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Wang Y, Liu Y, Zhou K, Bauer BA, Liu B, Su T, Mo Q, Liu Z. The duration of acupuncture effects and its associated factors in chronic severe functional constipation: secondary analysis of a randomized controlled trial. Therap Adv Gastroenterol 2019; 12:1756284819881859. [PMID: 31636713 PMCID: PMC6785923 DOI: 10.1177/1756284819881859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 09/18/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Electroacupuncture (EA) has been shown to improve complete spontaneous bowel movements (CSBMs), but the duration of its effects remains unknown. The objective of this study was to explore the duration of acupuncture effects after treatment and its associated factors for chronic severe functional constipation (CSFC). METHODS This was a secondary analysis of a multicenter, randomized, sham-acupuncture (SA) controlled trial that included 1075 participants with CSFC. The primary outcome, the duration of acupuncture effects after treatment, was the number of weeks during the 12-week follow-up period that participants were to meet the weekly CSBM responder criteria. A weekly CSBM responder was defined as a participant who had at least three CSBMs for a given week and an increase from baseline of at least one CSBM for that same week. We performed a retrospective multivariate analysis to explore potential factors associated with sustained acupuncture effects. RESULTS The duration of acupuncture effects in the EA group (5.5 weeks) was significantly higher than the duration of SA effects in the SA group (2.2 weeks) with a between-group difference of 3.2 weeks (95% CI, 2.77-3.78; p < 0.001). A younger age and higher baseline CSBMs per week [regression coefficient (RC) -0.06, 95% confidence interval (CI) (-0.06 to -0.04); RC 2.43, 95% CI 1.78-3.60; respectively] were associated with longer durations of acupuncture effects. CONCLUSIONS EA had sustained post-treatment effects for CFSC. A significant association among a younger age, higher baseline CSBMs and sustained acupuncture effects was observed. Further research is needed to confirm the association. TRIAL REGISTRATION ClinicalTrials.gov (NCT01726504). Registered on 26 August 2012.
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Nanda S, Mahapatra S, Lindeen SA, Bernau JL, Cutshall SM, Schierwater B, Chon TY, Wahner-Roedler DL, Bauer BA. Evaluation of a Novel Wellness Assessment Device (Preventiometer): A Feasibility Pilot Study. Glob Adv Health Med 2019; 8:2164956119881096. [PMID: 31637111 PMCID: PMC6785912 DOI: 10.1177/2164956119881096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/14/2019] [Accepted: 09/05/2019] [Indexed: 12/20/2022] Open
Abstract
Background Periodic wellness assessments can provide an estimate of a person’s relative risks for major diseases, but wellness visits are underused. Our suggestion is to use a comprehensive device during a single visit. Objective The goal of this pilot study was to evaluate the feasibility of a novel one-stop wellness device (Preventiometer; iPEx5 GmbH, Greifswald, Germany) for performing multiple tests and providing a comprehensive wellness assessment in a short period. Methods A Preventiometer was used to provide wellness assessments for 10 healthy volunteers who then answered a 25-question survey to rate their satisfaction with the testing and their overall impression. Results All volunteers agreed or strongly agreed with the following: The assessment reports were easy to understand, the Preventiometer met their satisfaction, the participants were comfortable during the assessment, and all measurements and testing were well coordinated. Participants liked the instant test result feature. Most (90%) agreed that the machine was useful for a quick health assessment for busy people, and 70% felt that it was time efficient. Conclusion In this feasibility pilot study, the Preventiometer performed multiple tasks and provided a comprehensive wellness assessment in a short period. Participants reported remarkably high satisfaction with the tests. A larger study is needed to prove that this is a pragmatic approach to help individuals improve their health.
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Yang J, Chon TY, Li G, Mallory MJ, Bublitz SE, Do A, Xiao L, Xiong D, Bauer BA. Tai Chi for patients with mild cognitive impairment: A protocol for a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2019; 98:e17118. [PMID: 31577701 PMCID: PMC6783215 DOI: 10.1097/md.0000000000017118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 08/19/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is an intermediate stage between the cognitive changes of normal aging and early dementia. Tai Chi (TC) may be particularly beneficial to patients with MCI due to its whole-body coordination characteristics. This systematic review protocol aims to outline the methods that will be used to assess the comparative effectiveness and safety of TC for MCI through a systematic review and meta-analysis. METHODS A systematic review will identify and evaluate randomized controlled trials (RCTs) that examined the effects and safety of TC compared to a placebo, conventional treatment, and no treatment on cognitive function in individuals with MCI. Studies from databases of MEDLINE, PubMed, Embase, Global Health, Cochrane Library, and Scopus from January 1990 to March 2019 reported in English will be searched. Two independent reviewers will screen the studies for inclusion with the eligibility criteria and extract data. Risk of bias of individual studies will be assessed in line with Cochrane risk of bias tool. The overall quality of cumulative evidence will be assessed using selected Grading of Recommendations, Assessment, Development, and Evaluations criteria. Statistics will be used for heterogeneity assessment, sensitivity analysis, data synthesis, generating funnel plots, and subgroup analysis. Meta-analysis will be performed, if sufficiently homogeneous studies are found. A narrative synthesis will be conducted, grouping studies by exposure and outcome definitions, and describing any differences by subgroups. RESULTS This study will provide practical and targeted evidence in investigating the impact of TC exercise for individuals with MCI. CONCLUSION The findings of our study will provide updated evidence to determine whether TC is an effective intervention to patients with MCI. TRIAL REGISTRATION NUMBER International Prospective Register for Systematic Reviews (PROSPERO) number CRD42019125104.
