Five-week yin yoga-based interventions decreased plasma adrenomedullin and increased psychological health in stressed adults: A randomized controlled trial

Effects of Yin Yoga on Burden and Self-Compassion in Caregivers of Persons With Dementia: A Pilot Study

Informal caregivers of persons with dementia face tremendous challenges in balancing their own needs and those of the care recipient. The aim of the current pilot study was to test the feasibility and acceptability of a Yin yoga intervention on caregiver burden and self-compassion. This study used a convenience sample (N = 5) with one group pre-survey/post-survey design. Participants were asked to complete a 60-minute Yin yoga intervention via Zoom three times per week for 8 weeks. Pre- and post-intervention comparisons were performed on caregiver burden (Zarit Burden Interview Scale) and self-compassion (Neff Self-Compassion Scale). Results indicated that the intervention was feasible and acceptable with slight modifications, including (a) leveraging social networks to increase the scope of recruitment efforts nationally and increase the size and diversity of the sample, (b) adding an activity log to better understand adherence, and (c) offering more live yoga sessions. [Journal of Gerontological Nursing, 49(6), 22-27.].

Associations of Plasma Bioactive Adrenomedullin Levels with Cardiovascular Risk Factors in BRCA1/2 Mutation Carriers

Background Cardiovascular disease (CVD) is an important cause of morbidity and mortality in breast cancer survivors. Effective screening modalities to identify CVD risk are lacking in this population. Adrenomedullin (ADM) has been suggested as a biomarker for subclinical cardiac dysfunction in the general population. Levels of ADM have been proven to be responsive to lifestyle changes that lead to improved cardiovascular health. As BRCA1/2 mutation carriers are deemed to be at an increased risk for CVD, the aim of this study was to examine plasma ADM levels in a cohort of BRCA mutation carriers and to assess their association with cardiovascular risk factors.

Methods Plasma ADM concentrations were measured in 292 female BRCA1/2 mutation carriers with and without a history of breast cancer. Subjects were classified into high versus low ADM levels based on the median ADM level in the entire cohort (13.8 pg/mL). Logistic regression models were used to estimate the odds ratios (OR) of having elevated ADM levels by several cardiovascular risk factors.

Results Of all women (median age: 43 years), 57.5% had a previous diagnosis of breast cancer. The median time between diagnosis and study entry was three years (range: 0 – 32 years). Women presenting with metabolic syndrome had 22-fold increased odds of having elevated ADM levels (p < 0.001). Elevated ADM levels were associated with lower cardiorespiratory fitness (OR = 0.88, p < 0.001) and several parameters of obesity (p < 0.001). ADM levels were higher in women who have ever smoked (OR = 1.72, p = 0.02). ADM levels were not associated with a previous diagnosis of breast cancer (p = 0.28).

Conclusions This is the first study in BRCA mutation carriers that has linked circulating ADM levels to traditional cardiovascular risk factors. The long-term clinical implications of these findings are yet to be determined.

Boosting prosocial career aspirations: Loving-kindness meditation relates to higher communal career goals in youth

Wanting to help others and benefit society in one's future career are examples of communal career goals. Raising these goals in youth should increase interest in HEED‐occupations (Healthcare, Early Education, Domestic, and the Domestic fields) which are strongly gender‐skewed and face labor shortage. Research has yet to find ways to increase communal career goals. In this study, we test the novel hypothesis that after listening to a brief loving‐kindness meditation, participants will rate stronger communal career goals, as compared to controls. In three experimental studies, volunteering high‐school students (Study 1 and 3) and university students (Study 2) listened to a 12‐min recording of the meditation with the explicit purpose of investigating its effect on stress. They thereafter filled out an apparently unrelated career goal survey. We compared the results with a control group that just rated the career goals (Studies 1–3) and a control group that listened to calm music before filling out the survey (Study 2 and 3). The results showed that the high‐school students rated higher communal career goals after listening to the meditation, as compared to controls. We did not replicate the result in the sample of university students, which could relate to adults having less flexible career goals than youth, or to a ceiling effect in communal goals. This is the first study that has demonstrated a method with the potential of increasing communal career goals in youth. In addition to increasing interest in HEED, raising communal goals could benefit society, since they are intrinsically prosocial.

