Showing papers in "Alternative Therapies in Health and Medicine in 1997"

Comparing Hatha yoga with dynamic group psychotherapy for enhancing methadone maintenance treatment: a randomized clinical trial

Abstract: Background As more methadone treatment programs are funded in an attempt to curb substance abuse and HIV infection among iv drug users, more cost effective treatment approaches are being sought Objectives To investigate whether clients in outpatient methadone maintenance treatment who practice weekly Hatha yoga in a group setting experience more favorable treatment outcomes than those who receive conventional group psychodynamic therapy Methods After a 5-day assessment period, 61 patients were randomly assigned to methadone maintenance enhanced by traditional group psychotherapy (ie, conventional methadone treatment) or an alternative Hatha yoga therapy (ie, alternative methadone treatment) Patients were followed for 6 months and evaluated on a variety of psychological, sociological, and biological measures The revised Symptom Check List provided the primary psychological measures; the Addiction Severity Index provided various indices of addictive behaviors Results The evidence revealed that there were no meaningful differences between traditional psychodynamic group therapy and Hatha yoga presented in a group setting Both treatments contributed to a treatment regimen that significantly reduced drug use and criminal activities Psychopathology at admission was significantly related to program participation regardless of treatment group Discussion In addition to examining the characteristics of patients who present for treatment, this study identifies unexpected staff issues that complicate the integration of alternative and traditional treatment strategies Conclusion Alternative methadone treatment is not more effective than conventional methadone treatment, as originally hypothesized However, some patients may benefit more from alternative methadone treatment than conventional methadone treatment Additional research is necessary to determine characteristics that identify patients who might benefit from alternative methadone treatment

Coping, life attitudes, and immune responses to imagery and group support after breast cancer treatment

Abstract: BackgroundThe pilot study used clinical trial methodology to differentiate the effects of imagery and support on coping, life atti- tudes, immune function, quality of life, and emotional well-being after breast cancer. MethodsWomen (N=47) who completed treatment for primary breast cancer, excluding stage IV, were randomly assigned to standard care (n=15) or six weekly support (n=16) or imagery (n=16) sessions. Self-report measures included Ways of Coping-Cancer, Life Attitude Profile, Quality of Life (FACT-B), Profile of Mood States, and Functional Support. Immune measures included natural killer cell activity, plasma neopterin, interferon-γ, interleukins 1α , 1β, and 2, and beta-endorphin levels. Differences between groups over time were tested using general linear models, adjusted for pretest score and covariates (age, stage, and months posttreatment). ResultsFor all women, interferon- γ increased, neopterin decreased, quality of life improved, and natural killer activity remained unchanged. Compared with standard care, both interven- tions improved coping skills (seeking support) and perceived social support, and tended to enhance meaning in life. Support boosted overall coping and death acceptance. When comparing imagery with support, imagery participants tended to have less stress, increased vigor, and improved functional and social quality of life. ConclusionAlthough imagery reduced stress and improved quali- ty of life, both imagery and support improved coping, attitudes, and perception of support. The clinical implications of these changes war- rant further testing. (Alternative Therapies in Health and Medicine. 1997;3(5):57-65)

An experimental study of the effects of distant, intercessory prayer on self-esteem, anxiety, and depression.

Abstract: DESIGN Randomized, controlled, double-blind study. PATIENTS 496 volunteers: those who prayed (agents, n = 90) and those who were prayed for (subjects, n = 406). INTERVENTION Agents were randomly assigned to either a directed or nondirected prayer group; photos and names of subjects were used as a focus. Subjects were randomly assigned to three groups: those prayed for by nondirected agents, a control group, and those prayed for by directed agents. Prayer was offered for 15 minutes daily for 12 weeks. Each subject was prayed for by three agents. MAIN OUTCOME MEASURES Five pretest and posttest objective measures and six posttest subjective measures were taken. RESULTS Subjects improved significantly on all 11 measures. Agents improved significantly on 10 measures. A significant positive correlation was found between the amount of prayer the agents did and their scores on the five objective tests. Agents had significantly better scores than did subjects on all objective measures. Subjects' views of the locus of God's action showed significance in three objective measures. Improvement on four objective measures was significantly related to subjects' belief in the power of prayer for others. Improvement on all II measures was significantly related to subjects' conviction concerning whether they had been assigned to a control or an experimental group. Possible explanations include the placebo/faith effect, the time displaced effect, and extraneous prayer.

