reproducibly following needle stimulation and also violet laser stimulation. CONCLUSIONS: A new instrumentation for skin impedance measurements is presented. The following hypotheses suggested by our results will have to be tested in further studies: Needle acupuncture causes significant, specific local changes of electrical skin impedance parameters. Optical stimulation (violet laser) at an acupoint causes direct electrical biosignal changes.

Biomed Eng Online. 2010 Nov 23;9:78. Litscher G, Wang L. Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and TCM Research Center Graz, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria. gerhard.litscher@medunigraz.at.

Full Title: A grounded theory study of homeopathic practitioners' perceptions and experiences of the homeopathic consultation.

Research into the homeopathic consultation has largely focused on patients' experiences, although the practitioner is a crucial component of the therapeutic context and may have an important part in optimizing health outcomes. Therefore the aim of this qualitative research was to gain an in-depth understanding of homeopathic practitioners' perceptions and experiences of the consultation. Medical and non-medical homeopaths were sampled from the registers of the Faculty and Society of Homeopaths. Two phases of data collection were employed. Phase 1 used in depth face-to-face interviews enabling the development of an initial model of the homeopathic consultation. Phase 2 involved observations of homeopathic consultations and practitioner reflective diaries in order to confirm, refute, or enlarge the model. Using the constant comparative method of grounded theory five main categories emerged, exploring the journey, finding the level, responding therapeutically, understanding self, and connecting, forming a model entitled "a theoretical model of a UK classical homeopathic consultation" which describes how homeopaths view and enact the consultation process. This study suggests that the process of identifying and prescribing the remedy is embedded in the consultation, highlighting the interconnectedness of the whole homeopathic consultation and aspects of the consultation that are unique and specific to homeopathy.

Evid Based Complement Alternat Med. 2011;2011:957506. Eyles C, Leydon GM, Lewith GT, Brien S. Department of Primary Care, University of Southampton, Hampshire SD17 1BJ, UK.

FULL TITLE: Effect of hypnotic pain modulation on brain activity in patients with temporomandibular disorder pain.

Hypnosis modulates pain perception but the associated brain mechanisms in chronic pain conditions are poorly understood. Brain activity evoked by painful repetitive pin-prick stimulation of the left mental nerve region was investigated with use of fMRI in 19 patients with painful temporomandibular disorders (TMD) during hypnotic hypoalgesia and hyperalgesia and a control condition. Pain intensity and unpleasantness of the painful stimulation was scored on a 0-10 Numerical Rating Scale (NRS). NRS pain and unpleasantness scores during hypnotic hypoalgesia were significantly lower than in the control condition and significantly higher in the hypnotic hyperalgesia condition. In the control condition, painful stimulation caused significant activation of right posterior insula, primary somatosensory cortex (SI), BA21, and BA6, and left BA40 and BA4. Painful stimulation during hypnotic hyperalgesia was associated with increased activity in right posterior insula and BA6 and left BA40 whereas hypnotic hypoalgesia only was associated with activity in right posterior insula. Unexpectedly, direct contrasts between control and hypnotic hyperalgesia conditions revealed significant decreases in S1 during hyperalgesia. Direct contrasts between control and hypnotic hypoalgesia conditions demonstrated significant decreases in right posterior insula and BA21, as well as left BA40 during hypoalgesia. These findings are the first to describe hypnotic modulation of brain activity associated with nociceptive processing in chronic TMD pain patients and demonstrate that hypnotic hypoalgesia is associated with a pronounced suppression of cortical activity and a disconnection between patient-based scores and cortical activity in S1 during hypnotic hyperalgesia.

Pain. 2010 Dec;151(3):825-33. Abrahamsen R, Dietz M, Lodahl S, Roepstorff A, Zachariae R, Østergaard L, Svensson P. Department of Clinical Oral Physiology, School of Dentistry, Aarhus University, Aarhus, Denmark.

FULL TITLE: Music therapy protocol development to enhance swallowing training for stroke patients with dysphagia.

Considering the devastating condition of dysphagia, it is necessary to provide intensive therapeutic regimen based on interdisciplinary approach. In this aspect, music-enhanced swallowing protocol was developed through a pilot study. Then, the modified protocol from a pilot study was examined with 8 stroke patients in a local hospital. The protocol was designed to improve oral motor control, laryngeal elevation, breathing, and swallowing functions. The dependent variables measured included reflex, respiration, and laryngeal functions using the Frenchay Dysarthria assessment. Results from the initial to the midevaluation showed that pitch in the laryngeal category were statistically significant after 6th sessions. After the 12th session, when the final evaluation was compared with the initial assessment, additional categories revealed statistically significant changes. It is recommended that this study should be replicated with a control group and a larger sample using either FEES or video fluoroscopy for scientific data to further substantiate music therapy outcomes in stroke rehabilitation.

