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Background Multimedia multi-device measurement platforms may make the assessment of prevention-related medical variables with a focus on cardiovascular outcomes more attractive and time-efficient. The aim of the studies was to evaluate the reliability (Study 1) and the measurement agreement with a cohort study (Study 2) of selected measures of such a device, the Preventiometer. Methods In Study 1 (N = 75), we conducted repeated measurements in two Preventiometers for four examinations (blood pressure measurement, pulse oximetry, body fat measurement, and spirometry) to analyze their agreement and derive (retest-)reliability estimates. In Study 2 (N = 150), we compared somatometry, blood pressure, pulse oximetry, body fat, and spirometry measurements in the Preventiometer with corresponding measurements used in the population-based Study of Health in Pomerania (SHIP) to evaluate measurement agreement. Results Intraclass correlations coefficients (ICCs) ranged from .84 to .99 for all examinations in Study 1. Whereas bias was not an issue for most examinations in Study 2, limits of agreement for most examinations were very large compared to results of similar method comparison studies. Conclusion We observed a high retest-reliability of the assessed clinical examinations in the Preventiometer. Some disagreements between Preventiometer and SHIP examinations can be attributed to procedural differences in the examinations. Methodological and technical improvements are recommended before using the Preventiometer in population-based research.

PURPOSE: The purpose of this study was to evaluate acupuncture use among breast cancer survivors, including perceived symptom improvements, and referral patterns. METHODS: Breast cancer survivors who had used acupuncture for cancer- or treatment-related symptoms were identified using an ongoing prospective Mayo Clinic Breast Disease Registry (MCBDR). Additionally, Mayo Clinic electronic health records (MCEHR) were queried to identify eligible participants. All received a mailed consent form and survey including acupuncture-related questions about acupuncture referrals, delivery, and costs. Respondents were also asked to recall symptom improvements, symptom severity before and after acupuncture treatment, and time to benefit on Likert scales. RESULTS: Acupuncture use was reported among 415 participants (12.3%) of the MCBDR. Among MCBDR and MCEHR eligible participants, 241 women returned surveys. 193 (82.1%) participants reported a symptomatic benefit from acupuncture and 57 (24.1% of participants reported a “substantial benefit” or “totally resolved my symptoms” (corresponding to 4 and 5 on the 5-point Likert scale). Mean symptom severity decreased by at least 1 point of the 5-point scale for each symptom; the percentage of patients who reported an improvement in symptoms ranged from 56% (lymphedema) to 79% (headache). The majority of patients reported time to benefit as “immediate” (34%) or “after a few treatments” (40.4%). Over half of participants self-referred for treatment, 24.1% were referred by their oncologist. Acupuncture delivery was more frequent in private offices (61.0%) than in hospital or medical settings (42.3%). Twelve participants (5.1%) reported negative side effects, such as discomfort. CONCLUSIONS: Acupuncture is commonly utilized by patients for a variety of breast cancer-related symptoms. However, patients frequently self-refer for acupuncture treatments and most acupuncture care is completed at private offices, rather than medical clinic or hospital settings.

Background Over a third of critical illness survivors suffer from mental health problems following hospitalization. Memories of delusional experiences are a major risk factor. In this project, ICU doulas delivered a unique positive suggestion intervention targeting the vulnerable time period during critical illness when these memories are formed. Methods Adult critically ill patients were recruited for this single-arm, prospective pilot study. These ICU patients received a positive suggestion intervention daily during their ICU stay in parallel with their medical treatment. The intervention was designed to be delivered over a minimum of two sessions. Feasibility was defined as intervention delivery on ≥ 70% of ICU days after patient enrollment. As a secondary analysis, psychometric questionnaires were compared to those of a historic control cohort of patients receiving standard care in the ICU using adjusted linear regression models. Results Of the 97 patients who received the intervention and were alive at the end of their ICU course, 54 were excluded from analyses mostly for having received only one session because of a short ICU length of stay of N = 299), patients receiving the intervention had higher severity of illness and longer length of stay. When adjusted for baseline differences, patients both with and without mechanical ventilation who received the intervention scored lower on the Hospital Anxiety and Depression Scale (HADS)—Depression subscale. The intervention was also associated with reduced HADS-Anxiety subscale among ventilated patients. Conclusions Positive therapeutic suggestion delivered by ICU doulas is feasible in the ICU setting. A randomized trial is warranted to better delineate the role that positive suggestion and ICU doulas may play in ongoing interprofessional efforts to humanize critical care medicine. The study was registered on clinicaltrials.gov (NCT03736954) on 03/14/2018 prior to the first patient enrollment https://clinicaltrials.gov/ct2/show/NCT03736954?cond=ICU+Doulas+Providing+Psychological+Support&draw=2&rank=1.

