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Yosipovitch G, Canchy L, Ferreira BR, Aguirre CC, Tempark T, Takaoka R, Steinhoff M, Misery L. Integrative Treatment Approaches with Mind-Body Therapies in the Management of Atopic Dermatitis. J Clin Med 2024; 13:5368. [PMID: 39336855 PMCID: PMC11432615 DOI: 10.3390/jcm13185368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 08/22/2024] [Accepted: 08/26/2024] [Indexed: 09/30/2024] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a complex pathophysiology characterized by intense pruritus, often associated with psychological stress and atopic and non-atopic comorbidities that significantly reduce quality of life. The psychological aspects of AD and the interaction between the mind and body via the skin-brain axis have led to an interest in mind-body therapies (MBT). The aim of this article is, therefore, to reinforce the importance of psychodermatological care in AD. We performed a focused literature review on holistic practices or integrative MBT in AD, including education, cognitive behavioral therapy, habit reversal, meditation, mindfulness, hypnotherapy, eye movement desensitization and reprocessing, biofeedback, progressive muscle relaxation, autonomous sensory meridian response, music therapy, massage, and touch therapy. A multidisciplinary holistic approach with MBT, in addition to conventional pharmacologic antipruritic therapies, to break the itch-scratch cycle may improve AD outcomes and psychological well-being. Although there is a paucity of rigorously designed trials, evidence shows the potential benefits of an integrative approach on pruritus, pain, psychological stress, anxiety, depressive symptoms, and sleep quality. Relaxation and various behavioral interventions, such as habit reversal therapy for replacing harmful scratching with massaging with emollient 'plus', may reduce the urge to scratch, while education may improve adherence to conventional therapies.
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Affiliation(s)
- Gil Yosipovitch
- Miami Itch Center, University of Miami, Miami, FL 33130, USA
| | - Ludivine Canchy
- La Roche-Posay Laboratoire Dermatologique, 92300 Levallois-Perret, France
| | - Bárbara Roque Ferreira
- Laboratoire Interactions Epithéliums Neurones (LIEN), University of Brest, 29200 Brest, France
- Department of Dermatology, Algarve University Hospital Centre, ULS Algarve, 8000-386 Faro, Portugal
| | | | - Therdpong Tempark
- Department of Pediatrics, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand
| | - Roberto Takaoka
- Division of Dermatology, Medical School Hospital, University of Sao Paulo, Sao Paulo 05403-000, SP, Brazil
| | - Martin Steinhoff
- Department of Dermatology, Weill Cornell Medicine, New York, NY 10065, USA
- Department of Medicine, Weill Cornell Medicine-Qatar, Doha 3050, Qatar
- College of Health and Life Sciences, Hamad-Bin Khalifa University-Qatar, Doha 5825, Qatar
- Department of Dermatology & Venereology, Hamad Medical Corporation, Doha 3050, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha 3050, Qatar
| | - Laurent Misery
- Laboratoire Interactions Epithéliums Neurones (LIEN), University of Brest, 29200 Brest, France
- Department of Dermatology, University Hospital of Brest, 29200 Brest, France
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Romero-García PA, Ramirez-Perez S, Miguel-González JJ, Guzmán-Silahua S, Castañeda-Moreno JA, Komninou S, Rodríguez-Lara SQ. Complementary and Alternative Medicine (CAM) Practices: A Narrative Review Elucidating the Impact on Healthcare Systems, Mechanisms and Paediatric Applications. Healthcare (Basel) 2024; 12:1547. [PMID: 39120250 PMCID: PMC11311728 DOI: 10.3390/healthcare12151547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/29/2024] [Accepted: 07/03/2024] [Indexed: 08/10/2024] Open
Abstract
While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM's applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients' perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.
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Affiliation(s)
- Patricia Anaid Romero-García
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
| | - Sergio Ramirez-Perez
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), CUCS, Universidad de Guadalajara, Guadalajara 44100, Jalisco, Mexico
| | - Jorge Javier Miguel-González
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Departamento de Investigación, Instituto Cardiovascular de Mínima Invasión (ICMI), Zapopan 45116, Jalisco, Mexico
| | - Sandra Guzmán-Silahua
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Unidad de Investigación Epidemiológica y en Servicios de Salud, CMNO OOAD Jalisco Instituto Mexicano del Seguro Social, Guadalajara 44160, Jalisco, Mexico
| | - Javier Adan Castañeda-Moreno
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
| | - Sophia Komninou
- Faculty of Health and Life Science, Swansea University, Swansea SA2 8PP, UK;
| | - Simón Quetzalcoatl Rodríguez-Lara
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
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Srinivasan R, McVoy M, Neudecker M, Divan MK, Wu A, Cascio ME, Dusek JA, Miller DW. Mind-Body Interventions for Youth with Chronic Medical Conditions: A Scoping Review of the Literature. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:620-644. [PMID: 38498029 DOI: 10.1089/jicm.2023.0427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Background and purpose: Little is known about the applicability, utilization, and effectiveness of mind-body interventions (MBIs) for conditions that are not predominantly pain, neoplastic, or psychiatric, particularly in pediatric patients. This scoping review describes research pertaining to such interventions in youth with nonpain, noncancer, and nonpsychiatric predominant chronic medical conditions. Methods: Searches of EBSCO CINAHL, Elsevier Scopus, Ovid for MEDLINE, and Ovid PsycInfo were conducted to investigate MBIs in youth under 18 years of age with nonpain, noncancer, and nonpsychiatric predominant chronic medical conditions. Articles published between 2010 and 2020 were included. Abstracts were screened by three authors for inclusion, and disagreements were resolved by a designated author. Selected full-text articles were divided among all authors for review of study quality, intervention feasibility and acceptability, and effectiveness. Results: The search yielded 1010 titles with 15 meeting the final inclusion criteria, studying a total of 641 youth. Participants ranged in age from 6 to 19 years (included studies had data on participants <18 years reported separately); 61.5% were female (n = 394) and 38.5% were male (n = 247). The two most common conditions studied were asthma and irritable bowel syndrome, with yoga being the most popular intervention. Overall, MBIs showed promising preliminary evidence for improving symptoms and quality of life in youth with chronic medical conditions. Conclusion: MBIs have been successfully delivered and show promise in symptom palliation and quality of life improvement for youth with a variety of chronic medical conditions. More data from high-quality randomized controlled trials are needed to further characterize the effectiveness of specific modalities for specific conditions.
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Affiliation(s)
- Roshini Srinivasan
- Duke University School of Medicine, Durham, North Carolina, USA
- University Hospitals Connor Whole Health, Cleveland, Ohio, USA
| | - Molly McVoy
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Mandy Neudecker
- University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Mina Kumari Divan
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Amy Wu
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | | | - Jeffery A Dusek
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - David W Miller
- University Hospitals Connor Whole Health, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
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Leiby A, Albenberg L, Langseder A, Kennedy M, Pressman N, Chiu S, Rosh JR. A prospective, controlled multisite trial of yoga in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2024; 78:272-279. [PMID: 38327225 DOI: 10.1002/jpn3.12081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/24/2023] [Accepted: 11/18/2023] [Indexed: 02/09/2024]
Abstract
AIM To investigate whether a structured yoga program improves health-related quality of life (HRQOL) and self-efficacy in pediatric patients receiving care for inflammatory bowel disease (IBD). METHODS IBD patients who were 10-17 years old participated in a 12 week, in-person yoga intervention at two clinical sites. Outcomes were measured at time of consent (T0), start of yoga (T1), and completion of yoga (T2) and 3 months after yoga completion (T3) using the IMPACT-III, Pediatric Quality of Life Inventory (PedsQL), and General Self Efficacy (GSE) scales. RESULTS Seventy-eight patients were enrolled. Fifty-six patients completed nine or more classes. 73.2% had Crohn's disease and 26.8% ulcerative colitis or IBD-unclassified. A significant increase in IMPACT-III was seen from T1 to T3 (mean change of 5.22, SD = 14.33, p = 0.010), in the PedsQL (mean change = 2.3, SD = 10.24, p = 0.050), and GSE (mean change = 1, SD = 3.60, p = 0.046). 85.2% of patients reported yoga helped them to control stress. Long-term data was available for 47 subjects with 31.9% (n = 15) continuing to practice yoga one to 3 years after study completion. CONCLUSION This structured 12-week yoga program showed significant improvements in HRQOL and general self-efficacy, particularly 3 months after classes were concluded suggesting that yoga's benefits may persist. Yoga is a safe and effective adjunct to standard medical care to improve QOL and self-efficacy in youth with IBD.
