Institute for Alternative Futures Seeks Input

WHO Issues Environmental Exposure Report 

A new report issued by the World Health Organization (WHO) states that as much as 24% of all disease is caused by environmental exposures that can be averted. The report further estimates that preventing environmental risk could save as many as four million lives a year.

Preventing Disease Through Healthy Environments—Towards an Estimate of the Environmental Burden of Disease is the most comprehensive and systematic study ever undertaken on how preventable environmental hazards contribute to a wide range of diseases and injuries. By focusing on the environmental causes of disease and how various diseases are influenced by environmental factors, the analysis breaks new ground in understanding the interactions between environment and health.

“The report issued today is a major contribution to ongoing efforts to better define the links between environment and health,” said Dr. Anders Nordström, WHO’s acting director-general. “We have always known that the environment influences health very profoundly, but these estimates help us to demonstrate that creating a supportive environment can be a successful strategy in improving health.”

The research, which involved a systematic review of the literature as well as surveys of over 100 experts worldwide, identifies specific diseases impacted by specific well-known environmental hazards and by how much. The four main diseases influenced by poor environments are diarrhea, lower respiratory infections, various forms of unintentional injuries, and malaria. Measures that can be taken immediately to reduce this environmental disease burden include promotion of safe household water storage and better hygienic measures, use of cleaner and safer fuels, increased safety of the built environment, more judicious use and management of toxic substances in the home and workplace, and better water resource management.

The diseases that were identified as having the largest number of deaths annually from modifiable environmental factors include the following:

The report concludes that, by setting priorities for measures aimed at curbing these serious killers, millions of unnecessary deaths can be prevented every year and that working with sectors such as energy, transport, agriculture, and industry to ameliorate the root environmental causes of ill health will be crucial.

The full report and its executive summary can be found at http://www.who.int/quantifying_ehimpacts/publications/preventingdisease/en/index.html.

PIM Announces Four New Service Scholarships 

The University of Arizona’s Program in Integrative Medicine (PIM) recently received a generous gift to create four new “Service Scholarships” for its Fellowship in Integrative Medicine. Thanks to this donation, the Brenda Craft Service Scholarships will be granted to doctors or nurse practitioners who practice medicine with socio-economically disadvantaged patients.

“The cost of the PIM fellowship is often a stretch for doctors and nurse practitioners who work in community health centers,” explains Victoria Maizes, MD, executive director of PIM. “At the same time, we have seen our graduates who practice in these settings successfully bring integrative practices to their patients. Through our Service Scholarships, we are able to grow access to integrative medicine to people at all economic levels.”

The first Service Scholarship was awarded to Dr. Mila Zatulovsky in January 2006. Dr. Zatulovsky has spent the last 10 years working at the Children’s HUB Center, the first nonprofit comprehensive health assessment center for children with unique health needs. Located in one of the poorest communities in Los Angeles, the Children’s HUB Center assists children who are the victims of abuse and neglect, as well as foster children and foster parents.

Applications for the Service Scholarships are currently being accepted. Applicants should practice in community health clinics or with medically underserved populations and have a strong commitment to making integrative medicine available to their patients. For more information, please contact Moira Andre at (520) 626-2865, or mandre@email.arizona.edu, or visit www.integrativemedicine.arizona.edu.

View Large Image Download to PowerPoint

Mila Zatulovsky, MD

NCCAM Names New Director of Office of Policy, Planning, and Evaluation 

Heather G. Miller, PhD, MFS, was selected as the new director for the Office of Policy, Planning, and Evaluation within the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH). Dr. Miller will serve as senior advisor to the NCCAM’s director on science, science policy, and other strategic issues, as well as oversee the planning, evaluation, and reporting activities for the Center.

Dr. Miller joined the NCCAM in 2003, when she was appointed senior advisor for Women’s Health. Prior to that, she was the senior advisor to the deputy director of Extramural Research in the Office of the Director, NIH.

“I am delighted that Dr. Miller has assumed this critical leadership role at NCCAM. It offers the opportunity to plan the Center’s investments across the many complex areas of complementary and alternative medicine research, to critically appraise the success of those investments, and to report their results to our many stakeholders,” said Stephen E. Straus, NCCAM director. “Her experience, skill, and clear understanding of the responsibilities of this office will be essential in her new position within the Center.”

Richard Davidson Selected as One of Time Magazine’s Top 100 People 

Meditation researcher Richard Davidson, PhD, was named to Time magazine’s list of the top 100 people. The May 8, 2006, special issue of Time depicted the lives and ideas of the world’s most influential people in the categories of leaders and revolutionaries, scientists and thinkers, heroes and pioneers, builders and titans, and artists and entertainers. Davidson was among the 16 scientists so honored.

