The Creek Indians have used the Native American Method (NAM) to relieve pain. A helper moves his or her hands for 30 to 45 seconds about 5 cm above the painful part of a sufferer's body. The research team has found no indications that other researchers have conducted a similar study of NAM.
The Creek Indians have used the Native American Method (NAM) to relieve pain. A helper moves his or her hands for 30 to 45 seconds about 5 cm above the painful part of a sufferer's body. The research team has found no indications that other researchers have conducted a similar study of NAM.
The Creek Indians have used the Native American Method (NAM) to relieve pain. A helper moves his or her hands for 30 to 45 seconds about 5 cm above the painful part of a sufferer's body. The research team has found no indications that other researchers have conducted a similar study of NAM.
6 Dec/Jan 2012 30 Westerlund, et alNative American EMF Pain Relief
Context: The Creek Indians have used the Native American Method (NAM) for centuries to relieve pain. Johns Hopkins Hospital in Baltimore redeveloped the method in the 1990s when Bear Heart, a Creek Indian Shaman, did voluntary work there. NAM healing involves a helper moving his or her hands for 30 to 45 seconds about 5 cm above the painful part of a sufferers body. The helper places both hands parallel to each other, with one hand in front of the affected part of the body and the other hand to the back side of the body. Objectives: The purpose of this pilot study investigating NAM was to determine the effcacy of using human electro- magnetic felds for relieving minor pain, such as dysmenor- rhea, in healthy women. The research team has found no indications that other researchers have conducted a similar study of NAM. Design: The research team assigned participants sequen- tially to one of two experimental groups: the NAM group, treated with NAM, or the control group, treated with a simu- lation. The team conducted the intervention under masked conditions combined with light conversation between care- giver and participant. Prior to the study, the team held an interview with each participant to determine demographic characteristics and medical history. The team obtained informed consents from all participants. The hospitals ethics committee cleared the study. Settings: The research team invited women with dysmen- orrhea attending the Nursing School of the Diputacin de Mlaga in Mlaga, Spain and female staff from Hospital Universitario Regional Carlos Haya in Mlaga, Spain to participate in the current study. Participants: The research team initially enrolled 75 women in the study, and 49 completed it. Of these women, the research team assigned 20 to the NAM group and 29 to the control group. Intervention: Both groups were treated under masked conditions and with light conversation. The total time for the procedure was 4-5 minutes. In the experimental group the team performed the NAM. For the control group the team carried out a simulation procedure that did not involve the use of their hands in proximity to the source of the patients pain. Outcome Measures: Each participant rated her intensity of pain before and after the application of the interven- tion (whether treatment or simulation) using: (1) a visual analog scale (VAS) for pain valuation (from 1 to 10), (2) a Goldberg-type scale rating anxiety as facial expressions in 3 steps: discomfort manifested as (1) anxiety/depression, (2) bearable pain, and (3) a smile. Afterwards the participants gave an answer to a question about her need (yes or no) for a complementary analgesic at the end of the experiment or the simulation. Results: NAM produced a signifcant drop in the level of menstrual pain. On average, the value changed from 7 to 2 on the VAS for the NAM group compared to no signifcant change for the control group. Participants in the NAM group had a positive experience. They were without pain during the frst 12 hours after treatment, with no administration of pain killer. The intervention diminished their expectation of a normally high intensity of pain at the next menstruation to half or zero. Of the control group, 15 out of 29 participants wanted analgesics after the simulation. Conclusions: Despite its small sample size, this study of human magnetic felds showed statistically signifcant effcacy of NAM for minor pain relief in dysmenorrhea. The interven- tion had a lingering positive effect on the women. Hence, it appears that this intervention can help reduce minor pain in young women with dysmenorrhea and can reduce the need for analgesics. Abstract Effect of Human Electromagnetic Fields in Relief of Minor Pain by Using a Native American Method Stina Westerlund, RN; Maria Elvira Gonzlez Medina, RN; and Olga Prez Gonzlez ORIGINAL RESEARCH Author Disclosure Statement: A grant from Consejera de Salud