Transcendental Meditation for women affected by domestic violence: Study protocol of a pilot randomised, controlled trial

Matthew J. Leach,Heather Lorenzon,Sandy Nidich 한국한의학연구원 2020 Integrative Medicine Research Vol.9 No.4

Background: Almost one in three women worldwide will be exposed to domestic and family violence some time in their life. This violence can contribute to physical, social, economic and psychological harm. Transcendental Meditation® (TM) may help to lessen the physical and emotional burden of domestic violence. Methods: The objective of this pilot, parallel-group, randomized controlled trial is to compare the effectiveness of TM to support group control, on quality-of-life, perceived stress and mood in women affected by domestic violence. Women living in Adelaide, South Australia, who have experienced domestic violence in their lifetime, will be randomized to eight weeks of standardised TM training or facilitated group support sessions. Health-related quality of life (AQoL-8D), severity of depression, anxiety and perceived stress (DASS-21), and symptoms of post-traumatic stress disorder (PCL-5) will be self-reported by women at baseline, week 8 (post-intervention) and week 16 (follow-up). Data will be analysed by intention-to-treat using linear mixed-effects models. Discussion: TM is an effortless, easily practiced and convenient relaxation technique, with reportedly high rates of adherence. While previous studies have shown TM to be effective in improving a range of psychological and behavioural outcomes across different populations, the effects of TM in survivors of domestic violence is largely unknown. If the study described herein is able to demonstrate the benefits of TM in this population, it might offer survivors an accessible, long-term and potentially cost-effective treatment option for domestic violence-induced distress, anxiety and depression. Trial registration: ACTRN12620000467932.

Enablers and barriers to evidence implementation in complementary medicine: A systematic review

Matthew J. Leach,Yasamin Veziarib 한국한의학연구원 2022 Integrative Medicine Research Vol.11 No.4

Background: Despite the push for complementary medicine (CM) practitioners to engage in evidence implementation, and arguments in support of evidence-based practice (EBP), uptake of EBP amongst most CM professions remains low. This review aimed to synthesise the evidence examining the barriers and enablers to evidence implementation in CM. Methods: Any primary study examining enablers and barriers to evidence implementation in CM were eligible for inclusion. Eight databases and search engines were searched for eligible studies. Reference lists of included studies were screened, and authors of included studies were contacted to identify current or unpublished studies that met the inclusion criteria. Results: Thirty-nine published and unpublished studies were included in this review. The seven pub- lished qualitative studies and 25 published quantitative studies were rated as moderate to high quality. Fifty-two distinct barriers and 62 discrete enablers were identified. Reported barriers were predominantly structural (e.g. limited availability of time and clinical evidence) and cognitive (e.g. skills deficits), with relatively fewer studies reporting cultural (e.g. lack of industry support) or attitudinal barriers (e.g. lack of interest in, or relevance to CM). Enablers of evidence implementation largely focussed on improving access to bibliographic databases and evidence reviews, supporting skills acquisition, and cultivating lead- ership and interprofessional/interagency collaboration. Conclusions: The findings of this review highlight the diverse barriers and enablers to evidence imple- mentation in CM that span multiple dimensions. The interplay between these various factors highlights the complexity of evidence implementation, and the need for a targeted multistakeholder, multidimen- sional solution to optimise evidence-based practice in CM.

Essential oils for agitation in dementia [rELOAD]: A pragmatic, cluster-randomized, placebo-controlled, pilot feasibility trial

Matthew J. Leach,Merrian Sangalli,Ian Breakspear,Sandra Walsh 한국한의학연구원 2021 Integrative Medicine Research Vol.10 No.4

