How Physicians and Nursing Staff Perceive Effectiveness and Tolerability of Bryophyllum Preparations: An Online Survey in an Anthroposophic Hospital.

BACKGROUND: Bryophyllum preparations are widely used in anthroposophic medicine, most often for mental and behavioural disorders. Three prospective studies have revealed positive effects of Bryophyllum pinnatum on sleep quality, and various trials have shown very good tolerability. Results from animal models have indicated CNS depressant and anxiolytic effects. This survey was conducted at the hospital "Klinik Arlesheim" in Switzerland to find out how the physicians and the nursing staff perceive the effectiveness and the tolerability of the Bryophyllum preparations they most frequently use. DESIGN: Internal, anonymous online survey of healthcare professionals (April 8-May 31, 2022). The questionnaire comprised 105 multiple-choice questions. Answering the questions was taken as consent to participate in the survey. PARTICIPANTS AND METHODS: All physicians and nursing staff with a valid email address at the hospital "Klinik Arlesheim AG" were invited via email to participate in this REDCap survey. The data were analysed descriptively. RESULTS: Out of 266 invited participants, 48 answered some and 36 answered all questions (response rate between 18.0% and 13.5%). The participants had long experience with Bryophyllum preparations and were comprised approximately equal numbers of physicians and nursing staff. Various Bryophyllum preparations from the hospital's own production and Wala Heilmittel GmbH (in both cases produced from the species B. daigremontianum) and from Weleda AG (species B. pinnatum) were used. The indications for which most participants had prescribed or administered Bryophyllum preparations "very frequently" were anxiety, sleep disorders, crisis situations in oncology, posttraumatic stress disorder, benzodiazepine dependence/withdrawal, and depression. Improvements such as relief from restlessness, decreased anxiety, balance, easier falling asleep, better sleeping through, increased resilience, mood elevation, and less urge to move one's legs were reported "frequently" or "very frequently." Almost all participants agreed that Bryophyllum can be used to reduce the intake of synthetic sedatives or psychotropic drugs, but only approximately half believed that it could replace them. The majority of participants mentioned good tolerability of the various products, but a few reported occasional stomach or intestinal irritation, daytime fatigue, drowsiness, diarrhoea, and nausea. CONCLUSION: Bryophyllum preparations are perceived as helpful in the treatment of various mental disorders, particularly anxiety, and are generally well tolerated. Most of these preparations are used for indications that have not yet been clinically investigated.Bryophyllum-Präparate werden in der Anthroposophischen Medizin sehr häufig zur Behandlung von psychischen und Verhaltensstörungen eingesetzt. Drei prospektive Studien zeigten zudem positive Wirkungen von Bryophyllum pinnatum (BP) auf die Schlafqualität. Auch die Verträglichkeit wurde in allen bisherigen Studien als sehr gut bewertet. In Tiermodellen wurden ZNS-depressive und anxiolytische Effekte von BP festgestellt. Die hier durchgeführte Umfrage fand an der Klinik Arlesheim (Schweiz) statt. Sie diente dazu herauszufinden, wie Ärztinnen und Ärzte sowie das Pflegepersonal die Wirksamkeit und Verträglichkeit der von ihnen am häufigsten verwendeten Bryophyllum-Präparate wahrnehmen.Interne, anonyme, Online-Befragung unter ärztlichen und pflegerischen Fachkräften (8. April­31. Mai 2022). Der Fragebogen umfasste 105 Multiple-Choice-Fragen. Die Beantwortung der Fragen wurde als Zustimmung zur Teilnahme an der Umfrage interpretiert.Alle Ärztinnen, Ärzte und Pflegefachpersonen mit einer gültigen E-Mail-Adresse der "Klinik Arlesheim AG" wurden per E-Mail eingeladen, an dieser REDCap-Umfrage teilzunehmen. Die Daten wurden deskriptiv ausgewertet.Von den 266 eingeladenen Teilnehmenden beantworteten 48 einige und 36 alle Fragen (Antwortquote zwischen 18.0% und 13.5%). Die Teilnehmenden hatten langjährige Erfahrung mit Bryophyllum-Präparaten und setzten sich etwa zu gleichen Teilen aus ärztlichen und pflegerischen Fachkräften zusammen. Die Resultate zeigen, dass verschiedenste Bryophyllum-Präparate aus klinikeigener Herstellung, von der Wala Heilmittel GmbH (Art B. daigremontianum) und von der Weleda AG (Art B. pinnatum) verwendet werden. Zu den Indikationen, bei denen die meisten Teilnehmenden Bryophyllum-Präparate "sehr häufig" verordnet oder angewendet haben, gehören Angstzustände, Schlafstörungen, Krisensituationen in der Onkologie, Posttraumatische Belastungsstörung, Benzodiazepin-Abhängigkeit/Entzug und Depressionen. Gesundheitsverbesserungen wie Linderung von Unruhe, verminderte Angst, Ausgeglichenheit, leichteres Einschlafen, besseres Durchschlafen, erhöhte Belastbarkeit, Stimmungsaufhellung und weniger Drang, die Beine zu bewegen, wurden als "häufig" oder "sehr häufig" angegeben. Fast alle Teilnehmenden waren sich einig, dass Bryophyllum verwendet werden kann, um die Einnahme von synthetischen Beruhigungsmitteln oder Psychopharmaka zu reduzieren, aber nur etwa die Hälfte gab an, dass es diese ersetzen kann. Die Mehrheit der Teilnehmenden spricht von einer guten Verträglichkeit der verschiedenen Produkte. Einige wenige berichteten von gelegentlicher Magen- oder Darmreizung, Tagesmüdigkeit, Schläfrigkeit, Durchfall und Übelkeit.Bryophyllum-Präparate werden als hilfreich bei der Behandlung verschiedener psychischen Störungen, insbesondere bei Angstzuständen, angesehen und im Allgemeinen gut vertragen. Die meisten der angegebenen Präparate werden für Indikationen verwendet, die noch nicht klinisch untersucht worden sind.

