Express News Service

THIRUVANANTHAPURAM:For city-based yoga instructor T Sreeram, the pandemic and subsequent lockdowns called for the need to take care of mental and physical health. He has been practising yoga for the past 17 years and recently, he and his team, called Sahasra Aarush Yoga, won accolades for their 12-hour-long attempt of suryanamaskara. The team did 1,009 rounds of the suryanamaskara and won a place in the Asia Book of Records and India Book of Records. He is now gearing up to set the world record for Chandranamaskara or moon salutation, a rare form of yoga practice.

Sreeram, 52, and his 14 disciples have been practising at Gandhi Bhavan, Thycaud, for a month now. The moon salutation includes 16 asanas or steps per round. Sreeram aims to promote yoga among more people by showcasing its importance.

After suryanamaskara, we all gained confidence in our body and mind. The moon salutation involves more tough poses including back bending, which makes the body more flexible, It is a good therapy for back pain too.

Last month we started the practice and are planning to attempt the Guinness World Records in January next year, adds Sreeram who also plans to attempt a four-hour-long sheershasana or headstand for the Guinness World Records. Sreeram studied yoga after being inspired by his father, an army officer who had participated in the second world war and practised yoga. Suryanamaskara, simple and powerful yoga practice, cleanses one internally, he says.

If your mind and internal system are healthy and happy, it reflects immediately on the outer body, especially the face. Also, performing 25 rounds of pranayamas in a day will boost the immune system and help with breath control, adds Sreeram.

Read the rest here:
The yoga way of life - The New Indian Express

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Eye On | The Yogi Grind | An inclusive caf, yoga studio and plant shop - wenatcheeworld.com

Shilpa Shetty kickstarts November with a combination of yoga positions(Instagram/@theshilpashetty)

Shilpa Shetty wants to end the year on a healthy note. As we rang into the second last month of the year, it is only a matter of weeks before this year ends and the next one arrives. The moment Shilpa Shetty had the same realization, she felt the need to kickstart the week and the month on a fresh note of yoga, fitness and wellness.

Shilpa Shetty swears by yoga and the snippets of her fitness routine often find way to her Instagram profile. The actor also keeps sharing the steps to performs and the benefits of the yoga positions with the intention of motivating her fans to take up the same.

Shilpa Shetty was back on Monday with a fresh video of herself in her home garden, amidst greenery and on her favourite place the yoga mat. In the video, Shilpa can be seen performing a combination of four yoga positions to stretch her back muscles. For Monday, Shilpa chose Viparita Shalabasana, Ardha Shalabasana, Dhanurasana, and Balasana.

ALSO READ: Straight from the farm, Shilpa Shetty speaks of organic farming

She started by stretching her body while keeping her hands and her legs in air and balancing her body on her stomach. She then went on to move her legs in a vertical position, perpendicular to her body. In the later part of the video, Shilpa can be seen performing the Dhanurasana where she bent her legs inwards and held the feet with her body hands. Its the first day of the second last month of the year! When I realised this, I decided to start the day, week, and month with yoga, she wrote in her caption.

Shilpa noted down the benefits of performing the asanas. Its one of the best ways to stretch and strengthen the back and spine. While this routine helps strengthen the neck and shoulder, it also helps improve digestion and helps tone the thighs and glutes (buttocks). The body feels completely rejuvenated and ready to take on the day ahead, wrote Shilpa.

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Shilpa Shetty kickstarts November with a combination of yoga positions - Hindustan Times

Welcome to the Well+Good SHOP. Our editors put their years of know-how to work in order to pick products (from skin care to self care and beyond) theyre betting youll love. Even better? In articles marked with the Well+Good SHOP logolike this oneyoure able to add to cart without ever leaving Well+Good. Happy shopping! Explore the SHOP

Youve got a yogi in your life, and youre thinking about getting them another pair of leggingsdont. It *is* the thought that counts, but if youre spending your money on a gift with the hopes theyll actually use it, get them something they dont already have a ton of. Naya Rappaport, yoga trainer withAlo Moves, shares the gifts your yoga-obsessed friends actually want.

