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American Journal of Industrial Medicine Jun 2024U.S. construction workers experience high rates of injury that can lead to chronic pain. This pilot study examined nonpharmacological (without medication prescribed by...
BACKGROUND
U.S. construction workers experience high rates of injury that can lead to chronic pain. This pilot study examined nonpharmacological (without medication prescribed by healthcare provider) and pharmacological (e.g., prescription opioids) pain management approaches used by construction workers.
METHODS
A convenience sample of U.S. construction workers was surveyed, in partnership with the U.S. National Institute for Occupational Safety and Health (NIOSH) Construction Sector Program. Differences in familiarity and use of nonpharmacological and pharmacological pain management approaches, by demographics, were assessed using logistic regression models. A boosted regression tree model examined the most influential factors related to pharmacological pain management use, and potential reductions in use were counterfactually modeled.
RESULTS
Of 166 (85%) of 195 participants reporting pain/discomfort in the last year, 72% reported using pharmacological pain management approaches, including 19% using opioids. There were significant differences in familiarity with nonpharmacological approaches by gender, education, work experience, and job title. Among 37 factors that predicted using pharmacological and non-pharmacological pain management approaches, training on the risks of opioids, job benefits for unpaid leave and paid disability, and familiarity with music therapy, meditation or mindful breathing, and body scans were among the most important predictors of potentially reducing use of pharmacological approaches. Providing these nonpharmacological approaches to workers could result in an estimated 23% (95% CI: 16%-30%) reduction in pharmacological pain management approaches.
CONCLUSION
This pilot study suggests specific factors related to training, job benefits, and worker familiarity with nonpharmacological pain management approaches influence use of these approaches.
PubMed: 38899539
DOI: 10.1002/ajim.23630 -
International Journal of Yoga 2024Infertility, a widespread medical condition affecting numerous couples globally, persists as a challenge despite advances in assisted reproductive technologies (ARTs),... (Review)
Review
Infertility, a widespread medical condition affecting numerous couples globally, persists as a challenge despite advances in assisted reproductive technologies (ARTs), often burdened by financial, physical, and emotional strains. Complementary and alternative approaches, notably yoga, have garnered attention for potentially enhancing fertility outcomes. Studies reveal yoga's influence on factors contributing to infertility, including reduced oxidative stress (OS) and oxidative DNA damage (ODD). OS, linked to mutagenic base formation, higher malondialdehyde levels, abnormal methylation, and altered gene expression, can impair sperm genome integrity. Yoga's efficacy is evident in lowering OS, positively affecting signal transmission, gene expression, and physiological systems. Furthermore, yoga has a positive impact on addressing the dysregulation of apoptosis, resulting in improved processes such as spermatogenesis, sperm maturation, and motility, while also reducing DNA fragmentation. OS correlates with genome-wide hypomethylation, telomere shortening, and mitochondrial dysfunction, contributing to genome instability. Yoga and meditation significantly reduce OS and ODD, ensuring proper reactive oxygen levels and preserving physiological systems. The review explores potential mechanisms underlying yoga's positive impact on infertility, including enhanced blood flow, reduced inflammation, relaxation response, and modulation of the hypothalamic-pituitary-adrenal axis. Furthermore, a comprehensive review of the literature reveals substantial evidence supporting the positive effects of yoga on infertility factors. These include oxidative stress (OS), oxidative DNA damage (ODD), epigenetic changes, hormonal balance, ovarian function, menstrual irregularities, and stress reduction. In summary, yoga emerges as a promising adjunctive therapy for infertility, demonstrating the potential to mitigate key factors influencing reproductive success. Although preliminary evidence indicates the positive effects of yoga on infertility, further clinical research is imperative to define specific benefits, molecular mechanisms associated, optimal protocols, and long-term effects in infertility treatment plans.
