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Hojo E, Sui Y, Shan X, Zheng K, Rossman P, Manduca A, Powell GM, An KN, Zhao KD, Bauer BA, Ehman RL, Yin Z. MR elastography-based slip interface imaging (SII) for functional assessment of myofascial interfaces: A feasibility study. Magn Reson Med 2024. [PMID: 38523575 DOI: 10.1002/mrm.30087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE Abnormal adherence at functional myofascial interfaces is hypothesized as an important phenomenon in myofascial pain syndrome. This study aimed to investigate the feasibility of MR elastography (MRE)-based slip interface imaging (SII) to visualize and assess myofascial mobility in healthy volunteers. METHODS SII was used to assess local shear strain at functional myofascial interfaces in the flexor digitorum profundus (FDP) and thighs. In the FDP, MRE was performed at 90 Hz vibration to each index, middle, ring, and little finger. Two thigh MRE scans were performed at 40 Hz with knees flexed and extended. The normalized octahedral shear strain (NOSS) maps were calculated to visualize myofascial slip interfaces. The entropy of the probability distribution of the gradient NOSS was computed for the two knee positions at the intermuscular interface between vastus lateralis and vastus intermedius, around rectus femoris, and between vastus intermedius and vastus medialis. RESULTS NOSS map depicted distinct functional slip interfaces in the FDP for each finger. Compared to knee flexion, clearer slip interfaces and larger gradient NOSS entropy at the vastus lateralis-vastus intermedius interface were observed during knee extension, where the quadriceps are not passively stretched. This suggests the optimal position for using SII to visualize myofascial slip interface in skeletal muscles is when muscles are not subjected to any additional force. CONCLUSION The study demonstrated that MRE-based SII can visualize and assess myofascial interface mobility in extremities. The results provide a foundation for investigating the hypothesis that myofascial pain syndrome is characterized by changes in the mobility of myofascial interfaces.
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Affiliation(s)
- Emi Hojo
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Yi Sui
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Xiang Shan
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Keni Zheng
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Phillip Rossman
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Armando Manduca
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Garret M Powell
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Kai-Nan An
- Orthopedics Research, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Kristin D Zhao
- Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Brent A Bauer
- General Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Richard L Ehman
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Ziying Yin
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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Sung J, Rajendraprasad SS, Philbrick KL, Bauer BA, Gajic O, Shah A, Laudanski K, Bakken JS, Skalski J, Karnatovskaia LV. The human gut microbiome in critical illness: disruptions, consequences, and therapeutic frontiers. J Crit Care 2024; 79:154436. [PMID: 37769422 PMCID: PMC11034825 DOI: 10.1016/j.jcrc.2023.154436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/23/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023]
Abstract
With approximately 39 trillion cells and over 20 million genes, the human gut microbiome plays an integral role in both health and disease. Modern living has brought a widespread use of processed food and beverages, antimicrobial and immunomodulatory drugs, and invasive procedures, all of which profoundly disrupt the delicate homeostasis between the host and its microbiome. Of particular interest is the human gut microbiome, which is progressively being recognized as an important contributing factor in many aspects of critical illness, from predisposition to recovery. Herein, we describe the current understanding of the adverse impacts of standard intensive care interventions on the human gut microbiome and delve into how these microbial alterations can influence patient outcomes. Additionally, we explore the potential association between the gut microbiome and post-intensive care syndrome, shedding light on a previously underappreciated avenue that may enhance patient recuperation following critical illness. There is an impending need for future epidemiological studies to encompass detailed phenotypic analyses of gut microbiome perturbations. Interventions aimed at restoring the gut microbiome represent a promising therapeutic frontier in the quest to prevent and treat critical illnesses.
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Affiliation(s)
- Jaeyun Sung
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Kemuel L Philbrick
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Brent A Bauer
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ognjen Gajic
- Department of Pulmonary & Critical Care, Mayo Clinic, Rochester, MN, USA
| | - Aditya Shah
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - Krzysztof Laudanski
- Department of Anesthesiology and Perioperative Care, Mayo Clinic, Rochester, MN, USA
| | - Johan S Bakken
- Department of Infectious Diseases, St Luke's Hospital, Duluth, MN, United States of America
| | - Joseph Skalski
- Department of Pulmonary & Critical Care, Mayo Clinic, Rochester, MN, USA
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Yang J, Lim KH, Mohabbat AB, Fokken SC, Johnson DE, Calva JJ, Do A, Mueller MR, Chon TY, Bauer BA. Robotics in Massage: A Systematic Review. Health Serv Res Manag Epidemiol 2024; 11:23333928241230948. [PMID: 38379713 PMCID: PMC10878202 DOI: 10.1177/23333928241230948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024] Open
Abstract
Background Over the past few years, a growing number of studies have explored massage robots. However, to date, a dedicated systematic review focused solely on robot-assisted massage has not been conducted. Objective To systematically identify and summarize evidence from studies concerning robot-assisted massage in healthcare settings. Methods An extensive literature search, involving electronic databases Ovid and Scopus, was conducted from the inception of the databases up to March 2023. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and relevant papers were chosen based on the predefined inclusion criteria. Given the substantial methodological diversity among the included studies, a qualitative analysis was conducted. Results Seventeen studies met the inclusion criteria, comprising 15 preliminary trials, one quasi-experimental study, and one randomized controlled trial. Approximately 29% of the studies focused on the application of robotic massage for patients, 24% targeted both healthy volunteers and patients, and the remaining 47% were preclinical trials assessing the effectiveness of robotic massage solely on healthy volunteers. Primary interventions included robotic massage for oral rehabilitation, scalp massage, low back massage, shoulder massage, and full-body massage. All studies provided evidence that robotic massage interventions can enhance health and well-being, indicating a promising future for the integration of robotics in the field of massage therapy. Conclusions In general, robotic massage interventions offer physical and mental health benefits. Robot-assisted massage may be integrated into care provision as an adjunct to enhance human well-being. Nonetheless, further research is needed to confirm these findings.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kia Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Arya B. Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Shawn C. Fokken
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Devan E. Johnson
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jason J. Calva
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Alexander Do
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Tony Y. Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Yang J, Lim KH, Lim KT, Woods JT, Mohabbat AB, Wahner-Roedler DL, Ganesh R, Bauer BA. Complementary and alternative medicine for long COVID: a systematic review of randomized controlled trials. Ther Adv Chronic Dis 2023; 14:20406223231204727. [PMID: 37841213 PMCID: PMC10571674 DOI: 10.1177/20406223231204727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Background Complementary and alternative medicine (CAM) interventions are growing in popularity as possible treatments for long COVID symptoms. However, comprehensive analysis of current evidence in this setting is still lacking. Objective This study aims to review existing published studies on the use of CAM interventions for patients experiencing long COVID through a systematic review. Design Systematic review of randomized controlled trials (RCTs). Methods A comprehensive electronic literature search was performed in multiple databases and clinical trial registries from September 2019 to January 2023. RCTs evaluating efficacy and safety of CAM for long COVID were included. Methodological quality of each included trial was appraised with the Cochrane 'risk of bias' tool. A qualitative analysis was conducted due to heterogeneity of included studies. Results A total of 14 RCTs with 1195 participants were included in this review. Study findings demonstrated that CAM interventions could benefit patients with long COVID, especially those suffering from neuropsychiatric disorders, olfactory dysfunction, cognitive impairment, fatigue, breathlessness, and mild-to-moderate lung fibrosis. The main interventions reported were self-administered transcutaneous auricular vagus nerve stimulation, neuro-meditation, dietary supplements, olfactory training, aromatherapy, inspiratory muscle training, concurrent training, and an online breathing and well-being program. Conclusion CAM interventions may be effective, safe, and acceptable to patients with symptoms of long COVID. However, the findings from this systematic review should be interpreted with caution due to various methodological limitations. More rigorous trials focused on CAM for long COVID are warranted in the future.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kia Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kia Teng Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Arya B. Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Ravindra Ganesh
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
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Junge M, Krüger M, Wahner-Roedler DL, Bauer BA, Dörr M, Bahls M, Chenot JF, Biffar R, Schmidt CO. The Preventiometer - reliability of a cardiovascular multi-device measurement platform and its measurement agreement with a cohort study. BMC Med Res Methodol 2023; 23:103. [PMID: 37095457 PMCID: PMC10127382 DOI: 10.1186/s12874-023-01911-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/03/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Multimedia multi-device measurement platforms may make the assessment of prevention-related medical variables with a focus on cardiovascular outcomes more attractive and time-efficient. The aim of the studies was to evaluate the reliability (Study 1) and the measurement agreement with a cohort study (Study 2) of selected measures of such a device, the Preventiometer. METHODS In Study 1 (N = 75), we conducted repeated measurements in two Preventiometers for four examinations (blood pressure measurement, pulse oximetry, body fat measurement, and spirometry) to analyze their agreement and derive (retest-)reliability estimates. In Study 2 (N = 150), we compared somatometry, blood pressure, pulse oximetry, body fat, and spirometry measurements in the Preventiometer with corresponding measurements used in the population-based Study of Health in Pomerania (SHIP) to evaluate measurement agreement. RESULTS Intraclass correlations coefficients (ICCs) ranged from .84 to .99 for all examinations in Study 1. Whereas bias was not an issue for most examinations in Study 2, limits of agreement for most examinations were very large compared to results of similar method comparison studies. CONCLUSION We observed a high retest-reliability of the assessed clinical examinations in the Preventiometer. Some disagreements between Preventiometer and SHIP examinations can be attributed to procedural differences in the examinations. Methodological and technical improvements are recommended before using the Preventiometer in population-based research.
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Affiliation(s)
- Martin Junge
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
- Present Address: nxt statista GmbH & Co. KG, Hamburg, Germany
| | - Markus Krüger
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany.
- Present Address: Unit of Prosthodontics, Gerodontology, and Biomaterials, Centre of Oral Health, University of Greifswald, Greifswald, Germany.
| | | | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Marcus Dörr
- Department of Internal Medicine B (Cardiology), University Medicine, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University of Greifswald, Greifswald, Germany
| | - Martin Bahls
- Department of Internal Medicine B (Cardiology), University Medicine, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University of Greifswald, Greifswald, Germany
| | - Jean-François Chenot
- Department of General Practice, Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | - Reiner Biffar
- Unit of Prosthodontics, Gerodontology, and Biomaterials, Centre of Oral Health, University of Greifswald, Greifswald, Germany
| | - Carsten O Schmidt
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
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Zhou X, Ma Q, Yang J, Mohabbat AB, Croghan IT, Tan CLC, Chen J, Bauer BA. Clinical outcome measures reporting in randomized trials evaluating Tuina therapy for chronic nonspecific low back pain: A systematic review. Medicine (Baltimore) 2023; 102:e33628. [PMID: 37083789 PMCID: PMC10118339 DOI: 10.1097/md.0000000000033628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/05/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Tuina has gained widespread attention and utilization for the management of chronic nonspecific low back pain (CNLBP). However, evidence-based guidance for choosing accurate and appropriate outcome measures of Tuina is lacking. The objective of this study is to systematically synthesize the existing outcome measures reported in randomized controlled trials (RCTs) evaluating Tuina therapy in CNLBP. METHODS Electronic literature searches were conducted in multiple English and Chinese databases from their inception to May 2022. RCTs were included if they involved clinical outcome measures in Tuina treatment for patients with CNLBP. Outcome instruments for each study were extracted and analyzed. Evidence from included studies were assessed using the Cochrane risk-of-bias tool. RESULTS Of the 735 identified articles, 17 articles with 1628 participants were included. Measurement domains in these RCTs were mainly reported in terms of pain (94%) and physical activity (71%), followed by safety (41%), Chinese medicine outcome (35%), and quality of life (12%). Moreover, several limitations with existing outcomes were reported, including lack of emphasis on the evaluation of quality of life, inadequate safety monitoring, as well as insufficient and vague Chinese medicine outcome measures. All trials were deemed to be of poor methodological quality. CONCLUSION Pain and physical disability were the most frequently studied outcome domains in CNLBP treated by Tuina therapy. More rigorous and high-quality trials with appropriately selected outcome measures are needed in the future.