de la Junta de Andalucia supported this study. D ysmenorrhea is a medical condition that is character- ized by severe uterine pain during menstruation. It can produce different kinds of symptoms, including sharp, throbbing, or dull pain. Nausea can begin before or during menstruation. Many investigators all over the world have studied the prevalence of dysmenorrhea. Taking some examples from the world, Sharama, Malhorta, Teanejer, and Saha in India 1 indicated that more than 67% of their 198 adolescent subjects experienced dysmenorrhea. The studys participants were between the ages of 13 and 19. Another study by Banikarim, Chacko, and Kelder included 706 female Hispanic adolescents in grades 9 through 12. The Integrative Medicine Vol. 10, No. 6 Dec/Jan 2012 31 researchers found that more than 85% experienced dysmenor- rhea, and 38% missed school because of it. 2 A study by Sule, Uman, and Madugu engaged 200 African Muslim, adolescent females of which 36.4% indicated a high prevalence of pain during menstruation. 3,4 A WHO systematic review indicates prevalence dysmenorrhea between 16.8% to 81% depending on the study and population. 4 The purpose of the research teams pilot study investigating the Native American Method (NAM), was to determine the eff- cacy of using human electromagnetic felds for relieving minor pain such as dysmenorrhea in healthy women. Bear Heart, a Creek Indian Shaman, and Molly Larkin in their book The Wind is My Mother 5 describe NAM as a method of pain relief based on the theory that the human body has electromagnetic felds. In personal interviews, Bear Heart explained that one hand acts as a positive pole and attracts the negative ions in the blood vessels during NAM administration while the other hand acts as a negative pole, attracting the positive ions. This force is small, but according to Bear Heart, signifcant enough to open the blood vessels to nutrients and oxygen. This prac- tice results in increased circulation that thereby diminishes pain. The native North American Creek (or Muskogee) tribes have used NAM for centuries. Bear Heart did voluntary work at the Johns Hopkins Hospital in Baltimore, Maryland, during several years in the late 1980s. He lectured for the doctors and the medical staff during the years 1993 to 1995. The chief doctor gave permission to the nursing staff to perform NAM on patients that voluntarily wanted to try it to soothe general pain. Afterwards, improvement in the fow of blood was noted among the patients by the nursing staff. S.O. Fedoruk,chief physicist at the Saskatoon Cancer Clinic in Saskatchewan, Canada, notes, magnetic felds, which are a result of the electrical activity inside the body, around human beings, can be measured using highly sensitive magnet meters. 6 About 2 years ago, it became possible to measure this radiation thanks to investigators who constructed a sensor chip that can refect the radiation, thus allowing researchers to measure it on a screen. Nordenstrm found that damaged tissue has an electrical potential different from that of healthy tissue. 7 Robert Bech studied various healers during their healing ceremonies. 8 He traveled around the world measuring healers by using electro- encephalography (EEG) while they were healing and discov- ered that their brain-wave frequency was between 7.8 and 8 Hz, the same frequency as the Earths magnetic felds. Methods Participants The research team invited women with dysmenorrhea who were attending the Nursing School of the Diputacin de Mlaga in Mlaga, Spain and female staff of the Hospital Universitario Regional Carlos Haya in, Mlaga, Spain to participate in the current study. The study was blinded to ensure that a placebo effect (the power of suggestion) did not affect the results; the subjects did not know if they were receiving a NAM treat- ment or a simulation. The researchers were not blinded as to whether they were providing a treatment or simulation. The research team recruited a total of 75 women for the study, and as the team accepted participants, they sequen- tially allocated them to one of the two groups; 1 woman to the NAM group and the next to the control group. Only 49 women completed the study. Twenty-six women withdrew from the study because of personal and medical problems. The research team carried out the study in accordance with guidelines from the 1975 Helsinki Convention. The study included menstruating women, from those expe- riencing their frst menstruation to those at the end of the fertile period who no longer menstruate, who had at least 3 episodes of painful menstrual cycles (dysmenorrhea). Exclu- sion criteria included functional or organic pathologies that a doctor diagnosed, treatment with painkillers, or use of a prescription for hormones that a doctor prescribed. Native American Method Treatment or Simulation Of the 49 total