A member of the Mind and Life Institute Board of Directors, Davidson is the director of the Laboratory for Affective Neuroscience and the W.M. Keck Laboratory for Functional Brain Imaging and Behavior at the University of Wisconsin at Madison. In 2000, he received the Distinguished Scientific Contribution Award, the most prestigious award given by the American Psychological Association for lifetime achievement. Educated in psychology at New York and Harvard universities, he has published more than 150 articles and coauthored or edited 13 books, most recently, Visions of Compassion: Western Scientists and Tibetan Buddhists Examine Human Nature, and The Handbook of Affective Science.

Davidson has worked with the Dalai Lama and other Tibetan monks to demonstrate how meditation alters brain function. His studies may lead to new therapeutic approaches for mood and anxiety disorders.

EXPLORE interviewed Richard Davidson in its September 2005 issue, which is available at www.explorejournal.com.

View Large Image Download to PowerPoint

Richard Davidson, PhD

Scholarships for Rheumatology Fellows Available 

The University of Arizona, Program in Integrative Medicine (PIM), recently announced two new scholarships for the 2008 Fellowship class. The scholarships are for academic rheumatologists who wish to incorporate integrative medicine therapeutic approaches into their practice and teaching.

“Integrative medicine brings valuable treatment options including dietary strategies, nutritional supplements, and mind-body interventions to rheumatology,” says PIM executive director Dr. Victoria Maizes. “We view these new scholarships as a unique opportunity to bring broader academic awareness of integrative medicine’s role in treating conditions that are commonly seen by rheumatologists.”

The scholarships were made possible by the Alana S. Jones & Colburn A. Jones/David Lovell & Lura Lovell Endowed Chair in Integrative Rheumatology. Andrew Weil, MD, founding director of PIM, was presented with the Endowed Chair in Rheumatology at a special ceremony in November 2003.

For more information on how to apply, please contact Moira Andre at (520) 626-2865, or mandre@email.arizona.edu, or visit www.integrativemedicine.arizona.edu.

First HerbDay To be Held in October 

Five national nonprofit organizations—the American Botanical Council (ABC), the American Herbalists Guild (AHG), the American Herbal Pharmacopoeia (AHP), the American Herbal Products Association (AHPA), and the United Plant Savers (UpS)—are working together to launch HerbDay, a national event that will celebrate the importance of herbs and herbalism through independently planned activities on October 14, 2006, and/or during the days leading up to and following that date.

Sponsors already planning activities include the US Botanic Gardens, the Natural Foods Merchandiser, the National Nutritional Foods Association (NNFA), Nature’s Resource, Vitamin World, Great Earth Vitamins, Nature’s Sunshine, and the Tai Sophia Institute.

To learn more or to register a new event, please visit www.herbday.org.

Esalen Institute and IONS Collaborate With E*TV 

The Esalen Institute and the Institute of Noetic Sciences are collaborating with Essential*TV, an Internet television channel, to offer high-quality, TV-style educational programming. With nearly 400 titles of wellness, fitness, personal transformation, and spirituality/religious programming, the collective library is the largest offering of its kind. The Web site, http://www.essentialtv.com, is scheduled to go live in September 2006.

Essential*TV was born out of a desire to provide individuals with inspiration, information, support, and guidance through life’s transitions. “At crucial moments in my life, I have been helped tremendously by the kind of programs on Essential*TV,” said Joseph Lehnen, Essential*TV president.

Essential*TV has built an extensive network of independent film producers, media companies, and learning institutions such as the Esalen Institute and the Institute of Noetic Sciences, which have opened their libraries to extend this wisdom to the world community. “Since Esalen’s founding more than 40 years ago as the country’s first center for progressive thought, we have archived irreplaceable program content from pioneering teachers in fields such as alternative medicine, integral practice, physics, and consciousness,” said Harry Feinberg, executive director of operations at the Esalen Institute. “We welcome this exciting and innovative new concept that will enable us to deliver this content to a global audience and further our work in the world.”

The library of offerings includes programs with Pema Chodron, Larry Dossey, Thich Nhat Hanh, Rupert Sheldrake, Huston Smith, Andrew Weil, and many others. All programs are available 24 hours a day. A day pass sells for $1.95 for three shows, and the monthly pass is $9.95. For more information, contact Essential*TV at http://www.essentialtv.com/ or email feedback@essentialtv.com.