PubMed: 38899142
DOI: 10.4103/ijoy.ijoy_211_23 -
International Journal of Yoga 2024Depression has been expected to be the second-leading cause of disability, followed by autism, attention and hyperactivity disorder, and learning disorder. Yoga therapy... (Review)
Review
BACKGROUND
Depression has been expected to be the second-leading cause of disability, followed by autism, attention and hyperactivity disorder, and learning disorder. Yoga therapy has found to be beneficial in managing psychiatric disorders.
AIM
The present study undertakes a scoping review of research on yoga therapy in psychiatric disorders among children and adolescents.
METHODS
Online database was used to identify papers published 2004-2023, from which we selected 11 publications from the United States, Canada, Iran, India, and Australia that used yoga therapy as a primary outcome variable among participants aged 3 years or older.
RESULTS
The papers reviewed were randomized controlled trials. All studies examined yoga therapy, but one study used mindfulness-based therapy and used few techniques of yoga therapy. The studies examined the effect of yoga therapy on early childhood and adolescence on various psychiatric symptoms such as stress, inattention, hyperactivity, anxiety, depression, and many more.
CONCLUSION
While the quality of studies is generally high, research on yoga therapy among children and adolescents with psychiatric disorders would benefit from careful selection of methods and reference standards, suitability for yoga therapy, and prospective cohort studies linking early childhood exposures with yoga therapy outcomes throughout childhood and adolescence.
PubMed: 38899134
DOI: 10.4103/ijoy.ijoy_227_23 -
Frontiers in Psychology 2024Although Cognitive Behavioral Therapy (CBT) is the most often used intervention in forensic treatment, its effectivity is not consistently supported. Interventions...
INTRODUCTION
Although Cognitive Behavioral Therapy (CBT) is the most often used intervention in forensic treatment, its effectivity is not consistently supported. Interventions incorporating knowledge from neuroscience could provide for more successful intervention methods.
METHODS
The current pilot study set out to assess the feasibility and usability of the study protocol of a 4-week neuromeditation training in adult forensic outpatients with impulse control problems. The neuromeditation training, which prompts awareness and control over brain states of restlessness with EEG neurofeedback, was offered in addition to treatment as usual (predominantly CBT).
RESULTS
Eight patients completed the neuromeditation training under guidance of their therapists. Despite some emerging obstacles, overall, the training was rated sufficiently usable and feasible by patients and their therapists.
DISCUSSION
The provided suggestions for improvement can be used to implement the intervention in treatment and set up future trials to study the effectiveness of neuromeditation in offender treatment.
PubMed: 38899124
DOI: 10.3389/fpsyg.2024.1354997 -
Sleep Jun 2024Mindfulness-based interventions (MBI) have been shown to improve psychosocial functioning in medical populations but have not been studied in narcolepsy. This study...
STUDY OBJECTIVES
Mindfulness-based interventions (MBI) have been shown to improve psychosocial functioning in medical populations but have not been studied in narcolepsy. This study examined the feasibility and acceptability of an MBI that was adapted for narcolepsy, including three variations in program length.
METHODS
Adults with narcolepsy (N = 60) were randomized to MBI groups of varying durations: brief (4 weeks), standard (8 weeks), or extended (12 weeks). Participants completed assessments at baseline, 4 weeks, 8 weeks, and 12 weeks. To assess feasibility and acceptability, primary outcomes included attendance, meditation practice, and data completeness. Additionally, participants completed measures of mindfulness, self-compassion, mood, sleep, psychosocial functioning, and cognition. An effect size of Cohen's d ≥ 0.5 was used as the pre-specified benchmark for a minimal clinically important difference (MCID).
RESULTS
The attendance, meditation, and data completeness benchmarks were met by 71.7%, 61.7%, and 78.3% of participants, respectively. Higher proportions of the brief and extended groups met these benchmarks compared to the standard group. All groups met the MCID for mindfulness, self-compassion, self-efficacy for managing emotions, positive psychosocial impact, global mental health, and fatigue. Standard and extended groups met the MCID for anxiety and depression, and extended group met the MCID for additional measures including social and cognitive functioning, daytime sleepiness, hypersomnia symptoms, and hypersomnia-related functioning.
