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Contributors DavidAldridge Chair ofQualitativeResearch ServicesUniversityofthe HealthSciences, inMedicine, UniversitatWillten/Herdecke, Bethesda,MD,USA Witten,Germany JuliannG Kiang Professor,Departmentsof John AAstin ComplementaryMedicine Medicine and Pharmacology,Uniformed ResearchInstitute, California PacificMedical ServicesUniversityofthe HealthSciences, Center,SanFrancisco,California, USA Bethesda, Maryland; DeputyChief, Department ofCellularInjury,Walter Reed Army Instituteof MAllanCooperstein Independent Research, SilverSpring,Maryland, USA Clinical/Forensic Psychologist, WillowGrove, PA,USA Gaia LMKile Complementary and Alternative MedicineResearchCenter, Universityof Cindy CCrawford Samueli Institutefor Michigan, Michigan, USA InformationBiology, DepartmentofFamily Medicine, Uniformed ServicesUniversity ofthe PingYLu CEO,BurlIerInformationArchitects Health Sciences,Bethesda, MD,USA Inc.,PO Box2482,Kensington, Maryland,USA JefferyADusek Associate Director for Clinical EdwinMay CognitiveSciencesLaboratory, Reseach,Mind BodyMedical Institute, Beth PaloAlto,CA,USA Israel Deaconess Medical Center, Boston,MA, USA Michael Mayer The Psychotherapyand Healing Center, Berkeley,CA,USA LindaK George Duke University,Durham, USA RogerNelson PrincetonEngineering AnomaliesResearch, Princeton, New Jersey, BrendaWGillespie Centerfor Statistical USA Consultationand Research,Universityof Michigan,Michigan, USA Sean 6Laoire Menlo Park, CA, USA Tim Harlow CollegeSurgery,Collumpton, Yifang Qian Community Health Networkof Devon, UK San Francisco,San Francisco,CA,USA David Hufford Professor,Departmentof Dean Radin InstituteofNoetic Sciences, Humanities,Pennsylvania StateCollegeof Petaluma,CA,USA Medicine,Hershey, PA,USA Marilyn Schlitz InstituteofNoetic WayneBJonas Director,SamueliInstitutefor Sciences,Petaluma;Institutefor Healthand Information Biology,Associate Professor, Healing,California PacificMedical Center, DepartmentofFamilyMedicine,Uniformed CAlUSA vii viii CONTRIBUTORS Stefan Schmidt Universitatsklinikum Freiburg, HaraldWalach Klinikumder Universitat, Institut fur Umweltmedizin und Institutfur Umweltmedizinand Krankenhaushygiene, Freiburg, Germany Krankenhaushygiene, Freiburg,Germany Jane Sherwood ResearchNurseCoordinator, Sara LWarber Complementary and Alternative MassachusettsGeneral Hospital,Centerfor the Medicine Research Center, Universityof IntegrationofMedicine and Innovative Michigan, Ann Arbor MI,USA Technology, Boston,MA,USA XinYan ChongqingInstitute ofTraditional Jerry Solfvin California PacificMedicalCenter Chinese Medicine, Chongqing,Sichuan ResearchInstitute, SanFrancisco,CA,USA Province, Peoples Republic of China Andrew G Sparber Nursingand PatientCare Garret Yount California PacificMedical Center Services,ClinicalCenter, National Instituteof ResearchInstitute,SanFranciscoCA,USA Health, USA Jessica Utts Professor,DepartmentofStatistics, University ofCalifornia, Davis,CA,USA Foreword 'a healthscientistadministrator.'Morespecifical ly,they were seeking a health scientist adminis trator with interest, not a mere curiosity, in the fields of complementary medicine, spirituality, andhealing.Theeditorswere pursuingsomeone who would or could be willing, most positively, toread thevariouschaptersthen help make deci sions on a national basis to incorporate or reject the messages being transferred in the dialogues into an academic research and clinical strategy. My goal was to explicitly become an advocate andtoassistindevelopinganationalstrategyfor incorporating spirituality and medicine into future sponsoredresearch initiatives,educational projects, and ultimately, clinical services.In fact, .to participatein 'drawing' the blueprintforspir- ituality and healing in academic medicine! This was a serious and important task placed before me.So,with the knowledge thatIwould, try,try my best, to fulfill this honor, I proceeded to accept the invitation. As the Vice Dean for Research of the Penn StateCollege ofMedicine,ahealthyand growing academic health center, and an Associate Vice ©MassimoLislrVCORBIS President for Health Sciences Research for Penn State University, a research-intense land grant HEALTHCARE IN RENAISSANCE: university, one of my responsibilities is toenvis A CHARIOT DRAWN BY TWO age