Integrated Health Research Articles

Cross-Sectional Survey Analysis of Institutional Research Partnerships in Complementary and Integrative Health: Identifying Barriers and Facilitators.

Objective: Collaboration between complementary and integrative health (CIH) institutions and research-intensive (R1) institutions has been successfully undertaken in the United States, resulting in federally funded research projects, educational programs, and faculty development. The aim of this cross-sectional survey study was to explore the barriers and facilitators to establishing and maintaining such collaborative partnerships. Methods: A 32-question survey was sent to participants recruited through author contacts and resources, literature review, and database searches. Participants were required to be researchers and affiliates who attempted, completed, or had current collaborative endeavors involving CIH and R1 institutions. Data were collected in the research electronic data capture (REDCap) system and descriptive quantitative and qualitative data analysis was undertaken. Results: A total of 26 unique entries were included in the final data analysis; four of which were paired entries (one from an R1 institution and one from a CIH institution) to make up two dyad data collections. Eighty-one percent of the participants had senior leadership roles at CIH institutions representing five CIH disciplines-East Asian medicine (acupuncture and Traditional Chinese Medicine), chiropractic medicine, massage therapy, naturopathy, and yoga. Collaborative research projects were often (>38%) in response to specific project funding mechanisms. Over 60% of the collaborations also included educational activities and faculty development. Collaborations resulted in multiple different types of benefits to both institutions but were not without associated challenges. Conclusion: Collaborations between R1 and CIH institutions can be cooperative, productive, and mutually beneficial. Funding mechanisms supporting R1 and CIH collaboration increase CIH research productivity as well as the development of innovative research methodology to study the real-world practice of CIH therapies, whole systems, and whole person health. CIH researchers would greatly benefit from such funding, allowing access to research infrastructure, professional development, and the provision of protected time to conduct research.

Navigating Nurse Wellness in Rural America.

The aim of this study's phase 1 was to determine the current wellness levels of RNs in rural America settings, including barriers to maintain and recommendations for wellness. Nurses are experiencing more anxiety and burnout currently than prepandemic. A review of literature revealed a gap in describing nurses' wellness and strategies to maintain wellness in rural American healthcare settings. The Integrative Health and Wellness Assessment (IHWA) V2 2022 holistically measured participants' wellness. The survey was deployed in 2023 to 6989 clinical nurses, nurse leaders, and advanced practice nurses. The IHWA V2 2022 mean was 134.72. Significant findings included age, years of experience, and role. Barriers of insufficient time, work environment, and family responsibilities were identified. Recommendations involved the work environment, stress management, and healthy boundaries with suggestions to implement in rural settings. Study findings can assist leaders to implement interventions that positively impact nurse wellness in rural settings. Interventions promoting wellness are essential for nurses to meet these same needs of their patients.

Vulnerability assessment of major urban tunnel subjected to fire induced by traffic incidents - a case study

As a type of critical transportation infrastructures, safety of major tunnels in urban transportation corridors has become unprecedentedly crucial. In various fire incidents with high temperature environment, the ceiling and wall of a tunnel would risk spalling, strength reduction, and even structural failure. In addition to risks of structural damage, high temperature and thick smoke in fire incidents will increase the risk of severe injury and even death due to burning, lack of oxygen, inhaling smoke and reduced visibility for people inside the tunnel. Limited mobility of evacuees would delay the evacuation process by endangering the safety of both evacuees and first responders. A comprehensive simulation-based case study is conducted to look into the fire and smoke simulation as well as potential threats to structural integrity and human health caused by fire in typical traffic incidents of three types of vehicles. Fire and smoke simulation are conducted using the Fire Dynamics Simulator (FDS), followed by the thermal and structural analyses with ANSYS. The comprehensive parametric study provides insights in terms of the impacts of different parameters including various typical traffic fire incidents on the structural performance and potential threats to evacuees.

Startup AYUSH Portal

The AYUSH Portal is designed to promote the incorporation of India's traditional medicinal systems Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy into the nation's healthcare ecosystem. Recognizing the increasing global acceptance of AYUSH practices, the Government of India has initiated Centers of Excellence to support prominent institutions involved in research and education and drug development. Notable initiatives include collaborations with premier institutions such as AIIMS and IIT Jodhpur to explore integrative health research and address key public health challenges. Programs like the Ayurgyan and Ayurswasthya Schemes prioritize research in the AYUSH sector, promoting innovations in preventive and integrative health care. The establishment of the AYUSH-ICMR Advanced Center for Integrative Research seeks to create a vibrant ecosystem for scientific validation of traditional practices. During the COVID-19 pandemic, the Ministry of AYUSH demonstrated the efficacy of traditional medicine by releasing clinical management protocols and guidelines based on Ayurveda and Yoga, highlighting their role in public health emergencies. This paper discusses the methodology adopted in the AYUSH Portal, emphasizing collaborative research efforts, intellectual property rights, and the integration of AYUSH therapies in mainstream healthcare to achieve the goal of "One Nation, One Health."

