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OBJECTIVES: This study compares the effects of an integrated yoga program with brief supportive therapy on distressful symptoms in breast cancer outpatients undergoing adjuvant radiotherapy.MATERIALS AND METHODS: Eighty-eight stage II and III breast cancer outpatients were randomly assigned to receive yoga (n = 44) or brief supportive therapy (n = 44) prior to their radiotherapy treatment. Intervention consisted of yoga sessions lasting 60 min daily while the control group was imparted supportive therapy once in 10 days during the course of their adjuvant radiotherapy. Assessments included Rotterdam Symptom Check List and European Organization for Research in the Treatment of Cancer-Quality of Life (EORTC QoL C30) symptom scale. Assessments were done at baseline and after 6 weeks of radiotherapy treatment. RESULTS: A GLM repeated-measures ANOVA showed a significant decrease in psychological distress (P = 0.01), fatigue (P = 0.007), insomnia (P = 0.001), and appetite loss (P = 0.002) over time in the yoga group as compared to controls. There was significant improvement in the activity level (P = 0.02) in the yoga group as compared to controls. There was a significant positive correlation between physical and psychological distress and fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, and constipation. There was a significant negative correlation between the activity level and fatigue, nausea and vomiting, pain, dyspnea, insomnia, and appetite loss. CONCLUSION: The results suggest beneficial effects with yoga intervention in managing cancer-and treatment-related symptoms in breast cancer patients.

BACKGROUND: Studies have shown that distress and accompanying neuroendocrine stress responses as important predictor of survival in advanced breast cancer patients. Some psychotherapeutic intervention studies have shown have modulation of neuroendocrine-immune responses in advanced breast cancer patients. In this study, we evaluate the effects of yoga on perceived stress, sleep, diurnal cortisol, and natural killer (NK) cell counts in patients with metastatic cancer.METHODS: In this study, 91 patients with metastatic breast cancer who satisfied selection criteria and consented to participate were recruited and randomized to receive "integrated yoga based stress reduction program" (n = 45) or standard "education and supportive therapy sessions" (n = 46) over a 3 month period. Psychometric assessments for sleep quality were done before and after intervention. Blood draws for NK cell counts were collected before and after the intervention. Saliva samples were collected for three consecutive days before and after intervention. Data were analyzed using the analysis of covariance on postmeasures using respective baseline measure as a covariate. RESULTS: There was a significant decrease in scales of symptom distress (P < 0.001), sleep parameters (P = 0.02), and improvement in quality of sleep (P = 0.001) and Insomnia Rating Scale sleep score (P = 0.001) following intervention. There was a decrease in morning waking cortisol in yoga group (P = 0.003) alone following intervention. There was a significant improvement in NK cell percent (P = 0.03) following intervention in yoga group compared to control group. CONCLUSION: The results suggest modulation of neuroendocrine responses and improvement in sleep in patients with advanced breast cancer following yoga intervention.

Several studies have documented the beneficial short term effects of yoga in type 2 diabetics. In this prospective two-armed interventional randomized control study, 277 type 2 diabetics of both genders aged above 28 years who satisfied the study criteria were recruited from 5 zones in and around Bengaluru, India. They were allocated to a yoga-based life style modification program or exercise-based life style modification program. Integrated yoga special technique for diabetes included yogasanas, pranayama, meditation and lectures on yogic life style. Control intervention included physical exercises and life style education. Medication score, blood glucose, HbA1c and lipid profile were assessed at baseline and after 9 months. Intention to treat analysis showed better reduction (P < 0.05, Mann-Whitney test) in the dose of oral hypoglycemic medication required (Yoga - 12.8 %) (Yoga-12.3 %) and increase in HDL (Yoga-7 %) in Yoga as compared to the control group; FBG reduced (7.2 %, P = 0.016) only in the Yoga group. There was significant reduction within groups (P < 0.01) in PPBG (Yoga-14.6 %, Control-9 %), HbA1c (Yoga-14.1 %, Control-0.5 %), Triglycerides (Yoga-15.4 %, Control-16.3 %), VLDL (Yoga-21.5 %, Control-5.2 %) and total cholesterol (Yoga-11.3 %, Control-8.6 %). Thus, Yoga based life style modification program is similar to exercise-based life style modification in reducing blood glucose, HbA1c, triglycerides, total cholesterol and VLDL. Yoga is better than exercise in decreasing oral hypoglycemic medication requirement and LDL; and increasing HDL in type 2 diabetics.

