Introduction: Cancer patients often choose complementary and alternative medicine (CAM) in palliative care, often in addition to conventional treatment and without medical advice or approval. Herbal medicines (HM) are the most commonly used type of CAM, but rarely available on an in-patient basis for palliative care. The motivations which lead very ill patients to travel far to receive such therapies are not clear. A qualitative study was therefore carried out to investigate influences on choosing to attend a CAM herbal hospice, to identify cancer patients' main concerns about end-of-life care. Methods: Semi-structured interviews with 32 patients were conducted and analysed using thematic analysis. Patients were recruited from Arokhayasala, a Buddhist cancer hospice in Thailand which provides CAM, in the form of HM, a restricted diet, Thai yoga, deep-breathing exercises, meditation, chanting, Dhamma, laughter and music therapy, free-of-charge. Results: The main factors influencing decision-making were a positive attitude towards HMs and previous use of them, dissatisfaction with conventional treatment, the home environment and their relationships with hospital doctors. Conclusion: Patients' own perceptions and experiences were more important in making the decision to use CAM, and especially HM, in palliative cancer care than referral by healthcare professionals or scientific evidence of efficacy. Patients were prepared to travel far and live away from home to receive such care, especially as it was cost-free. In view of patients' previously stated satisfaction with the regime at the Arokhayasala, these findings may be relevant to the provision of in-patient cancer palliative care to other patients. (C) 2016 Elsevier GmbH. All rights reserved.
It is well understood that wilderness expeditions improve well-being; however, there is little supporting quantitative data. The aim of this study was to measure the impact of wilderness expeditions on self-esteem (SE) and connectedness to nature (CN) and assess whether benefits varied according to participant and expedition characteristics. SE and CN were assessed pre? and post?wilderness expeditions in 130 adolescents using Rosenberg?s SE scale and the state CN scale. Two-way ANOVA revealed significant increases in SE and CN (p < .001) as a result of single expeditions. There was also an interaction effect of expedition and gender on SE (p < .05). Males had a higher SE at the start but female SE increased most. Linear regression revealed that living environment, gender, and the length and location of the expedition did not contribute to changes in SE and CN. Regular contact with natural environments will improve adolescent well-being, with the largest improvements in females.
For over a decade, a wilderness outing program in Michigan's Upper Peninsula has been the object of continuing research focusing on the impact of an intense nature experience on people's lives. The results discussed here are based on the questionnaires completed by the 49 participants in the last two years of the Program. A consistently striking finding of this ongoing research program has been the richness of the psychological benefits obtained. Based on familiarity and preference ratings of photographs, reactions to the solo experience, and ratings of moods and feelings both before and at the conclusion of the Program, the results speak to the pervasive power of the wilderness environment experience. It is suggested that the implications of these findings may transcend the particular environment. The psychological dimensions reflected here are likely to be vital aspects of effective human functioning in other settings as well.
Some parks, preserves, and other natural areas serve people well; others are disappointing. Successful design and management requires knowledge of both people and environments.With People in Mind explores how to design and manage areas of "everyday nature" -- parks and open spaces, corporate grounds, vacant lots and backyard gardens, fields and forests -- in ways that are beneficial to and appreciated by humans. Rachel Kaplan and Stephen Kaplan, leading researchers in the field of environmental psychology, along with Robert Ryan, a landscape architect and urban planner, provide a conceptual framework for considering the human dimensions of natural areas and offer a fresh perspective on the subject. The authors examine physical aspects of natural settings that enhance preference and reduce fear ways to facilitate way-finding how to create restorative settings that allow people to recover from the stress of daily demands landscape elements that are particularly important to human needs techniques for obtaining useful public input
Purpose To evaluate yoga's impact on inflammation, mood, and fatigue. Patients and Methods A randomized controlled 3-month trial was conducted with two post-treatment assessments of 200 breast cancer survivors assigned to either 12 weeks of 90-minute twice per week hatha yoga classes or a wait-list control. The main outcome measures were lipopolysaccharide-stimulated production of proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-), and interleukin-1 (IL-1), and scores on the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF), the vitality scale from the Medical Outcomes Study 36-item Short Form (SF-36), and the Center for Epidemiological Studies-Depression (CES-D) scale. Results Immediately post-treatment, fatigue was not lower (P > .05) but vitality was higher (P = .01) in the yoga group compared with the control group. At 3 months post-treatment, fatigue was lower in the yoga group (P = .002), vitality was higher (P = .01), and IL-6 (P = .027), TNF- (P = .027), and IL-1 (P = .037) were lower for yoga participants compared with the control group. Groups did not differ on depression at either time (P > .2). Planned secondary analyses showed that the frequency of yoga practice had stronger associations with fatigue at both post-treatment visits (P = .019; P < .001), as well as vitality (P = .016; P = .0045), but not depression (P > .05) than simple group assignment; more frequent practice produced larger changes. At 3 months post-treatment, increasing yoga practice also led to a decrease in IL-6 (P = .01) and IL-1 (P = .03) production but not in TNF- production (P > .05). Conclusion Chronic inflammation may fuel declines in physical function leading to frailty and disability. If yoga dampens or limits both fatigue and inflammation, then regular practice could have substantial health benefits.
Purpose To evaluate yoga's impact on inflammation, mood, and fatigue. Patients and Methods A randomized controlled 3-month trial was conducted with two post-treatment assessments of 200 breast cancer survivors assigned to either 12 weeks of 90-minute twice per week hatha yoga classes or a wait-list control. The main outcome measures were lipopolysaccharide-stimulated production of proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-), and interleukin-1 (IL-1), and scores on the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF), the vitality scale from the Medical Outcomes Study 36-item Short Form (SF-36), and the Center for Epidemiological Studies-Depression (CES-D) scale. Results Immediately post-treatment, fatigue was not lower (P > .05) but vitality was higher (P = .01) in the yoga group compared with the control group. At 3 months post-treatment, fatigue was lower in the yoga group (P = .002), vitality was higher (P = .01), and IL-6 (P = .027), TNF- (P = .027), and IL-1 (P = .037) were lower for yoga participants compared with the control group. Groups did not differ on depression at either time (P > .2). Planned secondary analyses showed that the frequency of yoga practice had stronger associations with fatigue at both post-treatment visits (P = .019; P < .001), as well as vitality (P = .016; P = .0045), but not depression (P > .05) than simple group assignment; more frequent practice produced larger changes. At 3 months post-treatment, increasing yoga practice also led to a decrease in IL-6 (P = .01) and IL-1 (P = .03) production but not in TNF- production (P > .05). Conclusion Chronic inflammation may fuel declines in physical function leading to frailty and disability. If yoga dampens or limits both fatigue and inflammation, then regular practice could have substantial health benefits.
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