Integrative medicine at academic health centers: a survey of clinicians’ educational backgrounds and practices.

Fam Med. 2013 May;45(5):330-4

Authors: Ehrlich G, Callender T, Gaster B

Abstract

BACKGROUND AND OBJECTIVES: Integrative medicine is a relatively new field that seeks to combine conventional and nonconventional approaches to patient care. Many academic health centers have now established integrative medicine clinics, yet little is known about the clinicians who practice at them. We used a nationwide survey to characterize the backgrounds, clinical practices, and involvement in research and education of clinicians who practice integrative medicine at academic health centers.

METHODS: Participants included clinicians (MDs, DOs, PAs, and nurse practitioners) who practice at 30 different integrative medicine clinics that are affiliated with academic health centers.

RESULTS: Completed surveys from 136 of 162 clinicians were received (84% response rate). The integrative therapies that clinicians most often reported providing themselves were breathing exercises (66%), herbal medicine prescribing (61%), meditation (44%), and functional medicine (34%). The integrative therapies that clinicians most often referred their patients for were acupuncture (96%), massage (92%), yoga (85%), and meditation (79%). Respondents reported spending a mean of 20% of their time training medical students, and 63% had participated in research in the past year.

CONCLUSIONS: This survey provides the first national assessment of clinicians practicing integrative medicine at academic health centers. These clinicians use a wide variety of complementary and alternative therapies and appear involved in the research and education missions of their academic health centers.

PMID: 23681684 [PubMed - in process]

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Dance Recognition System Using Lower Body Movement.

J Appl Biomech. 2013 May 13;

Authors: Simpson TT, Wiesner SL, Bennett BC

Abstract

The current means of locating specific movements in film necessitate hours of viewing, making the task of conducting research into movement characteristics and patterns tedious and difficult. This is particularly problematic for the research and analysis of complex movement systems such as sports and dance. While some systems have been developed to manually annotate film, to date no automated way of identifying complex, full body movement exists. With pattern recognition technology and knowledge of joint locations, automatically describing filmed movement using computer software is possible. This study utilized various forms of lower body kinematic analysis to identify codified dance movements. We created an algorithm that compares an unknown move with a specified start and stop against known dance moves. Our recognition method consists of classification and template correlation using a database of model moves. This system was optimized to include nearly 90 dance and Tai Chi Chuan movements, producing accurate name identification in over 97% of trials. In addition, the program had the capability to provide a kinematic description of either matched or unmatched moves obtained from classification recognition. (179).

PMID: 23676192 [PubMed - as supplied by publisher]

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Related Articles

Can social dancing prevent falls in older adults? a protocol of the Dance, Aging, Cognition, Economics (DAnCE) fall prevention randomised controlled trial.

BMC Public Health. 2013 May 15;13(1):477

Authors: Merom D, Cumming R, Mathieu E, Anstey KJ, Rissel C, Simpson JM, Morton RL, Cerin E, Sherrington C, Lord SR

Abstract

BACKGROUND: Falls are one of the most common health problems among older people and pose a major economic burden on health care systems. Exercise is an accepted stand-alone fall prevention strategy particularly if it is balance training or regular participation in Tai chi. Dance shares the ‘holistic’ approach of practices such as Tai chi. It is a complex sensorimotor rhythmic activity integrating multiple physical, cognitive and social elements. Small-scale randomised controlled trials have indicated that diverse dance styles can improve measures of balance and mobility in older people, but none of these studies has examined the effect of dance on falls or cognition. This study aims to determine whether participation in social dancing: i) reduces the number of falls; and ii) improves cognitive functions associated with fall risk in older people.Methods/design: A single-blind, cluster randomised controlled trial of 12 months duration will be conducted. Approximately 450 participants will be recruited from 24 self-care retirement villages that house at least 60 residents each in Sydney, Australia. Village residents without cognitive impairment and obtain medical clearance will be eligible. After comprehensive baseline measurements including physiological and cognitive tests and self-completed questionnaires, villages will be randomised to intervention sites (ballroom or folk dance) or to a wait-listed control using a computer randomisation method that minimises imbalances between villages based on two baseline fall risk measures. Main outcome measures are falls, prospectively measured, and the Trail Making cognitive function test. Cost-effectiveness and cost-utility analyses will be performed. DISCUSSION: This study offers a novel approach to balance training for older people. As a community-based approach to fall prevention, dance offers older people an opportunity for greater social engagement, thereby making a major contribution to healthy ageing. Providing diversity in exercise programs targeting seniors recognises the heterogeneity of multicultural populations and may further increase the number of taking part in dance classes.Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12612000889853The trial is now in progress with 12 villages already have been randomised.

