2023 Bastyr University Student and Faculty Research Symposium
Bastyr University
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▼ 01_Acupuncture Back to top
Identifying Analyses Relevant to Case Report Writing in Acupuncture Research
Lisa Conboy, Lisa Taylor-Swanson, Kathleen Lumiere, David Riley
Abstract
Purpose. By design, case reports capture patient information from a Whole Person perspective. They also are an enduring way for acupuncturists to communicate findings. Strengths of these reports include their level of detail, placement of the patient in their environment or context, and inclusion of the practitioner’s diagnostic reasoning. These factors allow for reporting with high ecological validity. The inherent complexity of a case report is a strength.
A challenge in data analysis of case reports is this same inherent complexity. How to summarize across case reports to create suggestions for further exploration? The immediate purpose of this project is to provide an overview of ways to qualitatively and quantitatively offer such data summaries. A subsequent purpose is conducting analyses from a database collected by Convergent Points, a peer reviewed case report journal. Regardless of publication, if cases meet the reporting standards of the journal, they may be included in the database.
Methods. We conducted a review of peer reviewed literature for articles discussing complexity science, systems and system science, whole person, or holistic health AND Chinese herbal medicine, or acupuncture. Types of analyses relevant to acupuncture and Chinese medicine case reporting were collated.
Results. Suitable qualitative and quantitative analyses were identified. (1) Narrative Analysis with resulting tables or word clouds. (2) Open coding, Thematic analysis with resulting codes and (3) Targeted coding, Thematic analysis with resulting codes. Coding can then be used prospectively to consider new case reports. Also, code frequency can be counted for comparison. (4) Systematic Review of case reports. Cochrane Collaboration states that for rare outcomes, only case series may be available.
Conclusions: Complexity science can help to summarize data across case reports written according to CARE guidelines (or another template) and common acupuncture data elements. Analytical case report summaries may inform both research and practice.
A challenge in data analysis of case reports is this same inherent complexity. How to summarize across case reports to create suggestions for further exploration? The immediate purpose of this project is to provide an overview of ways to qualitatively and quantitatively offer such data summaries. A subsequent purpose is conducting analyses from a database collected by Convergent Points, a peer reviewed case report journal. Regardless of publication, if cases meet the reporting standards of the journal, they may be included in the database.
Methods. We conducted a review of peer reviewed literature for articles discussing complexity science, systems and system science, whole person, or holistic health AND Chinese herbal medicine, or acupuncture. Types of analyses relevant to acupuncture and Chinese medicine case reporting were collated.
Results. Suitable qualitative and quantitative analyses were identified. (1) Narrative Analysis with resulting tables or word clouds. (2) Open coding, Thematic analysis with resulting codes and (3) Targeted coding, Thematic analysis with resulting codes. Coding can then be used prospectively to consider new case reports. Also, code frequency can be counted for comparison. (4) Systematic Review of case reports. Cochrane Collaboration states that for rare outcomes, only case series may be available.
Conclusions: Complexity science can help to summarize data across case reports written according to CARE guidelines (or another template) and common acupuncture data elements. Analytical case report summaries may inform both research and practice.
Presented by
Lisa Conboy, Lisa Taylor-Swanson, Kathleen Lumiere, David Riley
<klumiere@bastyr.edu>
Institution
Harvard Medical School and Maryland University of Integrative Health; College of Nursing, University of Utah; Acupuncture and East Asian Medicine, Bastyr University; National University of Natural Medicine
▼ 03_Herbal Sciences Back to top
The Efficacy of Honey as a Menstruum Compared to Other Traditional Menstruums
Tristan Verdoorn
Abstract
The Efficacy of Honey as a Menstruum Compared to Other Traditional Herbal Menstruums
Tristan Verdoorn, Kaleb Lund, PhD, RH(AHG)
Study objectives: Honey is considered too viscous to act as a menstruum, and this experiment aims to disprove that theory. This study will create 1:5 Ligusticum porteri preparations using traditional menstruums and honey, and then compare the extractability of ligustilide and ferulic acid in each preparation to determine which menstruum best extracts these lipophilic phytochemicals.
Methods: Standards of ligustilide and ferulic acid were run through HPLC to create a standard gradient. Two trials of extracts of 1:5 Ligusticum porteri were prepared using traditional menstruum and methods adhering to g:mL ratio. The honey was prepared in a 1:5 g:g ratio as honey was too viscous to measure volumetrically. All extracts were diluted by 1:10 before being processed through HPLC to determine ligustilide and ferulic acid content.
Results: This initial study of honey as a menstruum showed that honey outperformed all other menstruums in the run, with nearly double the ligustilide as ethanol extracts and a third more ferulic acid than the ethanol extracts.
Conclusion: This study suggests that honey may have a place in herbal medicine as a menstruum in its own right. The organoleptic and HPLC results show that honey can extract lipophilic constituents, and this experiment is but the first step toward discovering what constituents have an affinity for honey, how honey compares to other traditional menstruum for specific constituent extractions, and how economical honey extraction methods might be for herbalists.
Presented by Institution Tristan Verdoorn Bastyr University, Botanical Medicine Department
Character count: 1494 Word count: 268
Study objectives: Honey is considered too viscous to act as a menstruum, and this experiment aims to disprove that theory. This study will create 1:5 Ligusticum porteri preparations using traditional menstruums and honey, and then compare the extractability of ligustilide and ferulic acid in each preparation to determine which menstruum best extracts these lipophilic phytochemicals.
Methods: Standards of ligustilide and ferulic acid were run through HPLC to create a standard gradient. Two trials of extracts of 1:5 Ligusticum porteri were prepared using traditional menstruum and methods adhering to g:mL ratio. The honey was prepared in a 1:5 g:g ratio as honey was too viscous to measure volumetrically. All extracts were diluted by 1:10 before being processed through HPLC to determine ligustilide and ferulic acid content.
Results: This initial study of honey as a menstruum showed that honey outperformed all other menstruums in the run, with nearly double the ligustilide as ethanol extracts and a third more ferulic acid than the ethanol extracts.
Conclusion: This study suggests that honey may have a place in herbal medicine as a menstruum in its own right. The organoleptic and HPLC results show that honey can extract lipophilic constituents, and this experiment is but the first step toward discovering what constituents have an affinity for honey, how honey compares to other traditional menstruum for specific constituent extractions, and how economical honey extraction methods might be for herbalists.
Presented by Institution Tristan Verdoorn Bastyr University, Botanical Medicine Department
Character count: 1494 Word count: 268
Presented by
Tristan Verdoorn
Institution
Bastyr University, Department of Botanical Medicine
HPLC Analysis Comparing the Amounts and Concentrations of Therapeutic Compounds Present in Solidago canadensis Buds and Flowers
Stephanie Kuzell
Abstract
HPLC Analysis Comparing the Concentrations of Therapeutic Compounds Present in Solidago canadensis Buds and Flowers
Student: Stephanie Kuzell
Faculty: Kaleb Lund, PhD, RH(AHG)
Objective: The goal of this experiment was to determine the differences in therapeutically significant constituents, if any, between bud and flower in order to determine when is the best time to harvest this plant for medicine.
Method: Solidago canadensis buds and flowers were harvested from Bastyr’s gardens. A total of two harvests were taken on 9/27/22 and 10/4/22, and were frozen at -20 oC until testing began. Standards of caffeic acid, ferulic acid, quercetin, rutin, p-coumaric acid, and chlorogenic acid were prepared in methanol and diluted to standards of 6.12 - 100 µg/mL. The fresh herb was chopped and processed for testing, weighed separately to 2 grams, and a 1:5 extraction was made of each specimen in 70% methanol. S. canadensis samples and standards were analyzed by reverse phase HPLC using a C18 column and a two mobile phases consisting of A) 0.1% formic acid in water and B) 0.1% formic acid in acetonitrile, with a gradual gradient transition over a period of time.