Toxicant and Disease Database Updated 

The Collaborative on Health and the Environment (CHE) recently announced that it has improved and updated the CHE Toxicants and Disease Database, available at http://database.healthandenvironment.org. This is a scientifically based, Web-interactive database summarizing the evidence of exposure to chemical contaminants and over 180 associated human diseases or conditions.

The revised database is now searchable by Chemical Abstract Service (CAS) number as well as by disease, disease category, and toxicant. Created by CHE partner scientists Drs. Sarah Janssen, Gina Solomon, and Ted Schettler, the database also offers users the opportunity to provide feedback and suggestions on content and to share the database with other colleagues. A condensed version of the database is also available for distribution in printed spreadsheet format. For more information, contact Eleni@HealthandEnvironment.org.

Academic Consortium Conference Highlights Recent Research 

The first North American Research Conference on Complementary and Integrative Medicine was held May 24-27, 2006, in Edmonton, Alberta. Sponsored by the Consortium of Academic Health Centers for Integrative Medicine and supported by multiple philanthropists, private foundations, and the National Institutes of Health, the conference highlighted recent research in complementary, alternative, and integrative medicine. Nearly 700 people from 27 countries attended the conference.

Research presented at the conference included the results of the following studies:

This study looked at 632 patients aged ≥40 years with chronic arthritis of the hip and knee. The patients were randomly assigned to receive up to 15 acupuncture sessions over three months or receive no acupuncture. All study participants were allowed to receive additional usual medical care covered by health insurance companies. After three months of treatment, symptoms of osteoarthritis decreased in patients in the acupuncture group but not in those receiving routine care alone, an effect that persisted for up to six months. In addition, quality of life improved significantly more in the acupuncture group.

Researchers in this study evaluated the potential of integrative care that combines conventional and complementary/alternative medicine for the treatment of subacute low back pain in a hospital setting. The investigators randomized adults with subacute low back pain in a 1:2 ratio to usual care or usual care plus treatment by the integrative care team at the Brigham and Women’s Hospital. The multidisciplinary team consisted of individuals with expertise in acupuncture, chiropractic, internal medicine, massage therapy, neurology, nursing, nutritional counselling, occupational therapy, orthopaedics, psychiatry/mind-body, physical therapy, and rheumatology. Treatment was provided for up to 12 weeks and was modified based on progress and input by the team. The investigators assessed differences in pain scores (on a 0-10 scale) and functional status (on a 0-23 scale) at the start of the trial and at two, five, and 12 weeks. Over the 12 weeks, participants in the integrative care group had an average of 12.2 visits and experienced significantly greater reduction in pain scores (0.37 per week compared with 0.14 per week for those in the usual care group) and functional status (1.11 per week compared with 0.49 per week for those in the usual care group).

Participants aged ≥25 years were recruited in 1995, and the data for the analysis were collected between 2001 and 2002, during five-year follow-up interviews. Potentially dangerous drug-herb interactions were analyzed for individuals taking cardiovascular agents, including digoxin, furosemide, and warfarin; and neuroleptic agents, including alprazolam, levodopa, lithium, phenelzine, and selective serotonin reuptake inhibitors. The concomitant use of St. John’s Wort with cyclosporin, spironolactone, or venlafaxine was also examined. At the five-year follow-up, 81% of the original participants were remaining, the average age was 70 years (range, 31-99 years), and 70% were female. Of the 7,652 participants remaining, 1,069 (14%) were taking at least one of the prescription medications for which drug-herb interactions were assessed. Only 14 (1.3%) of the 1,069 participants were using at least one contraindicated drug-herb combination. Of the 514 subjects on one of the cardiovascular medications, 13 (2.5%) were concomitantly using a contraindicated herb. Only one of the 514 subjects taking a neuroleptic agent was identified as at-risk for a potential drug-herb interaction (lithium and psyllium). No subjects were concomitantly using the potentially dangerous combination of St. John’s Wort with cyclosporin, spironolactone, or venlafaxine.

This study looked at 68 adults over the age of 35 with a diagnosis of osteoarthritis of the knee who experienced pain levels between four and nine on a pain scale (0 = no pain, 10 = worst pain ever). Patients received either eight weeks of Swedish full-body therapeutic massage or eight weeks of usual care. In the massage group, massages were given twice weekly for the first four weeks and then once weekly for the remainder of the trial. The two groups were comparable in demographic and baseline clinical characteristics. Specifically, most participants were white, female, elderly, and generally overweight. When investigators measured pain in the patients following the eight-week trial, they found that the massage therapy group demonstrated significant decreases in pain sensation and stiffness as well as improvements in physical function and the time to walk 50 feet. At 16 weeks, improvements seen in the massage therapy group generally persisted.

