Psychoneuroimmunology and Healing Touch in HIV Disease

The purpose of this study was to ascertain the effects of Healing Touch (HT) on well-being and neuroendocrine function in individuals living with HIV disease. A total of 27 males completed the 4-week HT intervention. Each weekly HT session lasted 30 minutes and consisted of only the chakra connection, Because of the small sample size and the impact of gender on neuroendocrine and immune function, women were not included in this study Dependent variables included well-being as measured by three well-being and two psychological distress instruments, serum serotonin, salivary DHEA and cortisol, and a variety of enumerative and functional measures of immune function. A pretest-posttest design experimental design including a wait-list control group was used. Multivariate analysis of covariance was used to test the research hypotheses followed by univariate analysis of variance to detect the contribution of individual variables to the overall multivariate models. It was hypothesized that HT would increase participant well-being, serum serotonin and salivary DHEA; decrease salivary cortisol; and improve immune function in individuals living with HIV disease, All of the research hypotheses were rejected. Discussion of the results as well as directions for future research are presented

Suicide-related discussions with depressed primary care patients in the USA: gender and quality gaps. A mixed methods analysis

Objective: To characterise suicide-risk discussions in depressed primary-care patients. Design: Secondary analysis of recordings and self reports by physicians and patients. Descriptive statistics of depression and suicide-related discussion, with qualitative extraction of disclosure, enquiry and physician response. Setting: 12 primary-care clinics between July 2003 and March 2005. Participants: 48 primary-care physicians and 1776 adult patients. Measures: Presence of depression or suicide-related discussions during the encounter; patient and physician demographics; depression symptom severity and suicide ideation as measured by the Patient Health Questionnaire (PHQ9); physician’s decision-making style as measured by the Medical Outcomes Study Participatory Decision-Making Scale; support for autonomy as measured by the Health Care Climate Questionnaire; trust in their physician as measured by the Primary Care Assessment Survey; physician response to suicide-related enquiry or disclosure. Results: Of the 1776 encounters, 128 involved patients scoring \u3e14 on the PHQ9. These patients were seen by 43 of the 48 physicians. Suicide ideation was endorsed by 59% (n1⁄475). Depression was discussed in 52% of the encounters (n1⁄466). Suicide-related discussion occurred in only 11% (n1⁄413) of encounters. 92% (n1⁄412) of the suicide discussions occurred with patients scoring \u3c2 on PHQ9 item 9. Suicide was discussed in only one encounter with a male. Variation in elicitation and response styles demonstrated preferred and discouraged interviewing strategies. Conclusions: Suicide ideation is present in a significant proportion of depressed primary care patients but rarely discussed. Men, who carry the highest risk for suicide, are unlikely to disclose their ideation or be asked about it. Patient-centred communication and positive healthcare climate do not appear to increase the likelihood of suicide related discussion. Physicians should be encouraged to ask about suicide ideation in their depressed patients and, when disclosure occurs, facilitate discussion and develop targeted treatment plans

Control Group Design: Enhancing Rigor in Research of Mind-Body Therapies for Depression

Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research about mind-body therapies, we suggest that researchers should consider 4 key questions: whether the study design matches the research question; whether the control group addresses performance, expectation, and detection bias; whether the control group is ethical, feasible, and attractive; and whether the control group is designed to adequately control for nonspecific intervention effects. Based on these questions, we provide specific recommendations about control group design with the goal of minimizing bias and maximizing validity in future research

Exploring the Relationships Between Mindfulness and Biobehavioral Factors Associated with CVD in Women

Purpose: This study examined the relationship between mindfulness and specific biobehavioral factors associated with increased cardiovascular disease risk in women. Design: A secondary data analysis was conducted on baseline data collected in a larger study examining the effects of tai chi on cardiovascular disease risk in women. Subjects: 96 women aged 35-50 years with increased waist circumference and a family history of cardiovascular disease. Measures: Biological measures included: fasting glucose, insulin and lipids, as well as C-reactive protein and cytokines. Behavioral measures included: mindfulness, fatigue, perceived stress, depressive symptoms, social support, self-compassion and spiritual thoughts and behaviors. Results: Mindfulness was significantly correlated with perceived stress and depressive symptoms. Conclusion: Though mindfulness was not significantly correlated with the biological factors measured, it was significantly associated with several behavioral factors and may therefore provide opportunities for clinical practice and future research examining the role of mindfulness practice to decrease perceived stress and depressive symptoms and ultimately decrease cardiovascular disease risk in women.https://scholarscompass.vcu.edu/uresposters/1186/thumbnail.jp

