Background: Cancers are one of the leading causes of mortality worldwide. Cancer patients are inc... more Background: Cancers are one of the leading causes of mortality worldwide. Cancer patients are increasingly seeking integrative care clinics to promote their health and well-being during and after treatment. Aim: To examine relationships between physical activity (PA) and quality of life (QoL) in a sample of cancer patients enrolling in integrative care in a supportive care clinic. Also, to explore circulating inflammatory biomarkers and heart rate variability (HRV) in relationship to PA and QoL. Methods: A cross-sectional design of adult patients who sought care in the InspireHealth clinic, Vancouver, British Columbia, Canada. Patients with complete PA data (n = 118) answered psychosocial questionnaires, provided blood samples, and received HRV recordings before enrollment. Patients were stratified into “less” versus “more” active groups according to PA guidelines (150 minutes of moderate or 75 minutes of vigorous PA or an equivalent combination). Results: Breast (33.1%) and prostat...
Background: The evaluation of freestanding integrative cancer clinical programs is challenging an... more Background: The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. Objectives: A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. Study Design/Methods: This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. Results: The InspireH...
The Journal of Alternative and Complementary Medicine, 2020
Objectives: Practitioners of Biofield Tuning assess health status of their clients by detecting o... more Objectives: Practitioners of Biofield Tuning assess health status of their clients by detecting off-the-body biofield perturbations using tuning fork (TF) vibrations. This study tested inter-rater agreement (IRA) on location of these perturbations. Design: Three Biofield Tuning practitioners, in randomized order, identified locations of the 4-5 "strongest" perturbations along each of 4 sites for the same series of 10 research subjects. Setting/Location: An Integrative Health and Medicine Center in La Jolla, CA. Subjects: Adult volunteers with no serious current illness and no prior experience of a Biofield Tuning session. Interventions: Practitioners used an activated 174 Hz unweighted TF to "comb" the same four sites per subject, located on the left and right sides of the base of the spine and the heart. Outcome Measures: Practitioners identified and vocalized the distance from the body of perturbations along each site. Distances were recorded by a research assistant in the clinic room. No health information related to perturbation sites was discussed with the subjects. Results: Practitioners reported 6.3 ± 0.6 (mean ± standard deviation) perturbations per combed site per subject, with no significant difference among the raters. The overall level of IRA was low based initially on a first-pass, nonstatistical, analysis of results, with "agreement" defined within a tolerance of ±2 inches. In this approach agreement was 33%. More rigorous statistical analysis, including a statistical test using a Monte Carlo approach, strongly supported the conclusion of poor IRA. Conclusions: IRA was low despite attempts to balance the real-world practice of Biofield Tuning with the constraints of research. For example, while IRA necessitates multiple assessments of the same subject, no information exists as to whether an initial assessment may affect subsequent assessments. Our study exemplifies the challenges faced when attempting to fit interventions with incompletely understood procedures and mechanisms into conventional research designs.
Little is known about the potential influences of social and psychosocial variables in accounting... more Little is known about the potential influences of social and psychosocial variables in accounting for ethnic differences in the β-adrenergic receptor. We examined the effects of ethnicity, social class, and other variables on an in vivo marker of β-adrenergic receptor responsiveness (Chronotropic 25 Dose, CD25) for 224 African-Americans and Caucasian-Americans. Social class was determined using the clinician-rated Hollingshead two-factor index. The Cook–Medley hostility and Buss–Durkee assaultiveness subscales were administered to a subset of subjects. Results indicated that African-Americans had decreased β-receptor responsiveness compared to Caucasian-Americans after controlling for social class, age, and smoking (P=0.001). Secondary analysis for a subset of subjects revealed significant hostility×ethnicity interactions, such that hostility predicted decreased β-receptor responsiveness for Caucasian-Americans (P=0.004), but not for African-Americans. Thus, decreased β-adrenergic receptor responsiveness in African-Americans does not appear to be due to differences in current social class, age, or smoking status, nor to higher reports of hostility.
Stage B, asymptomatic heart failure (HF) presents a therapeutic window for attenuating disease pr... more Stage B, asymptomatic heart failure (HF) presents a therapeutic window for attenuating disease progression and development of HF symptoms, and improving quality of life. Gratitude, the practice of appreciating positive life features, is highly related to quality of life, leading to development of promising clinical interventions. However, few gratitude studies have investigated objective measures of physical health; most relied on self-report measures. We conducted a pilot study in Stage B HF patients to examine whether gratitude journaling improved biomarkers related to HF prognosis. Patients (n = 70; mean [standard deviation] age = 66.2 [7.6]years) were randomized to an 8-week gratitude journaling intervention or treatment as usual. Baseline (T1) assessments included the six-item Gratitude Questionnaire, resting heart rate variability (HRV), and an inflammatory biomarker index. At T2 (midintervention), the six-item Gratitude Questionnaire was measured. At T3 (postintervention), T1...