The greatest gift is quality time with loved ones, says Rappaport. Theres nothing better than that; but something tangible would be a basket of small goodies that all yoga practitioners would love and use. Ahead, all the makings of the dream gift basket for your favorite yoga aficionado.

With theWell+Good SHOP, you can now add products to your cart right from this article page. Just click on the product below and more details will pop up in a new window. Hit add to cart and voila! Thats it! As you read more SHOP articles, you can keep adding products to your cart and check out when youre ready (look for the cart icon on the right side of your screen).

Ritual Oil Trio $58.00

Whether theyre using a few drops in their diffuser, on their skin, or in a mix to clean their yoga mat, essential oils are just thatessential! This set of three from The Well offers curated blends for different moods. Just an FYI, theyre created with sustainably sourced oils and are designed to energize, reset, and calm. These are specifically roller oils, so you can easily roll on your pulse points (behind ears, on temples, etc.)

The Well Relax Essential Oil Blend $48.00

If you need a bottle you can use for your diffuser or dilute with water, this essential oil blend from The Well actually comes with a dropper. The scent encourages relaxation and is formulated with Buddha wood, lavender, sweet orange, vetiver, sweet marjoram, and amyris.

Yogi Bare Lightweight Travel Yoga Mat, Cosmic $70.00

We love this Yogi Bare mat because its so lightweight and makes going to yoga class easy-peasy (its also machine washable and gorgeoussomething your yogi pal may not already own). Another mat that stands out is one thatd make their life a little easier: the new no-slip yoga mat towel from Alo. Its got a silicone pattern backing for extra grip.

Uncommon Goods Self-Sanitizing Water Bottle $95.00

Rappaport says you cant go wrong with a Hydro Flask (her personal favorite), and we get why. Theyre ultra-insulated water bottles that wont leak no matter what. Our second favorite? This self-sanitizing water bottle that uses UV-C LED lights that knock out 99.9 percent of bacteria every two hours (this happens with the push of a buttonits pretty cool).

Intelligent Change The Five Minute Journal $25.00

Yoga is more than an exercise or way to get flexible: Its a lifestyle. Those who are truly invested in the practice are also working on personal, spiritual development. This is why Rappaport suggests a good journal. The Five Minute Journal is an excellent tool for logging mood, tracking gratitude, and setting intentions for your day.

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Our editors independently select these products. Making a purchase through our links may earn Well+Good a commission.

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These Are the Best Gifts To Give Your Friend Who Loves Yoga, According to a Yoga Trainer - Well+Good

Ember, the latest NPC to arrive in Fortnite, will assign players with the Fire Yoga questline. There are five stages, which can be considered the best way of leveling up in Chapter 3 Season 8.

The first stage involves destroying a fireplace at one of several different POIs. After that, they can set ten structures on fire and emote within 5 meters of a smoking car. The fourth stage is to ignite an opponent with a firefly jar, which can admittedly require players to have stellar aim.

The final stage to complete the Fire Yoga questline is to heal at a campfire.

Ember will be found to the west of the orchard, a landmark introduced in Chapter 2 Season 1. The orchard can be found to the northeast of Corny Crops. There's a hill to the west of that landmark where Ember will be wandering around. Players can get close to the hill and see the familiar chat icon come up on their minimap.

Stage one is to destroy a fireplace at one of several POIs, which isn't too difficult. Stage two and stage four require firefly jars, so keep those on hand. The former stage can be done with the Dragon's Breath sniper, but that's an Exotic. Stage three requires damaging a car until it smokes.

The final stage of Ember's Fire Yoga questline is simple: heal at a campfire. Campfires can be found all across the Fortnite map. There are nearly 100, so finding one shouldn't be too difficult.

The best locations for campfires are near bodies of water. There are multiple campsites near rivers which come with campfires. Fortnite players will need to have less than 85 health for this to work. They can then activate it, receive a bit of health and complete the challenge.

The full questline is:

Fortnite Season 8 Ember Fire Yoga questline challenges: Full list and how to complete them

Where to find Ember in Fortnite Season 8

Where to destroy a fireplace at Lazy Lake, Craggy Cliffs and Holly Hedges in Fortnite Chapter 2 Season 8

These Fortnite challenges are all live.