Results: S. canadensis buds and flowers from 10/4 had all tested constituents present, where the buds from 9/27 lacked both ferulic acid and caffeic acid. Buds from 10/4 had higher concentrations of rutin, chlorogenic acid, p-coumaric acid, and caffeic acid. The flowers from 10/4 the ferulic acid and quercetin were more abundant.
Conclusion: This data suggests there is a small optimal window to harvest the buds of S. canadensis for therapeutic purposes, and for the broadest spectrum of constituents both the bud and the flower should be harvested to make medicine.
Word count= 294
Objective: The goal of this experiment was to determine the differences in therapeutically significant constituents, if any, between bud and flower in order to determine when is the best time to harvest this plant for medicine.
Method: Solidago canadensis buds and flowers were harvested from Bastyr’s gardens. A total of two harvests were taken on 9/27/22 and 10/4/22, and were frozen at -20 oC until testing began. Standards of caffeic acid, ferulic acid, quercetin, rutin, p-coumaric acid, and chlorogenic acid were prepared in methanol and diluted to standards of 6.12 - 100 µg/mL. The fresh herb was chopped and processed for testing, weighed separately to 2 grams, and a 1:5 extraction was made of each specimen in 70% methanol. S. canadensis samples and standards were analyzed by reverse phase HPLC using a C18 column and a two mobile phases consisting of A) 0.1% formic acid in water and B) 0.1% formic acid in acetonitrile, with a gradual gradient transition over a period of time.
Results: S. canadensis buds and flowers from 10/4 had all tested constituents present, where the buds from 9/27 lacked both ferulic acid and caffeic acid. Buds from 10/4 had higher concentrations of rutin, chlorogenic acid, p-coumaric acid, and caffeic acid. The flowers from 10/4 the ferulic acid and quercetin were more abundant.
Conclusion: This data suggests there is a small optimal window to harvest the buds of S. canadensis for therapeutic purposes, and for the broadest spectrum of constituents both the bud and the flower should be harvested to make medicine.
Word count= 294
Presented by
Stephanie Kuzell
Institution
Bastyr University
Lavandula angustifolia essential oil quality comparison by GCMS
Lily Douglas, Megan Fagerlie, Safiya Hasnie
Abstract
Lavandula angustifolia essential oil quality comparison by GCMS
Authors: Lily Douglas, Megan Fagerlie, Safiya Hasnie
Supervisor: Kaleb Lund, PhD, RH (AHG)
Objective: This study was conducted to determine the quality of various Lavandula angustifolia essential oils available to the general public. Since essential oil quality is not thoroughly regulated, they are often adulterated with the wrong plant species, odorless diluents, cheap synthetics, or other potentially harmful chemicals. Most essential oil companies make claims on their packaging, such as "100% pure" or "therapeutic grade" which have no official definition or means of regulation. These products have the potential to be highly dangerous, which makes it important to do proper research into widely trusted companies. The goal of this research is to encourage a culture of transparency, public education and high ethical standards in the industry.
Methods: Lavandula angustifolia essential oil samples from DoTERRA, Pranarom, Snow Lotus, Gold Essence Aromas, 365 Whole Foods, Aura Cacia, Garden of Life, and Expressive Essentials were analyzed via GC-MS to obtain a full constituent profile.
Results: The Lavandula angustifolia essential oil samples from Snow Lotus, Pranarom, Aura Cacia, 365 Whole Foods, and Garden of Life passed the quality test based on ISO standards. The samples from Expressive Essentials, DoTERRA, and Gold Essence Aromas failed due to the presence of adulterants. Of significant concern, the Gold Essence Aromas sample was heavily adulterated with a toxic chemical called diethylene glycol monoethyl ether.
Conclusion: Price seems to be correlated with quality for essential oils with lower retail prices. However, a higher price does not necessarily guarantee quality. This is illustrated in the data for the DoTERRA sample, which ranked third most expensive, but contained adulterants. The industry should require plant ID verification and accurate ingredient labeling, and establish a certification process for using the term "therapeutic grade." Character count: 2041 Word count: 298
Objective: This study was conducted to determine the quality of various Lavandula angustifolia essential oils available to the general public. Since essential oil quality is not thoroughly regulated, they are often adulterated with the wrong plant species, odorless diluents, cheap synthetics, or other potentially harmful chemicals. Most essential oil companies make claims on their packaging, such as "100% pure" or "therapeutic grade" which have no official definition or means of regulation. These products have the potential to be highly dangerous, which makes it important to do proper research into widely trusted companies. The goal of this research is to encourage a culture of transparency, public education and high ethical standards in the industry.
Methods: Lavandula angustifolia essential oil samples from DoTERRA, Pranarom, Snow Lotus, Gold Essence Aromas, 365 Whole Foods, Aura Cacia, Garden of Life, and Expressive Essentials were analyzed via GC-MS to obtain a full constituent profile.
Results: The Lavandula angustifolia essential oil samples from Snow Lotus, Pranarom, Aura Cacia, 365 Whole Foods, and Garden of Life passed the quality test based on ISO standards. The samples from Expressive Essentials, DoTERRA, and Gold Essence Aromas failed due to the presence of adulterants. Of significant concern, the Gold Essence Aromas sample was heavily adulterated with a toxic chemical called diethylene glycol monoethyl ether.
Conclusion: Price seems to be correlated with quality for essential oils with lower retail prices. However, a higher price does not necessarily guarantee quality. This is illustrated in the data for the DoTERRA sample, which ranked third most expensive, but contained adulterants. The industry should require plant ID verification and accurate ingredient labeling, and establish a certification process for using the term "therapeutic grade." Character count: 2041 Word count: 298
Presented by
Megan Fagerlie, Lily Douglas, and Safiya Hasnie
Institution
Bastyr University
▼ 04_Naturopathic Medicine Back to top
Heart Rate Variability Biofeedback as Adjunctive Treatment of Generalized Anxiety Disorder: A Case Report
Sarah JaeHwa Park, Maya Roth
Abstract
Introduction: Generalized anxiety disorder (GAD) is a common psychiatric disorder that can cause significant functional impairment to a patient’s life. Mind body therapies (MBT) have increasingly been used as an intervention to manage symptoms of anxiety. Heart rate variability (HRV) biofeedback is a specific MBT that utilizes real-time feedback on autonomic functioning to train the physiological stress response through diaphragmatic breathing.
Case Presentation: A 39 year old female was referred for a seven-week HRV biofeedback training protocol at xxx Clinic for adjunctive treatment of GAD and depression. She had been taking citalopram for approximately four months prior to the first visit.
Discussion/Conclusion: After completing the seven week protocol, the patient’s anxiety improved from severe to mild, and her depression improved from mild to minimal. This improvement was maintained at a four-week follow-up, and eight weeks after the final visit, she reported that her anxiety was no longer a concern to her. HRV biofeedback demonstrated to be an effective adjunctive treatment for GAD in this patient’s case; however further research is needed to elucidate the effects of HRV biofeedback in patients with GAD.
Presented by
Sarah JaeHwa Park
Institution
Bastyr University California
▼ 05_Nutrition Back to top
Measuring the Effect of Food Presentation
Saba Samadani
Abstract
Objectives and Aims: This experimental study will use a randomized repeated measure design to explore the effects of food design (conventional slices of fruits and vegetables vs. fruits and vegetables displayed in a flower design) and food container (paper plate vs. OmieBox) on fruit and vegetable consumption in children attending preschool in Seattle, Washington.
Methods: The crossover study allows each participant to serve as their own control or independent variable. Participating preschools will randomly be assigned to one of three groups: control group, food design intervention group, food container intervention group. Study participants will consume an offered snack containing fruit and vegetables during a set snack time while at preschool, and researchers will assess intake based on measuring the weight of the food consumed. Weight measurements will be recorded using a calibrated scale before the food is served to children and after the children are done eating.