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Yang J, Chon TY, Bauer BA. Use of Acupuncture in Overweight/Obese Women with Polycystic Ovary Syndrome. Med Acupunct 2019; 31:267-268. [PMID: 31624524 DOI: 10.1089/acu.2019.1375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Overweight/obesity has been identified as the most common chronic condition associated with patients who have polycystic ovary syndrome (PCOS). This increases the overall cost of public health care. While current effective and safe conventional medical treatments for overweight and obesity exist, such treatments are limited because of their poor feasibility and side-effects. As a complementary therapy, acupuncture has recently received overwhelming attention to assist weight loss in women who have PCOS, as well as addressing other elements of the disorder, such as stress, irregular menstrual cycles, and infertility. Despite acupuncture's efficacy and safety, questions remain as to its robust evidence. Therefore, the purpose of this clinical commentary is to summarize the current status of associated clinical practices and the action mechanisms of acupuncture treatment for weight control in patient with PCOS. This commentary also outlines relevant concerns for future research.
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VanDolah HJ, Bauer BA, Mauck KF. Clinicians' Guide to Cannabidiol and Hemp Oils. Mayo Clin Proc 2019; 94:1840-1851. [PMID: 31447137 DOI: 10.1016/j.mayocp.2019.01.003] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/03/2018] [Accepted: 01/04/2019] [Indexed: 01/05/2023]
Abstract
Cannabidiol (CBD) oils are low tetrahydrocannabinol products derived from Cannabis sativa that have become very popular over the past few years. Patients report relief for a variety of conditions, particularly pain, without the intoxicating adverse effects of medical marijuana. In June 2018, the first CBD-based drug, Epidiolex, was approved by the US Food and Drug Administration for treatment of rare, severe epilepsy, further putting the spotlight on CBD and hemp oils. There is a growing body of preclinical and clinical evidence to support use of CBD oils for many conditions, suggesting its potential role as another option for treating challenging chronic pain or opioid addiction. Care must be taken when directing patients toward CBD products because there is little regulation, and studies have found inaccurate labeling of CBD and tetrahydrocannabinol quantities. This article provides an overview of the scientific work on cannabinoids, CBD, and hemp oil and the distinction between marijuana, hemp, and the different components of CBD and hemp oil products. We summarize the current legal status of CBD and hemp oils in the United States and provide a guide to identifying higher-quality products so that clinicians can advise their patients on the safest and most evidence-based formulations. This review is based on a PubMed search using the terms CBD, cannabidiol, hemp oil, and medical marijuana. Articles were screened for relevance, and those with the most up-to-date information were selected for inclusion.
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Bingener-Casey J, Bauer BA, Cutshall SM, Skaran PE, Cheville AL, Sloan JA. The feasibility of individualized prehabilitation for patients undergoing gastrointestinal cancer resections: a pilot study. MINERVA CHIR 2019; 74:112-113. [PMID: 30646679 DOI: 10.23736/s0026-4733.18.07584-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Chesak SS, Khalsa TK, Bhagra A, Jenkins SM, Bauer BA, Sood A. Stress Management and Resiliency Training for public school teachers and staff: A novel intervention to enhance resilience and positively impact student interactions. Complement Ther Clin Pract 2019; 37:32-38. [PMID: 31445365 DOI: 10.1016/j.ctcp.2019.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Burnout in teachers has been linked to decreased effectiveness as educators, and suboptimal interactions with students. The purpose of this pilot study was to assess the outcomes of a brief Stress Management and Resiliency Training (SMART) program for public school staff. MATERIALS AND METHODS This single-arm, prospective trial involved an investigation of the effects of a brief SMART program on participant stress, anxiety, resilience, gratitude, happiness, life satisfaction, and quality of life (QOL). RESULTS Significant improvements were noted in participant anxiety (P < 0.001), stress (P = 0.003), gratitude (P = 0.001), happiness (P < 0.001), life satisfaction (P < 0.001), and QOL (P < 0.001). Most participants reported that the skills learned positively affected interactions with students (77.2%) and coworkers (72.2%). CONCLUSIONS The SMART program showed promising effectiveness for improving anxiety, stress, gratitude, happiness, life satisfaction and QOL. Given the prevalence and impact of teacher burnout, larger, controlled trials and broader dissemination of the intervention are warranted.
