Complementary and Integrative Medicine and Eating Disorders in Youth: Traditional Yoga, Virtual Reality, Light Therapy, Neurofeedback, Acupuncture, Energy Psychology Techniques, Art Therapies, and Spirituality.

Eating disorders (EDs) are a non-heterogeneous group of illnesses with significant physical and mental comorbidity and mortality associated with maladaptive coping. With the exception of lisdexamfetamine (Vyvanse) for binge eating disorder, no medications have been effective for the core symptoms of ED. ED requires a multimodal approach. Complementary and integrative medicine (CIM) can be helpful as an adjunct. The most promising CIM interventions are traditional yoga, virtual reality, eye movement desensitization and reprocessing, Music Therapy, and biofeedback/neurofeedback.

Integrative Medicine in Long COVID.

Physiatry and Integrative Medicine practice approaches the care of patients holistically to achieve recovery and optimal function. The current lack of knowledge on proven treatments for long COVID has resulted in a surge in both demand and use of complementary and integrative health (CIH) treatments. This overview summarizes CIH therapies using the framework of the United States National Center for Complementary and Integrative Health, divided into nutritional, psychological, physical, and combinations of these categories. Representative therapies selected based on the availability of published and ongoing research for post-COVID conditions are described.

Prevalence and associated factors of complementary and integrative medicine use in patients afflicted with COVID-19.

BACKGROUND: Complementary and Integrative Medicine (CIM) is often taken up by individuals seeking relief from different diseases. This study investigates the prevalence and associated factors of CIM use in patients with COVID-19. METHODS: In this telephone-based, cross-sectional study, data on CIM usage were collected from COVID-19 patients from February till June 2020 in Fars province, Iran using a researcher-made checklist. Additionally, we asked about the patients' attitudes toward these treatments. RESULTS: Out of 453 patients diagnosed with COVID-19, 400 (88.30%) responded to our calls and agreed to participate in the study. Among them, 276 patients reported using CIM to treat COVID-19 [prevalence: 69% (95% CI: 64.2 to 73.5)]. The most frequently used herbal medicine among COVID-19 patients was ginger (n = 273, 98.9%), thyme (n = 263, 95.3%), and black cumin (n = 205, 74.3%). Most of these patients were recommended to use herbal medicine by their families and friends (n = 96, 34.8%). Univariable logistic regression revealed that age under 50 years old, residency in urban areas (including the capital of the province and small cities), employment, academic education, and being an outpatient were statistically significant factors resulting in CIM usage. Multivariable logistic regression revealed that CIM use among outpatients was 3.65 times more than among inpatients. In addition, patients under 50 years old used CIM 85% more than older patients. Ultimately, only 9 (3.3%) patients consulted with their doctors regarding these medications. No side effects due to CIM use were reported. CONCLUSION: Many patients with COVID-19 used CIM, but few consulted with their physicians in this regard. Therefore, physicians should ask their patients about CIM usage, and patients should also report their use of CIM therapies during their medical visits. Furthermore, age and hospitalization status affected CIM use among patients with COVID-19.

Natural Alternatives and the Common Cold and Influenza.

The use of complementary and integrative medicine has increased . It is estimated that one-third of the population of the United States uses some form of alternative medicine. Physicians should consider integrative medicine therapies . Alternative medical therapies for the common cold and influenza include herbal supplements, dietary supplements, diet, and other adjunct therapies. However, it is important to research and study these therapies. Therefore, communication with patients and other health care providers is important. This will ensure effective and positive patient care experiences. Further randomized clinical trials are necessary to further establish the role of various alternative options.

Stay Home, Work Safe: Attitudes and Beliefs of Members of a Department of Palliative Care, Rehabilitation, and Integrative Medicine Regarding Remote Work during the COVID-19 Pandemic.