Research has shown that HIV-1 infection causes impaired immune function by binding to the CD4 molecule on immune cells. The investigators assessed whether the green tea component epigallocatechin gallate (EGCG) is capable of inhibiting the binding of HIV proteins called gp120, which are essential for the virus to attach to CD4 molecules and gain entry into host cells. Specifically, the investigators analyzed the binding ability of gp120 to EGCG-treated and untreated immune cells expressing CD4. EGCG markedly inhibited the binding of HIV gp120 proteins to these immune cells in a dose-dependent manner. In addition, molecular modeling studies suggested that EGCG and gp120 both bind to the same spot on CD4 molecules.

In this study, researchers evaluated probiotic supplements labeled to contain Lactobacillus and sold across Washington state for viability, contamination, label accuracy, storage recommendations, and price at the point of purchase by the consumer. In their analysis of 94 samples, the investigators found that 83 (88%) samples proved viable, and, of these, laboratory results matched manufacturer labeling exactly for seven (8%) products, and 42 (51%) products contained at least one organism that matched labeling at both genus and species level. Seventy-three (88%) products contained organisms matching labeling at the genus level. Finally, 67 (71%) of products contained at least one organism not listed on the label, and eight (10%) had more than one potentially pathogenic organism.

In this study, 63 patients were randomized to eight weeks of usual care or meditation, in which individuals were asked to practice a meditation program at home six hours a week. All patients were under the regular care of their rheumatologist and remained on prescribed medications. Assessments were made at the start of the trial and then at two months and six months later. Analyses indicated that, at two months, psychological distress was reduced by 30% in the meditation group and 10% in the control group. From baseline to six months, psychological distress was reduced by 33% in the meditation group and 2% in controls. Rheumatoid arthritis disease activity (which includes joint tenderness, patient assessment, and other measures) was not affected at two months, but, at six months, the meditation group had an 11% mean decrease in disease activity with 0% change among controls. At two months, the meditation group had a 25% mean decrease in nonspecific inflammation, compared with an 8% increase in controls. At six months, this inflammation dropped 35% in the meditation group, compared with an 11% increase in controls, suggesting a 46% improvement associated with treatment.

The study looked at 130 complementary/alternative medicine schools accredited by a federally recognized accrediting agency in one or more of five disciplines: chiropractic, acupuncture and Oriental medicine, massage therapy, naturopathic medicine, and direct-entry midwifery. Also included were 28 conventional academic medical schools that are part of the Consortium of Academic Health Centers for Integrative Medicine. The results indicated that more than 50% of the relationships between the two disciplines were based on informal contacts, whereas 15% to 30% were formal relationships. Specifically, conventional programs were more likely to have formal relationships with schools of acupuncture (32%) and massage (20%) and less likely with chiropractic (12%) and naturopathic medicine (8%).

Fifty-two patients with chronic low back pain were randomly assigned to receive twice-weekly Iyengar yoga (n = 28) or were wait-list control (n = 24) for 12 weeks. The primary outcome was the change in the functional disability scores between baseline and study end using the Roland-Morris Questionnaire (RMQ) and Oswestry Disability Index (ODI). Yoga was associated with a 2.5-point and 2.9-point improvement in RMQ and ODI, respectively, when compared with wait-list controls. When compared with controls, the yoga intervention was associated with significant improvements in the emotional well-being subscale of the SF-36 (P = .03) and insomnia using the impaired sleep index (P = .02), as well as significant reductions in evening salivary cortisol levels among men (P = .05). There were no differences between groups in pain intensity, anxiety, depression, and positive affect.

Thirty women undergoing first-trimester surgical abortions at the family planning clinics of a large hospital in Quebec City were randomized into a control group that received standard care and a hypnosis group that received, in addition to standard care, an intervention of hypnosis. Patients in both groups were given the option to control their pain with nitrous oxide (N2O) sedation administered through a nose mask as often and for as long as they wanted during the procedure. N2O sedation as the primary outcome was assessed at each step of the procedure. In the hypnosis group, 36% of patients requested N2O sedation during the procedure as compared with 87% in the control group (P < 01). No differences between the groups were found in reports of pain and anxiety during the procedure.

For more information about the conference or to view all the conference abstracts on-line, including oral presentations, poster sessions, symposiums, and workshops, please visit http://www.imconsortium-conference2006.com/.