See the rest here:
Ember Fire Yoga questline: Where to find and heal from a campfire in Fortnite Chapter 2 Season 8 - Sportskeeda

Yoga is an exercise well known to increase energy and brighten moods - just what we all need as the days get darker.

According to the NHS website There's some evidence that regular yoga practice may be beneficial for people with high blood pressure, heart disease, aches and pains including lower back pain depression and stress.

Healthline adds, Multiple studies have shown that it can decrease the secretion of cortisol, the primary stress hormone.

Read more: The city centre roof terrace in Cardiff where you can do sunrise yoga

The proof is in the pudding so as the weather gets darker and colder, a yoga retreat at one of these top options in Wales could be the trick to beating the winter blues.

Here our sister website 2Chill runs down some available:

When: November 25

Where: Garth Barns, Garth, Llanidloes, Powys

Price: From 575

Enjoy nourishing meals and yoga workshops during a long weekend in mid Wales which promises two yoga sessions per day with a variety of techniques.

Each morning will start with breathe and flow yoga practices while the afternoons will be filled with restorative yoga sessions.

Breakfast, lunch and dinner are provided, prepared by a local chef.

The sessions are run by Adrienn Szigeti, who studied by immersing herself in yogic studies in India and the Himalaya Yoga Valley in Goa.

When: November 5, 19 and December 17

Where: Old Lan Farmhouse, Login, Whitland, Carmarthenshire

Price: From 567

Advertised as a package to rejuvenate your mind, body and spirit, this holistic body wellness package at a farmhouse in Login, Carmarthenshire is offering it all.

From yoga and pole fitness to colour therapy and making your own remedies, this is one for someone not afraid to throw themselves into the unexpected.

The package includes two nights accommodation and meals.

When: November 25, December 9

Where: Stables Wellbeing, Llwyn Dewi, Trap, Llandeilo, Carmarthenshire

Price: From 489

Based in a renovated barn with underfloor heating in the stunning Brecon Beacons, this retreat is the perfect getaway from the stress of daily life.

The barn even has six acres of land with ancient medieval chapel ruins and a woodland walk.

You can try two practices which complement each other - yoga and pilates and try different styles of each while the barn also offers nourishing vegan food to keep you well fed.

When: November 11, 14

Where: Ty Capel B&B, Neptune Road, Tywyn, Gwynedd

Price: From 593

Surrounded by the beautiful coast of Gwynedd and beautiful landscapes of Snowdonia, this four day retreat promises yoga, meditation, walks, gong bath, Reiki and mindfulness.

Visitors will stay in a gothic style converted chapel which was a former Methodist chapel.

There will be two or three yoga classes per day run by instructors Frankie and Katy with the option of beginner or intermediate and daily meals provided.

You will be trying different yoga styles including Vinyasa, Yin, Restorative and Nidra.

When: November 15, 19

Where: The Old Granary, Groes Ddu Farm, Nr Dolanog Powys

Price: From 568

If you missed out on taking time off in summer, this autumn retreat is your opportunity to rejuvenate and recharge with twice daily yoga sessions, daily guided meditation and creative journaling and walks.

Try Yin and Restorative yoga with instructor Josephine McGrail, a healer and yoga teacher who usually teaches in London.

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Best yoga retreats in Wales to beat the winter blues - Wales Online

LOS ANGELES--(BUSINESS WIRE)--Today, Lenovo's Yoga brand and Intel Evo platform announced the return of their award-winning music creative program, For All Creators. This year, the brand is expanding its creative scope to include art, architecture, and design to help create an unforgettable experience in partnership with multi-platinum Universal Music Group Singer/Songwriter/Actor Troye Sivan and Architectural Digest. The program celebrates the power of technology to empower creativity and self-expression by harnessing fans' and creators' imagination and virtually partnering them with elite visionaries like Troye and a notable designer. Select creators will work alongside them to create a bespoke art installation inspired by Lenovos top-of-the-line, 2-in-1 Yoga laptop for an exclusive performance to celebrate Art Basel Miami Beach, in partnership with Architectural Digest.

Im thrilled to be partnering with Lenovo and Intel Evo on For All Creators. I cant wait to see the originality and creativity from the contest winners and go on this artistic journey with them. It will be incredible to see their authentic designs come to life and have the opportunity to showcase their work alongside one of my all-time favorite designers for my performance in celebration of Art Basel, said Troye Sivan.

