Integrative Medicine Practitioners Research Articles

ЗВУКОВАЯ ТЕРАПИЯ И МУЗЫКАЛЬНАЯ МЕДИЦИНА: БИОЛОГИЧЕСКИЕ МЕХАНИЗМЫ (Часть 2)

This article provides clinicians and other medical professionals with an introduction to the related fields of Sound Therapy and Music Medicine, outlining some of the many biological mechanisms advantageously activated by these modern modalities. The umbrella term for audible sound therapies is often popularly referred to as «Vibrational Medicine», embracing the energetic (vibrational) interconnectedness of the mind-body system. The information provided is intended for physicians, psychologists, music therapists, nurses, integrative medicine practitioners, and wellness practitioners utilizing the therapeutic potential of Vibrational Medicine. Since the body is comprised of vibrational energy, a wide variety of energetic modalities are available to support the patient’s physiology, and the article describes some of the many physiological mechanisms initiated by Sound Therapy and Music Medicine, perhaps most importantly, pain mediation, achieved by locally applied specific sound frequencies. Other mechanisms, such as vagal stimulation, are described and achieved by experiencing specific sound frequencies or music via headphones. The article is in two parts: Part 1 was published in the past issue (3-2023) of the «Medicine and Art» journal (https://doi.org/10.60042/2949-2165-2023-1-3-60-93). It provides a short history of therapeutic sound, followed by definitions of Music Therapy, Music Medicine, and Sound Therapy, followed by sections on some of the many biological mechanisms activated by full body immersion in music or specific sound frequencies, including an introduction to pain mediation by sound. Part 2 includes breaking the pain-spasm pain cycle in spinal injury by sound; pain relief and anxiety relief by acupressure and sonopuncture; oxygen-driven healing by sound; musical stimulation of the immune system; sonic stimulation of the vagus nerve via headphones and by vocalizations; and last, a look into the future of vibrational medicine.

Findings from Clinical, Historical, and Educational Research Conducted at the HOHM Foundation Office of Research

Background: This presentation provides an overview of the research work at HOHM Foundation and the most inspiring results from the last 5 years, highlighting important findings from our numerous published and ongoing research projects. Methods: HOHM Foundation officially launched its Office of Research (HOHM Research) in 2017 in keeping with the mission to enrich and support homeopathy, and an overarching aim to build infrastructure whereby rigorous outcomes-based research supports the deepening and expansion of the discipline of Homeopathy. Results: Recent peer-reviewed publications include five papers on the education of complementary and integrative medicine practitioners, as well as three observational case series of selected COVID-19 cases from the HHN Clinic. Additional papers based on the 5000+ dataset of acute cases from the Homeopathy Help Network (HHN) clinic are currently being prepared. From the Practitioner Generated Research Network (PGRN) – an organization promoting practice-based, patient-focused, practitioner-generated research that potentizes the profession of homeopathy and expands it into the larger scientific and integrative medical communities - a paper exploring attitudes to and uptake of repertory software in homeopathy clinical practice was published in Homeopathy in 2023. Current papers from the PGRN in the publication phase include an observational clinical case series using MYMOP 2017-20, and an observational clinical case series using MYCaW 2020-22 data, both collected from clients who attended the Academy of Homeopathy Education (AHE) chronic clinic. Other current research work focusses on artificial intelligence in Homeopathy, on the characteristics, demographics and perceptions of users of homeopathy in the US, the 2022 North American homeopathy education surveys, the 2023 North American workforce survey, and a clinical trial on Homeopathy in the management of Silicosis taking place in Brazil. Discussion: HOHM Research produces robust, relevant publications, and bring awareness of the effectiveness of homeopathy through real-world, outcomes-based research, focusing on clinical, historical, and educational research outputs.