Results and Implications: The hypothesized findings may show that grams of consumed fruits and vegetables were increased when food was presented in a flower design or offered in an Omiebox. One potential benefit of this study could be finding an effective method for encouraging fruit and vegetable consumption in children.
Presented by
Saba Samadani
Institution
Bastyr University
Consumer perceptions of (and strategies for avoiding) ‘ultra-processed’ food products – a cross-sectional analysis in Vermont
Nick Rose, Ph.D. (Cand.), Travis Reynolds, Ph.D., Emily Belarmino, Ph.D., Lisa Chase, Ph.D. Jane Kolodinsky, Ph.D.
Abstract
Background: Research increasingly associates ultra-processed food (UPF) consumption with a range of diet-related diseases, leading to discussions of interventions for reducing UPF consumption. However, little is known regarding consumer perceptions of UPF, including the degree to which consumers prioritize nutrient content relative to degree of processing when evaluating a food’s overall healthfulness.
Objectives: To describe the health-related criteria consumers prioritize when selecting foods in the marketplace and examine whether perceptions of UPF products are predictive of these criteria.
Methods: Online survey collected from 671 Vermont residents in 2022, randomly sampled from a commercially available email list. Survey questions assessed perceptions of UPF and how consumers prioritize nutrient (sugar, fat, sodium) and non-nutrient (ingredients, processing) criteria when assessing the healthfulness of packaged foods. Descriptive statistics present perceptions of UPF, the proportion of respondents prioritizing each criterion, and demographic characteristics (age, gender, income, education) of the sample. Associations between variables are compared using chi-squares and logistic regression (p<0.05).
Results: When assessing the healthfulness of food products, respondents prioritized levels of added sugar (52.6% of respondents), ingredients (44.4%), and minimal processing (42.8%); and were less concerned with sodium (41.3%) and fat (37.3%) contents. Half of respondents (55%) had previously heard of the term “ultra-processed foods,” and the majority (91%) of those who had heard of UPF were concerned about the levels of UPF in their diets. Nearly a third of respondents (30%) reported making changes to reduce their UPF purchase and consumption patterns, and these respondents were more likely to prioritize minimal processing (OR: 2.99, 95% CI: 2.0-4.4) and kitchen ingredients (OR: 1.70; 95% CI: 1.2-2.5) after controlling for demographic variables.
Conclusion: The public is concerned with high levels of ultra-processed foods in their diets and considers a range of non-nutrient criteria when identifying healthier food choices, including criteria related to ultra-processing.
Objectives: To describe the health-related criteria consumers prioritize when selecting foods in the marketplace and examine whether perceptions of UPF products are predictive of these criteria.
Methods: Online survey collected from 671 Vermont residents in 2022, randomly sampled from a commercially available email list. Survey questions assessed perceptions of UPF and how consumers prioritize nutrient (sugar, fat, sodium) and non-nutrient (ingredients, processing) criteria when assessing the healthfulness of packaged foods. Descriptive statistics present perceptions of UPF, the proportion of respondents prioritizing each criterion, and demographic characteristics (age, gender, income, education) of the sample. Associations between variables are compared using chi-squares and logistic regression (p<0.05).
Results: When assessing the healthfulness of food products, respondents prioritized levels of added sugar (52.6% of respondents), ingredients (44.4%), and minimal processing (42.8%); and were less concerned with sodium (41.3%) and fat (37.3%) contents. Half of respondents (55%) had previously heard of the term “ultra-processed foods,” and the majority (91%) of those who had heard of UPF were concerned about the levels of UPF in their diets. Nearly a third of respondents (30%) reported making changes to reduce their UPF purchase and consumption patterns, and these respondents were more likely to prioritize minimal processing (OR: 2.99, 95% CI: 2.0-4.4) and kitchen ingredients (OR: 1.70; 95% CI: 1.2-2.5) after controlling for demographic variables.
Conclusion: The public is concerned with high levels of ultra-processed foods in their diets and considers a range of non-nutrient criteria when identifying healthier food choices, including criteria related to ultra-processing.
Presented by
Nick Rose
Institution
Bastyr University, University of Vermont
Eggshell Membrane Collagen: A Source of Therapeutic Peptides?
James Roninger
Abstract
Scientists have long believed that various dietary proteins are completely broken down into individual amino acids during the phases of the digestion process. However, substantial evidence exists in both animal and human studies that di-peptides (protein fragments containing 2 amino acids) are absorbed intact from the small intestine through specific cellular peptide transport sites. These peptides are measurable in the bloodstream using various analytical methods, and also appear to be bioactive and have positive effects on human tissues such as the skin and joints. Hydrolyzed collagen supplements, made from different animal tissues such as pork and fish have become widely popular due to the assumption that they have regenerative effects such as improved skin and joint health. However, certain potential dietary sources of peptides from animal foods have not been well researched. Eggshell membrane (EM) is one such source. A small number of promising studies have shown that EM supplements result in significant reduction of symptoms in humans with osteoarthritis: reduced pain and swelling, increased range of motion. But very little is known about the absorption of potentially bioactive peptides from EM, and a better understanding is needed. More complete evidence of peptide absorption in humans can establish that peptides from EM are a novel, viable nutritional tool.
Presented by
James Roninger
Institution
Bastyr University
PTSD & Metabolic Syndrome: The Inflammation, Blood Sugar Regulation, Hormone, & Genomic Relationships with Nutrition Interventions
Dr. Jennifer Coomes
Abstract
Note: The abstract below is the abstract in the paper.
Post Traumatic Stress Syndrome (PTSD) has a number of psychological symptoms that are debilitating and consistently detrimental to a person’s health. In this literature review research, the relationship between PTSD and Metabolic Syndrome (MetS) is extensively explored in relationships to inflammatory responses, blood sugar regulation and metabolism, hormones and neurotransmitters as well as genes and single nucleotide polymorphisms (SNPs). Nutritional interventions are also considered in depth in relationship to findings in this review. PTSD and MetS was found to be associated with chronic metabolic acidosis, cortisol imbalances, hippocampus dysfunction, shifts in immune responses, micronutrient deficiencies, metabolic dysfunctions, and increased risk for infections, tumor development, cancer, and Alzheimer’s Disease (AD). Evidence for improvements in the diagnostic criteria and standard of care for PTSD and MetS is provided to help healthcare providers implement better nutrition and integrative therapeutic interventions with patients.
Post Traumatic Stress Syndrome (PTSD) has a number of psychological symptoms that are debilitating and consistently detrimental to a person’s health. In this literature review research, the relationship between PTSD and Metabolic Syndrome (MetS) is extensively explored in relationships to inflammatory responses, blood sugar regulation and metabolism, hormones and neurotransmitters as well as genes and single nucleotide polymorphisms (SNPs). Nutritional interventions are also considered in depth in relationship to findings in this review. PTSD and MetS was found to be associated with chronic metabolic acidosis, cortisol imbalances, hippocampus dysfunction, shifts in immune responses, micronutrient deficiencies, metabolic dysfunctions, and increased risk for infections, tumor development, cancer, and Alzheimer’s Disease (AD). Evidence for improvements in the diagnostic criteria and standard of care for PTSD and MetS is provided to help healthcare providers implement better nutrition and integrative therapeutic interventions with patients.
Presented by
Dr. Jennifer Coomes
<jcoomes@Bastyr.edu>
Institution
Bastyr University, Maryland University of Integrative Health
But how does it taste? Testing climate-friendly, nutrient-dense breads for consumer acceptability
Ann Bailey
Abstract
The United Nations Sustainable Development Goals (SDGs) recognize the importance of increasing sustainable agriculture (2.4) and ending malnutrition (2.2). One step in meeting these goals is to redesign food products to have an improved climate resiliency and increased nutrient density. The popularity of refined wheat bread renders it a target for this treatment. The objective of this study is to test three composite flours for their suitability in creating a loaf of bread that uses climate resilient crops and has an improved nutritional density compared to 100% wheat
In phase one, the properties of composite flour blends made with millet, teff, or sorghum are compared with wheat. Using ANOVA analysis, significant variations in properties (p>.05) will be noted.
