OBJECTIVE: To apply the Bradford Hill criteria, which are widely used to establish causality between an environmental agent and disease, to evaluate the relationship between over-the-counter intranasal zinc gluconate therapy and anosmia. DESIGN: Patient and literature review applying the Bradford Hill criteria on causation. SETTING: University of California, San Diego, Nasal Dysfunction Clinic. PATIENTS: The study included 25 patients who presented to the University of California, San Diego, Nasal Dysfunction Clinic complaining of acute-onset anosmia after intranasal application of homeopathic zinc gluconate gel. MAIN OUTCOME MEASURES: Each of the 9 Bradford Hill criteria--strength of association, consistency, specificity, temporality, biological gradient (dose-response), biological plausibility, biological coherence, experimental evidence, and analogy--was applied to intranasal zinc gluconate therapy and olfactory dysfunction using published, peer-reviewed medical literature and reported clinical experiences. RESULTS: Clinical, biological, and experimental data support the Bradford Hill criteria to demonstrate that intranasal zinc gluconate therapy causes hyposmia and anosmia. CONCLUSIONS: The Bradford Hill criteria represent an important tool for scientifically determining cause between environmental exposure and disease. Increased Food and Drug Administration oversight of homeopathic medications is needed to monitor the safety of these popular remedies.

Arch Otolaryngol Head Neck Surg. 2010 Jul;136(7):673-6. Davidson TM, Smith WM. Department of Surgery, Division of Otolaryngology-Head and Neck Surgery and Continuing Medical Education, University of California, San Diego, School of Medicine, 9500 Gilman Dr, La Jolla, CA 92037-0612, USA. tdavidson@ucsd.edu

FULL TITLE: Home-based music therapy--a systematic overview of settings and conditions for an innovative service in healthcare.

BACKGROUND: Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. METHODS: The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. RESULTS: A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. CONCLUSIONS: We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from music therapists, patients and their families HBMT is also interesting as a blueprint for home based care for other groups of caregivers.

BMC Health Serv Res. 2010 Oct 14;10:291. Schmid W, Ostermann T. The German Center for Neurodegenerative Diseases DZNE, Witten, Germany.

By Coach Cary Bayer

In a previous column, I discussed how a cat's liveliness can help you expand your business as a healer. In today's column I'll discuss how a cat's dying can help you grow your business, as well. But first things first; the following were the main points from that earlier article:

1. Think highly of yourself and others will be attracted to you.
2. Let others support you.
3. Let others touch you. Cuddling against them isn't bad either.
4. Exercise keeps you young in body and heart.
5. Nap when you feel like it; it's good for your soul and your body.
6. It's innocent to be the center of attention.
7. Curiosity thrills the cat.
8. The more playful you are, the more you're loved and prospered.
9. If you're happy and you know it, purr away--you'll be feline groovy.

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There has been much written to support music therapy as an adjunct in managing pain and anxiety in palliative care patients in Western societies, but little written on its use in developing countries. In light of increasing numbers of terminally ill patients in Tanzania owing to HIV/AIDS and cancer, limited access to opioids, and a growing interest in palliative care support, this study looks at the application of music in this context. The study reviews the history and principles of therapeutic music and outlines its role in palliative care. A qualitative study was conducted by questionnaire of 17 professionals involved in home-based palliative care in Tanzania. Findings include beliefs about the power of music, how music is being used to bring comfort to the dying patient, and the most important aspects of helpful music to many Tanzanian palliative care patients. Music can powerfully affect body, mind and spirit. It is vocal music, which is an accepted therapeutic music tool used to bring comfort to the palliative care patient and their family members. Finally, music is an active and participatory activity in Tanzanian culture, even for the dying.

Int J Palliat Nurs. 2010 Oct;16(10):499-504. Hartwig R. hartwig@gmail.com

FULL TITLE: Living AnatoME: Teaching and learning musculoskeletal anatomy through yoga and pilates.

Living AnatoME, a program designed in 2004 by two medical students in conjunction with the Director of Anatomy, teaches musculoskeletal anatomy through yoga and Pilates. Previously offered as an adjunct to the Gross Anatomy course in 2007, Living AnatoME became an official part of the curriculum. Previous research conducted on the program demonstrated its efficacy in providing relaxation and well-being to students who attended. In 2007, with all 144 gross anatomy students required to participate in a 1.5 hour Living AnatoME session on the upper and lower limbs, the impact of the program on students' comprehension of musculoskeletal anatomy was analyzed through the administration of 25-question pre- and post-tests, gauging knowledge in the following domains: upper limb, lower limb, muscle function, palpation, attachment/location, clinical correlate, and control (i.e., material not emphasized during the intervention). Analysis of postintervention tests revealed significant improvement in total Living AnatoME scores as well as in the domains of upper limb, muscle function, and palpation, indicating the possible efficacy of Living AnatoME in teaching anatomy. Performance on control questions also improved, although not significantly, which may indicate the role of other variables (e.g., additional study time) in increased performance.

Anat Sci Educ. 2010 Nov-Dec;3(6):279-86. doi: 10.1002/ase.181. McCulloch C, Marango SP, Friedman ES, Laitman JT. Center for Anatomy and Functional Morphology, Mount Sinai School of Medicine, New York, New York 10029-6574, USA. carrie.mcculloch@mssm.edu

OBJECTIVE: To determine the effectiveness of sustained uterine massage started before delivery of the placenta in reducing postpartum hemorrhage. METHODS: A randomized controlled trial conducted in Egypt and South Africa between September 2006 and February 2009. A total of 1964 pregnant women were randomly allocated to 1 of 3 treatment groups: intramuscular oxytocin, sustained uterine massage, or both treatments. Blood loss within 30 minutes of delivery was recorded. RESULTS: The incidence of blood loss of 300 mL or more within 30 minutes of delivery was significantly higher in the massage group than in the massage plus oxytocin (RR 1.88; 95% CI, 1.29-2.74 in Assiut, and RR 1.3; 95% CI, 1.00-1.68 in SA) and the oxytocin only group (RR 1.7; 95% CI, 1.11-2.61 in Assiut, and RR 2.24; 95% CI, 1.54-3.27 in SA). In both centers, use of additional uterotonics was significantly higher in the uterine massage group compared with the other 2 groups. CONCLUSION: Uterine massage was less effective than oxytocin for reducing blood loss after delivery. When oxytocin was used, there was no additional benefit from uterine massage. The effectiveness of uterine massage in the absence of oxytocin was not studied. ACTRN: 12609000372280.