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Pearson ACS, Cutshall SM, Hooten WM, Rodgers NJ, Bauer BA, Bhagra A. Perspectives on the use of aromatherapy from clinicians attending an integrative medicine continuing education event. Altern Ther Health Med 2019; 19:174. [PMID: 31299970 PMCID: PMC6625079 DOI: 10.1186/s12906-019-2572-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 06/23/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND The use of essential oils is growing in the United States, but clinician attitudes, experience, and beliefs regarding their use have not previously been studied. METHODS One hundred five of 106 clinician attendees (99.1%) of an integrative medicine continuing education conference were surveyed using an audience response system to obtain baseline information. Response frequencies of each item were reported. Nonparametric correlations were assessed comparing the statement "In the last 12 months, I have used essential oils for myself and/or my family" with the other agree/disagree statements using Spearman's rho. RESULTS A majority of participants personally used integrative medicine approaches other than aromatherapy (92.6%) and recommended them clinically (96.8%). Most had personally used essential oils (61%) and wished to offer essential oil recommendations or therapies to their patients (74.0%). Only 21.9% felt confident in their ability to counsel patients on safe use. Personal use of essential oils was highly correlated with confidence in the ability to counsel patients on safe use (Spearman coefficient 0.376, P = 0.000). CONCLUSIONS This study indicates that clinicians interested in integrative medicine desire to provide aromatherapy recommendations, but do not feel confident in their ability to do so.
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Stern SA, Weaver HA, Spencer JR, Olkin CB, Gladstone GR, Grundy WM, Moore JM, Cruikshank DP, Elliott HA, McKinnon WB, Parker JW, Verbiscer AJ, Young LA, Aguilar DA, Albers JM, Andert T, Andrews JP, Bagenal F, Banks ME, Bauer BA, Bauman JA, Bechtold KE, Beddingfield CB, Behrooz N, Beisser KB, Benecchi SD, Bernardoni E, Beyer RA, Bhaskaran S, Bierson CJ, Binzel RP, Birath EM, Bird MK, Boone DR, Bowman AF, Bray VJ, Britt DT, Brown LE, Buckley MR, Buie MW, Buratti BJ, Burke LM, Bushman SS, Carcich B, Chaikin AL, Chavez CL, Cheng AF, Colwell EJ, Conard SJ, Conner MP, Conrad CA, Cook JC, Cooper SB, Custodio OS, Dalle Ore CM, Deboy CC, Dharmavaram P, Dhingra RD, Dunn GF, Earle AM, Egan AF, Eisig J, El-Maarry MR, Engelbrecht C, Enke BL, Ercol CJ, Fattig ED, Ferrell CL, Finley TJ, Firer J, Fischetti J, Folkner WM, Fosbury MN, Fountain GH, Freeze JM, Gabasova L, Glaze LS, Green JL, Griffith GA, Guo Y, Hahn M, Hals DW, Hamilton DP, Hamilton SA, Hanley JJ, Harch A, Harmon KA, Hart HM, Hayes J, Hersman CB, Hill ME, Hill TA, Hofgartner JD, Holdridge ME, Horányi M, Hosadurga A, Howard AD, Howett CJA, Jaskulek SE, Jennings DE, Jensen JR, Jones MR, Kang HK, Katz DJ, Kaufmann DE, Kavelaars JJ, Keane JT, Keleher GP, Kinczyk M, Kochte MC, Kollmann P, Krimigis SM, Kruizinga GL, Kusnierkiewicz DY, Lahr MS, Lauer TR, Lawrence GB, Lee JE, Lessac-Chenen EJ, Linscott IR, Lisse CM, Lunsford AW, Mages DM, Mallder VA, Martin NP, May BH, McComas DJ, McNutt RL, Mehoke DS, Mehoke TS, Nelson DS, Nguyen HD, Núñez JI, Ocampo AC, Owen WM, Oxton GK, Parker AH, Pätzold M, Pelgrift JY, Pelletier FJ, Pineau JP, Piquette MR, Porter SB, Protopapa S, Quirico E, Redfern JA, Regiec AL, Reitsema HJ, Reuter DC, Richardson DC, Riedel JE, Ritterbush MA, Robbins SJ, Rodgers DJ, Rogers GD, Rose DM, Rosendall PE, Runyon KD, Ryschkewitsch MG, Saina MM, Salinas MJ, Schenk PM, Scherrer JR, Schlei WR, Schmitt B, Schultz DJ, Schurr DC, Scipioni F, Sepan RL, Shelton RG, Showalter MR, Simon M, Singer KN, Stahlheber EW, Stanbridge DR, Stansberry JA, Steffl AJ, Strobel DF, Stothoff MM, Stryk T, Stuart JR, Summers ME, Tapley MB, Taylor A, Taylor HW, Tedford RM, Throop HB, Turner LS, Umurhan OM, Van Eck J, Velez D, Versteeg MH, Vincent MA, Webbert RW, Weidner SE, Weigle GE, Wendel JR, White OL, Whittenburg KE, Williams BG, Williams KE, Williams SP, Winters HL, Zangari AM, Zurbuchen TH. Initial results from the New Horizons exploration of 2014 MU 69, a small Kuiper Belt object. Science 2019; 364:364/6441/eaaw9771. [PMID: 31097641 DOI: 10.1126/science.aaw9771] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/16/2019] [Indexed: 11/02/2022]
Abstract
The Kuiper Belt is a distant region of the outer Solar System. On 1 January 2019, the New Horizons spacecraft flew close to (486958) 2014 MU69, a cold classical Kuiper Belt object approximately 30 kilometers in diameter. Such objects have never been substantially heated by the Sun and are therefore well preserved since their formation. We describe initial results from these encounter observations. MU69 is a bilobed contact binary with a flattened shape, discrete geological units, and noticeable albedo heterogeneity. However, there is little surface color or compositional heterogeneity. No evidence for satellites, rings or other dust structures, a gas coma, or solar wind interactions was detected. MU69's origin appears consistent with pebble cloud collapse followed by a low-velocity merger of its two lobes.