the future of the health research enterprise DOLPHINS and tohelp planascientificpathfortheuniversity When the editors of this wonderful book asked in order that the faculty be active participants in metowritetheforeword theyindicatedthat they the sciences and technologies of the decades to were seekingsomeonewho wasnot an expertin come.Thisisnotsimplyanexerciseof'crystal ball thefield ofspiritualityandhealing, for that Iam gazing,' but a program of comprehensive and not, but they were looking to select, what indi intense study not unlike the activity of business viduals who perform my duties are called; prognosticatorsor even hurricane forecasters. ix x FOREWORD Thereisamplehistoryofplanningforthebasis Raphael had and, Iquote again, 'the love and of scientific change. Change in science is illus objectivity to penetrate deeply enough into the trated through a plethora ofoutdated textbooks, artofa pastage to give it new life.']Ifelt,when many of these only three or four years old, and reviewing the chapters, that the authors library stacks full of publications reporting on addressed both the art and scienceofspirituality the acquisition and transfer of new basic and with such a passion that, like Raphael, they are clinical knowledge. In this new technology era, proceedingto 'giveitnew life.'] the pace of change is so rapid that as short as a I will make analogies of this 'Triumph' with one-year lapse of laboratory work or reading the emergenceofthis science, and Iuse this term may cause a loss ofone's currency in any scien deliberately, thescienceofspirituality,theimpact tificdiscipline. Thereisaconstantand increasing ofspiritualityonboth humanhealthandhealing, flow of new innovations and technologies being andonthepotentialforphilosophicalandempir conceived, analyzed, and validated, often in icalchangesontheenginesofhealthcareresearch human subject studies via clinical trials and can take place in the nation's academic health demonstration projects. This is an era, however, centers. where there is the ever importantenvironmental A depiction of the Triumph of Galatea illus factor never seen, to this degree, in centuries of trates Galatea, the sea-nymph, traveling rapidly scientific progress - that is an enormous public acrossthe oceanwavesinachariotdrawnby two interest and public advocacy.The public's quest dolphins. You can almost envisage the rush of for new cures, treatments, and ways to prevent hermovementanda'swirling' around her ofthe disease and maintain health is insatiable - itisa fairmaidens,seagods, andcherubs.!Shealone is quest that drives change through buying and freeand independentof the swirlinghumanand prescribing practices and, many times through part human companions.I Art critics have federal scientific budget allocations. The described this magnificent piece as one which National InstitutesofHealthbudgetison course 'achievesconstantmovement .. .withoutletting to double its appropriations in five years. This it become restless and unbalanced." A message doubling isthe result ofpublic engagement. The that on our quest for acceptance of spirituality's very positive cases of research funding forAIDS influence on healingwe shouldbe,and Ibelieve, and breast cancer arevery well publicized exam are mindful of.This fresco will help us focus on ples ofpublic interest, advocacy,and action. our thoughts as we transition from fantasy to Without lightening the importance of my mis spirituality. sion of producing a foreword for an important The journeyof spirituality into the practice of document, Idecided toprovidemy impressions, medicineand into academic institutions has not, of my recently acquired views, of the future of as of today, had the acceleration and movement spirituality and healing in academic medicine, visualized in this fresco. In fact, ifnot for books throughavisual treat. like this one and some dynamic and intellectual Raffaello Sanzio, more popularly known as leadership of Duke University, The National Raphael, one of the artistic giants of the InstituteforHealthcareResearch,and the institu RenaissanceEra,never could have imaginedthat tions that house the authors, I believe there hisfrescoentitled,TheTriumph ofGalatea,painted would not be enough 'momentum' - especially in an Italian palazzo would be discussed in a in the