Int J Gynaecol Obstet. 2010 Oct;111(1):32-6. Abdel-Aleem H, Singata M, Abdel-Aleem M, Mshweshwe N, Williams X, Hofmeyr GJ. Department of Obstetrics and Gynecology, Women's Health Centre, Assiut University Hospital, Assiut, Egypt. aleemh@yahoo.com

FULL TITLE: People who expect to enter psychotherapy are prone to believing that they have forgotten memories of childhood trauma and abuse.

We asked 1004 undergraduates to estimate both the probability that they would enter therapy and the probability that they experienced but could not remember incidents of potentially life-threatening childhood traumas or physical and sexual abuse. We found a linear relation between the expectation of entering therapy and the belief that one had, but cannot now remember, childhood trauma and abuse. Thus individuals who are prone to seek psychotherapy are also prone to accept a suggested memory of childhood trauma or abuse as fitting their expectations. In multiple regressions predicting the probability of forgotten memories of childhood traumas and abuse, the expectation of entering therapy remained as a substantial predictor when self-report measures of mood, anxiety, post-traumatic stress disorder symptom severity, and trauma exposure were included.

Memory. 2010 Jul;18(5):556-62. Rubin DC, Boals A. Duke University, Durham, NC, USA. david.rubin@duke.edu

Full Title: Integration of complementary and alternative medicine into medical schools in Austria, Germany and Switzerland - Results of a cross-sectional study.

BACKGROUND: The results of a survey of decision makers (directors of clinical departments, along with research and education institutes) at German medical schools in 1997 demonstrated that although most respondents were in favour of integrating complementary and alternative medicine (CAM) into medical school curricula, only a minority had implemented these into their medical schools. The aims of this study were to evaluate the current opinions on CAM from decision makers at medical schools in three German-speaking countries and the present extent to which it has been integrated. METHODS: In 2004 we sent a standardised questionnaire to 1,017 department directors at medical schools in Austria (A, n = 75), Germany (G, n = 873) and Switzerland (CH, n = 69). RESULTS: 487 questionnaires (overall response rate: 48%, country-specific response rate: A 39%; G 49%; S 42%) were returned. 40% of respondents had a positive opinion on CAM, whereas 28% had a neutral and 29% a negative opinion and 3% were unsure with a significant difference between Germany (44% positive opinion) in favour for CAM vs. Switzerland (22%; p = 0,021). The CAM therapies rated most positively were acupuncture (53%), osteopathy (52%) and naturopathy (38%) with no statistical differences between the countries. Naturopathy (39%) and herbal medicine (34%) were viewed more positively in Germany compared to Austria (4%, p = 0.001 and 8%, p = 0.01), but not to Switzerland (27%, p = 0.289 and 24%, p = 0.353). The majority of respondents favoured the integration of CAM into the medical system (research 85%, teaching 84% and treatment 60%). However, only 162 respondents (34%) indicated that CAM therapies had already been integrated into the curriculum at their medical schools (treatment 26%, research 19% and education 18%) with no significant differences between the countries. Respondents of Switzerland indicated lower activity of CAM integration (treatment 10% and research 10%) compared to Austria (28%, p = 0.016 and 28%, p = 0.016) and Germany (27%, p = 0.01 and 20%, p = 0.174). CONCLUSIONS: The majority of respondents favoured the integration of CAM into the medical system. However, this integration remains limited and does not reflect the high usage of CAM in the population.

Wien Med Wochenschr. 2010 Nov 16. Brinkhaus B, Witt CM, Jena S, Bockelbrink A, Ortiz M, Willich SN. Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany, benno.brinkhaus@charite.de.

FULL TITLE: Neurofeedback intervention in fibromyalgia syndrome; a randomized, controlled, rater blind clinical trial.

We designed a randomized, rater blind study to assess the efficacy of EEG Biofeedback (Neurofeedback-NFB) in patients with fibromyalgia syndrome (FMS). Eighteen patients received twenty sessions of NFB-sensory motor rhythm (SMR) treatment (NFB group) during 4 weeks, and eighteen patients were given 10 mg per day escitalopram treatment (control group) for 8 weeks. Visual Analog Scales for pain and fatigue, Hamilton and Beck Depression and Anxiety Inventory Scales, Fibromyalgia Impact Questionnaire and Short Form 36 were used as outcome measures which were applied at baseline and 2nd, 4th, 8th, 16th, 24th weeks. Mean amplitudes of EEG rhythms (delta, theta, alpha, SMR, beta1 and beta2) and theta/SMR ratio were also measured in NFB group. All post-treatment measurements showed significant improvements in both of the groups (for all parameters p < 0.05). NFB group displayed greater benefits than controls (for all parameters p < 0.05). Therapeutic efficacy of NFB was found to begin at 2nd week and reached to a maximum effect at 4th week. On the other hand, the improvements in SSRI treatment were also detected to begin at 2nd week but reached to a maximum effect at 8th week. No statistically significant changes were noted regarding mean amplitudes of EEG rhythms (p > 0.05 for all). However, theta/SMR ratio showed a significant decrease at 4th week compared to baseline in the NFB group (p < 0.05). These data support the efficacy of NFB as a treatment for pain, psychological symptoms and impaired quality of life associated with fibromyalgia.

Appl Psychophysiol Biofeedback. 2010 Dec;35(4):293-302. Kayiran S, Dursun E, Dursun N, Ermutlu N, Karamürsel S. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kocaeli University, Umuttepe Campus, Old Istanbul Road 10, 41380 Kocaeli, Turkey.

Full Title: Acupuncture as an adjunct therapy in the treatment of eating disorders: a randomised cross-over pilot study.

