Volitional yoga breathing techniques influence several physiological functions depending on the changes made in depth of breathing, relative duration of exhalation to inhalation, and breath frequency. The practice guidelines for three routinely practiced and researched yoga breathing practices (bhastrika pranayama [bellows breath], bhramari pranayama [bee breath], and kapalabhati pranayama [breath of fire]) were compared between the traditional written texts (i.e., Hatha Yoga Pradipika, Gheranda Samhita) and published research indexed in PubMed (a total of 73 studies; 25 on bhastrika pranayama, 17 on bhramari pranayama, and 31 on kapalabhati pranayama). We compared the specifications for posture, time of day, location, and duration of practice; frequency, depth, and holding (kumbhaka) of the breath; speed and/or force and right or left nostril use for inhalation and exhalation; duration of inhalation relative to exhalation; thoracic or diaphragmatic breathing (or comparable terms in the traditional texts); mental state; physiological locks (bandhas) ; and hand gestures (mudras). Differences between the practice guidelines in the traditional texts and published research with respect to the depth of b reathing (bhastrika pranayama), relative breath phase duration (bhramari pranayama), and breath frequency (kapalabhati pranayama) are presented despite the findings being restricted to published studies from a single bibliographic database. Differences in the way yoga breathing is practiced could influence the physiological effects obtained, and differences between methods reported in published studies could make it difficult to summarize the effects of yoga breathing practice across studies.

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UNASSIGNED: Burnout, depression, and suicidality among residents of all specialties have become a critical focus of attention for the medical education community.
UNASSIGNED: As part of the 2017 Resident Wellness Consensus Summit in Las Vegas, Nevada, resident participants from 31 programs collaborated in the Educator Toolkit workgroup. Over a seven-month period leading up to the summit, this workgroup convened virtually in the Wellness Think Tank, an online resident community, to perform a literature review and draft curricular plans on three core wellness topics. These topics were second victim syndrome, mindfulness and meditation, and positive psychology. At the live summit event, the workgroup expanded to include residents outside the Wellness Think Tank to obtain a broader consensus of the evidence-based toolkits for these three topics.
UNASSIGNED: Three educator toolkits were developed. The second victim syndrome toolkit has four modules, each with a pre-reading material and a leader (educator) guide. In the mindfulness and meditation toolkit, there are three modules with a leader guide in addition to a longitudinal, guided meditation plan. The positive psychology toolkit has two modules, each with a leader guide and a PowerPoint slide set. These toolkits provide educators the necessary resources, reading materials, and lesson plans to implement didactic sessions in their residency curriculum.
UNASSIGNED: Residents from across the world collaborated and convened to reach a consensus on high-yield-and potentially high-impact-lesson plans that programs can use to promote and improve resident wellness. These lesson plans may stand alone or be incorporated into a larger wellness curriculum.

Breast cancer-related lymphoedema (BCRL) is a chronic condition that requires lifelong management to prevent the condition worsening and to reduce the threat of infection. Women are affected in all domains of their life. As a holistic practice, yoga may be of benefit by reducing both the physical and psychosocial effects of lymphoedema. Women with BCRL are attending yoga classes in increasing numbers, so it is essential that yoga be based on principles that ensure lymphoedema is controlled and not exacerbated. Two Randomised Controlled Trials with a yoga intervention have had positive results after an 8-week intervention (n=28) and 6-months after a 4-week intervention (n=18). The first study had several significant results and women reported increased biopsychosocial improvements. Both studies showed trends to improved lymphoedema status. The yoga interventions compromised breathing, physical postures, meditation and relaxation practices based on Satyananda Yoga®, with modifications to promote lymphatic drainage and following principles of best current care for those with BCRL. Individual needs were considered. The yoga protocol that was used in the 8-week trial is presented. Our aim is to provide principles for yoga teachers/therapists working with this clientele that can be adapted to other yoga styles. Further, these principles may provide a basis for the development of yoga programs for people with secondary lymphoedema in other areas of their body as the population requiring cancer treatment continues to increase. Whilst the style of yoga presented here has had positive outcomes, further application and research is needed to fully demonstrate its effectiveness.

Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. © 2017 American Cancer Society.

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