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Published Abstracts Online at European Journal of Integrative Medicine (EuJIM) now!

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8th European Congress for Integrative Medicine
ECIM 2015 Global Summit on Integrative Medicine and Healthcare

Exploring the Evidence Base for Integrated and Sustainable Research, Healthcare and Workforce for Patients

Greater Copenhagen, Denmark
September 26-27th, 2015


The ECIM 2015 Global Summit offers an innovative, solution-driven platform for physicians and healthcare practitioners, researchers and students, politicians and patients, to collectively exchange and discuss research and research findings in the field of integrative medicine and collectively work on the vision and science, economics and education for optimal healthcare. There will be moderated academic and scientific sessions and open-forum expert panel discussions with interactive feedback from these sessions. We will gather together in Greater Copenhagen, gateway to Scandinavia’s Medicon Valley and the Nordic Regions. We invite you to enjoy a pre-summit concert at the DR Koncerthuset and a day of exploring Copenhagen before traveling North to Helsingør, home to Hamlet’s Kronborg Castle where the Summit will be hosted at the breathtaking waterfront crystal Culture Yard. Participants will gather together in halls with views of the sea toward Sweden, which will be used for Parallel Research Sessions and ReThinkBox Sessions that will explore the prominent issues that healthcare is facing globally and the scientific evidence for or against Integrative Medicine that includes Complementary and Traditional Medicine.

Day One: Economics & Science – Global Healthcare and Integrative Medicine Models

Day Two: Moving Forward – Integrated Healthcare Workforce, Education and Patient Care


 

Preliminary Poster Sessions and Titles are Listed in Alphabetical Order, Subject to Change.
Presenting Author’s Name and Institution forthcoming, upon registration and acceptance for publication in the European Journal of Integrative Medicine (EuJIM).

ETHNOPHARMACOLOGY

Resistance to Antibiotics and Antifungal Medicinal Products: Can Complementary and Alternative Medicine Help Solve the Problem in Infection Diseases? The Introduction of a Dutch Research Consortium
Presenting Author: Erik W. BAARS
Co-Authors: Kok, Esther T.(1), Jong, Miek J (2), Gravendeel, Barbara (3), Van Leeuwen, Willem B (4), Baars, Erik W (5)
Institutions: 1. Professorship of Anthroposophic Healthcare , University of Applied Sciences, Leiden, The Netherlands; 2. Department Healthcare and Nutrition, Louis Bolk Institute, Driebergen, the Netherlands; 3. Professorship of Biodiversity, University of Applied Sciences, Leiden, The Netherlands; 4. Professorship of Innovative Molecular diagnostics, University of Applied Sciences, Leiden, The Netherlands; 5. Professorship of Anthroposophic Healthcare, University of Applied Sciences, Leiden, The Netherlands and Department Healthcare and Nutrition, Louis Bolk Institute, Driebergen, the NETHERLANDS

Beneficial Effects of a Rose Hip Preparation Containing Seeds and Shells on Aging and Wrinkles of the Skin
Presenting Author: Kaj Winther
Co-Authors: L Petharat, K Wongsuphasawat, K Winther
Institution: University of Copenhagen

Differential Effect of Various Preparations of Viscum Album on Maturation and Activation of Human Dendritic Cells and T-Cell Response
Presenting Author: Chaitrali Saha
Co-Authors: Chaitrali Saha, Alain Friboulet, Jagadeesh Bayry, Srinivas Kaveri
Institution: National Institute of Health and Medical Research (INSERM) Unit 1138, Paris, FRANCE

Patient Survey with Althaea Officinalis L Root Extract in Dry Cough
Presenting Author: Karin Kraft
Co-Authors: Sabine C Koch, Thomas Ostermann, Anna Steinhage, Philip Kende, Karl Haller, Fabian Chyle

Rapid and Cost-Effective Assessments of the Safety & Benefits of Herbal remedies with Using Systems Biology Technology (Fast-Pharma)
Presenting Author’s Name: Joan CAMPBELL-TOFTE

Co-Authors: Per Mølgaard, Kaj Winther
Institution: Parker Institute, Frederiksberg University Hospital, 2200 Frederiksberg DENMARK

Viscum Album Promotes Anti-Tumor Response By Modulating M1/M2 Macrophage Polarization Switch
Presenting Author: Chaitrali Saha