OBJECTIVE: This study examines the role of acupuncture as an adjunct therapy in the treatment of eating disorders in female patients. DESIGN: A randomised cross-over study was used in this study. The two treatments phases were the private multi-disciplinary outpatient eating disorder facility in Melbourne, Australia, only (referred to as their treatment as usual) and a continuation of their treatment as usual supplemented by acupuncture. PARTICIPANTS: Patients receiving treatment at a private multi-disciplinary outpatient eating disorder facility in Melbourne, Australia were asked to participate in the study. Nine consenting women (5 with Anorexia Nervosa, 4 with Bulimia Nervosa), aged (mean and SD) 23.7 (9.6) years, participated in the study. MAIN OUTCOME MEASURES: The main outcome measure was the Eating Disorder Inventory-3. Secondary outcome measures were the Becks Depression Inventory-2, State Trait Anxiety Inventory and the Eating Disorder Quality of Life Scale. RESULTS: There was evidence that acupuncture improved the participants' Quality of Life as measured by the physical/cognitive and psychological components of the Eating Disorder Quality of Life scale. There was also evidence of decreases in anxiety (both State and Trait as measured by the State Trait Anxiety Intervention) and perfectionism (as measured by the Eating Disorder Inventory-3). CONCLUSION: This pilot study shows potential of the benefit of acupuncture as an adjunct therapy in the treatment of eating disorders particularly in the area of quality of life.

Complement Ther Med. 2010 Dec;18(6):233-40. Fogarty S, Harris D, Zaslawski C, McAinch AJ, Stojanovska L. Victoria University, Melbourne, Australia. sarah.fogarty@live.vu.edu.au

In November 2007, the Society for Acupuncture Research (SAR) held an international symposium to mark the 10th anniversary of the 1997 NIH Consensus Development Conference on Acupuncture. The symposium presentations revealed the considerable maturation of the field of acupuncture research, yet two provocative paradoxes emerged. First, a number of well-designed clinical trials have reported that true acupuncture is superior to usual care, but does not significantly outperform sham acupuncture, findings apparently at odds with traditional theories regarding acupuncture point specificity. Second, although many studies using animal and human experimental models have reported physiological effects that vary as a function of needling parameters (e.g., mode of stimulation) the extent to which these parameters influence therapeutic outcomes in clinical trials is unclear. This White Paper, collaboratively written by the SAR Board of Directors, identifies gaps in knowledge underlying the paradoxes and proposes strategies for their resolution through translational research. We recommend that acupuncture treatments should be studied (1) "top down" as multi-component "whole-system" interventions and (2) "bottom up" as mechanistic studies that focus on understanding how individual treatment components interact and translate into clinical and physiological outcomes. Such a strategy, incorporating considerations of efficacy, effectiveness and qualitative measures, will strengthen the evidence base for such complex interventions as acupuncture.

Evid Based Complement Alternat Med. 2011;2011:180805. Langevin HM, Wayne PM, Macpherson H, Schnyer R, Milley RM, Napadow V, Lao L, Park J, Harris RE, Cohen M, Sherman KJ, Haramati A, Hammerschlag R. Department of Neurology, University of Vermont, Burlington, VT 05405, USA.

FULL TITLE: Social processes affecting the mnemonic consequences of rumors on children's memory.

This research examined whether the impact of overheard rumors on children's memory for their experiences varies as a function of social processes. The results of two experiments revealed that the very same errant rumor had different consequences for children's recollections depending on the degree and type of social interactions they had with peers after exposure to the rumor. In both experiments, 3- to 5-year-olds overheard a false rumor about a recently experienced event and then were interviewed about the event 1 week later. In Experiment 1, children were more likely to report experiencing rumored-but-nonoccurring information if they were allowed to interact naturally with peers following exposure to the rumor than if they were prevented from peer exchange. In Experiment 2, exposure to the rumor induced greater memory contamination if it was planted among familiar peers than if it was encountered among strangers.

J Exp Child Psychol. 2010 Dec;107(4):479-93. Epub 2010 Jul 24. Principe GF, Daley L, Kauth K. Department of Psychology, Ursinus College, Collegeville, PA 19426, USA. gprincipe@ursinus.edu

Full Title: Awareness of basic life support among medical, dental, nursing students and doctors.

To study the awareness of Basic Life Support (BLS) among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. A cross-sectional study was conducted by assessing responses to 20 selected basic questions regarding BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. After excluding the incomplete response forms the data was analysed on 1,054 responders. The results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual. Out of 1,054 responders 345 were medical students, 75 were medical interns, 19 were dental students, 59 were dental interns, 105 were homeopathy interns, 319 were nursing students, 72 were doctors, 29 were dentists, 25 were nursing faculty and six were homeopathy doctors. No one among them had complete knowledge of BLS. Only two out of 1054 (0.19%) had secured 80 - 89% marks, 10 out of 1054 (0.95%) had secured 70 - 79% marks, 40 of 1054 (4.08%) had secured 60 - 69% marks and 105 of 1054 (9.96%) had secured 50 - 59% marks. A majority of them, that is, 894 (84.82%) had secured less than 50% marks. Awareness of BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges is very poor.

Indian J Anaesth. 2010 Mar;54(2):121-6. Chandrasekaran S, Kumar S, Bhat SA, Saravanakumar, Shabbir PM, Chandrasekaran V. Vinayaka Mission's Kirupananda Variyar Medical College, Salem, Tamilnadu, India.

FULL TITLE: Laughter yoga versus group exercise program in elderly depressed women: a randomized controlled trial.

BACKGROUND: Laughter Yoga founded by M. Kataria is a combination of unconditioned laughter and yogic breathing. Its effect on mental and physical aspects of healthy individuals was shown to be beneficial. OBJECTIVE: The objective of this study was to compare the effectiveness of Kataria's Laughter Yoga and group exercise therapy in decreasing depression and increasing life satisfaction in older adult women of a cultural community of Tehran, Iran. METHODS: Seventy depressed old women who were members of a cultural community of Tehran were chosen by Geriatric depression scale (score?>?10). After completion of Life Satisfaction Scale pre-test and demographic questionnaire, subjects were randomized into three groups of laughter therapy, exercise therapy, and control. Subsequently, depression post-test and life satisfaction post-test were done for all three groups. The data were analyzed using analysis of covariance and Bonferroni's correction. RESULTS: Sixty subjects completed the study. The analysis revealed a significant difference in decrease in depression scores of both Laughter Yoga and exercise therapy group in comparison to control group (p? Int J Geriatr Psychiatry. 2010 Sep 16. Shahidi M, Mojtahed A, Modabbernia A, Mojtahed M, Shafiabady A, Delavar A, Honari H. Department of Counseling, School of Psychology & Training Sciences, Allameh Tabatabai University, Tehran, Iran.

