Full title: Differential frontal-parietal phase synchrony during hypnosis as a function of hypnotic suggestibility.

Spontaneous dissociative alterations in awareness and perception among highly suggestible individuals following a hypnotic induction may result from disruptions in the functional coordination of the frontal-parietal network. We recorded EEG and self-reported state dissociation in control and hypnosis conditions in two sessions with low and highly suggestible participants. Highly suggestible participants reliably experienced greater state dissociation and exhibited lower frontal-parietal phase synchrony in the alpha2 frequency band during hypnosis than low suggestible participants. These findings suggest that highly suggestible individuals exhibit a disruption of the frontal-parietal network that is only observable following a hypnotic induction.

Psychophysiology. 2011 Apr 15. doi: 10.1111/j.1469-8986.2011.01211.x. Terhune DB, Cardeña E, Lindgren M. Department of Psychology, Lund University, Lund, Sweden Department of Experimental Psychology, University of Oxford, Oxford, UK.

This paper is designed to provide an introduction to music therapy in the continuum of cancer care. The value and use of music therapy during diagnosis and treatment, palliation, hospice, actively dying, and bereavement have been well documented. The music therapy process will be identified, research will be shared, and the importance and role of music therapy in palliative medicine and supportive cancer care discussed. Music therapy is invaluable throughout the entire cancer treatment process.

Semin Oncol. 2011 Jun;38(3):403-6. Gallagher LM. The Cleveland Clinic Arts and Medicine Institute, Cleveland, OH; Harry R. Horvitz Center for Palliative Medicine (a World Health Organization Demonstration Project), Cleveland Clinic Taussig Cancer Center, Cleveland, OH.

Full title: Increased EMG response following electromyographic biofeedback treatment of rectus femoris muscle after spinal cord injury.

OBJECTIVE: To study increases in electromyographic (EMG) response from the right and left rectus femoris muscles of individuals with long-term cervical spinal cord injuries after EMG biofeedback treatment. DESIGN: Repeated measure trials compared EMG responses before and after biofeedback treatment in patients with spinal cord injuries. MAIN OUTCOME MEASURES: The Neuroeducator was used to analyse and provide feedback of the EMG signal and to measure EMG response. SETTING: Department of Traumatic Orthopaedics, School of Medicine, University of São Paulo, Brazil. PARTICIPANTS: Twenty subjects (three men and 17 women), between 21 and 49 years of age, with incomplete spinal cord injury at level C6 or higher (range C2 to C6). Of these subjects, 10 received their spinal cord injuries from motor vehicle accidents, one from a gunshot, five from diving, three from falls and one from spinal disc herniation. RESULTS: Significant differences were found in the EMG response of the right rectus femoris muscle between pre-initial (T1), post-initial (T2) and additional (T3) biofeedback treatment with the subjects in a sitting position [mean (standard deviation) T1: 26µV (29); T2: 67µV (50); T3: 77µV (62)]. The mean differences and 95% confidence intervals for these comparisons were as follows: T1 to T2, -40.7 (-53.1 to -29.4); T2 to T3, -9.6 (-26.1 to 2.3). Similar differences were found for the left leg in a sitting position and for both legs in the sit-to-stand condition. CONCLUSIONS: The EMG responses obtained in this study showed that treatment involving EMG biofeedback significantly increased voluntary EMG responses from right and left rectus femoris muscles in individuals with spinal cord injuries.

Physiotherapy. 2011 Jun;97(2):175-9. Epub 2010 Aug 4. De Biase ME, Politti F, Palomari ET, Barros-Filho TE, De Camargo OP. Institute of Orthopaedics and Traumatology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.

Episiotomy is the most common perineal incision in obstetric and midwifery. Nowadays alternative and complementary methods such as Aromatherapy using essential oils are established as an alternative therapy. This research was carried out to assess the effect of lavender oil in wound healing. This randomized control trial was conducted on 120 primiparous women with singleton pregnancy, without any acute and chronic disease and allergy who had undergone normal spontaneous vaginal delivery and episiotomy. They were randomly allocated in case and control groups. Case group received lavender oil and controls received povidone-iodine. Incision sites were assessed on the 10th day postpartum. 25 out of 60 women in lavender group and 17 mothers in control group had no pain (p = 0.06). There was no significant difference between two groups in surgery site complications. However, redness in lavender group was significantly less than controls (p < 0.001). This study suggests application of lavender essential oil instead of povidone-iodine for episiotomy wound care.

