PS1-12: Acceptability of Group Acupuncture Clinics at a Health Maintenance Organization.

Clin Med Res. 2010 Mar;8(1):45

Authors: McMullen C, McCuaig S, Weih J, Elder C

Background: This project aims to assess whether group clinics represent an appropriate and viable mechanism for delivering acupuncture services in a conventional managed care setting. Methods: We are conducting a qualitative analysis with adult patients complaining of back or neck pain who have recently received acupuncture services at Kaiser Permanente Northwest. About half of these patients are receiving acupuncture in a group setting. During group acupuncture sessions, about 4-6 patients are treated at one time by a single practitioner. During treatments, patients are seated in reclining chairs in a shared treatment room. Distal acupoints are used so that patients do not need to remove clothing. Patients are asked about satisfaction with their clinician and care received, as well as level of overall clinical improvement. We also ask participants to comment on the advantages and disadvantages of the group clinic setting, and to offer suggestions for improvement. Analysis: Data analysis involves three steps. First, we use aggregate respondent answers to each interview question to generate a list of response themes for each question. Second, we summarize each respondent's answers, to highlight individuals' reactions to group acupuncture. We then return to the data to identify overarching themes or new themes that were not addressed in the first two efforts. Results: We have conducted fourteen out of an anticipated fifty telephone interviews. Preliminary analysis of patient responses revealed the following themes: both groups reported improvements in quality of life and pain control, but expressed concerns about appointment availability. Patients receiving group acupuncture reported that they were generally satisfied with their care. Patientreported advantages of group acupuncture include greater flexibility in length of time of appointment, and more time with the clinician. Disadvantages include perceived lack of privacy. In contrast, participants attending individual acupuncture sessions stated strong preferences for remaining in individual sessions, and were unable to imagine how group care could be feasible. Conclusions: We conclude that, despite misgivings expressed by patients who have not experienced group acupuncture, those who did participate in the group sessions were generally satisfied and reported clinical improvement.

PMID: 20305200 [PubMed - in process]

Laser acupuncture for myofascial pain of the masticatory muscles.

Schweiz Monatsschr Zahnmed. 2010;120(3):213-9

Authors: Katsoulis J, Ausfeld-Hafter B, Windecker-Gétaz I, Katsoulis K, Blagojevic N, Mericske-Stern R

Summary Purpose: The purpose of this investigation was to evaluate the effectiveness of laser acupuncture within the scope of a pilot study. Methods: 108 adult patients were examined and of those eleven patients were included in the prospective pilot study. These patients took part voluntarily and were diagnosed with tendomyopathy of the masticatory musculature with maximum face and jaw pain on a visual analogous scale VAS >/= 30 in the last 14 days. Four patients wanted to be sure not to be assigned to the placebo group and were treated with the laser (group1, verum open, N = 4). The remaining seven were split by means of block randomisation into groups 2 (verum blind, N = 3) and 3 (placebo blind, N = 4). Two local points (ST 6, SI 18) and two distant points (SI 3, LI 4) on both sides of the body were stimulated (groups 1 and 2) or placebo-stimulated (group 3) with the LASERneedle(R) machine for 15 minutes twice a week for three weeks (6 sessions). After three months a clinical follow-up was carried out, which included a standardised questionnaire as to the maximum pain intensity (VAS and verbal scale) and on the need for further treatment. A pain reduction (VAS) of about 50% was evaluated as a success.Results: Pain decreased on average 40 VAS points for ten of eleven patients. The pain reduction on the VAS in group 1 (verum open) was more than 50% for all four patients, in group 3 (placebo blind) for three of four patients, and in group 2 (verum blind) all remained under 50%. The evaluation on the verbal scale showed a pain reduction from moderate to very strong pains initially, to moderate, light and no pain after three months for all three groups. Discussion: The range of application of the laser was limited by the narrow inclusion criteria of the pilot study. The laser acupuncture (open and blinded) did not show a negative effect in any group. The pain reduction was strongest with the blinded patients of the placebo group. The worst performance was in the blinded group with laser acupuncture. Conclusion: Due to the low number of participants, no clear conclusion can be drawn. Laser needle acupuncture may be a treatment option for patients with an interest in a noninvasive, complementary therapy. But clarification and treatment planning on an individual basis must take place first.

PMID: 20238281 [PubMed - in process]

Acupuncture transmitted infections.

BMJ. 2010;340:c1268

Authors: Woo PC, Lin AW, Lau SK, Yuen KY

PMID: 20299695 [PubMed - in process]

Cancer Survivors' Spiritual Well-Being and Use of Complementary Methods: A Report from the American Cancer Society's Studies of Cancer Survivors.

J Relig Health. 2010 Mar 19;

Authors: Crammer C, Kaw C, Gansler T, Stein KD

We examined associations between spiritual well-being and CAM use among 4,139 cancer survivors. We also explored the classification of religious/spiritual practices (R/S) as CAMs and alternative subscale structures of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp). We evaluated three aspects of spirituality, Faith, Peace, and Meaning, and use of 19 CAMs in 5 domains. Mind-body methods were subdivided into R/S and non-R/S. All FACIT-Sp factors were associated with CAM use, but in different directions: Meaning and Faith were positively associated; Peace was negatively associated. Peace was negatively associated with R/S CAMs, but not non-R/S CAMs. The prevalence of CAM use dropped from 79.3 to 64.8% when R/S items were excluded. These findings confirm an association between spiritual well-being and CAM use, including some non-R/S CAMs, and provide evidence of the benefits of using the three-factor FACIT-Sp solution and treating R/S CAMs as a separate category.