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Kim K, Shin KM, Hunt CL, Wang Z, Bauer BA, Kwon O, Lee JH, Seo BN, Jung SY, Youn Y, Lee SH, Choi JC, Jung JE, Kim J, Qu W, Kim TH, Eldrige JS. Nonsurgical integrative inpatient treatments for symptomatic lumbar spinal stenosis: a multi-arm randomized controlled pilot trial. J Pain Res 2019; 12:1103-1113. [PMID: 30992679 PMCID: PMC6445233 DOI: 10.2147/jpr.s173178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background Lumbar spinal stenosis (LSS) is a chronic condition that causes low back pain and neurogenic claudication, often resulting in significant limitation of daily activities. In this open-label randomized controlled pilot study, we assessed the safety and feasibility of 4-week novel integrative inpatient treatments for LSS. Methods Thirty-six symptomatic LSS patients were randomly and equally allocated to one of the three groups: Mokhuri Chuna treatment 1 (MT1) group, Mokhuri Chuna treatment 2 (MT2) group, or conventional management treatment (CMT) group. MT1 patients were treated with herbal medication, Mokhuri Chuna, and acupuncture, and received daily physician consultation; MT2 patients were treated with Mokhuri Chuna and acupuncture without any herbal medication, and received daily physician consultation; and CMT patients received conventional pain management therapy that included epidural steroid injection, oral NSAID, and muscle relaxant medication, along with daily physiotherapy. The primary outcome of this pilot study was safety as measured by the type and incidence of adverse events (AEs). The secondary outcome measures included VAS score for low back pain and leg pain, Oswestry Disability Index, Oxford Claudication Score (OCS), walking capacity on a 50 m flat track and treadmill, and EuroQol-5D score. Magnetic resonance imaging was also performed up to 6 months after treatment cessation. Results Thirty-four treated patients were included in the analysis, based on the modified intention-to-treat principle. No serious AEs were observed or reported. Compared to the CMT group, the MT1 and MT2 groups did show significant improvement at 3 and 6 months in various domains, including pain (VAS score for leg and back pain) and function (OCS and treadmill walking). Conclusion These novel multimodal integrative treatments for LSS are both clinically safe and logistically feasible. Larger, adequately powered randomized controlled trials will be necessary to assess comparative efficacy and thoroughly analyze the cost-effectiveness of each treatment approach. Clinical trial registration number (CRIS) KCT0001218.
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Bhagra A, Medina-Inojosa JR, Vinnakota S, Arciniegas MC, Garcia M, Sood A, Mahapatra S, Lopez-Jimenez F, Bauer BA, Cha SS, Mulvagh SL. Stress Management and Resilience Intervention in a Women's Heart Clinic: A Pilot Study. J Womens Health (Larchmt) 2019; 28:1705-1710. [PMID: 30907678 DOI: 10.1089/jwh.2018.7216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: In general, women report higher stress levels than men. High baseline anxiety, depression, and stress levels are associated with greater risk of cardiovascular diseases. Current evidence for efficacy of stress management interventions for women is limited. This study aimed at assessing the effect of a stress management and resiliency training (SMART) program for decreasing stress, anxiety, and depressive symptoms. Methods: Fifty moderately or severely stressed Women's Heart/Preventive Cardiology Clinic patients consented to the SMART intervention delivered online (n = 36) or in-person (n = 9). Primary outcome measures were the observed changes between baseline and at 12 weeks for the following psychometric tools: General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaires (PHQ-9), Perceived Stress Scale (PSS), and Brief Resiliency Scale (BRS). Results: Forty-five patients completed the study. We observed significant improvements in PSS and GAD-7, but not in PHQ-9 or BRS, after the SMART intervention. When assessing outcomes among those with depressive symptoms at baseline (PHQ-9 > 15), we observed significant changes in PSS, GAD-7, and PHQ-9. No differences between online and in-person program delivery methods were found (all p-values >0.05). Conclusions: Training exposure using the SMART program to decrease stress and anxiety in women seeking preventive cardiology services was feasible and similarly effective, whether delivered online or in a single in-person session. Impacts on depression and resilience likely require a more intensive approach. In the future, larger randomized clinical trials with additional training and longer follow-up are warranted.