Co-Authors: Alain Friboulet, Jagadeesh Bayry, Srinivas Kaveri
Institution: National Institute of Health and Medical Research (INSERM) Unit 1138, Paris, FRANCE

Cranberry Polyphenols Regulate In-Vitro Human T-Cell Responses Induced by E.Coli Bacteria Isolated From Urinary Infection.
Presenting Author: Daniele Saverino
Co-Authors: Piatti1, I. A. Naim2,3, D. Garofalo2,3, D. Saverino3
Institutions: 1 Dipartimento di scienze chirurgiche e diagnostiche integrate (DISC), Università di Genova, 2 Istituto di Studi Superiori – ISSUGE, Università di Genova, 3 Dipartimento di Medicina Sperimentale (DIMES), Università di Genova, Italy.

 

Antibacterial, Antifungal and Antimutagenic Activity of Unani Herbal Drug-Chirayita (Swertia chirayita Linn.)
Presenting Author: Dr. Sumbul REHMAN, MD
Co-Author: Dr. Abdul Latif
Institution: Department of Ilmul Advia (Unani Pharmacology & Pharmaceutical Sciences), Faculty of Unani Medicine, Aligarh Muslim University, Aligarh-202001 (U.P) INDIA


 

INTEGRATIVE MODELS FOR HEALTHCARE AND MEDICAL SCHOOL EDUCATION

An Integrative Approach in the Treatment of Chronic Obstructive Pulmonary Disease: the Role of the Ozone Therapy
Presenting Author: Emma BORRELLI, MD, PhD
Institution: University of Siena, Department of Medical Biotechnologies, Siena, ITALY

Are Students of Health Professions in Germany Interested in Naturopathy and Complementary Medicine?
Presenting Author: Dr. Beate STOCK-SCHROEER
Co-Authors: Roman Huber, Stefanie Joos, Petra Klose
Institution: Carstens-Foundation, GERMANY

Development of a Pilot Project on Integrated Chinese-Western Medicine in Hong Kong Public Healthcare System
Presenting Author: Eric ZIEA
Co-Authors: Henny HUI, Mia LI, Dora TSUI, Christine LAM, Joyce HYSIEH, CHUNG Kam-fung, Edith CHAN
Institution: Chinese Medicine Department, Hospital Authority, HONG KONG

From Regional to National rules in CAM Education: the State-Regions National Agreement approved in Italy
Presenting Author: Sonia Baccetti
Health Direction of Tuscany Region, Tuscan Network of Integrative Medicine, Via Taddeto Alderotti 26/N, Firenze, Firenze, ITALY

Integrative Medicine in Prevention Program: Dream or Reality?
Presenting Author: Silvi Saxer, MD, Msci, PhDc
Co-Author: Sovilj Mirjana PhD
Institution: UN ECPD (ATIM and IEFPG)

Integrated Medicine, Multimorbidity, Polypharmacy and Antimicrobial Resistance
Presenting Author: Dr. Peter Fisher, MD
Co-Author: Dr. John Hughes
Institution: Royal London Hospital for Integrated Medicine, 60 Great Ormond Street, London WC1N 3HR, UNITED KINGDOM

Perception of Future Integrative Medicine by Health Professionals. Qualitative Research
Presenting Author:Daiva Jakuboniene
Co-Author: Aušra Beržanskytė
Institution: Natūraliosios terapijos centrasm, Justiniškių 62a, Vilnius, LITHUANIA.

Types of Complementary and Alternative Medicine in a Global European City
Presenting Author: Dr. Antonia Ramirez Perez
Institution: Universidad Pablo de Olavide, Carretera de Utrera, km 1, 41013 Sevilla, SPAIN.