participants, 20 received treatment with NAM (the NAM group), and 29 received a simulation (the control group). The research team obtained informed consent from all participants. When joining the study, the researchers held an initial meeting where they gave every participant a questionnaire that included demographic characteristics: age, marital status, education, medical history, intensity of pain, and use of anal- gesic medication with and without a doctors prescription. The team personally informed every participant about the proce- dure during the intervention. The research team assigned each participant the same researcher throughout the study. The research team measured pain level by 2 methods: (1) a visual analog scale (VAS) that represented each participants evaluation of pain on a scale of one to ten, (2) a Goldberg- type 9,10 of scale signaling 3 levels: (1) a face expressing a smile, (2) a face expressing a bearable pain, and (3) a face expressing discomfort/anxiety/depression. Additionally, researchers recorded whether the participants desired a complementary analgesic (yes or no) at the end of the experiment or the simu- lation. A second meeting, during which the assigned member of the research team performed the intervention, took place on the frst day of the participants next menstrual period. The assigned researcher talked with the participant, placed her in a standing position, and blindfolded her; then the assigned researcher performed a treatment with NAM or a simula- tion. In all, the team needed no more than 4 to 5 minutes per patient. For the NAM group, the assigned researcher employed the method that Bear Heart used, moving his or her hands about 5 cm above the participants lower abdomen without touching the participants body. The researcher placed both hands parallel to each other, with one hand in front of the lower part of the body and the other hand to the back side of the body. The treatment lasted 30 to 45 seconds in conjunction with light conversation. Westerlund, et alNative American EMF Pain Relief Integrative Medicine Vol. 10, No. 6 Dec/Jan 2012 32 Westerlund, et alNative American EMF Pain Relief The intervention in the control group followed a similar procedure. In this group, the assigned researcher did not impose his or her hands, although the blindfolded patient was unaware that the researcher was not conducting a treatment. The intervention lasted the same time, 4 to 5 minutes with light conversation. After the treatment or simulation, the assigned researcher asked if the participant wanted to have or needed a pain killer. The researcher then followed up with her participant by tele- phone or e-mail within 12 hours of the intervention to ascer- tain pain level and the need for analgesic medication. The researcher then made another follow up contact by telephone or e-mail to ascertain the pain during the following menstrual period. The practitioners on the research team had a total of 8 to 9 years of experience with the NAM technique, training each other through Bear Hearts published materials. Results Participants Demographics Of the 75 women recruited, only 49 completed the study. Twenty-six women withdrew because of personal and medical problems. The average age of the subjects admitted to the study was 31, with a range between 14 and 49 years of age. Nine of out 10 participants were Spanish and the rest were from outside Spain. In the groups, 23 of 49 were married or cohabitating. Of the 49 participants, 18 (36.7 %) had stopped smoking and 18 (36.7%) were current smokers during the study. All subjects in the 2 groups reported being satisfed or very satisfed with their lives so far. Participants Prior Histories Of the women in the study, 32 of the 49 (65.3%) reported a family history of problematic pain at menstruation. 20 women (40.8 %) reported pain on the frst day of their frst menstrua- tion, and 15 (30.6 %) women experienced problems with menstrual pain later in life vs the early years of menstruating. Of the 49 women, 19 (38.8 %), had consulted a doctor to get pain medication or other treatment (eg, hormones). The medications that the consulting doctors prescribed were the following: antiinfammatory (16.3 %), a combination of analgesic and antiinfammatory (4.1%), hormonal medicine (8.1%), and for 1 participant, an analgesic of a morphine deri- vate. The participants took the following medications without a doctors prescription: 21 (42.9%) took an antiinfammatory; 14 (28.5%) took an analgesic, 5 (10.2%) combined analgesics and antiinfammatory medicine, and 9 (18.4%) took nothing at all. Participants had tried the following alternative treatments: 18 (36.7%) used warmth as an alternative method to calm their pain; 19 (38.8%) tried relaxation; 9 (18.4%) bought medical herbs; 7 (14.3%) received acupuncture; and 2 (4.1%) consulted a person with