ЗВУКОВАЯ ТЕРАПИЯ И МУЗЫКАЛЬНАЯ МЕДИЦИНА: БИОЛОГИЧЕСКИЕ МЕХАНИЗМЫ (Часть 1)

This article provides clinicians and other medical professionals with an introduction to the related fields of Sound Therapy and Music Medicine, outlining some of the many biological mechanisms advantageously activated by these modern modalities. The umbrella term for audible sound therapies is often popularly referred to as «Vibrational Medicine», embracing the energetic (vibrational) interconnectedness of the mind-body system. The information provided is intended for physicians, psychologists, music therapists, nurses, integrative medicine practitioners, and wellness practitioners utilizing the therapeutic potential of Vibrational Medicine. Since the body is comprised of vibrational energy, a wide variety of energetic modalities are available to support the patient’s physiology, and the article describes some of the many physiological mechanisms initiated by Sound Therapy and Music Medicine, perhaps most importantly, pain mediation, achieved by locally applied specific sound frequencies. Other mechanisms, such as vagal stimulation, are described and achieved by experiencing specific sound frequencies or music via headphones. The article is in two parts: Part 1 provides a short history of therapeutic sound, followed by definitions of Music Therapy, Music Medicine, and Sound Therapy, followed by sections on some of the many biological mechanisms activated by full body immersion in music or specific sound frequencies, including an introduction to pain mediation by sound. Part 2 will be published in the next issue of the «Medicine and Art» journal. It includes breaking the pain-spasm pain cycle in spinal injury by sound; pain relief and anxiety relief by acupressure and sonopuncture; oxygen-driven healing by sound; musical stimulation of the immune system; sonic stimulation of the vagus nerve via headphones and by vocalizations; and last, a look into the future of vibrational medicine.

Cultural stress: The undiagnosed epidemic of our time

Global technologies that have made the world more interconnected have also, inadvertently, amplified the forces of stress that are now with us 24 hours a day, 7 days a week. The accumulated impact of this stress I call cultural stress anxiety syndrome and call on integrative medicine practitioners to recognize that it is exacerbating whatever acute stressors are also present in our patients’ lives. In this Commentary, I outline seven major components of cultural stress (time pressure, digital intrusion, digital dependency, isolation, sedentary lifestyle, poor sleep and uncertainty), describe their health consequences, and finally, offer cultural stress-specific remedies I have utilized in my own practice, along with studies that affirm their efficacy. My hope is that we, as integrative medicine practitioners who are cognizant of the role that stress plays in disease development, will more fully appreciate the added impact of cultural stress, and advise our patients on the importance of proactive stress management.Please cite this article as: Murad H. Cultural stress: the undiagnosed epidemic of our time. J Integr Med. 2023; 21(3): 221–225.

From the "what" to the "how": Teaching integrative medicine-related skills to medical students during COVID-19

ObjectiveTo examine the impact of an integrative medicine (IM) course on self-perceived IM-related communication and research skills. MethodsA 3-day mandatory "hybrid" (online and in-person) IM course was held within COVID-19 restrictions for 161 pre-clerkship medical students, with workshops facilitated by mentor healthcare professionals (IM and non-IM) and student-directed tasks. Self-perceived levels of 6 IM-related skills were scored (from 1 to 5) for history-taking; communicating with patients with "alternative" health-beliefs; referral to IM consultations; assessing risks/benefits; and working with non-medical IM practitioners. Results137 students (85.1%) completed pre-/post-course questionnaires, with overall scores improving from pre-course (1.98 ± 0.92) to post-course (3.31 ± 0.63; p < 0.0001), for the entire group and student subgroups (with vs. without prior IM experience). Multivariate analysis found no association between age, gender, primary language or prior experience with IM and improvement in skill scores. ConclusionsThe IM course increased self-perceived skill levels, reflecting the course curriculum and workshops. Further research needs to explore the application of these skills during clinical training. Practice implicationsTeaching medical students about IM in a course comprising communication and research skills was shown to be feasible and effective. The application of IM-related skills needs to be evaluated during the clinical clerkship.