Background Clinical guidelines recommend non-pharmacological interventions as the first line of treatment for agitation in dementia. One intervention that shows some promise as a treatment for agitation is essential oils. The objective of this study was to provide preliminary evidence of the effectiveness and feasibility of using topically-administered, individualized essential oil preparations for the alleviation of agitation in persons with dementia. Methods We conducted a 10-week pragmatic, cluster-randomized, placebo-controlled, pilot feasibility trial to compare the effectiveness of topically-administered, individualized essential oil preparations to control (placebo) preparations. Outcomes included frequency and severity of agitation, quality of life, frequency of antipsychotic medication use and physical restraint, incidence of adverse events, and trial feasibility. Participants with dementia and clinically significant agitation were recruited from five residential aged-care facilities across regional South Australia. Results Thirty-eight participants were randomized from five sites. Accounting for random effects, we found statistically significant differences between the intervention and control groups in Pittsburgh Agitation Scale (PAS) aberrant vocalization sub score, Cohen Mansfield Agitation Inventory (CMAI) verbally agitated sub score and CMAI total score at week 4, but not at weeks 8 (post-intervention) or 10 (follow-up). No significant time-group interactions were observed for other PAS/CMAI scores or sub scores, quality of life - Alzheimer's disease total score, or frequency of physical restraint or as-needed antipsychotic medication. No adverse events were reported in any group. Conclusions The study findings highlight some promising effects of topically-administered, individualized essential oil preparations for agitation in dementia, and indicate that a large multi-center, cluster-randomized controlled trial of this treatment is feasible. Trial registration Australian New Zealand Clinical Trial Registry [ACTRN12617001159347]. Background Clinical guidelines recommend non-pharmacological interventions as the first line of treatment for agitation in dementia. One intervention that shows some promise as a treatment for agitation is essential oils. The objective of this study was to provide preliminary evidence of the effectiveness and feasibility of using topically-administered, individualized essential oil preparations for the alleviation of agitation in persons with dementia. Methods We conducted a 10-week pragmatic, cluster-randomized, placebo-controlled, pilot feasibility trial to compare the effectiveness of topically-administered, individualized essential oil preparations to control (placebo) preparations. Outcomes included frequency and severity of agitation, quality of life, frequency of antipsychotic medication use and physical restraint, incidence of adverse events, and trial feasibility. Participants with dementia and clinically significant agitation were recruited from five residential aged-care facilities across regional South Australia. Results Thirty-eight participants were randomized from five sites. Accounting for random effects, we found statistically significant differences between the intervention and control groups in Pittsburgh Agitation Scale (PAS) aberrant vocalization sub score, Cohen Mansfield Agitation Inventory (CMAI) verbally agitated sub score and CMAI total score at week 4, but not at weeks 8 (post-intervention) or 10 (follow-up). No significant time-group interactions were observed for other PAS/CMAI scores or sub scores, quality of life - Alzheimer's disease total score, or frequency of physical restraint or as-needed antipsychotic medication. No adverse events were reported in any group. Conclusions The study findings highlight some promising effects of topically-administered, individualized essential oil preparations for agitation in dementia, and indicate that a large multi-center, cluster-randomized controlled trial of this treatment is feasible. Trial registration Australian New Zealand Clinical Trial Registry [ACTRN12617001159347].

Prevalence and predictors of naturopathic practitioners’ self-reported practice behaviours: results of an international survey

Amie Steel,Iva Lloyd,Hope Foley,Matthew J. Leach 한국한의학연구원 2022 Integrative Medicine Research Vol.11 No.4

Background The naturopathic workforce spans over 108 countries and is estimated to provide care to over 5.5 million patients globally per month. Despite such demand, naturopathic practitioners are not well integrated into mainstream health systems, in part due to poor knowledge about naturopathy among policy makers and other health professionals. This study aims to describe naturopathic practitioners’ practice behaviours and examine the characteristics that predict the use of naturopathic treatments and practices around the world. Methods An international cross-sectional online survey was distributed through World Naturopathic Federation membership organisations and social media accounts. Multivariate reverse stepwise logistic regression was undertaken to examine potential predictors of practice behaviours, adjusting for the influence of demographic and practice characteristics Results A response rate of 78.4% was achieved (n=478). Lifestyle modifications, dietary changes, nutritional products and herbal medicines were most consistently prescribed Always or Most of the time. At least one-half of participants discussed nine of the ten health topics during clinical practice Always or Most of the time. More than one-half (55.1%) of participants practiced in a location with statutory regulation/occupational certification. Compared to participants located in countries with voluntary certification/no regulation, those in countries with statutory registration/occupational licensing had higher odds of prescribing nutritional products (adjusted odds ratio (aOR)=2.5) or IV/injection therapies (aOR=18.4). Conclusion The findings of this study provide important insights into contemporary naturopathic practice behaviour, which may help to overcome misconceptions about such practice among other health professionals, policy makers and the community.