Clinical characteristics and therapeutic behavior of breast cancer patients using mistletoe therapy consulting a clinic offering integrative oncology: a registry data analysis.

MOTIVATION: Cancer patients often use complementary and/or alternative medicine, such as mistletoe therapy, alongside conventional cancer therapies. In Switzerland, so far not much is known about treatment patterns of breast cancer patients using integrative oncology. Solid knowledge on complementary care utilization may help to enhance integrative oncology care in Switzerland. METHODS: In this exploratory, descriptive database study, we investigated the treatment pathways of a cohort of breast cancer patients who received mistletoe therapy and were documented in the cancer registry of an anthroposophic Swiss hospital offering integrative oncology treatments. RESULTS: Patients treated with mistletoe in this cohort are in median 10 years younger than Swiss breast cancer patients as a whole. Only 5.8% of these patients were treated with mistletoe alone, while 60.5% of them supplemented chemotherapy and/or hormone therapy and/or surgery and/or radiation with mistletoe therapy. Nearly 80% of patients started conventional therapy followed by additional mistletoe therapy or started mono mistletoe therapy after completion of conventional therapies. The median time from initial diagnosis to hospital admission (inpatient and/or outpatient) was less than one year. Almost ¾ of the patients were treated in an outpatient setting only. CONCLUSION: From our data, it appears that younger breast cancer patients are more likely to use mistletoe therapy simultaneously with or following their conventional medical therapies. The extent to which these patients discuss their mistletoe therapy and eventually other complementary and/or alternative therapies with their primary oncologists is not clear from the data. We therefore recommend that (Swiss) oncologists should openly discuss the desire for integrative oncology therapies, especially with their younger breast cancer patients, in order to find the best holistic care pattern for these patients.

Unexpected Cardiovascular Oscillations at 0.1 Hz During Slow Speech Guided Breathing (OM Chanting) at 0.05 Hz.

Slow breathing at 0.1 Hz (i.e., 6 cycles per minute, cpm) leads to strong cardiovascular oscillations. However, the impact of breathing below 6 cpm is rarely addressed. We investigated the influence of OM chanting, an ancient Indian mantra, with approx. 3 respiratory cpm (0.05 Hz) on the synchronisation of heart period (RR), respiration (RESP) and systolic blood pressure (SBP). Nine healthy, trained speech practitioners chanted three sequences of five subsequent OM with 2 min pauses in between. Each single OM chanting consisted of taking a deep breath and a long "OM" during expiration and lasted approx. 20 s. ECG, respiration and blood pressure were recorded continuously, of which the RR tachogram, RESP and SBP were derived. Synchronisation between the signals was computed using the phase difference between two signals. During OM chanting synchronisation among the oscillations of RR, SBP and RESP was significantly increased compared to rest. Furthermore, OM chanting at breathing frequencies between 0.046 and 0.057 Hz resulted in 0.1 Hz oscillations in RR and SBP. In conclusion, OM chanting strongly synchronized cardiorespiratory and blood pressure oscillations. Unexpected oscillations at 0.1 Hz in SBP and RR appear at breathing frequencies of approx. 0.05 Hz. Such frequency doubling may originate from an interaction of breathing frequency with endogenous Mayer waves.