knowledge of homeopathies. Just 3 participants (6.1%) relied upon the imposition of hands (not NAM), and the same number (not the same persons) used praying and visualization. Other remedies were tried by 8 participants (16.3%). Statistical Analysis The research team performed an initial exploratory analysis to study the distribution of the experimental variables. The team compared the two groups using a cross-tabulation of variables for which the team had obtained data before the interven- tion. For qualitative variables, the team used a Chi-square and Fisher exact test, and for continuous variables, the team used the Wilcoxon test to compare the values before and after the treatment. The team also contrasted absolute changes in the variables abdominal pain and headache pain between groups using the Mann Whitney test. The team also used ANCOVA analysis to compare pain at the next menstruation after treat- ment between the groups, adjusting for baseline pain and for the variable always-pain-with-menstruation. The research team worked with a signifcance level of 95% and analyzed the data using the SPSS 15.0 statistical package. A signifcantly greater proportion of women in the NAM group, (75%, 15 of 20) had continuous pain when menstruating prior to the study compared with the control group (37.9%, 11 of 29). Statistically signifcant differences existed between the groups in the alternative method(s) used to calm pain. The NAM group used prayers 3 persons (15%) and the imposition of hands (not NAM) 3 persons (15%) more frequently than the control group (Table 1). In reference to headache symptoms, the absolute change value after treatment was 0.8 (standard deviation 1.85) in the NAM group, and the research team detected no change in the control group. The differences were statistically signifcant ( P =.01). According to the VAS value for pain valuation, the absolute change value after treatment was 6.1 (standard devia- tion 2.07) for the NAM group and 0.003 (standard deviation 0.19) for the control group. The differences observed were statistically signifcant (P <.001) (Table 2). The pain at next menstruation period measured in the 49 participants was related with the variable pain before the study according to the visual scale (P <.001) and for the experimental group this relationship was not being changed by the variable always-pain-with-menstruation. (Figure 1) Concerning the use of analgesics after the intervention, 41.4% of the participants treated with the simulation wanted some analgesics, whereas no one in the NAM group needed analgesics. These differences were statistically signifcant. Also, in measurements with the Goldberg-type scale, faces showed an improvement for the NAM group, with 18 partici- pants (90%) leaving the treatment with a smile (Table 3). Discussion Types of Energy Healing The US National Center for Complementary and Alterna- tive Medicine (NCCAM) has executed many complementary and alternative medicine (CAM) trials. In the publication National Information Centre for Health Statistics, number 12, Integrative Medicine Vol. 10, No. 6 Dec/Jan 2012 33 Westerlund, et alNative American EMF Pain Relief Variable No NAM* (N=29) NAM* (N=20) N (%) N (% ) Birth place Spain 27 (93.1) 19 (95.0) Other countries 2 (6.8) 1 (5.0) Civil status Married/ living with partner 18 (62.0) 8 (40.0) Single 9 (31.0) 12 (60.0) Divorced/ separated 2 (6.8) 0 (0) Laboral situation Student 7 (24.1) 6 (30.0) Employed 22 (75.9) 14 (70.0) Life situation Satised 18 (62.1) 14 (70.0) Very satised 11 (37.9) 6 (30.0) Cronical diseases 3 (10.3) 4 (20.0) Family member with menstruational pain 20 (69.0) 14 (70.0) Menstruational pain at rst occasion 11 (37.9) 9 (45.0) 2 rst years 10 (34.5) 4 (20.0) of having menstruations Much later in life 8 (27.6) 7 (35.0) Always pain when Menstruation ** 11 (37.9) 15 (75.0) Consulting a doctor 10 (34.5) 9 (45.0) Treatment for pain 9 (31.0) 8 (40.0) Type of medicine anti-inammatory 4 (50.0) 4 (50.0) Analgesics 0 (0) 2 (25.0) analgesicsmorphine 1 (12.5) 0 (0) analgesic and antiin 1 (12.5) 0 (0) Hormones/ antiinf + horm 2 (25) 2 (25.0) Type of self-medicationanti-inammatory 8 (38.1) 13 (68.4) Analgesics 9 (42.9) 5 (26.3) analg/antiinf 4 (19.0) 1 (5.3) Medicinal herbs 3 (10.3) 6 (30.0) Remedy of warmth 10 (34.5) 8 (40.0) Relaxation 13 (44.8) 6 (30.0) Acupuncture 2 (6.9) 5 (25.0) Homoeopathy 0 (0) 2 (10.0) Imposition of hands** 0 (0) 3 (15.0) Prayers** 0 (0) 3 (15.0) Other methods 3 (10.3) 5 (25.0) Ex smokers 11 (37.9) 7 (35.0) Current smokers 11 (37.9) 7 (35.0) Age 32 (sd=8) 30 (sd=9) How many times consutling a doctor 2 (sd=2) 1 (sd=1) Number of cigarrettes 3 (sd=5) 3 (sd=5)
