Background: Numerous studies have reported that spending time in nature is associated with the improvement of various health outcomes and well-being. This review evaluated the physical and psychological benefits of a specific type of exposure to nature, forest therapy.

Method: A literature search was carried out using MEDLINE, PubMed, ScienceDirect, EMBASE, and ProQuest databases and manual searches from inception up to December 2016. Key words: “Forest” or “Shinrin -Yoku” or “Forest bath” AND “Health” or “Wellbeing”. The methodological quality of each randomized controlled trials (RCTs) was assessed according to the Cochrane risk of bias (ROB) tool.

Results: Six RCTs met the inclusion criteria. Participants’ ages ranged from 20 to 79 years. Sample size ranged from 18 to 99. Populations studied varied from young healthy university students to elderly people with chronic disease. Studies reported the positive impact of forest therapy on hypertension (n = 2), cardiac and pulmonary function (n = 1), immune function (n = 2), inflammation (n = 3), oxidative stress (n = 1), stress (n = 1), stress hormone (n = 1), anxiety (n = 1), depression (n = 2), and emotional response (n = 3). The quality of all studies included in this review had a high ROB.

Conclusion: Forest therapy may play an important role in health promotion and disease prevention. However, the lack of high-quality studies limits the strength of results, rendering the evidence insufficient to establish clinical practice guidelines for its use. More robust RCTs are warranted.

The purpose of this study was to explore the effects of a four-week martial arts program implemented once a week on children diagnosed with attention-deficit hyperactivity disorder (ADHD) between the ages of four and seven. This was a single group, pre- and post-intervention assessment pilot study. The total sample of the study was four children (n=4) and the martial arts classes were based on the Duke Kenpo Little Tiger Program by Jonathan Duke of Mesa, Arizona. Change was measured using the Behavior Rating Inventory of Executive Function, 2nd edition (BRIEF-2) parental form and participants were encouraged to record at-home practice. Data were collected pre-intervention and four weeks afterwards. Limitations included small sample size, measurement limitation (e.g., ceiling effect), data based on parental report, a short intervention period, potential instructor bias, and uneven gender distribution. Given the small sample size (n=4), this study did not complete statistical analysis and alternatively described the changing patterns of the participant's ADHD symptoms from BRIEF-2 measures pre and post intervention. The results of this study could not generate the power to detect significance to state significant implications. However, the trends suggested that some participants declined in executive function in certain areas (e.g., task-monitoring and planning) and improved in other areas (e.g., working memory and organization of materials). All participants demonstrated improvement within the cognitive (CRI) scale of the BRIEF-2 and future studies may explore the potential for martial arts interventions in children under seven as a means to improve the cognitive aspect of executive function development. In addition, future studies may consider exploring the role of frequency versus time for at-home martial arts practice for children with ADHD under the age of seven.

For this creative project, an instructional video on relaxation techniques was created. The relaxation techniques demonstrated were intended to help patients with comorbid cancer and sleep disturbance fall asleep with greater ease. Based on a literature review, autogenic training and tai chi were chosen as the relaxation techniques to demonstrate in the video project. The literature review informed what components of autogenic training and tai chi should be included in the video. A patient with cancer was asked to participate in the making of the video. The patient was guided through autogenic training and tai chi. The patient provided feedback on her experience after completing each technique. The video also included background information on the two relaxation techniques. The completed video was presented to the director of Natural Medicine and Detox in Phoenix, AZ, a naturopathic physician, and a cancer survivor. These individuals provided feedback on what they liked about the video and what they thought needed improvement. The video was posted on YouTube as a resource for patients with cancer. https://www.youtube.com/watch?v=04kYz1kSCaU

Significance Background: Human papilloma virus (HPV) is the most common sexually transmitted infection, affecting 79 million Americans today and an additional 14 million Americans becoming infected with HPV each year. HPV infection may lead to the development of genital warts and several types of cancers including both cervical and oropharyngeal cancers. The promotion of currently available HPV vaccines is important to prevent HPV transmission and reduce the prevalence of the comorbidities associated with infection. Promotion to Vietnamese-Americans in particular is important because of the increased rates of cervical cancers seen in this population. As Vietnamese-American mothers often act as the primary healthcare decision maker for their children, they were chosen as the target population for this intervention. Purpose: This study aims to (1) develop personal digital stories about HPV and HPV vaccination among Vietnamese women with adolescent children who are vaccinated against HPV; and (2) share these stories with a group of Vietnamese American mothers and assess the effect of the stories in changing the attitudes, beliefs, and intention to vaccinate for HPV. Methods: This study used a two-step process to design, implement, and evaluate digital stories to improve Vietnamese mothers' attitudes, beliefs, and intention to vaccinate their adolescent children against HPV. The first step was a formative research design to develop the digital stories. The second step was quasi-experimental with a pre and posttest design to evaluate the effect of the stories. Results: The first phase has produced two digital stories which will be screened recruitment has been completed for phase two. Content analysis showed the importance of community resources, the desire to protect children, a history of familial and/or personal cancer, concerns about side effects, and the influence of healthcare providers as themes in both stories. Recruitment efforts are underway to recruit eligible Vietnamese mothers to assess the effect of these stories. Data collection is ongoing. Conclusions and lessons learned: The project has yielded two digital stories and recruitment for phase two is underway. This project has been successful in obtaining IRB approval, recruiting phase one participants, holding a digital storytelling workshop, designing the phase two survey, and beginning data collection efforts. The phase two recruitment has been challenging and will necessitate a change in strategy to find participants.