Lenovo, Intel Evo and Troye Sivan have launched the program across social channels by calling all creators in North America to submit a sketch, mood board or collage that bring alive various creative expressions/themes as outlined on a custom microsite created for the program - Visit https://lenovoyogacreatorscontest.com/ for full Official Rules and Entry Guidelines.

At Lenovo, our mission is to develop technology that empowers and inspires people. The For All Creators program provides creatives the opportunity to showcase their talents and integrate technology, music, art and culture through this performance by Troye Sivan featuring a stunning Lenovo Yoga art installation, said Gerald Youngblood, Chief Marketing Officer of Lenovo North America.

The competition winners will be selected by a jury that includes Troye Sivan and will be notified no later than November 15th, 2021. All will have the opportunity to video chat directly with Troye Sivan and the notable designer to discuss their submission, the creative expressions/themes and conceptualize the art installation together.

The winning creators will also be gifted a Lenovo Yoga laptop, have integration into the art installation, receive a Best Buy Creator pack and more!

The art installation will be the centerpiece of Troye's performance in celebration of Art Basel, which will be teased live on TikTok. The power and creative functionality of the Lenovo Yoga will be used to conceptualize, design, and bring it to life both on-screen and at the venue.

Its been an absolute pleasure teaming up with Lenovo and Intel to bring the For All Creators program to life and see it continue on this year with Troye Sivan, said Richard Yaffa, Global Head of Universal Music Group for Brands, We are always looking for creative ways to involve UMG artists with forward thinking brands and in this particular case witnessing how music, design and technology can ignite creativity and inspiration.

Like the art installation and performance, the Yoga 9i is crafted for a premium entertainment experience, featuring stunning visuals enabled by Dolby Vision for ultra-vivid picture quality and spectacular sound powered by Dolby Atmos Speaker System. And with up to 15+ hours of battery life1, the Yoga 9i enables creators, and fans, to work from anywhere without sacrificing comfort, performance, or high resolution.

The Lenovo Yoga brand is available exclusively at Best Buy in the United States and at select retailers in Canada as well as on lenovo.com.

1 All battery life claims are approximate and based on test results using the MobileMark 2014 ver 1.5 battery life benchmark test. Actual results will vary and depend on numerous factors including product configuration and usage, software, operating conditions, wireless functionality, power management settings, screen brightness and other factors. The maximum capacity of the battery will naturally decrease with time and usage. See https://bapco.com/products/mobilemark-2014/ for additional details.

About Troye Sivan

Troye Sivan, has amassed over 10 billion combined global streams, including one billion video streams, over the course of his career. His sophomore album, Bloom (Capitol Records), was named as one of the best albums of 2018 by critics at Rolling Stone, The Guardian, USA Today, Billboard, OUT, NPR Music and numerous other publications, with TIME saying, Troye Sivan is the perfect pop star.

In A Dream, which followed in 2020, included the hits Take Yourself Home and Easy. Troye later teamed up with Kacey Musgraves on a new version of Easy, which featured Mark Ronson, which has racked up over 74 million combined streams worldwide. You, Troyes recent collaboration with Regard and Tate McRae, has become a top 10 hit at Top 40 radio, marking his highest-charting single at the format. The track, which climbed to the No. 1 position on Billboards Hot Dance/Electronic Songs chart, has amassed over 200 million combined global streams.

His numerous awards include a Billboard Music Awards trophy, three MTV Europe Music awards and two GLAAD Media wins. Revelation, his collaboration with Jnsi for the film Boy Erased which Troye co-starred in was nominated for a Golden Globe for Best Original Song Motion Picture and shortlisted for an Oscar. Louder Than Bombs, a track Troye co-wrote, is featured on the BTS album Map of The Soul:7, which debuted at #1 in the U.S., Korea, Australia and around the world in 2020.