Physical Activity Training for Functional Mobility in Older Persons

The effectiveness of low-intensity physical activity for improving functional ability and psycho logical well-being in chronically impaired older individuals was demonstrated in a pilot study. Participants who completed 6 weeks of structured low-intensity exercise (N = 77) improved in the time and number of steps required to walk a measured course, in self-assessments of mobility and flexibility, and in three measures of well-being. Those who continued to exercise in a peer-led program (n = 32) maintained improvements in mobility and optimism after 18 weeks.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68101/2/10.1177_073346489501400401.pd

Confrontation and politeness strategies in physician-patient interactions

The therapeutic sucess of physician-patient interactions depends in large part on how physicians interpret and respond to patients' implicit and explicit messages. Using a hypothetical vignette, in which a patient refuses to comply with a recommended therapeutic regimen, we found that first-year medical students with no classroom training in medical interviewing implicity recognized that the situation called for face preserving or polite linguistic behavior. Ninety percent of them used culturally sanctioned politeness forms to repair the conversational breakdown depicted in the vignette. They responded to this clinical scenario, however, with linguistic behaviors borrowed from their everyday interactions, some of which were culturally appropriate, but not necessarily therapeutic. We suggest that students can learn to adapt their culturally appropriate behaviors and engage in therapeutic communication as physicians if they are given the necessary conceptual tools. We discuss how Brown and Levinson's theories of politeness and strategic language usage can (1) provide a framework for interpreting communication in general and physician-patient interaction in particular, (2) illuminate some of the problems inherent in doctor-patient encounters, and (3) be used prescriptively for teaching students and health professionals how to avoid some communication difficulties.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27511/1/0000555.pd

Control Group Design: Enhancing Rigor in Research of Mind-Body Therapies for Depression

Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research about mind-body therapies, we suggest that researchers should consider 4 key questions: whether the study design matches the research question; whether the control group addresses performance, expectation, and detection bias; whether the control group is ethical, feasible, and attractive; and whether the control group is designed to adequately control for nonspecific intervention effects. Based on these questions, we provide specific recommendations about control group design with the goal of minimizing bias and maximizing validity in future research

Psychoneuroimmunology-Based Stress Management during Adjuvant Chemotherapy for Early Breast Cancer

Objective. In a randomized trial of women with early stage breast cancer undergoing adjuvant chemotherapy, two stress management interventions, tai chi training and spiritual growth groups, were compared to a usual care control group, to evaluate psychosocial functioning, quality of life (QOL), and biological markers thought to reflect cancer- and treatment-specific mechanisms. Method. The sample consisted of 145 women aged 27–75 years; 75% were Caucasian and 25% African American. A total of 109 participants completed the study, yielding a 75% retention rate. Grounded in a psychoneuroimmunology framework, the overarching hypothesis was that both interventions would reduce perceived stress, enhance QOL and psychosocial functioning, normalize levels of stress-related neuroendocrine mediators, and attenuate immunosuppression. Results. While interesting patterns were seen across the sample and over time, the interventions had no appreciable effects when delivered during the period of chemotherapy. Conclusions. Findings highlight the complex nature of biobehavioral interventions in relation to treatment trajectories and potential outcomes. Psychosocial interventions like these may lack sufficient power to overcome the psychosocial or physiological stress experienced during the chemotherapy treatment period. It may be that interventions requiring less activity and/or group attendance would have enhanced therapeutic effects, and more active interventions need to be tested prior to and following recovery from chemotherapy

Mindfulness: An effective coaching tool for improving physical and mental health:

This article provides an overview of the mechanisms of action, evidence base, and practice of mindfulness, with an emphasis on how to easily incorporate this valuable skill into practice