Background: The coronavirus disease 2019 (COVID-19) pandemic compelled rapid transition to work from home for the University of Texas MD Anderson Cancer Center Palliative, Rehabilitation, and Integrative Medicine (PRIM) department to ensure social distancing and prevention of transmission. Objectives: To survey the attitudes and beliefs of personnel toward remote work during the COVID-19 pandemic. Methods: One hundred forty-eight clinical, research, and administrative PRIM department employees were invited to participate in an anonymous voluntary survey in May 2020, two months after the beginning of the COVID-19 pandemic and transition to work from home in the geographic location of Houston, Texas. The survey comprised 25 questions, including employee demographics and attitudes and beliefs toward working from home and the COVID-19 pandemic. Results: Ninety-four percent (139) of employees responded, with high response rates among all three employee arms. The majority of respondents were female (74%), between the ages of 30 and 59 years (87%), had broadband Internet (93%), and shared office space before working from home (59%). There were overall positive reports of experience (87%) and emotional response (79%) toward working from home, especially for those more concerned about COVID-19 illness and spread, shared office space, and those reporting adequate resources and equipment for remote work. Clinical role, however, was associated with a less positive response (80%), less productivity (29%), and higher levels of stress (62%). Most of the department also reported increased emotional exhaustion (68%). When surveyed about permanently working from home, most of the department responded favorably (69%). Conclusions: The PRIM rapid transition to remote work was associated with positive perceptions by most members of the clinical, research, and administrative teams. Insight from this survey can serve as a model for future rapid transitions in remote work and merits follow-up studies to prepare us for a postpandemic work environment. Clinical Trial Registration number NCI-2021-01265.

Interest and need for continuing medical education in pediatric complementary and integrative medicine: a cross-sectional survey from Switzerland.

BACKGROUND: Pediatric integrative medicine, combining conventional and complementary medical approaches for children and adolescents, is an integral part of the health care system in Switzerland. However, there is still a lack of complementary and integrative medicine topics in training and continuing educational programs. For the first time on a national level, the 2021 annual conference of the Swiss Society of Pediatrics was entirely dedicated to the topic of integrative medicine. METHODS: Using a cross-sectional online survey, this study investigated congress participants' evaluation and feedback with the aim to assess whether the program had met their objectives and to get empirical data on their attitude, expectations and needs regarding pediatric complementary and integrative medicine. Descriptive methods were used to present the results. RESULTS: Among 632 participants of the conference, 228 completed the evaluation form (response rate 36%). The overall feedback about the congress and the main theme of pediatric integrative medicine was clearly positive. The majority of respondents had achieved their educational objectives including complementary and integrative medicine issues. 82% were motivated to learn more about complementary and integrative medicine and 66% were stimulated to integrate complementary therapies into their professional practice. CONCLUSION: This study from Switzerland confirms the interest in integrative medicine among pediatricians and supports the need for pre- and postgraduate pediatric training on topics related to complementary and integrative medicine. Developing and adapting training and continuing medical education based on evaluations of participant feedback can promote professional development and improve patient care for the benefit of physicians and patients.

Tracking discussions of complementary, alternative, and integrative medicine in the context of the COVID-19 pandemic: a month-by-month sentiment analysis of Twitter data.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a novel infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the paucity of evidence, various complementary, alternative and integrative medicines (CAIMs) have been being touted as both preventative and curative. We conducted sentiment and emotion analysis with the intent of understanding CAIM content related to COVID-19 being generated on Twitter across 9 months. METHODS: Tweets relating to CAIM and COVID-19 were extracted from the George Washington University Libraries Dataverse Coronavirus tweets dataset from March 03 to November 30, 2020. We trained and tested a machine learning classifier using a large, pre-labelled Twitter dataset, which was applied to predict the sentiment of each CAIM-related tweet, and we used a natural language processing package to identify the emotions based on the words contained in the tweets. RESULTS: Our dataset included 28 713 English-language Tweets. The number of CAIM-related tweets during the study period peaked in May 2020, then dropped off sharply over the subsequent three months; the fewest CAIM-related tweets were collected during August 2020 and remained low for the remainder of the collection period. Most tweets (n = 15 612, 54%) were classified as positive, 31% were neutral (n = 8803) and 15% were classified as negative (n = 4298). The most frequent emotions expressed across tweets were trust, followed by fear, while surprise and disgust were the least frequent. Though volume of tweets decreased over the 9 months of the study, the expressed sentiments and emotions remained constant. CONCLUSION: The results of this sentiment analysis enabled us to establish key CAIMs being discussed at the intersection of COVID-19 across a 9-month period on Twitter. Overall, the majority of our subset of tweets were positive, as were the emotions associated with the words found within them. This may be interpreted as public support for CAIM, however, further qualitative investigation is warranted. Such future directions may be used to combat misinformation and improve public health strategies surrounding the use of social media information.