Distant intentionality and healing: assessing the evidence.

Abstract: Since the 1950s, researchers have attempted to understand reports of distant or "psychic" healing, developing experimental protocols that test the distant healing hypothesis by measuring biological changes in a target system while ruling out suggestion or self-regulation as counterexplanations. This article provides a brief overview of these "healing analog" experiments. It also provides a summary and meta-analysis of 30 formal experiments in which self-reported healers, "psychics," and other self-selected volunteers attempted to influence autonomic nervous system activity in a distant person. Results across the experiments showed a significant and characteristic variation during distant intentionality periods, compared with randomly interspersed control periods. Possible alternative explanations for the reported effects are considered. Finally the implications of distant intentionality are discussed for an understanding of the possible mechanisms of distant healing, the nature of the mind-body relationship, and the role of consciousness in the physical world.

Intercessory prayer in the treatment of alcohol abuse and dependence: a pilot investigation.

Abstract: OBJECTIVE: To conduct a pilot study of the effect of intercessory prayer on patients entering treatment for alcohol abuse or dependence. DESIGN: In addition to standard treatment, 40 patients admitted to a public substance abuse treatment facility for treatment of alcohol problems who consented to participate were randomized to receive or not receive intercessory prayer (double-blind) by outside volunteers. Assessments were conducted at baseline, 3 months, and 6 months. RESULTS: No differences were found between prayer intervention and nonintervention groups on alcohol consumption. Compared with a normative group of patients treated at the same facility participants in the prayer study experienced a delay in drinking reduction. Those who reported at baseline that a family member or friend was already praying for them were found to be drinking significantly more at 6 months than were those who reported being unaware of anyone praying for them. Greater frequency of prayer by the participants themselves was associated with less drinking, but only at months 2 and 3. CONCLUSION: Intercessory prayer did not demonstrate clinical benefit in the treatment of alcohol abuse and dependence under these study conditions. Prayer may be a complex phenomenon with many interacting variables. Language: en

Stress-induced immunosuppression and therapeutic touch.

Abstract: OBJECTIVE: The specific aim of this study was to evaluate the effectiveness of therapeutic touch in reducing the adverse immunological effects of stress in a sample of highly stressed students. Long-term goals are to develop methods by which a variety of stress-reduction techniques can be tested for efficacy. DESIGN: Experimental. SETTING: A large urban medical university in a southern coastal city. SUBJECTS: Healthy medical and nursing students who are taking professional board examinations. INTERVENTION: Therapeutic touch. MAIN OUTCOME MEASURES: T-lymphocyte function (CD25) and immunoglobulin levels. RESULTS: Subjects who received therapeutic touch and subjects who did not had significantly different levels of IgA and IgM; CD25 (mitogen-stimulated T-lymphocyte function) and IgG levels differed in the expected direction between the two groups, but the differences were not statistically significant. Apoptosis (programmed cell death) was significantly different between the two groups. CONCLUSIONS: The small sample size requires cautious interpretation of the results. This is a pilot study designed to provide evidence to show that further study of therapeutic touch as an intervention that may be useful in reducing the adverse immunologic consequences of anxiety related to stress in otherwise healthy students is warranted. Change in immune function related to anxiety and the relief of anxiety can be measured. Subsequent power analysis suggests sample sizes of 90 subjects per group are required to confirm the conclusions.

Job stress reduction therapies.

