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Maryland University of Integrative Health

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Sullivan M.,Maryland University of Integrative Health | Leach M.,University of South Australia | Snow J.,Maryland University of Integrative Health | Moonaz S.,Maryland University of Integrative Health
Complementary Therapies in Medicine | Year: 2017

Introduction Little is known about the adoption of evidence-based practice (EBP) by yoga therapists (YTs). Objective To determine the attitudes, skills, training, use, barriers and facilitators to the use of EBP amongst North American YTs Design Cross-sectional, descriptive survey Methods Self-identified YTs practicing in North America were invited to participate in an online survey. YT attitudes, skills, training, utilisation, barriers to use, and facilitators of EBP use were measured using the 84-item Evidence-Based practice Attitude and utilization SurvEy (EBASE). Results 367 members responded (∼20% of eligible participants). Attitudes towards EBP were generally positive with 88% agreeing that professional literature and research findings were useful for the practice of yoga therapy. Most (80%) were interested in improving their skills and the majority agreed that EBP improves the quality of care (68%), assists in making decisions (74%) and takes into account the YTs clinical experience when making clinical decisions (59%). Moderate to moderately-high levels of perceived skill in EBP were reported mostly utilizing online search engines (51%). Lack of clinical evidence was the only notable barrier to uptake reported by YTs (48%). Facilitators to EBP included access to online EBP education materials (70.6%), ability to download full-text journal articles and access to free online databases in the workplace (67.3%). Conclusion North American YTs report positive attitudes, moderate to moderately-high levels of perceived skill and moderate uptake of EBP. This aligns them with other complementary and integrative health practitioners. Initiatives to support the adoption of EBP are proposed as a means of improving best practice in yoga therapy. © 2017 Elsevier Ltd


Snow J.E.,Maryland University of Integrative Health | Leach M.J.,University of South Australia | Clare B.A.,Maryland University of Integrative Health
Journal of Complementary and Integrative Medicine | Year: 2017

Evidence-based practice (EBP) has been the focus of increasing attention in the teaching and delivery of both complementary and conventional healthcare. Western herbal medicine (WHM) is a system of complementary healthcare rooted in tradition. How WHM practitioners perceive, are prepared for, and use EBP, has to date been largely ignored. We therefore examined the use, opinion, skills, and training in EBP, and barriers and facilitators of EBP uptake, among herbal practitioners in the United States (US). The study utilized a cross-sectional, descriptive survey design. A sample of US clinical herbalists was invited to complete a validated online questionnaire, the Evidence-Based practice Attitude and utilization SurvEy (EBASE). Seventy-four US herbal practitioners completed the survey (response rate=35%). Participants demonstrated a generally positive attitude toward EBP (median attitude subscore 31 [possible range=8-40]), a moderate to high level of self-assessed skill in EBP (median skill subscore 46 [13-65]) and a moderate level of EBP uptake (median use subscore 12 [0-24]). Apart from a lack of clinical evidence in herbal medicine, there were few perceived barriers to EBP uptake among herbal practitioners. Access to the Internet, online databases and full-text journal articles were considered most useful in facilitating the uptake of EBP in WHM practice. Respondents' attitudes, skill level, and uptake of EBP were generally consistent with other complementary and alternative medicine providers. Educational initiatives, including those focused on the appraisal and application of evidence, may help to optimize the use of EBP among WHM practitioners. © 2016 by De Gruyter.


Huffaker G.,Retired Pediatric Ophthalmologist from the Riverside Medical Center in | Petrie D.,Dalhousie University | Kreisberg J.,Maryland University of Integrative Health
The Permanente journal | Year: 2015

This report on the First International Congress on Whole Person Care, sponsored by McGill University, is based on the experiences of two attending authors who developed a poster of Integral Theory that emphasized the importance of taking multiple perspectives in all areas of human inquiry to allow a "big picture" perspective on medicine. Interiors (thoughts, intentions, will) of both physician and patient are as important as the exteriors (measurable parameters, such as lab results) which are often emphasized.


With an upcoming publication in the Worldwide Leaders in Healthcare, Jody Roblyer, RN, PNP-BC, joins the prestigious ranks of the International Nurses Association. Jody is a Registered Nurse, Pediatric Primary Care Nurse Practitioner, and Health Coach with 35 years of experience in her field and an extensive expertise in all facets of nursing, especially alternative health, homeopathy, detoxification, and health coaching. Jody is currently serving patients at Monarch Holistic Healing in Upperco, Maryland, which she established in 2013. Alongside her work in private practice, Jody is a Clinical Instructor at Johns Hopkins University School of Nursing in Baltimore, Maryland. Jody Roblyer graduated with her Bachelor of Science Degree in Nursing from Binghamton University. An advocate for continuing education, Jody went on to gain her Master of Science Degree with a focus on Pediatric Primary Care and Nursing Education from the University of Maryland. Jody then obtained her postgraduate certification in Health Coaching at Maryland University of Integrative Health, and has earned the coveted title of Fellow in Anti-Aging Functional and Regenerative Medicine by the American Academy of Anti-Aging Medicine. To keep up to date with the latest advances and developments in her field, Jody maintains a professional membership with the National Association of Pediatric Nurse Practitioners and the Chesapeake Chapter of the National Association of Pediatric Nurse Practitioners. A Board Certified Pediatric Nurse Practitioner, Jody attributes her great success to her hard work, and continuing her education. When she is not assisting patients, Jody enjoys organic gardening, hiking, and butterflies. Learn more about Jody Roblyer here: http://inanurse.org/network/index.php?do=/4134007/info/ and be sure to read her upcoming publication in the Worldwide Leaders in Healthcare.