[Integrative medicine: scientific literature in 2021]. / Médecine integrative - Littérature scientifique en 2021.

To illustrate the novelties in integrative and complementary medicine in 2021, the authors present a selection of six articles. One of them is specifically related to COVID-19. The other articles deal with themes that are always relevant and where complementary approaches represent a real added value. Two articles focus on low back pain, a common problem in primary care medicine. The others examine acupuncture in the oncological context, the use of therapeutic suggestions in an operative context, and Tai Chi. The authors thus provide an overview of the range of possible complementary therapeutic approaches that are increasingly supported by evidence, inviting them to be better integrated into clinical practice.

Pour illustrer les nouveautés en médecine intégrative et complémentaire en 2021, les auteur·e·s présentent une sélection de six articles. L'un s'intéresse plus spécifiquement au Covid-19. Les autres touchent des thématiques qui restent toujours d'actualité et où des approches complémentaires peuvent représenter une réelle plus-value. Deux articles ont pour thème les lombalgies, problématique courante en médecine de premier recours. Les autres examinent l'acupuncture dans le contexte oncologique, l'utilisation de suggestions thérapeutiques dans un contexte opératoire, et le Tai Chi. Les auteur·e·s donnent ainsi un aperçu de l'éventail d'approches thérapeutiques complémentaires possibles et de plus en plus soutenues par la science, invitant à les intégrer de mieux en mieux dans la pratique clinique.

From the "what" to the "how": Teaching integrative medicine-related skills to medical students during COVID-19.

OBJECTIVE: To examine the impact of an integrative medicine (IM) course on self-perceived IM-related communication and research skills. METHODS: A 3-day mandatory "hybrid" (online and in-person) IM course was held within COVID-19 restrictions for 161 pre-clerkship medical students, with workshops facilitated by mentor healthcare professionals (IM and non-IM) and student-directed tasks. Self-perceived levels of 6 IM-related skills were scored (from 1 to 5) for history-taking; communicating with patients with "alternative" health-beliefs; referral to IM consultations; assessing risks/benefits; and working with non-medical IM practitioners. RESULTS: 137 students (85.1%) completed pre-/post-course questionnaires, with overall scores improving from pre-course (1.98 ± 0.92) to post-course (3.31 ± 0.63; p < 0.0001), for the entire group and student subgroups (with vs. without prior IM experience). Multivariate analysis found no association between age, gender, primary language or prior experience with IM and improvement in skill scores. CONCLUSIONS: The IM course increased self-perceived skill levels, reflecting the course curriculum and workshops. Further research needs to explore the application of these skills during clinical training. PRACTICE IMPLICATIONS: Teaching medical students about IM in a course comprising communication and research skills was shown to be feasible and effective. The application of IM-related skills needs to be evaluated during the clinical clerkship.

Sensing the lightness: a narrative analysis of an integrative medicine program for healthcare providers in the COVID-19 department.