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Affiliation(s)
- Alycia Leiby
- Division of Pediatric Gastroenterology and Nutrition, Atlantic Children's Health-Goryeb Children's Hospital, Atlantic Health System, Morristown, New Jersey, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Lindsey Albenberg
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Annette Langseder
- Division of Pediatric Gastroenterology and Nutrition, Atlantic Children's Health-Goryeb Children's Hospital, Atlantic Health System, Morristown, New Jersey, USA
| | - Mary Kennedy
- Division of Pediatric Gastroenterology and Nutrition, Atlantic Children's Health-Goryeb Children's Hospital, Atlantic Health System, Morristown, New Jersey, USA
| | - Naomi Pressman
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Stephanie Chiu
- Atlantic Center for Research, Atlantic Health System, Morristown, New Jersey, USA
| | - Joel R Rosh
- Division of Pediatric Gastroenterology, Liver Disease and Nutrition, The Steven and Alexandra Cohen Children's Medical Center of New York, New York City, New York, USA
- Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, USA
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Lee J, Bifano SM, Bombacie MJ, Lakhaney D, Steinberg DM, Gangopadhyay M, Porter R, Stenglein SL, Gold MA. The Development of a Multidisciplinary Support Network to Support Hospitalized Pediatric Patients, Their Families, and Hospital Staff During the COVID-19 Pandemic. Med Acupunct 2023; 35:180-185. [PMID: 37609551 PMCID: PMC10440643 DOI: 10.1089/acu.2023.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Background The COVID-19 pandemic led to emotional and behavioral challenges for hospitalized pediatric patients, their families, and staff. Visitor restrictions, closure of patient lounges and playrooms, masking requirements, and enhanced isolation rules resulted in limited access to typical sources of psychosocial support during this traumatic event. Complementary and integrative health therapies such as acupuncture and related therapies are well suited to provide the humanitarian support patients and families need during times of crisis. Objective The Multidisciplinary Support Network (i.e., Network) was formed to redesign the delivery of acupuncture and other integrative therapies alongside psychosocial support for hospitalized children, their families, and staff. Intervention Network members represented a broad range of previously siloed disciplines including integrative therapies, art therapy, child life, nursing, pastoral care, adolescent medicine, pediatric hospital medicine, psychology, and child and adolescent psychiatry. The Network aimed to identify gaps in service and create resources to support children and families during this challenging time. Results The Network compiled existing complementary and integrative services, provided training on integrative therapies to staff, pediatric trainees, and faculty, developed the Comfort Box containing items to provide symptom relief including pain, anxiety and difficulty sleeping, as well as closed-circuit programming, a pediatric companionship program connecting medical student volunteer companions with pediatric patients, and a well-being workbook. Conclusion Collaborative teamwork across disciplines using integrative therapies was key to humanitarian efforts to support hospitalized children and their families during this crisis.
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Affiliation(s)
- Jennifer Lee
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Morgan Stanley Children's Hospital, NewYork-Presbyterian, New York, NY, USA
| | - Susanne M. Bifano
- Morgan Stanley Children's Hospital, NewYork-Presbyterian, New York, NY, USA
| | - Michelle J. Bombacie
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Divya Lakhaney
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Morgan Stanley Children's Hospital, NewYork-Presbyterian, New York, NY, USA
| | - Dara M. Steinberg
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Maalobeeka Gangopadhyay
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Rechelle Porter
- UCSF Benioff Children's Hospital of Oakland California, Oakland, CA, USA
| | - Stacy L. Stenglein
- Morgan Stanley Children's Hospital, NewYork-Presbyterian, New York, NY, USA
| | - Melanie A. Gold
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
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Yang H, Wang X, Wang X, Yang J, Zhang W, Ding Y, Sang T, Chen W, Wang W. Effect of mindfulness-based mind-body therapies in patients with non-specific low back pain-A network meta-analysis of randomized controlled trials. Front Aging Neurosci 2023; 15:1148048. [PMID: 37455934 PMCID: PMC10340124 DOI: 10.3389/fnagi.2023.1148048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Background/objectives Although mindfulness-based mind-body therapy (MBMBT) is an effective non-surgical treatment for patients with non-specific low back pain (NLBP), the best MBMBT mode of treatment for NLBP patients has not been identified. Therefore, a network meta-analysis (NMA) was conducted to compare the effects of different MBMBTs in the treatment of NLBP patients. Methods PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched for randomized controlled trials (RCTs) applying MBMBT for the treatment of NLBP patients, with all of the searches ranging from the time of database creation to January 2023. After 2 researchers independently screened the literature, extracted information, and evaluated the risks of biases in the included studies, the data were analyzed by using Stata 16.0 software. Results A total of 46 RCTs were included, including 3,886 NLBP patients and 9 MBMBT (Yoga, Ayurvedic Massage, Pilates, Craniosacral Therapy, Meditation, Meditation + Yoga, Qigong, Tai Chi, and Dance). The results of the NMA showed that Craniosacral Therapy [surface under the cumulative ranking (SUCRA): 99.2 and 99.5%] ranked the highest in terms of improving pain and disability, followed by Other Manipulations (SUCRA: 80.6 and 90.8%) and Pilates (SUCRA: 54.5 and 71.2%). In terms of improving physical health, Craniosacral Therapy (SUCRA: 100%) ranked the highest, followed by Pilates (SUCRA: 72.3%) and Meditation (SUCRA: 55.9%). In terms of improving mental health, Craniosacral Therapy (SUCRA: 100%) ranked the highest, followed by Meditation (SUCRA: 70.7%) and Pilates (SUCRA: 63.2%). However, in terms of improving pain, physical health, and mental health, Usual Care (SUCRA: 7.0, 14.2, and 11.8%, respectively) ranked lowest. Moreover, in terms of improving disability, Dance (SUCRA: 11.3%) ranked lowest. Conclusion This NMA shows that Craniosacral Therapy may be the most effective MBMBT in treating NLBP patients and deserves to be promoted for clinical use. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, PROSPERO [CRD42023389369].
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Affiliation(s)
- Huanying Yang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Xiangfu Wang
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Xuetao Wang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Jianxia Yang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Wanqian Zhang
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Yanfang Ding
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Tingrui Sang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Weiguo Chen
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Wanhong Wang
- Department of Traditional Chinese Nursing, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
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Grasser LR, Marusak H. Strong Mind, Strong Body: The Promise of Mind-Body Interventions to Address Growing Mental Health Needs Among Youth. MENTAL HEALTH SCIENCE 2023; 1:58-66. [PMID: 37810896 PMCID: PMC10557954 DOI: 10.1002/mhs2.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/10/2023] [Indexed: 10/10/2023]
Abstract
As the prevalence of childhood and adolescent anxiety, depression, and other mental health concerns continues to rise, there has been an unprecedented increase in support of mind-body practices like yoga, dance, meditation, mindfulness, aerobic exercise, and more-in part driven by the mental health burden imposed by the COVID-19 pandemic. While a growing body of evidence supports the safety and effectiveness of mind-body approaches, gaps in funding for and empirical research on mechanistic underpinnings, methodology development to assess multi-component therapeutic practices, dissemination and implementation, and diversity in researchers, practitioners, and recipients remain. As a consequence, the neurobiological impacts of mind-body techniques are not well understood nor broadly accepted as standard forms of care by clinicians and insurers-often being considered as 'alternative' rather than 'complementary' or 'integrative'. In this commentary, we summarize work from our labs and others highlighting the promise of mind-body approaches for improving mental health in youth, in line with the National Institute of Mental Health's strategic plan to address health disparities. We offer a potential framework for implementation and research-the Expressive Therapies Continuum. We also propose solutions to key research and policy gaps, that by could have positive public health impacts for those who are struggling and to prevent emergence of psychiatric illness, especially in developing youth.
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Affiliation(s)
- Lana Ruvolo Grasser
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit MI
| | - Hilary Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit MI
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Ganzevoort IN, Fokkema T, Mol-Alma HJ, Heida A, Van der Veen AL, Vermeulen K, Benninga MA, Vlieger AM, Berger MY, Holtman GA. Home-based guided hypnotherapy for children with functional abdominal pain and irritable bowel syndrome in primary care: study protocol for a randomised controlled trial. BMJ Open 2023; 13:e069653. [PMID: 37156587 PMCID: PMC10173965 DOI: 10.1136/bmjopen-2022-069653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION Children often present to primary care with functional abdominal pain (FAP) or irritable bowel syndrome (IBS), and around half still have abdominal complaints 1 year later. Hypnotherapy is an evidence-based treatment that is used in specialist care, but it lacks evidence in primary care. This study will investigate the (cost) effectiveness of home-based guided hypnotherapy for children with FAP or IBS in primary care. METHODS AND ANALYSIS We report the design of a pragmatic randomised controlled trial among children aged 7-17 years, diagnosed with FAP or IBS by their general practitioner (GP), with assessments over 12 months. The control group will receive care as usual (CAU) by their GP (eg, communication, education and reassurance), while the intervention group will receive CAU plus 3 months of home-based guided hypnotherapy via a website. The primary outcome will be the proportion of children with adequate relief from abdominal pain/discomfort at 12 months, analysed on an intention-to-treat basis. Secondary outcomes will include the adequacy of pain relief at 3 and 6 months, pain/discomfort severity, pain frequency and intensity, daily functioning and impact on function, anxiety and depression, pain beliefs, sleep disturbances, school absence, somatisation, and healthcare use and costs. We must include 200 children to determine a 20% difference in those with adequate relief (55% control vs 75% intervention). ETHICS AND DISSEMINATION The Medical Ethics Review Committee of the University Medical Center Groningen, the Netherlands, approved this study (METc2020/237). The results will be disseminated to patients, GPs and other stakeholders via email, a dedicated website, peer-reviewed publications and presentations at national and international conferences. We plan to collaborate with the Dutch Society of GPs to implement the results in clinical practice. TRIAL REGISTRATION NUMBER NCT05636358.