Abstract: Background Job stress among healthcare workers has received more attention in recent years, perhaps because these professionals are prime candidates for high stress levels. Method The immediate effects of brief massage therapy, music relaxation with visual imagery, muscle relaxation, and social support group sessions were assessed in 100 hospital employees at a major public hospital. Design The effects of the therapies were assessed using a within-subjects pre-post test design and by comparisons across groups. Results Groups reported decreases in anxiety, depression, fatigue, and confusion, as well as increased vigor following the sessions. Conclusion That the groups did not differ on these variables suggests that these particular therapies, when applied for short periods of time, are equally effective for reducing stress among hospital employees.

Medical marijuana and its use by the immunocompromised.

Abstract: Background Those immunocompromised by AIDS or cancer chemotherapy use marijuana to allay symptoms of their disease or treatment. Some researchers believe that marijuana may further suppress the immune system. A list of immunological hazards that may be present in marijuana was collated and assessed, and clinical recommendations regarding the use of marijuana by immunocompromised individuals were made. Methods Databases and other sources from 1964 to 1996 were searched using keywords (e.g., cannabinoids, cannabis, hemp, marijuana). This was supplemented by a manual search of bibliographies, nonindexed books, and journals, and by consultation with experts. All reports were analyzed for antecedent sources. Data validity was assessed by source, identification methodology, and frequency of independent observations. Results Substances implicated as potential immunological hazards in marijuana include endogenous constituents (cannabinoids, pyrolyzed gases, and particulates) and a longer list of exogenous contaminants, both natural (fungi and their metabolites) and synthetic (pesticides and adulterants). Conclusion Burning of marijuana creates toxins of combustion. Particulate toxins (tars) are reduced by the use of vaporizer apparati. Gas-phase toxins are filtered by water pipes, but water pipes also filter some tetrahydrocannabinol, making this strategy counterproductive. Viable fungal spores in marijuana pose the greatest hazard to immunocompromised patients, though they can be sterilized by several methods. Pesticide residues and other adulterants may be present in black-market marijuana, but are absent in sources of marijuana that are approved by the Food and Drug Administration.

An exploration of the meaning and use of spirituality among women with HIV/AIDS.

Abstract: Disease progression and the onset of AIDS slowly strip away the human form and dignity. As the physical body succumbs to the disease, those with HIV/AIDS search for meaning in life as they seek ways to prolong survival. The purpose of this study was to explore the meaning and use of spirituality in women infected with HIV/AIDS. Data were generated through the use of focus group methodology in eight sessions. The sample was composed of 45 women, aged 20 to 63, of whom 12 were white and 33 were black. Focus group sessions generated 76 descriptions of spirituality and six major themes: relationship with a supreme being, prayer and meditation, healing, peace, love, and religiosity. The acceptance of spirituality as a component of health and quality of life requires a shift in perspective that may allow for the development of new treatment and care strategies that are meaningful to those whose conditions are presently incurable.

Voluntary control of vascular tone by using skin-temperature biofeedback-relaxation in patients with advanced heart failure