In phase two, bread will be made with each of the flours. A triangle test will be administered to a sample of consumers to determine if they discern between loaves. A taste test will test consumer acceptability of the breads.
Composite flours made from millet, sorghum or teff are expected to differ in significant ways when subjected to functional tests. However, the adjusted loaves of bread are not expected to demonstrate a significant difference in taste.
Redesigning already existing foods to have higher climate resiliency and nutrient density, while maintaining taste, is one way to approach the SDGs 2.4 and 2.2. This approach has the benefit of causing minimal disruption to consumer patterns while increasing the sustainability of the food system and improving nutrition. A profile which includes the properties of the flours, climate resiliency of the grains, and nutrient profile of the loaves will allow manufacturers and government policy officials to make informed choices about which composite flour options to pursue.
Composite flours made from millet, sorghum or teff are expected to differ in significant ways when subjected to functional tests. However, the adjusted loaves of bread are not expected to demonstrate a significant difference in taste.
Redesigning already existing foods to have higher climate resiliency and nutrient density, while maintaining taste, is one way to approach the SDGs 2.4 and 2.2. This approach has the benefit of causing minimal disruption to consumer patterns while increasing the sustainability of the food system and improving nutrition. A profile which includes the properties of the flours, climate resiliency of the grains, and nutrient profile of the loaves will allow manufacturers and government policy officials to make informed choices about which composite flour options to pursue.
Presented by
Ann Bailey
Institution
Bastyr University
▼ 06_Psychology Back to top
A call for clinical ACTivism: A literature review of Acceptance Commitment Therapy mechanisms for treating sexual and gender minority stressors
Savannah Stidhams, BA and Caitlin Dzikon, Ph.D.
Abstract
A call for clinical ACTivism: A literature review of Acceptance Commitment Therapy mechanisms for treating sexual and gender minority stressors
Student: Savannah Stidhams, MACP student Faculty Advisor: Danielle Ung, Ph.D.
Objective: Acceptance Commitment Therapy (ACT) is a well-supported, third-wave behavioral approach aimed at increasing psychological flexibility through six core processes. However, there is a dearth of literature examining the efficacy of ACT interventions for stressors and negative mental health outcomes specific to the experiences of gender and sexual minorities (GSM). The purpose of this review is to understand the scope of existent research on ACT approaches to GSM stressors and to identify and evaluate the efficacy of specific ACT components in addressing GSM stressors. This research is crucial to facilitating culturally sensitive care.
Methods: This literature review examined thirteen peer-reviewed scientific journal articles published between 2013-2023 that assessed the efficacy of ACT techniques for treating GSM stressors. It was conducted in March of 2023 utilizing the PsychINFO database with the following search terms: “ACT and Sexual and Gender Minorities,” “ACT and LGBTQIA,” “Psychological Flexibility and Sexual and Gender Minorities,” and “Mindfulness AND Sexual and Gender Minorities”.
Results: Two ACT group therapy pilot studies, three clinical case studies, and eight cross-sectional designs indicated ACT as a clinically relevant modality for GSM stressors. Specifically, ACT improved shame, internal stigma, depression, anxiety, HIV-stigma, burnout, and work stress for GSMs. Psychological flexibility, mindfulness, and self-compassion were indicated as critical concepts in GSM experiences, and recommendations to include Self-Compassion Therapy (CFT) along with other clinical adaptations were highlighted.
Conclusion: ACT is an under-researched, but promising modality for clinical interventions with GSM clients. Due to disproportionate shaming in the LGBTQ+ community, CFT in conjunction with ACT is indicated as possibly more effective. Adaptations and further research are recommended.
Funding: This research was not funded.
Word Count: 262
Student: Savannah Stidhams, MACP student Faculty Advisor: Danielle Ung, Ph.D.
Objective: Acceptance Commitment Therapy (ACT) is a well-supported, third-wave behavioral approach aimed at increasing psychological flexibility through six core processes. However, there is a dearth of literature examining the efficacy of ACT interventions for stressors and negative mental health outcomes specific to the experiences of gender and sexual minorities (GSM). The purpose of this review is to understand the scope of existent research on ACT approaches to GSM stressors and to identify and evaluate the efficacy of specific ACT components in addressing GSM stressors. This research is crucial to facilitating culturally sensitive care.
Methods: This literature review examined thirteen peer-reviewed scientific journal articles published between 2013-2023 that assessed the efficacy of ACT techniques for treating GSM stressors. It was conducted in March of 2023 utilizing the PsychINFO database with the following search terms: “ACT and Sexual and Gender Minorities,” “ACT and LGBTQIA,” “Psychological Flexibility and Sexual and Gender Minorities,” and “Mindfulness AND Sexual and Gender Minorities”.
Results: Two ACT group therapy pilot studies, three clinical case studies, and eight cross-sectional designs indicated ACT as a clinically relevant modality for GSM stressors. Specifically, ACT improved shame, internal stigma, depression, anxiety, HIV-stigma, burnout, and work stress for GSMs. Psychological flexibility, mindfulness, and self-compassion were indicated as critical concepts in GSM experiences, and recommendations to include Self-Compassion Therapy (CFT) along with other clinical adaptations were highlighted.
Conclusion: ACT is an under-researched, but promising modality for clinical interventions with GSM clients. Due to disproportionate shaming in the LGBTQ+ community, CFT in conjunction with ACT is indicated as possibly more effective. Adaptations and further research are recommended.
Funding: This research was not funded.
Word Count: 262
Presented by
Savannah Stidhams
Institution
Bastyr University
The World of Sleep: What to Consider When Standard Sleep Hygiene Recommendations Don’t Help
Justin Thompson & Caitlin Dzikon
Abstract
This study investigates the intricate connections between sleep, race/health disparities, nutrition, and attention, utilizing the Biopsychosocial Model as a comprehensive framework. Sleep is crucial for physical and mental well-being, and insufficient or poor-quality sleep can have significant health consequences. Sleep disparities have been observed among different racial and ethnic groups, potentially influenced by socioeconomic factors, access to healthcare, and cultural beliefs. Nutrition has emerged as a critical factor in sleep regulation, with specific nutrients and dietary patterns impacting sleep outcomes. Additionally, dopamine, a neurotransmitter involved in attention and reward, has been implicated in sleep regulation. Disruptions in dopamine signaling can affect circadian rhythms and the sleep-wake cycle. By examining fourteen peer-reviewed research articles and a self-documented case study, this research aims to provide a comprehensive analysis of the complex interactions between sleep, race/health disparities, nutrition, and attention. The findings are expected to yield valuable insights that can inform the development of interventions and policies to improve sleep outcomes and reduce health disparities among individuals from diverse backgrounds.
Presented by
Justin Thompson
Institution
Bastyr University
Effectiveness of ACT in social anxiety treatment
Dave Sax, Caitlin Dzikon, & Danielle Ung
Abstract
The Efficacy of ACT in The Treatment of Social Anxiety Disorder
Student: Dave Sax
Faculty Advisor: Caitlin Dzikon, PhD & Danielle Ung, PhD
Objective: Social anxiety disorder (SAD), is defined as experiencing symptoms of worry, physiological arousal and distress socially evaluated situations. The most common evidence-based treatments for social anxiety (i.e. CBT), focus on reducing symptoms and exposure to the anxiety-provoking situations while using the new strategies. Acceptance & Commitment Therapy (ACT), is an evidence-based therapy that focuses on helping individuals respond to distressful situations in ways that align with their values and goals and focuses on using acceptance and mindfulness strategies and commitment and behavior change processes, to increase psychological flexibility. The focus shifts from symptom reduction, to value-committed action, whether symptoms are present or not. This project seeks to identify support for using ACT for those with SAD.