About Lenovo

Lenovo (HKSE: 992) (ADR: LNVGY) is a US$60 billion revenue Fortune Global 500 company serving customers in 180 markets around the world. Focused on a bold vision to deliver smarter technology for all, we are developing world-changing technologies that power (through devices and infrastructure) and empower (through solutions and software) millions of customers every day and together create a more inclusive, trustworthy and sustainable digital society for everyone, everywhere. To find out more visit https:www.lenovo.com, follow us on LinkedIn, Facebook, Twitter, YouTube, Instagram, Weibo and read about the latest news via our StoryHub.

LENOVO and YOGA are trademarks of Lenovo. Intel, the Intel logo, and other Intel marks are trademarks of Intel Corporation or its subsidiaries. DOLBY, DOLBY VISION and DOLBY ATMOS are among the registered and unregistered trademarks of Dolby Laboratories, Inc. in the United States and/or other countries. All other trademarks are the property of their respective owners. 2020, Lenovo Group Limited.

About Universal Music Group

At Universal Music Group, we exist to shape culture through the power of artistry. UMG is the world leader in music-based entertainment, with a broad array of businesses engaged in recorded music, music publishing, merchandising and audiovisual content. Featuring the most comprehensive catalogue of recordings and songs across every musical genre, UMG identifies and develops artists and produces and distributes the most critically acclaimed and commercially successful music in the world. Committed to artistry, innovation and entrepreneurship, UMG fosters the development of services, platforms and business models in order to broaden artistic and commercial opportunities for our artists and create new experiences for fans. For more information on Universal Music Group visit http://www.universalmusic.com

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Troye Sivan Partners With Lenovo Yoga and Intel Evo to Inspire a New Generation of Creators by Bringing Back the Award-Winning Music Program For All...

Active rest might be an oxymoron, yet it perfectly describes what students sometimes need the most. Amid assignment-induced stress, it is sometimes necessary to purposefully set aside time to reset, and restorative yoga is the perfect solution. Syllabus week is long gone, and the doom and gloom that comes with midterms, papers and actual schoolwork has set in.

Restorative yoga originates from the teachings of B.K.S. Iyengar, a yoga practitioner from India. His original teachings included invigorating classes that utilized props to help practitioners align the body. Yoga teacher Judith Hanson Lasater helped the practire grow in popularity with her 2005 book, Relax and Renew: Restful Yoga for Stressful Times.

Over time, restorative yoga has evolved to take many forms. The poses and style of practice vary between instructors, but the end goal remains the same: Refresh the body and mind. With the use of props like yoga blocks or blankets to remove any strain on the muscles, restorative yoga can decrease stress and improve mental health.

Angel Gonzalez, a certified yoga instructor with over 200 hours of practice, offers a restorative yoga class each Monday in Yates Studio A with calming music, string lights and extensive guidance for those just starting out with restorative yoga.

Restorative yoga is a yoga practice in which we support the body to such an extent that we feel safe enough to completely relax the body and mind, Gonzalez said in an interview with The Hoya. So typically the poses are held for a long time, and youll only do four to six poses. And the reason why your body is fully supported is to allow your muscles to fully relax.

This relaxed state triggers a hormonal response from the parasympathetic nervous system, the system that allows the body to rest, replenish cells and calm down from fight-or-flight hormones triggered by the sympathetic nervous system.

Restorative yoga allows you to enter the parasympathetic system, or the parasympathetic nervous system, in order to kind of replenish or restart those systems, Gonzalez said.

To get into this deep state of active relaxation, yoga poses like childs pose and corpse pose are not too straining, so it is easier to focus on easing the mind. Restorative yoga is beneficial to mental health, since participants enter with the intention to relax and distress both physically and mentally.

Gonzalez first began practicing yoga midway through his undergraduate years, when he was pursuing a degree that he disliked in order to meet familial expectations. When he started doing yoga, he felt transformed by the practice.

It was a time that was difficult for me; I was in a degree that I wasnt entirely happy with, Gonzalez said. I took a chance of taking some yoga classes every year in my university. It was a wonderful studio. And that was it.

Gonzalezs dilemma is not uncommon; many college students can feel unhappy with their studies at certain points throughout the semester, so trying out yoga classes might be the perfect activity to engage in during a particularly stressful week.

Betsy Regan (COL 25) tried out Gonzalezs restorative yoga class at Yates for the first time this week, attempting to take a relaxing and restful break from studying (Full disclosure: Regan is a Blog writer at The Hoya).