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Affiliation(s)
- Xuan Zhou
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Qingyu Ma
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Arya B. Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Ivana T. Croghan
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | | | - Jiaxu Chen
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
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Yang J, Zhou X, Ma Q, Woods JT, Mohabbat AB, Do A, Brault JS, Jensen MA, Shin KM, Shen L, Zhao C, Cheong KCP, He K, Guo Y, Chen Z, Tang S, Tang Y, Tan CIC, Chen J, Bauer BA. Efficacy and safety of Tuina for chronic nonspecific low back pain: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33018. [PMID: 36862888 PMCID: PMC9981398 DOI: 10.1097/md.0000000000033018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVE Chronic nonspecific low back pain (CNLBP) is a serious medical and social problem resulting in functional decline and decreased work ability. Tuina, a form of manual therapy, has been sparsely used to treat patients with CNLBP. To systematically assess the efficacy and safety of Tuina for patients with CNLBP. METHODS Multiple English and Chinese literature databases were searched until September 2022 for randomized controlled trials (RCTs) of Tuina in the treatment of CNLBP. The methodological quality was assessed using the Cochrane Collaboration's tool, and certainty of the evidence was determined with the online Grading of Recommendations, Assessment, Development and Evaluation tool. RESULTS Fifteen RCTs with 1390 patients were included. Tuina demonstrated a significant effect on pain (SMD: -0.82; 95% CI -1.12 to -0.53; P < .001; I2 = 81%) and physical function (SMD: -0.91; 95% CI -1.55 to -0.27; P = .005; I2 = 90%) when compared to control. However, Tuina resulted in no significant improvement for quality of life (QoL) (SMD: 0.58; 95% CI -0.04 to 1.21; P = .07; I2 = 73%;) compared to control. The Grading of Recommendations, Assessment, Development and Evaluation evidence quality was determined to be low level for pain relief, physical function, and QoL measurements. Only six studies reported adverse events; none were serious. CONCLUSION Tuina might be an effective and safe strategy for treating CNLBP in terms of pain and physical function, but not for QoL. The study results should be interpreted with caution for their low-level evidence. More multicenter, large-scale RCTs with a rigorous design are required to further confirm our findings.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Xuan Zhou
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Qingyu Ma
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | | | - Arya B. Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Alexander Do
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Jeffrey S. Brault
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Mark A. Jensen
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Kyung-Min Shin
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Longbin Shen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Canghuan Zhao
- Department of Acupuncture, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | | | - Kejie He
- Department of Acupuncture, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yu Guo
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Zhuoming Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shujie Tang
- Department of Orthopedics, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Yong Tang
- Department of Orthopedics, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | | | - Jiaxu Chen
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
- *Correspondence: Brent A. Bauer, Division of General Internal Medicine, Mayo Clinic, 200 1st St SW Rochester, MN 55905 (e-mail: )
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Ghosh K, Nanda S, Hurt RT, Schroeder DR, West CP, Fischer KM, Bauer BA, Fokken SC, Ganesh R, Hanson JL, Lindeen SA, Pruthi S, Croghan IT. Mindfulness Using a Wearable Brain Sensing Device for Health Care Professionals During a Pandemic: A Pilot Program. J Prim Care Community Health 2023; 14:21501319231162308. [PMID: 36960553 PMCID: PMC10041582 DOI: 10.1177/21501319231162308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE The purpose of this feasibility pilot study was to evaluate safety and adherence of a wearable brain sensing wellness device designed to reduce stress among healthcare professionals (HCP). METHODS A total of 40 HCP were invited to participate in an open-label pilot study. Participants were asked to use a brain sensing wearable device (MUSE-S™) on a daily basis to reduce their stress, for a total of 90 days. Total study participation duration was 180 days. Study enrollment began in August 2021 and ended December 2021. The exploratory outcomes included stress, depression, sleep, burn-out, resilience, quality of life, and cognition. RESULTS Among the 40 HCP in study, the majority were female (85%), white (87.5%) and with an average age of 41.3 ± 11.0 years (SD). Participants used the wearable device an average of 23.8 times over a 30-day period with a mean duration of 5.8 min with each use. Study results demonstrate the positive impact of guided mindfulness using the wearable device MUSE-S™ and its accompanying application (APP). A statistically significant improvement was found for a reduction in stress (P < .001) and improvement in resilience (P = .02), quality of life (P = .003), and cognition (P < .001). The majority (91.9%) of the participants indicated they felt more relaxed after using the device, and 73% indicated they would continue to use this device at end-of-study. No adverse effects were reported. CONCLUSION Study results show that 3 to 10 min of guided meditation during work hours through the use of a brain sensing wearable device is safe and acceptable, with associated health benefits for HCP.
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Yang J, Shin KM, Do A, Bierle DM, Abu Dabrh AM, Yin Z, Bauer BA, Mohabbat AB. The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review. J Pain Res 2023; 16:1017-1023. [PMID: 36974308 PMCID: PMC10039621 DOI: 10.2147/jpr.s395457] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/14/2023] [Indexed: 03/29/2023] Open
Abstract
Fibromyalgia (FM) is a chronic pain sensitivity syndrome characterized by diffuse musculoskeletal pain and many other systemic manifestations. Low-dose naltrexone (LDN) has been increasingly used as an off-label treatment option in FM. However, current evidence on the safety and efficacy of LDN in patients with FM is not well known. To systematically assess the current evidence on the safety and efficacy of LDN use in the treatment of FM. A comprehensive bibliographic search was conducted on EBM Reviews - Cochrane Central Register of Controlled Trials, EBM Reviews - Cochrane Database of Systematic, Embase, Ovid MEDLINE(R) and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, Daily and Versions and Scopus databases in September 2022. Inclusion criteria were articles that were published in English, focusing on clinical trials involving LDN for the treatment of FM. Two reviewers independently screened and extracted the data. A qualitative analysis was used due to the high methodological heterogeneity between studies. The electronic search produced 805 articles. After applying the inclusion criteria, 9 articles (one RCT, two case reports, two case series, and four pilot trials) were selected for evaluation. LDN intervention protocols, study designs, and follow-up periods were different among the included studies. Overall, LDN was found to be effective in the symptomatic management of FM, and of the 78% of included studies that evaluated for safety, no severe adverse events were reported. Proving the efficacy and safety of low-dose naltrexone is a future possibility based on current study data, but the level of scientific evidence is limited. Future well-designed trials with large sample sizes are required.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kyung-Min Shin
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054, South Korea
| | - Alex Do
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Dennis M Bierle
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Abd Moain Abu Dabrh
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Ziying Yin
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Arya B Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
- Correspondence: Arya B Mohabbat, Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, RO_GO_17_102GIM, Rochester, MN, 55905, USA, Tel +1-507-284-2511, Email
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Yang J, Croghan IT, Fokken SC, Johnson DE, Calva JJ, Do A, Mueller MR, Bauer BA, Chon TY. Satisfaction and Feasibility Evaluation of an Electronic Massager-Expert Manipulative Massage Automation (EMMA): A Pilot Study. J Prim Care Community Health 2023; 14:21501319231199010. [PMID: 37698255 PMCID: PMC10498686 DOI: 10.1177/21501319231199010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Electronic massagers have gained popularity for their non-invasive and cost-effective approach to healthcare. However, existing electronic massagers require manual manipulation, leading to inconsistency. OBJECTIVE To investigate the feasibility and acceptability of the Electronic Massager-Expert Manipulative Massage Automation (EMMA) among the American population. METHODS A single-arm pilot study was conducted at Mayo Clinic Rochester campus. Participants received massage therapy with the EMMA treatment model and completed a demographics and Satisfaction Survey Questionnaire. Data were collected using REDCap, and statistical analysis was performed. RESULTS Twenty healthy volunteers (13 women, 7 men; median age, 47 years) participated and completed the intervention within 2 weeks. No adverse events were reported. Overall, the acceptability and satisfaction of massage utilizing EMMA were high, with all participants finding the study worthwhile, willing to participate again, and willing to recommend the study to others. Regarding the overall experience, 65.0% reported a better-than-expected experience. Responses to open-ended post-treatment questions showed that most participants enjoyed the warmth (35%), pressure (25%), and relaxation (20%) provided by EMMA, with the majority suggesting no changes or improvements were needed. However, some participants expressed a desire for an expanded massage area (20%). CONCLUSIONS This study suggests that the EMMA massager has high acceptability and satisfaction among healthy volunteers, thus demonstrating its feasibility. However, further research is needed to optimize EMMA and assess its clinical effectiveness.
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Croghan IT, Hurt RT, Fokken SC, Fischer KM, Lindeen SA, Schroeder DR, Ganesh R, Ghosh K, Bausek N, Bauer BA. Stress Resilience Program for Health Care Professionals During a Pandemic: A Pilot Program. Workplace Health Saf 2022; 71:173-180. [PMID: 35787711 PMCID: PMC10079895 DOI: 10.1177/21650799221093775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The COVID-19 pandemic has led to increased burnout and staff turnover for health care providers (HCPs). The purpose of this pilot study was to evaluate the safety and acceptability of a Stress Resilience Program (SRP) for reducing perceived stress and improving resilience among HCPs during a pandemic. METHOD Of the 12 HCPs expressing interest in the study, 10 were enrolled in this study. Participants attended three in-person visits (consent/screen, baseline, and end-of-study). The SRP consisted of education related to resilience enhancement and a breathing device (BreatherFit®) for combined respiratory muscle training (cRMT). Participants completed 4 weeks of cRMT and applied situational breathing strategies as needed. Outcomes measured were changes in stress (PSS-10), resilience (BRS), depression (PRIME-MD), and sleep (PSQI and Ōura Ring®). FINDINGS The majority of participants were male (60%) and White (60%) with an average age of 39.7 years. Changes from baseline to end-of-treatment indicated a positive trend with significant stress reduction (-3.2 ± 3.9, p = .028) and nonsignificant depression reduction (-0.5 ± 0.7, p = .05). Resilience was high at baseline and continued to stay high during the study with a nonsignificant increase at end-of-study (+0.07 ± 0.7, p = .77). No changes in overall sleep scores were noted. All participants agreed the study was worthwhile, 80% indicated they would repeat the experience, while 90% indicated they would recommend the study to others. CONCLUSION/APPLICATION TO PRACTICE Because of its size and portability, SRP is an easily applicable and promising option for reducing stress among HCPs during a high-stress period, such as a pandemic. Larger studies are needed.
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Affiliation(s)
- Ivana T Croghan
- Department of Medicine, Division of General Internal Medicine.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.,Department of Quantitative Health Sciences
| | - Ryan T Hurt
- Department of Medicine, Division of General Internal Medicine
| | - Shawn C Fokken
- Department of Medicine, Division of General Internal Medicine
| | | | | | | | - Ravindra Ganesh
- Department of Medicine, Division of General Internal Medicine
| | - Karthik Ghosh
- Department of Medicine, Division of General Internal Medicine
| | - Nina Bausek
- Department of Cardiovascular Disease, Mayo Clinic
| | - Brent A Bauer
- Department of Medicine, Division of General Internal Medicine
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12
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Lim KT, Lim KH, Zhou X, Yang J, Shin KM, Mohabbat AB, Baude WW, Nanda S, Bauer D, Theberath M, Theberath N, Bauer BA, Ganesh R. Dietary Supplements for Pain Relief in Patients with Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Chin Med 2022; 50:1197-1218. [PMID: 35642461 DOI: 10.1142/s0192415x22500495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Pain is the most frequently encountered symptom by patients with fibromyalgia (FM). Dietary supplements (DSs) in particular have a proven impact as a possible adjunctive therapy for symptom management in FM. However, there is currently no conclusive review outlining the evidence for DSs in pain management in FM. This study aims to assess currently available studies evaluating the use of DSs for pain relief in FM. Randomized controlled trials regarding the use of DSs on adult FM patients were included for evidence synthesis. Study results indicated that DSs significantly relieved pain in FM (SMD 1.23; 95% CI 0.02-2.43, P = 0.046) but did not improve quality of life (QoL) (SMD 0.73; 95% CI -0.07-1.53, P = 0.075) in the data. Adverse events of DSs varied from mild to severe, with the most common being gastrointestinal symptoms and androgenic side effects in 5.7% and 3.9% of patients, respectively. More well-designed RCTs are required in the future. The protocol for this review has been published on PROSPERO (CRD42020149941).
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Affiliation(s)
- Kia Teng Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kia Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xuan Zhou
- Formula-pattern Research Centre, School of Traditional Chinese Medicine, Jinan University Guangzhou, Guangdong Province 510632, P. R. China
| | - Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Kyung-Min Shin
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, South Korea
| | - Arya B Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Wyatt W Baude
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Sanjeev Nanda
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - David Bauer
- Chemistry & French St. Olaf College, Northfield, MN 55057, USA
| | | | | | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Ravindra Ganesh
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
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13
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Spilg EG, Kuk H, Ananny L, McNeill K, LeBlanc V, Bauer BA, Sood A, Wells PS. The impact of Stress Management and Resilience Training (SMART) on academic physicians during the implementation of a new Health Information System: An exploratory randomized controlled trial. PLoS One 2022; 17:e0267240. [PMID: 35452478 PMCID: PMC9032401 DOI: 10.1371/journal.pone.0267240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/02/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The Stress Management and Resilience Training (SMART) program is an evidence-based intervention designed to build resilience in physicians in clinical practice. The objective of the current study was to assess the impact of the SMART program on academic physicians' levels of resilience, subjective happiness, stress, and anxiety, and specifically during the implementation of a new hospital-wide Health Information System (HIS). METHODS A total of 40 physicians in a tertiary care academic hospital were randomized (allocation ratio 1:1) to either the SMART intervention or the control condition. The SMART intervention consisted of one mandatory two-hour in-person workshop and an optional 24-week online program, designed to support the materials delivered in the workshop. Outcome measures were assessed using validated scales administered online at baseline and at 3-months and 6-months follow-up. RESULTS After adjusting for baseline levels of each outcome, no statistically significant intervention effect was observed for resilience, subjective happiness, stress or anxiety at 3-months or 6-months follow-up. However, physicians in the intervention group demonstrated improvements in resilience, stress and anxiety at follow-up that were within the range of clinically relevant differences. CONCLUSIONS The findings of this exploratory study provide modest support that the SMART intervention may be beneficial for proactively addressing physician wellness during the implementation of a new HIS and that larger randomized trials are warranted. TRIAL REGISTRATION NCT04384861.