OBJECTIVES: The research addressing physical and emotional exhaustion among healthcare providers (HCPs) in COVID-19 departments is limited. We examined the impact of integrative medicine (IM) intervention for HCPs working in isolated COVID-19 in-patient departments, addressing concerns and well-being. METHODS: HCPs working in 3 isolated COVID-19 in-patient departments underwent 40-min IM treatment sessions (including acupuncture, manual movement, and/or mind-body modalities) provided by integrative oncology practitioners. The MYCAW (Measure Yourself Concerns and Well-being) questionnaire examined HCP concerns and free-text narratives following IM treatments. Data were qualitatively analyzed using ATLAS.Ti software for systematic coding. RESULTS: A total of 181 HCPs underwent 305 IM treatments. Narrative themes focused on physical symptoms (primarily pain and fatigue) and emotional concerns, including perceived communication barriers with patients, and reflections on well-being and insights following IM treatments. HCPs reported feeling a sense of "relief" which was likely related to the 3 main effects of the IM intervention: a sense of "being cared for" and treated; experiencing emotional, sometimes spiritual effects of the treatment; and the feeling of relaxation, combined with the relief of pain. Qualitative analysis identified clusters of emotional and spiritual-related keywords such as "calming," "release," "relaxation," and "disengagement" following the first IM session (119 of 181 narratives, 65.7%). CONCLUSIONS: HCPs working in isolated COVID-19 departments reported improved well-being and the addressing of their concerns following IM treatment sessions provided during their work shift. Further research is needed to explore the impact of IM on HCP burnout and resilience in palliative care settings.

Tele-Integrative Medicine to Support Rehabilitative Care.

Complementary and integrative health (CIH) modalities have therapeutic value in the multidisciplinary rehabilitation of chronic pain patients. Evidence of such has been seen with the Whole Health Model at the (Veterans Affairs) VA Healthcare system. CIH therapies, including yoga, tai chi, mindfulness meditation, hypnosis, self-massage, and acupressure, are significantly effective for managing chronic pain with little to no negative effects, and can be easily incorporated into telemedicine care with great potential benefit. The future of wellness in telemedicine is evolving with great potential, and needs further attention to addressing barriers of care.

Efficacy of Integrated Traditional Chinese and Western Medicine for Treating COVID-19: A Systematic Review and Meta-Analysis of RCTs.

Background: Integrated Chinese and Western medicine (integrated medicine) is routinely used in the treatment of coronavirus disease 2019 (COVID-19) in China. In this study, we undertook a systematic review and meta-analysis of published randomized controlled trials (RCTs) to evaluate the efficacy of integrated medicine therapy for patients with COVID-19. Methods: In this meta-analysis, we searched PubMed, Embase, Web of Science, SinoMed, China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), and Wanfang databases from inception to April 12, 2021, to identify RCTs of integrated medicine in the treatment of COVID-19. The quality of RCTs was assessed by the Cochrane risk of bias tool. RevMan v5.3 and Stata software packages were used for statistical analysis. Results: Nineteen RCTs involving 1,853 patients met our inclusion criteria. Compared with patients treated by conventional Western medicine (CWM), patients treated by integrated medicine have a higher overall effective rate [RR = 1.17, 95% CI: (1.10, 1.26), p < 0.00001], fever disappearance rate [RR = 1.25, 95% CI: (1.04, 1.50), p = 0.02], fatigue disappearance rate [RR = 1.28, 95% CI: (1.00, 1.63), p = 0.05], and chest CT improvement rate [RR = 1.24, 95% CI: (1.14, 1.34), p < 00001]. Beneficial effects of the integrated medicine therapy were also seen in C-reactive protein (CRP) level [WMD = -4.14, 95% CI: (-6.38, -1.91), p = 0.0003] and white blood cell (WBC) count [WMD = 0.35, 95% CI: (0.11, 0.58), p = 0.004]. Subgroup analyses showed that, when the treatment time is <2 weeks, the effect of integrated medicine treatment is more obvious in improving the overall effective rate, clinical symptoms (fever, fatigue, and cough), the CRP level, and WBC count compared with that of the CWM treatment. For patients with severe and non-severe COVID-19, integrated medicine is more effective in improving fever and cough symptoms and WBC count than using CWM alone. Conclusion: The results of the current meta-analysis suggested that the integrated medicine can improve the clinical symptoms, chest CT and infection indicators of COVID-19 patients. Even if the treatment time is <2 weeks, the effect of integrated medicine in improving symptoms is more obvious compared with the treatment of CWM. However, the results should be interpreted cautiously due to the heterogeneity among the studies.

