An innovative approach to reducing medical care utilization and expenditures.
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In a retrospective study, we assessed the impact on medical utilization and expenditures of a multicomponent prevention program, the Maharishi Vedic Approach to Health (MVAH). We compared archival data from Blue Cross/Blue Shield Iowa for MVAH (n = 693) with statewide norms for 1985 through 1995 (n = 600,000) and with a demographically matched control group (n = 4,148) for 1990, 1991, 1994, and 1995. We found that the 4-year total medical expenditures per person in the MVAH group were 59% and 57% lower than those in the norm and control groups, respectively; the 11-year mean was 63% lower than the norm. The MVAH group had lower utilization and expenditures across all age groups and for all disease categories. Hospital admission rates in the control group were 11.4 times higher than those in the MVAH group for cardiovascular disease, 3.3 times higher for cancer, and 6.7 times higher for mental health and substance abuse. The greatest savings were seen among MVAH patients older than age 45, who had 88% fewer total patients days compared with control patients. Our results confirm previous research supporting the effectiveness of MVAH for preventing disease. Our evaluation suggests that MVAH can be safely used as a cost-effective treatment regimen in the managed care setting. (+info)
Unconventional dentistry: Part I. Introduction.
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This is the first in a series of five articles providing a contemporary overview and introduction to unconventional (alternative) dentistry (UD) and correlation with unconventional (alternative) medicine (UM). UD is analogous to and conceptually inseparable from UM. Dentists should learn about UD and UM and be aware of evidence on the safety and effectiveness of treatments and procedures. While being skeptical of promotions, dentists should be able to accept and encompass science-based advances and reject unproven and disproven methods. Incorporating selected unconventional methods with conventional dentistry in selected patients for specific purposes may be useful to both patients and dentists. Improved education in critical thinking, research, science, medicine, behaviour, communication and patient management is needed. (+info)
The etiologies, pathophysiology, and alternative/complementary treatment of asthma.
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A chronic inflammatory disorder of the respiratory airways, asthma is characterized by bronchial airway inflammation resulting in increased mucus production and airway hyper-responsiveness. The resultant symptomatology includes episodes of wheezing, coughing, and shortness of breath. Asthma is a multifactorial disease process with genetic, allergic, environmental, infectious, emotional, and nutritional components. The underlying pathophysiology of asthma is airway inflammation. The underlying process driving and maintaining the asthmatic inflammatory process appears to be an abnormal or inadequately regulated CD4+ T-cell immune response. The T-helper 2 (Th2) subset produces cytokines including interleukin-4 (IL-4), IL-5, IL-6, IL-9, IL-10, and IL-13, which stimulate the growth, differentiation, and recruitment of mast cells, basophils, eosinophils, and B-cells, all of which are involved in humoral immunity, inflammation, and the allergic response. In asthma, this arm of the immune response is overactive, while Th1 activity, generally corresponding more to cell-mediated immunity, is dampened. It is not yet known why asthmatics have this out-of-balance immune activity, but genetics, viruses, fungi, heavy metals, nutrition, and pollution all can be contributors. A plant lipid preparation containing sterols and sterolins has been shown to dampen Th2 activity. Antioxidant nutrients, especially vitamins C and E, selenium, and zinc appear to be necessary in asthma treatment. Vitamins B6 and B12 also may be helpful. Omega-3 fatty acids from fish, the flavonoid quercetin, and botanicals Tylophora asthmatica, Boswellia serrata and Petasites hybridus address the inflammatory component. Physical modalities, including yoga, massage, biofeedback, acupuncture, and chiropractic can also be of help. (+info)
Reflections on a new medical cosmology.
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Since the nineteenth century the theory and practice of mainstream Western medicine has been grounded in the biomedical model. In the later years of the twentieth century, however, it has faced a range of serious problems, which when viewed collectively, remain unresolved despite a variety of responses. The question we now face is whether these problems can be dealt with by modifying and extending the principles underlying the biomedical model, or whether a more radical solution is required. Recent critiques of Western medicine have focused mainly on the biopsychosocial model in relation to the former approach, but it will be contended that this cannot deal adequately with the challenges that medicine currently faces, because although it addresses both the scientific and humanistic aspects of medicine it fails to harmonise them. I shall therefore argue for the necessity of a more radical approach, and suggest that what is required to accomplish this is the development of a new medical cosmology, rooted in an older and more global framework. Such a fundamental change would inevitably involve a long term process which it is not yet possible to fully comprehend let alone specify in detail. Some of the necessary features of such a new medical cosmology can, however, already be distinguished and the outline of these is described. (+info)
Do the sick have a right to cadaveric organs?
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One way of increasing the supply of organs for transplantation is to adopt a policy giving the sick a right to cadaveric organs. Such a right would entail the coercive transfer of organs from the dead without their previous consent. Because this policy would violate individual autonomy and the special relation between humans and their bodies, it would be morally unjustifiable. Although a rights-based non-consensual model of salvaging cadaveric organs would be medically desirable, a communitarian-based consensual model would be a morally justifiable alternative way of addressing the problem of organ scarcity. (+info)
Science and Human Behavior, dualism, and conceptual modification.
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Skinner's Science and Human Behavior is in part an attempt to solve psychology's problem with mind-body dualism by revising our everyday mentalistic conceptual scheme. In the case of descriptive mentalism (the use of mentalistic terms to describe behavior), Skinner offers behavioral "translations." In contrast, Skinner rejects explanatory mentalism (the use of mental concepts to explain behavior) and suggests how to replace it with a behaviorist explanatory framework. For experiential mentalism, Skinner presents a theory of verbal behavior that integrates the use of mentalistic language in first-person reports of phenomenal experience into a scientific framework. (+info)
Critical care research: weaving a body-mind-spirit tapestry.
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Master weavers historically characterize the weaving of a tapestry as a calling, a transformation, a healing or sacred work. Tapestries are created by the collective efforts of many and are configured by the weavers' consciousness and spirit. A holistic framework used to weave a body-mind-spirit tapestry for guiding holistic clinical practice and research is described. Various research studies that document the effects of holistic interventions on patients' outcomes are examined. Implications for clinical practice are explored. (+info)
Fostering a healing presence and investigating its mediators.
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The purpose of this paper is the exploration and explication of the complex phenomena of "healing presence" and of appropriately supportive theoretical approaches to integrate emerging models for research design. Healing presence is described as an interpersonal, intrapersonal, and transpersonal to transcendent phenomenon that leads to a beneficial, therapeutic, and/or positive spiritual change within another individual (healee) and also within the healer. An integrated framework merging knowledge from diverse fields of research develops the multiple elements of healing presence, the healer, the healee's capacity for response and the healing effect as an entangled phenomenon. A conceptual systemic model is presented, and questions and dilemmas that emerge are delineated. An integrated qualitative-quantitative research design is proposed. A systemic relationship model, which includes the healer, the healee, and persons within the healee's environment is presented. The challenges are substantial, but the research questions are meaningful and worthwhile. The goal is to foster healing at bio-psycho-social-spiritual levels of the human being. (+info)