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Rieck TM, Lee JR, Ferguson JA, Peterson LA, Martin Lillie CM, Clark MM, Limburg PJ, Bauer BA. A Randomized Controlled Trial in the Evaluation of a Novel Stress Management Tool: A Lounge Chair Experience. Glob Adv Health Med 2019; 8:2164956119892597. [PMID: 31827983 PMCID: PMC6886274 DOI: 10.1177/2164956119892597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 11/08/2019] [Accepted: 11/14/2019] [Indexed: 11/15/2022] Open
Abstract
Objectives The aim of this study was to compare the stress reduction effects of spending 25 minutes reclining in a SolTec™ Lounge between 2 intervention groups. Group 1 experienced the Lounge with multilayered music on an external speaker, while group 2 experienced the Lounge with multilayered music and synchronous vibration and magnetic stimulation from within the chair. Subjects In total, 110 participants with a self-reported stress level of 4 or higher on a 0- to 10-point scale were recruited from the local community including employees. Participants were randomized into receiving 1 of the 2 interventions. There were no significant differences between the group’s average stress levels prior to the interventions. Interventions Both groups received a 25-minute session in a dimly lit, quiet area on the Lounge with multilayered music. The second group also received vibration and magnetic stimulation that were synchronized with the music. Design Current stress level as well as ratings or feelings of anxiety, tenseness, energy, focus, happiness, relaxation, nervousness, creativeness, and being rested were recorded before and after the session. Results Both groups of participants reported equivalent decreased feelings of stress after using the Lounge. Participants receiving the synchronous multilayered music, vibration, and magnetic stimulation did report significantly reduced feelings of tenseness, feeling more relaxed, and feeling more creative when compared with the group that received music only. Conclusion Spending 25 minutes in the SolTec™ Lounge with multilayered music is an effective way to reduce self-reported stress in individuals who self-report having a high stress level. If confirmed by future studies, including synchronous vibration and magnetic stimulation with the multilayered music might be an effective stress reduction strategy.
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Ganesh R, Mahapatra S, Fuehrer DL, Folkert LJ, Jack WA, Jenkins SM, Bauer BA, Wahner-Roedler DL, Sood A. The Stressed Executive: Sources and Predictors of Stress Among Participants in an Executive Health Program. Glob Adv Health Med 2018; 7:2164956118806150. [PMID: 30364454 PMCID: PMC6196623 DOI: 10.1177/2164956118806150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/07/2018] [Accepted: 09/17/2018] [Indexed: 12/23/2022] Open
Abstract
Background Stress is highly prevalent in the U.S. society, especially in executives, and is a well-documented risk factor for a wide range of medical disorders. Knowledge of common sources of stress and predictive factors may help identify executives at risk of high stress and allow us to appropriately refer them for stress management treatment. Objective The primary aim of this study was to identify common sources of stress, predictors of high stress, and other correlates among executives. Methods This was a cross-sectional survey of executives who requested a stress management consult at our institution. We abstracted the data from a 14-item intake survey as well as from the patient interview. Results Of the 839 executives, 827 executives (98.6%) who were referred for individual stress management consults completed the stress-related questions of the survey; 51.3% of these executives reported having a high stress level. Study participants mostly struggled with the well-being measures of sleep, anxiety, energy level, and diet. The majority reported that their main stressor was work related (n = 540, 64.4%) followed by family related (n = 371, 44.2%), health related (n = 170, 20.3%), and work–life balance (n = 62, 7.4%). In unadjusted analysis, high stress was associated with younger age (P = .006), lower quality-of-life scores (P < .001), and less physical activity (P < .001). In multivariable analyses, the strongest predictors for high stress level were younger age (odds ratios [OR] = 0.84, P = .045) and worse quality-of-life indicators such as anxiety (OR = 2.72, P < .001), diet (OR = 0.78, P = .02), and sleep (OR = 0.74, P < .003). Conclusion These findings suggest that executives with a high level of stress might be best helped through a multimodality stress management program. Our findings merit replication in larger studies and more definitive confirmation with prospective clinical trials.