J Music Ther. 2010 Summer;47(2):102-19. Kim SJ. Myongji University, Seoul, Korea.

FULL TITLE: Neck pain in Hong Kong: a telephone survey on consequences and health service utilization.

STUDY DESIGN: A regionally representative telephone survey using a 2-stage randomization process. OBJECTIVE: (1) To investigate the prevalence and consequence of neck pain in terms of disability and rate of absenteeism from work. (2) To describe the health services utilization pattern of neck pain subjects and to analyse the factors associated with neck pain and health services utilization pattern. SUMMARY OF BACKGROUND DATA: There has been a lack of reliable information on the health service utilization pattern of neck pain subjects, the consequences and the patient perceived effectiveness of neck pain management in Hong Kong and Asian countries. METHODS: Subjects were interviewed on the sociodemographic characteristics, occurrence and consequences of neck pain, and the health utilization pattern. A random sample of the respondents was re-interviewed 7 to 10 days after the initial interview, by an independent interviewer for the reliability check. RESULTS: A total of 4640 subjects were interviewed. The 12-month prevalence was 64.6% (95% CI: 63.2%-66.0%). About 38.0% of these patients suffered from moderate to severe pain. Moreover, 17.7% of these subjects had to limit their social activities and 19% had to limit their work. About 25% of those subjects had consulted medical or health practitioners. Medical consultation is the majority and physiotherapy came second. Self-massage was the most preferred (83.3%) mode of self-care. Physiotherapy was regarded as the most effective health service, with 60% of the respondents' neck pain completely removed. Although most people chose self-massage to be the most effective self-care treatment, only one-third (30.2%) of them had their neck pain improved by less than a half. CONCLUSION: Neck pain is highly prevalent with an increasing impact in Hong Kong. More than one-third of neck pain patients suffered from moderate to severe pain and around 20% of them had to limit their work. About 25% of neck pain patient have consulted medical or health professionals. Physiotherapy and private medical clinic were the 2 service providers with high percentage of perceived complete improvement. There was a general trend that more neck pain patients used complementary therapies.

Spine (Phila Pa 1976). 2010 Oct 1;35(21):E1088-95. Chiu TT, Leung AS, Lam P. Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong. rstchiu@polyu.edu.hk

by William Mitchell

Doesn't every therapeutic intervention involve suggestive communication or a shift in thinking or sensory experience? Hypnosis is a process of communication that allows the client to use their own power for self-help, maintaining health and healing. "Hypnosis allows for therapeutic possibilities simply not likely through other means. This alone warrants serious consideration."(Michael Yapko, PhD,Family Therapy Magazine,Aug.2008)

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In concert with growing public interest in complementary and alternative medicine (CAM), these therapies and products have been increasingly studied over the past two decades for the treatment of sleep disorders. While systematic reviews have been conducted on acupuncture and valerian in the treatment of insomnia, to date no comprehensive review has been conducted on all major CAM treatments. We sought to address this via a rigorous systematic review of hypnotic CAM interventions, including herbal and nutritional medicine, acupuncture, acupressure, yoga, tai chi, massage, aromatherapy and homoeopathy. The electronic databases MEDLINE (PubMed), CINAHL, PsycINFO, and The Cochrane Library were accessed during late 2009 for CAM randomized controlled trials (RCTs) in the treatment of chronic insomnia. Sixty-four RCTs were identified, of which 20 studies involving eight CAM interventions met final inclusion criteria. Effect size calculations (where possible) and a quality control analysis using a modified Jadad scale were undertaken. Many RCTs lacked methodological rigor, and were commonly excluded due to small sample size or an inadequate control condition. Among the studies that met inclusion criteria, there was evidentiary support in the treatment of chronic insomnia for acupressure (d=1.42-2.12), tai chi (d=0.22-2.15), yoga (d=0.66-1.20), mixed evidence for acupuncture and L-tryptophan, and weak and unsupportive evidence for herbal medicines such as valerian. Surprisingly, studies involving several mainstream CAM therapies (e.g., homoeopathy, massage, or aromatherapy) were not located or did not meet basic inclusion criteria. If CAM interventions are to be considered as viable stand-alone or adjuvant treatments for sleep disorders, future researchers are urged to use acceptable methodology, including appropriate sample sizes and adequate controls. RCTs evaluating other untested CAM therapies such as massage, homoeopathy, or osteopathy are encouraged, as is the exploration of using CAM therapies adjuvantly with conventional therapies.

Sleep Med Rev. 2010 Jun 5. Sarris J, Byrne GJ. Department of Psychiatry, Faculty of Medicine, The University of Melbourne, 130 Church St. Richmond 3121, Melbourne, Victoria, Australia; Brain Sciences Institute, Swinburne University of Technology, 400 Burwood Rd, Hawthom 3123, Melbourne, Victoria, Australia.