To understand patient satisfaction with acupuncture appointment duration for the first and subsequent appointments in the plan of care, time spent with the acupuncture provider, willingness to pay for longer duration appointments, and lack of insurance coverage. Patients who were referred for an acupuncture consult to the Center for Integrative Medicine at Mayo Clinic were asked to participate in the survey in August 2014. Patients were given paper survey at time of appointment check-in and entered into Research Electronic Data Capture Survey database tool to reveal patient-reported outcomes. In total, 104 of 329 patients receiving acupuncture treatment responded to the survey with a 32% response rate. Insight and recommended changes to the duration of the initial and subsequent appointments were obtained. Most patients reported that time spent with the provider (76 cases, 74%) and appointment length (74 cases, 68%) were "just right". Seventy cases (70%) of respondents indicated that they wanted longer treatment. Patients reported return appointments with duration of 30 min was not enough. Fifty-three patients (62%) were willing to pay for additional costs not covered by insurance. We used patient feedback to assess the acupuncture practice in a complementary and integrative medicine program. Most patients referred for the acupuncture consult appeared to be satisfied with the current level of practice. These findings were used to establish a quality improvement plan that may be implemented to improve patient satisfaction with the acupuncture practice.

The purpose of the study was to learn about the level of experience with, interest in, and desire for knowledge about integrative medicine (IM) among cancer survivors. Cancer survivors attending the 2014 National Cancer Survivors Day in Rochester, MN, were recruited to participate in a one-page survey about their ongoing health concerns and symptoms, as well as their experience with, interest in, and desire for knowledge about IM. Two-sided t test was used for univariate analyses of impact of sex, time since diagnosis, and age. Among the 260 cancer survivors, 171 persons (female, 74 %; male, 26 %) completed the survey (mean age, 64.6 years). Symptoms most commonly somewhat or more bothersome were fear of recurrence (52 %), stress (43 %), fatigue (43 %), difficulty sleeping (33 %), and weight gain (31 %). The most used IM resources were exercise (75 %), improved nutrition and diet (66 %), stress management (42 %), dietary supplementation (33 %), meditation (25 %), and massage (22 %). Older patients (age, ≥65 years) were less experienced with, interested in, and desiring of knowledge about IM techniques. Sex and time since diagnosis were not strongly predictive of most survey response categories. Cancer survivors have adverse effects for years into survivorship. They use and express interest in various IM techniques to help manage symptoms. It is critical that oncology providers help survivors address ongoing health concerns. Education about and access to evidence-based IM techniques may have important roles in comprehensive cancer survivorship programs.

With the increasing use of complementary and alternative medicine (CAM) in the US, academic medical centres need to provide evidence-based CAM information and services. To develop a CAM programme involving practice, education and research at our tertiary-care academic medical centre, we initiated a four-pronged approach: (i) creation of an interdisciplinary CAM interest group, (ii) a survey of CAM use among 1514 patients seen at our institution, (iii) a survey of knowledge and attitudes toward CAM among 660 physicians in our institution’s Department of Internal Medicine and (iv) a pilot study of CAM consultations provided at no cost to 102 patients. Bringing together individuals from multiple disciplines across our institution resulted in numerous alliances and collaborations. We documented that many of our internists thought that addressing CAM therapies would improve patient satisfaction and that our patients used CAM therapies and found CAM consultations helpful. Our present programme is devoted to practice (a CAM consultation service has been implemented), education (medical school lectures and a postgraduate-level curriculum in CAM medicine have been developed) and research (there are several ongoing clinical trials).

Objective: To evaluate and compare the use of complementary and alternative medicine (CAM) by patients seen in five specialty areas of a tertiary-care centre.

Complementary and alternative medicine (CAM) represents a diverse group of therapies, modalities and belief systems that have grown rapidly in popularity over the past decade. As more and more patients incorporate CAM into their usual health care, opportunities and challenges for conventional medicine increase. One area that has not received much attention is the role that CAM will play in preventive medicine. Caregivers focused on wellness and a preventive approach to health will increasingly be challenged by the explosion in CAM modalities that patients continue to explore. Recognising which therapies can be dangerous and which can be incorporated beneficially into a preventive medicine strategy will be critical. Finally, the emphasis on lifestyle that is inherent in most CAM therapies may yield a unique opportunity to enhance preventative health approaches.

Health wellness is a state of the homeostasis. Chinese medicine incorporate many concept including holistic medicine and individualized medicine to promote health wellness. Different domains of Chinese medicine were exclusively adopted after the first introduction of acupuncture to USA. Mayo as one of the best USA hospital created a foundation for the more widespread introduction of Chinese medicine into the US especially on the health wellness promotion.

Methods A randomized-controlled trial was designed for colorectal abdominal surgery patients. Patients were randomized to either receive a 20 minute massage on POD 1 and 2, 20 minutes of ambulation, or a visit by the massage therapist (no massage). Baseline physiologic data (HR, SBP/DBP, RR) were collected 30 minutes prior to and after either intervention. A standardized assessment of patient perception of pain, tension, anxiety, satisfaction with overall care, and relaxation level utilizing a visual analog scale (10 point Likert scale) was obtained before and after the intervention. The IRB approved study was powered to detect a difference at the 80% level. Repeated measures models were used to compare the symptom scores at different time points. T-tests were used to compare same day pre-post intervention changes.