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Clark SD, Bauer BA, Vitek S, Cutshall SM. Effect of Integrative Medicine Services on Pain for Hospitalized Patients at an Academic Health Center. Explore (NY) 2018; 15:61-64. [PMID: 30243950 DOI: 10.1016/j.explore.2018.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/22/2018] [Accepted: 07/16/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pharmaceuticals such as opioids have routinely been prescribed for pain management. However, there has been an increasing epidemic of prescription opioid abuse, causing demand for nonpharmacologic complementary and integrative therapies for pain management. OBJECTIVE To determine if integrative medicine services provided to inpatients could help reduce pain posttreatment. In addition, this study aimed to track total services requested and performed over the fourth quarter of 2017. DESIGN, SETTING, AND PARTICIPANTS This prospective study analyzed documented integrative medicine services requested, indications for the requests, and pre- and posttreatment pain scores. A paired t test was used to determine significance. The study population was inpatients, from October 1, 2017, through December 31, 2017, at Mayo Clinic's Methodist and St. Mary's Hospitals in Rochester, Minnesota. RESULTS During the study period, 1220 integrative services were provided with a majority being massage therapy (1,064; 87.2%), followed by acupuncture (112; 9.1%). Massage therapy and acupuncture were highly significant (P < 0.00) at reducing pain scores posttreatment to inpatients. Over one-third of patients fell asleep during their therapy service time. CONCLUSION AND RELEVANCE Integrative therapies are appropriate modalities to help alleviate pain and other symptoms for the inpatient population. Due to the effectiveness of these modalities, integrative therapies may be a complement to opioids prescribed for pain. In addition, with over one-third of the patients falling asleep during therapy, our results suggest that integrative therapies can promote a state of relaxation. Future studies are warranted to determine the impact of integrative medicine therapies on sleep deprivation and other common symptoms of hospitalized patients.
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Mahapatra S, Bhagra A, Fekadu B, Li Z, Bauer BA, Wahner-Roedler DL. Incorporation of integrative medicine education into undergraduate medical education: a longitudinal study. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018; 15:442-449. [PMID: 29103413 DOI: 10.1016/s2095-4964(17)60367-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Integrative medicine (IM) combines complementary medical approaches into conventional medicine and considers the whole person. We implemented a longitudinal IM short-course curriculum into our medical school education. This study aimed to evaluate the feasibility and effectiveness of the curriculum via knowledge and attitude surveys regarding IM among students. METHODS A mandatory short IM curriculum across all years of medical school was created and taught by IM professionals and physician faculty members with expertise in integrative therapies. Graduating classes of 2015 and 2016 completed the same survey in their first and third years of medical school. Paired data analysis was done, and only students who completed surveys at both time points were included in final analyses. RESULTS Of 52 students in each class, 17 (33%) in the class of 2015 and 22 (42%) in the class of 2016 completed both surveys. After the IM curriculum, students' knowledge of and comfort with several IM therapies-biofeedback, mindfulness, and the use of St. John's wort-improved significantly. Students' personal health practices also improved, including better sleep, exercise, and stress management for the class of 2015. Students graduating in 2016 reported decreased alcohol use in their third year compared with their first year. CONCLUSION It is feasible to incorporate IM education into undergraduate medical education, and this is associated with improvement in students' knowledge of IM and personal health practices.
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Zolfaghari M, Mirhosseini SJ, Baghbeheshti M, Bauer BA. The Effect of Classic Chest Physiotherapy on Postoperative Pain Scores and Hospital Stay in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial. Galen Med J 2018; 7:e838. [PMID: 34466414 PMCID: PMC8343894 DOI: 10.22086/gmj.v0i0.838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/12/2017] [Accepted: 07/18/2017] [Indexed: 11/30/2022] Open
Abstract
Background Chest physiotherapy (CPT) is a care that increases the mobilization of several structures from both muscle and subcutaneous tissue. We planned to investigate the effect of classic CPT on pain, fatigue, satisfaction, and hospital length of stay (LOS) in patients undergoing off-pump coronary artery bypass graft (CABG). Materials and Methods This study was a randomized controlled trial that conducted on 50 patients undergoing elective off-pump CABG. The patients have been randomly divided into two groups; in the group A (n=25) patients received physiotherapy at a single session of classic CPT, 4 times during 2nd to 5th days for 15 minutes in every session, in the group B (n=25) patients had not protocol of this exercise therapy (control). Results The average age of all participants was 62.08 ±9.08 years. Of the 50 patients, 33 (66%) was male. Classic CPT significantly decreased pain (P=0.04), hospital LOS (P=0.010) and could increase in patients' satisfaction (P<0.001). However, it had no considerable effect on fatigue (P=0.725). Conclusion According to our findings, classic CPT could improve postoperative care after off-pump CABG surgery.
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Saw JJ, Curry EA, Ehlers SL, Scanlon PD, Bauer BA, Rian J, Larson DR, Wolanskyj AP. A brief bedside visual art intervention decreases anxiety and improves pain and mood in patients with haematologic malignancies. Eur J Cancer Care (Engl) 2018; 27:e12852. [PMID: 29667288 DOI: 10.1111/ecc.12852] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 11/27/2022]
Abstract
Treatment of cancer-related symptoms represents a major challenge for physicians. The purpose of this pilot study was to determine whether a brief bedside visual art intervention (BVAI) facilitated by art educators improves mood, reduces pain and anxiety in patients with haematological malignancies. Thirty-one patients (21 women and 10 men) were invited to participate in a BVAI where the goal of the session was to teach art technique for ~30 min. Primary outcome measures included the change in visual analog scale, the State-Trait Anxiety Inventory and the Positive and Negative Affect Schedule scale, from baseline prior to and immediately post-BVAI. Total of 21 patients (19 women and two men) participated. A significant improvement in positive mood and pain scores (p = .003 and p = .017 respectively) as well as a decrease in negative mood and anxiety (p = .016 and p = .001 respectively) was observed. Patients perceived BVAI as overall positive (95%) and wished to participate in future art-based interventions (85%). This accessible experience, provided by artists within the community, may be considered as an adjunct to conventional treatments in patients with cancer-related mood symptoms and pain, and future studies with balanced gender participation may support the generalisability of these findings.