CONCLUSION
Results suggest that the remote delivery and data collection methods are feasible to employ in future clinical trials, and it appears that the extended MBI provides the most favorable clinical impact while maintaining attendance and engagement in meditation practice.
PubMed: 38895897
DOI: 10.1093/sleep/zsae137 -
Journal of Materials Chemistry. B Jun 2024Carrier-free nanomedicines offer advantages of extremely high drug loading capacity (>80%), minimal non-drug constituent burden, and facile preparation processes....
Carrier-free nanomedicines offer advantages of extremely high drug loading capacity (>80%), minimal non-drug constituent burden, and facile preparation processes. Numerous studies have proved that multimodal cancer therapy can enhance chemotherapy efficiency and mitigate multi-drug resistance (MDR) through synergistic therapeutic effects. Upon penetration into the tumor matrix, nanoparticles (NPs) are anticipated to be uptaken by cancer cells, primarily through clathrin-meditated endocytosis pathways, leading to their accumulation in endosomes/lysosomes within cells. However, endo/lysosomes exhibit a highly degradative environment for organic NPs and drug molecules, often resulting in treatment failure. Hence, this study designed a lysosomal escape mechanism with carrier-free nanomedicine, combining the chemotherapeutic drug, curcumin (Cur), and the photothermal/photodynamic therapeutic drug, indocyanine green (ICG), for synergistic cancer treatment (ICG-Cur NPs) a facile preparation process. To facilitate endo/lysosomal escape, ICG-Cur NPs were modified with metal-phenolic networks (MPNs) of different thickness. The results indicate that a thick MPN coating promotes rapid endo/lysosomal escape of ICG-Cur NPs within 4 h and enhances the photothermal conversion efficiency of ICG-Cur NPs by 55.8%, significantly improving anticancer efficacy in both chemo- and photo-therapies within 3D solid tumor models. This finding underscores the critical role of endo/lysosomal escape capacity in carrier-free drug NPs for therapeutic outcomes and offers a facile solution to achieve it.
PubMed: 38895858
DOI: 10.1039/d4tb00465e -
Global Advances in Integrative Medicine... 2024Mindfulness-based interventions (MBIs) are supported by clinical practice guidelines as effective non-pharmacologic interventions for common symptoms experienced by...
BACKGROUND
Mindfulness-based interventions (MBIs) are supported by clinical practice guidelines as effective non-pharmacologic interventions for common symptoms experienced by cancer patients, including anxiety, depression, and fatigue. However, the evidence predominately derives from White breast cancer survivors. Racial and ethnic minority patients have less access to integrative oncology care and worse cancer outcomes. To address these gaps, we designed and piloted a series of mindfulness-based group medical visits (MB-GMVs), embedded into comprehensive cancer care, for racially and ethnically diverse patients in cancer treatment.
METHODS
As a quality improvement project, we launched a telehealth MB-GMV series for patients undergoing cancer treatment, delivered as four weekly 2-hour visits billable to insurance. Content was concordant with evidence-based guidelines and established MBIs and adapted to improve cultural relevance and fit (eg, access-centered, trauma-informed, with inclusive communication practices). Program structure was adapted to address barriers to participation, with ≥50% slots per series reserved for racial and ethnic minority patients. Intake surveys incorporated a demographic questionnaire and symptom assessments. Evaluations were sent following the visits.
RESULTS
In our first ten cohorts (n = 78), 80% of referred patients enrolled. Participants were: 22% Asian, 14% Black, 17% Latino, 45% non-Latino White; 65% female; with a median age of 54 years (range 27-79); and 80% had metastatic cancer. Common baseline symptoms included lack of energy, difficulty sleeping, and worrying. Most patients (90%) attended ≥3 visits. On final evaluations, 87% patients rated the series as "excellent"; 81% "strongly agreed" that they liked the GMV format; and 92% would "definitely" recommend the series to others. Qualitative themes included empowerment and connectedness.