Renegotiating the Biopolitics of Physical Activities among Ethnic Minority Groups in the Netherlands

Research on physical activities among religious and minority ethnic groups in Europe often focuses on classical public health issues or how to ‘empower’, and ‘equip’ people to stay healthy as well as integrated. In producing healthy citizens, bodies have been disciplined and are attuned to dominant discourses regarding religion, race, minority ethnic groups, and their health practices. This paper aims to show how minority ethnic groups, through physical activities, pursue their wellbeing beyond matters of integration and physical health. With a focus on participants from the predominantly Muslim Somali-Dutch and Christian Ghanaian-Dutch communities in the Netherlands, I argue from a biopolitical lens that physical activities are used by state institutions to ‘produce’ bodies in particular ways that are meaningful to the state. However, the demands of the state on ethnic minority groups often leads to the racialisation of bodies. Compliance with and resistance to disciplinary mechanisms emerge around understanding and engaging in physical activities. Thus, people adopt creative ways to incorporate physical activities into their daily routines, considering their migration situation and living conditions to address or negotiate issues of sociality, intimacy, and morality. This paper, therefore, shows how engaging in physical activities enables the embodiment of different forms of sociality, experience, and aesthetics that are important in the pursuit of wellbeing, especially when dealing with racisms.

Development and Application of a Smart Mattress and Integrated Health Management System for Real-time Monitoring Utilizing Theory of Inventive Problem Solving and Signal Processing Techniques

Development and Application of a Smart Mattress and Integrated Health Management System for Real-time Monitoring Utilizing Theory of Inventive Problem Solving and Signal Processing Techniques

Piloting an Educational Approach to Assess eHealth Literacy and Evidence-Based Medicine in Integrative Health: A Feasibility and Validation Study.

Introduction: Low rates of online health literacy put consumers at risk of misinformation, but this could be mitigated through practitioner engagement. Integrative health (IH) crosses health care disciplines, so it is well-positioned to improve health information sharing. IH practitioners require evidence-based medicine (EBM) and electronic health literacy (eHL) competencies to make such impact. Several EBM assessments exist, but none are IH-specific. The Fresno Test of EBM FEBM is a validated, performance-based assessment used in medical education. We sought to assess feasibility of incorporating eHL and EBM assessments into graduate coursework while adapting and validating the FEBM for an IH audience (FEBM-IH). Methods: A pilot observational design was used to adapt, evaluate, administer, and validate the FEBM-IH. Revalidation of the FEBM-IH began with a discipline-focused adaptation, which was reviewed by an expert panel. The FEBM-IH was then administered to IH students and faculty. Independently scored assessments determined inter-rater reliability, internal consistency, item discrimination, and item difficulty. eHL assessments (eHEALS and General Health Numeracy Test-6) were also embedded in the online course. Results: Outcome completion rates suggest the FEBM-IH and eHL assessment tools are feasible to include in online courses, with 68.9% (102/148) eligible participants joining and 76.5% (78/102) completing all questions in all measures. The FEBM-IH demonstrated excellent assessor agreement (kappa = 0.97, p < 0.001), high internal consistency (α = 0.799), and acceptable item discrimination (0.26-0.68). Median self-perceived eHL scores increased from 30/40 to 33/40 points by course's end, suggesting some increase in eHL. Conclusions: Tools were feasible to integrate; FEBM-IH maintains acceptable validity; and further exploration of the relationship between EBM and eHL is warranted.