Initiating Conversations on Integrative Oncology Amongst Cancer Professionals, Integrative Medicine Practitioners and Cancer Patients – The CANCERTALK Initiative

Integrative Medicine (IM) is a philosophy and practice of medicine which addresses the whole person and not just symptoms of disease. It encompasses complementary and alternative therapies which work alongside mainstream medical treatments and may include aspects of nutrition, physical activity and mind-body therapies such as massage, aromatherapy and reflexology. Similarly, Integrative Oncology (IO) addresses the epigenetic changes which can cause cancer (with nutrition, exercise and lifestyle factors), above and beyond cancer genetics, through the use of complementary and alternative approaches on top of traditional cancer treatments. Between 40% and 60% of cancer patients use some form of complementary and alternative therapies as part of Integrative Oncology, but only few will tell their oncologist or cancer nurse specialist. This is often because of the generalized lack of awareness from clinicians of the benefits of Integrative Oncology in improving cancer patient outcomes. In addition, there is currently no funding model in the UK National Health Service (NHS) that can support the routine use of complementary and alternative therapies in clinic. As a result, people with cancer tend to seek support from integrative oncology charities or private integrative practitioners. Our study is the first evaluation of a cancer podcast in UK which aims at initiating conversations between mainstream and integrative practitioners around the routine use of Integrative Oncology practices in the NHS. The purpose of the podcast initiation is to bridge the gap between mainstream and integrative medicine practitioners and pave the way to new models of Integrative Oncology care in the NHS. The results from the first six months of the program are very encouraging, in terms of clinician appetite to explore Integrative Oncology in their routine clinical practice. The next six months will see more mainstream clinicians becoming engaged in conversational talks, which will help lift the barriers to the adoption and diffusion of Integrative Oncology in UK.

Evidence-based practice guideline on integrative medicine for stroke 2019.

Stroke is the leading cause of death and disability in China. Chinese medicine integrated with conventional medicine is now widely used in the prevention and treatment of stroke. A clinical practice guideline for the application of integrative medicine in stroke is urgently needed. This guideline was developed following the methodology and procedures recommended in the World Health Organization Handbook for Guideline Development and the Guideline Development Handbook for Diagnosis and Therapy of Integrative Medicine. The quality of evidence and strength of recommendations were evaluated using the GRADE approach. The guideline followed the RIGHT statement and AGREE II was consulted to ensure its quality. A multidisciplinary working team was established. Eleven research questions from 15 clinical questions were identified by questionnaire surveys, face-to-face meetings, and analyzed by the working team. Fourteen recommendations regarding integrative medicine for ischemic stroke, hemorrhagic stroke, and complications of stroke were formulated from systematic reviews of the benefits, harms, cost-effectiveness, quality of evidence, the values and preferences of patients and their family members, feedback on proposed recommendations from medical practitioners from a variety of disciplines, and a face-to-face consensus meeting. This guideline focuses on clinical treatments that are specific to integrative medicine for stroke and can be used at all levels in medical institutions and rehabilitation facilities. The end-users of the guideline are most likely to be medical practitioners, including Chinese herbal medicine specialists, acupuncturists, integrative medicine practitioners, physicians, physical therapists, and clinical pharmacists.