university medical centers, to allow the preface of a Spirituality and Healing compendi scienceofspirituality to remainafloat. um almost 500years after his death. This book is a celebration, and I believe an Why pick a painting by Raphael? Because impetusfor change. Raphael was dedicated, to what art critics Why am Ioptimisticaboutspirituality'sfuture exclaim, and, I quote 'reconstructing the lost acceptance in healthcare? Why do Ibelieve con architectureoftheeternalcity.']InRaphael'scase ventional medicine has in the last decade Rome,in ours, the eternal city ofMedicine. embarked on its own renaissance, which FOREWORD xi will encourage the pursuit of the science of tunities facing a growing medical center in its spirituality? efforttoachieveandsustainitsgoal ofexcellence. I will answer these questions by examining In that approachhe and the faculty identified key first the universities and then as a group, indi values which included, 'Excellence,Compassion, vidual physicians,scientists, and the public. Innovation and Integrity.' The vision of Wake First the universities - the time is upon us for Forestwith relation to the clinicalenterprise is to the halls ofacademia, I'll callthem, 'coalitions of evolve in such a manner that 'we maintain and intellect,' to open their doors to the science of enhance our position in the market place of spiritualityand its role inhealing. healthcare delivery both in reality and in the DonaldKennedy,former PresidentofStanford public's perception.' The public'sperception isa University, writing a few years ago in an essay concept that we would not have addressed so entitled Making Choices intheResearch University3 intensely just one decade ago. Collectively, as indicates that 'directionalshifts' will be required changeagents,we areopeningourinstitutionsto if American research universities, and I include newconceptsandideas. ThecompassionvalueIs academic health centers, are going to meet one that relates closely to the contents of this society's expectations for the new millennium. book. The valueisarticulated in the WakeForest One reason Kennedy, as do I, believes that the 'Strategy' as:'Being aware of,and responsive to, shiftwillbeimplementedisbecause, asKennedy the physical,emotional,spiritual, and intellectual states so eloquently, and Iquote: needsofothers.' Thejustcitedauthorshavebeen thepioneersof Neverhaveouruniversitieslivedinamoreabruptly changingsociety.Tospeakof'academicrigor'by this areaofchangeinscienceand it's time forthis wayofappealingtothedisciplinarystatusquois pioneeringspirit tobecome contagious. Thus, the self-evidentlyanachronisticnow. Weneedtoopenup writings of these three academic leaders help therigidcagesofinstitutionalthoughtandcustomto comfort me,in the reality that the universitiesare, newcultures,newalignments,andnewproblems.' in fact,open or 'opening' to the concepts that we Kennedy does not address the issues are studying this day. Thus, the movement will spirituality and healing. I, however, believe that occur - and even if some universities must be spirituality and its effect on healing does apply pulled, they willattainmomentum. and the new 'openness' of universities to Thus, to the dolphins. Let's call one 'con innovative and non-traditional approaches can ventional' and the other 'spiritual.' Healing, of helpbreak theacademic'scultural'rigormortis? to the universalpatient,inmy opinion,mustutilize newconceptsthat havenotbeenpartofthehigher both. The philosophies must move together in educationenterprises'own business plans. parallel. In the past, infactvery recentpast, they Nannerl O. Keohane, President of Duke were going at different speeds and in diverse University also a proponent ofchange, writes in directions. Would the chariot remain afloat? an article on Missionof theResearch University4 Certainlynot!Ifwe considerthebeautifulGalatea that: as the 'universal, healthy patient' exhibiting a high quality of life looking up to the heavens. Themodemresearchuniversityoccupiesadistinctive nicheinbothspaceandtime,compoundedofequal That image would certainly change with her partsofintensenostalgiclocalismandagenerous conventional and spiritual caregivers moving in sensethatmembersofauniversityarecitizensofthe different directions at different rates! Just world.Yet,universitiesarealsoforward-looking, remember