A SAÚDE MENTAL NA ATENÇÃO BÁSICA: AVANÇOS E DESAFIOS

Introduction: Mental health is an essential part of primary care, fundamental for the prevention and management of mental disorders. This study highlights the advances and challenges of this integration, such as collaborative models and the use of telemedicine, which have expanded access and care effectiveness, especially in remote contexts. Material and Methods: A literature review was conducted following PRISMA guidelines, including articles published between 2007 and 2023, in Portuguese, English, and Spanish. The search was carried out in the PubMed, SciELO, Scopus, and Google Scholar databases, using specific descriptors. The articles were qualitatively analyzed, identifying patterns, gaps, and relevant strategies for integrating mental health into primary care. Results and Discussion: The results point to significant advances, such as the inclusion of specialized professionals, continuous training, and technologies like telemedicine, which have increased the resolvability and reach of care. However, barriers such as insufficient financial resources, social stigma, and workload overload still limit the effectiveness of the integrated model. Future strategies include increased funding, intersectoral articulation, and the adoption of technological tools, as well as public policies focused on equity and stigma reduction. Conclusions: The integration of mental health into primary care is a complex yet indispensable challenge to improve the quality of life of the populations served. This study reinforces the need for sustainable and collaborative solutions aligned with local and global demands.

Climate change and mental health: overview of UK policy and regulatory frameworks to stimulate and inform future research and practice.

In the context of climate change, the impacts of extreme weather events are increasingly recognised as a significant threat to mental health in the UK. As clinicians and researchers with an interest in mental health, we have a collective responsibility to help understand and mitigate these impacts. To achieve this, however, it is vital to have an appreciation of the relevant policy and regulatory frameworks. In this feature article, a collaboration amongst mental health and policy experts, we provide an overview of the integration of mental health within current climate policies and regulations in the UK, including gaps and opportunities. We argue that current policy and regulatory frameworks are lacking in coverage, ambition, detail and implementation, as increases in weather extremes and their negative impacts on mental health outpace action. For example, across current national and local climate policies, there is almost no reference to the impacts of extreme weather events on mental health. Whilst alarming, this provides scope for future research to fill evidence gaps and inform policy and regulatory change. We call for mental health and policy experts to work together to improve our understanding of underlying mechanisms and develop practical interventions, helping to bring mental health within climate policy and regulatory frameworks.

Advancing Physiotherapy in Mental Health

The role of physiotherapy as an element of mental health care continues to expand and evolve. Mental health care is recognized by World Physiotherapy as a specialty area, but the requisite training and accreditation standards vary drastically across and even within countries. While the biopsychosocial (BPS) model of health and wellness has been around for some time, it is often deployed in a fragmented way. Physiotherapists working to improve and advance whole-person care as part of health promotion may benefit from recent models of “integrative health” which aim to approach the biopsychosocial concept from a perspective which more fully recognizes the effects of physical, cognitive/emotional, sociocultural, and environmental elements in combination. This perspective can aid in developing treatment plans which address underlying factors rather than treating physical symptoms as isolated factors. These efforts do not come without challenges and physiotherapists must be versed in a broad set of mind-body medicine, integrative medicine, and whole-person care concepts, methods, and strategies to safely and effectively implement them in clinical practice.

Integrative and complementary practices in public health: a literature review

The use of complementary and alternative medicine as public health care has been accepted in many branches of conventional medicine. There is a scarcity of studies that systematize the use of Complementary and Alternative Medicine in the treatment of various pathologies. Integrative and Complementary Health Practices arise from the problem of lack of care in the global promotion of other healthcare methods by the population. The work seeks to understand, through the literature, the importance of integrative and complementary practices in health. The adopted method was the bibliographic review with a search in databases using the descriptors integrative practices, complementary practices, health, and alternative therapies. Among the results obtained, we highlight that the most commonly used types of complementary therapies are biofeedback, cognitive behavioral therapy, relaxation techniques, and other techniques such as spirituality, studied as practices that affect health. As for the historical aspects involving integrative and complementary practices in health, there was an evolution from the dissemination of its applications. As for the use of complementary and alternative medicine, we understand that primary care professionals tend to propose and accept this type of therapy more, especially after observing its effectiveness.

Provider Identified Access Barriers to Delivering Acupuncture to Persons with Traumatic Brain Injury and Chronic Pain: A Cross-Sectional Self-Report Survey.