Complement Ther Clin Pract. 2011 Feb;17(1):50-3. Epub 2010 Jun 17. Vakilian K, Atarha M, Bekhradi R, Chaman R. Nursing and Midwifery College, Arak University of Medical Sciences, Arak, Tehran, Iran. swt_f@yahoo.com

Laura Allen is the author of the Plain & Simple Guide to Therapeutic Massage & Bodywork Examinations (2nd ed, LWW, 2009) and One Year to a Successful Massage Therapy Practice (LWW, 2008. Her new book, A Massage Therapist's Guide to Business, will be available in January 2011. She has although authored a romance novel, Affair of the Heart, that's available as an e-book through Amazon and affiliated sites. Allen is a sitting member of the North Carolina Board of Massage & Bodywork Therapy, and is North Carolina's delegate to the Federation of State Massage Therapy Boards. She is also Nationally Certified and an Approved Provider of Continuing Education under the NCBTMB. Allen is a regular contributor to Massage Magazine, Massage & Bodywork Magazine, and Massage News. Allen is an accomplished musician, singer and songwriter who has made appearances on public radio, public television, and has appeared as a guest on 5 CDs, as well as recording one of her own with the band Hogwild. She is the owner of THERA-SSAGE, an alternative wellness clinic located in Rutherfordton NC employing over a dozen practitioners of different disciplines. "

For more information visit: www.LauraAllenmt.com.

Art Riggs is a Certified Advanced Rolfer® and massage therapist who has been teaching bodywork since 1988 and now sells Myofascial release videos and manuals worldwide. A lifetime of hard physical activity and high level athletic pursuits including ultra-marathons led him to bodywork, first as a grateful recipient, and later as a student. The fulfillment he experienced in both receiving and performing bodywork led him away from his graduate studies in Exercise Physiology at the University of California, Berkeley to a full time career as a Rolfer and teacher of Deep Tissue Massage. He has conducted numerous workshops for health spas and for medical professionals, including physical therapists, and has assisted in Rolf Institute trainings. For the first ten years of his practice, he specialized in myofascial release at a physical therapy clinic where an interest in the treatment of injuries was cultivated. He has worked with several Olympic athletes, professional football and basketball players, and professional dancers and musicians to treat injuries and to improve performance. However, his teaching and the practice of working with the general population to provide a better awareness of their bodies and allow more ease and comfort in their everyday lives remains the most gratifying aspect of his work.

For more information visit: www.DeepTissueMassageManual.com.

Dr. Michael Lenarz practices chiropractic in a small northwest Washington town called Sedro-Woolley. He is also founder of a small chain of chiropractic offices in Washington State and Michigan. He received his doctorate from Sherman College in Spartanburg, SC where he was awarded the B.J. Palmer Philosophical Distinction Award. He is now a member of the SHerman COllege Board of Regents and Board of Trustees. He was awarded the Chiropractor of the year award from the Blair Chiropractic Society (A chiropractic technique group) in 2003.

For more information visit: www.TheChiropracticWay.com.

by Coach Cary Bayer

At the end of the 1980's, futurist John Naisbitt wrote a book that envisioned, among other things, a more sensitive world emerging as a response to the high tech revolution. His Megatrends camped out at the top of the New York Times best-seller list for nearly two years, selling eight million copies in 57 countries. Naisbitt's polished crystal ball saw the forthcoming trend, "High Tech/High Touch" that has much to teach healers, whether they work in traditional modalities or their more alternative counterparts.

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Full Title: Athletes Are Different: Factors That Differentiate Biofeedback/Neurofeedback for Sport Versus Clinical Practice

by Vietta Wilson, PhD, and Erik Peper, PhD

Biofeedback and neurofeedback training procedures are often different for athletes than for clinical patients. Athletes come to improve performance whereas patients come to reduce symptoms. This article outlines factors that distinguish work with athletes from work with clinical patients. The differences in training include the purpose of training, the nature of the participant in training, session design, and covert factors underlying the training. Unlike clients, athletes often do intensive transfer of learning training, between 2 and 6 hours of daily sport practice across days, weeks, and months. Although biofeedback and neurofeedback are important factors for enhancing peak performance, there are many covert and overt factors producing performance success such as motivation, intensity of training, ''A-ha'' experiences, experimental expectancy, behavioral consequences, and mastery learning. The training process with athletes is illustrated through a case example of a young tennis player who mastered control of his anger.