Parents' vaccination information seeking, satisfaction with and trust in medical providers in Switzerland: a mixed-methods study.

OBJECTIVES: The aim of this study was to better understand parental trust in and satisfaction with information sources and medical providers regarding decision making about childhood vaccines. SETTING: The study was part of a Swiss national research programme investigating vaccine hesitancy and underimmunisation. PARTICIPANTS: We conducted qualitative interviews with 37 providers and 30 parents, observed 34 vaccination consultations, and then conducted quantitative surveys with 130 providers (both complementary and alternative medicine (CAM) oriented and biomedically oriented) and 1390 parents. MAIN OUTCOME MEASURES: Participants' vaccination information sources used in their decision-making process, parents' trust in and satisfaction with these sources and providers. RESULTS: Based on the Parent Attitudes about Childhood Vaccines scale, we considered 501 parents as vaccine-hesitant (VH) and 889 parents as non-VH. Whereas both groups mentioned providers as the most trusted source of information, VH-parents were less likely to mention paediatricians (N=358 (71%) vs N=755 (85%)) and public health authorities (N=101 (20%) vs N=333 (37%)) than non-VH-parents. VH-parents were more likely to have consulted another provider (N=196 (39%) vs N=173 (19%)) than non-VH-parents, to express less satisfaction with both their primary (N=342 (82%) vs N=586 (91%)) and other providers (N=82 (42%) vs N=142 (82%)) and less trust in their primary (N=368 (88%) vs N=632 (98%)) and other providers (N=108 (55%) vs N=146 (84%)). VH-parents were less likely to be satisfied with their biomedical primary provider than non-VH-parents (100 (69%) vs 467 (91%)). However, when the primary provider was CAM-oriented, there were similar levels of satisfaction among both groups (237 (89%) VH-parents vs 118 (89%) non-VH-parents). All differences were significant (p<0.05). CONCLUSIONS: While the provider remains the main information source, VH parents turn to additional sources and providers, which is likely related to VH parents being rather dissatisfied with and distrusting in obtained information and their provider. ETHICS: The local ethics committee (Ethikkommission Nordwest- und Zentralschweiz, EKNZ; project ID number 2017-00725) approved the study.

Determinants of vaccine hesitancy in Switzerland: study protocol of a mixed-methods national research programme.

INTRODUCTION: Vaccine hesitancy is a complex public health issue referring to concerns about the safety, efficacy or need for vaccination. Relatively little is known about vaccine hesitancy in Switzerland. This ongoing study (2017-2021) focuses on biomedical and complementary and alternative medicine (CAM) providers and their patients since healthcare professionals play important roles in vaccination decision-making. This national research programme seeks to assess the sociocultural determinants of vaccine hesitancy regarding childhood and human papillomavirus vaccines in Switzerland. We aim to provide a detailed characterisation of vaccine hesitancy, including CAM and biomedical perspectives, patient-provider interactions, and sociocultural factors, to establish the mediating effects of vaccine hesitancy on underimmunisation, and to design an intervention to improve vaccination communication and counselling among physicians, parents and adolescents. METHODS AND ANALYSIS: Our transdisciplinary team employs a sequential exploratory mixed-methods study design. We have established a network of more than 150 medical providers across Switzerland, including more than 40 CAM practitioners. For the qualitative component, we conduct interviews with parents, youth, and biomedical and CAM providers and observations of vaccination consultations and school vaccination information sessions. For the quantitative component, a sample of 1350 parents of young children and 722 young adults (15-26 years) and their medical providers respond to questionnaires. We measure vaccine hesitancy with the Parent Attitudes about Childhood Vaccines 15-item survey and review vaccination certificates to assess vaccination status. We administer additional questions based on findings from qualitative research, addressing communication with medical providers, vaccine information sources and perceptions of risk control vis-à-vis vaccine-preventable diseases. The questionnaires capture sociodemographics, political views, religion and spirituality, and moral foundations. ETHICS AND DISSEMINATION: The study was approved by the local ethics committee. The results will be published in peer-reviewed journals and disseminated to healthcare professionals, researchers and the public via conferences and public presentations.

Can Speech-Guided Breathing Influence Cardiovascular Regulation and Mood Perception in Hypertensive Patients?