the simple formula we learned in restless,pioneering,attemptingtodiscernandeven physics. Parallelisminthis caseisimportant- we tocontrolthefuture." need both dolphins - not a merger, but a Richard H. Dean, M.D., the Senior Vice complementaryteam approach. President for Health Affairs at Wake Forest Ifind many physicians and scientists who are University recently completed an in depth trying to inhibit the pace of our spirituality 'Strategy' for distilling the issues and oppor- dolphin, usingbothdoubt and recalcitrance. xii FOREWORD Ido believe we can overcomethis withcareful I'll even add another, 'yet,' to Dr. Levin's. and comprehensive study, validation, and most Physiciansupongraduationfrom medicalschool ofallperseverance. take an oath ultimately derived from the DrWayneJonas, mycolleagueandfriend, like Hippocratic oath and hopefully, in sincere myself, is optimistic and predicts that as current earnestness,notonlyin a 'ceremonialcontext' of complementaryandalternative medicine groups graduation from four years of rigorous study. become more 'professional' the therapies and The first lines of the oathare: preventive modalities they promote will be Iswearby all the godsand goddesses,making adopted into the mainstream. them my witness, that I will fulfill according to Now tothe doctors, patients, and public. my ability and judgment this oath and this Dr Edmund Pellgrino, noted ethicist, presents covenant:" ... in his writings an earlier image of the physician An oathtoGods! Arich historyofcenturiesof asa'benevolent,benign,andauthoritarianfigure medicine and by medicine practitioners of who decided what is best for his/her patients." covenants with deities. Is this not at least a Thatimage servedsociety well inatime thatwas partial underpinning that should have been simpler, and when decisions on healthcare did sufficient to 'connect' the profession with the not involve, as they do today, to quote Dr. issue of religious or spiritual involvement in Pellgrino, a 'host of new value and moral their patients? questions'." It more easily fulfilled expectations As has been debated over the past few years, in a society in which there were fewer educated I must admit that the issue of spirituality and people who would say, to quote Dr. Pellegrino religionwas at timesconfusedandintermingled. again, 'Just a moment - I would like to under Spiritualityhasbeendefinedas, andIquote: 'the standwhatishappening! Iwant to have a say in spirit or the soul, as distinguished from the what you are going to do's Dr.Pellegrino and I body, what is often thought of as the better or agree to quote him once more: 'A healing higher part of the mind.'? It is a search for the decision isone that will make the patient whole sense of meaning and purpose of life.? On the again, restore bodily harmony ifthat is possible, other hand, religion is a 'system of belief, and perhaps even make it better than before the worship, conduct, often involving a code of illness occurred." ethics and philosophy.'9 I believe that the Areview article published a half decade ago message today is that organized religion is but instructs us on the recalcitrance ofphysicians to one methodology of expressing our spirituality. move in the directions of society. Consider the Either is importantin the healing process and in dolphinanalogy and whatthismeans.DrJeffreyS. the holistic approach to an individual or LevinofthelnternationalCenterforIntegrationof patient'swell-being. Heath and Spiritualitywrites thatsurveys show When one is severely ill or near end of life, that 80%of Americans believe 'in the power of there is almost always a trilogy of spiritual God or prayer to improve the course of illness" inputs. In my experience on the hospital ethics and almost 70% of physicians report patients committee I have found input from 1) a asking for religious counseling when in the representative from the patient's family, 2) a course of terminal illness. 