Cardiovascular therapeutics: A new potential for anxiety treatment?

Besides the well‐recognized risk factors, novel conditions increasing cardiovascular morbidity and mortality are emerging. Undesirable emotions and behavior such as anxiety and depression, appear to participate in worsening cardiovascular pathologies. On the other hand, deteriorating conditions of the heart and vasculature result in disturbed mental and emotional health. The pathophysiological background of this bidirectional interplay could reside in an inappropriate activation of vegetative neurohormonal and other humoral systems in both cardiovascular and psychological disturbances. This results in circulus vitiosus potentiating mental and circulatory disorders. Thus, it appears to be of utmost importance to examine the alteration of emotions, cognition, and behavior in cardiovascular patients. In terms of this consideration, recognizing the potential of principal cardiovascular drugs to interact with the mental state in patients with heart or vasculature disturbances is unavoidable, to optimize their therapeutic benefit. In general, beta‐blockers, central sympatholytics, ACE inhibitors, ARBs, aldosterone receptor blockers, sacubitril/valsartan, and fibrates are considered to exert anxiolytic effect in animal experiments and clinical settings. Statins and some beta‐blockers appear to have an equivocal impact on mood and anxiety and ivabradine expressed neutral psychological impact. It seems reasonable to suppose that the knowledge of a patient's mood, cognition, and behavior, along with applying careful consideration of the choice of the particular cardiovascular drug and respecting its potential psychological benefit or harm might improve the individualized approach to the treatment of cardiovascular disorders.

Exercise interventions to reduce anxiety in mid-life and late-life anxiety disorders and subthreshold anxiety disorder: a systematic review

BACKGROUND

Anxiety disorders are highly prevalent and cause significant distress, disability, and cost. Medication adverse effects and interactions increase in mid-life and late-life, highlighting the need for effective non-pharmacological interventions.

OBJECTIVES

We aimed to evaluate the extent of evidence supporting exercise interventions for anxiety and subthreshold anxiety disorders in mid-life and late-life.

DESIGN

Systematic review.

DATA SOURCES AND METHODS

We searched MEDLINE, PsycINFO, Embase, Emcare, Ovid Nursing, CINAHL Plus, Cochrane Library, Health Collection, Humanities & Social Sciences Collection, and https://clinicaltrials.gov databases for trials published January 1994-May 2019. Randomised controlled trials of exercise interventions involving aerobic exercise or resistance training for adults aged 40 years and above with anxiety or subthreshold anxiety disorders in residential or health settings were identified. The primary outcome was change in anxiety. We excluded trials including participants aged below 40 years, participants with diagnosis of separation anxiety, selective mutism, obsessive-compulsive disorder, acute stress disorder and post-traumatic stress disorder, and head-to-head comparisons of interventions. Trial quality was assessed using the Cochrane Risk of Bias Tool and evidence synthesised in narrative form.

RESULTS

Four trials totalling 132 participants met inclusion criteria, although some had methodological limitations. Interventions included a home-based resistance training intervention, supervised group-based aerobic intervention, Tai Chi intervention, and supervised group-based aerobic and strength intervention. Three trials included late-life participants and the fourth mid-life. Three trials demonstrated greater reductions in anxiety in the intervention group compared with control. The fourth trial showed pre-post reductions in anxiety in both groups, with between-group difference not reaching statistical significance.

CONCLUSION

There is limited supportive evidence suggesting that exercise interventions have potential to be effective, feasible and safe non-pharmacological interventions for anxiety and subthreshold anxiety disorders in mid-life and late-life. The heterogeneity, limited number and high risk of bias of some trials meant that we were not able to conduct a meta-analysis. Tailoring of interventions may improve uptake and reduce dropout. The paucity of research in this area with only four included trials demonstrates the urgent need for future and larger trials to provide proof of concept, data about effective types and doses of exercise interventions, and guidance to community, clinical, and public health services.