PMID: 23675705 [PubMed - as supplied by publisher]

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Qigong as a novel intervention for service members with mild traumatic brain injury.

Explore (NY). 2013 May-Jun;9(3):142-9

Authors: Yost TL, Taylor AG

Abstract

PURPOSE: To describe the experience of internal qigong practice in service members diagnosed with mild traumatic brain injury (mTBI).

THEORETICAL FRAMEWORK: The study used qualitative descriptive phenomenological methods originally described by Husserl and later refined by Giorgi.

METHODOLOGY: Participants were interviewed about their experiences while learning qigong to determine their level of interest, benefits, and/or adverse effects; ease of learning/performing the routine; and any barriers to practice.

SAMPLE: Six service members with mTBI receiving outpatient neurorehabilitation at the Defense and Veterans Brain Injury Center-Charlottesville Rehabilitation Center.

INTERVENTION: Participants learned Reflective Exercise Qigong, a form of qigong developed specifically to require less complex movement and balance than most forms of qigong, making it ideal for those with potential coordination and balance issues.

DATA COLLECTION: Semistructured interviews took place after four weeks of formal qigong instruction, then again after the subjects completed eight weeks. Interview data were analyzed with phenomenological methods described by Giorgi.

RESULTS: Four themes emerged from the interview data: “the physical experience of qigong,” “regaining control,” “no pain, a lot of gain,” and “barriers to qigong practice.” Participants offered examples of how qigong enabled them to control refractory symptoms after mTBI while decreasing reliance on pharmacotherapy. All agreed that qigong was uniquely conducive to the disciplined mindset of military service members and that the simplicity of Reflective Exercise qigong, compared with similar modalities such as tai chi and yoga, was well suited to individuals with decreased balance, cognition, and memory related to mTBI.

PMID: 23643369 [PubMed - in process]

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An Observational Study of the Health Benefits of Yoga or Tai Chi Compared With Aerobic Exercise in Community-Dwelling Middle-Aged and Older Adults.

Am J Geriatr Psychiatry. 2013 May 1;

Authors: Siddarth D, Siddarth P, Lavretsky H

PMID: 23642461 [PubMed - as supplied by publisher]

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Gene expression profiling and pathway analysis of hepatotoxicity induced by triptolide in Wistar rats.

Food Chem Toxicol. 2013 Apr 29;

Authors: Wang J, Jiang Z, Ji J, Wang X, Wang T, Zhang Y, Tai T, Chen M, Sun L, Li X, Zhang L

Abstract

Triptolide (TP), a major component of TWHF, is widely used to treat rheumatoid arthritis, systemic lupus erythematosus, nephritis and leprosy. However, its clinical use is limited by hepatotoxicity. To further elucidate the underlying mechanism of its hepatotoxic effects, hepatic gene expression profiles were analyzed. TP (1000 and 300 μg/kg) was orally administered to Wistar rats for 14 days. Current study indicated that female rats were more sensitive to TP-induced hepatotoxicity than males. Genome-wide microarray analyses identified 3329 differentially expressed genes in liver of female rats. Analyses of these genes identified over-represented functions associated with insulin signaling pathway, glucose metabolism, cell cycle, oxidative stress and apoptosis, which were consistent with the results of significant increase of Caspase-3 activity and reduction of serum glucose, GSH/GSSG ratio, glucose-6-phosphatase and phosphoenolpyruvate carboxykinase activities, liver glycogen. In addition, it was observed for the first time that glucocorticoids and IGF1 might get involved in TP-induced hepatotoxicity. These data suggest that TP treatment could alter the hepatic redox status, reduce serum glucose and induce hepatocyte apoptosis, consistent with the differential expression of genes involved in insulin signaling pathway, glucose metabolism pathway and cell stress pathway, all of which might contribute to the overall TP-induced hepatotoxicity.