Methods: The present study evaluated 10 peer-reviewed scientific journal articles assessing the effectiveness of ACT as a treatment for social anxiety disorder. The literature review used both the PubMed and PsychINFO databases and included only original, peer-reviewed studies, and excluded case studies, meta-analyses and/or systematic reviews. We selected 10 articles published between the dates of 2013 and 2023 based on their evaluation of ACT for social anxiety disorder.
Results: Many benefits of ACT for the treatment of SAD were found including: Increased psychological flexibility, Increased overall wellbeing, Decreased anxiety and stress, effective even without in-person therapy and when compared to CBT it was shown to be equal in reducing distress of unpleasant thoughts and effects on avoidance behavior last longer.
Conclusion: While the go-to treatment for anxiety, including social anxiety, has been CBT, many people don’t respond to these methods and/or some prefer an alternative approach. Our research supports the use of ACT as at least an equal modality, if not superior in some regards to CBT in the treatment of SAD.
Funding: There was no funding for this study.
Objective: Social anxiety disorder (SAD), is defined as experiencing symptoms of worry, physiological arousal and distress socially evaluated situations. The most common evidence-based treatments for social anxiety (i.e. CBT), focus on reducing symptoms and exposure to the anxiety-provoking situations while using the new strategies. Acceptance & Commitment Therapy (ACT), is an evidence-based therapy that focuses on helping individuals respond to distressful situations in ways that align with their values and goals and focuses on using acceptance and mindfulness strategies and commitment and behavior change processes, to increase psychological flexibility. The focus shifts from symptom reduction, to value-committed action, whether symptoms are present or not. This project seeks to identify support for using ACT for those with SAD.
Methods: The present study evaluated 10 peer-reviewed scientific journal articles assessing the effectiveness of ACT as a treatment for social anxiety disorder. The literature review used both the PubMed and PsychINFO databases and included only original, peer-reviewed studies, and excluded case studies, meta-analyses and/or systematic reviews. We selected 10 articles published between the dates of 2013 and 2023 based on their evaluation of ACT for social anxiety disorder.
Results: Many benefits of ACT for the treatment of SAD were found including: Increased psychological flexibility, Increased overall wellbeing, Decreased anxiety and stress, effective even without in-person therapy and when compared to CBT it was shown to be equal in reducing distress of unpleasant thoughts and effects on avoidance behavior last longer.
Conclusion: While the go-to treatment for anxiety, including social anxiety, has been CBT, many people don’t respond to these methods and/or some prefer an alternative approach. Our research supports the use of ACT as at least an equal modality, if not superior in some regards to CBT in the treatment of SAD.
Funding: There was no funding for this study.
Presented by
David Sax
Institution
Bastyr University
Who am I now? Long-term changes in self-identity after traumatic brain injury and how counseling interventions might help: A literature review
Savannah Stidhams, BA and Caitlin Dzikon, Ph.D.
Abstract
Who Am I Now? Long-Term Changes in Self-Identity After Traumatic Brain Injury and How Counseling Interventions Might Help: A Literature Review
Student: Savannah Stidhams, MACP student Faculty Advisor: Caitlin Dzikon, PhD
Objective: A traumatic brain injury (TBI) results in a spectrum of neuropsychological changes which are often accompanied by significant psychosocial changes. These factors can have a negative impact on self-identity, but in the context of a TBI there is limited research on strategies and long-term psychotherapeutic support needed for reflection and acceptance of self after TBI. The purpose of this review is to understand the presently identified components of self-identity in relationship to TBI, the scope of current literature regarding these constructs, and to serve as a call to action for a clinical focus on how facets of self-identity interact with mental health after a TBI.
Methods: The present study evaluated 10 peer-reviewed scientific journal articles published between 2013-2023 assessing various components of self-identity in relationship to TBI status. The literature review was conducted in April of 2023, and utilized the search terms: “Traumatic Brain Injury,” “Brain Damage,” “Head Injury,” “Neurocognitive Injury,” “Neurocognitive Injury,” “Self-Identity,” “Self-Concept,” “Ego-Identity,” “Identity Changes,” “Identity,” and “Social Identity” in the PsychINFO database.
Results: Findings indicate that self-congruence, having a valued place in the world, and being respected, accepted, and validated by others are key components of self-concept post-TBI. Social connection, cognitive reappraisal strategies, and analysis of self-concept changes in relationship to gender identity are also indicated. We provide suggestions for therapists in addressing these issues.
Conclusion: In general, self-concept appears to be interconnected with social connection, relationship to the self, and relationship to the larger world. Addressing these factors therapeutically may yield higher levels of congruence for folks recovering from a TBI. There is a significant need for more research regarding self-concept assessment, intervention, and intersection with female and non-binary clients post-TBI.
Funding: This project was not funded.
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Student: Savannah Stidhams, MACP student Faculty Advisor: Caitlin Dzikon, PhD
Objective: A traumatic brain injury (TBI) results in a spectrum of neuropsychological changes which are often accompanied by significant psychosocial changes. These factors can have a negative impact on self-identity, but in the context of a TBI there is limited research on strategies and long-term psychotherapeutic support needed for reflection and acceptance of self after TBI. The purpose of this review is to understand the presently identified components of self-identity in relationship to TBI, the scope of current literature regarding these constructs, and to serve as a call to action for a clinical focus on how facets of self-identity interact with mental health after a TBI.
Methods: The present study evaluated 10 peer-reviewed scientific journal articles published between 2013-2023 assessing various components of self-identity in relationship to TBI status. The literature review was conducted in April of 2023, and utilized the search terms: “Traumatic Brain Injury,” “Brain Damage,” “Head Injury,” “Neurocognitive Injury,” “Neurocognitive Injury,” “Self-Identity,” “Self-Concept,” “Ego-Identity,” “Identity Changes,” “Identity,” and “Social Identity” in the PsychINFO database.
Results: Findings indicate that self-congruence, having a valued place in the world, and being respected, accepted, and validated by others are key components of self-concept post-TBI. Social connection, cognitive reappraisal strategies, and analysis of self-concept changes in relationship to gender identity are also indicated. We provide suggestions for therapists in addressing these issues.
Conclusion: In general, self-concept appears to be interconnected with social connection, relationship to the self, and relationship to the larger world. Addressing these factors therapeutically may yield higher levels of congruence for folks recovering from a TBI. There is a significant need for more research regarding self-concept assessment, intervention, and intersection with female and non-binary clients post-TBI.
Funding: This project was not funded.
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Presented by
Savannah Stidhams
<savannah.miller@bastyr.edu>
Institution
Bastyr University
Community gardens and biopsychosocial health
Ezra Conklin, Lauren Thom and Dr. Naomi Lester
Abstract
The Impact of Community Garden Participation on Biopsychosocial Health:
A Literature Review
Students: Ezra Conklin & Lauren Thom
Faculty Advisor: Naomi Lester, Ph.D.
Objective: Biopsychosocial health outcomes may be boosted by adding holistic approaches to standard biomedical treatments, and past studies have suggested that community garden participation may benefit numerous aspects of biopsychosocial health. The hypothesis of this project was that the research literature would show that participation in community gardens improves biopsychosocial health.
Methods: Studies for critical review were identified by searching the PsycInfo and PubMed databases. This returned 142 results, of which 33 were original studies meeting project inclusion criteria.
Results: Results of reviewed studies generally indicated that community garden participation is beneficial for biological health by fostering positive health-related behaviors and perceptions of health, although results for specific biomarkers like heart rate and blood pressure were mixed. The literature indicated that community garden participation positively impacts psychological and social health across many age and ethnic groups, with unique added benefits for individuals in indigenous, refugee, and immigrant populations.
Conclusion: The literature broadly supports community garden participation as beneficial for biopsychosocial health. Further research is needed to more fully explore biological health outcomes and nuances of psychosocial outcomes in specific populations.
Funding: n/a
Students: Ezra Conklin & Lauren Thom
Faculty Advisor: Naomi Lester, Ph.D.