Impact of a Yin Yoga and meditation intervention on pharmacy faculty and student well-being

BACKGROUND

Student pharmacists and faculty exhibit high levels of stress, independent of the current coronavirus 2019 pandemic, and their path toward wellness, including a reduction in stress and anxiety, is of the utmost importance. Yoga and meditation are proven interventions to reduce stress and anxiety and increase wellness. Yin yoga is an adaptable, quiet practice ideal for those lacking previous yoga experience, flexibility, and time.

OBJECTIVE

To evaluate the impact of a 6-week yin yoga and meditation intervention on College of Pharmacy faculty and students' stress perception, anxiety levels, and mindfulness skills.

METHODS

Faculty and students participated in a 6-week pilot program comprising a once-weekly yin yoga class followed by guided meditation. Yin yoga was selected for its quiet meditative style. Participants completed a pre- and postquestionnaire at 6 weeks and 3 and 6 months to evaluate potential changes in perceived stress scores, anxiety scores, and mindfulness skills. The questionnaire was composed of 3 self-reporting tools: Beck Anxiety Inventory (BAI), Perceived Stress Scale, and the Five Facet Mindfulness Questionnaire.

RESULTS

Twenty participants, 12 students and 8 faculty (ages 18-66 years), completed the study. Anxiety and stress scores decreased, and mindfulness increased at 6 weeks, 3 months and 6 months, with all changes reaching statistical significance. No participants reported being in the "high" category of anxiety after intervention using BAI categorical data, although this finding was not statistically significant.

CONCLUSION

Faculty and students demonstrated a reduction in stress and anxiety levels and an increase in mindfulness after a 6-week yin yoga and meditation program. Outcomes suggest that inclusion of an adaptable, meditative practice, which may easily be replicated at home, for as little as once per week for 6 weeks may reduce stress and anxiety and increase mindfulness long term. Creating a culture of wellness should be a priority for all Colleges of Pharmacy.

Association between yoga, physiologic and psychologic health: A cross sectional study

PURPOSE

To compare markers of health associated with chronic diseases between yoga and non-yoga participants.

METHODS

30 participants were categorized as either: 1) "Yoga" engaging in yoga ≥2 times/week for ≥6 months, or 2) "Non-yoga" not engaging in yoga.

RESULTS

Perceived Stress Scale (PSS) and Beck Depression Inventory-II (BDI-II) scores were significantly different between the yoga and non-yoga groups (PSS: 8.0 vs. 17.5, respectively, p < 0.05; BDI-II: 1.0 vs. 5.5, respectively, p < 0.05). No significant differences were evident between groups for inflammatory markers nor Complex V of the mitochondrial electron transport chain. The erythrocyte sedimentation rate values differed between groups based on clinical cutoffs, with yoga participants categorized as normal (11.0 mm) and non-yoga above normal (21.5 mm).

CONCLUSION

This research supports that yoga participation is associated with lower PSS and BDI-II scores but does not support a relationship with markers of inflammation. Further research is warranted.

Effects of one month of Common Yoga Protocol practice appear to be mediated by the angiogenic and neurogenic pathway: A pilot study

OBJECTIVE

To examine the molecular effects of mindful activities such as yoga and meditation DESIGN: This was an open label single arm exploratory yoga intervention study.

STUDY PARTICIPANTS

64 healthy individuals within the age of 18-60 years were recruited for this one month yoga intervention study.

INTERVENTION

Common Yoga Protocol (CYP) is a standardized yoga protocol released by Ministry of AYUSH, India for International Yoga Day. It includes all aspects of yoga i.e. asanas, pranayama and meditation. It is designed for adoption by all age groups for the health of community.