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Affiliation(s)
- Ilse Nadine Ganzevoort
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Tryntsje Fokkema
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Harma J Mol-Alma
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Anke Heida
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Adriëlla L Van der Veen
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Karin Vermeulen
- Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Marc A Benninga
- Department of Paediatric Gastroenterology, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
| | - Arine M Vlieger
- Department of Paediatrics, Sint Antonius Hospital, Nieuwegein, The Netherlands
| | - Marjolein Y Berger
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - G A Holtman
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
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Garbers S, Umar NQ, Hand RE, Usseglio J, Gold MA, Bruzzese JM. Mind-Body Integrative Health (MBIH) Interventions for Sleep among Adolescents: A Scoping Review of Implementation, Participation and Outcomes. ADOLESCENT RESEARCH REVIEW 2022; 7:565-589. [PMID: 36619475 PMCID: PMC9815202 DOI: 10.1007/s40894-021-00176-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/24/2021] [Indexed: 05/17/2023]
Abstract
Adolescents get insufficient sleep, adversely affecting health. Mind-body integrative health interventions for adolescents have been shown to reduce stress, a barrier to good sleep. This scoping review aimed to synthesize mind-body integrative health interventions for adolescents, how interventions were implemented, who was reached. A systematic search of four online databases was conducted. Randomized, quasi-experimental, and single-group designs with participants ages 10-24 years were included. Twelve studies covering 10 interventions using mindfulness, qigong, aromatherapy, or yoga were identified. Participants were predominantly female; only one study reported participants' race or ethnicity (81% non-Hispanic white). Most (n=6) interventions were delivered in groups, and half reported significant improvements in subjective sleep quality. Mindfulness-based stress reduction and mindfulness-based cognitive therapy were the most commonly used modalities, with reported impact on sleep outcomes measured objectively. The two interventions that found statistically significant, moderate improvements in objectively-measured sleep onset latency and sleep efficiency were of higher intensity and used mindfulness. Four interventions were self-directed; participants in these struggled with adherence; significant impacts on sleep were not found. While findings were mixed, stemming in part from the quality of the underlying studies, this review identified several promising features of interventions, including using mindfulness, ensuring sufficient intervention dose, and targeting interventions towards adolescents with poor sleep at baseline (rather than a general population of adolescents). The findings suggests that sleep interventions for adolescents may improve psychological well-being as an intermediate effect, as sleep improvements were observed mostly among participants with poor sleep quality or anxiety symptoms at baseline. This review identified several gaps in the literature. Despite documented racial and ethnic disparities in sleep quality among adolescents, published evidence of mind-body integrative health-based sleep interventions among Black and Latinx adolescents is lacking. None of the studies in this review assessed developmental stage or age differences, despite documented differences in sleep across age groups of adolescents. These two gaps in the evidence should be addressed in future intervention research.
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Affiliation(s)
- Samantha Garbers
- Columbia University Mailman School of Public Health, Heilbrunn Department of Population & Family Health, New York, NY
| | - Nawal Q. Umar
- Columbia University Mailman School of Public Health, New York, NY
| | - Rachel E. Hand
- Columbia University Mailman School of Public Health, New York, NY
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia University Irving Medical Center, New York, NY
| | - Melanie A. Gold
- Columbia University Mailman School of Public Health, Heilbrunn Department of Population & Family Health, New York, NY
- Columbia University Irving Medical Center, Department of Pediatrics, Division of Child and Adolescent Health, New York, NY
- New York-Presbyterian, School-Based Health Centers, New York, NY
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10
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Pasqualucci P, Seifert G, Filho VO, Dos Santos AC. The implementation of an online mindfulness-based program for pediatric patients at a tertiary hospital in South America: a feasibility study protocol. Pilot Feasibility Stud 2022; 8:220. [PMID: 36180940 PMCID: PMC9526254 DOI: 10.1186/s40814-022-01176-z] [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] [Received: 03/18/2022] [Accepted: 09/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background The prevalence of chronic and complex pediatric health conditions has quickly risen over the last decades. Chronic and complex health conditions make pediatric patients and their families more susceptible to many distressing events during their lifespan. Mindfulness-based interventions have become a popular intervention for individuals living with chronic illnesses and have been adapted for pediatric populations with good results, including online versions. This study intends to report an implementation protocol of an online mindfulness-based program for adolescents to address an important gap in stress relief and health promotion for pediatric patients. Methods In this article, we describe the rationale and design of an implementation study of an online mindfulness-based program for pediatric patients at a tertiary pediatric hospital in South America. Participants will be recruited during one year to participate in an eight-session online mindfulness-based program. To assess our primary aim of feasibility, we will exam recruitment, retention and participation rates. Participants will also complete a symptomatology evaluation (i.e., depression, anxiety, and stress symptoms) at baseline and immediately at post-treatment and fidelity will be evaluated by a structured questionnaire. Discussion This study will be the first known to assess the implementation of an online mindfulness-based program for a pediatric population at a tertiary pediatric center in South America under real-life conditions. This study will establish the feasibility of a novel intervention aimed at promoting mental health and positive coping strategies among pediatric patients with chronic and complex health conditions. Evidence from this study would be useful to patients, families, clinicians, and policymakers and will help to devise strategies of health promotion for the pediatric population, as well as serve as a model for a future trial to examine efficacy of the proposed intervention. Trial registration This research has been registered at Ensaiosclinicos.gov.br, identifier RBR-23trp87. Registered 25 February 2022—retrospectively registered.
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Affiliation(s)
- Paula Pasqualucci
- Unit of Integrative Pediatrics, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
| | - Georg Seifert
- Unit of Integrative Pediatrics, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.,Department of Pediatrics, Division of Oncology and Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Vicente Odone Filho
- Unit of Integrative Pediatrics, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.,Department of Pediatrics, Division of Oncology and Hematology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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11
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Graubard R, Perez-Sanchez A, Katta R. Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology. Dermatol Pract Concept 2021; 11:e2021091. [PMID: 34631261 DOI: 10.5826/dpc.1104a91] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 01/24/2023] Open
Abstract
Stress has multiple and wide-ranging physiologic and clinical impacts on skin disease. This has led to an interest in mind body therapies as potential adjunct treatments for skin disease. The stress response results in the activation of the endocrine, neurologic, and immune systems, with a resulting cascade of impacts, that are both systemic and cutaneous. The 2 main arms of the stress response are the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis. The resultant release of cortisol, catecholamines, and neuropeptides has multiple effects. Clinically, these have been shown to increase skin inflammation, increase itching, impair skin barrier function, impair wound healing, and suppress immunity. Mind body therapies are those that focus on the interaction between the mind and the body, with the goal to influence physical function and impact health. These have been shown to ameliorate some of the harmful physiologic changes attributed to stress or to reduce harmful behaviors. In some cases, such as with biofeedback, they may also result in beneficial physiologic changes. Treatments such as meditation, biofeedback, hypnosis, guided imagery, and others have been evaluated in the treatment of skin disease and have shown some benefits. Although randomized controlled trials are limited, these interventions have shown beneficial effects on itching, psychosocial outcomes, and even skin severity. These interventions have been evaluated in diseases such as atopic dermatitis, psoriasis, trichotillomania, and others. Given the potential benefits, improvements in psychosocial outcomes, and a low risk profile, referral to qualified practitioners or multidisciplinary clinics should be considered for some patients.
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Affiliation(s)
| | | | - Rajani Katta
- Baylor College of Medicine, Houston, TX, USA.,McGovern Medical School at the University of Texas Houston, USA
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12
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Amjadi K. Exploring Factors That Influence Children's Growth and Development During a Pandemic. Glob Pediatr Health 2021; 8:2333794X211042464. [PMID: 34471654 PMCID: PMC8404674 DOI: 10.1177/2333794x211042464] [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] [Received: 07/16/2021] [Accepted: 08/09/2021] [Indexed: 11/17/2022] Open
Abstract
The potential long-term impacts of natural or man-made disasters on children and adolescents have been the subject of numerous scientific research studies over the past decades. Since the rise of the COVID-19 pandemic, however, it has become even more important to continue these investigations in order to address the special needs of our youth. While the virus itself appears to cause less pathology in them compared to adults, the effects go beyond the disease itself. The pandemic has caused extremely high levels of stress for both the children and their families. As a result, special attention has to be given to the possible long-term impacts on their growth and development. It is very important for physicians and other healthcare providers to recognize the signs and symptoms of stress and monitor for physical and mental health inequities, and to be able to provide support when help is needed. Identifying culturally effective solutions and reaching out to community based organizations or partners for resources and programs with which families identify is an important part of this healing provision. Mind-body therapies and practices such as meditation, visualization, breathing exercises, Movazeneh®, and Tamarkoz® are effective complementary therapies that can be utilized in pediatrics and help children and adolescents learn self-care skills that they could apply throughout their lives. Health providers should become educated in these safe and noninvasive techniques themselves, and consider them as possible therapeutic approaches for the treatment of stress in their pediatric patients.