Objective: Biopsychosocial health outcomes may be boosted by adding holistic approaches to standard biomedical treatments, and past studies have suggested that community garden participation may benefit numerous aspects of biopsychosocial health. The hypothesis of this project was that the research literature would show that participation in community gardens improves biopsychosocial health.
Methods: Studies for critical review were identified by searching the PsycInfo and PubMed databases. This returned 142 results, of which 33 were original studies meeting project inclusion criteria.
Results: Results of reviewed studies generally indicated that community garden participation is beneficial for biological health by fostering positive health-related behaviors and perceptions of health, although results for specific biomarkers like heart rate and blood pressure were mixed. The literature indicated that community garden participation positively impacts psychological and social health across many age and ethnic groups, with unique added benefits for individuals in indigenous, refugee, and immigrant populations.
Conclusion: The literature broadly supports community garden participation as beneficial for biopsychosocial health. Further research is needed to more fully explore biological health outcomes and nuances of psychosocial outcomes in specific populations.
Funding: n/a
Presented by
Ezra Conklin and Lauren Thom
<Ezra.conklin@bastyr.edu>
Institution
Bastyr University
Using Psychological Flexibility to Assess Mental Health During the Perinatal Period
Brionna Butz, BS and Caitlin Dzikon, PhD
Abstract
Psychological flexibility refers to the extent to which a person can cope with changes in circumstances. There’s reason to believe that psychological flexibility would be important for the perinatal period as individuals become pregnant, go through childbirth, and begin parenting. This period carries with it many stressors, many unexpected events, and new challenges. This study evaluates how well psychologically flexibility assessment tools identify and predict mental health problems in the perinatal period. We propose using a psychological flexibility assessment tool in clinical settings could help identify individuals at risk for perinatal mood and anxiety disorders.
Eleven peer-reviewed scientific journal articles were evaluated which included a measurement of psychological flexibility to assess various components of mental health distress in individuals who are pregnant, trying to conceive, or within two years postpartum. The literature review was conducted in April of 2023, utilizing the PubMed database and ACBS Publications Resource list.
Our results saw associations between psychological flexibility, many biopsychosocial factors of the perinatal period, and other diagnostic measures for anxiety, depression, and obsessive-compulsive symptoms, suggesting using an assessment of psychological flexibility appears useful for this population. We propose psychological flexibility is helpful because of its transdiagnostic nature which has the capacity to identify perinatal distress beyond depression or anxiety symptoms, unlike other common questionnaires. Our results encourage mental health clinicians and other medical providers to recognize psychological flexibility as an important intervention target and consider using process-based counseling strategies like acceptance and commitment therapy which emphasize psychological flexibility as an intervention outcome in therapy.
Eleven peer-reviewed scientific journal articles were evaluated which included a measurement of psychological flexibility to assess various components of mental health distress in individuals who are pregnant, trying to conceive, or within two years postpartum. The literature review was conducted in April of 2023, utilizing the PubMed database and ACBS Publications Resource list.
Our results saw associations between psychological flexibility, many biopsychosocial factors of the perinatal period, and other diagnostic measures for anxiety, depression, and obsessive-compulsive symptoms, suggesting using an assessment of psychological flexibility appears useful for this population. We propose psychological flexibility is helpful because of its transdiagnostic nature which has the capacity to identify perinatal distress beyond depression or anxiety symptoms, unlike other common questionnaires. Our results encourage mental health clinicians and other medical providers to recognize psychological flexibility as an important intervention target and consider using process-based counseling strategies like acceptance and commitment therapy which emphasize psychological flexibility as an intervention outcome in therapy.
Presented by
Brionna Butz
Institution
Bastyr University
The Effectiveness of In-person and Telehealth Applied Behavior Analysis for Children and Adolescents with Autism Spectrum Disorder: A Literature Review
Grace Bicket, Regina Greenwood, Naomi Lester, PhD
Abstract
The Effectiveness of In-person and Telehealth Applied Behavior Analysis for Children and Adolescents with Autism Spectrum Disorder: A Literature Review
Students: Grace Bicket and Regina Greenwood
Faculty Advisor: Naomi Lester, Ph.D.
Objective: The prevalence of Autism Spectrum Disorder (ASD) is 1 in 100 children worldwide across diverse socioeconomic, racial, and ethnic backgrounds, imposing a high economic burden on families and affecting caregiver quality of life. The COVID-19 pandemic catalyzed a surge in the need for readily available therapy services, leading to a transition towards telehealth Applied Behavior Analysis (ABA) therapy. This project evaluated the research literature on the effectiveness of both in-person and telehealth ABA therapy for treatment of ASD among children and adolescents.
Methods: Research literature was identified from databases including PubMed, PsycInfo (EBSCO), and ERIC, searched between 09/20/2022 and 02/26/2023. Based on selection criteria including age, diagnosis of ASD, type of therapy, and publication date, 31 studies were included for critical review.
Results: Applied Behavior Analysis (ABA) therapy is effective both in-person and over telehealth. Communication, social skills, and learning capacities improved among children aged 3 to 11 years when ABA therapy was provided in-person. The therapy was more successful in natural settings such as homes and schools and correlated positively with treatment intensity (dosage). Telehealth ABA therapy also produced skill gains, however, prerequisite skills and caregiver support impacted outcomes. Telehealth methods were also effective for training caregivers to enhanced ABA therapy outcomes.
Conclusion: Both in-person and telehealth methods for ABA therapy can be effective for some individuals with ASD. In addition, educating caregivers to assist with therapy can boost the positive outcomes for the children and adolescents as well as their caregivers. In-person, telehealth and hybrid ABA methods warrant additional study as do programs to train caregivers as part of ABA therapy.
Funding: n/a
Students: Grace Bicket and Regina Greenwood
Faculty Advisor: Naomi Lester, Ph.D.
Objective: The prevalence of Autism Spectrum Disorder (ASD) is 1 in 100 children worldwide across diverse socioeconomic, racial, and ethnic backgrounds, imposing a high economic burden on families and affecting caregiver quality of life. The COVID-19 pandemic catalyzed a surge in the need for readily available therapy services, leading to a transition towards telehealth Applied Behavior Analysis (ABA) therapy. This project evaluated the research literature on the effectiveness of both in-person and telehealth ABA therapy for treatment of ASD among children and adolescents.
Methods: Research literature was identified from databases including PubMed, PsycInfo (EBSCO), and ERIC, searched between 09/20/2022 and 02/26/2023. Based on selection criteria including age, diagnosis of ASD, type of therapy, and publication date, 31 studies were included for critical review.
Results: Applied Behavior Analysis (ABA) therapy is effective both in-person and over telehealth. Communication, social skills, and learning capacities improved among children aged 3 to 11 years when ABA therapy was provided in-person. The therapy was more successful in natural settings such as homes and schools and correlated positively with treatment intensity (dosage). Telehealth ABA therapy also produced skill gains, however, prerequisite skills and caregiver support impacted outcomes. Telehealth methods were also effective for training caregivers to enhanced ABA therapy outcomes.
Conclusion: Both in-person and telehealth methods for ABA therapy can be effective for some individuals with ASD. In addition, educating caregivers to assist with therapy can boost the positive outcomes for the children and adolescents as well as their caregivers. In-person, telehealth and hybrid ABA methods warrant additional study as do programs to train caregivers as part of ABA therapy.
Funding: n/a
Presented by
Grace Bicket and Regina Greenwood
<Grace.Bicket@bastyr.edu>
Institution
Bastyr University
▼ 07_Public Health Back to top
Herb-Drug Interactions (HDIs): A Continuing Education Pilot Program for Registered Pharmacists
Brian C. Carrell, Kara M.K. Bensley, PhD, MSc, Cristina Ciupitu-Plath, MSc, DrPH, Kaleb Lund, PhD, RH (AHG), & Eric Yarnell, ND, RH (AHG)
Abstract
Objective: The use of herbal products is widespread and often not disclosed by patients to their healthcare team. Previous studies have indicated that pharmacists lack confidence in counseling patients on the use of herbal products, suggesting the need for an evidence-based intervention. This pilot seeks to translate current research into an evidence-based intervention for registered pharmacists.