Full article.

by Tim Brunson, PhD

Frequently a person undergoes psychotherapy due to their inability to integrate life's experiences in a healthy and productive way. This is caused by problems with their values and beliefs, which are the patterns that they use to filter reality. I see these values and beliefs functioning as a lens, which both limits options and gives a rather incomplete and inaccurate view of the universe and its unlimited possibilities – which is the ultimate reality. Such a person regularly and inadequately accommodates and assimilates their perceptions, which survive the filtering process. This leaves them ill prepared to handle the breadth of life's experiences. Although psychotherapy should help a client or patient overcome this problem, too often it can contribute to its perpetuation.

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The purpose of this study was to investigate the use and perceived benefit of complimentary and alternative medicine (CAM) and physiotherapy treatments tried by people with chronic fatigue syndrome (CFS) to ease painful symptoms. This study used a descriptive, cross-sectional design. People with CFS who experienced pain were recruited to this study. Participants were asked during a semistructured interview about the treatments they had tried to relieve their pain. Each interview was conducted in the home of the participant. Fifty participants were recruited, of which, 10 participants were severely disabled by CFS. Eighteen participants were trying different forms of CAM treatment for pain relief at the time of assessment. Three participants were currently receiving physiotherapy. Throughout the duration of their illness 45 participants reported trying 19 different CAM treatments in the search for pain relief. Acupuncture was reported to provide the most pain relief (n=16). Twenty-seven participants reported a total of 16 different interventions prescribed by their physiotherapist. The results of this study suggest some physiotherapy and CAM treatments may help people manage painful CFS symptoms. Future research should be directed to evaluating the effectiveness of interventions such as acupuncture or gentle soft tissue therapies to reduce pain in people with CFS.

Physiother Theory Pract. 2011 Jul;27(5):373-83. Epub 2010 Nov 1. Marshall R, Paul L, Wood L. Physiotherapist, Research Assistant, Nursing & Health Care, Faculty of Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom.

Full title: Predicting successful learning of SMR neurofeedback in healthy participants: methodological considerations.

Neurofeedback (NF) is a tool that has proven helpful in the treatment of various disorders such as epilepsy or attention deficit disorder (ADHD). Depending on the respective application, a high number of training sessions might be necessary before participants can voluntarily modulate the electroencephalographic (EEG) rhythms as instructed. In addition, many individuals never learn to do so despite numerous training sessions. Thus, we are interested in determining whether or not performance during the early training sessions can be used to predict if a participant will learn to regulate the EEG rhythms. Here, we propose an easy to use, but accurate method for predicting the performance of individual participants. We used a sample set of sensorimotor rhythm (SMR 12-15 Hz) NF training sessions (experiment 1) to predict the performance of the participants of another study (experiment 2). We then used the data obtained in experiment 2 to predict the performance of participants in experiment 1. We correctly predicted the performance of 12 out of 13 participants in the first group and all 14 participants in the second group; however, we were not able to make these predictions before the end of the eleventh training session.

Appl Psychophysiol Biofeedback. 2011 Mar;36(1):37-45. Weber E, Köberl A, Frank S, Doppelmayr M. Department of Physiological Psychology, University of Salzburg, Hellbrunnerstrasse 34, Salzburg, Austria.

Full title: Prevalence of complementary medicine use in a phase 1 clinical trials program: The MD Anderson Cancer Center Experience.