Preliminary evidence suggests efficacy of yoga as add-on treatment for schizophrenia, but the underlying mechanism by which yoga improves the symptoms of schizophrenia is not completely understood. Yoga improves self-reflection in healthy individuals, and self-reflection abnormalities are typically seen in schizophrenia. However, whether yoga treatment improves impairments in self-reflection typically seen in patients with schizophrenia is not examined. This paper discusses the potential mechanism of yoga in the treatment of schizophrenia and proposes a testable hypothesis for further empirical studies. It is proposed that self-reflection abnormalities in schizophrenia improve with yoga and the neurobiological changes associated with this can be examined using empirical behavioural measures and neuroimaging measures such as magnetic resonance imaging.

CONTEXT: Breast cancer patients awaiting surgery experience heightened distress that could affect postoperative outcomes.AIMS: The aim of our study was to evaluate the effects of yoga intervention on mood states, treatment-related symptoms, quality of life and immune outcomes in breast cancer patients undergoing surgery. SETTINGS AND DESIGN: Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited for a randomized controlled trial comparing the effects of a yoga program with supportive therapy plus exercise rehabilitation on postoperative outcomes following surgery. MATERIALS AND METHODS: Subjects were assessed prior to surgery and four weeks thereafter. Psychometric instruments were used to assess self-reported anxiety, depression, treatment-related distress and quality of life. Blood samples were collected for enumeration of T lymphocyte subsets (CD4 %, CD8 % and natural killer (NK) cell % counts) and serum immunoglobulins (IgG, IgA and IgM). STATISTICAL ANALYSIS USED: We used analysis of covariance to compare interventions postoperatively. RESULTS: Sixty-nine patients contributed data to the current analysis (yoga n = 33, control n = 36). The results suggest a significant decrease in the state (P = 0.04) and trait (P = 0.004) of anxiety, depression (P = 0.01), symptom severity (P = 0.01), distress (P < 0.01) and improvement in quality of life (P = 0.01) in the yoga group as compared to the controls. There was also a significantly lesser decrease in CD 56% (P = 0.02) and lower levels of serum IgA (P = 0.001) in the yoga group as compared to controls following surgery. CONCLUSIONS: The results suggest possible benefits for yoga in reducing postoperative distress and preventing immune suppression following surgery.

CONTEXT: Pre- and postoperative distress in breast cancer patients can cause complications and delay recovery from surgery.OBJECTIVE: The aim of our study was to evaluate the effects of yoga intervention on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery. METHODS: Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited in a randomized controlled trial comparing the effects of a yoga program with supportive therapy and exercise rehabilitation on postoperative outcomes and wound healing following surgery. Subjects were assessed at the baseline prior to surgery and four weeks later. Sociodemographic, clinical and investigative notes were ascertained in the beginning of the study. Blood samples were collected for estimation of plasma cytokines-soluble Interleukin (IL)-2 receptor (IL-2R), tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma. Postoperative outcomes such as the duration of hospital stay and drain retention, time of suture removal and postoperative complications were ascertained. We used independent samples t test and nonparametric Mann Whitney U tests to compare groups for postoperative outcomes and plasma cytokines. Regression analysis was done to determine predictors for postoperative outcomes. RESULTS: Sixty-nine patients contributed data to the current analysis (yoga: n = 33, control: n = 36). The results suggest a significant decrease in the duration of hospital stay (P = 0.003), days of drain retention (P = 0.001) and days for suture removal (P = 0.03) in the yoga group as compared to the controls. There was also a significant decrease in plasma TNF alpha levels following surgery in the yoga group (P < 0.001), as compared to the controls. Regression analysis on postoperative outcomes showed that the yoga intervention affected the duration of drain retention and hospital stay as well as TNF alpha levels. CONCLUSION: The results suggest possible benefits of yoga in reducing postoperative complications in breast cancer patients.