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Affiliation(s)
- Edward G. Spilg
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Hanna Kuk
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lesley Ananny
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada
| | - Kylie McNeill
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Vicki LeBlanc
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada
| | - Brent A. Bauer
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Amit Sood
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Philip S. Wells
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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14
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Theberath M, Bauer D, Chen W, Salinas M, Mohabbat AB, Yang J, Chon TY, Bauer BA, Wahner-Roedler DL. Effects of COVID-19 pandemic on mental health of children and adolescents: A systematic review of survey studies. SAGE Open Med 2022; 10:20503121221086712. [PMID: 35371484 PMCID: PMC8972920 DOI: 10.1177/20503121221086712] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Mental health problems among children and adolescents are increasingly observed during the outbreak of COVID-19, leading to significant healthcare concerns. Survey studies provide unique opportunities for research during this pandemic, while there are no existing systematic reviews in this setting. The objective was to summarize existing survey studies addressing the effects of the current COVID-19 pandemic on the mental health of children and adolescents. Methods For this systematic review, we performed an electronic search in multiple databases from December 2019 to December 2020. The quality appraisal of the included studies was performed with the Critical Appraisal Skills Programme Qualitative Checklist. Because of the high methodological heterogeneity between studies, a narrative synthesis of the qualitative data was used. Results In total, 35 survey studies with 65,508 participants, ranging from 4 to 19 years of age, are included in this review. Anxiety (28%), depression (23%), loneliness (5%), stress (5%), fear (5%), tension (3%), anger (3%), fatigue (3%), confusion (3%), and worry (3%) were the most common mental health issues reported. Children and adolescents with psychiatric and/or developmental disorders, such as severe obesity, chronic lung disease, attention deficit hyperactivity disorder, cystic fibrosis, and obsessive-compulsive disorders, were especially vulnerable to the mental health effects of the COVID-19 pandemic. Age, gender, psychological quality, and negative coping strategies were identified as risk factors for the development of mental health problems. Social and family support, along with a positive coping style, was associated with better outcomes. Conclusion The impact of the COVID-19 pandemic on mental health of children and adolescents is multifaceted and substantial. Survey studies regarding child and adolescent mental health amid COVID-19 indicated that anxiety, depression, loneliness, stress, and tension are the most observed symptoms. Positive coping strategies with family and social support may be important to achieving better outcomes. Due to limited available evidence, more well-designed studies in this area are urgently needed.
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Affiliation(s)
| | | | | | - Manisha Salinas
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Arya B Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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15
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Munoz-Casabella A, Wahner-Roedler DL, Croghan IT, Petterson TM, Fuehrer DL, Bauer BA. Use of Complementary and Integrative Medicine Among Patients With Glioblastoma Multiforme Seen at a Tertiary Care Center. Glob Adv Health Med 2022; 11:2164957X221078543. [PMID: 35360507 PMCID: PMC8961379 DOI: 10.1177/2164957x221078543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/03/2022] [Indexed: 12/14/2022] Open
Abstract
Background Glioblastoma multiforme (GBM) is among the most aggressive and lethal tumors, with a median survival of 12-15 months. Many patients use complementary and integrative medicine (CIM) therapies to supplement their cancer treatment. Objective To determine the prevalence of CIM use and identify the most frequently used types of CIM in a cohort of patients with GBM seen at a tertiary care medical center in the United States. Methods An anonymous survey was mailed through the US Postal Service from August 1, 2019, through February 21, 2020, to patients with GBM. Results A total of 346 surveys were mailed, and 146 responses (42%) were received. The median age of respondents was 61 years (range, 52-68 years), and 85 (58%) were male. Most patients had undergone surgery (90%), chemotherapy (96%), and radiotherapy (95%). The median time from diagnosis of GBM to survey participation was 18 months (range, 12-31 months). Most respondents (81%) used some form of CIM, most frequently meditation (22%), relaxation and other stress management techniques (19%), chiropractic therapy (16%), and acupuncture (12%). Compared with men, women more commonly meditated (32% vs 16%; P = .046) and practiced yoga (20% vs 6%; P = .04). We observed age-based differences, with younger patients more commonly meditating, practicing relaxation and stress management techniques, and receiving chiropractic therapy (P < .05 for all). Conclusions Providers should encourage patients with GBM to discuss their interest in CIM therapies and guide them to evidence-based treatments that may help improve their quality of life.
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Affiliation(s)
- Amanda Munoz-Casabella
- Department of Neurology, Mayo
Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and
Science, Rochester, MN, USA
| | | | - Ivana T. Croghan
- Division of General Internal
Medicine, Mayo Clinic, Rochester, MN, USA,Department of Quantitative Health
Sciences, Mayo Clinic, Rochester, MN, USA,Division of Community Internal
Medicine, Mayo Clinic, Rochester, MN, USA,Ivana T. Croghan, PhD, Division of General
Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
| | - Tanya M. Petterson
- Department of Quantitative Health
Sciences, Mayo Clinic, Rochester, MN, USA
| | - Debbie L. Fuehrer
- Division of General Internal
Medicine, Mayo Clinic, Rochester, MN, USA
| | - Brent A. Bauer
- Division of General Internal
Medicine, Mayo Clinic, Rochester, MN, USA
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16
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Prasad K, Prasad A, George M, Sandhu GS, Inojosa JRM, Bhagra A, Mahapatra S, Petterson TM, Lackore KA, Croghan IT, Bauer BA, Wahner-Roedler DL. Temporal Trends in Use of Complementary Therapies Among Patients With Cardiovascular Disorders. Am J Cardiol 2022; 167:118-124. [PMID: 35031110 DOI: 10.1016/j.amjcard.2021.11.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/15/2022]
Abstract
This study aimed to evaluate the use and frequency of complementary and integrative medicine (CIM) therapies in an outpatient cohort with cardiovascular disease (CVD) and compare trends over time. This cross-sectional point-of-care prospective study assessed patients attending a cardiology outpatient clinic. As in our 2009 cohort, data were collected with a 17-question survey on demographic characteristics, CVD history, current use and future interest in CIM. In total, 964 patients completed the survey. CIM use continues to be high (2009 vs 2018, 83.4% vs 81.8%) (p = 0.34), with dietary supplements the most common therapy (75% in both studies). We observed increased use of mind-body therapies (28.5% vs 23.9%, p = 0.02), especially meditation, yoga, and tai chi. Of the patients receiving CIM therapies, 41.9% reported using CIM for heart-related symptoms. Relaxation, stress management, and meditation were the top three mind-body therapies for CVD-related symptoms in both cohorts. Reporting of CIM use to clinicians is low (15%) and interest on future use is high (47%). In conclusion, CIM is highly used in cardiology patients-4 of 10 patients use CIM for CVD-related symptoms. Most take dietary supplements, with an increased use of mind-body therapies. Our data highlight the importance of documenting CIM use in practice and the need for research to document efficacy.
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Affiliation(s)
- Kavita Prasad
- Integrative Medicine Clinic, Zumbro Valley Health Center, Rochester, Minnesota
| | - Abhiram Prasad
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
| | - Merit George
- Division of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gurpreet S Sandhu
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Anjali Bhagra
- Division of General Internal Medicine, Department of Medicine
| | | | - Tanya M Petterson
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Kandace A Lackore
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Ivana T Croghan
- Division of General Internal Medicine, Department of Medicine
| | - Brent A Bauer
- Division of General Internal Medicine, Department of Medicine
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17
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Zhou X, Yang J, Ma QY, Guo Y, He KJ, Shen LB, Fan Q, Philip CKC, Keng TB, Celia TIC, Bauer BA, Chen JX. The effectiveness of Tuina in managing chronic non-specific low back pain: A protocol of a multicenter international randomized controlled trial. Medicine (Baltimore) 2022; 101:e28883. [PMID: 35363203 PMCID: PMC9281981 DOI: 10.1097/md.0000000000028883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Chronic non-specific low back pain (CNLBP) is a common complaint about medical care and carries a heavy social burden. The efficacy of Tuina (TN) or physiotherapy (PT) for CNLBP has been evaluated in previous systematic reviews. However, there is no high-quality evidence to support the efficacy of Tuina. Therefore, this study aims to conduct a large-scale, multicenter, high-quality clinical trial to provide evidence for Tuina to treat CNLBP. METHODS This is a multicenter, assessor-, and analyst-blinded, randomized controlled trial with 3 parallel arms: TN, PT, and TN combined with PT (Tuina combined with physiotherapy) group. Six hundred twelve eligible CNLBP patients will be randomly assigned to the groups in a 1:1:1 ratio in 3 centers. The TN intervention includes 9-step routine techniques, while the PT intervention includes a physiotherapy treatment plan based on a patient's symptoms. The interventions for both groups will last for 30 minutes and will be carried out for 6 sessions in 8 weeks. The primary outcome will be the visual analog scale pain score. And the secondary outcomes will include the Oswestry Disability Index, spinal range of motion, 36-item short-form health survey. Safety evaluation will be recorded during the whole study. All data in this randomized controlled trial will be analyzed by SAS 9.4. DISCUSSION The results of this trial will provide evidence to evaluate the efficacy of Tuina's value as a treatment for CNLBP. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR2000040288, November 27, 2020).
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Affiliation(s)
- Xuan Zhou
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong Province, China
| | - Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Qing-yu Ma
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong Province, China
| | - Yu Guo
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong Province, China
| | - Ke-jie He
- Department of Acupuncture, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Long-bin Shen
- Rehabilitation Medicine Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Qiao Fan
- Center for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | | | - Tay Boon Keng
- Department of Orthopedic Surgery, Singapore General Hospital, Singapore
| | | | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Jia-xu Chen
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong Province, China
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18
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Yang J, Shin KM, Abu Dabrh AM, Bierle DM, Zhou X, Bauer BA, Mohabbat AB. Ginseng for the Treatment of Chronic Fatigue Syndrome: A Systematic Review of Clinical Studies. Glob Adv Health Med 2022; 11:2164957X221079790. [PMID: 35186446 PMCID: PMC8848096 DOI: 10.1177/2164957x221079790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 01/25/2022] [Indexed: 11/17/2022] Open
Abstract
Background Chronic fatigue syndrome (CFS) is a complex and often disabling chronic condition emerging worldwide, with no curative or definitive therapy yet identified. Ginseng has been widely used to treat fatigue in other patient groups and conditions; however, a systematic review focusing solely on the impact of ginseng on fatigue in patients with CFS has not been performed. Objective This study aimed to assess the current state of evidence regarding ginseng for CFS. Methods Multiple databases were searched from inception to October 2020. All data was extracted independently and in duplicates. Outcomes of interest included the effectiveness and safety of ginseng in patients with CFS. Results 2 studies enrolling 68 patients were deemed eligible, including one randomized clinical trial and one prospective observational study. The certainty of evidence in the effectiveness outcome was low and moderate from both studies, while the safety evidence was very low as reported from one study. Conclusion Study findings highlight a potential benefit of ginseng therapy in the treatment of CFS. However, we are not able to draw firm conclusions due to limited clinical studies. The paucity of data warrants limited confidence. There is a need for future rigorous studies to provide further evidence.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kyung-Min Shin
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | | | - Dennis M Bierle
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Xuan Zhou
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Arya B Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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19
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Wood C, Cutshall SM, Lawson DK, Ochtrup HM, Henning NB, Larsen BE, Bauer BA, Mahapatra S, Wahner-Roedler DL. Music Therapy for Anxiety and Pain After Spinal Cord Injury: A Pilot Study. Glob Adv Health Med 2022; 10:21649561211058697. [PMID: 35003903 PMCID: PMC8728770 DOI: 10.1177/21649561211058697] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 10/21/2021] [Indexed: 12/25/2022] Open
Abstract
Background Music therapy (MT) programs have been used in various health care settings to
reduce patients’ pain, anxiety, and stress. However, few studies have
investigated its effects on patients with spinal cord injury (SCI), a
frequently serious event requiring extensive rehabilitation. Objective This pilot study evaluated the feasibility of offering music-assisted
relaxation (MAR) during rehabilitation for patients with SCI. We also
measured the effect of MAR on the patients’ pain, anxiety, and stress
levels. Methods Patients were hospitalized at Mayo Clinic (Rochester, Minnesota) from
September 2015 through September 2017 for rehabilitation of an SCI. Eligible
patients received 2, 20-minute, personalized MAR sessions. Interventions
were facilitated by a board-certified music therapist (MT-BC) and included
diaphragmatic breathing, guided imagery, and passive muscle relaxation with
live guitar accompaniment and spoken, improvised, or singing voice. Two
surveys (Generalized Anxiety Disorder [GAD-7] and Perceived Stress Scale
[PSS-10]) were used at the time of study consent and again upon hospital
dismissal. Pain, anxiety, and relaxation were assessed before and after both
MT sessions with visual analog scales (VASs), scored from 0 to 10.