Abstract: Background Advanced heart failure is characterized by activation of the sympathetic nervous system and intense vasoconstriction. Biofeedback-relaxation techniques have been used successfully to treat conditions with similar pathophysiological features. Objectives The purpose of this study was to determine if conscious control of skin temperature via a biofeedback-relaxation technique could produce vasodilation and alter central hemodynamic status and circulating levels of catecholamines in patients with heart failure. Methods Forty patients with advanced heart failure were randomly assigned to either an intervention or a control group. The study was done in a special cardiac step-down unit accepting patients for hemodynamic monitoring. The patients in the intervention group had one session of skin-temperature biofeedback augmented by imagery of hand warmth and modified progressive muscle relaxation. Skin temperature, systemic vascular resistance, cardiac output, plasma levels of norepinephrine and epinephrine, oxygen consumption, respiratory rate, and pulmonary wedge pressure were measured before and after the biofeedback session. Control patients had the same measurements made but were not given instruction in biofeedback-relaxation techniques. Results Patients in the biofeedback-relaxation and control groups had comparable clinical profiles at baseline. Patients undergoing biofeedback-relaxation showed the following changes: (1) increase in skin temperature of 3.1 +/- 2.8 degrees F (1.7 +/- 1.5 degrees C) in the finger and 1.5 +/- 5.2 degrees F (0.4 +/- 1.2 degrees C) in the foot, (2) increase in cardiac output of 0.30 +/- 0.33 L/min, (3) decrease in systemic vascular resistance of 152 +/- 225 dyne.sec.cm-5, and (4) decrease in respiratory rate of 4.5 +/- 3.2 breaths per minute. The biofeedback group exhibited no changes in catecholamine levels or oxygen consumption. No changes in any of these parameters were seen in the control group. Discussion Despite the presence of marked vasoconstriction in patients with advanced heart failure, a single session of biofeedback-relaxation can increase finger temperature and cardiac output and decrease systemic vascular resistance and respiratory rate, apparently without effect on systemic levels of catecholamines or oxygen consumption.

Evaluating distant healing: a research review.

Abstract: The term "distant healing" describes any purely mental effort undertaken by one person with the intention to improve physical or emotional well-being in another. Various forms of distant healing including prayer and "psychic healing" are widely used throughout the United States and other parts of the world. There currently exist numerous, well-controlled experimental trials demonstrating distant mental effects on humans, animals, and other biological systems. At this time, however, insufficient formal research trials have been completed to definitively determine whether such activities do in fact have a clinical impact independent of psychological effects. The key in studying the concept of distant healing is separating the putative distant effect from changes that may be due to causes such as hope, expectation, relaxation, or other participation activities. This review discusses some of the most compelling evidence for a genuine distant healing effect and identifies correctable methodological issues that frequently confound research in this area.

Homeopathic treatment of depression and anxiety.

Abstract: Background Homeopathy is a well-established therapeutic system with potential relevance to psychiatry, but as yet it is largely untested. Objective To report the use of homeopathic treatment in patients with depression and anxiety. Methods Individually selected homeopathic remedies were used on an outpatient basis to treat 12 adults who had major depression, social phobia, or panic disorder. The patients either requested homeopathic treatment or received it on a physician's recommendation after partial or poor response to conventional therapies. Duration of treatment was 7 to 80 weeks. Response was monitored by using a clinical global scale (n = 12), the self-rated SCL-90 scale (n = 8), and the Brief Social Phobia Scale (n = 4). Results Overall response rates were 58% according to the clinical global improvement scale and 50% according to the SCL-90 or the Brief Social Phobia Scale. Conclusions Homeopathy may be useful in the treatment of affective and anxiety disorders in patients with mildly to severely symptomatic conditions.

Entrainment and the cranial rhythmic impulse.

Abstract: Entrainment is the integration or harmonization of oscillators. All organisms pulsate with myriad electrical and mechanical rhythms. Many of these rhythms emanate from synchronized pulsating cells (eg, pacemaker cells, cortical neurons). The cranial rhythmic impulse is an oscillation recognized by many bodywork practitioners, but the functional origin of this impulse remains uncertain. We propose that the cranial rhythmic impulse is the palpable perception of entrainment, a harmonic frequency that incorporates the rhythms of multiple biological oscillators. It is derived primarily from signals between the sympathetic and parasympathetic nervous systems. Entrainment also arises between organisms. The harmonizing of coupled oscillators into a single, dominant frequency is called frequency-selective entrainment. We propose that this phenomenon is the modus operandi of practitioners who use the cranial rhythmic impulse in craniosacral treatment. Dominant entrainment is enhanced by "centering," a technique practiced by many healers, for example, practitioners of Chinese, Tibetan, and Ayurvedic medicine. We explore the connections between centering, the cranial rhythmic impulse, and craniosacral treatment.