Use of Complementary and Alternative Medicine in Patients with Organ Transplantation in Switzerland
Presenting Author: Klaus VON AMMON, MD 
Co-Authors: Frei-Erb M, von Ammon K, Torchetti L
Institution: Institute of Complementary Medicine, University of Bern, SWITZERLAND

Integrating Conventional Tobacco Cessation Approaches into Complementary Medicine Practices: Inverting the Integrative Medicine Model

Integrative Health Care in Dutch Hospitals, Nursing homes and Mental Health Institutions

The integrated approach in allergic diseases: the experience of the Centre for Integrated Medicine Hospital of Pitigliano


 

INTEGRATIVE ONCOLOGY

Hypoglossal Acupuncture for Dysgeusia in Cancer Patients Undergoing Chemotherapy: Study Protocol of a Randomized Sham-Controlled Trial
Presenting Author: Dr. Heidemarie Haller
Co-Authors: Heidemarie Haller, Taige Wang, Romy Lauche, Kyung-Eun Choi, Petra Voiß, Sabine Felber, Jana Pannenbäcker, Beyhan Ataseven, Anna Paul, Gustav Dobos, Sherko Kümmel
Institution: Department of Internal and Integrative Medicine, Kliniken EssenMitte, Faculty of Medicine, University of Duisburg-Essen, GERMANY.

Psychospiritual Analysis as Predictor of the Efficacy of Chemotherapy and Immunotherapy
Presenting Author: Dr. Giusy Messina
Institution: Department of Psychology, University of Bergamo, ITALY

Safety of Combined Therapy with Helixor Mistletoe Preparations and Targeted Therapies in Cancer Patients
Presenting Author: Dr. Friedemann Schad
Co-Authors: Megan L Steele, Jan Axtner, Antje Happe, Matthias Kroez, Harald Matthes, Friedemann Schad
Institution: Gemeinschaftskrankenhaus Havelhöhe, Berlin GERMANY

Tumour Cell Derived Effects on Monocyte/Macrophage Polarization and Function and Modulatory Potential of Viscum Album Lipophilic Extract In-Vitro
Presenting Author: Myriam Estko
Co-Authors: Stephan Baumgartnerb,c; Konrad Urechb; Matthias Kunzb; Ursula Regueirob; Peter Heusserc; Ulrike Weissensteinb
Institutions: b Hiscia Institute, Society for Cancer Research, 4144 Arlesheim, SWITZERLAND; c Institute of Integrative Medicine, Witten/Herdecke University, 58448 Witten, GERMANY

Updating the EPAAC/JRC Survey on Integrative Oncology Centres in Europe
Presenting Author: 
Elio Giovanni Rossi
Co-Authors: Mariella Di Stefano, Chiara Cervino, Sonia Baccetti, Zuleika Saz-Parkinson, Silvia Deandrea, Asli Utulurk, Donata Lerda
Institution: Hospital Campo di Marte ASL 2 Lucca, Homeopatic Clinic, via dell’ospedale, Lucca, Lucca 55100, ITALY

Mistletoe Extracts Stimulate Immature Dendritic Cells and Prevent Tumor-Induced Immunosuppression In-Vitro
Presenting Author: Roman Huber
Co-Authors: Ann-Sophie Sanchez, Sophie Rieger, Barbarta Sauer, Roman Huber, Carsten Gründemann
Institution: University Medical Center Freiburg, GERMANY

 

Cancer-Related Fatigue and Its Treatment in Complementary Medicine


 

MIND-BODY AND AYURVEDA

Ayurvedic Versus Conventional Dietary and Lifestyle Counseling for Mothers With Burnout-Syndrome: A Randomized Controlled Pilot Study
Presenting Author: Christian Kessler
Co-Authors: Nico Steckhan, Martin Forster, Larissa Meier, Elmar Stapelfeldt, Andreas Michalsen
Institutions: Immanuel Hospital Berlin and Charité Medical University, Integrative Medicine, Königstr. 63, Berlin, Berlin 14109, GERMANY

Craniosacral Therapy Efficacy in Chronic Neck Pain: A Follow-Up Study
Presenting Author: Dr. Heidemarie Haller
Co-Authors: Romy Lauche, Holger Cramer, Thomas Rampp, Felix J Saha, Thomas Ostermann, Gustav Dobos
Institution: Department of Internal and Integrative Medicine, Kliniken EssenMitte, Faculty of Medicine, University of Duisburg-Essen, GERMANY.

Evaluation of an Arts-Based Emotion Regulation Training in Male Prison Inmates – A Pilot Study
Presenting Author: Thomas Ostermann
Co-Authors: Sabine C Koch, Thomas Ostermann, Anna Steinhage, Philip Kende, Karl Haller, Fabian Chyle
Institution:  Institute for Integrative Medicine, Faculty of Health, Institue for Integrative Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, Herdecke, 58313, GERMANY.