A public survey of traditional, complementary and integrative medicine use during the COVID-19 outbreak in Hong Kong.

BACKGROUND: During COVID-19, the public actively sought non-pharmacological and self-management approaches to prevent infection. Little is known on the use of traditional, complementary and integrative medicine (TCIM) by the public as preventive measures. This study investigated the prevalence and patterns of TCIM use during the pandemic, and identified factors associated with its use among the general population in Hong Kong. METHODS: An online cross-sectional survey was conducted from November to December 2020. The survey solicited information on the respondents' sociodemographic characteristics, risk perception of the pandemic, and use of TCIM before and during the pandemic. Logistic regression analysis was conducted to determine predictors of TCIM use. RESULTS: In total, 632 responses (completion rate = 88.1%) were analyzed. TCIM was used by 44.0% of respondents during the pandemic. The most popular forms of TCIM were vitamins or other dietary supplements (n = 160, 25.3%) and Chinese herbal medicine (n = 122, 19.3%) during the pandemic. The most frequently reported indication was strengthening the immune system, especially for vitamins or other dietary supplements (n = 142/160, 88.8%). Respondents who reported using TCIM were more likely to be female (adjusted odds ratio [aOR] = 1.82, 95% confidence interval [CI] = 1.29-2.59), had higher education attainment (aOR = 2.21, 95% CI = 1.39-3.59), and older-aged (age >55 years: aOR = 1.77, 95% CI = 1.04-3.02). Respondents who resided in districts with moderate to high number of confirmed COVID-19 cases (aOR = 1.60, 95% CI = 1.07-2.42) and had a higher level of risk perception (aOR = 1.04, 95% CI = 1.01-1.07) were also more likely to use TCIM. CONCLUSION: TCIM was used commonly in Hong Kong during the COVID-19 pandemic. While vaccination and social distancing remain the mainstay of controlling the pandemic, professional bodies should proactively consider public preferences and provide information regarding the effectiveness and safety of TCIM for COVID-19 prevention and treatment.

A Thoughtful Rebirth of Health Care: Lessons From the Pandemic.

In 16 years of practice, I had never seen a patient light a cigarette or pour a glass of wine in front of me. Yet, that occurred at the very onset of the COVID-19 era, a time that has shattered any preconceived notions of what I might experience during a clinical visit. The COVID-19 pandemic has forced many physicians to approach patient care in completely different ways. While many have been providing care in hospitals, many more of us have had to stop seeing patients in person, shift to telemedicine, and consider other ways to improve the health of our patients. The rapid changes we have had to make in the last year have demonstrated the resiliency of our profession. This is a critical time to refocus and make sure that health care is person-centered, encompasses all modifiable health determinants, and helps individuals achieve health rather than primarily manage disease.

Digital Consultations During COVID-19: A Multiperspective Mixed-Methods Study in an Integrative Medicine Setting in Switzerland.

Objective: We evaluated digital consultations at a University Hospital in Switzerland within an integrative medicine outpatient setting. Patients' and treatment providers' (physicians and therapists) evaluated digital conversation-based consultations as well as the digital delivery of practical exercises. Methods: Digital consultations between March 15, 2020 and April 30, 2020 were identified. Between June and July 2020, patients and treatment providers completed online questionnaires addressing challenges and advantages of their digital consultations. Both groups documented their satisfaction and working alliance (Working Alliance Inventory). In addition, semistructured qualitative interviews with treatment providers were conducted. Findings: A total of 82 online surveys (response rate 47%) about the digital consultations were available for analyses, with 60 patients correctly identifying at least one treatment provider, and 9 interviews were performed. Patients and treatment providers overall evaluated the new setting of digital consultation as feasible and an efficient consultation format. Interestingly, the working alliance was rated as good. Technical problems were mentioned as the main challenge and the delivery of practical exercises in digital consultations was seen more challenging than having digital conversation-based consultations. Conclusion: Digital consultations were established with overall positive evaluations and with a good working alliance between patients and providers. For the delivery of practical exercises it might be required to develop more innovative digital settings to overcome shortcomings of the digital format. Hybrid settings that combine the best of both settings could be a good option for future in postpandemic times.