BACKGROUND: The value of drug interviews in the treatment of conversion disorder is at present unknown. AIMS: To review all the available papers published in English that report on the use of drug interviews for treating conversion/dissociative disorder. METHOD: Databases (including EMBASE, MEDLINE and PsycINFO) were searched from 1920 to 2009. Selected publications had to report on the use of drug interviews in people diagnosed with a conversion/dissociative disorder. Qualitative and quantitative data were extracted. Predictors of a positive response were ascertained using meta-analytic techniques. RESULTS: Fifty-five papers meeting inclusion criteria were identified. No studies compared the intervention with a suitable control group. However, two studies reported high response rates when drug interview was used in individuals with treatment-resistant conversion disorder. In the meta-analysis, the use of suggestion and occurrence of emotional catharsis during the interview were positively associated with recovery. Combining two medications and comorbid psychiatric disorder were negatively associated with recovery. CONCLUSIONS: The evidence for effectiveness of drug interviews is of poor quality but it may be of benefit in the treatment of acute and treatment-resistant conversion disorder. A proactive approach during the interview, making suggestions the individual will respond, could influence outcome. Comorbid psychiatric disorder should be treated conventionally. Experimental studies to determine efficacy are required.

Br J Psychiatry. 2010 Aug;197:91-5. Poole NA, Wuerz A, Agrawal N. St Bartholomew's Hospital, East London Foundation Trust, West Smithfield, London EC1A 7BE, UK. norman.poole@googlemail.com

by Tim Brunson, PhD

What is hypnosis? And, does having an accurate definition really even matter? For the past several years I have attended courses and conferences in which the more forward looking organizers decided to include the topic of hypnosis or hypnotherapy presumably lest critics feel that they were not up-to-date with the latest innovations. Similarly, there continues to be a parade of medical, psychotherapeutic, and self-help books in which the authors – many of whom are very respected colleagues, friends, and even very influential mentors – have chosen either to dedicate an entire book to the topic or at least throw in a relevant chapter or a few pages. Even so, I cannot help but be dismayed at the inaccuracy of some of their comments and/or their omissions of some of the more relevant discoveries in related fields. Specifically, my present concern is regarding the lack of an effective and accurate definition of the word hypnosis.

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A Book Review by Tim Brunson, PhD

While reading the first couple of chapters of Anxiety Disorders: The Go-To Guide for Clients and Therapists by Carolyn Daitch, PhD, I was particularly affected by a very short phrase. She wrote that "anxiety is not a character flaw." As I look at this set of very common mental pathologies as the human power of simulation and anticipation gone awry, I concur with her simple yet, extremely profound approach. This is a book that provides both clarity and – more importantly – hope.

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FULL TITLE: The effectiveness of music in pediatric healthcare: a systematic review of randomized controlled trials.

The aim of this study was to systematically review the effectiveness of music on pediatric health-related outcomes. Five electronic databases were searched for randomized controlled/crossover trial designs published between 1984 and 2009. Eligible studies used music as a therapy or intervention, included participants 1 to 18 years, and focused on at least one health-related outcome (with the exclusion of procedural pain). Seventeen studies met the inclusion criteria. Quantitative synthesis was hampered by an inability to aggregate data arising from heterogeneity of interventions, outcomes and measurement tools. Qualitative synthesis revealed significant improvements in one or more health outcomes within four of seven trials involving children with learning and developmental disorders; two of three trials involving children experiencing stressful life events; and four of five trials involving children with acute and/or chronic physical illness. No significant effects were found for two trials involving children with mood disorders and related psychopathology. These findings offer limited qualitative evidence to support the effectiveness of music on health-related outcomes for children and adolescents with clinical diagnoses. Recommendations for establishing a consensus on research priorities and addressing methodological limitations are put forth to support the continued advancement of this popular intervention.

Evid Based Complement Alternat Med. 2011;2011:464759. Treurnicht Naylor K, Kingsnorth S, Lamont A, McKeever P, Macarthur C. Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada M4G 1R8.

Tony Wigram was Professor and Head of PhD Studies in Music Therapy at the University of Aalborg, Denmark, Honorary Research Fellow in the Faculty of Music at the University of Melbourne, Australia, and Reader in Music Therapy at Anglia Ruskin University, Cambridge, UK. He was Associate Editor of the Nordic Journal of Music Therapy, and a former President of both the European Music Therapy Confederation and the World Federation of Music Therapy. He was also Head Music Therapist at the Harper Children's Service in Hertfordshire, UK, and Research Advisor to Hertfordshire Partnership NHS Trust.

Full Title: From Passionate Process to Poetic and Playful Puzzle – Part I: The Art of Reviving and Writing "The Reorg Rag"™

by Mark Gorkin, LICSW

As I open this essay, please forgive an immodest turn. Upon reading or hearing one of my edgy or catchy phrasings, for example, the title of my book, Practice Safe Stress, or a motivational mantra, such as, "Do know your limits and don't limit your 'No's," I often receive some verbal or nonverbal sign of appreciation. This may then be followed by, "How did you come up with that?" or "Is that just how your mind works?" In my estimation, imaginative phrases, concepts or creative pieces are less the product of spontaneous combustion and more a journey-like process of swirling cogitation and personal passion within some informational or cultural context. That is, something has aroused my mind, heart and spirit and the ignition has caught my attention though, with hindsight, I may already have been subconsciously percolating and chewing on a related or background issue. The initial bubbling, boiling, gnashing and colliding of impressions and images, notions and emotions constitute the search for neuronal connections and novel associations.

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OBJECTIVE: Emerging research suggests that yoga may be beneficial for reducing symptoms and improving quality of life among breast cancer patients. However, very little is known about the characteristics of breast cancer patients who use yoga; thus, this study seeks to identify the sociodemographic and clinical characteristics of yoga users among this population. DESIGN: A cross-sectional survey study was conducted. SETTING: The study was conducted at an outpatient breast oncology clinic at a large university hospital. PARTICIPANTS: Three hundred postmenopausal breast cancer patients currently receiving aromatase inhibitors were included in this study. MAIN OUTCOME MEASUREMENT: Self-reported use of yoga following the cancer diagnosis was collected along with sociodemographic and clinical data. Multivariate logistic regression was used to identify independent predictors of yoga use among breast cancer patients. RESULTS: Of 300 participants, 53 (17.7%) reported having used yoga following cancer diagnosis. White patients were significantly more likely to use yoga than nonwhite patients (P = .02). Higher education level, lower BMI (body mass index), part-time employment status, previous chemotherapy, and radiation therapy were all associated with greater yoga use (all P < .05). Controlling for other factors, greater yoga use was independently associated with higher education level (adjusted odds ratio [AOR] 2.72, 95% confidence interval [CI], 1.15-6.46), and lower BMI (AOR 0.25, 95% CI, 0.09-0.66). CONCLUSION: Yoga use following breast cancer diagnosis was substantially higher for white patients and those with lower BMI and higher education levels. Considering its potential benefits for symptom management in cancer, more research is needed to understand the attitudes and barriers to yoga use among individuals with nonwhite race, lower education, and higher BMI level. Such investigation will help design yoga programs that are aligned to the needs of these populations.