Group Therapy, Combining Meditation and Jungian Analysis Methods May Help to Stabilize and Improve Multiple Sclerosis (MS) Patients
Presenting Author: Dr. El Janssens
Co-Authors: E Janssens, PF Cahen, JL Legrand
Institution: BELGIUM

Yoga Research: Current Challenges and Future Perspectives
Presenting Author: Dr. Sentahmil R Selvan
Co-Author: Nadia Ceratto
Yoga Research International, Irvine, California, USA

Ayurvedic Prakriti Analysis for Healthy Volunteers: Validating a Tool for Clinical Practice
Presenting Author: Dr Sanjeev RASTOGI
Institution: Rashtriya Ayurveda Vidyapeeth, New Delhi INDIA


 

MUSIC MEDICINE AND MUSIC THERAPY

Development of a Case Report Guideline for Anthroposophic Art Therapy
Presenting Author: Dr. Erik Baars
Co-Authors: Annemarie Abbing1, MSc; Anne Ponstein1, PhD; Gunver Kienle2, PhD; Harald Gruber3, PhD; Erik Baars1, PhD.
Institutions: 1 Professorship Anthroposophic Healthcare, University of Applied Sciences Leiden, The Netherlands; 2 Institute for Applied Epistemology and Medical Methodology, University of Witten/Herdecke, Freiburg, Germany; 3 Alanus University of Arts and Social Sciences, Alfter, GERMANY

Treating Palliative Care Patients in Pain with the Body Tambura: A Prospective Case Study at St. Joseph´s Hospice for Dying Destitute in Dindigul/ South India
Presenting Author: Dr. Cordula Dietrich
Co-Authors: Dr. Michael Teut, Dr. Samwel Kakukoo Lopoyetum,  Prof. S Narayanasamy, Father Thomas Rathapillil, Father Thadeus
Institution: Private Practice for Psychotherapy, Relaxationtherapy and Musiktherapy, Berlin, GERMANY in Cooperation with Gandhigram University Dindigul/SOUTH INDIA


 

NATUROPATHY, HOMEOPATHY AND PHYTOTHERAPY

Consumption of Herbal and Dietary Supplements in Patients Undergoing Bariatric Surgery: Cross-Sectional Prospective Study
Presenting Author: Samuel Attias
Complementary and Integrative Service, Bnai-Zion Medical Center, Israel, School of Public Health, University of Haifa, ISRAEL. Department of Surgery, Bnai Zion Medical Center, 47 Golomb street, PO Box 4940, Haifa 31048, ISRAEL

Herbal Medicine For Replacing Prokinetics in Functional GI Diseases
Presenting Author: Karin Kraft
Co-Authors: Olaf Kelber, Bettina Vinson, Karen Nieber, Martin Storr, Ahmed Madisch
Institution: Steigerwald Arzneimittelwerk GmbH, Scientific Department, Wallstr. 10, Mainz, 55122, GERMANY.

High-Dilutions as Mercury’s Chelating Agent
Presenting Author: LianeAthayde Beringhs-Bueno
Institution: Instituto De Homeopatia E Medicina Integrativa, BRAZIL

Lemon and Quince for the Treatment of Hay Fever Symptoms – A Randomized, Placebo Controlled Cross Over Study
Presenting Author: Roman Huber
Co-Authors: Annika Hoffmann; Sabine Klein; Carsten Gründemann; Manuel GarciaKäufer; Ursula Wolf
Institution: University Medical Center, Institute for Environmental Health Sciences, Breisacherstr. 115B, Freiburg, GERMANY

Modulation of Gastro-Intestinal Motility by a Herbal Medicinal Product – Mechanisms of Action
Presenting Author: Karin Kraft
Co-Authors: Stephanie Hoser, Olaf Kelber, Heba Abdel-Aziz, Samuel N Okpanyi, Karen Nieber
Institution:  Steigerwald Arzneimittelwerk GmbH, Scientific Department, Wallstr. 10, Mainz, 55122, GERMANY