Snow J.,Maryland University of Integrative Health
Explore: The Journal of Science and Healing | Year: 2016

Western herbal medicine (WHM) is a complex healthcare system that uses traditional plant-based medicines in patient care. Typical preparations are individualized polyherbal formulae that, unlike herbal pills, retain the odor and taste of whole herbs. Qualitative studies in WHM show patient-practitioner relationships to be collaborative. Health narratives are co-constructed, leading to assessments, and treatments with personal significance for participants. It is hypothesized that the distinct characteristics of traditional herbal preparations and patient-herbalist interactions, in conjunction with the WHM physical healthcare environment, evoke context (placebo) effects that are fundamental to the overall effectiveness of herbal treatment. These context effects may need to be minimized to demonstrate pharmacological efficacy of herbal formulae in randomized, placebo-controlled trials, optimized to demonstrate effectiveness of WHM in pragmatic trials, and consciously harnessed to enhance outcomes in clinical practice. © 2016 Elsevier Inc. All rights reserved.


Jeter P.E.,Wilmer Eye Institute | Nkodo A.-F.,Wilmer Eye Institute | Moonaz S.H.,Maryland University of Integrative Health | Moonaz S.H.,Annual Symposium on Yoga Research | Dagnelie G.,Wilmer Eye Institute
Journal of Alternative and Complementary Medicine | Year: 2014

Objective: A systematic review was done of the evidence on yoga for improving balance. Design: Relevant articles and reviews were identified in major databases (PubMed, MEDLINE®, IndMed, Web of Knowledge, EMBASE, EBSCO, Science Direct, and Google Scholar), and their reference lists searched. Key search words were yoga, balance, proprioception, falling, fear of falling, and falls. Included studies were peer-reviewed articles published in English before June 2012, using healthy populations. All yoga styles and study designs were included. Two (2) raters individually rated study quality using the Downs & Black (DB) checklist. Final scores were achieved by consensus. Achievable scores ranged from 0 to 27. Effect size (ES) was calculated where possible. Results: Fifteen (15) of 152 studies (age range 10-93, n=688) met the inclusion criteria: 5 randomized controlled trials (RCTs), 4 quasi-experimental, 2 cross-sectional, and 4 single-group designs. DB scores ranged from 10 to 24 (RCTs), 14-19 (quasi-experimental), 6-12 (cross-sectional), and 11-20 (single group). Studies varied by yoga style, frequency of practice, and duration. Eleven (11) studies found positive results (p<0.05) on at least one balance outcome. ES ranged from -0.765 to 2.71 (for 8 studies) and was not associated with DB score. Conclusions: Yoga may have a beneficial effect on balance, but variable study design and poor reporting quality obscure the results. Balance as an outcome is underutilized, and more probing measures are needed. © Copyright 2014, Mary Ann Liebert, Inc. 2014.


Zhu H.,Maryland University of Integrative Health
Medical Acupuncture | Year: 2014

Background: As an important modality of Traditional Chinese Medicine, acupuncture has been widely accepted by the Western world in the past 4 decades because of this modality's efficacy and safety. A vast amount of acupuncture research has been done. However, the mechanisms of acupuncture actions are still elusive. It is believed that the effects of acupuncture treatment begin from the moment of needle insertion.Methods: This review focuses on the acupuncture points and the three major reactions at the acupuncture points when needling is performed. These initial reactions may be the beginning of the healing process that initiates downstream effects through neuronal and humoral pathways. In addition to the physical reactions, this article also discusses the possibility of the effects of acupuncture on the healing process through a holistic pathway. Conclusions: Needling is the first step of traditional acupuncture therapy. Needling reactions - neuronal, biophysical, and biochemical - are the beginning of healing. The messengers of the three reactions involved may include neurotransmitters, cytokines, hormones, and inflammatory factors. Healing may be potentiated through these messengers in neuronal and humoral pathways. The reactions manifest as erythema and De Qi - both of which are common phenomena used as positive signs in acupuncture treatment. Acupuncture may also play a role in the healing process through the holistic pathway, which needs further study. © Copyright 2014, Mary Ann Liebert, Inc. 2014.