Dynamical energy systems and modern physics: Fostering the science and spirit of complementary and alternative medicine

Abstract: When systems theory is carefully applied to the concept of energy, some novel and far-reaching implications for modern physics and complementary medicine emerge. The heart of systems theory is dynamic interactions: systems do not simply act on systems, they interact with them in complex ways. By definition, systems at any level (e.g., physical, biological, social, ecological) are open to information, energy, and matter to varying degrees, and therefore interact with other systems to varying degrees. We first show how resonance between two tuning forks, a classic demonstration in physics, can be seen to reflect synchronized dynamic interactions over time. We then derive how the dynamic interaction of systems in mutual recurrent feedback relationships naturally create dynamic "memories" for their interactions over time. The mystery of how a photon (or electron) "knows" ahead of time whether to function as a particle or wave in the single slit/double slit quantum physics paradigm is potentially solved when energetic interactions inherent in the experimental system are recognized. The observation that energy decreases with the square of distance is shown not to be immutable when viewed from a dynamical energy systems perspective. Implications for controversial claims in complementary and alternative medicine, such as memory for molecules retained in water (homeopathy), remote diagnosis, and prayer and healing, are considered. A dynamical energy systems framework can facilitate the development of what might be termed "relationship consciousness," which has the potential to nurture both the science and spirit of complementary medicine and might help to create integrated medicine.

Utilization of Chinese medicine in Taiwan.

Abstract: This article examines the use of Chinese medicine in Taiwan. Based on a national sample survey, the authors investigated how Chinese medicine is being used and factors that are associated with its use among the Taiwanese. Results of the study suggest that Chinese medicine use among this population depends on health conditions, and that having a regular source of care for Chinese medicine as well as a preference for Chinese medicine are two predictors for its use. Policies on the integration of Chinese medicine or other traditional medicine into the modern healthcare system are recommended.

Systematic clinical auditing in complementary medicine: rationale, concept, and a pilot study.

Abstract: A scientific evaluation of complementary medical practices commonly used in healthcare is urgently required. Although randomized clinical trials are the primary tool for such an evaluation, for a number of conceptual and pragmatic reasons, they should not be the only tool. The authors propose systematic clinical auditing as a concept to (1) provide information on the "epidemiology" of complementary medical practices, (2) make the processes used in the daily practice of these complementary methods clearly intelligible, and (3) give a preliminary estimation of outcomes. Systematic clinical auditing uses mainly observational studies of large samples of patients. A pilot study was conducted to investigate the feasibility of using a systematic clinical audit in a hospital for traditional Chinese medicine in Germany. All 1597 patients admitted between February 1, 1992, and August 31, 1993, were included in the study. Patients' characteristics, diagnoses, and preventive and therapeutic interventions were recorded, and patients were asked to rate the intensity of their main complaints (on scale of 1 to 10) at admission; at discharge; and at 2, 6, and 12 months after admission. About two thirds of all patients had chronic pain complaints; the most common diagnosis was migraine (n = 244). Nearly all patients received acupuncture and Chinese herbal therapy; 61% received tuina massages, and 16% received qigong. The mean intensity of main complaints was 7.0 (2.0, SD) at admission, 4.6 (2.4) at discharge, and 5.5 (2.7) 12 months after admission. In the authors' opinion, systematic clinical auditing is a valuable tool for collecting basic information on structural characteristics, processes, and outcomes in complementary medicine and for determining representative and relevant questions for future randomized clinical trials.

The similia principle as a therapeutic strategy: a research program on stimulation of self-defense in disordered mammalian cells.