Rapid and Cost-Effective Assessments of the Safety & Benefits of Herbal Remedies With Using Systems Biology Technology (Fast-Pharma)
Presenting Author: Joan Campbell-Tofte. 
Co-Authors: Per Mølgaard, Kaj Winther
Institution: Frederiksberg Hospital, Nordre Fasanvej 57, 26, Frederiksberg, DK-1958, DENMARK

Valerian, Melissa, Passion Flower and Their Combination STW 32: Synergisms in Anxiolysis?
Presenting Author: Karin Kraft
Co-Authors: Samuel N Okpanyi, Olaf Kelber, Heba AbdelAziz, Jürgen Müller, Christiane Kolb, Karin Kraft Institution: Steigerwald Arzneimittelwerk GmbH, Scientific Department, Wallstr. 10, Mainz, 55122, GERMANY

Raman spectroscopy reveals difference in homeopathic potencies according to their scale


 

PATIENT EXPERTS AND PATIENT INVOLVEMENT IN RESEARCH STRATEGY

Closing the Gap: Improving Patient-centeredness in Primary Care
Presenting Author: Ajandek EORY MD, PhD
Co-Authors: Sandor Soos, MD; Mr. Ajandok Eory, PhD, MD; Laszlo Harsanyi, MD, PhD; Laszlo Kalabay, MD, PhD
Institution: Department of Family Medicine, Semmelweis University, Budapest, HUNGARY

Complementary Passive Hydrotherapy WATSU (WaterShiatsu) in the Rehabilitation of a Severely Traumatized Accident Survivor – a Prospective Case Report
Presenting Author: Agnes Schitter
Co-Author: Johannes Fleckenstein
Institution:  University of Bern, Institute of Complementary Medicine IKOM, Personalhaus 4, Inselspital, Bern, CH-3010, SWITZERLAND

Opinions About Studying Non Conventional Medicine
Presenting Author: Dr. Ramona JURCAU, MD PhD

Authors: Ramona Jurcău, Ph.D.; Ioana Jurcau, PhD MD; Nicolae Colceriu, PhD Ing; Vasile Bogdan, Professor 
Institution: “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca Romania

Peace of Storm – A Qualitative Study on the Use of Mindfulness in Dealing with Stress
Presenting Author: Karina Schött Jensen
Institution: University of Copenhagen, Marengovej 4, 2. Mf, Copenhagen S, 2300, DENMARK.

Social Networks and Social Media in the Choice of Complementary Medicine for Children
Presenting Author: Luisella Zanino
Co-Authors: G Trapani, F Macrì, L Zanino, D Careddu, S Gandus, MA Mele, I Mariotti, L Romeo, C Supino, BM Trapani, GP Salvioli
Institution: Società di Medicina Bioterapica, SMB Italia, ITALY.

What Motivates Women With Menstrual Pain to Participate in Self-Care Pain Research? A Qualitative Study
Presenting Author: Susanne Blödt
Institution: Charité – Universitätsmedizin Berlin, Institute for Social Medicine, Epidemiology and Health Economics, Luisenstr 57, Berlin, 10117, GERMANY


 

STRESS AND INTEGRATIVE HEALTH

Autonomic Regulation in Type-2 Diabetes With And Without Concomitant Obstructive Sleep Apnea Syndrome
Presenting Author: Roland Zerm

Co-Authors:Jecht Michael, Danilo Pranga, Matthias Girke
Institution: Havelhoehe, Kladower Damm221, Berlin, 14089, GERMANY

Food Intolerance as Risk of Elevated Serum Level of Oxytocin and Depression
Presenting Author: Assoc. Prof Dr Momir DUNJIC, M.D., Ph.D., F.I.C.A.E., Cert MD-ORT, Prof. of Ob/Gyn at  School of Medicine, University of Pristina; Prof. of Integrative Medicine at Pharmacutical Faculty, European University Belgrade, Coordinator of Master study of Integrative Medicine at University Alma Mater Europea ECM (Salzburg-Maribor), Member of Executive Board of  European Society of Integrative Medicne (Berlin); President of Serbian Association of Integrative Medicine (Belgrade); President of Serbian Medical Acupuncture Society 
Serbia
Co-Authors: Slavisa Stanisic, Slobodan Dunjic, Miodrag Stanisic, Dragan Jevdic
Institution: School of Medicine, University of Pristina, SERBIA

Validation of the Dutch State Version of the Autonomic Regulation (State-aR) Questionnaire in a Group of Patients and a Group of Healthy Persons
Presenting Author: Erik Wim Baars 
Co-Authors: Anne Ponstein, Esther T Kok, Rachel Heybroek, Willemijn Van der Veen, Matthias Kröz, Anja De Bruin
Institution: University of Applied Sciences Leiden, NETHERLANDS.