Explore (NY). 2010 Nov-Dec;6(6):359-63. Desai K, Bowman MA, Galantino ML, Hughes-Halbert C, Vapiwala N, Demichele A, Mao JJ. Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, PA 19104.

FULL TITLE: Effect of a yoga programme on an individual with Parkinson's disease: a single-subject design.

Purpose.?To investigate the effect of eight weekly yoga sessions on balance, mobility and reported quality of life of an individual with Parkinson's disease (PD). Furthermore, to test the methodology in order to inform future research. Method.?A 69-year-old female with an 8-year history of PD (Hoehn and Yahr rating two) was selected for the study, which had a single subject ABA design. A 1-week baseline was followed by an 8-week period of weekly 60?min yoga classes and a further 5 weeks of treatment withdrawal. Main outcome measures used were Berg Balance Scale (BBS), Timed Up and Go (TUG) and the Parkinson's Disease Questionnaire-39 (PDQ-39); collected at baseline, before, during and after the intervention and at follow-up. Results.?An improvement was noted in the BBS and TUG during the intervention phase; although these changes did not appear to be clinically significant. No change in quality of life as measured by the PDQ-39 was noted. Conclusions.?The objective improvements in functional activities during the intervention period were not clinically significant. Subjectively, the participant gained much enjoyment and relaxation from the yoga classes. This study justifies the need for further studies using a larger sample size. Additionally, it will inform the methodological design.

Disabil Rehabil. 2010 Nov 4. Hall E, Verheyden G, Ashburn A. Rehabilitation Research Unit, University of Southampton, Southampton General Hospital, Level E, Southampton, UK.

FULL TITLE: Complementary therapies for children undergoing stem cell transplantation: report of a multisite trial.

BACKGROUND: Children undergoing stem cell transplant (SCT) experience high levels of somatic distress and mood disturbance. This trial evaluated the efficacy of complementary therapies (massage, humor therapy, relaxation/imagery) for reducing distress associated with pediatric SCT. METHODS: Across 4 sites, 178 pediatric patients scheduled to undergo SCT were randomized to a child-targeted intervention involving massage and humor therapy, the identical child intervention plus a parent intervention involving massage and relaxation/imagery, or standard care. Randomization was stratified by site, age, and type of transplant. The interventions began at admission and continued through SCT Week +3. Primary outcomes included patient and parent reports of somatic distress and mood disturbance obtained weekly from admission through Week +6 using the Behavioral, Affective, and Somatic Experiences Scales. Secondary outcomes included length of hospitalization, time to engraftment, and usage of narcotic analgesic and antiemetic medications. RESULTS: A mixed model approach was used to assess longitudinal trends of patient and parent report outcomes and to test differences between groups on these measures. Significant changes across time were observed on all patient and parent report outcomes. However, no significant differences between treatment arms were found on the primary outcomes. Similarly, no significant between-group differences were noted on any of the medical variables as secondary outcomes. CONCLUSIONS: Results of this multisite trial failed to document significant benefits of complementary interventions in the pediatric SCT setting.

Cancer. 2010 Aug 15;116(16):3924-33. Phipps S, Barrera M, Vannatta K, Xiong X, Doyle JJ, Alderfer MA. Department of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-3678, USA. sean.phipps@stjude.org

Highly hypnotizable subjects received a nonhypnotic instruction to respond to a particular digit in a display and a posthypnotic suggestion to respond to a different digit. On some test trials, these 2 responses were tested separately; on others, they were placed in conflict. Overall, subjects were no more responsive to posthypnotic cues than to nonhypnotic cues, nor did their response latencies differ. However, response to posthypnotic cues diminished when they conflicted with the nonhypnotic cues. Analysis of response latencies showed that posthypnotic responding interfered with nonhypnotic responding (and vice versa), even on those trials where there was no procedural conflict. Posthypnotic behavior is not inevitably evoked by the presentation of the prearranged cue. Furthermore, the interference between posthypnotic and nonhypnotic responses indicates that posthypnotic responding consumes attentional resources. Both findings indicate that posthypnotic behavior is not automatic in the technical sense of that term.

Int J Clin Exp Hypn. 2010 Oct;58(4):367-82. Tobis IP, Kihlstrom JF. University of Wisconsin, Madison, USA.

FULL TITLE: Physical therapy and chiropractic use among childhood cancer survivors with chronic disease: impact on health-related quality of life.

INTRODUCTION: The use of rehabilitation services to address musculoskeletal, neurological and cardiovascular late effects among childhood cancer survivors could improve physical function and health-related quality-of-life (HRQL). We describe physical therapy (PT) and chiropractic utilization among childhood cancer survivors and their association with HRQL. METHODS: The sample included 5+ year survivors from the Childhood Cancer Survivor Study (N?=?9,289). Questions addressing use of PT or chiropractic services and HRQL (Medical Outcomes Survey Short Form (SF-36)) were evaluated. Multivariable regression models compared PT and/or chiropractic utilization between survivors and siblings, and by diagnosis, treatment and demographic characteristics; associations between chronic disease, PT/chiropractic use, and HRQL were similarly evaluated. RESULTS: Survivors were not more likely to use PT (OR 1.0; 95% CI 0.8-1.2) or chiropractic (OR 0.8; 95% CI 0.7-1.0) services than siblings. More survivors reported using chiropractic (12.4%) than PT (9.2%) services. Older age and having health insurance were associated with utilization of either PT or chiropractic services. Grade 3-4 chronic conditions and a CNS tumor or sarcoma history were associated with PT but not with chiropractic service utilization. Survivors with musculoskeletal (OR 1.8; 95% CI 1.1-2.9), neurological (OR 3.4; 95% CI 1.6-6.9), or cardiovascular (OR 3.3; 95% CI 1.6-6.9) chronic conditions who used PT/chiropractic services were more likely to report poor physical health than survivors who did not use services. CONCLUSIONS: The reported prevalence of PT/chiropractic among survivors is consistent with that reported by siblings. Severity of late effects is associated with service use and with reporting poor physical health. IMPLICATIONS FOR CANCER SURVIVORS: Long-term childhood cancer survivors do not appear to utilize rehabilitation services to optimize physical function and support increased HRQL.