CONCLUSION
Telehealth GMVs are a feasible, acceptable, and financially sustainable model for increasing access to MBIs. Diverse patients in active cancer treatment were able to participate and reported high levels of satisfaction with this series that was tailored to center health equity and inclusion.
PubMed: 38895040
DOI: 10.1177/27536130241263486 -
JAMA Network Open Jun 2024The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), recently identified internet gaming disorder (IGD) as a condition... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), recently identified internet gaming disorder (IGD) as a condition warranting more research, and few empirically validated treatments exist. Mindfulness meditation (MM) has multiple health benefits; however, its efficacy in treating IGD and potential neural mechanisms underlying MM treatment of the disorder remain largely unknown.
OBJECTIVE
To explore the efficacy of MM used to treat adults with IGD and to identify neural mechanisms underlying MM.
DESIGN, SETTING, AND PARTICIPANTS
This randomized clinical trial was performed from October 1 to November 30, 2023, at Hangzhou Normal University in Hangzhou, China. Adults (aged ≥18 years) who met at least 6 of the 9 DSM-5-TR proposed criteria for IGD were recruited to receive either MM or progressive muscle relaxation (PMR). Data analysis was performed on December 1, 2023.
INTERVENTION
Participants underwent MM training (an 8-session meditation program that focuses on attention and acceptance) and PMR training (an 8-time program for body relaxation) delivered in groups that met 2 times each week for 4 weeks.
MAIN OUTCOMES AND MEASURES
This per-protocol analysis included only participants who finished the pretest assessment, 8 training sessions, and posttest assessment. The main outcomes were addiction severity (measured with the DSM-5-TR proposed criteria for IGD and with Internet Addiction Test scores), gaming craving (measured with Questionnaire for Gaming Urges scores), and blood oxygen level-dependent signals assessed with cue-craving tasks on fMRI. Behavioral and brain measurements were compared using analysis of variance. Functional connectivity (FC) among identified brain regions was measured to test connectivity changes associated with MM.
RESULTS
This study included 64 adults with IGD. A total of 32 participants received MM (mean [SD] age, 20.3 [1.9] years; 17 women [53%]) and 32 received PMR (mean [SD] age, 20.2 [1.5] years; 16 women [50%]). The severity of IGD decreased in the MM group (pretest vs posttest: mean [SD], 7.0 [1.1] vs 3.6 [0.8]; P < .001) and in the PMR group (mean [SD], 7.1 [0.9] vs 6.0 [0.9]; P = .04). The MM group had a greater decrease in IGD severity than the PMR group (mean [SD] score change for the MM group vs the PMR group, -3.6 [0.3] vs -1.1 [0.2]; P < .001). Mindfulness meditation was associated with decreased brain activation in the bilateral lentiform nuclei (r = 0.40; 95% CI, 0.19 to 0.60; P = .02), insula (r = 0.35; 95% CI, 0.09 to 0.60; P = .047), and medial frontal gyrus (MFG; r = 0.43; 95% CI, 0.16 to 0.70; P = .01). Increased MFG-lentiform FC and decreased craving (pretest vs posttest: mean [SD], 58.8 [15.7] vs 33.6 [12.0]; t = -8.66; ƞ2 = 0.30; P < .001) was observed after MM, and changes in MFG-lentiform FC mediated the relationship between increased mindfulness and decreased craving (mediate effect, -0.17; 95% CI, -0.32 to -0.08; P = .03).
CONCLUSIONS AND RELEVANCE
In this study, MM was more effective in decreasing addiction severity and gaming cravings compared with PMR. These findings indicate that MM may be an effective treatment for IGD and may exert its effects by altering frontopallidal pathways.