Methods: A non-probability sample of seven registered pharmacists were enrolled in a continuing education pilot program on herb-drug interactions delivered via a 21-minute pre-recorded video.
Results: On a six-point Likert scale, mean self-rated confidence increased from 2.71 to 3.71 (p=0.004), mean self-rated knowledge increased from 2.71 to 3.71 (p=0.004), and perceived safety of herbal products increased from 2.43 to 3.86 (p=0.003). Pre/post-test scores on ten multiple-choice questions increased from 81.4% to 91.4% (p=0.086).
Conclusions: Growing prevalence of herbal product use presents public health opportunities and risks. Herbs are culturally accessible and show promise in preventing and managing chronic diseases; however, healthcare workers must receive adequate training in order to provide evidence-based patient counseling. This continuing education pilot program improves subjective measures, although the sample size was insufficient to detect a significant increase in objective pre/post-test scores.
Methods: A non-probability sample of seven registered pharmacists were enrolled in a continuing education pilot program on herb-drug interactions delivered via a 21-minute pre-recorded video.
Results: On a six-point Likert scale, mean self-rated confidence increased from 2.71 to 3.71 (p=0.004), mean self-rated knowledge increased from 2.71 to 3.71 (p=0.004), and perceived safety of herbal products increased from 2.43 to 3.86 (p=0.003). Pre/post-test scores on ten multiple-choice questions increased from 81.4% to 91.4% (p=0.086).
Conclusions: Growing prevalence of herbal product use presents public health opportunities and risks. Herbs are culturally accessible and show promise in preventing and managing chronic diseases; however, healthcare workers must receive adequate training in order to provide evidence-based patient counseling. This continuing education pilot program improves subjective measures, although the sample size was insufficient to detect a significant increase in objective pre/post-test scores.
Presented by
Brian C. Carrell
<Brian.Carrell@bastyr.edu>
Institution
Bastyr University, Department of Public Health
▼ 08_BURI & Faculty Research Showcase Back to top
NATUROPATHIC ONCOLOGY FOR METASTATIC BREAST CANCER: DESCRIPTION OF CARE AND OUTCOMES FROM THE CANADIAN/US INTEGRATIVE ONCOLOGY STUDY (CUSIOS)
Erin Sweet ND, MPH, FABNO; Leanna J. Standish ND, LAc, PhD, FABNO; Ellen Conte ND; Mark Legacy BSc; Linda Dale CCRP; Peih F. Chiang ND; Fred Dowd; Erica Rizzolo, ND; Dugald Seely ND MSc, FABNO
Abstract
OBJECTIVES
The Canadian/US Integrative Oncology Study is an uncontrolled observational study evaluating the effect of naturopathic oncology in a real-world setting. Here we report on outcomes from patients with metastatic breast cancer (MBC).
METHODS Patients were recruited from 12 outpatient naturopathic clinics across North America. The primary outcome was overall survival compared to the Surveillance Epidemiology and End Results registry (SEER). As a secondary analysis we compared time to mortality based on the type and frequency of complementary interventions. Additionally, this study provided a thorough description of the scope and frequency of recommendations made by NDs in the context of MBC.
RESULTS Of 165 enrolled patients had MBC. A bootstrap analysis significant differences in survival (median HR 0.84, 95% CI 0.65 – 1.04). Higher survival odds were seen in participants who received more intravenous vitamin C (IVC) treatments or saw their ND more frequently. ND recommendations were extensive and varied, with only showed no vitamin D, melatonin, curcumin, Trametes versicolor, IVC, and exercise recommended to more than 50% of the population.
CONCLUSIONS No survival benefits were seen in patients treated by NDs with MBC compared to registry data. The number of IVC treatments and ND visits were independently associated with improved survival; however, findings should be interpreted with caution given study limitations. ND recommendations were highly individualized with a handful recommended to more than half of participants.
This is the first North American multicenter observational study prospectively evaluating survival outcomes for patients receiving IO care from oncology-focused NDs. These findings will inform the profession and public of the potential impact that IO has on survival and quality of life. This research will provide a thorough description of the range of therapies provided by experienced NDs in an IO setting, cost utilization by patients, and a longitudinal analysis of patient experience.
ACKNOWLEDGEMENTS The John and Lottie Hecht Memorial Foundation
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METHODS Patients were recruited from 12 outpatient naturopathic clinics across North America. The primary outcome was overall survival compared to the Surveillance Epidemiology and End Results registry (SEER). As a secondary analysis we compared time to mortality based on the type and frequency of complementary interventions. Additionally, this study provided a thorough description of the scope and frequency of recommendations made by NDs in the context of MBC.
RESULTS Of 165 enrolled patients had MBC. A bootstrap analysis significant differences in survival (median HR 0.84, 95% CI 0.65 – 1.04). Higher survival odds were seen in participants who received more intravenous vitamin C (IVC) treatments or saw their ND more frequently. ND recommendations were extensive and varied, with only showed no vitamin D, melatonin, curcumin, Trametes versicolor, IVC, and exercise recommended to more than 50% of the population.
CONCLUSIONS No survival benefits were seen in patients treated by NDs with MBC compared to registry data. The number of IVC treatments and ND visits were independently associated with improved survival; however, findings should be interpreted with caution given study limitations. ND recommendations were highly individualized with a handful recommended to more than half of participants.
This is the first North American multicenter observational study prospectively evaluating survival outcomes for patients receiving IO care from oncology-focused NDs. These findings will inform the profession and public of the potential impact that IO has on survival and quality of life. This research will provide a thorough description of the range of therapies provided by experienced NDs in an IO setting, cost utilization by patients, and a longitudinal analysis of patient experience.
ACKNOWLEDGEMENTS The John and Lottie Hecht Memorial Foundation
Word count 299 Character count 2047
Presented by
Erin Sweet, ND, MPH, FABNO
Institution
Bastyr University and Canadian College of Naturopathic Medicine
Prospective Outcomes Trial in Patients Undergoing Care with Naturopathic Providers (POT PNP)
Chih-Yun Hsuing, ND, Brooke Thornton, ND, Hillary Anderson, Jessica Chon Hannah Bressler, Justice Erikson, Miranda Hill, Elidania Perez, Naomi Poirier, Shizue Haffeman-Udagawa, Erin Sweet, ND, MPH, FABNO
Abstract
OBJECTIVES:
Overall Aim
The overall aim of this prospective observational case series is to describe both the quality of life (QoL) changes over time associated with complementary and integrative medicine treatments provided by naturopathic physicians.
METHODS: Patients ≥18 presenting to the Bastyr Center for Natural Health (BCNH) for care who meet the following inclusion criteria are eligible to participate: speak English well enough to understand the consent form and able to read and understand the questionnaires. Patients will be consented and PROMIS Global Health-10 (PGH-10), Global Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9) will be administered at each visit. Questionnaires, ICD-10 codes, CPT codes and recommended treatments will be abstracted from the participants chart at the time of each visit and entered into the Research and Electronic Data Capture (REDCap) database.
RESULTS; Results are currently ongoing for our participants enrolled in the study. A total of 26 participants have been enrolled. A total of 57 visits have been completed.
CONCLUSION: Collecting this data will help to inform physicians and patients what conditions naturopathic physicians commonly treat, with what therapies, frequency of use, the cost of such treatments, and how these treatments are associated with QoL. This research is disseminated annually at various conferences, which addresses the need to conduct naturopathic clinical outcomes research and the goal of providing students with a research experience during their education and training. In addition to the current shift offered at the Bastyr Center for Natural Health (BCNH) (Hsuing), beginning Fall 2023, this project will be expanded to included two additional research-focused teaching shifts both at BCNH (Wallace) and Bastyr University San Diego (BUSD) (Aponte-Davila).