'Yet,' he states, that religious representative or counselor, and 3) the 'only ten percent of physicians even inquire physician,or othermedicalcare giver. about the patients beliefs or practices." A more Since biblical times, frequent prayer has been recent poll of 1,000American adults, concluded central to most religions. I am familiar with that '79% of the respondents believed that Jewish religiosity. The Amidah, a prayer recited a spiritual faith can help people recover from three times a day, includes a plea 'Heal us disease' and of these respondents, 63% Eternal One and we shall be healed.' Every suggested that physicians should engage in denomination and religion has a similar prayer. discussions aboutspiritual faith? With the patient as one half of a covenant, with FOREWORD xiii the physicians and the patienthaving interestin 2. The pace of application of new science the holisticapproachtohealing, whatshouldthe and technology to products is more rapid physician's rolebe? and more public than ever; gene therapy, The American Psychiatric Association has telemedicine, and home pregnancy tests. adopted guidelines which suggest that physi Scienceandmedicaladvancesarenowdescribed cians 'should maintain respect for their patient's at the newsstand in TheWallStreetJournal, New beliefs' and 'should not impose their own York Times, and Newsweek sometimes prior religious, anti-religious, or ideologic systems of to the physician or scientist receiving, by beliefs on their patients.' Care should not be a mail, the originalscientificreportin aScientific competition of remedies but a congruence. The Journal. physician's armamentarium should include 3. The country is spiritual. Religious par every adoring arrow the giver has to offer. ticipation isthe mostcommonform ofvoluntary Spiritualityshould, in my opinion, be considered group socialactivity in the UnitedStates.'?Ifone strongly by the physicianand other caregivers in combines all other kinds of voluntary group the patient'sholistichealing process. activities they do not exceed involvement in But, we know that not all support this view. church. We have more houses of worship than Sloan,etal,state that 'even inthebeststudies, the everbefore.!" There are organized school prayers evidence of an association between religion, at footballgames indefiance oflegislation. spirituality,andhealthisweakand "inconsistent."? 4. American Society is engaged as never The authors conclude that it is premature to before in bothbodyand spiritualhealth! Forthe promote faith and religion as adjunctive medical body we have treadmills, fitness clubs, 'thigh treatments. Some may agree. The goal for the busters,' and juicebars. For spirituality we have " advocate for incorporating spirituality into religious channels on 24 hours a day. Then mainstream medicine is to pursue and validate there's Sunday morning evangelist television. the hypothesis of its value through compre Most importantly, there are conferences in hensive researchinitiatives. spiritualism and health presented at Harvard, Iconclude with the suggestion that this book Johns Hopkins, George Washington, and Wake should be considered part of the infrastructure Forest Universities which have begun to inform in establishing a plan for building acceptance professionals and the public about how and developing a course for further maturation spiritualitycan be integrated into healthcare. of the science of spirituality in medicine. I believe that we must establish a national Why should we be optimistic that our plan approach for both the academic medicine and will work? It's because these premises are the public, based on a series of four basic, and concentric, merging, 'swirling,' science, health, current, premises. Let's review the public religion, spirituality, and public interest. interest analogy. The swirl is not random, it is controlled and balanced. 1. Our scientificknowledge base is extraordi Thepublic iscritical to oursuccess. nary. The opportunity for exciting advances in We need to engage the public with more medicine and healing have never, in our history, information from our studies, our conferences, been greater than today. The acquisition of new andouropportunitiesto learn. knowledge using molecular biology, functional Indeed we need to form another era of socio genetics, non-invasive imaging, and pharmacol medical reform.Socialreform has ahistory in this ogy and physiology have profound implications countryoftransformingmedicineand our country. forhealthand healing. I'll insertan editor'snote Nineteenth Century reformers advocated sanita here! It is almost too profound. Willthis book's tion, public