ABSTRACT A systematic review is the gold standard approach for integrating evidence-based informa... more ABSTRACT A systematic review is the gold standard approach for integrating evidence-based information and assessing gaps in healthcare, which require a specific and precise methodology not always taught in educational institutions or applied in practice. This lack in knowledge on how to properly conduct a systematic review impedes the development of rational, evidence-based health policy and contributes to the gap in translating evidence into practice as information in complementary and alternative medicine and integrative healthcare (CAM/IM) research continues to grow. In order to bridge this gap, Samueli Institute has developed a systematic review curriculum and teaches a 3-day introductory workshop on systematic review methodology and how to conduct a systematic review in a step-wise manner in the field of CAM/IM research. The instructors will share their hands-on approach to teaching and discuss diversities in learning while conquering five objectives of the curriculum. Instructors will share how to incorporate CAM/IM into the workshop and point out challenges to evidence-based medicine in CAM/IM. They will also share how to measure success through mentoring and evaluations, and lead a discussion around potential audiences for the workshop and how this might be incorporated into educational institutions who are focused on CAM/IM research.
With rising health care costs and the diversity of scientific and clinical information available ... more With rising health care costs and the diversity of scientific and clinical information available to health care providers it is essential to have methodologies that synthesize and distill the quality of information and make it practical to clinicians, patients and policy makers. Too often research synthesis results in the statement that "more and better research is needed" or the conclusions are slanted toward the biases of one type of stakeholder. Such conclusions are discouraging to clinicians and patients who need better guidance on the decisions they make every day. Expert panels are one method for offering valuable insight into the scientific evidence and what experts believe about its application to a given clinical situation. However, with improper management their conclusions can end up being biased or even wrong. There are several types of expert panels, but two that have been extensively involved in bringing evidence to bear on clinical practice are consensus pan...
Biofield therapies are noninvasive therapies in which the practitioner explicitly works with a cl... more Biofield therapies are noninvasive therapies in which the practitioner explicitly works with a client's biofield (interacting fields of energy and information that surround living systems) to stimulate healing responses in patients. While the practice of biofield therapies has existed in Eastern and Western cultures for thousands of years, empirical research on the effectiveness of biofield therapies is still relatively nascent. In this article, we provide a summary of the state of the evidence for biofield therapies for a number of different clinical conditions. We note specific methodological issues for research in biofield therapies that need to be addressed (including practitioner-based, outcomes-based, and research design considerations), as well as provide a list of suggested next steps for biofield researchers to consider.
Background: Cancers are one of the leading causes of mortality worldwide. Cancer patients are inc... more Background: Cancers are one of the leading causes of mortality worldwide. Cancer patients are increasingly seeking integrative care clinics to promote their health and well-being during and after treatment. Aim: To examine relationships between physical activity (PA) and quality of life (QoL) in a sample of cancer patients enrolling in integrative care in a supportive care clinic. Also, to explore circulating inflammatory biomarkers and heart rate variability (HRV) in relationship to PA and QoL. Methods: A cross-sectional design of adult patients who sought care in the InspireHealth clinic, Vancouver, British Columbia, Canada. Patients with complete PA data (n = 118) answered psychosocial questionnaires, provided blood samples, and received HRV recordings before enrollment. Patients were stratified into “less” versus “more” active groups according to PA guidelines (150 minutes of moderate or 75 minutes of vigorous PA or an equivalent combination). Results: Breast (33.1%) and prostat...
Background: The evaluation of freestanding integrative cancer clinical programs is challenging an... more Background: The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. Objectives: A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. Study Design/Methods: This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. Results: The InspireH...
The Journal of Alternative and Complementary Medicine, 2020
Objectives: Practitioners of Biofield Tuning assess health status of their clients by detecting o... more Objectives: Practitioners of Biofield Tuning assess health status of their clients by detecting off-the-body biofield perturbations using tuning fork (TF) vibrations. This study tested inter-rater agreement (IRA) on location of these perturbations. Design: Three Biofield Tuning practitioners, in randomized order, identified locations of the 4-5 "strongest" perturbations along each of 4 sites for the same series of 10 research subjects. Setting/Location: An Integrative Health and Medicine Center in La Jolla, CA. Subjects: Adult volunteers with no serious current illness and no prior experience of a Biofield Tuning session. Interventions: Practitioners used an activated 174 Hz unweighted TF to "comb" the same four sites per subject, located on the left and right sides of the base of the spine and the heart. Outcome Measures: Practitioners identified and vocalized the distance from the body of perturbations along each site. Distances were recorded by a research assistant in the clinic room. No health information related to perturbation sites was discussed with the subjects. Results: Practitioners reported 6.3 ± 0.6 (mean ± standard deviation) perturbations per combed site per subject, with no significant difference among the raters. The overall level of IRA was low based initially on a first-pass, nonstatistical, analysis of results, with "agreement" defined within a tolerance of ±2 inches. In this approach agreement was 33%. More rigorous statistical analysis, including a statistical test using a Monte Carlo approach, strongly supported the conclusion of poor IRA. Conclusions: IRA was low despite attempts to balance the real-world practice of Biofield Tuning with the constraints of research. For example, while IRA necessitates multiple assessments of the same subject, no information exists as to whether an initial assessment may affect subsequent assessments. Our study exemplifies the challenges faced when attempting to fit interventions with incompletely understood procedures and mechanisms into conventional research designs.