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13
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Cozzolino M, Celia G, Girelli L, Limone P. Effects of the Brain Wave Modulation Technique Administered Online on Stress, Anxiety, Global Distress, and Affect During the First Wave of the COVID-19 Pandemic: A Randomized Clinical Trial. Front Psychol 2021; 12:635877. [PMID: 34093317 PMCID: PMC8170086 DOI: 10.3389/fpsyg.2021.635877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/12/2021] [Indexed: 11/18/2022] Open
Abstract
This study aims to evaluate the effects of an innovative mind-body practice named the brain wave modulation technique (BWM-T) on stress, anxiety, global distress, and affect. The technique was administered online through a web-based video conferencing platform. The intervention started on week four of the first quarantine in Italy (week commencing 30th March 2020), for a duration of 4 weeks and ended before lockdown measures were loosened. 310 people participated in the study, mean age 28.73 years old (SD = 9.16), 77.8% women. Of these, about half were randomly assigned to the experimental group and the other half served as controls. Participants completed online psychological tests before and after the intervention. 266 people (144 experimental, 122 controls) completed the post-intervention tests. Consistent with our hypothesis, the study's findings indicate a reduction in the levels of stress, anxiety, global distress, and negative affect in the experimental group, compared to the control group. Moreover, the experimental group also showed higher levels of positive affect, compared to controls after the intervention. The present findings add to the current literature in suggesting that the BWM-T reduced stress not only when administered face-to face but also when administered online during the COVID-19 pandemic. Moreover, we also noted that the BWM-T has an effect on anxiety, global distress, and affect, which we had not investigated in previous studies.
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Affiliation(s)
- Mauro Cozzolino
- Department of Humanities, Philosophy and Education, University of Salerno, Fisciano, Italy
| | - Giovanna Celia
- Department of Economics, Management and Territory, University of Foggia, Foggia, Italy
| | - Laura Girelli
- Department of Humanities, Philosophy and Education, University of Salerno, Fisciano, Italy
| | - Pierpaolo Limone
- Department of Economics, Management and Territory, University of Foggia, Foggia, Italy
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14
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Zachary M, Sisley S. The Pediatric Obesity Encounter: Literature and Resources to Help with 4 Common Issues. Curr Nutr Rep 2021; 9:94-100. [PMID: 32350815 DOI: 10.1007/s13668-020-00308-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW We review here best practices and resources for pediatricians providing pediatric obesity management in 4 key areas: how to assess all of the relevant factors contributing to obesity, how to provide nutrition education, how to counsel families who eat out regularly, and what to do with patients who frequently make poor eating choices. RECENT FINDINGS While there are many resources indicating recommendations for the physical exam and laboratory tests, there are very few resources that give pragmatic advice on the counseling aspects of the pediatric obesity encounter. We note new nutrition research showing the importance of avoiding ultra-processed foods. Most importantly, we list several resources regarding useful questionnaires, nutrition guidance, and even further training for pediatricians. There is a need for more curation of resources in different aspects of obesity care. We hope that this review and list of resources are helpful for pediatricians and will empower families and can be expanded in the future.
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Affiliation(s)
- Montgomery Zachary
- Department of Pediatrics, Baylor College of Medicine, 1100 Bates St. #10068, Houston, TX, 77030, USA
| | - Stephanie Sisley
- Department of Pediatrics, Baylor College of Medicine, 1100 Bates St. #10068, Houston, TX, 77030, USA.
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15
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Adverse Events of Mind-Body Interventions in Children: A Systematic Review. CHILDREN-BASEL 2021; 8:children8050358. [PMID: 33947033 PMCID: PMC8146392 DOI: 10.3390/children8050358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
Mind-body interventions (MBIs) are one of the top ten complementary approaches utilized in pediatrics, but there is limited knowledge on associated adverse events (AE). The objective of this review was to systematically review AEs reported in association with MBIs in children. In this systematic review the electronic databases MEDLINE, Embase, CINAHL, CDSR, and CCRCT were searched from inception to August 2018. We included primary studies on participants ≤ 21 years of age that used an MBI. Experimental studies were assessed for whether AEs were reported on or not, and all other study designs were included only if they reported an AE. A total of 441 were included as primary pediatric MBI studies. Of these, 377 (85.5%) did not explicitly report the presence/absence of AEs or a safety assessment. There were 64 included studies: 43 experimental studies reported that no AE occurred, and 21 studies reported AEs. There were 37 AEs found, of which the most serious were grade 3. Most of the studies reporting AEs did not report on severity (81.0%) or duration of AEs (52.4%). MBIs are popularly used in children; however associated harms are often not reported and lack important information for meaningful assessment.
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16
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Bakshi N, Cooley A, Ross D, Hawkins L, Sullivan M, Astles R, Sinha C, Katoch D, Peddineni M, Gee BE, Lane PA, Krishnamurti L. A pilot study of the acceptability, feasibility and safety of yoga for chronic pain in sickle cell disease. Complement Ther Med 2021; 59:102722. [PMID: 33892094 DOI: 10.1016/j.ctim.2021.102722] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/12/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To determine the acceptability, feasibility and safety of yoga for chronic pain in sickle cell disease. DESIGN AND SETTING In Part A of this two-part study, adolescents with SCD and chronic pain (Group 1) and their parent (Group 2) completed a survey designed to capture pain characteristics, attitudes and practices related to yoga, and potential acceptability of a yoga program. In Part B, the study assessed the feasibility and safety of an instructor-led group yoga program. The study was registered on clinicaltrials.gov (NCT03694548). INTERVENTION Eight instructor-led group yoga sessions. MAIN OUTCOME MEASURES Feasibility and safety outcomes were chosen a priori, as follows: 1) Proportion of adolescent patients with SCD and chronic pain approached that consent to participate in Part A, 2) Proportion of adolescent participants enrolled in Part A that consent to participate in Part B, 3) Proportion of participants enrolled in Part B that attend at least 6 of 8 yoga sessions, 4) Proportion of participants enrolled in Part B with an ED visit or a hospitalization for pain within 24 h of completion of each yoga session, 5) Proportion of participants in Part B who complete all study assessments before, and at the end of the yoga program, 6) Adherence to submission of pain diary. RESULTS The median age of 15 patient participants in Part A was 16 (IQR 14-17), and 14 parents was 43.5 (IQR 42-51). Most participants were female. Most participant responses indicated a positive opinion of yoga. Nine adolescents (60 %) from Part A participated in Part B of the study. The median age of 9 participants in Part B was 17 (IQR 15-18), and 5 of the 9 participants were female (53.3 %). Only one participant was able to attend 3 of the 8 yoga sessions offered, and did not experience any ED visits or hospitalizations following the yoga sessions. None of the other feasibility endpoints were met in this study. CONCLUSIONS Patients with SCD and chronic pain overall have a positive opinion of yoga, but there are challenges with recruitment and retention of participants in a clinical trial of yoga, and barriers to feasibility of an in-person group yoga intervention.
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Affiliation(s)
- Nitya Bakshi
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA; Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | - Anthony Cooley
- Division of Hospital Medicine, Department of Pediatrics, Emory University, USA
| | - Diana Ross
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Lauren Hawkins
- Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA
| | | | - Rachel Astles
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Cynthia Sinha
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Deeksha Katoch
- Department of Pediatrics, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Manasa Peddineni
- NOVA Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA
| | - Beatrice E Gee
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA; Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Peter A Lane
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA; Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Lakshmanan Krishnamurti
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA; Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA, USA
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17
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Kanchibhotla D, Subramanian S, Kaushik B. Association of yogic breathing with perceived stress and conception of strengths and difficulties in teenagers. Clin Child Psychol Psychiatry 2021; 26:406-417. [PMID: 33588582 DOI: 10.1177/1359104521994633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mental health problems are increasing at an alarming rate throughout the world, and teenagers are no exception. They experience high levels of stress in their formative years which often leads to poor social behavior. In the present study, we examine the effect of Sudarshan Kriya Yoga (SKY), a yogic breathing technique on perceived stress and social behavior of school going teenagers. METHOD A cross-sectional survey was conducted. Teenagers who practiced SKY daily constituted the study group and teenagers who did not practice any form of yoga or meditation formed the control group. Child Perceived Stress scale (C-PSS) and Strength and Difficulty questionnaire (SDQ) were used to evaluate the mental health and social behavior of both groups. RESULTS Lower stress scores were observed among students who practiced SKY compared to their peers. A significant difference was observed between the groups with respect to emotional problems, conduct problems, peer problems, and pro-social behavior. Gender wise comparison highlighted that the females from the SKY group scored lower on emotional problems sub-scale compared to their counterparts from control group. Results also highlighted an improved peer to peer interaction among both boys and girls in the SKY group. CONCLUSION The results indicate the practice of SKY is associated with reduced stress, improved self-awareness, and social behavior.