Objective: Traumatic brain injury (TBI) clinical practice guidelines for pain management and rehabilitation support the use of nonpharmacologic complementary and integrative health (CIH) modalities, such as acupuncture for remediating pain. Barriers to delivering CIH modalities, such as acupuncture warrant examination. The objective of this study is to explore provider perspectives on challenges to accessing acupuncture treatment for chronic pain in persons with TBI and describe differences across health care settings. Setting: Civilian, Veterans Affairs (VA), and Department of Defense health care systems. Participants: Health care providers (n = 145) were recruited from November 2022 to March 2023 via email through professional organizations and health care systems. Design: Descriptive cross-sectional self-report online survey. Main Measures: A survey assessed barriers using a 5-point Likert scale (always a barrier to never a barrier) using the Levesque Access to Care framework. Results: Of the 137 participants who provided information on setting, 86 (63%) worked in civilian health care; 47 (34%) worked in the Department of VA; and 4 (2.6%) in the Department of Defense (8 were missing data). Overall, providers endorsed all ten items as being barriers to accessing acupuncture treatment. However, these barriers were more statistically more frequently reported for civilian providers compared with VA providers for six of the 10 items, including lack of caregiver support (p < 0.0001); own knowledge and understanding of the treatment (p = 0.0025); health care setting culture discourages the treatment (p = 0.0181); lack of qualified providers (p = 0.0467); insurance does not cover (p < 0.0001), and patient cannot afford (p < 0.0001). VA provider respondents were more likely to answer all six items, as "Rarely/Never a Barrier," while providers in a civilian setting were more likely to respond "Always/Frequently" or "Sometimes" a barrier. Conclusion: Results reflect the cultural, organizational, and structural differences that make acupuncture more accessible within the VA. understanding barriers to delivering care is critical to inform implementation strategy mapping efforts, to tailor strategies that are aimed to increase access and engagement with acupuncture treatment in civilian health care settings.

Data Ownership in the AI-Powered Integrative Health Care Landscape.

In the rapidly advancing landscape of artificial intelligence (AI) within integrative health care (IHC), the issue of data ownership has become pivotal. This study explores the intricate dynamics of data ownership in the context of IHC and the AI era, presenting the novel Collaborative Healthcare Data Ownership (CHDO) framework. The analysis delves into the multifaceted nature of data ownership, involving patients, providers, researchers, and AI developers, and addresses challenges such as ambiguous consent, attribution of insights, and international inconsistencies. Examining various ownership models, including privatization and communization postulates, as well as distributed access control, data trusts, and blockchain technology, the study assesses their potential and limitations. The proposed CHDO framework emphasizes shared ownership, defined access and control, and transparent governance, providing a promising avenue for responsible and collaborative AI integration in IHC. This comprehensive analysis offers valuable insights into the complex landscape of data ownership in IHC and the AI era, potentially paving the way for ethical and sustainable advancements in data-driven health care.

Integrative Health Psychology at MD Anderson Cancer Center: Emphasizing the Mind–Body Connection in Practice

Integrative Health Psychology at MD Anderson Cancer Center: Emphasizing the Mind–Body Connection in Practice

Exploring Managers' Insights on Integrating Mental Health into Tuberculosis and HIV Care in the Free State Province, South Africa.

The integration of mental health (MH) services into tuberculosis (TB) and HIV care remains a significant challenge in South Africa's Free State province. This study seeks to understand the perspectives of public health programme managers on the barriers to such integration and to identify potential strategies to overcome these challenges. Data were collected between February and October 2021 using qualitative methods including four individual semi-structured interviews and two focus group discussions with a total of 15 managers responsible for the MH, primary healthcare, TB, and HIV programmes. Thematic data analysis was guided by an adapted version of the World Health Organization's "building blocks" framework encompassing "service delivery", "workforce", "health information", "essential medicines", "financing", and "leadership/governance". Additionally, the analysis underscored the crucial role of "people", acknowledging their significant contributions as both caregivers and recipients of care. Managers highlighted significant concerns regarding the insufficient integration of MH services, identifying structural barriers such as inadequate MH management structures and staff training, as well as social barriers, notably stigma and a lack of family treatment adherence support. Conversely, they recognised strong management structures, integrated screening, and social interventions, including family involvement, as key facilitators of successful MH integration. The findings emphasise the need for a whole-system approach that addresses all building blocks while prioritising the role of "people" in overcoming challenges with integrating MH services into TB and HIV care.

The need and opportunities for mental health integration into global climate negotiations

The need and opportunities for mental health integration into global climate negotiations

Reaching people who use drugs with sexual and reproductive healthcare through syringe services programs: potential promise and missed opportunities

