A qualitative study exploring feasibility and acceptability of acupuncture, yoga, and mindfulness meditation for managing weight after breast cancer

Introduction: Weight gain is common after breast cancer. Yoga, mindfulness meditation, and acupuncture may assist with managing weight. However, evidence on effectiveness is limited. This study assessed the feasibility and acceptability of recruiting for and implementing a randomized controlled trial (RCT) evaluating these interventions as adjuncts to lifestyle interventions (diet and exercise) for weight management in women with breast cancer. Methods: Qualitative study involving virtual focus groups or semi-structured interviews. Participants were recruited via email invitation from a breast cancer consumer organization and breast cancer center in Australia. Eligible participants had received treatment for breast cancer, and were fluent in English. A purposive sample of culturally and linguistically diverse (CALD) participants was also recruited. Focus groups and interviews were audio-recorded, transcribed verbatim and analyzed using thematic analysis with the constant comparison method. Results: Emails were sent to 1415 women of which 37 provided data in 5 focus groups and 1 semi-structured interview, including 1 focus group (n = 6) with only women from CALD backgrounds. Yoga and mindfulness meditation were perceived as feasible and acceptable for weight management, but acupuncture was seen to be too invasive to be acceptable. A focus on wellness rather than weight reduction, flexible program delivery, trusted advice, consideration of participant burden and benefit, and peer-support were key factors perceived to increase feasibility and acceptability. Conclusions: Yoga and mindfulness meditation are acceptable and useful adjuncts to lifestyle interventions for weight management after breast cancer. This research places end-users at the forefront of trial design, and will inform future trials using these interventions for weight management and improving health and wellbeing after breast cancer

Spanish Validation of the Flourishing Scale in the General Population

Well-being research and its measurement have grown in the last two decades. The objective of this study was to adapt and validate the Flourishing Scale in a sample of Spanish adults. This was a cross-sectional study using a non-probabilistic sample of 999 Spanish general adult population participants. The psychometric properties of the scale were analysed from an exploratory and confirmatory perspective. Exploratory factor analysis showed a one-factor solution explaining 42.3% of the variance; an internal consistency of .846; temporal reliability correlation of .749; convergent validity with the Satisfaction with Life Scale of .521 and criterion validity with positive and negative affect (PANAS), pessimism and optimism (LOT-R) ranging from .270 to .488. Confirmatory factor analysis testing the one-factor solution showed a χ2 of 65.57 df = 20; CFI of .982, RMSEA of .06, average variance extracted index of .518 and composite reliability index of .841. Results showed that the Spanish version of the FS is a reliable and valid method for measuring high levels of well-bein

Harnessing the Four Elements for Mental Health

Humans are intimately connected to nature, and our physical and mental health is influenced strongly by our environment. The "elements," classically described in humoral theory as Fire, Water, Earth, and Air, all may impact our mental health. In a contemporary sense, these elements reflect a range of modifiable factors: UV light or heat therapy (Fire); sauna, hydrotherapy, and balneotherapy (Water); nature-based exposure therapy and horticulture (Earth); oxygen-rich/clean air exposure; and breathing techniques (Air). This theoretical scoping review paper details the emerging evidence for a range of these elements, covering epidemiological and interventional data, and provides information on how we can engage in "biophilic" activities to harness their potential benefits. Interventional examples with emerging evidentiary support include "forest-bathing," heat therapy, sauna, light therapy, "greenspace" and "bluespace" exercise, horticulture, clay art therapy activities, and pranayamic yoga breathing exercises. Further robust research is however required to firmly validate many of these interventions, and to establish their therapeutic applications for the benefit of specific mental health disorders

Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties

BACKGROUND: Cannabis has been documented for use in alleviating anxiety. However, certain research has also shown that it can produce feelings of anxiety, panic, paranoia and psychosis. In humans, Δ9-tetrahydrocannabinol (THC) has been associated with an anxiogenic response, while anxiolytic activity has been attributed mainly to cannabidiol (CBD). In animal studies, the effects of THC are highly dose-dependent, and biphasic effects of cannabinoids on anxiety-related responses have been extensively documented. A more precise assessment is required of both the anxiolytic and anxiogenic potentials of phytocannabinoids, with an aim towards the development of the 'holy grail' in cannabis research, a medicinally-active formulation which may assist in the treatment of anxiety or mood disorders without eliciting any anxiogenic effects. OBJECTIVES: To systematically review studies assessing cannabinoid interventions (e.g. THC or CBD or whole cannabis interventions) both in animals and humans, as well as recent epidemiological studies reporting on anxiolytic or anxiogenic effects from cannabis consumption. METHOD: The articles selected for this review were identified up to January 2020 through searches in the electronic databases OVID MEDLINE, Cochrane Central Register of Controlled Trials, PubMed, and PsycINFO. RESULTS: Acute doses of CBD were found to reduce anxiety both in animals and humans, without having an anxiogenic effect at higher doses. Epidemiological studies tend to support an anxiolytic effect from the consumption of either  CBD or THC, as well as whole plant cannabis. Conversely, the available human clinical studies demonstrate a common anxiogenic response to THC (especially at higher doses). CONCLUSION: Based on current data, cannabinoid therapies (containing primarily CBD) may provide a more suitable treatment for people with pre-existing anxiety or as a potential adjunctive role in managing anxiety or stress-related disorders. However, further research is needed to explore other cannabinoids and phytochemical constituents present in cannabis (e.g. terpenes) as anxiolytic interventions. Future clinical trials involving patients with anxiety disorders are warranted due to the small number of available human studies