BACKGROUND: A key end point of early cancer clinical trials is the assessment of toxicities and their possible association with new experimental drugs. Therefore, the concurrent use of complementary and alternative medicine (CAM) in patients with advanced malignancies seen in a dedicated phase 1 clinic was evaluated. METHODS: An investigator-designed survey was anonymously completed by patients seen in the phase 1 clinic. Pharmacologic CAM included any oral, topical, or intravenous agent, including vitamins, dietary supplements, and herbal products. Nonpharmacologic CAM included prayer, meditation, hypnosis, massage, and acupuncture. RESULTS: Of the 404 patients approached about completing the CAM survey, 394 (98%) agreed to respond, and 309 (78%) surveys were returned. Of those 309 patients, 162 (52%) used 1 or more CAM. Of the 162 CAM users, 77% utilized pharmacologic CAM, 71% used nonpharmacologic CAM, and 48% used both modalities. The most frequent CAM used were vitamins (70%), prayer (57%), and herbal products (26%). CAM utilization was not significantly associated with race, age, level of education, employment, or income level but was used more by women than men (P < .01). There was no statistically significant association between the use of CAM and quality of life as perceived by patients. Of the CAM users, 43% of patients had been using CAM for >5 years. Only 5% reported having side effects from using CAM, whereas 23% did not fully disclose their CAM use to their physicians. CONCLUSIONS: CAM usage is common in patients with advanced malignancies seen in a phase 1 clinic. Cancer 2011. © 2011 American Cancer Society.

Cancer. 2011 Apr 28. doi: 10.1002/cncr.26164. Naing A, Stephen SK, Frenkel M, Chandhasin C, Hong DS, Lei X, Falchook G, Wheler JJ, Fu S, Kurzrock R. Department of Investigational Cancer Therapeutics (Phase 1 Program), The University of Texas MD Anderson Cancer Center, Houston, Texas. anaing@mdanderson.org.

Research by Raz and his associates has repeatedly found that suggestions for hypnotic agnosia, administered to highly hypnotizable subjects, reduce or even eliminate Stroop interference. The present paper sought unsuccessfully to extend these findings to negative priming in the Stroop task. Nevertheless, the reduction of Stroop interference has broad theoretical implications, both for our understanding of automaticity and for the prospect of de-automatizing cognition in meditation and other altered states of consciousness.

Conscious Cogn. 2011 Jun;20(2):332-4. Epub 2010 Mar 30. Kihlstrom JF. Department of Psychology, University of California, Berkeley, 3210 Tolman Hall, MC 1650, Berkeley, CA 94720-1650, United States.

Full title: Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy - a systematic review of randomized controlled trials.

Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy - a systematic review of randomized controlled trials. Objective: To systematically review the evidence for MBSR and MBCT. Method: Systematic searches of Medline, PsycInfo and Embase were performed in October 2010. MBSR, MBCT and Mindfulness Meditation were key words. Only randomized controlled trials (RCT) using the standard MBSR/MBCT programme with a minimum of 33 participants were included. Results: The search produced 72 articles, of which 21 were included. MBSR improved mental health in 11 studies compared to wait list control or treatment as usual (TAU) and was as efficacious as active control group in three studies. MBCT reduced the risk of depressive relapse in two studies compared to TAU and was equally efficacious to TAU or an active control group in two studies. Overall, studies showed medium effect sizes. Among other limitations are lack of active control group and long-term follow-up in several studies. Conclusion: Evidence supports that MBSR improves mental health and MBCT prevents depressive relapse. Future RCTs should apply optimal design including active treatment for comparison, properly trained instructors and at least one-year follow-up. Future research should primarily tackle the question of whether mindfulness itself is a decisive ingredient by controlling against other active control conditions or true treatments.

Acta Psychiatr Scand. 2011 Apr 28. doi: 10.1111/j.1600-0447.2011.01704.x. Fjorback LO, Arendt M, Ornbøl E, Fink P, Walach H. The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aalborg Unit for Psychiatric Research, Aarhus University Hospital, Aalborg, Denmark Institute for Transcultural Health Studies, European University Viadrina, Frankfurt, Germany.

Abstract Objectives: Changes in gene expression after traditional Japanese massage therapy were investigated to clarify the mechanisms of the clinical effects of traditional Japanese massage therapy. Design: This was a pilot experimental study. Settings/location: The study was conducted in a laboratory at Tsukuba University of Technology. Subjects: The subjects were 2 healthy female volunteers (58-year-old Participant A, 55-year-old Participant B). Interventions: The intervention consisted of a 40-minute full-body massage using standard traditional Japanese massage techniques through the clothing and a 40-minute rest as a control, in which participants lie on the massage table without being massaged. Outcome measures: Before and after an intervention, blood was taken and analyzed by microarray: (1) The number of genes whose expression was more than double after the intervention than before was examined; (2) For those genes, gene ontology analysis identified statistically significant gene ontology terms. Results: The gene expression count in the total of 41,000 genes was 1256 genes for Participant A and 1778 for Participant B after traditional Japanese massage, and was 157 and 82 after the control, respectively. The significant gene ontology terms selected by both Participants A and B after massage were "immune response" and "immune system," whereas no gene ontology terms were selected by them in the control. Conclusions: It is implied that traditional Japanese massage therapy may affect the immune function. Further studies with more samples are necessary.