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Affiliation(s)
| | | | - Bharti Kaushik
- Department of Education of Groups with Special Needs, National Council of Educational Research and Training, New Delhi, Delhi, India
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18
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Liu A. Pediatric Complementary Medicine. Pediatr Ann 2021; 50:e91-e95. [PMID: 34038648 DOI: 10.3928/19382359-20210217-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Complementary medicine is being used more broadly by many patients and physicians; however, little formal education has been provided on the topic. Given the prevalence of its use, pediatricians should have awareness of the options available as well as a certain level of comfort in counseling patients and families. This article aims to broaden knowledge on this topic as well as the evidence to support its use. [Pediatr Ann. 2021;50(3):e91-e95.].
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Philipson A, Särnblad S, Ekstav L, Eriksson M, Fagerberg UL, Möller M, Mörelius E, Duberg A. An Intervention With Dance and Yoga for Girls With Functional Abdominal Pain Disorders (Just in TIME): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e19748. [PMID: 33320103 PMCID: PMC7772067 DOI: 10.2196/19748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/02/2020] [Accepted: 11/05/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Functional abdominal pain disorders (FAPDs) affect many children worldwide, predominantly girls, and cause considerable long-term negative consequences for individuals and society. Evidence-based and cost-effective treatments are therefore strongly needed. Physical activity has shown promising effects in the practical management of FAPDs. Dance and yoga are both popular activities that have been shown to provide significant psychological and pain-related benefits with minimal risk. The activities complement each other, in that dance involves dynamic, rhythmic physical activity, while yoga enhances relaxation and focus. OBJECTIVE This study aims to evaluate the effects of a dance and yoga intervention among girls aged 9 to 13 years with FAPDs. METHODS The study is a prospective randomized controlled trial among girls aged 9 to 13 years with functional abdominal pain, irritable bowel syndrome, or both. The target sample size was 150 girls randomized into 2 arms: an intervention arm that receives dance and yoga sessions twice weekly for 8 months and a control arm that receives standard care. Outcomes will be measured at baseline and after 4, 8, 12, and 24 months, and long-term follow-up will be conducted 5 years from baseline. Questionnaires, interviews, and biomarker measures, such as cortisol in saliva and fecal microbiota, will be used. The primary outcome is the proportion of girls in each group with reduced pain, as measured by the faces pain scale-revised in a pain diary, immediately after the intervention. Secondary outcomes are gastrointestinal symptoms, general health, mental health, stress, and physical activity. The study also includes qualitative evaluations and health economic analyses. This study was approved by the Regional Ethical Review Board in Uppsala (No. 2016/082 1-2). RESULTS Data collection began in October 2016. The intervention has been performed in 3 periods from 2016 through 2019. The final 5-year follow-up is anticipated to be completed by fall 2023. CONCLUSIONS Cost-effective and easily accessible interventions are warranted to reduce the negative consequences arising from FAPDs in young girls. Physical activity is an effective strategy, but intervention studies are needed to better understand what types of activities facilitate regular participation in this target group. The Just in TIME (Try, Identify, Move, and Enjoy) study will provide insights regarding the effectiveness of dance and yoga and is anticipated to contribute to the challenging work of reducing the burden of FAPDs for young girls. TRIAL REGISTRATION ClinicalTrials.gov (NCT02920268); https://clinicaltrials.gov/ct2/show/NCT02920268. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19748.
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Affiliation(s)
- Anna Philipson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Stefan Särnblad
- Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Lars Ekstav
- Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Ulrika L Fagerberg
- Centre for Clinical Research, Västmanland Hospital Västerås, Uppsala University, Uppsala, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Margareta Möller
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Evalotte Mörelius
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - Anna Duberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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20
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Cozzolino M, Vivo DR, Girelli L, Limone P, Celia G. The Evaluation of a Mind-Body Intervention (MBT-T) for Stress Reduction in Academic Settings: A Pilot Study. Behav Sci (Basel) 2020; 10:bs10080124. [PMID: 32751650 PMCID: PMC7464367 DOI: 10.3390/bs10080124] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 11/16/2022] Open
Abstract
This study is aimed at evaluating the outcomes of mind-body transformation therapy (MBT-T), previously known as the creative psychosocial genomic healing experience© (CPGHE). The intervention was aimed at reducing the perceived level of stress in two non-clinical groups of students with different educational levels and different expertise in the domain of well-being. Whereas participants from the first group were first-year university students, participants from the second group were students attending a post-graduate program in psychotherapy. All participants (n = 159) were exposed to a single session of MBT-T, each group in a separate session. The results of two paired-samples t-tests, conducted separately on the two samples, showed that there was a statistically significant reduction in the participants' perceived level of stress between pre- and post-intervention states in both samples (t88 = 5.39, p < 0.001; t53 = 4.56, p < 0.001 respectively). The results, therefore, showed that a single session of MBT-T was beneficial in reducing the perceived level of stress in both first-year university students and students attending a post-graduate program in psychotherapy, regardless of educational level and expertise in the domain of well-being.
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Affiliation(s)
- Mauro Cozzolino
- Department of Humanities, Philosophy and Education, University of Salerno, 84084 Fisciano, Italy; (D.R.V.); (L.G.)
- Correspondence: ; Tel.: +39-339-685-7115
| | - Deborah R. Vivo
- Department of Humanities, Philosophy and Education, University of Salerno, 84084 Fisciano, Italy; (D.R.V.); (L.G.)
| | - Laura Girelli
- Department of Humanities, Philosophy and Education, University of Salerno, 84084 Fisciano, Italy; (D.R.V.); (L.G.)
| | - Pierpaolo Limone
- Department of Humanities, Literature, Cultural Heritage, Education Sciences, University of Foggia, 71122 Foggia, Italy; (P.L.); (G.C.)
| | - Giovanna Celia
- Department of Humanities, Literature, Cultural Heritage, Education Sciences, University of Foggia, 71122 Foggia, Italy; (P.L.); (G.C.)
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21
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Cozzolino M, Girelli L, Vivo DR, Limone P, Celia G. A mind-body intervention for stress reduction as an adjunct to an information session on stress management in university students. Brain Behav 2020; 10:e01651. [PMID: 32383355 PMCID: PMC7303398 DOI: 10.1002/brb3.1651] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION This study describes the implementation of a mind-body intervention to reduce the perceived level of stress in a nonclinical group of university students. We used a novel approach including a single session of a mind-body technique known as the brain wave modulation (BWM) as an adjunct to a single information session on stress management. METHODS Three hundred and six students participated in the study. A quasi-experimental design was adopted: Students in the experimental group were exposed to an information session on stress management followed by a single session of the BWM, while the other students were exposed to the information session alone. RESULTS A 2 × 2 mixed factor analysis of variance demonstrated that the single session of the BWM was effective in reducing the perceived level of stress in the experimental group as compared to the control group. CONCLUSION The BWM is a very easy-to-learn technique that presents certain advantages over traditional mind-body methods.
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Affiliation(s)
- Mauro Cozzolino
- Department of Humanities, Philosophy and Education, University of Salerno, Fisciano, Italy
| | - Laura Girelli
- Department of Humanities, Philosophy and Education, University of Salerno, Fisciano, Italy
| | - Deborah R Vivo
- Department of Humanities, Philosophy and Education, University of Salerno, Fisciano, Italy
| | - Pierpaolo Limone
- Department of Humanities, Literature, Cultural Heritage, Education Sciences, University of Foggia, Foggia, Italy
| | - Giovanna Celia
- Department of Humanities, Literature, Cultural Heritage, Education Sciences, University of Foggia, Foggia, Italy
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22
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Impact of Sophrology on cardiopulmonary fitness in teenagers and young adults with a congenital heart disease: The SOPHROCARE study rationale, design and methods. IJC HEART & VASCULATURE 2020; 27:100489. [PMID: 32154361 PMCID: PMC7057190 DOI: 10.1016/j.ijcha.2020.100489] [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] [Received: 10/30/2019] [Revised: 02/17/2020] [Accepted: 02/20/2020] [Indexed: 11/21/2022]
Abstract
Background Recent advances in the field of congenital heart disease (CHD) have significantly improved the overall prognosis. Now more attention is being given to health-related quality of life (HRQoL) and promotion of physical activity. Non-invasive relaxation therapy may be effective in cardiac patients concerned with exercise-induced dyspnoea. The SOPHROCARE randomised trial aims to assess the impact of Caycedian Sophrology on cardiopulmonary fitness in adolescents and young adults with CHD. Methods The SOPHROCARE trial is a nationwide, multicentre, randomised, controlled study in CHD patients aged from 13 to 25 years old. Patients will be randomised into 2 groups (8 Sophrology group sessions vs. no intervention). The primary outcome is the change in percent predicted maximum oxygen uptake (VO2max) between baseline and 12-month follow-up. A total of 94 patients in each group is required to observe a significant increase of 10% in VO2max with a power of 80% and an alpha risk of 5%. The secondary outcomes are: clinical outcomes, cardiopulmonary exercise test parameters (VE/VCO2 slope, ventilatory anaerobic threshold, oxygen pulse, respiratory response to hypercapnia), health-related quality of life score (PedsQL), physical and psychological status. Conclusion After focusing on the survival in CHD, current research is opening on secondary prevention and patient-related outcomes. We sought to assess in the SOPHROCARE trial, if a Sophrology program, could improve exercise capacity and quality of life in youth with CHD. Trial registration Clinicaltrials.gov (NCT03999320).
