Psychological effects of Yi Ren Medical Qigong and progressive resistance training in adults with type 2 diabetes mellitus: a randomized controlled pilot study.

BACKGROUND: Previous studies suggest that qigong therapy has physiological benefits for adults with type 2 diabetes; however, information about the psychological benefits of qigong therapy in this population is limited. OBJECTIVE: The objective of this research project was to identify psychological responses to qigong vs control interventions in adults with type 2 diabetes. DESIGN: The research team designed a randomized, controlled, three-arm clinical trial comparing 12 weeks of Yi Ren Medical Qigong (YRMQ), progressive resistance training (PRT), and standard care. SETTING: The study was performed at Bastyr University Research Institute, Kenmore, Washington. PARTICIPANTS: Participants were 13 men and 19 women (N=32) with diagnosed type 2 diabetes, a mean age of 56.3 ± 8.1 (standard deviation) years, glycated hemoglobin > 7.5%, and fasting blood glucose > 7 mmol/dL (126 mg/dL). INTERVENTION: For 12 weeks, participants in the YRMQ and PRT group attended a 1-hour weekly group session that a certified instructor led and were instructed to practice at least twice a week for 30 minutes. PRIMARY OUTCOME MEASURES: The research team used the Perceived Stress Scale and the Beck Depression Inventory scores to analyze the data. RESULTS: YRMQ decreased perceived-stress scores by 29.3% (P < .05) and depression scores by 14.3% (not significant [NS]). The active control group, PRT, also decreased stress scores by 18.6% (NS) and decreased depression scores by 50% (P < .03). Stress and depression measures remained unchanged in the standard care group. CONCLUSION: YRMQ and PRT may be beneficial in reducing perceived stress and improving depression in patients with type 2 diabetes, although verification of the clinical significance of these findings requires a longer study with a larger sample size.

Omega-7 Mixed Fatty Acid Supplementation Fails to Reduce Serum Inflammatory Biomarkers: A Placebo-Controlled, Double-Blind Randomized Crossover Trial.

We report the effects of mixed omega-7 fatty acid supplementation on changes in serum hsCRP, TNFα, and IL-6 levels and self-reported outcomes in people with non-specific chronic musculoskeletal discomfort. DESIGN: A double-blind, placebo-controlled, 1:1 randomized single crossover trial composed of 688 mg/day palmiteolate for the verum and an equivalent amount of medium-chain triglycerides for the placebo. METHOD: Data were analyzed in two independent groups and as a crossover group. RESULTS: From 211 screened participants in 2017-2019, 56 were randomized. Six participants dropped out and fifty completers contributed to the statistical analyses. At baseline, none of the investigated biomarkers were significantly correlated to subjectively assessed musculoskeletal discomfort levels. For the two-group analysis (n = 26 and n = 24), none of the serum biomarkers reached statistical significance; however, a statistically significant placebo effect was found in the subjective outcomes. CONCLUSION: For the crossover analysis (n = 50), three weeks of supplementation with n7FA containing 688 mg per day of palmiteolate did not reduce serum inflammatory biomarkers nor did it improve subjectively measured quality of life (QoL) compared to placebo. Future studies should explore appropriate biomarkers, sufficient power, length of dosing, inclusion criteria for volunteers with higher BMI, and the verification of cis-palmiteolate versus trans-palmiteolate.

Concept map of dispositional humility among professionals in an interdisciplinary healthcare environment: qualitative synthesis.