This paper focuses on the current use of complementary medicine in Oncology. First, it reviews the general trends in the rise of complementary therapies in the United States and look at the organizations responsible for the advancement of research. Next reviewed is the specific use of complementary medicine in cancer prevention, during treatment, and post-treatment therapy for increased quality of life. There are many modalities used in the management of this disease including yoga, tai chi chuan, botanicals, probiotics and meditation practices. Each of these therapies has their own unique benefits and are used at different stages of disease prevention and treatment.

A cost analysis was done on the participant recruitment for an ongoing research project to promote colon cancer screening in Phoenix, Arizona. The aim of the 5-year project is to navigate people, who do not regularly see primary care physicians, from the community to a nearby clinic to be screened, using an intervention strategy called tailored navigation. Through tailored navigation, participants' barriers to being screened are addressed by Community Health Navigators, who call the participant over the span of 8 weeks following an initial class at a community site and give them information on how to overcome his or her specific barrier. The objective of this cost analysis is to explore the costs of recruiting a participant from the community to the initial class to a potential program manager. The process of recruitment involved recruitment of a community site, project introduction, the sign-up of interested participants, eligibility, baseline, and consent tests, and the class itself. A Community Site Liaison recruits sites and schedules class times. The Community Health Navigator conducts eligibility, baseline, and consent surveys and teaches the class, a sixty minute presentation on colon cancer screening. The cost of recruitment per community site was $541.23, and the cost per participant attending class was estimated to be $1,594.41 per participant with variation between $1,379.97 and $1,770.71 in optimistic and conservative scenarios, respectively.

Myeloproliferative neoplasm (MPN) patients suffer from fatigue and a reduced overall quality of life, both of which are not resolved with current pharmacologic therapy. The purpose of this study was to examine the effects of a 12-week online-streamed yoga intervention on fatigue and QoL in MPN patients as compared to a wait-list control group as well as to determine the feasibility of remotely collecting blood and saliva samples in a national sample. MPN patients were asked to complete 60 min/week of online yoga for 12 weeks. MPN fatigue and QoL were assessed online with single-item questions taken from the MPN SAF (fatigue and QoL) and NIH PROMIS (QoL) at baseline, week 7, and week 12. The practicality of the blood and saliva measures were defined as >70% completion rate at both baseline and week 12. Fidelity of the intervention (i.e., weekly yoga participation) was assessed via both self-report (i.e., daily log) and objective measurement (i.e., Clicky). Of the 62 MPN patients that enrolled in the study, 48 completed the intervention with 27 participating in the yoga group and 21 participating in the wait-list control group. Weekly yoga participation averaged ~41 min/week as measured objectively, whereas self-report yoga participation averaged ~56 min/week. The blood draw was determined to be practical with a 92.6% completion rate at baseline and a 70.4% completion rate at week 12. There were no significant differences from baseline to week 12 in MPN SAF fatigue (ES=0.18; p=0.724) or MPN SAF QoL (ES=-0.53; p=0.19), however, NIH PROMIS QoL was significantly improved from baseline to week 12 (ES=0.7; p=0.031) when compared to the control group. This study builds upon the findings from a prior feasibility study in demonstrating the feasibility of online yoga as well as its preliminary effects of improving total symptom burden, fatigue, pain, depression, anxiety, and sleep disturbance in MPN patients. Given the effects of yoga demonstrated both in the feasibility study and the current pilot study, a future randomized controlled trial with a larger sample size is warranted in order to further investigate the effectiveness of online yoga for MPN patient symptom burden and QoL.

Cancer survivors engaged in either six-week Internet-delivered mindfulness training or a usual-care control and were compared on the following outcome battery: The Hospital Anxiety and Depression Scale, the Profile of Mood States, the Pittsburgh Sleep Quality Index, and the Fatigue Symptom Inventory. Assessments were conducted before and after treatment and intervention compliance was monitored. Mindfulness treatments were delivered at a time and on a computer of the participants’ choosing. Multivariate analysis indicated that mindfulness training produced significant benefits on all measures (p < .05). Online mindfulness instruction represents a widely-accessible, cost-effective intervention for reducing psychological distress and its behavioral manifestations in cancer survivors, especially those who are unable to participate in in-person training.

The purpose of this phenomenological study was to explore the cultural, social, environmental, and gender factors that may influence physical activity (PA) in older Mexican American (MA) men living in Tucson, Arizona. The Mexican origin population is the fastest growing Hispanic subgroup in our nation, increasing from 20.6 million in the year 2000 to 31.8 million in 2010. Arizona has the sixth largest Hispanic population in the United States and the Mexican origin population accounts for 91% of Arizona's Hispanics. Despite the fast growing Mexican population, there are a limited number of studies that examine MAs and PA. There are even fewer interventions created to foster PA among older (≥65 years old) MA men. Fourteen individual interviews were conducted with older MA men living in Tucson, Arizona. Data was collected, organized, and analyzed according to the methodologies of Clark Moustakas and the Social Ecology Model for Health Promotion framework. Six themes emerged which reflected the older MA male's perception of health, masculinity, and physical activity: a) Retirement promotes self-care behaviors, b) Women, health care providers, and the Internet are important in promoting health, c) Aging changes physical activity, d) I take care of myself, e) Physical activity is a personal choice and lifestyle, and f) I learn and make adjustments as needed. Themes were used to create textural and structural descriptions of their experiences. Descriptions were formed into the essence of the phenomenon. The results of this study increase our understanding of health, masculinity, and physical activity in older MA men. This research will inform the development of an evidence-based PA intervention to promote cardiovascular (CV) health in older MA men that may be implemented in a variety of community-based settings.