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Buenz EJ, Verpoorte R, Bauer BA. The Ethnopharmacologic Contribution to Bioprospecting Natural Products. Annu Rev Pharmacol Toxicol 2018; 58:509-530. [DOI: 10.1146/annurev-pharmtox-010617-052703] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Mallory MJ, Hauschulz JL, Do A, Dreyer NE, Bauer BA. Case Reports of Acupuncturists and Massage Therapists at Mayo Clinic: New Allies in Expediting Patient Diagnoses. Explore (NY) 2017; 14:149-151. [PMID: 29395572 DOI: 10.1016/j.explore.2017.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 02/07/2017] [Indexed: 11/19/2022]
Abstract
Acupuncturists and massage therapists practicing within hospital and clinic settings is a relatively new, but growing phenomenon. Many clinical trials have documented the therapeutic roles these professionals can play in caring for patients. However, to our knowledge, little emphasis has been placed on their ability to aid in the diagnostic process. We report here our experience with these providers playing a critical role in contributing novel diagnostic information, both in the outpatient and inpatient settings. These observations suggest that acupuncturists and massage therapists can play a strategic role in helping achieve timely diagnoses for many patients. Strategies on how to incorporate these professionals into the care flow in the clinic and hospital are discussed.
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Thomley BS, Mahapatra S, Bauer BA, Mallory MJ, Li GX, Do A, Chon TY. Patient feedback for acupuncture practice improvement: A survey from Mayo Clinic. Chin J Integr Med 2017; 23:816-821. [PMID: 29080195 DOI: 10.1007/s11655-017-2779-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To understand patient satisfaction with acupuncture appointment duration for the first and subsequent appointments in the plan of care, time spent with the acupuncture provider, willingness to pay for longer duration appointments, and lack of insurance coverage. METHODS Patients who were referred for an acupuncture consult to the Center for Integrative Medicine at Mayo Clinic were asked to participate in the survey in August 2014. Patients were given paper survey at time of appointment check-in and entered into Research Electronic Data Capture Survey database tool to reveal patient-reported outcomes. RESULTS In total, 104 of 329 patients receiving acupuncture treatment responded to the survey with a 32% response rate. Insight and recommended changes to the duration of the initial and subsequent appointments were obtained. Most patients reported that time spent with the provider (76 cases, 74%) and appointment length (74 cases, 68%) were "just right". Seventy cases (70%) of respondents indicated that they wanted longer treatment. Patients reported return appointments with duration of 30 min was not enough. Fifty-three patients (62%) were willing to pay for additional costs not covered by insurance. CONCLUSIONS We used patient feedback to assess the acupuncture practice in a complementary and integrative medicine program. Most patients referred for the acupuncture consult appeared to be satisfied with the current level of practice. These findings were used to establish a quality improvement plan that may be implemented to improve patient satisfaction with the acupuncture practice.
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Cutshall SM, Mahapatra S, Hynes RS, Van Rooy KM, Looker SA, Ghosh A, Schleck CD, Bauer BA, Wahner-Roedler DL. Hand Massage for Cancer Patients Undergoing Chemotherapy as Outpatients: A Pilot Study. Explore (NY) 2017; 13:393-399. [PMID: 29097109 DOI: 10.1016/j.explore.2017.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 06/07/2017] [Accepted: 06/18/2017] [Indexed: 02/07/2023]
Abstract
CONTEXT There are no studies on the effect of volunteer-provided hand massage in a busy chemotherapy outpatient practice. OBJECTIVE To assess the feasibility of introducing hand massage therapy into an outpatient chemotherapy unit and to evaluate the effect of the therapy on various symptoms experienced by cancer patients. DESIGN A pilot, quasi-experimental, pretest-posttest study. SETTING Chemotherapy outpatient clinic of a large tertiary care academic medical center. PATIENTS/PARTICIPANTS Forty chemotherapy outpatients. INTERVENTION After being approached by a trained volunteer from a hand massage team, patients consented to receive a 20-minute hand massage before chemotherapy that was individualized according to patient preference and expressed needs. MAIN OUTCOME MEASURES The visual analog scale (VAS) was used to measure pain, fatigue, anxiety, muscular discomfort, nervousness, stress, happiness, energy, relaxation, calmness, and emotional well-being (on a scale from 0-10) before and after the intervention; a satisfaction survey was administered after the therapy. Patients' demographic data were summarized with descriptive statistics, and VAS total scores were compared between groups at each time point with the two-group t test. Feasibility was evaluated from the number of patients who were approached, received a hand massage, and completed the study surveys. RESULTS Of the 40 participants, 19 were men (mean age, 59.5 years). Significant improvement after hand massage was indicated by VAS scores for fatigue, anxiety, muscular discomfort, nervousness, stress, happiness, energy, relaxation, calmness, and emotional well-being (P < .05). Pain scores also improved, but the difference was not statistically significant (P = .06). All patients indicated that they would recommend hand massage to other patients, and 37 were interested in receiving it during their next chemotherapy treatment.