I have taken yoga before but never at Yates or a restorative class, Regan said in an interview with The Hoya. I liked it. It kind of felt like organized napping, but it was a nice break from my day. Id been studying a lot for my midterm, so it helped me relax, and it was a break that let me clear my head.

Gonzalez encourages everyone even remotely interested in yoga to try out variations, including restorative, as a form of relaxation and stress relief. For those unwilling to make the trek to Yates, YouTube also offers many free videos ranging from ten minutes to an hour.

Restorative yoga is accessible and can be adapted to everyone regardless of age, experience, injuries or physical ability, because we can always use props to accommodate and support peoples bodies, Gonzalez said. Everyone can practice the postures and experience relaxation.

Continue reading here:
Active Relaxation: The Power of Restorative Yoga - Georgetown University The Hoya

opinion

Jeff Binkley | Your Turn

Watch Video: After Tallahassee yoga studio shooting, yoga practiced downtown

Today marks three years since our daughter Maura lost her life, along with Dr. Nancy Van Vessem, in a hate-motivated shooting at the Tallahassee Hot Yoga Studio. Four other women were also wounded.

Lives, plans and dreams were shattered. Voids created that can never be filled.

Despite the perpetrators documented public history of hatred and unabated criminal behavior toward women and girls, the horrible crimes committed in Tallahassee three years ago today have never been legally identified or officially reported as hate crimes. Maura and the other victims were cruelly attacked for no other reason than being women, but Florida law does not recognize hate crimes against women though it does recognize bias motivation related to race, religion or national origin.

View Gallery: Maura's Voice foundation launch celebration

The victims' stories:

Since 2018, we have worked with legislative sponsors and the Florida Hate Crime Coalition in attempts to amend Floridas Hate Crime Law to include gender (along with gender identity and revised language on disability) in the victim classes for these crimes.This is the type of straightforward technical revision made through dozens of bills filed every year to improve Floridas criminal justice system. Yet, legislative leadership refuses to take action to advance this measure.

Several points, supported by experience and research, have been made repeatedly regarding why a comprehensive hate crimes statute would help protect Floridians.

They are all based on the generally accepted principles that to most effectively address crimes they must be uniformly and correctly reported for what they are, studied and better understood with recognition and penalties commensurate with their harm to individuals and society.

For a summary of this rationale, see https://florida.adl.organd click on initiatives and Florida hate crime coalition.

If what happened to Maura, Dr. Van Vessem and the other victims in Tallahassee while most members of the Legislature were in town for committee meetings, plus the substantial body of information submitted, is not enough to move Floridas Legislature to act and classify gender-motivated hate crimes as what they are we ask that leaders and those who have yet to step forward in support of legislation also consider the following:

Inclusive hate crime laws, in combination with best practices by law enforcement and the courts system, could have prevented what happened here on Nov. 2, 2018, and can prevent future violent crimes against women, girls (and others) from happening.

The perpetrator was charged twice and convicted once of battery (for inappropriate touching of women) in Leon County. If the Hate Crimes Law in place at the time had included gender, and police and the States Attorneys office had checked the perpetrators on-line, public postings, it would have been clear that he bore hatred and fetishized violent acts toward women.

Back story:

Using threat assessment techniques in evaluation could have identified the degree of risk. Then they could have included a well-documented hate crime charge with battery raising its status from a first-degree misdemeanor to a third-degree felony. This could have resulted in one or more felony convictions, a prison sentence that could have kept him off the streets and prohibition from legally purchasing a firearm (as he did to commit the attacks in Tallahassee).

Of course, no single statutory revision can prevent all violent hate crimes. But formally recognizing and appropriately punishing gender motivated hate crimes can go a long way in better protecting the rights and safety of women and girls in Florida.

Back story:

We ask all members of the Florida Legislature to look in their hearts, open their minds and make 2022 the year that violence against women and girls because of who they are is recognized as the serious crime it so clearly is.Whats stopping you?

Jeff Binkley and his wife, Margaret, are co-founders of Mauras Voice, an organization dedicated to addressing hatred and violence in our society.