INTRODUCTION: Palliative care is usually delivered late in the course of illness trajectory. This precludes patients on active disease modifying treatment from receiving the benefit of palliative care intervention. A survey was conducted to know the opinion of oncologists, oncology nurses, and patients about the role of early specialist palliative care in cancer. METHODS: A nonrandomized descriptive cross-sectional study was conducted at a tertiary cancer care center in India. Thirty oncologists, sixty oncology nurses, and sixty patients were surveyed. RESULTS: Improvement in symptom control was appreciated by oncologists, oncology nurses, and patients with respect to pain (Z = -4.10, P = 0.001), (Z = -5.84, P = 0.001), (Z = -6.20, P = 0.001); nausea and vomiting (Z = -3.75, P = 0.001), (Z = -5.3, P = 0.001), (Z = -5.1, P = 0.001); constipation (Z = -3.29, P = 0.001), (Z = -4.96, P = 0.001), (Z = -4.49, P = 0.001); breathlessness (Z = -3.57, P = 0.001), (Z = -5.03, P = 0.001), (Z = -4.99, P = 0.001); and restlessness (Z = -3.68, P = 0.001), (Z = -5.23, P = 0.001), (Z = -3.22, P = 0.001). Improvement in end-of-life care management was appreciated by oncologists and oncology nurses with respect to communication of prognosis (Z = -4.04, P = 0.001), (Z = -5.20, P = 0.001); discussion on limitation of life-sustaining treatment (Z = -3.68, P = 0.001), (Z = -4.53, P = 0.001); end-of-life symptom management (Z = -4.17, P = 0.001), (Z = -4.59, P = 0.001); perimortem care (Z = -3.86, P = 0.001), (Z = -4.80, P = 0.001); and bereavement support (Z = -3-80, P = 0.001), (Z = -4.95, P = 0.001). Improvement in health-related communication was appreciated by oncologists, oncology nurses, and patients with respect to communicating health related information in a sensitive manner (Z = -3.74, P = 0.001), (Z = -5.47, P = 0.001), (Z = -6.12, P = 0.001); conducting family meeting (Z = -3.12, P = 0.002), (Z = -4.60, P = 0.001), (Z = -5.90, P = 0.001); discussing goals of care (Z = -3.43, P = 0.001), (Z = -5.49, P = 0.001), (Z = -5.61, P = 0.001); maintaining hope (Z = -3.22, P = 0.001), (Z = -4.85, P = 0.001), (Z = -5.61, P = 0.001); and resolution of conflict (Z = -3.56, P = 0.001), (Z = -5.29, P = 0.001), (Z = -5.28, P = 0.001). Patients appreciated improvement in continuity of care with respect to discharge planning (Z = -6.12, P = 0.001), optimal supply of essential symptom control medications on discharge (Z = -6.32, P = 0.001), follow-up plan (Z = -6.40, P = 0.001), after hours telephonic support (Z = -6.31, P = 0.001), and preferred place of care (Z = -6.28, P = 0.001). CONCLUSION: Oncologists, oncology nurses, and patients felt that integration of early specialist palliative care in cancer improves symptom control, end-of-life care, health-related communication, and continuity of care. The perceptions of benefit of the palliative care intervention in the components surveyed, differed among the three groups.