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Ilievski V, Bhat UG, Suleiman-Ata S, Bauer BA, Toth PT, Olson ST, Unterman TG, Watanabe K. Oral application of a periodontal pathogen impacts SerpinE1 expression and pancreatic islet architecture in prediabetes. J Periodontal Res 2017. [PMID: 28643938 DOI: 10.1111/jre.12474] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Epidemiological studies suggest a close association between periodontitis and prediabetes/insulin resistance (IR) but whether periodontitis causes prediabetes in humans is not known. Using various animal models, we have recently established that periodontitis can be an initiator of prediabetes, which is characterized by glucose intolerance, hyperinsulinemia and IR. In addition, our in vitro studies indicated that Porphyromonas gingivalis (Pg) induced insulin secretion in MIN6 β cells and this induction was in part SerpinE1 (plasminogen activator inhibitor 1, PAI1) dependent. However, the mechanism(s) by which periodontitis induces prediabetes is not known. As α and β cells in pancreatic islets are the major modulators of glucose levels, we investigated whether experimental periodontitis by oral application of a periodontal pathogen caused molecular and/or cellular alterations in pancreatic islets and whether SerpinE1 was involved in this process. MATERIAL AND METHODS We induced periodontitis in C57BL/6 mice by oral application of a periodontal pathogen, Pg, and determined changes that occurred in islets following 22 weeks of Pg application. Pancreatic islet architecture was determined by 2-D and 3-D immunofluorescence microscopy and SerpinE1 and its target, urokinase plasminogen activator (uPA), as well as insulin, glucagon and Pg/gingipain in islets were detected by immunofluorescence. The presence of apoptotic islet cells was determined by both histochemical and immunofluorescence TUNEL assays. To investigate further the direct effect of Pg on apoptosis and the involvement of SerpinE1 in this process, we used SerpinE1 knockdown and scrambled control clones of the MIN6 pancreatic β-cell line. RESULTS Pg/gingipain was detected in both the periodontium and pancreas in the experimental group. Islets from animals that were administered Pg orally (experimental group) developed significant changes in islet architecture, upregulation of SerpinE1, and increased β-cell apoptosis compared with the control group. We also observed that exposure of MIN6 cells to Pg in vitro resulted in apoptosis. However, apoptosis was significantly reduced when SerpinE1 expression by MIN6 cells was knocked down. CONCLUSION Oral application of the periodontal pathogen Pg to C57BL/6 mice induces periodontitis, translocation of Pg/gingipain to the pancreas and results in complex alterations in pancreatic islet morphology. SerpinE1 appears to be involved in this process.
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Buenz EJ, Bauer BA. Potential role of high-stress employment in hypertension. JRSM Open 2017; 8:2054270417694292. [PMID: 28515952 PMCID: PMC5418908 DOI: 10.1177/2054270417694292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We report a patient with a reduction in blood pressure through cessation of high-stress employment.
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Buenz EJ, Parry GJ, Bauer BA, Howe CL, Hammond-Tooke G, Tsuchihara T, Kanzaki M, Peacey M. A potential therapeutic for chronic pain from the new zealand native stinging nettle urtica ferox(ongaonga). Journal of Neurology, Neurosurgery and Psychiatry 2017. [DOI: 10.1136/jnnp-2017-316074.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Borah BJ, Naessens JM, Glasgow AE, Bauer BA, Chon TY. Cost-effectiveness of acupuncture in an employee population: A retrospective analysis. Complement Ther Med 2017; 31:14-19. [PMID: 28434466 DOI: 10.1016/j.ctim.2017.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/06/2016] [Accepted: 01/12/2017] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To determine whether acupuncture is a cost-effective adjunct to usual care for Mayo Clinic employees and their dependents experiencing pain symptoms. DESIGN Retrospective review of the medical and billing records of 466 employee-patients and their dependents who had received acupuncture as part of their care and 466 propensity score-matched control patients. INTERVENTIONS Usual care in combination with acupuncture compared with usual care alone. MAIN OUTCOME MEASURES The primary outcome measure was the total costs of care for all medical care and pharmacy services incurred from 1year before the index visit to 14 months after the index date. Secondary outcomes included the number of hospital visits, total inpatient days, emergency department visits, primary care or general medicine office visits, specialty office visits, and physical therapy services. Pain scores (patient-rated scores from 0 to 10) were extracted from the medical record, if available. RESULTS Costs of care were similar between the 2 groups. No cost savings were noted for the acupuncture group. CONCLUSIONS Several limitations to the study may have precluded a finding of cost-effectiveness. Future studies should include prospective evaluation of costs and other outcomes in a comparison between acupuncture and usual care in a randomized control trial.
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