OBJECTIVES: Anthroposophic therapeutic speech (ATS) has been shown to positively influence heart rate variability (HRV) and cardiorespiratory coordination in healthy volunteers. This prospective, exploratory, pre-post study was performed to investigate ATS effects on baroreflex sensitivity (BRS), heart rate (HR), HRV by standard deviation of beat to beat intervals (SDNN), blood pressure (BP), and mood in hypertensive patients. DESIGN: Patients received three ATS treatments, alternating with three sham interventions (control). During the sessions, BP and electrocardiography were continuously recorded. BRS and SDNN were analyzed from those measurements. Changes in mood score were assessed by a questionnaire. All data were compared before and after intervention (ATS and control). RESULTS: Thirty-one patients participated, the majority diagnosed with arterial hypertension (22 out of 31). Pre-post analysis of the data revealed immediate and significant changes in hypertensive patients during control and ATS with respect to BRS (control: 6.57 to 6.92 msec/mmHg, p = 0.0349; ATS: 6.03 to 7.27 msec/mmHg, p < 0.0001), SDNN (control: 39 to 42 msec, p = 0.0058; ATS: 38 to 43 msec, p = 0.0003), and HR (control: 74 to 71 beats per minute [bpm], p < 0.0001; ATS: 74 to 70 bpm, p < 0.0001). In normotensive patients, those changes were generally less pronounced and less significant with respect to BRS (control: 8.13 to 8.56 msec/mmHg, p = 0.1102; ATS: 8.20 to 8.98 msec/mmHg, p = 0.0273), SDNN (control: 36 to 40 msec, p = 0.0002; ATS: 35 to 38 msec, p = 0.0556), and HR (control: 80 to 77 bpm, p < 0.0001; ATS: 80 to 78 bpm, p < 0.0011). Only in hypertensive patients significant long-term changes were observed for BRS (6.6 to 7.7 msec/mmHg, p = 0.0070), SDNN (39.1 to 45.5 msec, p = 0.0074), and HR (75.8 to 67.2 bpm, p = 0.0001). No significant long-term changes were observed in normotensive patients. The mean systolic BP did not change significantly during this study. Both ATS and control also yielded improvements in the mood summary score, which again were more apparent for ATS than for sham interventions, but these were more pronounced among normotensive patients (3.5 to 4.2) than for hypertensive patients (2.9 to 3.9). CONCLUSION: The results indicate that ATS has the potential to improve cardiovascular parameters which play an important role in BP regulation capability.

Physiologic effects of rhythmical massage: a prospective exploratory cohort study.

OBJECTIVE: This study was performed to characterize the physiologic effects of rhythmical massage (RM), an anthroposophic therapy whose effectiveness is supported by empirical observations and a prospective observational study. METHODS: Patients referred to RM at the Paracelsus Hospital Richterswil for any indication were continuously enrolled. They received an average of 10 RM sessions, which included not only the massage but also therapeutic rest in the supine position immediately thereafter. Effects of RM on surface temperature and on heart rate variability (HRV) were determined with infrared imaging (IRI) and electrocardiography (ECG), respectively. IRI of the patients' dorsal region was performed without clothes, in standing position, at the start and at the end of two waiting periods before and after RM. ECG was performed from the beginning of the first waiting period until the end of the second one. RESULTS: Results on IRI from 9 and ECG from 11 patients could be analyzed. RM led to an immediate increase in dorsal temperature. Furthermore, comparison of the IRI images for consecutive RM sessions showed a tendency toward improved warmth distribution as a progressive therapy effect. Analysis of the EGC results recorded during the waiting periods-in the sitting position--showed a significant increase of HRV after RM, as detected by the standard deviation of the beat-to-beat periods and a relative increase of low-frequency power. During the course of the RM sessions, the change in HRV during the therapeutic rest period depended on the initial value: Low initial values were enhanced, whereas high ones were reduced. CONCLUSIONS: RM led to an immediate increase in the patient's dorsal surface temperature, as well as increased HRV and sympathetic stimulation. In the long term, RM resulted in a progressive improvement of warmth distribution and regulation of the resting HRV.

Liquid crystal fibers of bent-core molecules.

Although the liquid-crystal research is well established in science, there are newly emerging exciting systems, that deserve extensive basic studies. One of these areas is the research of the bent-shaped molecules (so-called "banana liquid crystals"), which have delicate chirality and polarity properties. In this paper we show that these materials also have very unusual rheological features, such as the formation of stable fluid fibers and bridges. Under electric fields, these objects present striking mechanical effects, such as horizontal and transversal vibrations. Studies indicate that the research of banana-liquid-crystal fibers may lead to new type of artificial muscle systems.