Heart disease is the leading cause of global mortality, accounting for 13.7 million deaths annually. Optimising depression andanxiety symptoms in adults with heart disease is an international priority. Heart disease secondary prevention is best achievedthrough implementation of sustainable pharmacological and non-pharma cological interventions, including meditation.Meditation is a means of generating self-awareness and has implications for enhanced self-management of depression andanxiety symptoms. This review aims to identify high-level quantitative evidence for meditation interventions designed toimprove depression and/or anxiety symptoms among adults with heart disease and ascertain the most important elements ofmeditation interventions that facilitate positive depression and/or anxiety outcomes. This systematic review and narrative syn-thesis was completed in accordance with the PRISMA Statement and has adhered to the Cochrane Risk of Bias guideline. Sixdatabases were searched between 1975 and 2017. Statistically significant outcomes were demonstrated in over half (5/9) of phaseII meditation studies for depression and/or anxiety and involved 477 participants. Meditation interventions that generated positiveoutcomes for depression and/or anxiety included elements such as focused attention to body parts (or body scan) (3/4 studies)and/or group meetings (4/5 studies). Meditation is a means of reframing heart disease outpatient services towards an integratedmodel of care. Future adequately powered phase III studies are needed to confirm which meditation elements are associated withreductions in depression and anxiety; and the differential effects between concentrative and mindfulness-based meditation typesamong adults with heart disease.

Heart disease is the leading cause of global mortality, accounting for 13.7 million deaths annually. Optimising depression and anxiety symptoms in adults with heart disease is an international priority. Heart disease secondary prevention is best achieved through implementation of sustainable pharmacological and non-pharmacological interventions, including meditation. Meditation is a means of generating self-awareness and has implications for enhanced self-management of depression and anxiety symptoms. This review aims to identify high-level quantitative evidence for meditation interventions designed to improve depression and/or anxiety symptoms among adults with heart disease and ascertain the most important elements of meditation interventions that facilitate positive depression and/or anxiety outcomes. This systematic review and narrative synthesis was completed in accordance with the PRISMA Statement and has adhered to the Cochrane Risk of Bias guideline. Six databases were searched between 1975 and 2017. Statistically significant outcomes were demonstrated in over half (5/9) of phase II meditation studies for depression and/or anxiety and involved 477 participants. Meditation interventions that generated positive outcomes for depression and/or anxiety included elements such as focused attention to body parts (or body scan) (3/4 studies) and/or group meetings (4/5 studies). Meditation is a means of reframing heart disease outpatient services towards an integrated model of care. Future adequately powered phase III studies are needed to confirm which meditation elements are associated with reductions in depression and anxiety; and the differential effects between concentrative and mindfulness-based meditation types among adults with heart disease.

Heart disease is the leading cause of global mortality, accounting for 13.7 million deaths annually. Optimising depression and anxiety symptoms in adults with heart disease is an international priority. Heart disease secondary prevention is best achieved through implementation of sustainable pharmacological and non-pharmacological interventions, including meditation. Meditation is a means of generating self-awareness and has implications for enhanced self-management of depression and anxiety symptoms. This review aims to identify high-level quantitative evidence for meditation interventions designed to improve depression and/or anxiety symptoms among adults with heart disease and ascertain the most important elements of meditation interventions that facilitate positive depression and/or anxiety outcomes. This systematic review and narrative synthesis was completed in accordance with the PRISMA Statement and has adhered to the Cochrane Risk of Bias guideline. Six databases were searched between 1975 and 2017. Statistically significant outcomes were demonstrated in over half (5/9) of phase II meditation studies for depression and/or anxiety and involved 477 participants. Meditation interventions that generated positive outcomes for depression and/or anxiety included elements such as focused attention to body parts (or body scan) (3/4 studies) and/or group meetings (4/5 studies). Meditation is a means of reframing heart disease outpatient services towards an integrated model of care. Future adequately powered phase III studies are needed to confirm which meditation elements are associated with reductions in depression and anxiety; and the differential effects between concentrative and mindfulness-based meditation types among adults with heart disease.

The place of mind in the philosophical systems of India is briefly discussed. The philosophies selected are - Vedas, Upanishads, Six systems of philosophies (saddarsanas), Gita and materialistic school of Carvaaka. That mind is of subtle physical nature and that self is postulated as higher than mind in the hierarchy is being pointed out. Mind can be man's own friend to elevate him or his foe debasing him. Modern neuro - science and the ancient materialistic schools do not subscribe to the existence of self. An integrated approach extending beyond the mind in psychiatric care is suggested. Scientific and technological advances do not necessarily preclude a transcendent (spiritual) dimension to the total care.