Abstract: The similia principle is considered to be the essence of homeopathy. This article describes a research program for study of the similia principle in cultured mammalian cells. This systematic program with its rather simple research model was set up ultimately to contribute to the design of studies of the similia principle with more complex organisms such as humans. With respect to application of the similia principle, the concepts of self-defense and self-recovery are central. At the cellular level, self-defense and recovery largely depend on the availability of proteins with a cell-protective function, most notably, stress or heat shock proteins. To study the similia principle, we use four lines of research to examine the processes of self-defense. First, stimulation of self-defense in disturbed and disordered cells is studied by using low doses of an agent homologous or identical to the disturbing agent. The second line of research deals with the specificity of this stimulation: Is cellular self-defense after exposure to toxicant A also effectively stimulated in an analogous or heterologous way by low doses of other toxicants such as B or C? The third line of research involves the duration of low-dose sensitivity of disordered cells for homologous stimulations, in particular, the desensitization of cells toward these homologous stimulations. The fourth line of research deals with whether-according to the similia principle-the state of desensitization can be overruled by heterologous condition(s) that induce an analogous pattern of protector proteins (ie, a pattern closely resembling the damage-induced pattern) and thus effectively stimulate cellular defense and recovery.

Creating a spirituality curriculum for family practice residents.

Abstract: The purpose of this pilot study was to investigate issues related to the creation of a curriculum to teach spirituality to family practice residents; specifically, (1) to determine whether there was support among family practice residents and faculty to include such teaching in the residency curriculum, and (2) to determine specifically what should be taught and how it should be taught. The hypothesis was that residents and faculty would support such a curriculum and that specific educational methodologies could be identified to implement it. This was accomplished by conducting one-on-one interviews and focus groups and by administering a written curriculum needs assessment to family practice residents and faculty, compiling and interpreting the results, and subsequently writing an integrated curriculum.

A communication process: a new paradigm applied to high-dilution effects on the living body.

Abstract: Living beings communicate with their world nonverbally, whether on a somatic or a psychological level. This paradigm of signifiers or sense takes place in the framework of the logic of analogy. The signifier is the semantic object that materially designates information to be transmitted and dealt with; a homeopathic remedy is the mimetic representation of the disease. Differential levels of information organize the spread of signifiers; each level is the result of regulation and integration of the previous level. The living self is the never-ending process whereby levels of information are synthesized in the face of the informing environment. Such representations meet one another in the communication between the patient and the physician-remedy system. The medical device must reinform the patient and make the patient's signs and symptoms move toward a higher level of integration. The dilution of the remedy permits us to receive and treat it as information about disease. Signs and symptoms can be recognized as an erroneous adaptation; the organism is engaged in a process of paradoxical negation. The action of the remedies consists of a dynamic analogy between pieces of information. The paradigm of signifiers offers a new possibility for the exploration of informative therapeutics.

Causal modeling and alternative medicine.

Abstract: Many problems of health promotion or prevention call for an understanding of relations among variables embedded in complex causal webs that may include psychosocial, cultural, or environmental factors as well as biological dysfunction. Experimental investigation of these kinds of research problems is frequently impossible or not feasible. Causal modeling, particularly latent variable structural modeling, can provide a useful alternative to manipulative experimentation when one is trying to build and test explanatory models in a rigorous and systematic fashion. A hypothetical model of fibromyalgia is presented to illustrate how latent variable models can prove useful when the malady under investigation is of relatively complex multifactorial origin. Topics discussed include the fundamental notion underlying causal models, how such models solve problems due to measurement error, and why both cross-sectional and longitudinal models deserve consideration. A number of applications in medical research are described.

Participant assessment of a nonmedical breast cancer support group.

Abstract: BACKGROUND This study was designed to examine how a particular format of a support group for women with breast cancer was related to the use of the group and experiences of the participants. SUBJECTS A total of 131 women who participated in a breast cancer support group under the auspices of the YWCA were interviewed. RESULTS Findings replicated existing studies indicating such generic benefits of support group participation as enhanced sense of control, sharing of information and experiences, and acquaintance with positive role models. In addition to these benefits, participants reacted favorably to the opportunities provided by a drop-in format, an exercise component, and opportunities for sharing in a nonmedical setting. Active use of the group was associated with lack of emotional support from family. Active use also was associated with favorable reported outcomes for well-being and health.