J Altern Complement Med. 2011 Jun;17(6):553-5. Epub 2011 May 19. Donoyama N, Ohkoshi N. 1 Course of Acupuncture and Moxibustion, Department of Health, Faculty of Health Sciences, Tsukuba University of Technology , Tsukuba, Ibaraki, Japan .

Full title: Complementary and alternative medicine: Perception and use by physiotherapists in the management of low back pain.

BACKGROUND AND PURPOSE: The aim of this survey was to investigate complementary and alternative medicine (CAM) use by physiotherapists for the treatment of low back pain (LBP). METHODS: Questionnaires (n=1000) were distributed to physiotherapists randomly selected from the UK's Organisation of Chartered Physiotherapists in Private Practice (OCPPP). Results were analysed by SPSS. RESULTS: A response rate of 46% was obtained (n=459). 94.3% of respondents stated that they currently treated LBP; the most common CAMs used by physiotherapists were acupuncture (46.9%) and massage (2.1%). Physiotherapists perceived acupuncture, massage, osteopathy, chiropractic and yoga to be effective in the treatment of LBP, but were unsure about the effectiveness of other CAMs. DISCUSSION AND CONCLUSION: Physiotherapists in this sample often use acupuncture and massage to treat LBP, but appear to have little knowledge of other CAMs. Physiotherapists use mainstream methods such as mobilization and massage which could be perceived as CAM depending on the physiotherapists' perceptions and training, as these therapies have also been used and investigated by CAM practitioners. More research is required on the use of CAM as little is known regarding the effectiveness of these therapies on LBP.

Complement Ther Med. 2011 Jun;19(3):149-54. Epub 2011 Apr 27. Hughes CM, Quinn F, Baxter GD. School of Health Sciences, University of Ulster, Shore Road, Newtownabbey, Co., Antrim BT37 OQB, United Kingdom.

Introduction. "Instrumental hypnosis" allows researchers to model clinical symptoms in the laboratory, creating "virtual patients" with reversible disturbances in, for example, perception, action, memory, or belief. We used hypnosis to temporarily recreate somatoparaphrenia, a delusional belief that one's own limb belongs to someone else. Methods. We compared a "Fully Formed" somatoparaphrenia suggestion with a "Factor 1 + Factor 2" suggestion that attempted to generate the delusional belief from analogues of its hypothesised underlying factors (i.e., paralysis plus disrupted critical belief evaluation). We tested and then challenged subjects' responses to these suggestions. Results. Although many hypnotic subjects experienced temporary paralysis, only a minority claimed their arm did not belong to them. Notably, the Fully Formed suggestion was more successful in recreating features of somatoparaphrenia than the Factor 1 + Factor 2 suggestion. In response to the challenges, some of those who developed temporary somatoparaphrenia maintained their belief throughout the hypnosis session. Conclusions. We discuss these findings in terms of the "two-factor" theory of delusions and we highlight the advantages versus disadvantages of using hypnosis to explore such delusional beliefs in the laboratory.

Cogn Neuropsychiatry. 2011 May 27:1-28. Rahmanovic A, Barnier AJ, Cox RE, Langdon RA, Coltheart M. Macquarie Centre for Cognitive Science (MACCS), Macquarie University, Sydney, Australia.

Full title: Exploring nursing staff's attitudes and use of music for older people with dementia in long-term care facilities.