Jeter P.E.,Johns Hopkins University | Jeter P.E.,Maryland University of Integrative Health | Slutsky J.,Northeastern University | Singh N.,Patanjali Research Foundation | Khalsa S.B.S.,Harvard University
Journal of Alternative and Complementary Medicine | Year: 2015

Objective: A comprehensive bibliometric analysis was conducted on publications for yoga therapy research in clinical populations. Methods: Major electronic databases were searched for articles in all languages published between 1967 and 2013. Databases included PubMed, PsychInfo, MEDLINE, IndMed, Indian Citation Index, Index Medicus for South-East Asia Region, Web of Knowledge, Embase, EBSCO, and Google Scholar. Nonindexed journals were searched manually. Key search words included yoga, yoga therapy, pranayama, asana. All studies met the definition of a clinical trial. All styles of yoga were included. The authors extracted the data. Results: A total of 486 articles met the inclusion criteria and were published in 217 different peer-reviewed journals from 29 different countries on 28,080 study participants. The primary result observed is the three-fold increase in number of publications seen in the last 10 years, inclusive of all study designs. Overall, 45% of the studies published were randomized controlled trials, 18% were controlled studies, and 37% were uncontrolled studies. Most publications originated from India (n=258), followed by the United States (n=122) and Canada (n=13). The top three disorders addressed by yoga interventions were mental health, cardiovascular disease, and respiratory disease. Conclusion: A surge in publications on yoga to mitigate disease-related symptoms in clinical populations has occurred despite challenges facing the field of yoga research, which include standardization and limitations in funding, time, and resources. The population at large has observed a parallel surge in the use of yoga outside of clinical practice. The use of yoga as a complementary therapy in clinical practice may lead to health benefits beyond traditional treatment alone; however, to effect changes in health care policy, more high-quality, evidence-based research is needed. © Mary Ann Liebert, Inc. 2015.


Moonaz S.H.,Maryland University of Integrative Health | Bingham C.O.,Johns Hopkins University | Wissow L.,Johns Hopkins University | Bartlett S.J.,McGill University
Journal of Rheumatology | Year: 2015

Objective. To evaluate the effect of Integral-based hatha yoga in sedentary people with arthritis. Methods. There were 75 sedentary adults aged 18+ years with rheumatoid arthritis (RA) or knee osteoarthritis randomly assigned to 8 weeks of yoga (two 60-min classes and 1 home practice/wk) or waitlist. Poses were modified for individual needs. The primary endpoint was physical health [Medical Outcomes Study Short Form-36 (SF-36) physical component summary (PCS)] adjusted for baseline; exploratory adjusted outcomes included fitness, mood, stress, self-efficacy, SF-36 health-related quality of life (HRQOL), and RA disease activity. In everyone completing yoga, we explored longterm effects at 9 months. Results. Participants were mostly female (96%), white (55%), and college-educated (51%), with a mean (SD) age of 52 years (12 yrs). Average disease duration was 9 years and 49% had RA. At 8 weeks, yoga was associated with significantly higher PCS (6.5, 95% CI 2.0-10.7), walking capacity (125 m, 95% CI 15-235), positive affect (5.2, 95% CI 1.4-8.9), and lower Center for Epidemiologic Studies Depression Scale (-3.0, 95% CI-4.8-1.3). Significant improvements (p < 0.05) were evident in SF-36 role physical, pain, general health, vitality, and mental health scales. Balance, grip strength, and flexibility were similar between groups. Twenty-two out of 28 in the waitlist group completed yoga. Among all yoga participants, significant (p < 0.05) improvements were observed in mean PCS, flexibility, 6-min walk, and all psychological and most HRQOL domains at 8 weeks with most still evident 9 months later. Of 7 adverse events, none were associated with yoga. Conclusion. Preliminary evidence suggests yoga may help sedentary individuals with arthritis safely increase physical activity, and improve physical and psychological health and HRQOL. © 2015. All rights reserved.


PubMed | Georgia State University and Maryland University of Integrative Health
Type: | Journal: International journal of yoga therapy | Year: 2016

Generalized anxiety disorder (GAD) is a prevalent psychiatric disorder associated with substantial impairment and poor treatment response. Yoga influences processes that are linked to the maintenance of GAD including mindfulness, anxiety, and heart rate variability, but has yet to be evaluated among people with the disorder. The present study is a first step toward documenting the efficacy of yoga for reducing worry among people with GAD using a single-subject AB design case series and daily ratings of worry. Standardized self-report measures of worry, trait anxiety, experiential avoidance, mindfulness, and heart rate variability were assessed pre- and post-intervention. Three participants with primary GAD received eight twice-weekly Kripalu yoga sessions following a baseline data collection period. All participants showed systematic improvement in daily worry ratings on at least one index and all scores on self-reported measures of worry, anxiety, experiential avoidance, and mindfulness changed in the expected direction following yoga (with one or two exceptions). Participants also showed improved heart rate variability during a worry period from pre- to post-intervention. Yoga has the potential to improve the processes linked to GAD and should stimulate further research in this area.

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