PMID: 20300963 [PubMed - as supplied by publisher]

Acupuncture for essential hypertension.

Altern Ther Health Med. 2010 Mar-Apr;16(2):18-29

Authors: Kim LW, Zhu J

OBJECTIVE: To assess the efficacy of acupuncture for treatment of essential hypertension and the efficacy of acupuncture using prescription adhering to the principles of "syndrome differentiation." DATA SOURCES: Medline, Embase, Cochrane Central Register, and China National Knowledge Infrastructure (September 2008). STUDY SELECTION: Randomized, controlled trials comparing acupuncture with sham acupuncture, antihypertensive drugs, Chinese herbal medicine, or exercise in essential hypertension. DATA EXTRACTION: Two reviewers independently assessed trials for inclusion, extracted data, assessed methodological quality, and extracted outcome data on blood pressure. DATA SYNTHESIS: Treatment effects were summarized as mean differences with 95% confidence intervals. Twenty trials were included: three trials were relatively rigorous while others were methodologically suboptimal. Acupuncture arms achieved significant effect modification on blood pressure compared with control arms (19 comparisons: systolic blood pressure [SBP]: mean difference -4.23 mmHg, 95% confidence intervals -6.47 to -1.99; diastolic blood pressure [DBP]: -2.53, -3.99 to -1.08), with significant heterogeneity. In high-quality trials, blood pressure was significantly lower in treatments of acupuncture plus antihypertensive drug arms than in sham-acupuncture plus hypertensive drug arms (two comparisons: SBP: -5.72 mmHg, -8.77 to -2.68; DBP: -2.80, -5.07 to -0.54), with no significant heterogeneity. As for trials using prescription adhering to the principles of syndrome differentiation, we found a significant blood pressure reduction with acupuncture arms in comparison with control arms (11 comparisons: SBP: -6.46 mmHg, -8.04 to -4.87; DBP: -3.07, -4.17 to -1.96) with no significant heterogeneity. In contrast, in trials not using prescription adhering to the principles of syndrome differentiation, we found no significant reduction in blood pressure with acupuncture arms in comparison with control arms (eight comparisons: SBP: -1.55 mmHg, -5.39 to 2.29; DBP: -2.12, -4.97 to 0.73) with significant heterogeneity. CONCLUSIONS: Because of the paucity of rigorous trials and the mixed results, these findings result in limited conclusions. More rigorously designed and powered studies are needed.

PMID: 20232615 [PubMed - in process]

Series Mind/Body Medicine in Occupational HealthSession 3. Treatment and Management in Mind/Body Medicine.

Sangyo Eiseigaku Zasshi. 2010 Mar 17;

Authors: Nakao M

PMID: 20234117 [PubMed - as supplied by publisher]

Could integrative cancer treatment be cost-saving and resuscitate a submerged medical system?

Integr Cancer Ther. 2009 Sep;8(3):205-7

Authors: Block KI

PMID: 19815590 [PubMed - indexed for MEDLINE]

Neural correlates of focused attention and cognitive monitoring in meditation.

Brain Res Bull. 2010 Mar 8;

Authors: Manna A, Raffone A, Perrucci MG, Nardo D, Ferretti A, Tartaro A, Londei A, Del Gratta C, Belardinelli MO, Romani GL

Meditation refers to a family of complex emotional and attentional regulatory practices, which can be classified into two main styles - focused attention (FA) and open monitoring (OM) - involving different attentional, cognitive monitoring and awareness processes. In a functional magnetic resonance study we originally characterized and contrasted FA and OM meditation forms within the same experiment, by an integrated FA-OM design. Theravada Buddhist monks, expert in both FA and OM meditation forms, and lay novices with 10 days of meditation practice, participated in the experiment. Our evidence suggests that expert meditators control cognitive engagement in conscious processing of sensory-related, thought and emotion contents, by massive self-regulation of fronto-parietal and insular areas in the left hemisphere, in a meditation state-dependent fashion. We also found that anterior cingulate and dorsolateral prefrontal cortices play antagonist roles in the executive control of the attention setting in meditation tasks. Our findings resolve the controversy between the hypothesis that meditative states are associated to transient hypofrontality or deactivation of executive brain areas, and evidence about the activation of executive brain areas in meditation. Finally, our study suggests that a functional reorganization of brain activity patterns for focused attention and cognitive monitoring takes place with mental practice, and that meditation-related neuroplasticity is crucially associated to a functional reorganization of activity patterns in prefrontal cortex and in the insula.

PMID: 20223285 [PubMed - as supplied by publisher]

Development of postdural puncture headache following therapeutic acupuncture using a long acupuncture needle.

J Korean Neurosurg Soc. 2010 Feb;47(2):140-2

Authors: Jo DJ, Lee BJ, Sung JK, Yi JW

Acupuncture appears to be a clinically effective treatment for acute and chronic pain. A considerable amount of research has been conducted to evaluate the role that acupuncture plays in pain suppression; however, few studies have been conducted to evaluate the side effects of the acupuncture procedure. This case report describes a suspected postdural puncture headache following acupuncture for lower back pain. Considering the high opening pressure, cerebrospinal fluid leakage, and the patient's history of acupuncture in the lower back area, our diagnosis was iatrogenic postdural puncture headache. Full relief of the headache was achieved after administration of an epidural blood patch.

PMID: 20224715 [PubMed - in process]