Aims. This study aimed to explore nursing staff's attitudes and use of music for older people with dementia in long-term care facilities. Background. Music has shown positive outcomes in managing behavioural symptoms of older people with dementia. Older people living in long-term care facilities often do not have access to trained music therapists. Nursing staff provide the majority of direct care for institutionalised older people with dementia, therefore, will be the most appropriate personnel to learn and implement music therapy for those with dementia. To date, no studies have explored nursing staff's attitudes and use of music for those with dementia. Design. A cross-sectional research design was used. Methods. A convenience sample of 285 nursing staff caring for those with dementia in long-term care facilities in Taiwan were recruited. Participants received a self-administered questionnaire consisted of items exploring nursing staff's attitude and use of music for those with dementia. A total of 214 participants completed the questionnaires, giving a response rate of 75·1%. Results. Most nursing staff held positive attitudes towards use of music for older people with dementia (mean = 84·89, range 23-115), but only 30·6% (n = 66) had used music for those with dementia in practice. The majority perceived that they had limited knowledge and skills about use of music (72·9%). Over half of the participants reported that they lacked resources and time to implement music therapy in practice. Conclusions. Nursing staff need more formal training to use music for those with dementia. Nursing staff can be the suitable personnel to learn easily and implement music therapy as a part of routine activity programmes for those with dementia. Relevance to clinical practice. Appropriately trained nursing staff in long-term care facilities who use music therapy may help improve the mental health of older people with dementia.

J Clin Nurs. 2011 Jun;20(11-12):1776-1783. doi: 10.1111/j.1365-2702.2010.03633.x. Epub 2011 May 5. Sung HC, Lee WL, Chang SM, Smith GD. Authors: Huei-Chuan Sung, PhD, RN, Associate Professor, Department of Nursing, Tzu Chi College of Technology & Tzu Chi University and Supervisor, Department of Nursing, Tzu Chi Medical Centre; Wen-Li Lee, MSc, Senior Lecturer, Department of Radiological Technology, Tzu Chi College of Technology; Shu-Min Chang, MSN, RN, Senior Lecturer, Department of Nursing, Tzu Chi College of Technology, Hualien, Taiwan; Graeme D Smith, BA, PhD, RGN, Senior Lecturer, Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.

A certified NLP practitioner since l983, Jack Elias is recognized by the National Guild of Hypnotists and the Transpersonal Hypnotherapy Institute as a Clinical Hypnotherapist, and has trained in altered states processes and Ericksonian hypnosis. In addition, beginning in 1967 with five years of intensive Zen Buddhist practice, Jack continues over 40 years of practice and study of Buddhist and Siddha Yoga meditation and philosophy with recognized masters of these traditions. Jack offers private sessions for individuals, couples and families.

Author of the book and training program Finding True Magic, Jack Elias blends the insights and disciplines of hypnosis, NLP and a variety of meditative techniques to create a dynamic process of change for his clients and students.

Certified Transpersonal Hypnotherapist. Author of the highly regarded book, Finding True Magic: Transpersonal Hypnotherapy/NLP.

Bill O'Hanlon has authored or co-authored 30 books, the latest being Quick Steps to Resolving Trauma, A Guide to Trance Land; Pathways to Spirituality, Change 101: A Practical Guide to Creating Change, and Thriving Through Crisis. He has published 57 articles or book chapters.

His books have been translated into 15 languages: French, Spanish, Portuguese, Swedish, Finnish, German, Chinese, Bulgarian, Turkish, Korean, Indonesian, Italian, Croatian, Arabic and Japanese. He has appeared on Oprah (with his book Do One Thing Different), The Today Show, and a variety of other television and radio programs. Since 1977, Bill has given over 1,500 talks around the world. He has been a top-rated presenter at many national conferences and was awarded the 'Outstanding Mental Health Educator of the Year' in 2001 by the New England Educational Institute. Bill is a Licensed Mental Health Professional, Certified Professional Counselor, and a Licensed Marriage and Family Therapist. Bill is clinical member of AAMFT (and winner of the 2003 New Mexico AMFT Distinguished Service Award), certified by the National Board of Certified Clinical Hypnotherapists and a Fellow and a Board Member of the American Psychotherapy Association. He is known for his storytelling, irreverent humor, clear and accessible style and his boundless enthusiasm for whatever he is doing.

For more information visit: .

Full title: Patient characteristics and variation in treatment outcomes: which patients benefit most from acupuncture for chronic pain?