Participants completed a 7-question satisfaction survey after the second MAR
session. Results Twenty patients were enrolled (12 men, 8 women); 13 (65%) completed the MAR
interventions. The mean (SD) age was 53.7 (17.7) years. VAS scores for pain
significantly improved after both sessions (P ≤ .02). VAS scores for anxiety
also significantly improved after both sessions (P ≤ .02), as did VAS scores
for relaxation (P ≤ .02 for both). The satisfaction survey indicated that
patients generally believed that they benefited from MT. Rehabilitation
staff indicated that MT did not interfere with routine clinical care. Conclusion MT with live MAR is a feasible treatment for patients with SCI and may be
effective for reducing their pain and anxiety.
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Affiliation(s)
- Christina Wood
- Mayo Clinic Child Life Program, Mayo Clinic, Rochester, MN, USA
| | | | - Donna K Lawson
- Department of Research Administration, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Saswati Mahapatra
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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20
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Croghan IT, Hurt RT, Aakre CA, Fokken SC, Fischer KM, Lindeen SA, Schroeder DR, Ganesh R, Ghosh K, Bauer BA. Virtual Reality for Health Care Professionals During a Pandemic: A Pilot Program. J Prim Care Community Health 2022; 13:21501319221086716. [PMID: 35352605 PMCID: PMC8972930 DOI: 10.1177/21501319221086716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: The purpose of this pilot study was to evaluate the safety and use of a nature-based virtual reality (VR) experience among health care providers (HCP) during a pandemic. Methods: Twenty-four frontline HCP participated in this crossover pilot where the viewing order of the experiences were randomized. All participants attended in-person consent, baseline, and end-of-study visits. The intervention consisted of viewing 2 nature-based scenes (“walk in the woods” and “forest of focus”) through 3-D VR and with computer 4K graphic imagery. Randomization took place with regards to the viewing order (VR vs 4K computer video, scene 1 and 2). Outcomes measured were safety, acceptability and changes in intensity of anxiety feelings, resilience, emotional distress, cognitive function, and self-efficacy. Results: Among the 26 HCP expressing interest in the study, 24 enrolled in this study. The majority were male (58.3%), white (66.7%) and of an average age of 46.3 ± 10.5 years (standard deviation (SD)). End of the study survey showed that almost all participants (96%) would participate in the study again and recommend it to others. Twenty-three of the 24 participants also felt relaxed after seeing the imagery. With respect to anxiety (as measured by the STAI Y1), the VR “walk in the woods” had the greatest reduction from pre to post (6.4 points, SD = 5.98) followed by VR “forest of focus” (5.8 points, SD = 9.29), computer screen “forest of focus” (5.0 points, SD = 8.89), and computer screen “walk in the woods” (4.1 points, SD = 6.22). All 4 sessions had a significant decrease in score from pre to post (P-values ≤.005), but there was no significant difference in the change from pre- to post-session between the 4 groups (P-value = .5835). Conclusion: The use of the VR among HCP has promise for reducing stress among health care providers during a high stress period, such as a pandemic but much larger studies are needed.
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21
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Karnatovskaia LV, Varga K, Niven AS, Schulte PJ, Mujic M, Gajic O, Bauer BA, Clark MM, Benzo RP, Philbrick KL. A pilot study of trained ICU doulas providing early psychological support to critically ill patients. Crit Care 2021; 25:446. [PMID: 34930440 PMCID: PMC8691072 DOI: 10.1186/s13054-021-03856-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/06/2021] [Indexed: 12/02/2022] Open
Abstract
Background Over a third of critical illness survivors suffer from mental health problems following hospitalization. Memories of delusional experiences are a major risk factor. In this project, ICU doulas delivered a unique positive suggestion intervention targeting the vulnerable time period during critical illness when these memories are formed. Methods Adult critically ill patients were recruited for this single-arm, prospective pilot study. These ICU patients received a positive suggestion intervention daily during their ICU stay in parallel with their medical treatment. The intervention was designed to be delivered over a minimum of two sessions. Feasibility was defined as intervention delivery on ≥ 70% of ICU days after patient enrollment. As a secondary analysis, psychometric questionnaires were compared to those of a historic control cohort of patients receiving standard care in the ICU using adjusted linear regression models. Results Of the 97 patients who received the intervention and were alive at the end of their ICU course, 54 were excluded from analyses mostly for having received only one session because of a short ICU length of stay of < 2 days, transitioning to comfort care or not wanting to answer the study questionnaires. Forty-three patients who completed 2 or more sessions of the positive therapeutic suggestion intervention provided by two trained ICU doulas received it for a median of 4 days (IQR 3, 5), with each session lasting for a median of 20 min (IQR 14, 25). The intervention was delivered on 71% of days, meeting our pre-determined feasibility goal. Compared to historical controls (N = 299), patients receiving the intervention had higher severity of illness and longer length of stay. When adjusted for baseline differences, patients both with and without mechanical ventilation who received the intervention scored lower on the Hospital Anxiety and Depression Scale (HADS)—Depression subscale. The intervention was also associated with reduced HADS-Anxiety subscale among ventilated patients. Conclusions Positive therapeutic suggestion delivered by ICU doulas is feasible in the ICU setting. A randomized trial is warranted to better delineate the role that positive suggestion and ICU doulas may play in ongoing interprofessional efforts to humanize critical care medicine. The study was registered on clinicaltrials.gov (NCT03736954) on 03/14/2018 prior to the first patient enrollment https://clinicaltrials.gov/ct2/show/NCT03736954?cond=ICU+Doulas+Providing+Psychological+Support&draw=2&rank=1. Supplementary Information The online version contains supplementary material available at 10.1186/s13054-021-03856-3.
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Affiliation(s)
- Lioudmila V Karnatovskaia
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Katalin Varga
- Affective Psychology Department, Eötvös Loránd University, Budapest, Hungary
| | - Alexander S Niven
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Phillip J Schulte
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Midhat Mujic
- Anesthesia Clinical Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Ognjen Gajic
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Brent A Bauer
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Roberto P Benzo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Kemuel L Philbrick
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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22
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Yang J, Do A, Mallory MJ, Wahner-Roedler DL, Chon TY, Bauer BA. Acupressure: An Effective and Feasible Alternative Treatment for Anxiety During the COVID-19 Pandemic. Glob Adv Health Med 2021; 10:21649561211058076. [PMID: 34925968 PMCID: PMC8671653 DOI: 10.1177/21649561211058076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/19/2021] [Indexed: 01/15/2023] Open
Abstract
Anxiety is highly reported during the COVID-19 pandemic. The use of acupressure for anxiety is a common practice in integrative medicine, and previous literature has shown that acupressure can be an effective and feasible alternative treatment for decreasing anxiety. Given the social distancing requirements during the COVID-19 pandemic, it appears reasonable to assume that acupressure may be especially suited to treat anxiety under these circumstances. However, there has been relatively little reported use of acupressure for anxiety during the pandemic. This viewpoint aims to highlight the possible role of acupressure as a self-administered therapeutic approach for anxiety amidst the COVID-19 pandemic and to outline key areas for future research.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Alex Do
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Molly J Mallory
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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23
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Nanda S, Chon TY, Mahapatra S, Lindeen SA, Fischer KM, Krüger M, Schierwater B, Schmidt CO, Wahner-Roedler DL, Bauer BA. Preventiometer, a Novel Wellness Assessment Device, Used With Healthy Volunteers: A Phase 2 Study. Glob Adv Health Med 2021; 10:21649561211045016. [PMID: 34840917 PMCID: PMC8619782 DOI: 10.1177/21649561211045016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background We previously reported on a pilot study to assess the incorporation of a novel wellness assessment device, the Preventiometer (iPEx5 GmbH, Greifswald, Germany), into an academic medical practice. The present follow-up study expands on those data and evaluates the acceptability of the assessment process in a larger sample population. Objective The aim of this study was to evaluate participant satisfaction with the Preventiometer wellness assessment. Methods A total of 60 healthy volunteers participated. Each participant underwent a comprehensive wellness assessment with the Preventiometer and received data from more than 30 diagnostic tests. A 32-question survey (with a numeric rating scale from 0 to 10) was used to rate the wellness assessment tests and participants' impressions of the wellness assessment. Results Each assessment had a significantly higher rating than 7 (P < .001), and the majority of participants agreed or strongly agreed that they were satisfied (98.3%), and they strongly agreed that they were engaged the entire time (93.2%), and liked the instant test results feature of the Preventiometer device (93.2%). Conclusion This study confirms findings from our previous pilot study regarding the feasibility of the Preventiometer as a wellness assessment tool. The study further demonstrated that 98% of participants were satisfied with the assessment and that all of them would recommend it to others.
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Affiliation(s)
| | - Tony Y Chon
- Division of General Internal Medicine, MN, USA
| | | | | | | | - Markus Krüger
- Institute for Community Medicine, Mayo Clinic, Rochester, MN, USA.,Center for Oral Health, Universitätsmedizin Greifswald, Germany
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24
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Jones T, Purdy M, Stewart EA, Cutshall SM, Hathcock MA, Mahapatra S, Bauer BA, Ainsworth AJ. Lavender Aromatherapy to Reduce Anxiety During Intrauterine Insemination: A Randomized Controlled Trial. Glob Adv Health Med 2021; 10:21649561211059074. [PMID: 34820153 PMCID: PMC8606920 DOI: 10.1177/21649561211059074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Infertility is a global public health issue. Therapies such as intrauterine insemination (IUI) are effective but may be associated with considerable anxiety. Preliminary data suggest that decreasing this anxiety might lead to improved outcomes. Objective To determine whether lavender aromatherapy (LA) reduces anxiety during an IUI procedure. Methods A randomized controlled trial of women undergoing IUI at a hospital-based fertility clinic. The intervention and comparison were the use of LA vs water. Measurements were the change in anxiety level during an IUI procedure, with secondary assessment of pain scores, patient satisfaction, and pregnancy rates. Results In total, 67 women were screened, and 62 women randomly assigned to either placebo (n = 31) or LA (n = 31). No differences were observed in baseline demographic characteristics or visual analog scores for anxiety before IUI (mean [95% CI], 33.9 [25.2 to 45.6] mm vs 41.0 [33.0 to 49.0] mm) in the LA and placebo groups. However, a statistically significant change in anxiety was observed after LA inhalation during the procedure (mean [95% CI], −11.2 [−19.1 to −3.2]) compared with placebo (mean [95% CI], 1.3 [−5.6 to 8.2]; P = .02). No significant difference was observed in pain during IUI in the LA group vs placebo group. Patient satisfaction was high, with 93% of respondents in the LA group satisfied with the aromatherapy during their procedure. Additionally, 76% of participants who received placebo reported that they would prefer to use LA during their IUI. No statistically significant difference was detected in pregnancy rates between the 2 groups: 19.4% with LA vs 9.7% with placebo (P = .47). Conclusion LA reduced anxiety and was preferred by women during IUI fertility treatments.
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Affiliation(s)
- Tiffanny Jones
- Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - MacKenzie Purdy
- Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Elizabeth A. Stewart
- Division of Reproductive Endocrinology and Infertility, Mayo Clinic, Rochester, MN, USA
| | | | | | - Saswati Mahapatra
- Department of Research Administration, Mayo Clinic, Rochester, MN, USA
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Brent A. Bauer, Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905-0002, USA.
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25
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Stan DL, Cutshall SM, Adams TF, Ghosh K, Clark MM, Wieneke KC, Kebede EB, Donelan Dunlap BJ, Ruddy KJ, Hazelton JK, Butts AM, Jenkins SM, Croghan IT, Bauer BA. Wellness Coaching: An Intervention to Increase Healthy Behavior in Breast Cancer Survivors. Clin J Oncol Nurs 2021; 24:305-315. [PMID: 32441691 DOI: 10.1188/20.cjon.305-315] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Regular physical activity after breast cancer diagnosis improves survival rates and quality of life (QOL). However, breast cancer survivors rarely meet guidelines for recommended levels of physical activity. Wellness coaching interventions (WCIs) have improved exercise and health behaviors in other patient populations. OBJECTIVES This study assessed the feasibility and effectiveness of WCIs for increasing physical activity in breast cancer survivors; secondary measures included changes in dietary habits, weight, and QOL. METHODS 20 obese or overweight breast cancer survivors who recently completed active breast cancer treatment were recruited into a single-arm, 12-week WCI pilot feasibility study. The intervention was comprised of one in-person wellness coaching visit followed by four telephone calls over 12 weeks and 12 weekly emails containing wellness recommendations. FINDINGS Significant improvements from pre- to postintervention were seen in physical activity level, dietary habits, and in some aspects of QOL. Forty percent of participants achieved the 3% postintervention weight-loss goal, but this was not sustained at 30 weeks.