BACKGROUND: US healthcare consumers increasingly demand more integrative medical care. Collaboration among clinicians trained in different professional disciplines and specialties may require particular character traits and/or training that focus on factors that facilitate effective collaborative work. Dispositional humility may be a factor that balances self-focused desire for recognition with other-focused professional collaboration to serve patients. The objective of this paper is to create a concept map of dispositional humility in healthcare professionals as a factor to enhance collaboration. METHODS: Articles published between 1997 and 2017 were searched using the term "dispositional humility" or titles containing "humility" AND either "leadership," "cultural," "religious," "relational," or "personality." The abstracts were screened for relevance and full articles were located. To strengthen the scientific rigor of qualitative work by systematizing a method of concept analysis, the Walker and Avant's eight-step concept analysis was used. RESULTS: Ninety-five articles were reviewed in the qualitative synthesis, including 82 full-text articles from the original search and 13 full-text articles containing the concepts "empathy," "professionalism" or "openness" identified from references found in the 82 articles. A concept map was created after interpreting the contents of these articles. CONCLUSIONS: Collaboration requires not only professional competency but also positive dispositional factors. Dispositional humility allows clinicians to have an accurate self-assessment, to be open to new ideas, to appreciate the contribution of others, and to develop generosity. Dispositional humility in leaders can facilitate character development of team members and create an environment characterized by fairness and equality, transparency, non-punitive consequences for reporting errors and near-misses, and a safe and encouraging environment. Nonetheless, dispositional humility must be nurtured and developed through professional training because high educational attainment, career and financial success, and busy schedules may lead to a sense of self-importance and entitlement that promotes separation of team members into hierarchies based on professional disciplines and specialties.

Dispositional Humility Of Clinicians In An Interprofessional Primary Care Environment: A Mixed Methods Study.

OBJECTIVES: Dispositional humility in professionals is a character trait that allows one to monitor self-centered occupational drive and to pay attention to the needs of other professionals. The aim of this study is to test whether or not clinicians working in interprofessional team care environments identify the character trait of humility as an important factor for successful collaborative relationships. This study aimed to revise a concept map of dispositional humility created through literature review. DESIGN: An explanatory sequential mixed-methods study was composed of the HEXACO personality test and the Integrative Medicine Attitude Questionnaire, followed by summative and directed content analyses of one-on-one interview data in order to identify the element of dispositional humility. SETTING: In the State of Washington, USA, where physicians (MD/DO), nurse practitioners (NP) and naturopathic clinicians (ND) serve Medicaid patients in community clinics. PARTICIPANTS: 6 MDs, 4 NPs, and 11 NDs. RESULTS: Twenty-one primary care clinicians were enrolled. Fifteen clinicians completed the interview. It was observed that the: 1) honesty-humility trait (p<0.01), conscientiousness (&p<0.01), and openness to experience (p<0.05) domains of primary care clinicians were statistically significantly higher than the reference standards; 2) attitudes toward integrative medicine did not differentiate the different clinician types; and 3) qualitative data supported the component of dispositional humility as a desirable trait in professionals with whom they would like to work. CONCLUSION: To maintain high-quality patient care while working as a team, limiting self-interest while focusing on the needs of others may be necessary and in the best interest of patients. An attitude of accepting the principles of integrative medicine has permeated this sample of primary healthcare workers. Both quantitative and qualitative analyses revealed that humility was viewed as an important character trait for successful interprofessional collaboration. A revised concept map of dispositional humility to enhance collaborative relationships was created.

Positive correlation between the use of complementary and alternative medicine and internal health locus of control.

BACKGROUND: Because many people with chronic medical conditions use complementary and alternative medicine (CAM), understanding their psychosocial characteristics may be useful for identifying effective interventions. The health locus of control (HLOC) measures the perception of controlling one's own health outcomes by various attributes. People with a high internal HLOC believe that the outcome of their own health seeking is related to their behavior or personal investment. Earlier evidence has shown that a higher internal HLOC is a predictive factor of positive treatment outcomes. OBJECTIVE: This study measured the correlation between the degree of CAM use and the level of HLOC. DESIGN: An online cross-sectional survey was conducted via public bulletin boards and invitational e-mails. Data from 123 usable responses were analyzed for bivariate correlation between CAM use and HLOC. Subjective reports of various medical modalities were classified into six CAM domains and one conventional biomedicine domain. Subscales of HLOC included internal, chance, and powerful others. Chronic conditions, health status, and demographics were self-reported. RESULTS: Internal HLOC significantly correlated with CAM use (Spearman's rho, P < .004) but not with conventional medicine use (Spearman's rho, P > .130). Further analysis of this correlation for those people with chronic conditions could not identify a particular domain used more by people with a high internal HLOC (P > .187), but the lesser use of conventional medicine was significant (P < .031). CONCLUSION: Complementary and alternative medicine is either empowering or has empowered patients to use CAM. People who use CAM may have a better prognosis and better management of chronic conditions.