OBJECTIVES: The aim of this study was to identify patients' characteristics that increase or decrease their benefit from acupuncture treatment of chronic pain. METHODS: Patients with chronic low back pain, headache, neck pain, or pain due to osteoarthritis of the knee or hip, were included in 4 multicenter, randomized, controlled studies, all conducted in Germany. All patients received routine care; the patients randomized to the acupuncture group received additional acupuncture treatment. Data were pooled, and the main outcome was defined as the 3-month change from baseline of the SF-36 bodily pain subscale. To identify predictors for treatment effects and effect modifiers (ie, variables that interact with the form of treatment), patients' characteristics and their interaction with treatment were included in a mixed linear model to predict treatment outcome. RESULTS: A total of 9,990 patients who were treated by 2,781 physicians were analyzed. The outcome was markedly improved in the acupuncture group (P<0.001). Age, education, duration of illness, baseline pain, and some concomitant diseases predicted treatment outcome in both groups. Patients' characteristics that enlarged the acupuncture effect (ie, acted as effect modifiers) were being female (P=0.028), living in a multi-person household (P=0.002), failure of other therapies before the study (P=0.049), and former positive acupuncture experience (P=0.005). DISCUSSION: Future research to clarify the modifying effects with special focus on patients' expectations and other psychological variables is needed.

Clin J Pain. 2011 Jul-Aug;27(6):550-5. Witt CM, Schützler L, Lüdtke R, Wegscheider K, Willich SN. *Institute for Social Medicine, Epidemiology, and Health Economics, Charité Medical Center, Berlin †Carstens-Foundation, Essen ‡Institute for Medical Biometry and Epidemiology, University Hospital Eppendorf, Hamburg, Germany.

In this paper, we present a new, low-cost dry electrode for EEG that is made of flexible metal-coated polymer bristles. We examine various standard EEG paradigms, such as capturing occipital alpha rhythms, testing for event-related potentials in an auditory oddball paradigm and performing a sensory motor rhythm-based event-related (de-) synchronization paradigm to validate the performance of the novel electrodes in terms of signal quality. Our findings suggest that the dry electrodes that we developed result in high-quality EEG recordings and are thus suitable for a wide range of EEG studies and BCI applications. Furthermore, due to the flexibility of the novel electrodes, greater comfort is achieved in some subjects, this being essential for long-term use.

J Neural Eng. 2011 Apr;8(2):025008. Epub 2011 Mar 24. Grozea C, Voinescu CD, Fazli S. Fraunhofer Institute FIRST, Kekulestrasse 7, Berlin 12489, Germany. cristian.grozea@first.fraunhofer.de

Full title: Use of antioxidant and other complementary medicine by patients treated by antitumor chemotherapy: a prospective study.

Use of complementary and alternative medicine (CAM) has been reported to be more and more frequent among cancer patients in USA. The aim of this study was to analyze among French cancer patients the prevalence of CAM use, focusing on antioxidants (AO) that could interfere with antitumor agents. Seventy-nine patients, treated by antitumor chemotherapy in oncology day care unit, participated to an interview (medium age?=?60 years old). CAM use was reported by 42% of patients: mostly AO (24%) (selenium, green tea and vitamins ACE, more specifically), but also relaxation, acupuncture, hypnosis (19%) and homeopathy (15%). Among patients using CAM, 66% of them indicated that their physicians were not aware of this use and 47% of them thought that CAM use was safe. Nevertheless, for seven patients who have taken AO, previous in vitro and preclinical studies suggested interactions with antitumor chemotherapy. Therefore, CAM use and, more specifically, AO use is common among cancer patients treated by antitumor chemotherapy in France. Nevertheless, AO could generate interactions with conventional treatment. Clinical studies are warranted to evaluate these interactions, and adequate communication with patients is needed.

Bull Cancer. 2011 Jun 3. Thomas-Schoemann A, Alexandre J, Mongaret C, Azibi S, Dauphin A, Goldwasser F, Lemare F. Hôpital Cochin, service de pharmacie, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, FranceHôpital Cochin, service de pharmacie, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, FranceHôpital Cochin, service de pharmacie, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.