J Cancer Surviv. 2010 Oct 5. Montgomery M, Huang S, Cox CL, Leisenring WM, Oeffinger KC, Hudson MM, Ginsberg J, Armstrong GT, Robison LL, Ness KK. Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, USA, mmontgomery1@bama.ua.edu.

FULL TITLE: Heart Rate Variability (HRV) and Posttraumatic Stress Disorder (PTSD): A Pilot Study.

Exposure to combat experiences is associated with increased risk of developing Post Traumatic Stress Disorder. Prolonged exposure therapy and cognitive processing therapy have garnered a significant amount of empirical support for PTSD treatment; however, they are not universally effective with some patients continuing to struggle with residual PTSD symptoms. Heart rate variability (HRV) is a measure of the autonomic nervous system functioning and reflects an individual's ability to adaptively cope with stress. A pilot study was undertaken to determine if veterans with PTSD (as measured by the Clinician-Administered PTSD Scale and the PTSD Checklist) would show significantly different HRV prior to an intervention at baseline compared to controls; specifically, to determine whether the HRV among veterans with PTSD is more depressed than that among veterans without PTSD. The study also aimed at assessing the feasibility, acceptability, and potential efficacy of providing HRV biofeedback as a treatment for PTSD. The findings suggest that implementing an HRV biofeedback as a treatment for PTSD is effective, feasible, and acceptable for veterans. Veterans with combat-related PTSD displayed significantly depressed HRV as compared to subjects without PTSD. When the veterans with PTSD were randomly assigned to receive either HRV biofeedback plus treatment as usual (TAU) or just TAU, the results indicated that HRV biofeedback significantly increased the HRV while reducing symptoms of PTSD. However, the TAU had no significant effect on either HRV or symptom reduction. A larger randomized control trial to validate these findings appears warranted.

Appl Psychophysiol Biofeedback. 2010 Aug 3. Tan G, Dao TK, Farmer L, Sutherland RJ, Gevirtz R. Michael E. DeBakey Veterans Affair Medical Center, Houston, TX, USA.

Full Title: Ethnic differences in complementary and alternative medicine use among patients with diabetes.

OBJECTIVE: To evaluate the effect of ethnicity as a predictor of the use of complementary and alternative medicine (CAM) among patients with diabetes. DESIGN AND SETTINGS: A 16-item questionnaire investigating CAM use was distributed among patients attending the Taking Control of Your Diabetes (TCOYD) educational conferences during 2004-2006. Six TCOYD were held across the United States. Information of diabetes status and sociodemographic data was collected. CAM use was identified as pharmacologic (herbs and vitamins) and nonpharmacologic CAMs (e.g., prayer, yoga, and acupuncture). RESULTS: The prevalence of pharmacologic and non-pharmacologic CAMs among 806 participants with diabetes patients was 81.9% and 80.3%, respectively. Overall, CAM prevalence was similar for Caucasians (94.2%), African Americans (95.5%), Hispanics (95.6%) and Native Americans (95.2%) and lower in Pacific Islanders/others (83.9%) and Asians (87.8%). Pharmacologic CAM prevalence was positively associated with education (p=0.001). The presence of diabetes was a powerful predictor of CAM use. Several significant ethnic differences were observed in specific forms of CAM use. Hispanics reported using frequently prickly pear (nopal) to complement their diabetes treatment while Caucasians more commonly used multivitamins. CONCLUSIONS: Treatment with CAM widely used in persons with diabetes. Ethnic group differences determine a variety of practices, reflecting groups' cultural preferences. Future research is needed to clarify the perceived reasons for CAM use among patients with diabetes in clinical practice and the health belief system associated with diabetes by ethnic group.

Complement Ther Med. 2010 Dec;18(6):241-8. Villa-Caballero L, Morello CM, Chynoweth ME, Prieto-Rosinol A, Polonsky WH, Palinkas LA, Edelman SV. Family and Preventative Medicine Department, School of Medicine, University of California, San Diego, CA, United States.

Full Title: Does acupuncture improve quality of life for patients with pain associated with the spine? A systematic review.

This paper aimed to evaluate the effectiveness of acupuncture for qualities of life (QoL) in patients suffering from pain associated with the spine (PAWS). Acupuncture has been shown to reduce pain severity, but its effect on QoL is unknown. PubMed, CINAHL, and Cochrane Central Register of Controlled Trials as well as EMBASE were searched. Published randomized controlled trials on PAWS comparing acupuncture with waiting-list or sham interventions were considered. Eight out of 186 trials were included. For physical functioning, acupuncture was better than waiting-list at immediate and short-term followups; and was better than sham interventions at immediate assessment (SMD?=?0.40. 95% CI 0.06 to 0.74). For mental functioning, acupuncture was better than waiting-list at short-term followup and sham interventions at intermediate-term followup (SMD?=?0.27. 95% CI 0.03 to 0.51). A similar effect was observed on pain reduction. Discrepancies in point selection for relieving anxiety and insufficient training of trial acupuncturists were also identified. Acupuncture has a moderate effect on the improvement of physical functioning and pain for PAWS patients in the short term; but the effect for mental functioning is small and delayed. Future trials should address point selection and consistency in the qualifications of trial acupuncturists.

Evid Based Complement Alternat Med. 2011;2011:301767. Lu SC, Zheng Z, Xue CC. Traditional & Complementary Medicine Research Program, Health Innovations Research Institute and Discipline of Chinese Medicine, School of Health Sciences, RMIT University, Bundoora, VIC 3083, Australia.

FULL TITLE: Trance state effects and imagery vividness before and during a hypnotic assessment: a preliminary study.