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Integrative oder alternative Kinder- und Jugendmedizin? Monatsschr Kinderheilkd 2019. [DOI: 10.1007/s00112-019-0737-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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McClafferty H. An Overview of Pediatric Integrative Medicine. Pediatr Ann 2019; 48:e216-e219. [PMID: 31185111 DOI: 10.3928/19382359-20190515-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pediatric integrative medicine is an emerging field with significant potential to benefit children's health. It focuses on enhancing modern approaches to preventive health and expanding treatment options in complex or chronic conditions. The field fills important gaps in pediatric care and has accrued a robust body of supporting evidence to support its growth. This article provides an overview of pediatric integrative medicine, including background, scope of practice, strengths and challenges, safety and efficacy issues, and examples of how one might introduce integrative medicine into pediatric practice. [Pediatr Ann. 2019;48(6):e216-e219.].
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Thompson AP, Thompson DS, Jou H, Vohra S. Relaxation training for management of paediatric headache: A rapid review. Paediatr Child Health 2019; 24:103-114. [PMID: 30996601 DOI: 10.1093/pch/pxy157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 09/14/2018] [Indexed: 11/13/2022] Open
Abstract
The objective of this review was to assess the evidence on relaxation training for management of paediatric headaches. Our methodology was a rapid review of English-language peer reviewed published literature focused on studies evaluating relaxation training as a primary or adjunct management option for headache in a paediatric population (0 to 18 years of age). Seven studies involving 571 children were included in the review. The quality of evidence was very low using GRADE criteria. Headache frequency, duration, and intensity were the primary outcomes in the included studies. Results for the effects of relaxation training for paediatric headache are inconsistent. Four of the seven studies reported decreased headache frequency, two of the five studies reported decreased headache duration, and two of the six studies reported decreased headache intensity following relaxation training. No adverse events were reported. The current state of the evidence for relaxation training for management of paediatric headache is both inconsistent and of very low quality. High-quality research evaluating the effects of relaxation training for paediatric headaches is required to advance the field.
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Affiliation(s)
- Alison P Thompson
- Faculty of Nursing, University of Alberta, Edmonton, Alberta.,School of Nursing, Lakehead University, Thunder Bay, Ontario
| | | | - Hsing Jou
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta
| | - Sunita Vohra
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta
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Hypnotherapy or transcendental meditation versus progressive muscle relaxation exercises in the treatment of children with primary headaches: a multi-centre, pragmatic, randomised clinical study. Eur J Pediatr 2019; 178:147-154. [PMID: 30357468 PMCID: PMC6339662 DOI: 10.1007/s00431-018-3270-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 10/05/2018] [Accepted: 10/11/2018] [Indexed: 12/02/2022]
Abstract
Many children suffer from headaches. Since stress may trigger headaches, effective techniques to cope with stress are needed. We investigated the effectiveness of two mind-body techniques, transcendental meditation (TM) or hypnotherapy (HT), and compared them with progressive muscle relaxation (PMR) exercises (active control group). Children (9-18 years) suffering from primary headaches more than two times per month received either TM (N = 42), HT (N = 45) or PMR (N = 44) for 3 months. Primary outcomes were frequency of headaches and ≥ 50% reduction in headaches at 3 and 9 months. Secondary outcomes were adequate relief, pain coping, anxiety and depressive symptoms, somatisation and safety of treatment. Groups were comparable at baseline. Headache frequency was significantly reduced in all groups from 18.9 days per month to 12.5 and 10.5 at respectively 3 and 9 months (p < 0.001), with no significant differences between the groups. Clinically relevant headache reduction (≥ 50%) was observed in 41% and 47% of children at 3 and 9 months respectively, with no significant differences between the groups. No differences were observed in secondary outcome measures between the intervention groups. No adverse events were reported.Conclusion: All three techniques reduced primary headache in children and appeared to be safe.Trial registration: NTR 2955, 28 June 2011 ( www.trialregister.nl ) What is Known: • Stress may be an important trigger for both tension type headache and migraine in children. • Good data are lacking on the effect of transcendental meditation, hypnotherapy or progressive muscle relaxation as possible stress-reducing therapies in children with primary headaches. What is New: • Three non-pharmacological techniques, i.e., transcendental meditation, hypnotherapy and progressive muscle relaxation exercises, all result in a clinically significant reduction of headaches and use of pain medication. • No large differences between the three techniques were found, suggesting that children can choose either one of the three techniques based on personal preferences.
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Amedro P, Gavotto A, Gelibert D, Fraysse V, De La Villeon G, Vandenberghe D, Bredy C. Feasibility of clinical hypnosis for transesophageal echocardiography in children and adolescents. Eur J Cardiovasc Nurs 2018; 18:163-170. [PMID: 30230358 DOI: 10.1177/1474515118803513] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The use of hypnosis in children has been described more than two centuries ago, with a more recent research and clinical application. There is currently a good level of evidence for the efficacy of clinical hypnosis in children for minor surgery, medical procedures or pain management. The use of clinical hypnosis, in paediatric cardiology, for invasive procedures such as transesophageal echocardiography, has not been reported. AIMS This study evaluated the feasibility of clinical hypnosis in children undergoing transesophageal echocardiography. METHOD This prospective, non-randomised, cross-sectional study was carried out over 24 months in a paediatric cardiology referral centre. All children aged 10-18 years requiring a transesophageal echocardiography examination, outside the operating room and the catheterisation laboratory, were eligible for the study. Children and families could choose between transesophageal echocardiography under clinical hypnosis or under general anaesthesia (<15 years) or sedation (⩾15 years). RESULTS We included 16 children aged 11-18 years (seven girls, mean age 14.1±2.5 years). The hypnotic state was achieved for 15 out of the 16 participating children (94%). The transesophageal echocardiography examination could be completely achieved with a full diagnosis for 15 out of 16 children (94%). In all cases, a transesophageal echocardiography examination under clinical hypnosis provided a complete diagnosis. CONCLUSION This study demonstrated that hypnosis was feasible and effective for transesophageal echocardiography in adolescents and might be a good alternative to general anaesthesia. Further study with larger numbers of subjects and more diverse congenital cardiac conditions are needed to confirm the results in a more diverse sample.
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Affiliation(s)
- Pascal Amedro
- 1 Pediatric and Congenital Cardiology Department, CHU Montpellier, France.,2 PHYMEDEXP, CNRS, INSERM, University of Montpellier, France
| | - Arthur Gavotto
- 1 Pediatric and Congenital Cardiology Department, CHU Montpellier, France
| | | | | | | | | | - Charlene Bredy
- 1 Pediatric and Congenital Cardiology Department, CHU Montpellier, France
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Wang C, Preisser J, Chung Y, Li K. Complementary and alternative medicine use among children with mental health issues: results from the National Health Interview Survey. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:241. [PMID: 30157825 PMCID: PMC6116551 DOI: 10.1186/s12906-018-2307-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 08/14/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Mental health issues in children have become a serious public health concern in the U.S. within the past few decades. Emerging evidence suggests that Complementary and Alternative Medicine (CAM) can be beneficial for various mental health issues. However, little is known about the prevalence, reasons, and associated factors of CAM use among this population in the U.S. The purpose of this study is to examine the characteristics of CAM use among U.S. children with mental health issues. METHODS Utilizing the 2012 National Health Interview Survey data, we used descriptive analysis, Wald F-statistics, and multivariable survey logistic regression models to examine the prevalence, patterns, and associated factors of CAM use in children aged 4-17 (n = 10,233) adjusting for the complex sampling design. RESULTS CAM use is more popular among children with mental health issues compared with those without (19.2% vs. 10.1%, p < 0.001). Herbal remedies (9.1%), mind-body therapies (5.5%), and chiropractic care (5.3%) were the most frequently used modalities. Primary reasons for children to use CAM are because they are helpful (69.2%), natural (55.9%), and holistic (44.7%). The majority of CAM users perceived CAM therapies are helpful. Predictors of CAM use are children who are female, whose parents had a higher educational level and socioeconomic status, and who had at least one co-morbid medical condition. Only 18.4% of CAM usage was recommended by medical doctors. CONCLUSIONS Approximately 10 million parents of children with mental health issues reported the use of CAM therapies, mainly because of their desire for a more natural and holistic healthcare approach. Given that the majority of CAM users perceived CAM therapies as helpful, future studies should investigate the unique contributions of CAM in pediatric psychiatric care. Because a low percentage of CAM use was recommended by medical doctors, educational interventions designed to equip medical professionals with CAM knowledge and experience will be conducive to improving effective patient-physician communication in clinical settings. Since CAM use is reported as more prevalent by parents' of children with higher education and family income, effective strategies designed to reduce disparities in accessing promising CAM therapies are warranted.