The objective of this study was to assess the effect of Buddhist group therapy on patients with type 2 diabetes who had depressive symptoms. A quasi-experimental design study using a control group with matching technique was conducted. After informed consent was obtained, the "Nine questions for assessing depressive disorder symptom" (Isan language) was used to determine the patient's condition. A total of 62 patients with type 2 diabetes who had depressive symptoms were assigned to either the experimental group (n = 32) or the control group (n = 32). Patients in the experimental group were divided further into four groups (8 patients per group) and attended the Buddhist group therapy. The intervention consisted of a weekly Buddhist group gathering lasting 2 hours for 6 weeks plus home meditation practices. Patients in the control group received treatment as usual. Both groups received standard physician treatment, including medication. Physicians did not know who was in either the control or experimental groups. Results show that 6 months after the intervention, 65.6% and 100% of patients in the control group and experimental group, respectively, returned to normal level. The intention-to-treat analysis, which included two participants in the experimental group lost follow-up, yielded a small reduction in the number of patients who returned to normal level (93.8%). With intention-to-treat analysis, the relative risk on depressive symptoms between the experimental and control groups was 6.5 (95% confidence interval, 1.4-30.6). Qualitative data from the experimental group supported that there were therapeutic group factors involved. However, patients realized the truth of being oneself and also accepted their current living condition. In conclusion, this program is effective in reducing depressive symptoms.

Arch Psychiatr Nurs. 2011 Jun;25(3):195-205. Epub 2010 Nov 5. Rungreangkulkij S, Wongtakee W, Thongyot S.

Enzo Melandri represents an atypical route in Italian epistemology. Critic of neopositivism, he studied the relations between symbolic formations of theories and actual experience via the concept of schematism. He aimed to reincorporate science into the totality of praxis by articulating a phenomonology and archeology of knowledge. Epistemology thus becomes a meditation on the meaning of scientific reason and on its links to society.

Rev Synth. 2011 May;132(2):255-275. Cavazzini A. cavazz.a@tin.it.

Abstract Background: Several systematic reviews of acupuncture as a treatment of insomnia have recently emerged. Their results are far from uniform. Aim: To summarize and critically evaluate these reviews with a view of defining the reasons for their discrepant conclusions and providing an overall verdict about the therapeutic value of acupuncture for insomnia. Methods: Thirteen electronic databases (Medline, Embase, Amed, CINHAL, Health Technology Assessments, DARE, Cochrane, six Korean/Chinese databases) were searched for relevant articles and data from the included reviews were extracted according to pre-defined criteria. Their methodological quality was assessed using the 'Overview Quality Assessment Questionnaire'. Results: Ten systematic reviews of acupuncture for insomnia were published between 2003 and 2010. They differed in numerous respects. Several reviews draw strongly positive conclusions. Owing to these several caveats, the best evidence is, however, not clearly positive. Conclusion: The evidence for acupuncture as a treatment of insomnia is plagued by important limitations, e.g. the poor quality of most primary studies and some systematic reviews. Those that are sensitive to such limitations, fail to arrive at a positive verdict about the effectiveness of acupuncture.

Eur J Gen Pract. 2011 Jun;17(2):116-23. Epub 2011 Apr 4. Ernst E, Lee MS, Choi TY. Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter, UK.

Full title: Conservative management of post-surgical urinary incontinence in an adolescent using applied kinesiology: a case report.

INTRODUCTION: This case report describes the successful treatment of an adolescent female suffering daily stress and occasional total urinary incontinence with applied kinesiology methods and chiropractic manipulative therapy. PATIENT PRESENTATION: A 13-year-old female developed unpredictable urinary incontinence and right hip pain immediately following emergency open appendectomy surgery. The patient was forced to wear an incontinence pad throughout the day and night for 10 months because of unpredictable urinary incontinence. ASSESSMENT AND INTERVENTION: Chiropractic and applied kinesiology (AK) methods - a multi-modal diagnostic technique that utilizes manual muscle tests (MMT) for the detection of musculoskeletal impairments and specific AK techniques for correction of identified issues - were utilized to diagnose and treat this patient for muscle impairments in the lumbar spine and pelvis. RESULTS: Patient experienced a rapid resolution of her urinary incontinence and hip pain. A six-year follow-up confirmed complete resolution of symptoms. DISCUSSION: In this case, utilization of MMT allowed for the identification of several inhibited muscles. Utilizing the appropriate corrective techniques improved the strength of these muscles and resulted in their being graded as facilitated. Symptoms of urinary incontinence and hip pain resolved with this diagnostic and treatment approach. CONCLUSION: AK methods were useful for the discovery of a number of apparent causative factors underlying this patient's urinary incontinence and hip pain. Treatment for these pelvic-floor muscle and joint abnormalities resulted in rapid, long-lasting resolution of her urinary incontinence and hip pain.

Altern Med Rev. 2011 Jun;16(2):164-71. Cuthbert SC, Rosner AL. cranialdc@hotmail.com.