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26
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Fan T, Zhang Y, Lv Y, Chang J, Bauer BA, Yang J, Wang CW. Cutaneous myiasis with eosinophilic pleural effusion: A case report. World J Clin Cases 2021; 9:4803-4809. [PMID: 34222451 PMCID: PMC8223839 DOI: 10.12998/wjcc.v9.i18.4803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/07/2021] [Accepted: 05/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cutaneous myiasis is frequently observed; however, eosinophilic pleural effusion induced by this condition is rare.
CASE SUMMARY We report the case of a 65-year-old female Tibetan patient from Qinghai Province, who presented to West China Hospital of Sichuan University around mid-November 2011 with a chief complaint of recurrent cough, occasional hemoptysis, and right chest pain. There was no past medical and surgical history of note, except for occasional dietary habit of eating raw meat. Clinical examination revealed a left lung collapse and diminished breathing sounds in her left lung, with moist rales heard in both lungs. Chest X-rays demonstrated a left hydropneumothorax and a right lung infection. Chest computed tomography revealed a left hydropneumothorax with partial compressive atelectasis and patchy consolidation on the right lung. Laboratory data revealed peripheral blood eosinophilia of 37.2%, with a white blood cell count of 10.4 × 109/L. Serum immunoglobulin E levels were elevated (1650 unit/mL). Serum parasite antibodies were negative except for cysticercosis immunoglobulin G. Bone marrow aspirates were hypercellular, with a marked increase in the number of mature eosinophils and eosinophilic myelocytes. An ultrasound-guided left-sided thoracentesis produced a yellow-cloudy exudative fluid. Failure to respond to antibiotic treatment during hospitalization for her symptoms and persistent blood eosinophilia led the team to start oral albendazole (400 mg/d) for presumed parasitic infestation for three consecutive days after the ninth day of hospitalization. Intermittent migratory stabbing pain and swelling sensation on both her upper arms and shoulders were reported; tender nodules and worm-like live organisms were observed in the responding sites 1 wk later. After the removal of the live organisms, they were subsequently identified as first stage hypodermal larvae by the Sichuan Institute of Parasites. The patient’s symptoms were relieved soon afterwards. Telephonic follow-up 1 mo later indicated that the blood eosinophilia and pleural effusion were resolved.
CONCLUSION Eosinophilic pleural fluid can be present in a wide array of disorders. Myiasis should be an important consideration for the differential diagnosis when eosinophilic pleural effusion with blood eosinophilia is observed.
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Affiliation(s)
- Tao Fan
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yu Zhang
- Department of Respiratory and Critical Care Medicine, Chengdu Integrated Traditional Chinese and Western Medicine Hospital, Chengdu 610016, Sichuan Province, China
| | - Yan Lv
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jing Chang
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Brent A Bauer
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Juan Yang
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Cheng-Wei Wang
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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27
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Affiliation(s)
- Bryan J Neth
- Departments of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Brent A Bauer
- Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | | | - Rodolfo Savica
- Departments of Neurology, Mayo Clinic, Rochester, MN, United States
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28
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Feng Z, Yang J, Xu M, Lin R, Yang H, Lai L, Wang Y, Wahner-Roedler DL, Zhou X, Shin KM, Salinas M, Mallory MJ, Tang C, Patchett DC, Bauer BA, Cui S. Dietary supplements and herbal medicine for COVID-19: A systematic review of randomized control trials. Clin Nutr ESPEN 2021; 44:50-60. [PMID: 34330513 PMCID: PMC8166807 DOI: 10.1016/j.clnesp.2021.05.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The world is currently struggling with the Coronavirus disease 2019 (COVID-19) pandemic. Dietary supplements (DSs) and herbal medicine provide a potentially convenient and accessible method for its recovery, but direct evidence is limited. OBJECTIVE This study aims to investigate the effectiveness of DSs and herbs in patients with COVID-19. METHODS A systematic literature search was conducted in multiple electronic English and Chinese databases. Randomized controlled trials (RCTs) involving DSs or herbal medicine interventions on patients with COVID-19 from November 2019 to February 2021 were included. Data was extracted, summarized and critically examined. RESULTS Out of 9402 records identified in the initial search, twelve RCTs were included in this review. Risk of bias of these RCTs was deemed high. Most of the trials were of low methodologic quality. Nine studies showed herbal supplements were beneficial to the recovery of COVID-19 patients; zinc sulfate could shorten the duration of loss of smell but not total recovery from COVID-19. No severe adverse events were reported. CONCLUSION Herbal supplements may help patients with COVID-19, zinc sulfate is likely to shorten the duration of olfactory dysfunction. DS therapy and herbal medicine appear to be safe and effective adjuvant therapies for patients with COVID-19. These results must be interpreted with caution due to the overall low quality of the included trials. More well-designed RCTs are needed in the future.
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Affiliation(s)
- Zitong Feng
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mingzhu Xu
- Department of Rehabilitation, Shenzhen Hospital, Southern Medical University, 1333 Xinhu Road, Shenzhen, 518100, Guangdong, China
| | - Run Lin
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, Guangdong, China
| | - Huijun Yang
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, Guangdong, China
| | - Liting Lai
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yixiao Wang
- Department of Rehabilitation, Shenzhen Hospital, Southern Medical University, 1333 Xinhu Road, Shenzhen, 518100, Guangdong, China
| | | | - Xuan Zhou
- Formula- Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Kyung-Min Shin
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Manisha Salinas
- Division of Family Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Molly J Mallory
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Chunzhi Tang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - David C Patchett
- Department of Family Medicine, Mayo Clinic, Scottsdale, AZ, USA; Department of Integrative Medicine, Mayo Clinic, Scottsdale, AZ, USA.
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Shaoyang Cui
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China; Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, Guangdong, China.
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29
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Locker C, Mallory MJ, Bauer BA, Friedman PA, Dearani J, King KS, Erdman M, Deshmukh A, Wittwer ED, Crestanello JA, Schaff H. ACUPUNCTURE TREATMENT FOR ATRIAL FIBRILLATION IN THE POST-OPERATIVE CARDIO-THORACIC SETTING- A FEASIBILITY PILOT STUDY. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01725-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Kebede EB, Tan J, Iftikhar S, Abu Lebdeh HS, Duggirala MK, Ghosh AK, Croghan IT, Jenkins SM, Mahapatra S, Bauer BA, Wahner-Roedler DL. Complementary and Alternative Medicine Use by Patients From the Gulf Region Seen in the International Practice of a Tertiary Care Medical Center. Glob Adv Health Med 2021; 10:21649561211010129. [PMID: 33996270 PMCID: PMC8076768 DOI: 10.1177/21649561211010129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 02/25/2021] [Accepted: 03/25/2021] [Indexed: 12/30/2022] Open
Abstract
Background Patients from various countries may have unique patterns of using complementary and alternative medicine (CAM) and unique reasons for using it. Objective Our objective was to assess the use of CAM among patients from the Gulf region attending the Executive and International Health Program of the Department of General Internal Medicine at Mayo Clinic in Rochester, Minnesota. Methods This cross-sectional survey was administered to all patients who were from the Gulf region and were undergoing outpatient evaluation in the Executive and International Health Program. After their initial medical evaluation by a physician, the patients were invited to anonymously complete the modified International Complementary and Alternative Medicine Questionnaire. Results The survey was completed by 69 patients (41 women, 27 men; mean age, 45.4 years). The most frequently seen providers for CAM treatments were physicians (71.0% of patients), spiritual healers (29.0%), and chiropractors (20.3%). CAM treatments most frequently received from a physician were massage therapy (51.0%), hijama (38.8%), spiritual healing (24.5%), and acupuncture or herbs (16.3%). The most frequently used dietary supplements were ginger (42.0%), bee products (30.4%), and garlic (27.5%). The most common self-help therapies were prayers for health (68.1%), meditation (15.9%), and relaxation techniques (11.6%). CAM therapy, including visits to CAM providers, was used by 92.8% of patients. CAM was mainly used to improve well-being and long-term health conditions rather than for acute illnesses. Conclusion The use of CAM was high among our patients from the Gulf region, and the CAM therapies used by this population differed from the ones used by US patients. Physicians providing care to patients from the Gulf region should be aware of how the use of CAM may affect the care needs of these patients.
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Affiliation(s)
- Esayas B Kebede
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Judy Tan
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Salma Iftikhar
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Haitham S Abu Lebdeh
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota.,Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
| | - Murali K Duggirala
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Amit K Ghosh
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Ivana T Croghan
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota.,Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Sarah M Jenkins
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Saswati Mahapatra
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
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31
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Abstract
The sudden outbreak and global spread of COVID-19 demanded a tremendous amount of attention for viral respiratory infections (VRIs) in modern times. Evidence accumulated over the past few decades increasingly suggests the importance of recognizing the background and context of lifestyle factors in the prevention of VRIs recurrence. The focus of attention has specifically been on how to optimize respiratory barrier function and immune function during the period of the pandemic outbreak. This viewpoint discusses the impact of a healthy lifestyle on VRIs and demonstrates a practical approach to preventing the occurrence of VRIs based on contemporary evidence.
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Affiliation(s)
- David Patchett
- Department of Family Medicine, Mayo Clinic, Scottsdale, AZ.,Department of Integrative Medicine, Mayo Clinic, Scottsdale, AZ
| | - Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Jane Northern
- Department of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ
| | - Manisha Salinas
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
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32
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Abstract
Coronavirus disease (COVID-19) has expanded around the world, resulting in a pandemic with high morbidity and mortality. To date, no specific treatment or vaccine is available to treat or prevent this sudden and potentially deadly disease. Economic restructuring brings opportunities and challenges to integrative medicine treatment. In such complex situations, integrative medicine treatments are to be provided cautiously, and the shift from in-person visits to remote medical services might play an important role in how such services are delivered.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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33
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Yang J, Brault JS, Jensen MA, Do A, Ma Q, Zhou X, Shen L, Zhao C, Cheong KCP, He K, Guo Y, Chen Z, Tang S, Tang Y, Tan CIC, Chen J, Bauer BA. Tui Na for Chronic Nonspecific Low Back Pain: Protocol for a Systematic Review and Meta-analysis. JMIR Res Protoc 2021; 10:e20615. [PMID: 33502327 PMCID: PMC7875686 DOI: 10.2196/20615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 09/06/2020] [Accepted: 12/15/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic nonspecific low back pain (CNLBP) is one of the most common complex pain conditions, and it is strongly associated with high rates of disability. Even though several studies on Tui na for CNLBP have been reported, to our knowledge there has been no systematic review of the currently available publications. OBJECTIVE This study aims to develop a protocol for a systematic review and meta-analysis that will evaluate the effectiveness and safety of Tui na therapy for patients with CNLBP. METHODS An electronic literature search of PubMed, Embase, MEDLINE, Cochrane Library, Springer, Scopus, World Health Organization International Clinical Trials Registry Platform, Physiotherapy Evidence Database (PEDro), Clarivate Analytics, and Chinese biomedical databases (the China National Knowledge Infrastructure, Wan-fang database, Chinese Scientific Journals Database, and Chinese Biomedical Literature Databases) will be conducted. Studies will be screened by two reviewers independently based on titles and abstracts, followed by a full-text reading with eligibility criteria. Randomized controlled trials involving Tui na for patients with CNLBP will be reviewed. The primary outcomes of the study are improvement of pain, analgesic medication reduction, improvement of functional disability, and degree of satisfaction with the intervention. A secondary outcome is any adverse event of Tui na intervention. Methodological quality and risk of bias will be assessed with the Cochrane Collaboration Risk of Bias Tool. If studies are sufficient, a meta-analysis of the effectiveness will be performed. If possible, we will evaluate publication bias using funnel plots. If substantial heterogeneity between studies is present, and there are sufficient studies, subgroup analyses will be conducted to explain the study findings. RESULTS The review database searches will be initiated in December 2020, with findings expected by January 2021. CONCLUSIONS This protocol will establish a framework of a high-quality literature synthesis on the impact of Tui na treatment in patients with CNLBP. The proposed review will determine whether Tui na is effective and safe for CNLBP patients. TRIAL REGISTRATION PROSPERO CRD42020166731; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=166731. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/20615.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Jeffrey S Brault
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States
| | - Mark A Jensen
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States
| | - Alexander Do
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Qingyu Ma
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Xuan Zhou
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Longbin Shen
- Department of Acupuncture, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Canghuan Zhao
- Department of Acupuncture, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Kwok Chee Philip Cheong
- School of Physiotherapy and Exercise Science, Singapore General Hospital, Singapore, Singapore
| | - Kejie He
- Department of Acupuncture, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yu Guo
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Zhuoming Chen
- Department of Acupuncture, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shujie Tang
- Department of Orthopedics, College of Chinese Medicine, Jinan University, Guangzhou, China