FR01-11 KIDNEYS IN THE KITCHEN, TESTES AT THE TABLE: ANCIENT AND MODERN GENITOURINARY DELICACIES

You have accessJournal of UrologyHistory of Urology Forum I (FR01)1 Apr 2020FR01-11 KIDNEYS IN THE KITCHEN, TESTES AT THE TABLE: ANCIENT AND MODERN GENITOURINARY DELICACIES Alexandra L. Tabakin*, Arnav Srivastava, and Ephrem O. Olweny Alexandra L. Tabakin*Alexandra L. Tabakin* More articles by this author , Arnav SrivastavaArnav Srivastava More articles by this author , and Ephrem O. OlwenyEphrem O. Olweny More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000850.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: People have eaten genitourinary offal, or non-muscle meat, since biblical times. We present a brief history of the use of kidneys and testes as food in both ancient and contemporary culture. METHODS: Literature review of primary and secondary sources regarding consumption of kidneys and testes was performed. RESULTS: Usage of kidneys as food was first described in Deuteronomy 32:14 when the Lord fed Jacob “fat of kidneys of wheat”. Centuries later, ancient Greek physician Galen (130-200 AD) described kidneys as fattening and indigestible. He commented that most testes are “difficult to digest;” however, those of a young pig or rooster are “very pleasant and give the body excellent nourishment”. Succeeding Greek physician Oribasius, as well as Byzantine physicians Aetius of Amida and Paulus Aeginita, documented similar opinions in their manuscripts. In 8th century Greece, Olympic athletes ate raw testes to gain muscle and strength in preparation for competitions. In ancient India, Vātsyāyana, in his text Kama Sutra, recommended eating goat or ram testicle mixed with milk and sugar to boost libido. The idea that eating testes may improve strength, libido, and potency still persists in some regions. In China, testes served with penises, are purported to improve impotence if eaten regularly. In American agriculture, harvesting the testes of young lambs, calves, and turkeys has become a yearly spring tradition in many rural areas, as it is custom to not let any part of the animal go to waste. Annual “testicle festivals” are held throughout the United States where attendees eat various animal testes including renowned “Rocky Mountain Oysters”, deep fried and breaded bull testes. Kidneys, regarded for high B12 and iron content, were first incorporated into the American diet in the early 1940s after a meat shortage resulted from shipping meats overseas to troops fighting World War II. Americans incorporated offal into their diets, the consumption of which rose by 50% by 1955. Kidney meat consumption in the US has since declined but is still used commonly in Asia and Europe in stews and “steak and kidney pie”. Moreover, some integrative medicine practitioners recommend glandular orchic tablets and grass-fed beef kidney tablets, pill preparations of animal testes and kidneys, respectively, for low libido and improving kidney health. CONCLUSIONS: Many cultures revere kidney and testis meat as a delicacy. The perceived health benefits of these organ meats continue to influence people today. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e287-e288 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexandra L. Tabakin* More articles by this author Arnav Srivastava More articles by this author Ephrem O. Olweny More articles by this author Expand All Advertisement PDF downloadLoading ...

Treatment Interventions for the Management of Intestinal Permeability: A Cross-Sectional Survey of Complementary and Integrative Medicine Practitioners.

Objectives: This study aims to explore the treatment interventions complementary and integrative medicine (CIM) practitioners use in the management of an emerging health condition, increased intestinal permeability (IP), and the association these methods have on the observed time to resolve this condition. Design and setting: A cross-sectional survey of Australian naturopaths, nutritionists, and Western herbal medicine practitioners was undertaken (n = 227) through the Practitioner Research and Collaboration Initiative (PRACI) network. Outcome measures: Frequencies and percentages of the treatment methods, including chi-square analysis to examine the associations between treatment methods and observed time to resolve IP. Results: Thirty-six CIM practitioners responded to the survey (response rate 15.9%). CIM practitioners were found to use a multimodal approach in the management of IP with 92.6% of respondents using three or more categories of treatment interventions (nutritional, herbal, dietary, and lifestyle) with a mean total of 43.0 ± 24.89 single treatment interventions frequently prescribed. The main treatments prescribed in the management of IP were zinc (85.2%), probiotics: multistrain (77.8%), vitamin D (75.0%), glutamine (73.1%), Curcuma longa (73.1%), and Saccharomyces boulardii (70.4%). CIM practitioners also advocate patients with IP to reduce alcohol (96.3%), gluten (85.2%), and dairy (75.0%) consumption. Evaluation of antibiotics (75.0%) and nonsteroidal anti-inflammatory drugs (73.1%) prescriptions were frequently advised by CIM practitioners. A longer observed time to resolve IP was seen in CIM practitioners who did not reduce intense exercise in the management of IP (p = 0.02). Conclusions: This study represents the first survey of the treatments prescribed by CIM practitioners for IP and suggests that CIM practitioners use numerous integrative treatment methods for the management of IP. The treatment interventions frequently prescribed by CIM practitioners align with preclinical research, suggesting that CIM practitioners prescribe in accordance with the published literature. The findings of this study contribute to the implementation of clinical research in the management of IP, which considers multiple concurrent treatments.