hygiene and prevention from message beheardamidstallofthis technological infectious diseases. Twentieth century reformers advancement? examined social interventions in the health xlv FOREWORD consequences of smoking, violence against discussed in this book - spirituality does women, and more recently school lunches and supportthe healing process. nutrition. You, the readers, are also the pioneers, let's The twenty-first century public driven explore and discover together - In fact, let's reform can be the benefits of social, medical, triumphasGalateadoes.Allow me toend witha and spiritual integration of the practice of portionofaphysician'sprayerby Maimodes. Its medicine - a renewed covenant with practi languageisecumenical. tioners and patients that condones treatment Illuminatemymindthat itrecognize whatpresents that includes both body and soul. Academic itselfand that itmay comprehendwhatisabsentor medical centers and private medical practition hidden...fordelicateand indefinitearetheabounds ers should be open to providing the evidence ofthegreatart ofcaring forthelivesand healthof that there is validity to the postulates that are thycreatures.11 REFERENCES 1 OberhuberK1999.Raphael,ThePaintings,p.169 7 SloanRP,BagiellaE,Powell T1999.TheLancet,Religion, 2 GombrichEH1957.TheStoryofArt,pp. 234-235 Spirituality,andMedicine,353,February20 3 Kennedy,Donald,TheResearchUniversityinaTime 8 HippocraticOath,Translatedby LudwigEdelstein. ofDiscontent,Makingchoicesinthe Research ReprintedwithPermissionin:Veatch,RM:CaseStudies University,TheAmericanAcademyofArts & inMedicalEthics,Cambridge,MA, HarvardUniversity Sciences,1993,1994 Press,1977,p351-352. 4 KeohaneNannerl0, TheResearchUniversityinaTimeof 9 McKee,Chappel1992.JournalofFamilyPractice,35:2 Discontent,TheMissionofthe Research University, The 10 KoenigHaroldG1997.'IsReligion GoodforYour American AcademyofArts& Sciences,1993,1994 Health?,'TheHaworthPastoralPress,New York,NY 5 PellegrinoEdmundD,MD,1987.TheJournalofMedical 11 FreecnarDavidL,AbramsJudith1999.Illnessand HumanitiesandBioeihics,Toward AReconstructionof HealthintheJewishTradition,TheJewishPublication MedicalMorality,8:1,Spring/Summer SocietyPhil.,p160 6 LevinJeffrey,LarsonDavid,PuchalskiChristina1997. JayMoskowitz, PhD JAMA,'Religionand SpiritualityinMedicine: Research and Education,'278:9,September3 July 2002 Preface Healingpracticesthatusedirectmentalorspiritual 3.'Energy'healingapproaches techniques, such as prayer, ritual, dreamwork, 4.Therapeutic qigong (Chineseenergyhealing) imagery, directmentalintentions,and laying-onof 5.Directmentalinteractionwithliving systems hands, have been part of all known cultures. 6.Mind-matterinteractionstudies. Despitetheir universality, littlescientific attention Studieswereevaluatedwithestablishedquality has been directed toward investigating these criteria inscientificresearch.Eachareawas given practicesortheirclaims. Herewe present acritical an 'evidencelevel' classAtoF(Abeing the high summary of spiritual healing, 'energy' medicine est with at least three independent, high-quality and intentionality(intentionalmentaleffort)as an studies and F being the lowest with expert approach to illness,and make recommendations opinionwithouthighquality research). for future research in what we will call simply 'healing.'Weaddressthreequestions: SUMMARY OF FINDINGS 1.Arethe effectsofhealing 'real' asexamined by high-quality,independentlyreproduced Wefound over 2200publishedreports, including experiments? books, articles, dissertations, abstracts and other 2.How big arethe effectsofhealing writings on spiritual healing, energy medicine, interventions? and mental intention effects. This included l What clinicalimpact does healing have in 122laboratorystudies,80randomizedcontrolled real-lifeclinicalsituations? trials, 128 summaries or reviews, 95 reports of observational studies and non-randomized tri Finally, we address possible next steps for als, 271 descriptive studies, case reports, and improvementin healing research. surveys, 1268other writings including opinions, The book consists of critical summaries of claims, anecdotes, letters to editors, commen current research on healing and healing-related taries, critiques and meeting reports, and 259 areas by experts, research recommendations for selected