This preliminary study explored the relationship between imagery vividness before and during a hypnotic phenomenological assessment procedure, the Phenomenology of Consciousness Inventory-Hypnotic Assessment Procedure (PCI-HAP), while also assessing trance (hypnoidal) state effects and several other variables. The PCI-HAP allows the assessment of trance state effects associated with hypnotism to be quantified and statistically assessed. The 102 subjects completed the PCI-HAP along with several other questionnaire items. Correlational and regression analyses suggested that imagery vividness during hypnotism (hypnotic imagoic suggestibility) was predicted by combined imagery vividness before hypnotism and trance (altered) state effects during hypnotism. When measuring several additional variables, imagery vividness during hypnotism was found to be a function of self-reported hypnotic depth and additional other variables. The usefulness of these results for better understanding imagery vividness before and during hypnotism is discussed.

Int J Clin Exp Hypn. 2010 Oct;58(4):383-416. Pekala RJ, Maurer R, Kumar VK, Elliott-Carter N, Mullen K. Coatesville Veterans Administration Medical Center, Coatesville, Pennsylvania 19320, USA. pekalar@voicenet.com

FULL TITLE: An exploratory study on the effects of an expectancy manipulation on chemotherapy-related nausea.

CONTEXT: Previous research has shown that the effectiveness of acupressure bands in reducing chemotherapy-related nausea is related to patients' expectations of efficacy. OBJECTIVE: To test whether an informational manipulation designed to increase expectation of efficacy regarding acupressure bands would enhance their effectiveness. METHODS: We conducted an exploratory, four-arm, randomized clinical trial in breast cancer patients about to begin chemotherapy. All patients received acupressure bands and a relaxation CD. This report focuses on Arm 1(expectancy-neutral informational handout and CD) compared with Arm 4 (expectancy-enhancing handout and CD). Randomization was stratified according to the patient's level of certainty that she would have treatment-induced nausea (two levels: high and low). Experience of nausea and use of antiemetics were assessed with a five-day diary. RESULTS: Our expectancy-enhancing manipulation resulted in improved control of nausea in the 26 patients with high nausea expectancies but lessened control of nausea in 27 patients having low nausea expectancies. This interaction effect (between expected nausea and intervention effectiveness) approached statistical significance for our analysis of average nausea (P=0.084) and reached statistical significance for our analysis of peak nausea (P=0.030). Patients receiving the expectancy-enhancing manipulation took fewer antiemetic pills outside the clinic (mean(enhanced)=12.6; mean(neutral)=18.5, P=0.003). CONCLUSION: This exploratory intervention reduced antiemetic use overall and also reduced nausea in patients who had high levels of expected nausea. Interestingly, it increased nausea in patients who had low expectancies for nausea. Confirmatory research is warranted.

J Pain Symptom Manage. 2010 Sep;40(3):379-90. Epub 2010 Jun 25. Roscoe JA, O'Neill M, Jean-Pierre P, Heckler CE, Kaptchuk TJ, Bushunow P, Shayne M, Huston A, Qazi R, Smith B. University of Rochester James P. Wilmot Cancer Center, Rochester, New York 14642, USA. Joseph_Roscoe@urmc.rochester.edu

Full Title: The concept of health - in the history of medicine and in the writings of Hahnemann.

The number of notions of health is not infinite. In the history of medicine we can only find a number of different conceptions or paradigmatic ideas of health, in a variety of references and combinations. Health was seen as: 1. harmonious balance between principles or entities, 2. result of a struggle against opposing forces, 3. continuous dialectical process, 4. hierarchy of components or functions, 5. potential to perform and to develop, 6. transcendence towards higher levels of being, 7. result of conscious autonomous action, 8. optimal causal functioning, or 9. public task and responsibility. Hahnemann's view of health, as reflected in his writings, utilized virtually all of these elements. They reappear for instance as: 1. harmonious tuning of the life force, 2. defeat of pathogenetic influences, 3. admittance of aggravations, 4. autocracy of the spirit-like life principle, 5. reference to a higher goal of human existence, 6. perfecting character of medical service, 7. concern about dietetics and life style, 8. utilization of causality and natural science, and 9. appealing to governmental provisions and medical police. These paradigms have been repeatedly recombined and applied. The theory of medicine is the attempt to analyze, adjust, and develop concepts that meet the demand of contemporary medical practice. Medical theory lies between the fields of observable facts and metaphysical convictions. Distinguishing the levels of practice, theory, and metaphysics could allow the open discussion of theoretical issues, such as the concept of health or disease, without raising purely theoretical objections to well-established practice.

Homeopathy. 2010 Jul;99(3):215-20. Schmidt JM. Department of the History of Medicine, Ludwig-Maximilians-University of Munich, Germany. j.m.schmidt@lrz.uni-muenchen.de

Prazosin is recommended for treatment of Posttraumatic Stress Disorder (PTSD)-associated nightmares. Level A. Image Rehearsal Therapy (IRT) is recommended for treatment of nightmare disorder. Level A. Systematic Desensitization and Progressive Deep Muscle Relaxation training are suggested for treatment of idiopathic nightmares. Level B. Venlafaxine is not suggested for treatment of PTSD-associated nightmares. Level B. Clonidine may be considered for treatment of PTSD-associated nightmares. Level C. The following medications may be considered for treatment of PTSD-associated nightmares, but the data are low grade and sparse: trazodone, atypical antipsychotic medications, topiramate, low dose cortisol, fluvoxamine, triazolam and nitrazepam, phenelzine, gabapentin, cyproheptadine, and tricyclic antidepressants. Nefazodone is not recommended as first line therapy for nightmare disorder because of the increased risk of hepatotoxicity. Level C. The following behavioral therapies may be considered for treatment of PTSD-associated nightmares based on low-grade evidence: Exposure, Relaxation, and Rescripting Therapy (ERRT); Sleep Dynamic Therapy; Hypnosis; Eye-Movement Desensitization and Reprocessing (EMDR); and the Testimony Method. Level C. The following behavioral therapies may be considered for treatment of nightmare disorder based on low-grade evidence: Lucid Dreaming Therapy and Self-Exposure Therapy. Level C No recommendation is made regarding clonazepam and individual psychotherapy because of sparse data.

J Clin Sleep Med. 2010 Aug 15;6(4):389-401. Aurora RN, Zak RS, Auerbach SH, Casey KR, Chowdhuri S, Karippot A, Maganti RK, Ramar K, Kristo DA, Bista SR, Lamm CI, Morgenthaler TI; Standards of Practice Committee; American Academy of Sleep Medicine. Mount Sinai Medical Center, New York, NY, USA.

FULL TITLE: Yoga and pilates: Associations with body image and disordered-eating behaviors in a population-based sample of young adults.