Promotion of Testing for Celiac Disease and the Gluten-Free Diet Among Complementary and Alternative Medicine Practitioners.

We identified the frequency and assessed the validity of marketing claims made by American chiropractors, naturopaths, homeopaths, acupuncturists, and integrative medicine practitioners relating to the diagnosis and treatment of celiac disease and nonceliac gluten sensitivity (NCGS), both of which have increased in prevalence in recent years. We performed a cross-sectional study analyzing websites of practitioners from 10 cities in the United States and analyzed the websites for any mention of celiac or NCGS as well as specific claims of ability to diagnose, ability to treat, and treatment efficacy. We classified treatments promoted as true, false, or unproven, as assessed independently by 2 authors. Of 500 clinics identified, 178 (35.6%) made a claim regarding celiac disease, NCGS, or a gluten-free diet. Naturopath clinic websites have the highest rates of advertising at least one of diagnosis, treatment, or efficacy for celiac disease (40%), followed by integrative medicine clinics (36%), homeopaths (20%), acupuncturists (14%), and chiropractors (12%). Integrative medicine clinics have the highest rates of advertising at least one of diagnosis, treatment, or efficacy for NCGS (45%), followed by naturopaths (37%), homeopaths (14%), chiropractors (14%), and acupuncturists (10%). A geographic analysis yielded no significant variation in marketing rates among clinics from different cities. Of 232 marketing claims made by these complementary and alternative medicine (CAM) clinic websites, 138 (59.5%) were either false or unproven. A significant number of CAM clinics advertise diagnostic techniques or treatments for celiac disease or NCGS. Many claims are either false or unproven, thus warranting a need for increased regulation of CAM advertising to protect the public.

Treatment interventions for the management of intestinal permeability: A cross-sectional survey of complementary and integrative medicine practitioners

Animal models of nociception are critical for understanding biological processes associated with pain and its central effects on behavior, cognition, and emotions. However, unlike humans, laboratory animal models have less complex neural processing networks, making it difficult to correlate nociception with individual subjective experience. Although rodents are widely used in translational pain research, alternative experimental models may also be useful, reflecting evolutionarily conserved mechanisms of nociception and their related behavioral phenotypes. Novel model organisms, such as zebrafish (Danio rerio), are emerging as a promising in vivo tool to study nociception. Here, we discuss adult zebrafish models of pain and pain-like behavioral responses, summarize the existing challenges and outline future directions of research in this rapidly developing field.

Improving Usability of Electronic Health Records for Whole Systems Integrative Medicine Practitioners.

Improving Usability of Electronic Health Records for Whole Systems Integrative Medicine Practitioners.

Investigation into complementary and integrative medicine practitioners' clinical experience of intestinal permeability: A cross-sectional survey

BackgroundThis study aims to explore the conditions complementary and integrative medicine (CIM) practitioners associate with increased intestinal permeability (IP) and the methods they employ to assess IP. MethodsA cross-sectional survey of naturopaths, nutritionists and Western herbal medicine practitioners was undertaken (n = 227) through the Practitioner Research and Collaboration Initiative (PRACI) network. ResultsCIM practitioners (n = 36, response rate 15.9%) associate IP with gastrointestinal (100.0%), autoimmune (91.7%), skin (91.7%), neurological (80.6%), respiratory (55.6%) and liver-related conditions (44.4%). CIM practitioners frequently treat IP (72.7%); observing a minimum 3 months of treatment is required to resolve IP. Patient's signs and symptoms were the main reasons CIM practitioners suspected IP (94.1%). ConclusionCIM practitioners observe a clinical link between IP and a wide range of conditions, including those not yet recognised within the literature. The clinical experience of CIM practitioners holds substantial value to the advancement of research and the clinical management of IP.