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Affiliation(s)
- Claudia Wang
- School of Physical Education, Pingdingshan University, South Weilai Rd, Pingdingshan City New District, Pingdingshan, Henan Province 467000 People’s Republic of China
| | - John Preisser
- Department of Biostatistics, the University of North Carolina at Chapel Hill, Chapel Hill, NC 27516 USA
| | - Yunro Chung
- Fred Hutchinson Cancer Research, Seattle, WA 98109 USA
| | - Kaigang Li
- Department of Health & Exercise Science, Colorado State University, Fort Collins, CO 80523 USA
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Pandya SP. Yoga, Emotional Awareness and Happiness in Children: A Multi-City Study of the Chinmaya Bala Vihar Programme. CHILD & YOUTH CARE FORUM 2018. [DOI: 10.1007/s10566-018-9468-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kaiser P, Kohen DP, Brown ML, Kajander RL, Barnes AJ. Integrating Pediatric Hypnosis with Complementary Modalities: Clinical Perspectives on Personalized Treatment. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E108. [PMID: 30087271 PMCID: PMC6111600 DOI: 10.3390/children5080108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 02/06/2023]
Abstract
While pediatric integrative medicine (PIM) emphasizes an "evidence-based practice using multiple therapeutic modalities"; paradoxically, literature reviews examining the prevalence and/or efficacy of such mind⁻body approaches often address PIM modalities separately. Such contributions are relevant, yet documentation of how to deliver combined complementary approaches in children and youth are scarce. Nevertheless, integrative practitioners in clinical practice routinely mix approaches to meet the individual needs of each patient. Best practices are flexible, and include blending and augmenting services within the same session, and/or connecting modalities sequentially for an incremental effect, and/or referring to outside resources for additional interventions. Resonating with integrative medicine's definition, this article's goal is to demonstrate paradigms that "bring together complementary approaches in a coordinated way within clinical practice" by linking clinical hypnosis, the trail-blazer modality in PIM's history, with mindfulness, biofeedback, acupuncture, and yoga. Following the consideration of the overlap of guided imagery with hypnosis and an abridged literature report, this clinical perspective considers the selection of modalities within a collaborative relationship with the child/teen and parents, emphasizing goodness-of-fit with patients' contexts, e.g., symptoms, resources, interests, goals, and developmental stage. Case vignettes illustrate practical strategies for mixing approaches.
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Affiliation(s)
- Pamela Kaiser
- National Pediatric Hypnosis Training Institute (NPHTI), 29 Western Terrace, Minneapolis, MN 55426, USA.
| | - Daniel P Kohen
- National Pediatric Hypnosis Training Institute (NPHTI), 29 Western Terrace, Minneapolis, MN 55426, USA.
- Partners-in-Healing, 10505 Wayzata Blvd #200, Minnetonka, MN 55305, USA.
- Department of Pediatrics, University of Minnesota, 717 Delaware St SE #353, Minneapolis, MN 55414, USA.
| | - Melanie L Brown
- Department of Pediatrics, University of Minnesota, 717 Delaware St SE #353, Minneapolis, MN 55414, USA.
- Children's Hospitals and Clinics of Minnesota, 2525 Chicago Ave, Minneapolis, MN 55404, USA.
| | - Rebecca L Kajander
- National Pediatric Hypnosis Training Institute (NPHTI), 29 Western Terrace, Minneapolis, MN 55426, USA.
| | - Andrew J Barnes
- National Pediatric Hypnosis Training Institute (NPHTI), 29 Western Terrace, Minneapolis, MN 55426, USA.
- Department of Pediatrics, University of Minnesota, 717 Delaware St SE #353, Minneapolis, MN 55414, USA.
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Affiliation(s)
- Joy A Weydert
- Department of Pediatrics, University of Kansas Health System, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - Melanie L Brown
- Department of Pediatrics, University of Minnesota Medical School, Children's Hospitals and Clinics of Minnesota, 2525 Chicago Avenue South, Suite 32-T5, Minneapolis, MN 55304, USA
| | - Hilary McClafferty
- Department of Medicine, Center for Integrative Medicine, University of Arizona, PO Box 245153, Tucson, AZ 85724, USA
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Orr SL, Kabbouche MA, O’Brien HL, Kacperski J, Powers SW, Hershey AD. Paediatric migraine: evidence-based management and future directions. Nat Rev Neurol 2018; 14:515-527. [DOI: 10.1038/s41582-018-0042-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Shafto K, Gouda S, Catrine K, Brown ML. Integrative Approaches in Pediatric Palliative Care. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E75. [PMID: 29899281 PMCID: PMC6025424 DOI: 10.3390/children5060075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/22/2018] [Accepted: 06/05/2018] [Indexed: 11/26/2022]
Abstract
Pediatric palliative care is a field which focuses on caring for and treating the symptoms and distress typically associated with life-limiting illness. Integrative medicine is supported by evidence and aims to heal the whole person, including all aspects of one’s lifestyle. Therapies offered by integrative medicine often empower patients and families, allowing for a sense of control. This review addresses the merging of integrative medicine philosophy and modalities with the care given to children with life-limiting illness. We review an introduction to integrative medicine, trends in its incorporation in the healthcare setting, application to patients receiving palliative care and the management of specific symptoms. A case study is offered to illustrate these principles.
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Affiliation(s)
- Kate Shafto
- Department of Internal Medicine and Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Suzanne Gouda
- Department of Pediatrics, University of Chicago, Chicago, IL 60637, USA.
| | - Kris Catrine
- Department of Pain Medicine, Palliative Care and Integrative Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA.
| | - Melanie L Brown
- Department of Pain Medicine, Palliative Care and Integrative Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA.
- Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA.
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Lopez Abel B, I Martínez-Soto M, Luz Couce M. Integrative cardiology-state of the art of mind body therapies for the treatment of cardiovascular disease and risk factors. AIMS MEDICAL SCIENCE 2018. [DOI: 10.3934/medsci.2018.1.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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David H. [Rethinking birth: Ideas for pediatrician-coordinated care, from conception to the postnatal period]. Arch Pediatr 2017; 24:1169-1172. [PMID: 29158046 DOI: 10.1016/j.arcped.2017.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 09/15/2017] [Indexed: 11/24/2022]
Affiliation(s)
- H David
- Service de pédiatrie, CHV, 177, rue de Versailles, 78150 Le-Chesnay, France.
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Bethell CD, Solloway MR, Guinosso S, Hassink S, Srivastav A, Ford D, Simpson LA. Prioritizing Possibilities for Child and Family Health: An Agenda to Address Adverse Childhood Experiences and Foster the Social and Emotional Roots of Well-being in Pediatrics. Acad Pediatr 2017; 17:S36-S50. [PMID: 28865659 DOI: 10.1016/j.acap.2017.06.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/03/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE A convergence of theoretical and empirical evidence across many scientific disciplines reveals unprecedented possibilities to advance much needed improvements in child and family well-being by addressing adverse childhood experiences (ACEs), promoting resilience, and fostering nurturance and the social and emotional roots of healthy child development and lifelong health. In this article we synthesize recommendations from a structured, multiyear field-building and research, policy, and practice agenda setting process to address these issues in children's health services. METHODS Between Spring of 2013 and Winter of 2017, the field-building and agenda-setting process directly engaged more than 500 individuals and comprised 79 distinct agenda-setting and field-building activities and processes, including: 4 in-person meetings; 4 online crowdsourcing rounds across 10 stakeholder groups; literature and environmental scans, publications documenting ACEs, resilience, and protective factors among US children, and commissioning of this special issue of Academic Pediatrics; 8 in-person listening forums and 31 educational sessions with stakeholders; and a range of action research efforts with emerging community efforts. Modified Delphi processes and grounded theory methods were used and iterative and structured synthesis of input was conducted to discern themes, priorities, and recommendations. RESULTS Participants discerned that sufficient scientific findings support the formation of an applied child health services research and policy agenda. Four overarching priorities for the agenda emerged: 1) translate the science of ACEs, resilience, and nurturing relationships into children's health services; 2) cultivate the conditions for cross-sector collaboration to incentivize action and address structural inequalities; 3) restore and reward for promoting safe and nurturing relationships and full engagement of individuals, families, and communities to heal trauma, promote resilience, and prevent ACEs; and 4) fuel "launch and learn" research, innovation, and implementation efforts. Four research areas arose as central to advancing these priorities in the short term. These are related to: 1) family-centered clinical protocols, 2) assessing effects on outcomes and costs, 3) capacity-building and accountability, and 4) role of provider self-care to quality of care. Finally, we identified 16 short-term actions to leverage existing policies, practices, and structures to advance agenda priorities and research priorities. CONCLUSIONS Efforts to address the high prevalence and negative effects of ACEs on child health are needed, including widespread and concrete understanding and strategies to promote awareness, resilience, and safe, stable, nurturing relationships as foundational to healthy child development and sustainable well-being throughout life. A paradigm-shifting evolution in individual, organizational, and collective mindsets, policies, and practices is required. Shifts will emphasize the centrality of relationships and regulation of emotion and stress to brain development as well as overall health. They will elevate relationship-centered methods to engage individuals, families, and communities in self-care related to ACEs, stress, trauma, and building the resilience and nurturing relationships science has revealed to be at the root of well-being. Findings reflect a palpable hope for prevention, mitigation, and healing of individual, intergenerational, and community trauma associated with ACEs and provide a road map for doing so.