Network analysis highlights increased generalisation and evenness of plant-pollinator interactions after conservation measures

The decline of pollinators may alter the complex system of interactions that they establish with flowering plants, with potential negative consequences on both partners. Within this context, network analysis may be a useful tool to study ecological properties of plant-pollinator interactions and to evaluate the outcomes of conservation actions. Three conservation measures were implemented within the European LIFE + PP-ICON project to support the local pollinator community of a population of the rare plant Dictamnus albus in a protected area near Bologna, Italy. Artificial nesting sites were installed to support solitary bees, populations of native plants were reinforced to increase foraging resources for pollinators, and colonies of bumblebees reared from wild queens were released in the study area. In this work we evaluate the effects of these conservation actions on plant-pollinator networks over a period of four years, comparing a pre- (2011\u20132012) and a post-conservation (2013\u20132014) action period. The overall network generalisation increased after the implementation of conservation measures and interactions were more evenly distributed. Module composition significantly changed between the two periods, showing a marked rewiring of interactions. D. albus was a module hub both before and after conservation actions, thus emerging as an important node within its own module. In addition, some plant and pollinator species directly targeted by conservation measures became module connectors, highlighting their increased importance in linking different modules. Finally, the reinforcement of plant and pollinator populations led to increased flower visitation. These results indicate that conservation actions affected species both directly and indirectly and that the network of interactions has potentially increased its robustness and resilience towards possible species loss. This study highlights ways in which network analysis can be used to measure changes in plant-pollinator interactions in response to conservation actions

Integration of multispectral visible-infrared imaging and pointwise X-ray fluorescence data for the analysis of a large canvas painting by Carpaccio

In this work, we studied the canvas "The meeting of the pilgrims with the Pope" by Vittore Carpaccio fusing in a single data structure the pointwise XRF analysis with the Vis-IR multispectral data acquired on the painting. We proposed a workflow for analyzing and interpreting the data using Principal Component Analysis. The effectiveness of this approach is evaluated against the analysis of the data analyzed as separated contributions. The proposed procedure is demonstrated on the red pigments, which are predominant in this painting and in Carpaccio's production in general, highlighting information regarding the original artist's technique and regarding restored areas

An integrative collaborative care model for people with mental illness and physical comorbidities

Background Many individuals with mental health problems have comorbid physical conditions, or may present with substance/alcohol misuse or abuse issues. This results in complex treatment challenges that may not be adequately addressed by a model of care that is solely delivered by an individual clinician using a sole intervention. Mainstream pharmacotherapeutic treatment of mental health problems often have limited effectiveness in completely resolving symptoms, and may cause adverse side effects. Adjunctive treatment approaches, including nutraceuticals, lifestyle and behaviour change interventions, are widely used to assist with treatment of mental health problems. However, whilst these can be generally safer with fewer side effects, they have varying levels of evidentiary support. These circumstances warrant reframing the current treatment approach towards a more evidence-based integrative model which may better address the real-world challenges of psychiatric disorders and comorbid physical conditions. In essence, this means developing an integrative model of care which embodies an evidence-informed, personalized stepwise approach using both conventional pharmacological treatments alongside novel adjunctive treatments (where applicable) via the application of a collaborative care approach. Discussion In order to inform this position, a brief review of findings on common patterns of comorbidity in mental illness is presented, followed by identification of limitations of conventional treatments, and potential applications of integrative medicine interventions. Advantages and challenges of integrative mental health care, collaborative models of care, review of research highlights of select integrative approaches, and comment on potential cost advantages are then discussed. Summary We propose that a collaborative care model incorporating evidence-based integrative medicine interventions may more adequately address mental health problems with comorbid medical conditions. Robust research is now required of such a model, potentially within an integrative clinical practice

Yoga for anxiety: A systematic review and meta‐analysis of randomized controlled trials

Yoga has become a popular approach to improve emotional health. The aim of this review was to systematically assess and meta‐analyze the effectiveness and safety of yoga for anxiety. Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through October 2016 for randomized controlled trials (RCTs) of yoga for individuals with anxiety disorders or elevated levels of anxiety. The primary outcomes were anxiety and remission rates, and secondary outcomes were depression, quality of life, and safety. Risk of bias was assessed using the Cochrane tool. Eight RCTs with 319 participants (mean age: 30.0–38.5 years) were included. Risk of selection bias was unclear for most RCTs. Meta‐analyses revealed evidence for small short‐term effects of yoga on anxiety compared to no treatment (standardized mean difference [SMD] = −0.43; 95% confidence interval [CI] = −0.74, −0.11; P = .008), and large effects compared to active comparators (SMD = −0.86; 95% CI = −1.56, −0.15; P = .02). Small effects on depression were found compared to no treatment (SMD = −0.35; 95% CI = −0.66, −0.04; P = .03). Effects were robust against potential methodological bias. No effects were found for patients with anxiety disorders diagnosed by Diagnostic and Statistical Manual criteria, only for patients diagnosed by other methods, and for individuals with elevated levels of anxiety without a formal diagnosis. Only three RCTs reported safety‐related data but these indicated that yoga was not associated with increased injuries. In conclusion, yoga might be an effective and safe intervention for individuals with elevated levels of anxiety. There was inconclusive evidence for effects of yoga in anxiety disorders. More high‐quality studies are needed and are warranted given these preliminary findings and plausible mechanisms of action