TRIAL REGISTRATION
Chinese Clinical Trial Registry Identifier: ChiCTR2300075869.
Topics: Humans; Mindfulness; Male; Female; Internet Addiction Disorder; Adult; Meditation; Young Adult; Treatment Outcome; Magnetic Resonance Imaging; China; Video Games
PubMed: 38888924
DOI: 10.1001/jamanetworkopen.2024.16684 -
American Journal of Industrial Medicine Jun 2024Workplaces are suitable areas for smoking cessation programs and incentives. This study was carried out to determine the effectiveness of interventions in the workplace... (Review)
Review
OBJECTIVES
Workplaces are suitable areas for smoking cessation programs and incentives. This study was carried out to determine the effectiveness of interventions in the workplace for smoking cessation in working individuals.
METHODS
All studies published in English between 2013 and 2022 were searched in Pub Med, Science Direct, Scopus, Web of Science, and CINAHL databases. Meta-analysis was based on PRISMA 2020. The study protocol was registered with PROSPERO. A random effects model was applied to the meta-analysis processes, and Hedges' g was used to calculate the effect size.
RESULTS
Of the included studies, 11 were randomized controlled trials, and 8 were cluster randomized controlled trials. In different working sectors, various interventions such as motivational/individual interviews, group counseling, telephone coaching, web-based training, mindfulness meditation, and financial interventions were implemented. These interventions were carried out alone or in combination with one or more other interventions. The interventions generally have short-term effects, and financial incentives or supports were the factors that positively motivate the interventions. The joint effect size of attempts to quit smoking in the workplace (Hedges' g) was 1.171. Heterogeneity between studies was significant (Q = 199.762, p = 0.015, I = 80.477%). No publication bias was detected.
CONCLUSIONS
We determined that smoking cessation interventions applied in the workplace have a large effect. We recommend that the long-term effects of increasing effectiveness of these interventions be considered and planned in line with the needs of working groups.
PubMed: 38884628
DOI: 10.1002/ajim.23627 -
Journal of Visualized Experiments : JoVE May 2024This protocol presents a multi-modal neuroimaging approach to explore the potential brain activity associated with repetitive religious chanting, a widespread form of...
This protocol presents a multi-modal neuroimaging approach to explore the potential brain activity associated with repetitive religious chanting, a widespread form of mind training in both Eastern and Western cultures. High-density electroencephalogram (EEG), with its superior temporal resolution, allows for capturing the dynamic changes in brain activity during religious chanting. Through source localization methods, these can be attributed to various alternative potential brain region sources. Twenty practitioners of religious chanting were measured with EEG. However, the spatial resolution of EEG is less precise, in comparison to functional magnetic resonance imaging (fMRI). Thus, one highly experienced practitioner underwent an fMRI scanning session to guide the source localization more precisely. The fMRI data helped guide the selection of EEG source localization, making the calculation of K-means of the EEG source localization in the group of 20 intermediate practitioners more precise and reliable. This method enhanced EEG's ability to identify the brain regions specifically engaged during religious chanting, particularly the cardinal role of the posterior cingulate cortex (PCC). The PCC is a brain area related to focus and self-referential processing. These multimodal neuroimaging and neurophysiological results reveal that repetitive religious chanting can induce lower centrality and higher delta-wave power compared to non-religious chanting and resting state conditions. The combination of fMRI and EEG source analysis provides a more detailed understanding of the brain's response to repetitive religious chanting. The protocol contributes significantly to the research on the neural mechanisms involved in religious and meditative practices, which is becoming more prominent nowadays. The results of this study could have significant implications for developing future neurofeedback techniques and psychological interventions.
Topics: Humans; Magnetic Resonance Imaging; Electroencephalography; Brain; Neuroimaging; Multimodal Imaging; Religion; Adult
PubMed: 38884478
DOI: 10.3791/66221