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Affiliation(s)
- Christina D Bethell
- Child and Adolescent Health Measurement Initiative, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
| | - Michele R Solloway
- Child and Adolescent Health Measurement Initiative, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Stephanie Guinosso
- Child and Adolescent Health Measurement Initiative, California School-Based Health Alliance, Berkeley, Calif
| | - Sandra Hassink
- Center for Pharmacogenomics and Translational Research, Division of Pediatric Weight Management, Department of Pediatrics, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, Del
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Mind-Body Medicine in Pediatrics. CHILDREN-BASEL 2017; 4:children4090076. [PMID: 28841200 PMCID: PMC5615266 DOI: 10.3390/children4090076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 08/22/2017] [Accepted: 08/24/2017] [Indexed: 11/17/2022]
Abstract
The primary goals of this Special Issue are to encourage readers to become more familiar with the range of mind-body therapies and to explore their application in the pediatric clinical setting. The Special Issue includes a deliberate mix of case studies and practical clinical guidance, with the dual goals of piquing curiosity and providing resources for clinicians interested in pursuing further training.
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Duparc-Alegria N, Tiberghien K, Abdoul H, Dahmani S, Alberti C, Thiollier AF. Assessment of a short hypnosis in a paediatric operating room in reducing postoperative pain and anxiety: A randomised study. J Clin Nurs 2017; 27:86-91. [PMID: 28403569 DOI: 10.1111/jocn.13848] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To assess the impact of a short hypnotic session on postoperative anxiety and pain in major orthopaedic surgery. BACKGROUND Despite specific information given before a scheduled paediatric surgery, perioperative anxiety can become important. DESIGN Randomised Clinical Study. METHODS The study is an open single-centre randomised clinical study comparing a "control" group versus a "hypnosis" group receiving a short hypnosis pre-induction session as additional experimental analgesic procedure. The primary endpoint was the postoperative anxiety, blindly assessed using a visual analogue scale. RESULTS The study involved 120 children (age 10-18 years). The results showed no difference between control group versus hypnosis group. Twenty-four hours after surgery (Day+1), the patient's anxiety score was not different between control and hypnosis groups (median [Q1-Q3]: 1 [0; 3] vs. 0 [0; 3], respectively, p = .17). Each group experienced a significant decrease in anxiety level between the day before surgery (Day-1) and the day after surgery (Day+1) (median ([Q1-Q3]) difference of the anxiety score: 2 [4; 0] and 2 [4; 0], respectively, p < .0001 in each group). The postoperative pain scores were low and not different between groups (median [Q1-Q3]: 2 [0; 3] in control group vs. 3 [1; 3] in hypnosis group, p = .57). CONCLUSION This randomised study on a short hypnosis session performed in the operating room prior to a major surgery showed no difference in postoperative anxiety and pain levels. The decrease in anxiety and pain levels may be due to the addition of nurse pre-operative interviews and optimisation in communication in the operating room. RELEVANCE TO CLINICAL PRACTICE As postoperative anxiety level was low in both control and hypnosis groups, nurse pre-operative interviews and nurse training in hypnosis may contribute to the optimisation of global management and decrease the postoperative anxiety level.
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Affiliation(s)
- Nathalie Duparc-Alegria
- Pain Management Unit, Department of Anaesthesiology, AP-HP, Hôpital Robert-Debré, Paris, France
| | - Karine Tiberghien
- Pain Management Unit, Department of Anaesthesiology, AP-HP, Hôpital Robert-Debré, Paris, France
| | - Hendy Abdoul
- Unit of Clinical Epidemiology and CIC-EC 1456, AP-HP, Hôpital Robert-Debré, Paris, France.,Univ. Paris Diderot, Sorbonne Paris Cité, UMR-S 1123, Paris, France
| | - Souhayl Dahmani
- Pain Management Unit, Department of Anaesthesiology, AP-HP, Hôpital Robert-Debré, Paris, France.,Univ. Paris Diderot, Sorbonne Paris Cité, UMR-S 1141, DHU Protect, Paris, France.,INSERM, U1141, DHU Protect, Paris, France
| | - Corinne Alberti
- Unit of Clinical Epidemiology and CIC-EC 1456, AP-HP, Hôpital Robert-Debré, Paris, France.,Univ. Paris Diderot, Sorbonne Paris Cité, UMR-S 1123, Paris, France.,INSERM, U1123, ECEVE and CIC-EC 1456, Paris, France
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Brown ML, Rojas E, Gouda S. A Mind-Body Approach to Pediatric Pain Management. CHILDREN (BASEL, SWITZERLAND) 2017; 4:E50. [PMID: 28632194 PMCID: PMC5483625 DOI: 10.3390/children4060050] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/11/2017] [Accepted: 06/13/2017] [Indexed: 12/19/2022]
Abstract
Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind-body techniques that are often used in the adult population for pain and symptom management. In addition to providing significant pain relief, several studies have reported reduced use of opioid medications when mind-body therapies are implemented. Mind-body medicine is another approach that can be used in children with both acute and chronic pain to improve pain management and quality of life.
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Affiliation(s)
- Melanie L Brown
- Department of Pediatrics, The University of Chicago, Chicago, IL 60637, USA (E.R.).
- Department of Pain, Palliative Care and Integrative Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA.
| | - Enrique Rojas
- Department of Pediatrics, The University of Chicago, Chicago, IL 60637, USA (E.R.).
| | - Suzanne Gouda
- Department of Pediatrics, The University of Chicago, Chicago, IL 60637, USA (E.R.).
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Culbert T. Perspectives on Technology-Assisted Relaxation Approaches to Support Mind-Body Skills Practice in Children and Teens: Clinical Experience and Commentary. CHILDREN-BASEL 2017; 4:children4040020. [PMID: 28375179 PMCID: PMC5406679 DOI: 10.3390/children4040020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 03/13/2017] [Accepted: 03/19/2017] [Indexed: 02/03/2023]
Abstract
It has been well-established that a variety of mind-body (MB) techniques, including yoga, mental imagery, hypnosis, biofeedback, and meditation, are effective at addressing symptoms such as pain, anxiety, nausea, and insomnia, as well as helping with a wide variety of medical, emotional, and behavioral issues in pediatric populations. In addition, MB skills can also be health-promoting in the long-term, and with regular practice, could potentially contribute to longer attention spans, social skills, emotional regulation, and enhanced immune system functioning. Importantly, the benefits accrued from MB skills are largely dose-dependent, meaning that individuals who practice with some consistency tend to benefit the most, both in the short- and long-term. However, clinical experience suggests that for busy patients, the regular practice of MB skills can be challenging and treatment adherence commonly becomes an issue. This commentary reviews the concept of technology-assisted relaxation as an engaging and effective option to enhance treatment adherence (i.e., daily practice) for pediatric patients, for whom MB skills have been recommended to address physical and mental health challenges.
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Mind-Body Interventions for Pediatric Inflammatory Bowel Disease. CHILDREN-BASEL 2017; 4:children4040022. [PMID: 28368365 PMCID: PMC5406681 DOI: 10.3390/children4040022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 03/17/2017] [Accepted: 03/28/2017] [Indexed: 12/15/2022]
Abstract
Pediatric inflammatory bowel disease is an autoimmune disease that causes chronic inflammation of the gastrointestinal mucosa. There is emerging evidence that the brain–gut connection affects inflammatory bowel disease (IBD) patients more than previously thought. This is evidenced by comorbid mood disorders, irritable bowel symptoms concurrent with quiescent IBD, and the potential of psychosocial stressors to trigger IBD flares. Mind–body interventions such as psychotherapy, relaxation, mindfulness, biofeedback, yoga, and clinical hypnosis offer an adjunct to standard medical treatment for IBD. We will review the current evidence base for these mind–body interventions in the treatment of pediatric IBD, illustrate a case study, and offer suggestions for future research for this promising field.
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Abstract
Medical yoga is defined as the use of yoga practices for the prevention and treatment of medical conditions. Beyond the physical elements of yoga, which are important and effective for strengthening the body, medical yoga also incorporates appropriate breathing techniques, mindfulness, and meditation in order to achieve the maximum benefits. Multiple studies have shown that yoga can positively impact the body in many ways, including helping to regulate blood glucose levels, improve musculoskeletal ailments and keeping the cardiovascular system in tune. It also has been shown to have important psychological benefits, as the practice of yoga can help to increase mental energy and positive feelings, and decrease negative feelings of aggressiveness, depression and anxiety.
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