ACKNOWLEGEMENT: Funding for these studies has been provided by Bastyr University Research Institute. Contact: Erin Sweet esweet@bastyr.edu
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METHODS: Patients ≥18 presenting to the Bastyr Center for Natural Health (BCNH) for care who meet the following inclusion criteria are eligible to participate: speak English well enough to understand the consent form and able to read and understand the questionnaires. Patients will be consented and PROMIS Global Health-10 (PGH-10), Global Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9) will be administered at each visit. Questionnaires, ICD-10 codes, CPT codes and recommended treatments will be abstracted from the participants chart at the time of each visit and entered into the Research and Electronic Data Capture (REDCap) database.
RESULTS; Results are currently ongoing for our participants enrolled in the study. A total of 26 participants have been enrolled. A total of 57 visits have been completed.
CONCLUSION: Collecting this data will help to inform physicians and patients what conditions naturopathic physicians commonly treat, with what therapies, frequency of use, the cost of such treatments, and how these treatments are associated with QoL. This research is disseminated annually at various conferences, which addresses the need to conduct naturopathic clinical outcomes research and the goal of providing students with a research experience during their education and training. In addition to the current shift offered at the Bastyr Center for Natural Health (BCNH) (Hsuing), beginning Fall 2023, this project will be expanded to included two additional research-focused teaching shifts both at BCNH (Wallace) and Bastyr University San Diego (BUSD) (Aponte-Davila).
ACKNOWLEGEMENT: Funding for these studies has been provided by Bastyr University Research Institute. Contact: Erin Sweet esweet@bastyr.edu
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Presented by
Erin Sweet, ND, MPH, FABNO
Institution
Bastyr University
The Biological and Psychological Health Effects of Intermittent Fasting During Ramadan 2023
Aaron Donny-Clark, Anna Bernieri, Syeda (Safiya) Hasnie, Uma Scharf, Dr. Masa Sasagawa
Abstract
The Biological and Psychological Health Effects of Intermittent Fasting During Ramadan 2023
Aaron Donny-Clark, Anna Bernieri, Syeda (Safiya) Hasnie, Uma Scharf, Dr. Masa Sasagawa
Objectives: To determine biological and psychological effects of intermittent fasting during Ramadan. Plasma concentrations of serotonin, dopamine, brain-derived neurotropic factor (BDNF) and nerve growth factor (NGF) were measured at 3 time points. Kidney function and hydration were also measured at the time points. In addition, mood, stress, sense of belonging, sense of coherence, and empathy were also surveyed.
Methods: Blood draw, urinalysis, and surveys were conducted at 3 time points during the month of fasting. Blood was spun down, the plasma or serum transferred to a freezer tube, and stored at -70C for future bio-marker analysis by ELISA. Participants self-administered urinalysis dip sticks, photographically recorded them, and the photos were collected by the investigators. Surveys were taken online and administered via REDCAP.
Results: There were 17 participants in the Ramadan group and 7 controls. Preliminary analysis of survey data showed a decrease in Negative Affect (PANAS) and an increase in Meaningfulness (Sense of Coherence) in the Ramadan group compared to the control group.
Conclusion: This work is in progress. Summary conclusions will be presented after completion of ELISA testing and data analysis.
This study was approved by the Bastyr University Institutional Review Board (23-1728) and all participants signed written informed consent.
Funded by the Jay Little Fund of Bastyr University.
Objectives: To determine biological and psychological effects of intermittent fasting during Ramadan. Plasma concentrations of serotonin, dopamine, brain-derived neurotropic factor (BDNF) and nerve growth factor (NGF) were measured at 3 time points. Kidney function and hydration were also measured at the time points. In addition, mood, stress, sense of belonging, sense of coherence, and empathy were also surveyed.
Methods: Blood draw, urinalysis, and surveys were conducted at 3 time points during the month of fasting. Blood was spun down, the plasma or serum transferred to a freezer tube, and stored at -70C for future bio-marker analysis by ELISA. Participants self-administered urinalysis dip sticks, photographically recorded them, and the photos were collected by the investigators. Surveys were taken online and administered via REDCAP.
Results: There were 17 participants in the Ramadan group and 7 controls. Preliminary analysis of survey data showed a decrease in Negative Affect (PANAS) and an increase in Meaningfulness (Sense of Coherence) in the Ramadan group compared to the control group.
Conclusion: This work is in progress. Summary conclusions will be presented after completion of ELISA testing and data analysis.
This study was approved by the Bastyr University Institutional Review Board (23-1728) and all participants signed written informed consent.
Funded by the Jay Little Fund of Bastyr University.
Presented by
Aaron Donny-Clark
<Aaron.Donny-Clark@bastyr.edu>
Institution
Bastyr University
Food items consumption over the lifetime and association with risk of Parkinson's disease
Paola Costa-Mallen, Jessie Wagner, Kris Ronnie, Sarah Altvater
Abstract
Background
Some lifestyle and dietary habits over a lifetime may predispose to development of Parkinson’s disease (PD) in older age. Lifelong heavy consumption of dairy products has been previously associated with an increased PD risk, while coffee consumption was associated with reduced PD risk in some studies. However, the lifetime dietary factors that increase or decrease the risk of PD have not been completely elucidated.
Methods A total of 96 patients with PD diagnosis and 231 age- and gender- matched healthy control participants were included in the study. All 96 PD patients met the United Kingdom Brain Bank (UKBB) criteria of PD diagnosis as confirmed by a neurologist. Study participants were administered a modified version of the Willet Food Frequency Questionnaire (FFQ) to assess their dietary habits over the lifetime. Association of particular food items with PD status was tested by logistic regression.
Results Consumption of ≥ 1 ice-cream/ day over the lifetime was associated with increased PD risk, OR (95% CI) = 2.46 (1.13- 5.32), p = 0.024. Frequent consumption of caffeinated cola drinks over the lifetime, on the other hand, resulted in a significant reduction of PD risk, OR (95%CI) = 0.304 (0.153-0.605), p = 0.023. Liver consumption of ≥ once/month was also associated with a lower risk of PD: OR (95% CI) = 0.351 (0.187-0.659), p = 0.001. Other food items associated with a reduction of PD risk included hot cocoa drinks.
Conclusions The frequent consumption over the lifetime of some food items such as ice-cream resulted in an increased PD risk in this study, while regular consumption of liver, caffeinated cola drinks, and hot cocoa drinks reduced PD risk.
Funding NIH grant R21NS070202 and Bastyr Faculty Seed Grant 2016
Methods A total of 96 patients with PD diagnosis and 231 age- and gender- matched healthy control participants were included in the study. All 96 PD patients met the United Kingdom Brain Bank (UKBB) criteria of PD diagnosis as confirmed by a neurologist. Study participants were administered a modified version of the Willet Food Frequency Questionnaire (FFQ) to assess their dietary habits over the lifetime. Association of particular food items with PD status was tested by logistic regression.
Results Consumption of ≥ 1 ice-cream/ day over the lifetime was associated with increased PD risk, OR (95% CI) = 2.46 (1.13- 5.32), p = 0.024. Frequent consumption of caffeinated cola drinks over the lifetime, on the other hand, resulted in a significant reduction of PD risk, OR (95%CI) = 0.304 (0.153-0.605), p = 0.023. Liver consumption of ≥ once/month was also associated with a lower risk of PD: OR (95% CI) = 0.351 (0.187-0.659), p = 0.001. Other food items associated with a reduction of PD risk included hot cocoa drinks.
Conclusions The frequent consumption over the lifetime of some food items such as ice-cream resulted in an increased PD risk in this study, while regular consumption of liver, caffeinated cola drinks, and hot cocoa drinks reduced PD risk.
Funding NIH grant R21NS070202 and Bastyr Faculty Seed Grant 2016
Presented by
Paola Costa-Mallen
Institution
Bastyr University