Mind-body practices that intentionally generate positive emotion could improve health professionals’ well-being and compassion. However, the feasibility and impact of clinician training in these practices is unknown. Data were analyzed from 3 online modules offered to health professionals: (a) Gratitude, (b) Positive Word, and (c) Loving-kindness/Compassion meditation. Paired t tests were used to assess pre- to posttraining changes in gratitude (Gratitude Questionnaire), well-being (World Health Organization Well-Being Index), self-compassion (Neff’s Self-Compassion Scale), and confidence in providing compassionate care (Confidence in Providing Calm, Compassionate Care Scale). The 177 enrollees included diverse practitioners (nurses, physicians, social workers, and others). Training was associated with statistically significant improvements in gratitude (38.3 ± 4.6 to 39.5 ± 3.3), well-being (16.4 ± 4.0 to 17.9 ± 4.2), self-compassion (39.5 ± 8.1 to 43.1 ± 7.6), and confidence in providing compassionate care (73.3 ± 16.4 to 80.9 ± 13.8; P < .001 for all comparisons). Brief, online training appeals to diverse health professionals and improves their gratitude, well-being, self-compassion, and confidence in providing compassionate care.

<p>OBJECTIVES: The study objectives were to develop and objectively assess the therapeutic effect of a novel movement-based complementary and alternative medicine approach for children with an autism-spectrum disorder (ASD). DESIGN: A within-subject analysis comparing pre- to post-treatment scores on two standard measures of childhood behavioral problems was used. SETTINGS AND LOCATION: The intervention and data analysis occurred at a tertiary care, medical school teaching hospital. SUBJECTS: Twenty-four (24) children aged 3-16 years with a diagnosis of an ASD comprised the study group. INTERVENTION: The efficacy of an 8-week multimodal yoga, dance, and music therapy program based on the relaxation response (RR) was developed and examined. OUTCOME MEASURES: The study outcome was measured using The Behavioral Assessment System for Children, Second Edition (BASC-2) and the Aberrant Behavioral Checklist (ABC). RESULTS: Robust changes were found on the BASC-2, primarily for 5-12-year-old children. Unexpectedly, the post-treatment scores on the Atypicality scale of the BASC-2, which measures some of the core features of autism, changed significantly (p=0.003). CONCLUSIONS: A movement-based, modified RR program, involving yoga and dance, showed efficacy in treating behavioral and some core features of autism, particularly for latency-age children.</p>
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OBJECTIVES: The study objectives were to develop and objectively assess the therapeutic effect of a novel movement-based complementary and alternative medicine approach for children with an autism-spectrum disorder (ASD).DESIGN: A within-subject analysis comparing pre- to post-treatment scores on two standard measures of childhood behavioral problems was used. SETTINGS AND LOCATION: The intervention and data analysis occurred at a tertiary care, medical school teaching hospital. SUBJECTS: Twenty-four (24) children aged 3-16 years with a diagnosis of an ASD comprised the study group. INTERVENTION: The efficacy of an 8-week multimodal yoga, dance, and music therapy program based on the relaxation response (RR) was developed and examined. OUTCOME MEASURES: The study outcome was measured using The Behavioral Assessment System for Children, Second Edition (BASC-2) and the Aberrant Behavioral Checklist (ABC). RESULTS: Robust changes were found on the BASC-2, primarily for 5-12-year-old children. Unexpectedly, the post-treatment scores on the Atypicality scale of the BASC-2, which measures some of the core features of autism, changed significantly (p=0.003). CONCLUSIONS: A movement-based, modified RR program, involving yoga and dance, showed efficacy in treating behavioral and some core features of autism, particularly for latency-age children.