OUTCOME MEASURES

The participants were assessed for biochemical parameters including Fasting Sugar and Lipid profile. The molecular markers of neurogenesis (i.e. Brain derived Neurotropic Factor, BDNF) and Angiogenesis (i.e. Vascular Endothelial Growth Factor, VEGF and Angiogenin) along with Amyloid β (marker related to neuro-degenerative diseases) were assessed. All the assessments were made at baseline and after one month of the intervention.

RESULTS

After one month of CYP practice High Density Lipoprotein (HDL) levels increased significantly (p<0.001), although other biochemical parameters i.e. fasting sugar and other lipid assessments were found to be unaltered. Angiogenesis marker, angiogenin was increased significantly (p<0.002), other angiogenesis marker VEGF did not show any change along with BDNF, marker of neurogenesis. Amyloid β levels were also unaltered. Even though individual levels of VEGF and Amyloid β did not show any change, proportion of VEGF to Amyloid β showed a significant increase (p<0.001) after one month of CYP intervention indicating that the change in VEGF levels was significantly higher than the change in Amyloid β levels.

CONCLUSION

CYP practice may influence cell survival pathways mediated by angiogenic and neurogenic cross talk. Hence, CYP can be considered as a preventive measure for diseases associated with impaired angiogenic and neurogenic mechanism. This is the first study to examine the effects of CYP at the molecular level.

Range of Yoga Intensities From Savasana to Sweating: A Systematic Review

Background: There is limited research examining the intensity of yoga and intensity variations between different styles. The purpose of this review is to examine the intensity of yoga based on different physiologic responses both between different yoga styles and within styles of yoga. Methods: Articles were searched for on the PubMed database in early 2019. Inclusion criteria were as follows: (1) written in English, (2) cite a specific style of yoga and include whole yoga session, and (3) measure metabolic or heart rate response. Results: Ten articles were reviewed; articles reported oxygen consumption (n = 1), heart rate (n = 4), or both variables (n = 5). Yoga styles assessed included ashtanga (n = 2), Bikram (n = 3), gentle (n = 1), hatha (n = 3), Iyengar (n = 1), power (n = 1), and vinyasa (n = 1). Oxygen consumption commonly categorized yoga as a light-intensity activity, while heart rate responses classified different yoga into multiple intensities. Conclusion: This review demonstrates that large differences in intensity classifications are observed between different styles of yoga. Furthermore, metabolic and heart rate responses can be variable, leading to inconsistent intensity classifications. This is likely due to their nonlinear relationship during yoga. Thus, it is imperative that the field of yoga research works together to create a standard for reporting yoga.

Efficacy of complementary and integrative medicine on health-related quality of life in cancer patients: a systematic review and meta-analysis

Complementary and integrative medicine (CIM) has been used for improving health-related quality of life (HRQOL) in patients with cancer. The objective of this review is to evaluate the effects of CIMs on the HRQOL of cancer patients. We identified randomized controlled trials (RCTs) involving patients with cancer at any stage by retrieving electronic databases from the inception to February 14, 2018 (Systematic Review Registration: PROSPERO CRD42018091609). The main outcomes were HRQOL scores and related domains such as physical well-being scores. The standardized mean difference was used for the analysis and heterogeneity was assessed with the I ² statistic. A Bayesian framework was used to estimate the ranking order of efficacy in HRQOL change. Finally, 34 RCTs with 3,010 patients were included. As a whole, the results showed clearly superior efficacy of CIM in improving HRQOL. For different domains of HRQOL, different CIM interventions may play different roles. The ranking order of efficacy in change HRQOL was qigong plus mindfulness, Chinese herbal medicine, multimodal complementary medicine, qigong, nutritional supplement, mindfulness, acupuncture, yoga, and massage, and it was different among different domains. There was no evidence of publication bias. In conclusion, CIM may improve the HRQOL of cancer patients. More studies, especially focusing on male cancer patients, are needed to increase the confidence level of our findings.