books. Our findings in each of the six advancementofhealing research,and a compre areas areas follows: hensive bibliography of current publications on healing. To produce the bibliography we used expert summaries and their citations and addi Religious practices tional searches ofother sources includingacom Over 75% of 130 studies on the relationship prehensive literature search. Critical reviews between religious and spiritual practices and were carried out in sixareas: health outcomes reported positive associa 1.Health correlates ofspiritualand religious tions. However, almost all of this research is practices observational, with no high-quality randomized 2.Intercessory or healing prayer controlled trials. There is a positive relationship xvi PREFACE between religiouspracticesand reduced mortality, effects. Only five were randomized, however, better physical health, improved quality of life, and the quality of the research was judged as and lessmentalillnessand drugabuse. Evidence 'poor' with no high-quality replications. One levelwas O. study reported adverse effects. Evidence level was F. Prayer Six (46%)of 13 randomized controlled trials on Laboratoryresearch on bioenergy prayer involving 2328 patients reported One hundred and eleven studies were found significanteffectson at least one health outcome. thatwere donein the Weston laboratorymodels The quality of the research was judged as 'fair.' such as plants, cells, and animals testing the There were three medical conditions in whichat effectofenergyandmentalhealing.Forty-five of least one high-quality randomized clinical trial these were reviewed as they were randomized was done but there were no replications of these with parallel control groups. Average quality of trials. Positive effectswere reported for patients these studies was fair to good. Most were with acute heart disease, and for patients with statistically positive. Of the top 10 quality HIV/AIDScomplications. Negative results were studies evaluated, all but two reported positive reported for prayer healing of warts and effects in favor of the real vs. sham bioenergy alcoholism.Evidence levelwas B. treatment.Onlyoneindependentreplicationofa high quality study was attempted. Evidence 'Energy' healing level was B. Eleven (58%)of 19randomized controlled trials on 'energy' healing (usually therapeutic touch) Directmentalinteraction with living systems involving 1122patients reported positive effects. (DMILS):electrodermalactivity(EDA) The quality of the research was judged as 'fair.' Twenty-four studies involving 636 sessions Positive effects have been reported on pain and examined whether individuals could alter elec anxiety in bum patients and institutionalized tricalconductivityoftheskinofanotherindividual elderly, respectively, but no high-quality at a distance. Nine (37.5%) studies done in four independent replications of these studies were different laboratories were statistically positive. found.Evidence levelwas B. Most studies received 'good' quality ratings but there is no high quality meta-analysis of Qigong (laboratory research) independentreplications.Evidence levelwas B. Fifty-eightstudies(outof130reports) examining the biological effectsof qigong in the laboratory Directmentalinteraction with living systems (oncellsand animals) were reviewed. Almostall (DMILS):remote staring (RS) reported positive effects. The quality of this research was judged as 'poor' and there were no Seven publications describing 13 experiments independent high-quality replications on any with 300sessions examined whether EOA (skin single model. Asummary of the best laboratory conductance) changed when one individual was staring at another, through a closed-circuit TV. study todate on qigong ispresented in a section ofthisbook. Evidence level was C. Seven out of 13 experiments were significant (P < 0.05). Most studies received 'good' quality ratings butthere isno high-quality meta-analysis Qigong (clinical research) ofindependentreplications.One attemptat exact Thirty-threestudies (out of72reports examining replication by two experimenters with different the effects of qigong on high blood pressure) beliefs yielded different results. Evidence level were reviewed. Almost all reported positive wasB.

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