Southern California University of Health Sciences (SCUHS) is a private university located in Whittier, California and specializing in the health sciences. Academics are organized into four colleges and schools: the Los Angeles College of Chiropractic, the College of Eastern Medicine, the College of Science & Integrative Health, and the School of Professional Studies. The university is accredited by the WASC Senior College and University Commission.
BACKGROUND:Laughter yoga is a non-pharmacological and non-invasive therapeutic approach that integrates voluntary laughter with controlled breathing exercises. This systematic review aimed to evaluate research investigating the impact of laughter yoga on children's health outcomes. METHODS:This systematic review included studies with randomized controlled trial (RCT) and quasi-experimental designs, adhering to the PRISMA guidelines. This systematic review, conducted between December 18, 2023, and October 31, 2024, was guided by the PRISMA guidelines and a predefined protocol based on the PICOS-based protocol. Eligible studies included randomized controlled trials (RCTs) and quasi-experimental designs. A comprehensive literature search was conducted in Google Scholar, Medline/PubMed, Cochrane Library, Science Direct, CINAHL Complete, and OVID databases. Study selection was based on the PICOS framework, and methodological quality was assessed using the Joanna Briggs Institute-Meta Analysis Statistical Assessment and Review Instrument (JBI-MAStARI). Based on the inclusion criteria, six studies were incorporated into the review. RESULTS:The total sample across the included studies was 305 participants, with 66% of the studies involving at least 50 participants. Findings indicated that laughter yoga contributed to a reduction in anxiety and stress levels in children (p < 0.05), while no statistically significant effect was observed on depression scores (p > 0.05). Although no substantial improvement in self-esteem was reported, positive changes in self-concept were noted. Furthermore, laughter yoga was associated with an increase in salivary IgA levels (p < 0.01), whereas no significant influence on cortisol levels was found (p > 0.05). Additionally, the intervention was reported to alleviate pain, fatigue, and burnout while enhancing hope and overall happiness. CONCLUSIONS:Study results showed that laughter yoga promoted the increase in happiness and self-concept in children and improved their ability to cope with stress. It also provided a physiological improvement by positively affecting pain and fatigue. In light of these results, it is recommended that laughter yoga be used more widely in children's daily lives and clinical practices.
Purpose: To establish the validity and reliability of the Compassionate HEART Patient Questionnaire (CHPQ) for measuring relationship-centered care and exploring associations between patient ratings and mood state changes in patients with persistent pain. Methods: Thirty-nine adults with persistent pain (> 3 months) completed pre-/post-interaction Profile of Mood States assessments and rated providers using the Consultation and Relational Empathy (CARE) measure and the novel CHPQ following physical therapy evaluations. Psychometric properties were assessed through factor analysis, concurrent validity (correlation with CARE), and internal reliability (Cronbach's alpha). Pre-post mood changes were analyzed using Wilcoxon signed-rank test. Results: The CHPQ demonstrated good internal consistency (α = 0.86) and moderate correlation with CARE (r = 0.673, p < 0.001). Factor analysis revealed three factors explaining 85.9% of variance: Connected Compassionate Competence (54.3%), Genuine Therapeutic Presence (18.1%), and Relational Alliance (13.5%). Total Mood Disturbance decreased significantly post-interaction (-17.41 points, p < 0.001) with reductions in anger, tension, confusion, depression, and fatigue. Vigor also decreased significantly (-8.70, p < 0.001). CHPQ scores negatively correlated with fatigue reduction (r = -0.493, p = 0.001). Conclusions: The CHPQ shows promising psychometric properties as a comprehensive measure of relationship-centered care. The paradoxical vigor decrease alongside reduced negative affect suggests complex emotional processing during therapeutic encounters. The correlation between CHPQ scores and fatigue reduction indicates that compassionate care may mitigate specific distress aspects in patients with persistent pain. Future research should explore longitudinal outcomes and incorporate qualitative methods.
BACKGROUND:Early mobilization (EM) has become essential for improved recovery after surgery, but its particular advantages in cardiac surgery populations have not been consistently reported. OBJECTIVE:To systematically evaluate the effects of early mobilization on functional recovery outcomes, hospital length of stay, and safety profiles in patients undergoing cardiac surgery. METHODS:The systematic search was performed in six databases (PubMed, Google Scholar, Cochrane CENTRAL, PEDro, Embase, and Web of Science). The search included studies published between January 1, 2015, and August 2025. Inclusion criteria were that the studies must look at interventions of early mobilization (within 48 h of postoperative) in patients undergoing cardiac surgery, and the outcome measures may include functional capacity, length of stay in the hospital, or precautionary measures. Risk of Bias 2.0 (RoB 2) and Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) were used to evaluate the risk of bias. RESULTS:This review included 20 studies with 11,631 participants, 12 randomized controlled trials, four observational cohort studies, and four other study types. Most interventions were initiated within 24 h after the operation. Functional recovery outcomes were predominantly favorable. Early mobilization improved 6-Minute Walk Test (6MWT) distance and functional independence scores in the majority of studies, whereas hospital length of stay results were inconsistent, with approximately half of the studies reporting significant reductions. The safety profiles were excellent throughout the studies, and few serious adverse events could be directly related to early mobilization. Subgroup analyses showed that Coronary Artery Bypass Grafting (CABG) had specific advantages, which were possible even in frail older patients. CONCLUSIONS:Early mobilization following cardiac surgery appears safe and is associated with improvements in functional recovery (e.g., walking capacity and independence) and selected hospital outcomes (e.g., length of stay), although the magnitude of benefit varies across studies. TRIAL REGISTRATION:PROSPERO (CRD420251140353).
Introduction: In 2020 Medicare initiated reimbursement for acupuncture for treatment of chronic low back pain (cLBP), with coverage limited to services provided by physicians and certain clinicians under their supervision. Independent licensed acupuncturists are ineligible for payment. The restrictive terms of coverage may compromise adequate and equitable patient access to acupuncture under Medicare. The purpose of the study was to quantify utilization and treatment intensity of acupuncture for cLBP under Medicare by state. Methods: We employed a cross-sectional design to examine 2020–2023 Medicare claims. We measured Utilization as acupuncture recipients per 100,000 Part B beneficiaries and Treatment Intensity as acupuncture visits per 100,000 Part B beneficiaries. To model utilization and treatment intensity across US states, we estimated Empirical Bayes adjusted rates for each state using Poisson regression models with state-level covariates. Quintiles of rates for utilization and treatment intensity were mapped by state to illustrate geographic variation. Results: Among all states the mean rate of utilization was 235.4 recipients per 100,000 Part B beneficiaries. The mean rate of treatment intensity was 1,721.9 services per 100,000. Utilization appeared relatively higher in West coast, Northeastern, and northern prairie states and states with large urban areas. Conclusions: Utilization and treatment patterns related to acupuncture for Medicare Part B beneficiaries vary widely by state. The marked geographic variation in patient utilization and treatment intensity suggests that access is not equitable. The variation is likely related to both the availability of acupuncture services under Medicare and patient preference.