* NAM is the Native American method used as the intervention examined in this study. ** Statistical diferences P <0.05 Table 1: Characteristics of the Patients December 2008, there is an article on a study, Complementary and alternative medicine use among adults and children by P M Barnes, B Bloom, R L Nahin et al 11 that the National Health Statistics Report organized and this group of investigators executed. In comparison to a similar study in 2002, this study showed that about 4 of 10 Ameri- cans had tried a CAM therapy in the last 12 months; those people who had a custom in their cultures for generations were more open to using a CAM therapy. NCCAM has classifed CAM into 5 groups: (1) general system, (2) massage, (3) diet, (4) meditation and (5) energy healing therapies (EHT), in the last of which the research team classifes this study of NAM. The word energy, which comes from the Greek word energeia, means activity. Writers and practitioners of various forms of spiritu- ality and alternative medicine have adopted this word, referring to an aura or a feld around the body. Several kinds of EHT exist, including the following: Polarity Therapy (PT), is a holistic, alter- native-medicine health system developed in the 1990s. A PT practitioner manipulates the energy in the human body by using attrac- tion, repulsion, and neutrality. No positive evidence supports the practice. 12 Therapeutic Touch (TT) is another EHT, claiming to aid healing and reduce pain and anxiety. 13,14 TT practitioners say that they can detect and manipulate a patients energy feld by placing their hands on or near the patient. As of June 2008, 251 articles about TT were available in Pub Med, but the quality of the research material is questionable. A study published in the Journal of American Medical Association (JAMA) found that the TT prac- titioners could not detect the presence or absence of a hand placed a few inches above theirs when their vision was obstructed. The effect of the TT is less than the changes in the Earths magnetic feld or any other back- ground magnetic feld. Reiki, which means healing without energy depletion, is a palm-healing therapy developed in Japan in the 1920s. 15 Nurses have noticed that Reiki has relaxation effects.15 Interest is growing in the use of Reiki for self-care treatment or for care of others, but controversy exists about the method. A. Vitale published a review of Reiki-therapy in which she mentioned Wardell-Engebretss Integrative Medicine Vol. 10, No. 6 Dec/Jan 2012 34 Westerlund, et alNative American EMF Pain Relief study of the effect of Reiki on stress reduction. (Researchers collected salivary IgA, cortisol, blood pressure, Electromyog- raphy [EMG], and the State-Trait-Anxiety Inventory [STAI].) The trial showed that the state anxiety mean scores were lower after a 30-minute session. 16
Olsen and Hanson performed one of the earliest published studies assessing Reikis effect on pain. Each participant in this limited study received 1 Reiki treatment. The researchers used a 10-point VAS and a 6-point Lickert-type pain-rating scale before and after the Reiki treatment. The treatment resulted in a decrease in VAS and Lickert pain scores. 16 On the other hand, the US National Council against Health Fraud suggested that any clinical effect of Reiki may be due to suggestion (the placebo effect). 17 The US Confer- ence of Catholic Bishops banned the practice of Reiki at their health units, stating that it lacks scientifc and medical cred- ibility in communities. 18 In Consumer Health Digest, the American Medical Massage Association (AMMA) denounces fringe massage practices among the EHT therapies. 19 An April 2008 article by M Henderson published in The Times (United Kingdom), entitled Prince of Waless Guide to Alter- native Medicine Is Inaccurate, 20 quotes E Ernst, a professor of complementary medicine at the University of Exeter who says: There is no good evidence that Reiki is effective for any condition. Ernst also called for the entire guide to be recalled because of lack of evidence to support the effcacy of the thera- pies. Potential for Human Magnetic Fields Dysmenorrhea is a very common problem for women all over the world, causing those suffering from it to search for avail- able remedies, which can be seen in the increasing interest for alternative therapies in all papers and journals. NAM is a kind of CAM that assists people with pain relief in cases of minor medical conditions, thus minimizing the use of pain killers, which have a negative impact on the human body. According Pain change, mean (SD) Headache pain change, mean (SD) Table 2: Absolute Change in Pain Levels No NAM (N=29) 0.03(0.19) 0(0) No NAM (N=20) 6.1(2.07) 0.8(1.85) P value <0.001 < 0.01 Absolute change of pain and headache pain according to the visual analog scale measurements for both groups as determined after the intervention. NAM is the Native American method used as the intervention for this study. Figure 1: Experimental Group Change in Pain The average change in pain levels of