Little is known about the potential influences of social and psychosocial variables in accounting... more Little is known about the potential influences of social and psychosocial variables in accounting for ethnic differences in the β-adrenergic receptor. We examined the effects of ethnicity, social class, and other variables on an in vivo marker of β-adrenergic receptor responsiveness (Chronotropic 25 Dose, CD25) for 224 African-Americans and Caucasian-Americans. Social class was determined using the clinician-rated Hollingshead two-factor index. The Cook–Medley hostility and Buss–Durkee assaultiveness subscales were administered to a subset of subjects. Results indicated that African-Americans had decreased β-receptor responsiveness compared to Caucasian-Americans after controlling for social class, age, and smoking (P=0.001). Secondary analysis for a subset of subjects revealed significant hostility×ethnicity interactions, such that hostility predicted decreased β-receptor responsiveness for Caucasian-Americans (P=0.004), but not for African-Americans. Thus, decreased β-adrenergic receptor responsiveness in African-Americans does not appear to be due to differences in current social class, age, or smoking status, nor to higher reports of hostility.
Stage B, asymptomatic heart failure (HF) presents a therapeutic window for attenuating disease pr... more Stage B, asymptomatic heart failure (HF) presents a therapeutic window for attenuating disease progression and development of HF symptoms, and improving quality of life. Gratitude, the practice of appreciating positive life features, is highly related to quality of life, leading to development of promising clinical interventions. However, few gratitude studies have investigated objective measures of physical health; most relied on self-report measures. We conducted a pilot study in Stage B HF patients to examine whether gratitude journaling improved biomarkers related to HF prognosis. Patients (n = 70; mean [standard deviation] age = 66.2 [7.6]years) were randomized to an 8-week gratitude journaling intervention or treatment as usual. Baseline (T1) assessments included the six-item Gratitude Questionnaire, resting heart rate variability (HRV), and an inflammatory biomarker index. At T2 (midintervention), the six-item Gratitude Questionnaire was measured. At T3 (postintervention), T1...
ABSTRACT A systematic review is the gold standard approach for integrating evidence-based informa... more ABSTRACT A systematic review is the gold standard approach for integrating evidence-based information and assessing gaps in healthcare, which require a specific and precise methodology not always taught in educational institutions or applied in practice. This lack in knowledge on how to properly conduct a systematic review impedes the development of rational, evidence-based health policy and contributes to the gap in translating evidence into practice as information in complementary and alternative medicine and integrative healthcare (CAM/IM) research continues to grow. In order to bridge this gap, Samueli Institute has developed a systematic review curriculum and teaches a 3-day introductory workshop on systematic review methodology and how to conduct a systematic review in a step-wise manner in the field of CAM/IM research. The instructors will share their hands-on approach to teaching and discuss diversities in learning while conquering five objectives of the curriculum. Instructors will share how to incorporate CAM/IM into the workshop and point out challenges to evidence-based medicine in CAM/IM. They will also share how to measure success through mentoring and evaluations, and lead a discussion around potential audiences for the workshop and how this might be incorporated into educational institutions who are focused on CAM/IM research.
With rising health care costs and the diversity of scientific and clinical information available ... more With rising health care costs and the diversity of scientific and clinical information available to health care providers it is essential to have methodologies that synthesize and distill the quality of information and make it practical to clinicians, patients and policy makers. Too often research synthesis results in the statement that "more and better research is needed" or the conclusions are slanted toward the biases of one type of stakeholder. Such conclusions are discouraging to clinicians and patients who need better guidance on the decisions they make every day. Expert panels are one method for offering valuable insight into the scientific evidence and what experts believe about its application to a given clinical situation. However, with improper management their conclusions can end up being biased or even wrong. There are several types of expert panels, but two that have been extensively involved in bringing evidence to bear on clinical practice are consensus pan...
Biofield therapies are noninvasive therapies in which the practitioner explicitly works with a cl... more Biofield therapies are noninvasive therapies in which the practitioner explicitly works with a client's biofield (interacting fields of energy and information that surround living systems) to stimulate healing responses in patients. While the practice of biofield therapies has existed in Eastern and Western cultures for thousands of years, empirical research on the effectiveness of biofield therapies is still relatively nascent. In this article, we provide a summary of the state of the evidence for biofield therapies for a number of different clinical conditions. We note specific methodological issues for research in biofield therapies that need to be addressed (including practitioner-based, outcomes-based, and research design considerations), as well as provide a list of suggested next steps for biofield researchers to consider.
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Papers by Shamini Jain