Cost Savings from Reducing Pain Through the Delivery of Integrative Medicine Program to Hospitalized Patients.

An important task facing hospitals is improving pain management without raising costs. Integrative medicine (IM), a promising nonpharmacologic pain management strategy, is yet to be examined for its cost implications in an inpatient setting. This institution has had an inpatient IM department for over a decade. The purpose was to examine the relationship between changes in patients' pain, as a result of receiving IM therapy, and total cost of care during an inpatient hospital admission. In this retrospective analysis, data from an EPIC-based electronic health record (EHR) patient demographics, length of stay (LOS), and All Patient Refined Diagnosis Related Groups (APR-DRG) severity of illness measures were utilized. IM practitioners collected and entered patient-reported pain scores into the EHR. The authors regressed the demographic, change in pain, LOS, and APR-DRG variables with changes in pain on total cost for the hospital admission. To estimate cost savings to the hospital, they computed the average reduction in cost associated with reduction in pain by multiplying the coefficient for change in pain by average total cost. A large, tertiary care hospital in Minneapolis, MN. Adult inpatient admissions, 2730, during the study period where patients received IM for pain and met eligibility criteria. IM services provided to inpatients. Change in pain on an 11-point numeric rating scale before and after initial IM sessions; total costs for hospital admissions. Both LOS and age were found to increase cost, as did being white, male, married, and having APR-DRG severity coded as extreme. For patients receiving IM therapies, pain was reduced by an average of 2.05 points and this pain reduction was associated with a cost savings of $898 per hospital admission. For patients receiving IM therapies, pain was significantly reduced and costs were lowered by about 4%.

Training on Exercise is Medicine® Within an Integrative Medicine Curriculum.

Physicians are increasingly approached by individuals seeking integrative approaches to health care and well-being. Many integrative modalities include a physical activity component. Patients seek guidance from primary and specialty care providers on the safe and effective incorporation of these modalities into their lifestyle. Physicians and other health professionals receive very limited training in the clinical applications of exercise science. This paper reports on a curriculum designed to teach health professionals key exercise constructs for application to clinical practice for prevention and management of lifestyle-related disease, and incorporating the curriculum into a preventive medicine residency training program. The course was developed in 2012-2013, data collected in 2013-2015, and analysis was done in 2015. Six modules were developed as part of a 24-hour course. Each module included didactic, laboratory, and case examples. The modules included energetics, exercise and cardiorespiratory health, bone health, obesity and sarcopenia, balance and fall prevention, and behavior change and the use of technologies. The delivery was found feasible for all three components, delivered in 2-4-hour segments. The incorporation into the residency curriculum was feasible, efficacious, well received, and easily incorporated into the existing curriculum. This comprehensive curriculum has the potential to close the gap in medical school, residency, graduate, nursing, and integrative curricula on this important topic. Current practitioners would benefit in primary care and geriatric settings. This curriculum would also be useful for cross-disciplinary researchers, including public health, health behaviors, and integrative medicine practitioners.

Project ASPIRE: Incorporating Integrative Medicine Into Residency Training.

Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents’ attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period.

Integrative medicine is integral to providing patient-centered care

Integrative medicine is integral to providing patient-centered care

Practitioner Perspectives on Delivering Integrative Medicine in a Large, Acute Care Hospital.