the experimental group after the intervention as measured by the visual analog scale. Faces Strong Pain Bearable Pain Smile/No Discomfort Table 3: Change in Facial-expression Scale Measurement Before No (%) 9(45) 11(55) 0 (0) After No (%) 0 (0) 2(10) 18(90) Before No (%) 5(17) 24(83) 0(0) After No (%) 5(17) 24(83) 0(0) Change in pain for both groups after intervention. Measured by Goldberg-type scale rating pain through facial expression. NAM intervention is a Native American method. NAM NO NAM Integrative Medicine Vol. 10, No. 6 Dec/Jan 2012 35 Westerlund, et alNative American EMF Pain Relief to the discoveries, published in late 2011 by a group of investi- gators from Taiwan, young girls with repeated, intense chronic pain during their menstrual periods, experience a functional and structural alteration in their nervous system. 21 NAM could spare these young girls from these brain changes and give them a better quality of life. Conclusion Despite its small sample size, the pilot study with human magnetic felds showed statistically signifcant effcacy for minor pain relief of dysmenorrhea, and NAM may aid in reducing the amount of analgesic medication used for this condition. In this study, the intervention had a positive lingering effect on women who received the NAM treatment. They had no pain during the frst 12 hours after treatment and during the next menstruation. In women for whom high inten- sities of pain were the norm, the NAM treatment diminished pain to half or even to zero in comparison with earlier levels. Further studies using larger numbers of participants would be of value for establishing the validity of NAM for women with dysmenorrhea. Acknowledgements: The investigators carried out a pilot study, Registry Number: 1/04 about NAM on healthy women with dysmenorrhea with the approval of IMABIS and with a grant from Junta de Anda- luca, the government of the autonomous region of Andaluca in Spain. References 1. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report. 2008;(12):1-23. 1. Sharama P, Malhotra C, Teanejer DK, Saha R. Problems related to menstruation among adolescent girls. Indian J Pediatr. 2008;75(2):125-129. 2. Banikarim C, Chacko MR, Kelder SH. Prevalence and impact of dysmenorrhoea on Hispanic female adolescents. Arch Pedriatr Adolesc Med. 2000;154(12):1226-1229. 3. Sule ST, Uman HS, Madugu NH. Premenstrual symptoms and dysmenorrhoea among Muslim women in Zaria, Nigeria. Am Afr Med. 2007;6(2):68-72. 4. Latthe P, Latthe M, Say L, Glmezoglu M, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006;6:177. 5. Heart B, Larkin M. The Wind is My Mother. New York, New York: Clarkson N Potter, Inc; 2008. 6. Johns HE, Epp ER, Cormack DV, Fedoruk SO. 1000 Curie cobalt units for radiation therapy. II. Depth dose date and diaphragm design for the Saskatchewan 1000 curie cobalt unit. Br J Radiol. 1952;25(294):302-308. 7. Nordenstrm B. Biologically Closed Electric Circuits. Stockholm, Sweden: Nordic Medical Publications; 1998. 8. Beck RC. Motivation: Theories and Principles. 5th ed. London, England: Pearson; 2004. 9. Goldberg K, Brigdes K, Duncan-Jones P, Grayson D. Detecting anxiety and depression in general medical settings. BMJ. 1988;297(6653):897-899. 10. Salokangsa RK, Pentane O, Stengard E. Screening for depression in primary care. Development and validation of Depression Scale, a screening instrument for depression. Acta Psychiatr Scand. 1995;92(1):10-16. 11. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report. December 2008;(12):1- 23. 12. Aetna InteliHealth. http://www.intelihealth.com/IH/ihtIH/WSIHW000/408/408.html. Accessed February 10, 2012. 13. Lusby HR. A response to a critical evaluation of the theory and practice of therapeutic touch. Nurs Philos. 2003;4(1):86. 14. Rosa L, Rosa E, Sarner L, Barrett S. A close look at therapeutic touch. JAMA. 1998;279(13):1005-1010. 15. Bullock M. Reiki: a complementary therapy for life. Am J Hosp Palliat Care. 1997;14(1)31- 33. 16. Vitale A. An integrative review of Reiki touch therapy research. Holist Nurs Pract. 2007;21(4):167-179. 17. Jarvis WT. Reiki. National Council Against Health Fraud. http://www.ncahf.org/articles/ o-r/reiki.html. Accessed February 10, 2012. 18. United States Conference of Catholic Bishops. Guidelines for Evaluating Reiki as an Alternative Therapy. http://old.usccb.org/doctrine/Evaluation_Guidelines_finaltext_2009- 03.pdf. Accessed February 1, 2011. 19. No author listed. Consumer Health Digest #05-50: massage group denounces fringe practices. National Council Against Health Fraud. http://www.ncahf.org/digest05/05-50. html. Accessed July 31, 2011. 20. Henderson M. Prince of Waless guide to alternative medicine inaccurate. The Sunday Times. April 17, 2008. 21. Tu CH, Niddam DM, Chao HT, et al. Brain morphological changes associated with cyclic menstrual pain. Pain. 2010;150(3):462-468.