OBJECTIVE: To examine associations between participating in mind-body activities (yoga/Pilates) and body dissatisfaction and disordered eating (unhealthy and extreme weight control practices and binge eating) in a population-based sample of young adults. METHOD: The sample included 1,030 young men and 1,257 young women (mean age: 25.3 years, SD = 1.7) who participated in Project EAT-III (Eating and Activity in Teens and Young Adults). RESULTS: Among women, disordered eating was prevalent in yoga/Pilates participants and nonparticipants, with no differences between the groups. Men participating in yoga/Pilates were more likely to use extreme weight control behaviors (18.6% vs. 6.8%, p = .006) and binge eating (11.6% vs. 4.2%, p = .023), and marginally more likely to use unhealthy weight control behaviors (49.1% vs. 34.5%; p = .053), than nonparticipants after adjusting for sociodemographics, weight status, and overall physical activity. DISCUSSION: Findings suggest the importance of helping yoga/Pilates instructors recognize that their students may be at risk for disordered eating. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010.

Int J Eat Disord. 2010 Sep 22. Neumark-Sztainer D, Eisenberg ME, Wall M, Loth KA. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minnesota.

The Polish version of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A; Shor & Orne, 1962) was administered to 1174 participants (968 women and 206 men). Polish data were compared with other norming studies. Point-biserial item-scale correlations ranged from r = .12 (posthypnotic suggestion item) to r = .49. The Kuder-Richardson correlation of .70 was within the range of the reference samples. Test-retest reliability coefficients were obtained from one group of participants tested twice in the same session (r = .69, p < .05), and another group 8 weeks apart (r = .58, p < .05). Females scored significantly higher than males.

Int J Clin Exp Hypn. 2010 Oct;58(4):433-43 Siuta J. Jagiellonian University, Krakow, Poland. upsiuta@cyf-kr.edu.pl

FULL TITLE: Effects of music therapy on subjective sensations and heart rate variability in treated cancer survivors: a pilot study.

OBJECTIVE: Data on the effects of music therapy on subjective sensations and the physiological parameters of heart rate variability (HRV) in treated cancer survivors are scarce. The aim of this study was to determine whether or not music therapy affects the sensations of fatigue, comfort, and relaxation in cancer survivors, and affects the activities of the sympathetic and parasympathetic nervous systems as indicated by HRV parameters. METHODS: Twenty-three patients aged 30-67 years and with cancer that had been treated at least 6 months previously received music therapy for about 2h, which included singing, listening to music, learning the recorder, and performing music. Subjective sensations and electrocardiogram were recorded before and after the music therapy. The low-frequency and high-frequency components of HRV were assessed by the frequency analysis of sequential R wave to R wave intervals of electrocardiogram obtained from 5-min recordings. Subjective sensations were quantitatively assessed using a visual analog mood scale. RESULTS: Two hours of music therapy significantly increased relaxation sensations and significantly decreased fatigue sensation in treated cancer survivors. Moreover, the HRV parameters showed that parasympathetic nervous system activity increased and sympathetic nervous system activity decreased. CONCLUSION: This study provides preliminary evidence that music therapy may be clinically useful for promoting relaxation sensation and increasing parasympathetic nervous system activity in treated cancer survivors.

Complement Ther Med. 2010 Oct;18(5):224-6. Chuang CY, Han WR, Li PC, Young ST. Institute of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan. g39304001@ym.edu.tw

by Diana Moore CHt

I define kudalini energy as that life force energy associated with the chakra centers. It is that life force energy that begins the moment we take our first breath and according to Eastern philosophy, lies coiled at the root chakra (base of the spine) until uncoiled. It is the energy from Creator Source moving through your chakra centers downward to the creative source in Mother Earth and back up again to the Creator Source. It is my opinion that we, as humans, work with the kudalini energy every day but for many of us, we are not aware of it. Let's take a look at how kudalini energy works.

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Graham Howes has been an Actor Writer and Theatre Director for 35 years. He trained as an Actor and Teacher of Speech Drama and English. While part of the cast of FAME he had a damascene conversion as he realisedthat there were not many Hypnotherapists who were also performers and who could really understand the needs and difficulties experienced by them. Having trained in Hypnotherapy and NLP initially and joining the GHR register he worked his way up to a Harley Street practice. He broadened his practice and decided to flee to the English countryside and became a specialist in weight loss but also anxiety trauma PTSD panic attacks and serious sexual and physical abuse. He practices in Hadleigh near Ipswich Suffolk and Manningtree near Colchester Essex in the UK.

For more information visit Edgehypno.com.

Yoga is adjunctively utilized outside the United States in the treatment of a variety of diseases, including chronic obstructive pulmonary disease (COPD), but there are no studies assessing its adjunctive efficacy in the United States. We prospectively evaluated the effects of yoga training on the quality of life (QOL) and the parameters of lung function in patients with COPD. Thirty-three patients with documented COPD, per Global Initiative for Obstructive Lung Disease criteria, were recruited. All patients received standard COPD care. The QOL was assessed by the St. George Respiratory questionnaire. Standard spirometry and maximum inspiratory (maximal inspiratory pressure) and expiratory pressure (maximal expiratory pressure) were measured. Patients were taught selected yoga exercises including breathing exercises, meditation, and yoga postures for 1 hour, thrice a week for 6 weeks by a certified yoga therapist. The quality of life and lung function were again assessed at the end of 6 weeks. Twenty-two patients completed the study. Differences in preyoga versus postyoga scores were evaluated using paired t-tests. Statistically significant improvements (P < 0.05) were observed for the St. George Respiratory questionnaire [95% confidence interval (CI) 43.13-58.47], vital capacity (95% CI 2.53-7.65), maximal inspiratory pressure (95% CI 6.62-23.64), and maximal expiratory pressure (95% CI 1.63-13.81). Yoga when practiced by patients with COPD results in improvement in the QOL and lung function on a short-term basis. Additional research is needed to confirm these findings in a randomized controlled trial and in the longer term.

Am J Ther. 2010 Oct 22. Fulambarker A, Farooki B, Kheir F, Copur AS, Srinivasan L, Schultz S. 1Pulmonary Division, Department of Medicine, Rosalind Franklin University of Medicine and Science/The Chicago Medical School, North Chicago, IL; and 2VA Great Lakes Health Care System, North Chicago, IL.