| | - Yong Tang
- Department of Orthopedics, College of Chinese Medicine, Jinan University, Guangzhou, China
| | | | - Jiaxu Chen
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States
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Yang J, Wahner-Roedler DL, Zhou X, Johnson LA, Do A, Pachman DR, Chon TY, Salinas M, Millstine D, Bauer BA. Acupuncture for palliative cancer pain management: systematic review. BMJ Support Palliat Care 2021; 11:264-270. [PMID: 33441387 PMCID: PMC8380897 DOI: 10.1136/bmjspcare-2020-002638] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/11/2020] [Accepted: 12/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Pain is one of the most common and problematic symptoms encountered by patients with cancer. Due to the multifactorial aetiology, pain management of these patients frequently requires multidisciplinary interventions including conventional support and specialty palliative care. Acupuncture has been identified as a possible adjunctive therapy for symptom management in cancer pain, and there is currently no systematic review focused solely on the evidence of acupuncture on cancer pain in palliative care. OBJECTIVE To critically analyse currently available publications regarding the use of acupuncture for pain management among patients with cancer in palliative care settings. METHODS Multiple academic databases were searched from inception to 29 October 2020. Randomised controlled trials involving acupuncture in palliative care for treatment of cancer-related pain were synthesised. Data were extracted by two independent reviewers, and methodological quality of each included study was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence. RESULTS Five studies (n=189) were included in this systematic review. Results indicated a favourable effect of acupuncture on pain relief in palliative care for patients with cancer. According to OCEBM 2011 Levels of Evidence, they were level 2 in one case (20%), level 3 in two cases (40%) and level 4 in the remaining (40%). Low-level evidence adversely affects the reliability of findings. CONCLUSIONS Acupuncture may be an effective and safe treatment associated with pain reduction in the palliative care of patients with cancer. Further high-quality, adequately powered studies are needed in the future.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Xuan Zhou
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Lesley A Johnson
- Department of Women's Health/Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Alex Do
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Deirdre R Pachman
- Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Manisha Salinas
- Division of Family Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Denise Millstine
- Department of Women's Health/Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Yang J, Ganesh R, Wu Q, Li L, Ogletree SP, Del Fabro AS, Wahner-Roedler DL, Xiong D, Bauer BA, Chon TY. Battlefield Acupuncture for Adult Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Chin Med 2020; 49:25-40. [PMID: 33375924 DOI: 10.1142/s0192415x21500026] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Pain is a major public health problem, causing heavy social and economic burdens to patients and society while consuming tremendous medical resources at the same time. Thus, there is a critical need to find low-cost, efficacious, and therapeutic approaches to help manage pain. While acupuncture is increasingly recognized as a promising pain-relieving method, less is known about a specific form of auricular acupuncture known as Battlefield Acupuncture (BFA). The BFA technique involves the sequential placement of semi-permanent, single-use, French ASP[Formula: see text] golden needles to five specific acupoints in one or both ears, where they are left in place for 3-4 days or longer [Niemtzow, R.C., Battlefield acupuncture. Med. Acupunct. 19: 225-228, 2007]. The BFA needles (more accurately described as tiny conical darts) pierce the ear in designated locations in a particular order [Levy, C.E., N. Casler and D.B. FitzGerald. Battlefield acupuncture: an emerging method for easing pain. Am. J. Phys. Med. Rehabil. 97: e18-e19, 2018.]. (Figs. 4 and 5) It was developed by Dr. Richard C. Niemtzow in 2001, as a subgroup form of an auricular acupuncture technique based on the somatotopic arrangement of an inverted fetus pattern on the external ear [Romoli, M. Ear acupuncture: historical abstract-differences of ear cartography between the east and the west. Dtsch. Z. Akupunkt. 53: 24-33, 2010.]. Currently, BFA is widely used in the US military, but to our knowledge, there is no review which comprehensively synthesizes the current publications surrounding pain management. This review aims to investigate the effects and safety of BFA in adults with pain. Electronic databases were searched for randomized controlled trials (RCTs) published in English evaluating efficacy and safety of BFA in adults with pain, from database inception to September 6, 2019. The primary outcome was pain intensity change, and the secondary outcome was safety. Nine RCTs were included in this review, and five trials involving 344 participants were analyzed quantitatively. Compared with no intervention, usual care, sham BFA, and delayed BFA interventions, BFA had no significant improvement in the pain intensity felt by adults suffering from pain. Few adverse effects (AEs) were reported with BFA therapy, but they were mild and transitory. BFA is a safe, rapid, and easily learned acupuncture technique, mainly used in acute pain management, but no significant efficacy was found in adult individuals with pain, compared with the control groups. Given the poor methodological quality of the included studies, high-quality RCTs with rigorous evaluation methods are needed in the future.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States of America.,Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Guangdong, Medical University, Shenzhen, Guangdong 518052, P. R. China
| | - Ravindra Ganesh
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States of America
| | - Qinglong Wu
- College of Acupuncture and Rehabilitation, Guangzhou University of Traditional, Chinese Medicine, Guangzhou, Guangdong 510006, P. R. China
| | - Langping Li
- Department of Anesthesiology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong, University School of Medicine, Shanghai 200020, P. R. China
| | - Sandra P Ogletree
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN 55905, United States of America
| | - Anna S Del Fabro
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN 55905, United States of America
| | | | - Donglin Xiong
- Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Guangdong, Medical University, Shenzhen, Guangdong 518052, P. R. China
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States of America
| | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States of America
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36
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Dilaveri CA, Croghan IT, Mallory MJ, Dion LJ, Fischer KM, Schroeder DR, Martinez-Jorge J, Nguyen MDT, Fokken SC, Bauer BA, Wahner-Roedler DL. Massage Compared with Massage Plus Acupuncture for Breast Cancer Patients Undergoing Reconstructive Surgery. J Altern Complement Med 2020; 26:602-609. [PMID: 32673082 DOI: 10.1089/acm.2019.0479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objectives: Integrative therapies have been incorporated increasingly into health and wellness in the United States in recent decades. Their potential benefits are under evaluation in various situations, including pain and symptom relief for cancer patients and survivors. This pilot study evaluated whether combining two integrative complementary approaches augments a patient's benefit by reducing postoperative stress, pain, anxiety, muscle tension, and fatigue compared with one integrative complementary approach alone. Design: Patients undergoing autologous tissue breast reconstruction were randomly assigned to one of two postoperative complementary alternative therapies for three consecutive days. All participants were observed for up to 3 months. Subjects: Forty-two participants were recruited from January 29, 2016 to July 11, 2018. Interventions: Twenty-one participants were randomly assigned to massage alone and 21 to massage and acupuncture. Outcome measures: Stress, anxiety, relaxation, nausea, fatigue, pain, and mood (score 0-10) were measured at enrollment before surgery and postoperative days 1, 2, and 3 before and after the intervention. Patient satisfaction was evaluated. Results: Stress decreased from baseline for both Massage-Only Group and Massage+Acupuncture Group after each treatment intervention. Change in stress score from baseline decreased significantly more in the Massage-Only Group at pretreatment and posttreatment (p = 0.03 and p = 0.04). After adjustment for baseline values, change in fatigue, anxiety, relaxation, nausea, pain, and mood scores did not differ between groups. When patients were asked whether they would recommend the study, 100% (19/19) of Massage-Only Group and 94% (17/18) of Massage+Acupuncture Group responded yes (p = 0.49). Conclusion: No additive beneficial effects were observed with addition of acupuncture to massage for pain, anxiety, relaxation, nausea, fatigue, and mood. Combined massage and acupuncture was not as effective in reducing stress as massage alone, although both groups had significant stress reduction. These findings indicate a need for larger studies to explore these therapies further.
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Affiliation(s)
| | - Ivana T Croghan
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.,Department of Medicine Clinical Research Office, Mayo Clinic, Rochester, MN, USA
| | - Molly J Mallory
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Liza J Dion
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Karen M Fischer
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | | | - Minh-Doan T Nguyen
- Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA
| | - Shawn C Fokken
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Medicine Clinical Research Office, Mayo Clinic, Rochester, MN, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Havyer RD, Lapid MI, Dockter TJ, McCue SA, Stelpflug AJ, Bigelow ML, Robsahm MM, Elwood T, Strand JJ, Bauer BA, Cutshall SM, Sloan JA, Walton MP, Whitford KJ. Impact of Massage Therapy on the Quality of Life of Hospice Patients and Their Caregivers: A Pilot Study. J Palliat Care 2020; 37:41-47. [PMID: 33213233 DOI: 10.1177/0825859720975991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Evidence for massage therapy (MT) in hospice patients remains limited. We conducted a prospective pilot study on MTs impact on quality of life of hospice patients and caregivers. Patient-caregiver dyads were enrolled if patients scored ≥5 on pain, depression, anxiety, or well-being using the revised Edmonton Symptom Assessment System Revised (ESAS-r). The patient received MT weekly for up to 3 massages with assessments completed at baseline, after each massage, and 1 week after the final massage for patients and at baseline and 1 week after final massage for caregivers. A satisfaction survey was completed at study completion. A pro-rated area under the curve (AUC) was utilized to assess the primary endpoints of change in ESAS-r for patient ratings of pain, depression and anxiety as well as the Linear Analogue Self-Assessment (LASA). Median difference scores (end of study value)-(baseline value) for each participant and caregiver were calculated. Of 27 patients and caregivers enrolled, 25 patients received MT. Fifteen patients completed all 3 MT sessions and were given the final symptom assessment and satisfaction survey and their caregivers completed final assessments. The proportion of patients considered success (AUC > baseline) in the primary endpoints were the following: pain 40.9%, depression 40.9%, anxiety 54.5%, LASA 54.5%. Median difference scores were largely zero indicating no significant temporal change in symptoms. Patients were highly satisfied with MT. This pilot study indicated that MT was a feasible and well-received intervention in our population of patients with inadequately controlled symptoms.
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Affiliation(s)
- Rachel D Havyer
- Mayo Clinic Center for Palliative Medicine, 195110Mayo Clinic, Rochester, MN, USA.,Division of Community Internal Medicine, Department of Medicine, 384842Mayo Clinic, Rochester, MN, USA
| | - Maria I Lapid
- Mayo Clinic Center for Palliative Medicine, 195110Mayo Clinic, Rochester, MN, USA.,Mayo Clinic Hospice, 384842Mayo Clinic, Rochester, MN, USA.,Department of Psychiatry and Psychology, 384842Mayo Clinic, Rochester, MN, USA
| | - Travis J Dockter
- Biomedical Statistics and Informatics, 384842Mayo Clinic, Rochester, MN, USA
| | - Shaylene A McCue
- Biomedical Statistics and Informatics, 384842Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Theresa Elwood
- Mayo Clinic Hospice, 384842Mayo Clinic, Rochester, MN, USA
| | - Jacob J Strand
- Mayo Clinic Center for Palliative Medicine, 195110Mayo Clinic, Rochester, MN, USA.,Mayo Clinic Hospice, 384842Mayo Clinic, Rochester, MN, USA
| | - Brent A Bauer
- Division of Integrative Medicine & Health, Department of Medicine, 384842Mayo Clinic, Rochester, MN, USA
| | - Susanne M Cutshall
- Division of Integrative Medicine & Health, Department of Medicine, 384842Mayo Clinic, Rochester, MN, USA
| | - Jeff A Sloan
- Biomedical Statistics and Informatics, 384842Mayo Clinic, Rochester, MN, USA
| | - Monica P Walton
- Department of Psychiatry and Psychology, 384842Mayo Clinic, Rochester, MN, USA
| | - Kevin J Whitford
- Mayo Clinic Center for Palliative Medicine, 195110Mayo Clinic, Rochester, MN, USA.,Mayo Clinic Hospice, 384842Mayo Clinic, Rochester, MN, USA.,Division of Hospital Internal Medicine, Department of Medicine, 384842Mayo Clinic, Rochester, MN, USA
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Clark SD, Smidt JM, Bauer BA. Therapy Dogs' and Handlers' Behavior and Salivary Cortisol During Initial Visits in a Complex Medical Institution: A Pilot Study. Front Vet Sci 2020; 7:564201. [PMID: 33282927 PMCID: PMC7691227 DOI: 10.3389/fvets.2020.564201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/29/2020] [Indexed: 12/03/2022] Open
Abstract
Therapy dogs provide health benefits for individuals who suffer from illnesses, such as dementia, depression, loneliness, and aggression. Therapy dogs' impact on human health has been thoroughly studied; however, studies on dog welfare have been limited. Additionally, as dogs have evolved with humans, they have learned to read non-verbal social cues. Dogs can read humans' non-verbal body language and can react to their emotions. However, the body language of dogs is poorly understood and can lead to dog owner-directed aggression. Communication plays a vital role to be a cohesive therapy team. The purpose of this study was to assess perceived stress and cortisol concentrations in therapy dogs and their handlers during the first three visits in a hospital setting. Moreover, the study aimed to investigate whether, while in an overstimulating environment, a therapy dog handler can observe his or her dog's body language and correlate such observations to the dog's stress. Nine therapy dog teams from Mayo Clinic's Caring Canine Program participated in this study. A baseline salivary cortisol was collected from the handler and therapy dog each day of the visits. Once the team arrived, a pre-visit salivary cortisol was collected from the handler and therapy dog and, afterward, a post-visit salivary cortisol. Handlers were also asked to fill out a perceived stress survey on their own stress and that of their therapy dogs'. Behavior was documented by a staff member and the handler. For each visit, the therapy dogs were at the hospital on average 47 min and visited with nine people. There was significant correlation (P = 0.02) between the owner's perceived stress of his or her therapy dog and the dog's salivary cortisol concentrations. The handlers noted medium to high stress, and those dogs had higher cortisol concentrations post-visit. There was no significant difference in salivary cortisol for the handler and therapy dog over the course of the three visits and comparing pre- and post-visit. Overall, the dogs displayed mixed behaviors, with the three most reported being panting, lip licking, and yawning. However, salivary cortisol results suggest that the handlers and therapy dogs maintained their welfare state throughout the visits.