The use of integrative therapy based on Yoga and Ayurveda in the treatment of a high-risk case of COVID-19/SARS-CoV-2 with multiple comorbidities: a case report.

BACKGROUND: We report a high-risk case of a coronavirus disease 19 (COVID-19)-positive patient with comorbidities including diabetes mellitus (DM), hypertension (HTN), hypothyroidism and chronic kidney disease (CKD), treated successfully using an integrative therapy plan based on Ayurveda and Yoga, along with government-mandated compulsory modern western medicine (MWM) treatment. Recently, some evidence has been emerging on the use of Ayurveda for treatment of COVID-19. The classical texts of Ayurvedic medicine such as Charaka Samhita and Sushruta Samhita contain descriptions of pandemics of similar proportions and describe them as Janapadoddhvansa, meaning the destruction of communities, along with their causes and treatment. CASE PRESENTATION: The case reported herein is a 55-year-old man from Delhi, India, with confirmed (tested) COVID-19, who first took MWM for 7 days before seeking integrative therapy. The patient has comorbidities including DM, HTN, hypothyroidism and CKD and had developed symptoms including fever (which was resolved by the time integrative therapy was started), sore throat, dry cough, body aches, weakness, bad taste and smell, and heaviness in the abdomen. Based on the patient's symptoms and comorbidities, a treatment plan including Ayurvedic medicines, Yoga protocol, dietary recommendations and lifestyle modifications was prescribed by a registered Ayurveda doctor and a Yoga consultant. The patient started experiencing improvement in all the symptoms within 2 days after starting the treatment; he reported approximately [Formula: see text] relief from the symptoms after 5 days, and almost complete relief within 9 days. Also, the blood sugar levels (both fasting blood sugar [FBS] and postprandial blood sugar [PPBS]) exhibited significant improvement after 5 days, and decreased to within the normal range within 12 days. Besides relief in symptoms, the patient's real-time reverse transcription polymerase chain reaction (RT-PCR) test done on the 19th day returned negative results. CONCLUSIONS: Integrative therapy was found to be effective in mitigating the symptoms of COVID-19 in this patient with multiple comorbidities. Moreover, a significant improvement in blood sugar levels (not under control with modern medicine) was also achieved. Integrative therapy based on the classical texts of Ayurveda and Yoga may offer a promising and scalable treatment option for COVID-19 patients. A case series or a suitably designed randomized controlled trial is needed to assess its efficacy.

The intersection between integrative medicine and neuropathic pain: A case report.

INTRODUCTION: Neuropathic pain is a debilitating condition caused by lesion or disease of the somatosensory nervous system. Integrative modalities such as yoga, acupuncture, and massage are evidenced therapies for pain management. Additionally, medical cannabis and cannabinoids are emerging therapies for treatment of neuropathic pain (4,28). The authors of this study report a case of chronic neuropathic pain treated with integrative interventions. CASE PRESENTATION: The patient is a 71-year-old female with a past medical history of chronic neuropathic pain in her lower back and legs, degenerative arthritis, restless leg syndrome, carpal tunnel syndrome, and severe, chronic anxiety, presenting with worsening neuropathic pain. After over a decade of unsuccessful allopathic treatment, the patient sought out a more integrative approach to her pain management. A regimen of acupuncture, massage, gentle yoga, and medical cannabis was recommended. During the COVID-19 pandemic, she was unable to continue most of the integrative modalities and reported a significant increase in pain. The patient then joined a weekly Mind and Body program and began acupuncture treatments again, reporting a steady improvement in pain. CONCLUSION: The patient's chronic neuropathic pain was effectively treated using an integrative approach, with a combination of acupuncture, massage, yoga, mind-body approaches, and medical cannabis. While this case originally presented similarly to other cases of chronic neuropathic pain, it is unique in that it demonstrates the importance of an individualized complex approach, highlighting the patient's driven engagement in integrative modalities and medical cannabis.