Send letters to the editor (up to 200 words) or Your Turn columns (about 500 words) to letters@tallahassee.com. Please include your address for verification purposes only, and if you send a Your Turn, also include a photo and 1-2 line bio of yourself. You can also submit anonymous Zing!s atTallahassee.com/Zing. Submissions are published on a space-available basis. All submissions may be edited for content, clarity and length, and may also be published by any part of the USA TODAY NETWORK.

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Three years after yoga studio shooting, my daughter's death is a call for legislative action | Opinion - Tallahassee Democrat

1. Cognitive behavioral therapy intervention with yoga and education components improved pain management for patients on long-term opioids better than usual care

Abstract: https://www.acpjournals.org/doi/10.7326/M21-1436

URL goes live when the embargo lifts

A pragmatic randomized controlled trial comparing pain-related outcomes for patients with chronic pain receiving long-term opioid therapy found that patients who received cognitive behavioral therapy (CBT) in their treatment plans reported improvements in self-reported pain and greater reductions in pain impact after one year. The findings are published in Annals of Internal Medicine.

Long-term opioid use targeting chronic pain can be associated with significant adverse health outcomes. Alternative approaches to chronic pain management have been extensively studied in patients with specific types of chronic pain in specialty settings. However, this study is the first examination of alternative treatments for broad chronic pain who were being treated with opioids in a primary care setting.

Researchers from Kaiser Permanente Washington Health Research Institute randomly assigned 850 adult patients taking long-term opioid therapy for chronic pain to receive either usual care (n=417) or a CBT intervention (n=433) embedded in primary care. Frontline clinicians delivered the intervention that included talk therapy and yoga-based adaptive movement. The patients were assessed quarterly over 12 months for self-reported measures of pain and disability. The researchers found that patients receiving CBT had greater reductions in pain impact and pain-related disability compared to the usual care group. In addition, one in four patients receiving CBT reported more than 30 percent reductions in pain compared to similar reports from one in six patients receiving usual care. Patients in the CBT intervention group showed greater reduction in benzodiazepine use but there was no impact on opioid usage in either group.

Although effects of the intervention were modest, they persisted after treatment through final 12-month follow-up. Given the limited efficacy and safety of long-term opioid treatment of chronic pain and increasing demand for nonpharmacologic treatment, the researchers believe that this type of intervention may be an attractive option.

Media contacts For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with the lead author, Lynn DeBar, PhD, MPH, please contact Caroline Liou at Caroline.X.Liou@kp.org.

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2. NIH summarizes exiting knowledge and unanswered questions about anti-SARS-CoV-2 antibodies

Abstract: https://www.acpjournals.org/doi/10.7326/M21-3669

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Anti-SARS-CoV-2 antibodies have been used in health care and clinical settings to prevent and treat COVID-19. This summer, the National Institutes of Health (NIH) convened a virtual summit to summarize existing knowledge and identify key unanswered scientific questions about these antibodies. An article summarizing the discussion is published in Annals of Internal Medicine.

During the summit, presenters and expert panelists highlighted advances that have been made using anti-SARS-CoV-2 antibodies for prevention and treatment of COVID-19. To date, the U.S. Food and Drug Administration (FDA) has issued an approval for one antiviral drug to treat hospitalized patients and granted Emergency Use Authorizations (EUAs) for several single and combination monoclonal antibodies (mAbs) to treat persons in the outpatient setting. The experts also discussed ongoing studies to determine the potential benefit of high-titer convalescent plasma (CP) antibodies or hyperimmune globulin (HIG). Like mAbs, these CP and HIG antibodies have shown benefit in some instances when administered early.

Results in outpatients were more encouraging, according to the experts. In one trial, patients taking the mAb combination bamlanivimab-etesevimab had a 70 percent reduction in rates of hospitalization or death compared with placebo. As preventive therapy, mAbs could offer immediate protection for unvaccinated persons exposed to SARS-CoV-2 or those who have no specific exposure but work in high-risk settings. They could also be administered to the rare patient who cannot be vaccinated due to allergic reactions to components of the vaccine.