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Affiliation(s)
- Stephanie D Clark
- Division of General Internal Medicine, Section of Integrative Medicine and Health, Mayo Clinic, Rochester, MN, United States
| | - Jessica M Smidt
- Division of General Internal Medicine, Section of Integrative Medicine and Health, Mayo Clinic, Rochester, MN, United States
| | - Brent A Bauer
- Division of General Internal Medicine, Section of Integrative Medicine and Health, Mayo Clinic, Rochester, MN, United States
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Zhang R, Campanella C, Aristizabal S, Jamrozik A, Zhao J, Porter P, Ly S, Bauer BA. Impacts of Dynamic LED Lighting on the Well-Being and Experience of Office Occupants. Int J Environ Res Public Health 2020; 17:ijerph17197217. [PMID: 33023141 PMCID: PMC7579128 DOI: 10.3390/ijerph17197217] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 12/18/2022]
Abstract
As a critical factor in the built environment, lighting presents considerable influence on occupants. Previous research across static lighting conditions has found that both illuminance and correlated color temperature (CCT) affect occupants’ physiological and psychological functioning. However, little research has been conducted on the non-visual impacts of dynamic lighting with daily variation in illuminance and CCT levels. The purpose of this study is to better understand the impact of dynamic lighting on office occupants’ health, well-being and experience at a living lab. Fifteen participants were recruited to work in three office modules for four months. Four lighting conditions were designed and implemented in this study, including two static lighting conditions and two dynamic lighting conditions with a specific predefined control scheme. A prototype lighting system with enhanced control capabilities was configured and implemented to ensure the desired lighting environment protocol. Both objective methods and subjective surveys were used to assess the behavioral and physiological outcomes of interest, including mental stress, sleep, productivity, satisfaction, mood, visual comfort and perceived naturalness. The results showed that the daytime behavioral impacts were either positive or mixed. Specifically, a significant alertness increase was observed in the afternoon, indicating a potential solution to reduce the natural feelings of sleepiness during the workday. There was also a marginal benefit for mood. The nighttime impacts include a significant decrease in perceived sleep quality and sleep time after subjects were exposed to dynamic lighting. No significant differences were observed for mental stress, productivity, visual comfort, or perceived naturalness. The findings present additional insights into the non-visual impacts of dynamic lighting and give recommendations for further investigations.
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Affiliation(s)
- Rongpeng Zhang
- Well Living Lab, Rochester, MN 55902, USA; (C.C.); (S.A.); (A.J.); (J.Z.); (P.P.); (S.L.); (B.A.B.)
- Delos Labs, Delos Living, New York, NY 10014, USA
- Mayo Clinic, Rochester, MN 55902, USA
- Correspondence:
| | - Carolina Campanella
- Well Living Lab, Rochester, MN 55902, USA; (C.C.); (S.A.); (A.J.); (J.Z.); (P.P.); (S.L.); (B.A.B.)
- Delos Labs, Delos Living, New York, NY 10014, USA
- Mayo Clinic, Rochester, MN 55902, USA
| | - Sara Aristizabal
- Well Living Lab, Rochester, MN 55902, USA; (C.C.); (S.A.); (A.J.); (J.Z.); (P.P.); (S.L.); (B.A.B.)
- Delos Labs, Delos Living, New York, NY 10014, USA
- Mayo Clinic, Rochester, MN 55902, USA
| | - Anja Jamrozik
- Well Living Lab, Rochester, MN 55902, USA; (C.C.); (S.A.); (A.J.); (J.Z.); (P.P.); (S.L.); (B.A.B.)
- Delos Labs, Delos Living, New York, NY 10014, USA
- Mayo Clinic, Rochester, MN 55902, USA
| | - Jie Zhao
- Well Living Lab, Rochester, MN 55902, USA; (C.C.); (S.A.); (A.J.); (J.Z.); (P.P.); (S.L.); (B.A.B.)
- Delos Labs, Delos Living, New York, NY 10014, USA
- Mayo Clinic, Rochester, MN 55902, USA
| | - Paige Porter
- Well Living Lab, Rochester, MN 55902, USA; (C.C.); (S.A.); (A.J.); (J.Z.); (P.P.); (S.L.); (B.A.B.)
- Delos Labs, Delos Living, New York, NY 10014, USA
- Mayo Clinic, Rochester, MN 55902, USA
| | - Shaun Ly
- Well Living Lab, Rochester, MN 55902, USA; (C.C.); (S.A.); (A.J.); (J.Z.); (P.P.); (S.L.); (B.A.B.)
- Delos Labs, Delos Living, New York, NY 10014, USA
- Mayo Clinic, Rochester, MN 55902, USA
| | - Brent A. Bauer
- Well Living Lab, Rochester, MN 55902, USA; (C.C.); (S.A.); (A.J.); (J.Z.); (P.P.); (S.L.); (B.A.B.)
- Mayo Clinic, Rochester, MN 55902, USA
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Bauer BA, Townsend KM, Cutshall SM, Hazelton JF, Mahapatra S, Meek AM, Wahner-Roedler DL. Advanced Practice Providers' Knowledge, Attitudes, and Utilization of Complementary and Integrative Medicine at an Academic Medical Center. Altern Ther Health Med 2020; 26:8-16. [PMID: 32663179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
CONTEXT Complementary and integrative medicine comprises treatments used along with conventional medical care. Its use within care settings and communities has increased. OBJECTIVE We aimed to assess baseline knowledge and use of complementary and integrative medicine among advanced practice providers at an academic medical center and their attitudes toward it. METHODS A 50-question survey was sent to 1018 advanced practice providers at our academic medical center to evaluate their knowledge, attitudes, and utilization of complementary and integrative medicine therapies. RESULTS The 556 respondents (54.6% response rate) included physician assistants, nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists, and certified nurse midwives. Respondents reported a positive attitude toward complementary and integrative medicine and were likely to refer their patients to a complementary and integrative medicine practitioner (59%). They agreed that patients whose providers incorporate complementary and integrative medicine into their care have better clinical outcomes (nurse practitioners, 93%; certified registered nurse anesthetists, 87%; physician assistants, 85%; P = .002) and improved patient satisfaction (all respondents, 84%). Advanced practice providers, especially nurse practitioners, stated that they initiate the conversation to discuss the benefits and harms of complementary and integrative medicine with their patients (nurse practitioners, 93%; certified registered nurse anesthetists, 87%; physician assistants, 85%; P < .001). Respondents most frequently endorsed overall exercise, massage, and melatonin. Prospective randomized controlled trials were the most influential factor for attitude toward complementary and integrative medicine among physician assistants (50%), and personal experience was the most influential factor among nurse practitioners (52.9%) and certified registered nurse anesthetists (46.8%). CONCLUSIONS Advanced practice providers generally have positive attitudes toward complementary and integrative medicine, but utilization appears limited by a self-report of low knowledge of benefits and risks of various therapies. For patient safety and satisfaction, advanced practice providers require a strong complementary and integrative medicine knowledge base to counsel patients.
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Abstract
Objective: Laser acupuncture has become increasingly attractive in clinical practice, especially for patients with needle phobias well as elderly people and children. However, literature concerning the safety of laser acupuncture has been limited. This systematic review synthesizes the current available literature on the safety of laser acupuncture. Methods: Ovid MEDLINE,® Epub Ahead of Print, In-Process & Other Non-Indexed Citations Daily, Ovid Embase, Scopus, and EBM Reviews-Cochrane Central Register of Controlled Trials databases were searched for available randomized controlled trials (RCTs) on laser acupuncture. Safety data were extracted from the included studies. Adverse events (AEs) data were extracted and assessed in terms of severity and causality. Results: Of 737 articles, 21 RCTs were included. The majority of these RCTs reported that laser acupuncture was safe, without AEs; 6 trials reported AEs (including tingling, pain flare-ups, and transient fatigue). All AEs were mild and resolved spontaneously within 24 hours. The causal relationship between AEs and laser acupuncture was felt to be "certain" in 4 studies, "probable" in 1 study, and "possible" in 1 study. AEs were collected and monitored by evaluation methods in 7 trials: 5 with AE questionnaires, 1 with a checklist, and 1 with oral reports. Conclusions: Laser acupuncture appears to be a safe therapy associated with few mild and transient AEs. However, given the heterogeneity of current studies, large, well-designed placebo-controlled RCTs with rigorous evaluation methods are needed to assess the safety of laser acupuncture more completely.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Shenzhen, Guangdong, China
| | - Molly J Mallory
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Qinglong Wu
- College of Acupuncture and Rehabilitation, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Sara E Bublitz
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Alexander Do
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Donglin Xiong
- Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Shenzhen, Guangdong, China
| | | | - Peter T Dorsher
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Jacksonville, FL, USA
| | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Yang J, Bauer BA, Lindeen SA, Perlman AI, Abu Dabrh AM, Boehmer KR, Salinas M, Cutshall SM. Current trends in health coaching for chronic conditions: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99:e21080. [PMID: 32791680 PMCID: PMC7386956 DOI: 10.1097/md.0000000000021080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Chronic conditions are placing a serious burden on individuals as well as the health care system. Health coaching (HC) has emerged as a promising approach that can support effective lifestyle interventions for chronic conditions. However, until now there is no particularly comprehensive systematic review of HC impact on a chronic condition from the angle of patient improvement and detail coaching characteristics reported. OBJECTIVE To synthesize available studies on the efficacy and current status of HC interventions on the health of chronically ill adult patients. METHODS The literature search will be conducted for trials published in English within the past four years. Electronic databases CINAHL, Cochrane Library, Embase, MEDLINE, and Scopus will be searched with keywords describing HC for chronic diseases. Randomized controlled trials that compare HC interventions to conventional care or other alternative therapies will be included. Data extraction will be conducted by two reviewers independently, and enrolled trials will be evaluated for quality and bias assessment. If appropriate, meta-analysis will be conducted on the last stage of the review; otherwise, the study findings will be described narratively. The software Review Manager (Revman version 5.3.5.) provided by the Cochrane Collaboration will be applied for the meta-analysis. RESULTS This is the first study to comprehensively explore the effectiveness and current status of HC intervention for patients with chronic conditions. DISCUSSION Study findings from this review will advance the appropriate utilization of coaching practice by determining whether HC is effective and feasible among patients with chronic disease. If proven effective, this approach may be applied more broadly through public health interventions. The current status findings will also provide evidence to inform decisions for integrating HC interventions into the current management pathway for individuals with chronic conditions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020153280.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
- Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Shenzhen, Guangdong, China
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Stephanie A. Lindeen
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | | | | | - Kasey R. Boehmer
- Division of Knowledge and Evaluation Research, Mayo Clinic, Rochester
| | - Manisha Salinas
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, Florida, Minnesota, United States
| | - Susanne M. Cutshall
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
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Yang J, Bauer BA, Wu Q, Xiong D, Wahner-Roedler DL, Chon TY, Ganesh R. Impact of herbs and dietary supplements in patients with fibromyalgia: A protocol for a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99:e20257. [PMID: 32481303 PMCID: PMC7250040 DOI: 10.1097/md.0000000000020257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/14/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a common chronic pain condition that seriously affects the quality of patient lives. Its etiology, pathogenesis, and treatment still remain uncertain. Dietary supplements have been widely trialed for symptom relief for FM. The review aims to synthesize the previous literature publications to assess the impact of herbs and dietary supplements on FM patients. METHODS We will conduct a literature search in the following databases PubMed, MEDLINE, EMBASE, Cochrane Library, Scopus, and Global Health from database inception to December 2019. Clinical studies published in the English language that used human participants and address the efficacy, safety, and acceptability of herbs and dietary supplements on individuals with FM will be included. The risk of bias and quality assessment of each trial will be evaluated. If trials are enough, a meta-analysis will be conducted using software RevMan5.3, Cochrane Collaboration. RESULT Our review will be the first attempt to facilitate evidence-based management using herbs and dietary supplements to treat patients with FM. CONCLUSION The findings may provide a framework for future research and clinic practice in FM management. PROSPERO REGISTRATION NUMBER CRD42020149941.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Shenzhen
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Qinglong Wu
- College of Acupuncture and Rehabilitation, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Donglin Xiong
- Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Shenzhen
| | | | - Tony Y. Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ravindra Ganesh
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Clark SD, Martin F, McGowan RT, Smidt JM, Anderson R, Wang L, Turpin T, Langenfeld-McCoy N, Bauer BA, Mohabbat AB. Physiological State of Therapy Dogs during Animal-Assisted Activities in an Outpatient Setting. Animals (Basel) 2020; 10:E819. [PMID: 32397366 PMCID: PMC7277909 DOI: 10.3390/ani10050819] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/03/2020] [Accepted: 05/04/2020] [Indexed: 01/16/2023] Open
Abstract
Therapy dogs are increasingly being incorporated into numerous clinical settings. However, there are only a handful of studies that have focused on the impact of animal-assisted activity or therapy sessions on the wellbeing of the therapy dogs. Furthermore, these studies show mixed results. The goal of this study was to provide an in-depth picture of the effects of these interactions on the dogs involved by considering multiple physiological measures known to be associated with emotional state (continuous heart rate, heart rate variability, pre- and post-session tympanic membrane temperatures, and salivary cortisol and oxytocin concentrations). Nineteen Mayo Clinic Caring Canine therapy dogs completed five 20-minute animal-assisted activity (AAA) visits each in an outpatient clinical setting (Mayo Clinic Fibromyalgia and Chronic Fatigue Clinic). From a physiological perspective, the dogs showed a neutral to positive response to the AAA sessions. Heart rate (HR) was significantly lower at the end of the session compared with the beginning of the session (F = 17.26, df1 = 1, df2 = 29.7, p = 0.0003). The right tympanic membrane temperature was lower post-session (F = 8.87, df1 = 1, df2 = 107, p = 0.003). All other emotional indicators remained stable between pre- and post-session. These results suggest that the dogs involved were not negatively affected by their participation in the AAA. Moreover, there was some evidence suggesting the dogs may have been in a more relaxed state at the end of the session (lower HR and lower right tympanic membrane temperature) compared to the beginning of the session.