Echinacea alkylamides inhibit interleukin-2 production by Jurkat T cells.

Alkylamides present in Echinacea species have reported immunomodulatory actions, yet their direct effects on T lymphocytes, key mediators of antiviral immunity, are poorly understood. We hypothesized that constituents present in ethanolic extracts of Echinacea species exert direct immunomodulatory effects on human Jurkat T cells. Modulation of IL-2 production by submaximally stimulated Jurkat cells was determined in response to treatment with extracts prepared from dried aerial parts of Echinacea purpurea. Cells were treated with the extracts, with alkylamides or caffeic acid derivatives isolated from Echinacea species, or with corresponding ethanol vehicle, in the absence or presence of phytohemagglutinin and phorbal ester. E. purpurea extracted in a solvent mixture of 95:5 ethanol/water dose-dependently inhibited IL-2 production. This IL-2 inhibitory activity correlated with the presence of alkylamides but not caffeic acid derivatives, as determined by high performance liquid chromatography/electrospray ionization-mass spectrometry analysis. Simultaneous measurement of secreted IL-2 by ELISA and cell viability by the XTT assay showed that the 95:5 ethanol/water extract of E. purpurea was both IL-2 suppressive and cytotoxic at 50 and 100 microg/mL. Lower concentrations from 6.25 to 25 microg/mL significantly decreased IL-2 production but not cell viability. Alkylamides at concentrations found in a 50 microg/mL extract decreased IL-2 production by approximately 50%. Two Echinacea-derived alkylamides significantly depressed IL-2 production but not cell viability in a dose-dependent manner. Thus, alkylamides present in E. purpurea suppress the ability of activated Jurkat T cells to produce IL-2 independently of direct, cytotoxic effects.

Phase 1 Clinical Trial of Trametes versicolor in Women with Breast Cancer.

Introduction. Orally administered preparations from the Trametes versicolor (Tv) mushroom have been hypothesized to improve immune response in women with breast cancer after standard chemotherapy and radiotherapy. Methods. A phase I, two-center, dose escalation study was done to determine the maximum tolerated dose of a Tv preparation when taken daily in divided doses for 6 weeks after recent completion of radiotherapy. Eleven participants were recruited and nine women completed the study. Each cohort was comprised of three participants given one of three doses of Tv (3, 6, or 9 grams). Immune data was collected pre- and postradiation, at 3 on-treatment time points and after a 3-week washout. Results. Nine adverse events were reported (7 mild, 1 moderate, and 1 severe), suggesting that Tv was well tolerated. Immunological results indicated trends in (1) increased lymphocyte counts at 6 and 9 grams/day; (2) increased natural killer cell functional activity at 6 grams/day; (3) dose-related increases in CD8(+) T cells and CD19(+) B cells , but not CD4(+) T cells or CD16(+)56(+) NK cells. Conclusion. These findings show that up to 9 grams/day of a Tv preparation is safe and tolerable in women with breast cancer in the postprimary treatment setting. This Tv preparation may improve immune status in immunocompromised breast cancer patients following standard primary oncologic treatment.

Liver enzyme-mediated oxidation of Echinacea purpurea alkylamides: production of novel metabolites and changes in immunomodulatory activity.

The medicinal plant Echinacea is widely used to treat upper respiratory infections and is reported to stimulate the human immune system. A major constituent class of Echinacea, the alkylamides, has immunomodulatory effects. Recent studies show that alkylamides are oxidized by cytochrome P450 enzymes, but the immunomodulatory activity of these products is unknown. The objectives of this study were to characterize the products formed by incubation of an Echinacea extract and an isolated alkylamide with human liver microsomes, and to evaluate the influence of Echinacea alkylamides and metabolites on cytokine production by Jurkat human T cells. A novel class of carboxylic acid alkylamide metabolites was identified and shown to be the major constituents present after 2-h incubation of alkylamides with human liver microsomes. Echinacea alkylamides suppressed IL-2 secretion by stimulated T cells, and this effect was significantly lessened upon oxidation of the alkylamides to carboxylic acids and hydroxylated metabolites. These findings highlight the importance of considering the influence of liver enzyme metabolism when evaluating the immunomodulatory effects of alkylamides.