The experts also discussed several areas where knowledge gaps exist and how to address them. One important area of study is alternate routes of administration for mAbs and the potential effects of mAb infusions on COVID-19 vaccine immunogenicity. Several studies addressing these scientific questions (or knowledge gaps) are ongoing. According to the authors, the continuing emergence of SARS-CoV-2 variants underscores the critical need to identify classes of mAbs that can be successfully and effectively combined and to develop and evaluate broadly neutralizing antibody cocktails and bispecific antibodies to treat and prevent COVID-19.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. Submit media request to NIAID Media Inquiries at mediainquiries@niaid.nih.gov.

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3. Study finds that nearly a third of Medicare recipients now see 5 or more physicians each year

Over the past 20 years, the number of physicians with whom PCPs must coordinate care for Medicare patients has increased by 83 percent

Abstract: https://www.acpjournals.org/doi/10.7326/M21-1523

URL goes live when the embargo lifts

A new twenty-year study of Medicare recipients reveals that a larger number of Medicare patients are making more appointments with a larger number of specialists each year while engagement with primary care physicians failed to change. The study describes changing trends in medical care systems over the previous two decades and the implications these trends have for the future of primary and specialty care physicians in the United States. The findings are published in Annals of Internal Medicine.

The dominance of specialty care in American medical care systems have drawn concerns about fragmentation of care and ballooning health care costs with a high burden on primary care physicians (PCP) coordinating patient care.

Researchers from Harvard T.H. Chan School of Public Health analyzed Medicare claims made between 2000 and 2019, reviewing a data increase from 6,140,952 to 7,165,513 beneficiaries, respectively. The data showed that mean number of PCP office visits annually per beneficiary did not meaningfully increase, but the mean number of unique PCPs seen annually increased by 36%. At the same time, the mean number of specialist physician office visits annually increased by 20.3% and the mean number of unique specialist physicians seen annually increased by 34.2%. Researchers found that, as of 2019, 30.1% of Medicare recipients saw five or more physicians annually. According to the data, these changes mean that the number of other physicians with whom PCPs must coordinate care for Medicare patients has increased by 83 percent. Simultaneously, researchers learned that one third of Medicare patients do not utilize a PCP to coordinate their care at all. The research team contributes these trends to the increasing number of distinct medical subspecialties, changes in medical care systems, and decline in the availability and widespread use of PCPs across the United States.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author, Michael L. Barnett, MD, MS, please contact Todd Datz at tdatz@hsph.harvard.edu.

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4. Researchers suggest building a national biorepository infrastructure to prepare for future pandemics

Abstract: https://www.acpjournals.org/doi/10.7326/M21-2857

Editorial: https://www.acpjournals.org/doi/10.7326/M21-4145

URL goes live when the embargo lifts

Researchers from Boston Medical Center (BMC), a safety-net hospital in Boston, MA, recognized the importance of creating a COVID-19 biorepository to both support critical science and ensure representation in research for its urban patient population, most of whom are from underserved communities. The team describe their decision to build a hospital-wide biorepository for COVID-19 research samples and share challenges they overcame to coordinate the biorepositorys management with patients, researchers, and care teams. They call on hospital research teams, funders, policymakers, and infectious disease and public health communities to support biorepository implementation as an essential element of future pandemic preparedness. The paper is published in Annals of Internal Medicine.

The researchers describe how they created a biorepository that was inclusive of their patient population: largely non-White, lacking sufficient insurance, low income, no or limited English proficiency, and disproportionately at risk of COVID-19. Their centralized biorepository resulted in 48,000 samples from more than 10,000 patients, requiring adapting sample collection and lab logistics to prioritize safety and longevity, balancing research and clinical care, and creating a fee system for using samples to reduce costs. The researchers suggest that nationwide infrastructure and funding is necessary to support other hospitals and communities in preparation for the next pandemic.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author, Nahid Bhadelia, MD, MALD, please contact Erica Augustine, Communications & Outreach Associate at Center for Emerging Infectious Diseases Policy & Research (CEID) at erica@bu.edu.

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Annals of Internal Medicine

Randomized controlled/clinical trial

People

A Primary CareBased Cognitive Behavioral Therapy Intervention for Long-Term Opioid Users With Chronic Pain

2-Nov-2021

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CBT intervention with yoga and education comp - EurekAlert