PMID: 23639586 [PubMed - as supplied by publisher]

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[Fall Risk and Fracture. Aging and fall/fracture].

Clin Calcium. 2013 May;23(5):653-60

Authors: Kozaki K

Abstract

Fall deteriorates QOL and ADL of elderly people, especially when they suffer from hip and vertebral fractures. It is not easy to identify the cause of falling, because falling usually result from multiple factors. Among various potential causes, osteoporosis, osteoarthritis, medication of hypnotic drugs, and environmental factors are important, because they are frequent and can be modifiable. When evaluating fall risks, grasping power, one-leg standing time, timed up&go test, are useful. On the other hand, fall risk index, 22-item self-assessment test, is easy and even better in predicting future falls. In the Cochrane systematic review article 2009, exercise such as Tai-Chi, withdrawal of hypnotic drugs, and vitamin D supplementation are shown to prevent falls in community-dwelling elderly.

PMID: 23628677 [PubMed - in process]

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Effects of tai chi in patients with chronic obstructive pulmonary disease: preliminary evidence.

PLoS One. 2013;8(4):e61806

Authors: Yan JH, Guo YZ, Yao HM, Pan L

Abstract

BACKGROUND: Currently, several studies assessed the role of Tai Chi (TC) in management of chronic obstructive pulmonary disease, but these studies have wide variation of sample and convey inconclusive results. We therefore undertook a meta-analysis to assess the effects of TC.

METHODS: A computerized search through electronic databases was performed to obtain sample studies. The primary outcomes were 6-min walking distance (6MWD) and dyspnea. Secondary outcomes included health-related quality of life and pre-bronchodilator spirometry. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated and heterogeneity was assessed with the I(2) test. A random-effects meta-analysis model was applied.

RESULTS: Eight randomized controlled trials involving 544 patients met the inclusion criteria. The pooled WMDs were 34.22 m (95% CI 21.25-47.20, P<0.00001) for 6 MWD, -0.86 units (95% CI -1.44–0.28, P = 0.004) for dyspnea, 70 ml (95% CI 0.02-0.13, P = 0.01) for FEV1, 120 ml (95% CI 0.00-0.23, P = 0.04) for FVC. TC significantly improved the Chronic Respiratory Disease Questionnaire total score, and the St George’s Respiratory Questionnaire score except impact score.

CONCLUSIONS: Findings suggest that TC may provide an effective alternative means to achieve results similar to those reported following participation in pulmonary rehabilitation programs. Further studies are needed to substantiate the preliminary findings and investigate the long-term effects of TC.

PMID: 23626732 [PubMed - in process]

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Qi Talks, the NQA’s monthly tele-seminar series. Call in and join us each month as we present leaders from the world of the Energetic Arts for an hour of information, discussion and Q & A.

Register for Qi Talks

Qi Talks Schedule:

• June 6: Daisy Lee: Women and Qigong
• July 11: Michael McComiskey: Walt Disney Was Right… The Universe Is Magical: Qigong As A Spiritual Practice

Each talk is scheduled on a Thursday evening  from 8:30 – 9:30 PM EDT. Register for Qi Talks

Archives:

• April 11, 2013: Qigong For Recovery with Mark R Reinhart
• May 9, 2013: Shoshanna Katzman — Cultivating Intention: Qi Mind, Qi Body