BackgroundPeople who use drugs are at elevated sexual and reproductive health risk but experience barriers to services. Syringe services programs (SSP) are an important venue to provide integrated health services. Few studies have examined SSP use within intersecting gender, racial, and ethnic groups, including by injection drug use (IDU), and differences in sexual and reproductive health among these groups.MethodsWithin a cohort study among people who use unprescribed opioids in New York City, we conducted a nested cross-sectional study from November 2021-August 2022 assessing sexual health with a survey (n = 120). The parent study measured baseline characteristics, and the cross-sectional study survey measured self-reported past-year SSP use and sexual and reproductive health. We estimated SSP use within gender, racial, and ethnic groups by IDU, and the prevalence of sexual and reproductive health outcomes by gender, race, ethnicity, and SSP use.ResultsAmong men (n = 61) and women (n = 54), SSP use was disproportionately low among Black participants irrespective of IDU. Women reporting SSP use had a higher prevalence of multiple, new, sex trade, and/or casual sex partners, history of STI symptoms, and lack of effective STI prevention, although women who did not use SSP had non-negligible levels of risk with variation between racial and ethnic groups. Among men, sexual and reproductive health varied across racial and ethnic groups but not as clearly by SSP use.ConclusionsSSP offer opportunity to address elevated STI risk among people who use drugs but may miss certain intersecting gender, race, and ethnic groups.

Predictors of the development of disorders of body functions in children with cerebral palsy

Purpose of the study. Among the diseases of the nervous system, cerebral palsy (cerebral palsy) is the most common cause of disability in children. Cerebral palsy is characterized by disorders of statodynamic, mental, speech, sensory functions, as well as the presence of secondary complications due to changes in muscle tone and joint functions. The above functions are evaluated during a medical and social examination. To optimize the process of establishing the category of «disabled child» for children with cerebral palsy, it is relevant to identify predictors in determining the severity of persistent functional disorders as one of the criteria for establishing disability. To determine the predictors of the development of persistent functional disorders in children with cerebral palsy using discriminant analysis. Material and methods. The study used information from the acts and protocols of the medical and social examination of 1229 children with cerebral palsy, reflecting clinical, instrumental, psychophysical, integral indicators of the condition of patients. A correlation analysis was carried out to determine the relationship between integral health parameters and the severity of persistent disorders of body functions in order to select indicators for discriminant analysis. Using discriminant analysis, predictors of the development of persistent disorders of body functions in children with cerebral palsy were determined. Statistical significance was verified by means of a p-value with established significance levels of 0.05 to determine the significance of the correlation and 0.01 to select predictors based on the results of discriminant analysis. Results. According to the results of correlation and discriminant analysis, significant (p&lt;0.01) predictors of the development of functional disorders included: assessment of the patient»s general condition on the GMFCS scale, lack of control of pelvic organ function, delayed psychomotor development in the first year of life, delayed speech development, the presence of pseudobulbar syndrome, the disease code according to ICD-10. The accuracy of the created linear model was determined at the level of 0.92 in the task of classifying the severity of persistent disorders of body functions in children with cerebral palsy. Conclusion. The health indicators indicated in the results in children with cerebral palsy can be considered as significant predictors of the development of disorders of body functions. The developed classification model based on the selected predictors showed high accuracy (0.92) in the tasks of classifying the severity of persistent disorders of body functions in children with cerebral palsy.

Perspectives of Young Women with Breast Cancer: Patient Experiences Indicate Opportunities to Improve Treatment.

In this focus group study of 11 women younger than 45 years of age treated at Memorial Sloan Kettering Cancer Center (New York, NY, USA) between March 2020 and April 2021, patients were asked about their preferences for types of resources, and timing and method of information delivery. Patients expressed interest in personalized medicine, access to integrative health and a holistic approach to treatment, and early consultation for fertility preservation. Their narratives elaborated on how age at diagnosis influences interpersonal relationships and quality of life, and provides direction for interventions to better counsel and support this population.

Educational Strategies For Healthy Habits in Secondary School: Promoting Integral Health

Objectives: This article aims to integrate positive habits in secondary education, focusing on students' mental and physical health. It aims to promote self-care practices and emotional resilience. Theoretical Framework: It is based on theories of emotional education, active learning, and public health, highlighting the importance of training in healthy behaviors for students' physical, emotional, and social well-being. Method: A mixed method was used, using interactive activities, awareness-raising workshops, and digital technologies. Periodic evaluations were carried out to measure the impact of the interventions and encourage the active participation of teachers and students. Results and Discussion: Implementing the educational strategies improved physical activity intervention and reduced risk behaviors, such as substance use. Research Implications: The findings suggest that promoting positive behaviors in secondary education increases academic achievement and contributes to students' overall development. They highlight the need for educational policies that support these initiatives and encourage collaboration between school, family, and community. Originality/Value: It offers an innovative educational proposal that prioritizes students' personal growth and creates an environment conducive to learning. It fosters active collaboration between students and teachers and develops socio-emotional skills that strengthen the sense of community and belonging.