BACKGROUND: The diagnosis and treatment of cancer poses severe psychologic distress that impacts functional quality of life. While cancer directed treatments are directed purely against tumor killing, interventions that reduce treatment related distress and improve quality of life are the need of the hour. Yoga is one such mind body intervention that is gaining popularity among cancer patients. METHOD: Several research studies in the last two decades unravel the benefits of yoga in terms of improved mood states, symptom reduction, stress reduction and improved quality of life apart from improving host factors that are known to affect survival in cancer patients. However, several metaanalysis and reviews show equivocal benefits for yoga. In this review, we will study the Yoga interventions in cancer patients with respect to expectations, benefits and risks and analyse the principles behind tailoring yoga interventions in cancer patients. RESULTS: The studies on Yoga show heterogeneity with varied types of Yoga Interventions, duration, exposure, practices and indications. It also elucidates the situational context for reaping benefits and cautions against its use in several others. However, there are several reviews and bibliometric analysis of effects of yoga; most of them have not enlarged the scope of their review to cover the basic principles behind use of these practices in cancer patients. CONCLUSION: This review offers insight into the principles and practice of yoga in cancer patients.

We test the generally held belief that sacred forests are better managed thanforest reserves. Towards this end, tree diversity, population structure and their relation to site disturbances were studied in five replicate stands each of sacred forests and reference reserve forests in southern Eastern Ghats of Andhra Pradesh. In each of the study sites, two belt transects of size 5 x 1000 m were laid down randomly for assessing tree species. A total of 7836 trees belonging to 158 species were inventoried in all the stands. The stands in the sacred forests were more diverse, had higher basal area, and showed fewer signs of disturbance than the reference forest stands, supporting the view that local communities afford better protection and management to sacred groves. We suggest that the long-term sustenance of biodiversity in sacred forest sites require an integrated approach involving local communities as well the government sector.

This paper explains Tibetan Medicine and its adherence to the tradition. The author has also analysed its historicalbackground and its relationship to Ayurveda.

This paper explains Tibetan Medicine and its adherence to the tradition. The author has also analysed its historicalbackground and its relationship to Ayurveda.

A humanistic and transpersonal approach to personal growth necessitates careful inquiry into the often pathological world of egoistic functioning—where the psyche is engaged in a continual, defensive, and ruminative effort to assert the uniqueness, power, and positivity of an independent symbolic self. This article describes narrative research, conducted at the beginning of several undergraduate courses in personality theory, in which students (n = 229) were encouraged to introspect into the process of objectifying and evaluating the self. After undergoing brief mindfulness training, individuals spent 1 week journaling about salient upward and downward social comparisons, with particular attention to those experiences that triggered strong feelings of inferiority and superiority. Prototypic journal passages are quoted to illustrate central findings. Participants expressed a remarkably intense array of self-evaluative episodes, particularly along the dimensions of physical appearance and intellect. Discussion focuses on the very high frequency of social comparisons reported, the cyclical nature of self-evaluation and its implications for persistent suffering, and the spontaneous experiences of insight into ego transcendence and deeper levels of self-awareness. This work advances the humanistic project by detailing a novel mechanism for facilitating self-realization in an educational context.

Yoga is a traditional life-style practice used for spiritual reasons. However, the physical components like the asanas and pranayaamas have demonstrated physiological and therapeutic effects. There is evidence for Yoga as being a potent antidepressant that matches with drugs. In depressive disorder, yoga 'corrects' an underlying cognitive physiology. In schizophrenia patients, yoga has benefits as an add-on intervention in pharmacologically stabilized subjects. The effects are particularly notable on negative symptoms. Yoga also helps to correct social cognition. Yoga can be introduced early in the treatment of psychosis with some benefits. Elevation of oxytocin may be a mechanism of yoga effects in schizophrenia. Certain components of yoga have demonstrated neurobiological effects similar to those of vagal stimulation, indicating this (indirect or autogenous vagal stimulation) as a possible mechanism of its action. It is time, psychiatrists exploited the benefits if yoga for a comprehensive care in their patients.

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