Cool Down Reactions and Burnout and Work Stress in Nurses and Hospital Physicians – Validation of the Cool Down Index

Nurses´ situational awareness but not their hold in faith relates to stress perception, burnout, cool down reactions, and life satisfaction

Waiting for lumbar spinal stenosis surgery: suffering, resources to cope and expectations


 

TRADITIONAL CHINESE MEDICINE

Adherence to Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines in studies of acupuncture for patient with cancer
Presenting Author: Dr. John Hughes, MD
Co-Author: Dr. Peter Fisher, MD
Institution: Royal London Hospital for Integrated Medicine, 60 Great Ormond Street, London WC1N 3HR, UK.

Chinese Herbal Formula Yu-Dian Tang Treatment for Insomnia After Ischemic Stroke (Wind-Phlegm Blocking the Collaterals Type): A Randomized, Single-Blind, Clinical Trial
Presenting Author: Yong-hou Zhao
Co-Authors: Xiao Gao, Hao Zhang, Yu-ping Zhao, Jian-bo Chai, Zhi-jie Wang, Ming Li, Chun-juan Zhang, Yong-hou Zhao
Institution: The Second Hospital Affiliated Heilongjiang University of Chinese Medicine, Harbin 150000, CHINA

CF-CATS2: Using Technology to Integrate Tai Chi into Medical Treatments for People with Cystic Fibrosis – An RCT
Presenting Author: Patricia Ronan
Co-Authors: P Ronan, A Mian, A Lorenc, S Carr, S Madge, N Robinson
Institution: School of Health and Social Care, London South Bank University, 103 Borough Road, London, SE1 0AA, UNITED KINGDOM

Complex Treatment by Acupuncture and Moving Exercises for Handicapped Children
Presenting Author: Prof Dr. Gabriella HEGYI, PhD
Institution: Department of Complementary Medicine, Medical School, University of Pecs, Pecs, Hungary; Confucius Institute of Traditional Chinese Medicine, Pecs, HUNGARY

Developing an Acupuncture Protocol for the Treatment of Lower Limb Amputees with Phantom Limb Syndrome
Presenting Author: Prof Nicola ROBINSON
Co-Authors: Esmé Trevelyan, Warren A Turner, Lynn Summerfield Mann.
Institution: London South Bank University, UNITED KINGDOM

Effects of a Mechanical Needle Stimulation Pad on Chronic Low Back Pain – An Observational Trial
Presenting Author: Romy LAUCHE, PhD
Co-Authors: Felix Saha; Thomas Ostermann; Nicole Jacob; Holger Cramer; Gustav Dobos
Institution: Department of Internal and Integrative Medicine, Kliniken Essen Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany.

Photostimulation Via Light Frequencies of Acupuncture Points (Colorpuncture) for Fibromyalgia Syndrome (FMS)
Presenting Author: Antonia DI FRANCESCO, Scientific Director
Co-Authors: Pisano Anna Maria, Primitivo Vincenzo, Iasella Piera Alba, Manno Maura, Marzo Carlo.
Institution: IOMED Colorpuncture Department – Via A.C. Mannarino, 2 – 73100 Lecce ITALY

Resource Management using Information System in Chinese Medicine Service
Presenting Author: Corey LAM
Co-Authors: Rita CHEUNG, Veronica LI, CHUNG Kam-fung, Eric ZIEA
Institution:  Chinese Medicine Department, Hospital Authority, HONG KONG

Traditional Chinese Medicine as a Synergetic Treatment for Oncothermia
Presenting Author: Prof Dr. Gabriella HEGYI, PhD
Institution: Department of Complementary Medicine, Medical School, University of Pecs, Pecs, Hungary; Confucius Institute of Traditional Chinese Medicine, Pecs, HUNGARY

Comparing Acupuncture and Physical Therapy Treatment on Pain and Quality of Life of Women with Fibromiyalgia