Background. We describe the process and challenges of delivering integrative medicine (IM) at a large, acute care hospital, from the perspectives of IM practitioners. To date, minimal literature that addresses the delivery of IM care in an inpatient setting from this perspective exists. Methods. Fifteen IM practitioners were interviewed about their experience delivering IM services at Abbott Northwestern Hospital (ANW), a 630-bed tertiary care hospital. Themes were drawn from codes developed through analysis of the data. Results. Analysis of interview transcripts highlighted challenges of ensuring efficient use of IM practitioner resources across a large hospital, the IM practitioner role in affecting patient experiences, and the ways practitioners navigated differences in IM and conventional medicine cultures in an inpatient setting. Conclusions. IM practitioners favorably viewed their role in patient care, but this work existed within the context of challenges related to balancing supply and demand for services and to integrating an IM program into the established culture of a large hospital. Hospitals planning IM programs should carefully assess the supply and demand dynamics of offering IM in a hospital, advocate for the unique IM practitioner role in patient care, and actively support integration of conventional and complementary approaches.

Pharmacological doses of daily ascorbate protect tumors from radiation damage after a single dose of radiation in an intracranial mouse glioma model.

Pharmacological ascorbate is currently used as an anti-cancer treatment, potentially in combination with radiation therapy, by integrative medicine practitioners. In the acidic, metal-rich tumor environment, ascorbate acts as a pro-oxidant, with a mode of action similar to that of ionizing radiation; both treatments kill cells predominantly by free radical-mediated DNA damage. The brain tumor, glioblastoma multiforme (GBM), is very resistant to radiation; radiosensitizing GBM cells will improve survival of GBM patients. Here, we demonstrate that a single fraction (6 Gy) of radiation combined with a 1 h exposure to ascorbate (5 mM) sensitized murine glioma GL261 cells to radiation in survival and colony-forming assays in vitro. In addition, we report the effect of a single fraction (4.5 Gy) of whole brain radiation combined with daily intraperitoneal injections of ascorbate (1 mg/kg) in an intracranial GL261 glioma mouse model. Tumor-bearing C57BL/6 mice were divided into four groups: one group received a single dose of 4.5 Gy to the brain 8 days after tumor implantation, a second group received daily intraperitoneal injections of ascorbate (day 8–45) after implantation, a third group received both treatments and a fourth control group received no treatment. While radiation delayed tumor progression, intraperitoneal ascorbate alone had no effect on tumor progression. Tumor progression was faster in tumor-bearing mice treated with radiation and daily ascorbate than in those treated with radiation alone. Histological analysis showed less necrosis in tumors treated with both radiation and ascorbate, consistent with a radio-protective effect of ascorbate in vivo. Discrepancies between our in vitro and in vivo results may be explained by differences in the tumor microenvironment, which determines whether ascorbate remains outside the cell, acting as a pro-oxidant, or whether it enters the cells and acts as an anti-oxidant.

Pediatric Integrative Medicine Approaches to Attention Deficit Hyperactivity Disorder (ADHD).

Attention deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder in children and is increasing in prevalence. There has also been a related increase in prescribing stimulant medication despite some controversy whether ADHD medication makes a lasting difference in school performance or achievement. Families who are apprehensive about side effects and with concerns for efficacy of medication pursue integrative medicine as an alternative or adjunct to pharmacologic and cognitive behavioral treatment approaches. Integrative medicine incorporates evidence-based medicine, both conventional and complementary and alternative therapies, to deliver personalized care to the patient, emphasizing diet, nutrients, gut health, and environmental influences as a means to decrease symptoms associated with chronic disorders. Pediatric integrative medicine practitioners are increasing in number throughout the United States because of improvement in patient health outcomes. However, limited funding and poor research design interfere with generalizable treatment approaches utilizing integrative medicine. The use of research designs originally intended for drugs and procedures are not suitable for many integrative medicine approaches. This article serves to highlight integrative medicine approaches in use today for children with ADHD, including dietary therapies, nutritional supplements, environmental hygiene, and neurofeedback.