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Affiliation(s)
- Stephanie D. Clark
- Section of Integrative Medicine and Health, Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55901, USA; (S.D.C.); (J.M.S.); (B.A.B.)
| | - François Martin
- Nestlé Purina Research, St. Louis, MO 63102, USA; (F.M.); (R.T.S.M.); (R.A.); (L.W.); (T.T.); (N.L.-M.)
| | - Ragen T.S. McGowan
- Nestlé Purina Research, St. Louis, MO 63102, USA; (F.M.); (R.T.S.M.); (R.A.); (L.W.); (T.T.); (N.L.-M.)
| | - Jessica M. Smidt
- Section of Integrative Medicine and Health, Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55901, USA; (S.D.C.); (J.M.S.); (B.A.B.)
| | - Rachel Anderson
- Nestlé Purina Research, St. Louis, MO 63102, USA; (F.M.); (R.T.S.M.); (R.A.); (L.W.); (T.T.); (N.L.-M.)
| | - Lei Wang
- Nestlé Purina Research, St. Louis, MO 63102, USA; (F.M.); (R.T.S.M.); (R.A.); (L.W.); (T.T.); (N.L.-M.)
| | - Tricia Turpin
- Nestlé Purina Research, St. Louis, MO 63102, USA; (F.M.); (R.T.S.M.); (R.A.); (L.W.); (T.T.); (N.L.-M.)
| | - Natalie Langenfeld-McCoy
- Nestlé Purina Research, St. Louis, MO 63102, USA; (F.M.); (R.T.S.M.); (R.A.); (L.W.); (T.T.); (N.L.-M.)
| | - Brent A. Bauer
- Section of Integrative Medicine and Health, Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55901, USA; (S.D.C.); (J.M.S.); (B.A.B.)
| | - Arya B. Mohabbat
- Section of Integrative Medicine and Health, Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55901, USA; (S.D.C.); (J.M.S.); (B.A.B.)
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Zayas J, Ruddy KJ, Olson JE, Couch FJ, Bauer BA, Mallory MJ, Yang P, Zahrieh D, Athreya AP, Loprinzi CL, Cathcart-Rake EJ. Real-world experiences with acupuncture among breast cancer survivors: a cross-sectional survey study. Support Care Cancer 2020; 28:5833-5838. [PMID: 32253604 DOI: 10.1007/s00520-020-05442-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 03/27/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of this study was to evaluate acupuncture use among breast cancer survivors, including perceived symptom improvements and referral patterns. METHODS Breast cancer survivors who had used acupuncture for cancer- or treatment-related symptoms were identified using an ongoing prospective Mayo Clinic Breast Disease Registry (MCBDR). Additionally, Mayo Clinic electronic health records (MCEHR) were queried to identify eligible participants. All received a mailed consent form and survey including acupuncture-related questions about acupuncture referrals, delivery, and costs. Respondents were also asked to recall symptom severity before and after acupuncture treatment and time to benefit on Likert scales. RESULTS Acupuncture use was reported among 415 participants (12.3%) of the MCBDR. Among MCBDR and MCEHR eligible participants, 241 women returned surveys. A total of 193 (82.1%) participants reported a symptomatic benefit from acupuncture, and 57 (24.1% of participants) reported a "substantial benefit" or "totally resolved my symptoms" (corresponding to 4 and 5 on the 5-point Likert scale). The mean symptom severity decreased by at least 1 point of the 5-point scale for each symptom; the percentage of patients who reported an improvement in symptoms ranged from 56% (lymphedema) to 79% (headache). The majority of patients reported time to benefit as "immediate" (34%) or "after a few treatments" (40.4%). Over half of the participants self-referred for treatment; 24.1% were referred by their oncologist. Acupuncture delivery was more frequent in private offices (61.0%) than in hospital or medical settings (42.3%). Twelve participants (5.1%) reported negative side effects, such as discomfort. CONCLUSIONS Acupuncture is commonly utilized by patients for a variety of breast cancer-related symptoms. However, patients frequently self-refer for acupuncture treatments, and most acupuncture care is completed at private offices, rather than medical clinic or hospital settings.
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Affiliation(s)
- Jacqueline Zayas
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Medicine and the Mayo Clinic Medical Scientist Training Program, Rochester, MN, 55905, USA.
| | - Kathryn J Ruddy
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Brent A Bauer
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Molly J Mallory
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Ping Yang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - David Zahrieh
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Arjun P Athreya
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, 55905, USA
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Bauer BA. Integrative Medicine: A Step Beyond Being "Doctored Pretty Good". Glob Adv Health Med 2020; 9:2164956120910137. [PMID: 32158628 PMCID: PMC7047235 DOI: 10.1177/2164956120910137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/25/2020] [Accepted: 02/10/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Brent A Bauer
- Integrative Medicine and Health, Mayo Clinic, Rochester, Minnesota.,Department of Medicine, Mayo Clinic, Rochester, Minnesota
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Vitek SM, Bhagra A, Erickson EE, Cutshall SM, Slack SM, Rodgers NJ, Smidt JM, Jordan MJ, Bauer BA, Chon TY. Optimizing delivery to meet demand for integrative medicine services in an academic hospital setting: A pilot study. Explore (NY) 2020; 17:340-343. [PMID: 32249201 DOI: 10.1016/j.explore.2020.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/20/2020] [Accepted: 03/03/2020] [Indexed: 11/30/2022]
Abstract
CONTEXT A rapidly growing body of evidence shows the positive benefits of integrative medicine (IM) services for patients in hospital-based settings. IM therapies, such as acupuncture, massage, meditation and relaxation, and animal-assisted therapy, reduce symptom burden of pain, anxiety, and stress and increase sense of well-being and satisfaction in hospitalized patients. Current challenges facing hospitals are to move beyond proof-of-concept studies and to provide hospital-based IM therapies. OBJECTIVE The aim of our quality improvement project was to develop, implement, and evaluate a feasible, scalable, hospital-based "best practice" model for increasing demand for IM services and optimizing their delivery. DESIGN A multidisciplinary team convened to use quality improvement tools to outline a process for providing IM services. SETTING A large academic medical center in the Midwestern United States. PARTICIPANTS IM leadership staff, IM providers, nurses, hospital team members, support staff, and quality improvement staff. INTERVENTIONS After determining baseline levels of demand and service delivery, we sought to (1) increase nursing staff awareness of available IM services; (2) improve communication between IM providers and nurses; and (3) reinforce communication at the level of nurse supervisors, patients, and family members. MAIN OUTCOME MEASURES We recorded the numbers and types of IM services ordered at baseline and postimplementation and determined the new delivery rate of requested services. RESULTS We noted an increase in the number of IM orders, percentage of delivered IM services, and percentage of patients who reported that IM services improved their hospital stay.
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Affiliation(s)
- Sairey M Vitek
- Quality Management Services, Mayo Clinic, Rochester, Minnesota, United States
| | - Anjali Bhagra
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Emma E Erickson
- Department of Management Engineering & Internal Consulting, Mayo Clinic, Rochester, Minnesota, United States
| | - Susanne M Cutshall
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Stephanie M Slack
- Department of Nursing, Mayo Clinic, Rochester, Minnesota, United States
| | - Nancy J Rodgers
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Jessica M Smidt
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Mary J Jordan
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States.
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Yang J, Bauer BA, Wahner-Roedler DL, Chon TY, Xiao L. The Modified WHO Analgesic Ladder: Is It Appropriate for Chronic Non-Cancer Pain? J Pain Res 2020; 13:411-417. [PMID: 32110089 PMCID: PMC7038776 DOI: 10.2147/jpr.s244173] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 01/30/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION From 1986, the World Health Organization (WHO) analgesic ladder has been used as the simple and valuable pain-relieving guidance in the pharmaceutical pain management, however, with the development of medical history, notions about pain physiology and pain management have already updated. Is the analgesic ladder still appropriate for chronic non-cancer pain (CNCP) patients? This study aims to analyse the current usage of the analgesic ladder in patients with CNCP by evaluating previously published pertinent studies. METHODS Literature published in English from January 1980 to April 2019 and cited on PubMed database was included. Analysis on the analgesic ladder, current status of CNCP management, and a new revised ladder model were developed based on relevant literature. RESULTS The WHO analgesic ladder for cancer pain is not appropriate for current CNCP management. It is revised into a four-step ladder: the integrative therapies being adopted at each step for reducing or even stopping the use of opioid analgesics; interventional therapies being considered as step 3 before upgrading to strong opioids if non-opioids and weak opioids failed in CNCP management. DISCUSSION A simple and valuable guideline in past years, the WHO analgesic ladder is inappropriate for the current use of CNCP control. A revised four-step analgesic ladder aligned with integrative medicine principles and minimally invasive interventions is recommended for control of CNCP.
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Affiliation(s)
- Juan Yang
- Department of Pain Medicine, Shenzhen Nanshan People’s Hospital, Shenzhen518052, People’s Republic of China
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN55905, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN55905, USA
| | | | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN55905, USA
| | - Lizu Xiao
- Department of Pain Medicine, Shenzhen Nanshan People’s Hospital, Shenzhen518052, People’s Republic of China
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VanDolah HJ, Bauer BA, Mauck KF. In reply-Commercial Cannabidiol Caution: A New Gold Rush. Mayo Clin Proc 2020; 95:200-201. [PMID: 31902418 DOI: 10.1016/j.mayocp.2019.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 10/25/2019] [Indexed: 11/17/2022]
Affiliation(s)
| | - Brent A Bauer
- Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Karen F Mauck
- Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN
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Mohabbat AB, Mahapatra S, Jenkins SM, Bauer BA, Vincent A, Wahner-Roedler DL. Use of Complementary and Integrative Therapies by Fibromyalgia Patients: A 14-Year Follow-up Study. Mayo Clin Proc Innov Qual Outcomes 2019; 3:418-428. [PMID: 31993560 PMCID: PMC6978595 DOI: 10.1016/j.mayocpiqo.2019.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective To reevaluate the frequency and pattern of complementary and integrative medicine (CIM) use in patients with fibromyalgia (FM). Patients and Methods Consecutive patients with FM who were referred to the Mayo Clinic fibromyalgia treatment program from January 5 through July 27, 2017, were invited to complete a survey about their use of CIM therapies in the preceding 6 months. The survey asked about 3 primary CIM domains: treatments and techniques, vitamins and minerals, and herbs and other dietary supplements. For direct comparative purposes, we reused the survey instrument from our prior analogous study of CIM use, performed in 2003. Results Of the 310 patients who completed the survey, 304 (98.1%) reported using some form of CIM, similar to the percentage reported in our 2003 study (98%). The most frequently used CIM therapies in the current cohort were spiritual healing (54.0% [163 of 302]), massage therapy (50.0% [152 of 304]), chiropractic treatments (39.3% [118 of 300]), aromatherapy (39.0% [117 of 300]), exercise for a specific medical problem (38.6% [117 of 303]), melatonin (37.9% [77 of 203]), magnesium (36.3% [107 of 295]), green tea (36.1% [73 of 202]), and fish oil (34.5% [68 of 197]). We noted numerous substantial differences from the 2003 data in terms of the pattern of CIM use. Conclusion The use of CIM therapies among patients with FM continues to be extremely common for adult patients of all ages. Given the continued high prevalence of CIM use, health care professionals must have awareness and knowledge of these various modalities and their potential incorporation into a multifaceted FM treatment regimen.
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Affiliation(s)
- Arya B. Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
- Correspondence: Address to Arya B. Mohabbat, MD, Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
| | | | - Sarah M. Jenkins
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Ann Vincent
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
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